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View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter Kelsey Chittick is the author of Second Half: Surviving Loss and Finding Magic in the Missing. In this episode, Kelsey describes her long healing process following the sudden death of her husband, former NFL player Nate Hobgood-Chittick. She describes her life with Nate before and after football, including her premonitions that something was off about Nate and the subsequent finding that he suffered from chronic traumatic encephalopathy (CTE). She speaks openly about how she handled his death with her children, the trauma and grief they faced in the aftermath, and how she’s found ways to be happy in her new life. She shares deep insights into her healing process, including her experience with psychedelics and how the concept of “radical acceptance” has helped her to find joy once again. We discuss: Kelsey’s childhood in Florida as an athlete [2:15]; Meeting Nate and early relationship with him [7:45]; Nate’s unbelievable work ethic and desire to play in the NFL [12:30]; Life with a professional football player, playing through pain, and head injuries related to football [17:00]; Nate’s final days of football and early retirement struggles [23:30]; The tough transition from the NFL to a “regular life” and how Nate found a way to serve others [28:45]; Nate’s struggle with his weight and overall health after retirement [34:45]; Kelsey’s anxiety and premonitions of Nate’s impending death, and Nate’s changing demeanor [37:30]; The traumatic experience of learning of Nate’s death during her own spiritual journey to Jamaica [45:30]; Breaking the news to her children of their father’s death [51:00]; The darkest days following Nate’s passing and how her children were handling grief [55:30]; A new relationship with death, finding happiness, and the duality of feelings [1:02:45]; Nate’s autopsy results showing evidence of CTE [1:07:00]; The grieving process [1:15:00]; Dealing with grief with kids and how children grieve differently [1:19:15]; Healing through her first psychedelic experience [1:23:00]; The therapeutic potential of psychedelics, meditation, and more [1:33:45]; The concept of “radical acceptance” and the peace that comes with it [1:42:30]; The up and down experience of writing her book [1:47:45]; More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
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 is joined by special guest, Dr. Matt Kaeberlein. Together they answer many questions around the field of aging with an emphasis on three specific molecules—NAD, metformin, and rapamycin—and their purported geroprotective qualities. They first discuss aging biomarkers and epigenetic clocks before breaking down the advantages and limitations of the most common experimental models being used today to study aging and pharmacological possibilities for extending lifespan. Next they dive deep into NAD and the much-hyped NAD precursors, nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN). They compare data from NAD precursors to studies on metformin and rapamycin, assessing how they stack up against each other and using the comparison as an opportunity to illustrate how to make sense of new experimental data and make smart decisions about how to approach future research. 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 #35 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here. We discuss: Logic behind comparing NAD precursors to rapamycin and metformin [3:40]; Aging biomarkers: current state, usefulness, and future promise [7:00]; Epigenetic clocks: definition, use case, and limitations [14:45];   Advantages and limitations of studying aging in non-humans and the strengths and weaknesses of different model systems [26:30]; Aging studies: importance of control lifespans and the problems with reproducibility [34:15]; Intro to NAD, potential role in aging, relationship to sirtuins, and more [48:15]; NAD precursors (NR and NMN): current data [1:10:00]; Human studies with NAD precursors [1:25:45]; Comparing NAD lifespan data to data from metformin and rapamycin [1:28:30]; Defining a “clean drug” and a “dirty drug” [1:38:00]; Reason for the lack of rapamycin studies in humans compared to NAD and metformin [1:41:00]; Ranking the geroprotective molecules in terms of risk and reward [1:48:00]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube  
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 special episode of The Drive, we have pulled together a variety of clips from previous podcasts about exercise to help listeners understand this topic more deeply, as well as to identify previous episodes which may be of interest. In this episode, Peter discusses his framework for exercise, what he’s really optimizing for, and how to train today to be prepared for a good life at age 100. He describes the importance of strength and stability, and why deadlifting is an important tool to consider for longevity. Additionally, he details why training in zone 2 and zone 5 is important, gives a primer on VO2 max, and describes the most effective ways to engage in those types of exercise. Finally, Peter reveals his current exercise routine. We discuss: What is Peter optimizing for with his exercise? [3:00]; Preparing for a good life at age 100: Training for the “Centenarian Olympics” [6:00]; The importance of preserving strength and muscle mass as we age [21:45]; The value of deadlifts for stability and longevity when done properly [27:30]; The importance of zone 2 aerobic training [35:45]; The most effective ways to engage in zone 2 exercise [40:00]; Zone 5 training and VO2 max [44:15]; A primer on VO2 max [52:00]; Stability—the cornerstone upon which all exercise and movement relies [1:03:00]; Peter’s current exercise routine [1:07:45]; More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter Layne Norton holds a Ph.D. in nutritional sciences and is a physique coach, natural bodybuilder, and previous guest on The Drive. In the first half of this episode, Layne dives deep into the topic of energy balance, including the role that macronutrients and calories play in weight loss. He describes how many people struggle with tracking food and calories on their own across a variety of diets and how all of this can impact nutritional habits and behaviors. In the second half of the episode, Layne discusses the importance of protein and weightlifting for improving one’s body composition and increasing muscle mass. He explains how he would prescribe different training and nutrition programs for two hypothetical clients—a 50-year-old female who is entering menopause and wants to improve her health, and a 40-to-50-year-old male who wants to maximize muscle mass. Additionally, Layne discusses a number of supplements that could potentially benefit a training program including whey protein, branch chain amino acids, creatine, nitric oxide boosters, and more. We discuss: Defining energy balance and the role of calories [2:30]; Defining a calorie, whether they are all created equal, and how much energy you can extract from the food you eat [8:00]; Factors influencing total daily energy expenditure [12:15]: The challenge of tracking energy expenditure accurately, and the thermic effect of different macronutrients [23:30]; Challenges of sustained weight loss: metabolic adaptation, set points, and more [34:45]; Weight loss strategies: tracking calories, cheat meals, snacks, fasting, exercise, and more [40:45]; Sitting in discomfort, focusing on habits, and other lessons Layne learned as a natural bodybuilder [52:15]; Commonalities in people who maintain long-term weight-loss [1:01:15]; Does a ketogenic diet result in greater energy expenditure? [1:03:15]; The metabolic benefits of exercise, muscle mass, and protein intake [1:15:00]; The impact of lean muscle and strength on lifespan and healthspan [1:20:00]; Hypothetical case study #1: Training program for 50-year-old female [1:27:45]; Muscle protein synthesis in a trained athlete vs. untrained individual following a resistance training program [1:31:30]; Protein and amino acids needed to build and maintain muscle mass [1:37:15]; Nutrition plan for the hypothetical 50-year-old woman starting to build lean muscle [1:42:45]; Dispelling myths that excess protein intake increases cancer risk through elevations in mTOR and IGF [1:55:30]; Hypothetical case study #2: Training program for a 50-year-old, trained male wanting to increase muscle mass [2:04:00]; Maximizing hypertrophy while minimizing fatigue—is it necessary to train to muscular failure? [2:11:30]; Ideal sets and reps for the hypothetical 50-year-old male interested in hypertrophy [2:16:15];   Maximizing hypertrophy by working a muscle at a long muscle length [2:22:15]; Recommended lower body exercise routines and tips about training frequency [2:24:00]; Nutrition plan for the hypothetical 50-year old male wanting to add muscle [2:29:00]; Cycling weight gain and weight loss when building lean muscle mass, and expectations for progress over time [2:33:30]; Supplements to aid in hypertrophy training [2:38:30]; More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter Nir Barzilai, Director of the Institute for Aging Research at the Albert Einstein College of Medicine, is back for his third appearance on The Drive. In this episode, Nir divulges insights into lifespan and healthspan through the lens of his extensive research on centenarians as well as the latest from the TAME trial (Targeting/Taming Aging with Metformin), a multi-center study investigating the concept that the multi-morbidities of aging can be delayed in humans. He discusses common gene variants found in centenarians, important pathways for longevity, and ultimately what we can learn from centenarians about extending lifespan while also trying to improve healthspan. Additionally, Nir goes into depth on metformin as a longevity tool for humans, including studies with positive and negative results. He discusses the impact metformin can have on exercise for both strength training and cardiovascular training, as well as future research facilitated by data from the TAME Trial. He also touches on epigenetic clocks and concludes with his take on the usefulness of NAD precursors as a potential gero-protective agent. We discuss: Insights from genetic studies of centenarians and twins [3:00]; Genes with protective variants that aid longevity [13:00]; The relationship between growth hormone and IGF-1 [22:45]; Use of growth hormone as a longevity tool [34:00]; Longevity genotypes: the role of APOE e2, Lp(a), Klotho, and CETP [41:45]; The correlation between high TSH and longevity [46:30]; Important pathways for longevity [52:00]; Insights from centenarian studies, nature vs. nurture, and more [59:00]; The contraction of morbidity that comes with improved healthspan [1:08:00]; Defining healthspan [1:13:13]; Unique perspectives and positive attitudes of centenarians [1:17:30]; Lessons to take away from centenarians [1:24:00]; Metformin overview: history, studies, and potential for gero-protection [1:28:45]; The TAME trial (Targeting Aging with Metformin) [1:39:00]; The challenge of studying metformin in animals models [1:46:45]; How data from the TAME trial could provide insights into biomarkers of aging and facilitate a future study on proteomics [1:53:30]; The search for biomarkers to identify who can benefit from treatment [2:00:30]; The impact of metformin on exercise, and finding the right indication for the use of metformin [2:10:30]; Are NAD precursors geroprotective? [2:21:30]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube  
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 dives deep into the topic of atherosclerotic cardiovascular disease (ASCVD)—the number one killer in the developed world. Peter argues for the importance of paying attention to and understanding ASCVD given its ubiquity and inevitability. He goes into great detail about the development of atherosclerosis and how it can take hold at a very early age, the role of cholesterol, and the causal factors of ASCVD that determine prevention strategies. Additionally, he discusses the important metrics and biomarkers found in blood work, as well as diagnostic tests such as coronary artery calcium scores (CAC) and CT angiograms which help to determine the level of arterial damage present. Finally, Peter lays out the keys to understanding and interpreting calcium scores before wrapping up the conversation with his key takeaways regarding prevention. 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 #34 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here. We discuss: The importance of understanding atherosclerosis early in life [2:15]; Defining atherosclerotic cardiovascular disease (ASCVD), its causes, and the role of cholesterol [9:00]; The process of developing ASCVD, part 1 [15:00];  The process of developing ASCVD, part 2 [24:00]; The process of developing ASCVD, part 3 [32:45]; How early in life ASCVD can start to develop [40:30]; Case studies of atherosclerosis and figures showing real pathology [43:00]; Coronary artery lesions present in autopsies of different age groups [49:15]; The causal factors of ASCVD that determine prevention strategies [52:15]; Labs to identify biomarkers of ASCVD ]59:00]; Diagnostic tests to determine the level of arterial damage present—CAC, CTA, CIMT, and more [1:00:30] Keys to understanding and interpreting a CAC score and/or CTA results [1:05:15]; Is there a risk from cholesterol levels being too low? [1:13:00]; Key takeaways regarding prevention [1:15:45]; More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
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 second edition of the “Strong Convictions, Loosely Held” episode, Peter discusses topics on which his thoughts have evolved as a result of his interviews with podcast guests and other information he’s gained since episode 100. Peter covers topics including cancer therapy and screening, as well as prevention strategies for cardiovascular disease and Alzheimer’s disease. He also describes changes in his perspectives on time-restricted feeding and protein consumption and on the therapeutic use of psychedelics, and he discusses some sleep supplements with remarkable efficacy. He ends with a special discussion on all things Formula 1 racing. We discuss: The concept of “strong convictions, loosely held” [3:10]; Update on Peter’s upcoming book [8:30]; Cancer: the promise of immunotherapy [14:15]; Cancer: how aggressive screening for gastrointestinal cancers could save lives [24:30]; Cardiovascular disease: how early and aggressive lowering of apoB could change the course of ASCVD [31:30]; Alzheimer’s disease: genes that modify risk associated with the APOE4 variant [40:15]; Time-restricted feeding: where the benefit comes from, and when this practice can be problematic [44:00]; The common problem of protein underconsumption [51:45]; The tremendous impact of exercise on lifespan and healthspan [54:45]; Peter’s shoulder surgery [1:00:15]; An uninspiring viewpoint on NAD precursors as a longevity tool [1:06:15]; Psychedelics: a powerful therapeutic tool in the right setting [1:09:30]; Sleep: updated thoughts on blue light and a remarkable drug for aiding sleep quality [1:13:15]; Book recommendation from Peter [1:20:45]; Formula 1: the 5 variables that determine the winner [1:22:00]; F1: the drivers [1:26:00]; F1: the tires [1:27:30]; F1: the engine and chassis [1:32:00]; F1: rule changes around cars [1:34:15]; F1: importance of qualifying races [1:41:15]; F1: racing strategy [1:47:30]; F1: season outlook and predictions [1:51:00]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Episode Description: Today’s episode of The Drive is a rebroadcast of the conversation with Sarah Hallberg (released on May 17th, 2021). It's with great sadness that we report that Sarah recently lost her battle with lung cancer, and as such we've decided to republish her episode to honor her amazing work in challenging the status quo in the treatment of metabolic disease. Sarah Hallberg was the Medical Director at Virta Health and a physician who spent nearly two decades treating patients with obesity and type 2 diabetes. In the first half of this episode, Sarah discusses how she became a huge believer in the efficacy of carbohydrate restriction for the treatment of type 2 diabetes through her research and clinical experience. Sarah challenges the common beliefs about the role of dietary fat and carbohydrate on the plasma makeup of fatty acids and triglycerides. She also expresses the importance of understanding early predictors of metabolic illness—highlighting one particular fatty acid as the most important early predictor—before finishing with a discussion about how doctors might be able to personalize patients’ metabolic management in the future. In the second half of this episode, Sarah tells the personal story of her own lung cancer diagnosis. She talks about dealing with her grief, deciding to continue her work while prioritizing her family, and how she devised a plan to extend her survival as long as possible.  We discuss: How Sarah discovered the profound impact of carbohydrate restriction for reversing obesity and type 2 diabetes [2:00]; Prediabetes and metabolic syndrome: prevalence, early signs, and the importance of treating early [14:45]; Overview of fatty acids, how they are metabolized, and understanding what you see in a standard blood panel [28:00]; The relationship between diet composition and metabolic markers [34:00]; Why palmitoleic acid is such an important biomarker [47:00]; The best early indicators of metabolic disease [58:45]; Personalized management of metabolic illness [1:05:45]; Sarah’s cancer diagnosis and the beginning of her journey [1:14:00]; The emotional impact of a devastating diagnosis [1:26:00]; Sarah’s plan to extend survival [1:35:30]; Sarah’s aggressive treatment plan [1:46:15]; Life-threatening complications and the return of her cancer [1:57:45]; Sarah’s reflections on her approach to life with chronic cancer and balancing her time [2:09:45]; and More. Sign Up to Receive Peter’s Weekly Newsletter Connect With Peter on Twitter, Instagram, Facebook and YouTube
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Episode Description: Iñigo San-Millán is an internationally renowned applied physiologist and a previous guest on The Drive. His research and clinical work focuses on exercise-related metabolism, metabolic health, diabetes, cancer metabolism, nutrition, sports performance, and critical care. In this episode, Iñigo describes how his work with Tour de France winner Tadej Pogačar has provided insights into the amazing potential of elite athletes from a performance and metabolic perspective. He speaks specifically about lactate levels, fat oxidation, how carbohydrates in food can affect our lactate and how equal lactate outputs between an athlete and a metabolically unhealthy individual can mean different things. Next, he discusses how Zone 2 training boosts mitochondrial function and impacts longevity. He explains the different metrics for assessing one’s Zone 2 threshold and describes the optimal dose, frequency, duration, and type of exercise for Zone 2. Additionally, he offers his thoughts on how to incorporate high intensity training (Zone 5) to optimize health, as well as the potential of metformin and NAD to boost mitochondrial health. Finally, he discusses insights he’s gathered from studying the mitochondria of long COVID patients in the ICU. We discuss: The amazing potential of cyclist Tadej Pogačar [3:00]; Metrics for assessing athletic performance in cyclists and how that impacts race strategy [8:30]; The impact of performance-enhancing drugs and the potential for transparency into athletes’ data during competition [17:00]; Tadej Pogačar’s race strategy and mindset at the Tour de France [24:00]; Defining Zone 2, fat oxidation, and how they are measured [26:45]; Using fat and carbohydrate utilization to calculate mitochondrial function and metabolic flexibility [35:45]; Lactate levels and fat oxidation as it relates to Zone 2 exercise [40:00]; How moderately active individuals should train to improve metabolic function and maximize mitochondrial performance [51:45]; Bioenergetics of the cell and what is different in elite athletes [57:30]; How the level of carbohydrate in the diet affects fuel utilization and power output during exercise [1:08:30]; Glutamine as a source for making glycogen—insights from studying the altered metabolism of ICU patients [1:15:00]; How exercise mobilizes glucose transporters—an important factor in diabetic patients [1:21:00]; Metrics for finding Zone 2 threshold—lactate, heart rate, and more [1:25:00]; Optimal Zone 2 training: dose, frequency, duration, and type of exercise [1:41:15]; How to incorporate high intensity training (Zone 5) to increase VO2 max and optimize fitness [1:51:15]; Compounding benefits of Zone 2 exercise and how we can improve metabolic health into old age [2:01:45]; The effects of metformin, NAD, and supplements on mitochondrial function [2:05:15]; The role of lactate and exercise in cancer [2:13:30]; How assessing metabolic parameters in long COVID patients provides insights into this disease [2:19:00]; The advantages of using cellular surrogates of metabolism instead of VO2 max for prescribing exercise [2:25:45]; Metabolomics reveals how cellular metabolism is altered in sedentary individuals [2:33:45]; Cellular changes in the metabolism of people with diabetes and metabolic syndrome [2:39:15]; and More. Sign Up to Receive Peter’s Weekly Newsletter Connect With Peter on Twitter, Instagram, Facebook and YouTube
Become a Member to Listen to the Full Episode View the Show Notes Page for This Episode Episode Description: In this “Ask Me Anything” (AMA) episode, Peter discusses all things related to hydration, starting with how water is distributed in the body and the important concept of tonicity. He explains the difference between dehydration and volume depletion and their respective health consequences and implications. He describes the different conditions which affect our daily water needs, as well as the signs of dehydration and how it can affect performance. Next, he discusses all the ways in which we can rehydrate and when it makes sense to add electrolytes, glucose—or a combination of both—to rehydration fluids. Additionally, Peter gives his take on the plethora of sports drinks on the market and which ones stand out from the rest. Finally, he concludes with some key takeaways related to hydration.  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 #33 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here. We discuss: Peter’s incident leading to a renewed interest in hydration [3:15]; Water in the human body: percentage, location, and implications [6:00]; Defining tonicity—isotonic, hypotonic, and hypertonic [11:45]; Defining dehydration and volume depletion [19:00]; The health consequences of dehydration and volume depletion [21:45]; How do we actually lose water? [25:30]; How much water do we need every day? [28:00]; Signs of dehydration during exercise and how it can affect performance [32:45]; Is it possible to be overhydrated? [43:15]; Electrolytes: benefits and when to include them in rehydration fluids [47:00]; Glucose: benefits and when to include it in rehydration fluids 51:15]; The ability of glucose to improve absorption of sodium [58:45]; The type of carbohydrates in drinks than actually impact performance [1:02:00]; Sodium during workouts: is there an optimal ratio of carbohydrate to sodium? [1:05:00]; Pros and cons of sports drinks and which ones stand out [1:09:15]; How much hydration comes from the food we eat? [1:14:30]; Is there a downside to drinking electrolytes throughout the day even without exercise? [1:15:15]; Key takeaways related to hydration [1:18:15]; and More.  Sign Up to Receive Peter’s Weekly Newsletter Connect With Peter on Twitter, Instagram, Facebook & YouTube
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Episode Description: Ryan Hall is the fastest American ever to run the marathon (2:04:58) and half marathon (59:43) and is the author of the book Run the Mile You’re In. In this episode, Ryan discusses his amazing successes and epic failures during his remarkable running career and what he's learned through these experiences. Ryan explains not only the physical aspects of running - including his training routine, fueling regimen, and recovery process - but he also emphasizes the mental aspect of the sport. He discusses how accepting and reframing negative thoughts can empower you to take on challenges and reach your potential. Additionally, Ryan discusses the traits that make the best competitors, the keys to overcoming setbacks, and his amazing feat of 7 marathons in 7 days as a goodbye to the sport that gave him so much. We discuss: How Ryan got into running and his formative years of training [4:45]; The advantages of altitude—living high and training low [9:45]; Progressive overload, blood flow restriction, and switching up your workout routine [14:15]; Lessons learned from competing in the Beijing Olympics [16:45]; Importance of speed, power, and strength for runners [22:15]; The crazy idea that got Ryan hooked on running [35:15]; The mental aspect of training and the power of reframing negative thoughts [37:45]; The importance of fueling, and Ryan’s marathon diet [52:00]; Boosting performance with Tylenol and keeping core temperature down [59:00]; Ryan’s early struggles and later success at Stanford [1:09:45]; Keys to overcoming difficulty: faith, mindset, and being a better teammate [1:15:45]; Ryan’s professional running career and his discovery of his gift for marathon distances [1:22:00]; Reflections after breaking the American half marathon record, and challenges faced by retired athletes [1:32:45]; Ryan’s marathon training regimen at the Mammoth Track Club in 2010 [1:39:45]; Optimal body weight for competition and the pros and cons of going below your natural weight [1:48:45]; Training volume, importance of mixing up intensity level, and zone 2 and zone 5 for longevity [1:53:45]; The most impactful adjustments Ryan made to his training leading up the to 2011 Boston Marathon [1:58:15]; A new personal record at the 2011 Boston Marathon and lessons on maximizing your own potential [2:03:30]; Learning from failure and takeaways from his disappointing performance at the 2012 Olympics [2:12:30]; Utilizing cardio and strength training for overall health, and how Ryan uses blood flow restriction in his workouts [2:24:45]; Performance enhancing drugs (or lack thereof) in marathon runners [2:29:15]; Traits of the greatest marathon runners [2:32:30]; 7 marathons in 7 days on 7 continents—saying goodbye to the sport [2:38:45]; Reflections on what running has given Ryan [2:49:30]; and More. Sign Up to Receive Peter’s Weekly Newsletter Connect With Peter on Twitter, Instagram, Facebook and YouTube
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Episode Description: Steven Dell is an ophthalmologist, current Medical Director of Dell Laser Consultants, and a leader in refractive eye surgery with over 20 patents to his name. In this episode, Steven explains the anatomy and functional mechanics of the eye and how they relate to common variations in vision. He discusses changes in vision that occur with aging, the fundamentals of different types of vision loss, and provides an in-depth look into the various treatments and procedures available for corrective eye surgery. Additionally, Steven explains how one might protect the eyes and prevent vision loss—a topic particularly important for children in light of the epidemic of myopia.  We discuss: Why Steven chose ophthalmology, and the crossovers to other medical disciplines [3:45]; Anatomy of the eye, common types of vision loss, and age-related vision changes [14:15]; Eye drops that can potentially improve vision [27:30]; The explanation for different eye colors [33:15]; Physiology of the eye and its connections to the brain [34:45]; Understanding human vision through an evolutionary lens [41:00]; Enhancing vision beyond 20/20 [47:00]; Astigmatism: definition, cause, and high prevalence [51:30]; Nearsightedness (myopia): causes, epidemic in children, and prevention strategies [54:15]; Cataracts: impact of aging and how they can be repaired [1:05:00]; Lens implants that can correct and improve vision [1:19:30]; Effects of eye trauma [1:26:45]; Corneal abrasion from ‘dry eye’: causes, treatment, and prevention strategies [1:29:00]; Sunglasses for eye protection [1:35:00]; Solutions to correct nearsightedness [1:42:00]; Laser eye surgery—photorefractive keratectomy (PRK) [1:45:45]; Laser eye surgery—LASIK [2:02:00]; Laser eye surgery—small incision lenticule extraction (SMILE) [2:11:45]; Glaucoma: definition, causes, symptoms, and care [2:13:45]; Tips for preserving eye health [2:20:00]; Screen time and eye health [2:24:15]; Contact lenses: good hygiene and considerations [2:27:45]; A bonus benefit from repairing cataracts [2:29:00]; Questions about corrective eye surgery [2:31:30]; How an eye exam can be a window into metabolic illness [2:33:45]; and More. Sign Up to Receive Peter’s Weekly Newsletter Connect With Peter on Twitter, Instagram, Facebook and YouTube
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Episode Description: David Allison is an award-winning scientific writer who has been at the forefront of obesity research for the last 20 years. Currently the Dean of the Indiana University School of Public Health, he has also authored many publications on statistical and research methodology and how to improve research rigor and integrity. David’s focus on evidence and data brings forth an interesting discussion of what we know (and don’t know) about the science of obesity. He provides an insightful and unemotional explanation of the potential impact of nutritional epidemiology in public health while also explaining its many pitfalls and limitations. He offers his take on the path forward in addressing the obesity epidemic, and he closes with a lucid explanation for the evident lack of credibility in science and the steps we can take to change that.  We discuss: David’s background, interest in obesity, and focus on evidence [5:00]; The moment when the obesity crisis was recognized, and the sloppy science that ensued [13:00]; What twins studies tell us about the genetics of obesity [20:30]; How doctors and scientists have historically approached obesity treatment [23:45]; Do surgical procedures for obesity prolong life? [32:00]; The ‘Obesity Paradox’ [36:00]; Interpreting BMI and mortality data and considering confounders [43:15]; How body composition and ethnicity factor into consideration of BMI data [50:30]; Superior tools for measuring obesity at the individual level [57:15]; Using BMI data for actionable steps to combat obesity [1:02:00]; Why maintaining weight loss is more challenging than losing weight [1:06:00]; Differing perspectives on the utility of nutritional epidemiology [1:16:30]; A mouse study illustrating the impossibility of fully controlling for confounds in observational studies [1:22:15];   Limitations of nutritional epidemiology and how it can improve [1:26:30]; Addressing the obesity epidemic—the path forward and obstacles to overcome [1:37:15]; What David believes to be the most promising interventions we could take to address obesity and improve public health [1:47:30]; Reproducibility in science, normative and non-normative errors explained [1:51:30]; Rebuilding trust in science and differentiating between science and advocacy [1:59:00]; More. Sign Up to Receive Peter’s Weekly Newsletter Connect With Peter on Twitter, Instagram, Facebook and YouTube
Become a Member to Listen to the Full Episode View the Show Notes Page for This Episode Episode Description: In this “Ask Me Anything” (AMA) episode, Peter shares his current workout regimen and how he incorporates blood flow restriction (BFR). He walks through the mechanics and fundamentals of some of his favorite lifts including squats, deadlifts, and hip thrusters and stresses the relative importance of each in the context of longevity. He touches on the relative importance of muscle size vs. muscle strength and discusses the impact of fasting on muscle mass and the potential tradeoffs during aging. Peter then dives into the topic of testosterone replacement therapy (TRT) for both men and women, starting with a clinical discussion around how he actually replaces testosterone in patients. He explains the targets of this therapy as well as the risks and benefits, and he gives his interpretation of current data on the association between TRT and heart disease. 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#32 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here. We discuss: Peter’s current exercise routine [2:25]; How Peter incorporates blood flow restriction (BFR) into his workouts [5:45]; Relative importance of muscle size vs. muscle strength [16:45]; Comparing squats to deadlifts and why both are important [22:00]; Squatting technique and fundamentals [31:15]; Important cues to look for while lifting weights [38:30]; Proper mechanics of a deadlift [42:00]; Hip thrusters as an alternative to the squat or deadlift [44:00]; Split-leg work for simulating activities of daily living [47:00]; The impact of fasting/calorie restriction on muscle mass and the potential tradeoffs to consider [49:45]; Testosterone replacement therapy: considerations when contemplating TRT and Peter’s approach with patents [54:30]; Data on the association between TRT and heart disease [1:04:15]; TRT for women—risks and benefits [1:06:45]; Impact of fasting on testosterone levels [1:13:45]; and More. Sign Up to Receive Peter’s Weekly Newsletter Connect With Peter on Twitter, Instagram, Facebook & YouTube
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Episode Description: Sebastian Junger is an award-winning journalist, documentary filmmaker, and New York Times best-selling author. In this wide-ranging discussion, Sebastian shares stories from his time as a war reporter and how it shaped his understanding of the psychological effects of combat, including the sacred bond of soldiers, the forces that unify a tribe, and the psychological mechanisms that protect humans from painful experiences. He draws upon his personal struggle with PTSD as he discusses trauma as an all-too-common consequence of war and the importance of community in the healing process. He explains his interest in viewing human behavior through an evolutionary lens, including how it influences his parenting style, and he voices concerns over society’s continuous shift away from our evolutionary roots. Sebastian also tells the story of his near-death experience and his new perspective on the possibility of an afterlife.  Additionally, Sebastian shares his thoughts on the mental health implications of current events, such as the pandemic and the withdrawal of troops from Afghanistan, and contemplates what it really means to be “free” in modern society.    We discuss: Sebastian’s upbringing and early lessons about the evil of fascism [3:20]; Sebastian’s search for a career, interest in writing, and what he loved about tree removal [11:30]; How Sebastian became a great writer [19:30]; Sebastian’s experience with his Achilles injuries [25:30]; Work as a war reporter and his experience in combat in Afghanistan [28:00]; Psychological effects of war and Sebastian’s own experience with PTSD [36:30]; The sacred bond of soldiers and what Sebastian learned from his time with troops in Afghanistan [48:30]; An evolutionary perspective on the forces that unify and bind tribes [1:00:00]; Hunter-gatherer societies, dealing with loss, and the ancestral connection to the spiritual realm [1:08:30]; Psychological mechanisms that protect humans from painful experiences and the power in giving thanks [1:13:15]; How parenting has changed Sebastian, and the incredible pain of losing a child [1:21:15]; PTSD and the influence of community on healing [1:32:15]; Isolation of modern society and the debate over young kids sleeping in bed with their parents [1:37:45]; Why Sebastian doesn’t own a smartphone [1:43:30]; Parenting through an evolutionary lens [1:50:00]; Sebastian’s near-death experience and new perspective on the possibility of an afterlife [1:54:00]; Sebastian’s experience with depression and anxiety [2:12:00]; The pandemic’s impact on mental health [2:16:45]; Sebastian’s thoughts on the withdrawal of troops from Afghanistan [2:22:00]; Sebastian’s latest book—Freedom, and knowing when to quit [2:27:00]; Defining freedom in modern society [2:44:30]; More.   Sign Up to Receive Peter’s Weekly Newsletter Connect With Peter on Twitter, Instagram, Facebook and YouTube
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Episode Description: Rick Johnson, Professor of Nephrology at the University of Colorado and a previous guest on The Drive, returns for a follow-up about unique features of fructose metabolism, and how this system that aided the survival of human ancestors has become potentially hazardous based on our culture’s dietary norms. In this episode, Rick explains how the body can generate fructose from glucose and how circulating glucose and salt levels can activate this conversion. He discusses the decline in metabolic flexibility associated with aging, as well as how factors such as sugar intake or menopause-associated hormone changes can alter responses to sugar across a lifetime. In addition, Rick lays out strategies for combating the development of metabolic illness using dietary changes and pharmaceutical therapies, and he discusses the impact of fructose metabolism and uric acid on kidney function and blood pressure. He concludes with a discussion of vasopressin, a hormone that facilitates fructose’s effects on weight gain and insulin resistance. We discuss: Unique features of fructose metabolism and why it matters [2:45]; A primer on fructose metabolism and uric acid [10:30]; Endogenous fructose production, the polyol pathway, and the effect of non-fructose sugars [22:00]; Findings from animal studies of glucose and fructose consumption [29:00]; What calorie-controlled studies say about the claim that a “calorie is a calorie” [42:15]; Implications for aging and disease [51:15]; Impact of endogenous fructose production on obesity and metabolic syndrome [1:01:30]; Why vulnerability to the negative effects of sugar increases with age and menopause [1:04:30]; Dietary strategies to reduce the negative impact of fructose [1:16:30]; The role of hypertension in chronic disease and tips for lowering blood pressure [1:30:45]; The impact of fructose and uric acid on kidney function and blood pressure [1:39:45]; The potential role of sodium in hypertension, obesity, and metabolic syndrome [1:49:00]; The role of vasopressin in metabolic disease [1:54:00]; More. Sign Up to Receive Peter’s Weekly Newsletter Connect With Peter on Twitter, Instagram, Facebook and YouTube
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content   Episode Description:   In this “Ask Me Anything” (AMA) episode, Peter and Bob first answer a variety of questions related to heart rate variability (HRV): what it means, why it matters, and how to measure, interpret, and potentially elevate it. Next, they dive deep into the topic of alcohol, beginning with a discussion on the negative impact that it can have on sleep. They then break down the confusing body of literature suggesting potential health benefits to moderate levels of drinking compared to complete abstinence and point out the limitations of these studies. Finally, they conclude by analyzing data on the impact of moderate and heavy drinking on the liver and on risk for Alzheimer’s disease and dementia.   Please note: this AMA is audio only. 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 #31 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.   We discuss: What is heart rate variability (HRV), and why do we measure it? [2:10]; The association between low HRV and mortality risk [10:00]; What high and low HRV means and why athletes strive for a high HRV [15:30]; Factors that can raise or lower HRV [18:00]; How and when to measure HRV, and the best wearables [19:15]; Interpreting your personal HRV number and why there’s so much individual variation [23:15]; How Peter’s morning HRV reading impacts his decision to train [28:30]; Alcohol’s impact on sleep [31:30]; Metrics to track the impact of alcohol on your sleep [34:00]; Alcohol’s impact on the need to urinate during the night [39:00]; Alcoholic fatty liver disease (AFLD) [41:30]; Individual differences in the way people metabolize and react to alcohol consumption [44:15]; Analysis of epidemiology studies suggesting moderate alcohol consumption lowers mortality risk [52:00]; Alcohol consumption and Alzheimer’s disease [1:05:15]; Heavy alcohol consumption and risk of dementia [1:08:30]; Chronic effects of alcohol on the liver [1:17:45]; The relationship between alcohol, sleep, and automotive deaths [1:20:45]; and More.   Sign Up to Receive Peter’s Weekly Newsletter   Connect With Peter on Twitter, Instagram, Facebook & YouTube
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Episode Description: This episode is a follow-up to our recent COVID-19 podcast with Drs. Marty Makary and Zubin Damania (aka ZDoggMD). Here, we address many of the listener questions we received about our original discussion. In addition to Marty and ZDoggMD, we are also joined by Dr. Monica Gandhi, an infectious disease specialist and Professor of Medicine at the University of California, San Francisco. In this episode, we talk about new data on Omicron, long COVID, masks, kids and schools, vaccine mandates, policy questions, and treatments. We also discuss some of the most prevalent misinformation and spend time talking about claims made by Robert Malone. We end with a conversation about our exit strategy.  Please note: we recorded this episode on January 17, 2022, and in an effort to get it out as soon as possible, this won’t have full show notes or a video. Additionally, Monica was only able to join us for the first section of the podcast, so you’ll hear her drop off partway through. We discuss: Severity of infection from Omicron—reviewing the data [5:15]; Factors contributing to the relative mildness of Omicron infections [8:30]; Is SARS-CoV-2 evolving to cause less severe disease? [13:00]; Potential of Covaxin—an inactivated virus-based COVID-19 vaccine [17:45]; How B cells and T cells work together to defend against viruses [22:00]; Comparing COVID-19 vaccines, and the rationale for the time between doses [25:30]; Reviewing the purpose and effectiveness of boosters for reducing severity and transmission [32:30]; Debating vaccine mandates, and putting COVID’s mortality risk in perspective [41:00]; Why the topic of COVID has become so polarized [1:03:15]   Reviewing the data on masks for protecting oneself and protecting others [1:06:30]; The inconsistent logic used for mask mandates [1:16:00];  Long COVID and the potential for vaccines to reduce risk [1:21:45]; Risks for children and policies for schools [1:27:30]; Reviewing the outcomes from Sweden, where the government didn't impose lockdowns [1:31:00]; Draconian measures implemented in Canada [1:38:15];  Antiviral treatments for COVID and a common-sense approach [1:42:15]; Importance of ending tribalism and having rational discussions with humility [1:47:30]; Treating infection with monoclonal antibodies and convalescent sera [2:01:45]; Reviewing claims made by the controversial Dr. Robert Malone [2:11:15]; A potential exit strategy from the current situation [2:30:30]; Changes needed at the NIH [2:40:00]; More. Sign Up to Receive Peter’s Weekly Newsletter Connect With Peter on Twitter, Instagram, Facebook and YouTube
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Episode Description: Karl Deisseroth is a world-renowned clinical psychiatrist, neuroscientist, and author of Projections: A Story of Human Emotions. In the episode, Karl explains his unique career path that led to the development of optogenetics—a revolutionary technique that uses specialized light-sensitive ion channels to precisely control the activity of select populations of neurons. Karl provides a concise overview of how optogenetics works and how it can be used to better understand mental illness, to identify the neurons responsible for specific behaviors, and to guide development of new treatments. Karl uses his experience as a practicing psychiatrist to provide deep insights into depression, anxiety, autism, and personality disorders and explains the role of optogenetics in mapping out brain regions responsible for common mental health afflictions. We discuss: Karl’s journey through medical school and interest in the brain [5:00]; A profound medical school experience that changed Karl’s career path to psychiatry [17:30]; Karl’s commitment to research and challenges overcome early in his career [27:00]; The state of psychiatry and mental health therapies when Karl started his lab in 2004 [33:15]; Neuroscience 101: fundamentals of neuroanatomy and neurophysiology [38:15]; Traditional techniques for identifying the brain regions involved in specific behaviors [47:15];   Intro to optogenetics and how to get a gene into a neuron [51:15]; How viruses helped make optogenetics possible [1:01:45];   How optogenetics was used to investigate the effects of dopamine neurons [1:15:45]; Appreciating the power of optogenetics [1:22:00]; Investigating and treating anxiety with optogenetics [1:26:45]; Autism and autism-related anxiety, and the potential of optogenetics in treating autism [1:38:00]; Optogenetics as a powerful tool for the discovery and creation of medical treatments [1:45:00]; Karl’s inspiration to write his book, Projections [1:48:00]; Mania and bipolar disorder: evolutionary basis, symptoms, and the high prevalence in North America [1:52:45]; Depression: evolutionary basis and insights from optogenetics [2:03:15]; The effects of trauma early in life [2:18:45]; and More. Sign Up to Receive Peter’s Weekly Newsletter Connect With Peter on Twitter, Instagram, Facebook & YouTube
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Episode Description: Paul Conti, a returning guest on The Drive, is a practicing psychiatrist and recent author of Trauma: The Invisible Epidemic: How Trauma Works and How We Can Heal From It, in which he offers valuable insights on healing from trauma. In this episode, Paul explains how his personal experience with trauma and his many years seeing patients have shaped his understanding of trauma’s impact on the brain, its common patterns and manifestations, and how often people don't recognize the implications of trauma in their own life. He discusses major challenges in recognizing trauma, including the lack of biomarkers in psychiatry and psychology, as well as the misguidance of the mental health system in targeting symptoms as opposed to root problems. He talks about shame as the biggest impediment to healing from trauma and offers solutions to how, as a society, we can start to change the stigma of mental health and allow more people to receive help. Finally, he concludes with a discussion about the potential role of psychedelics like psilocybin and MDMA in treating trauma. We discuss: Paul’s background and unique path to psychiatry [2:30]; A personal tragedy that shaped Paul’s understanding of trauma and resulting feelings of shame and guilt [5:30]; The current state of psychiatry training and need for improvement [20:15]; The over-reliance on outdated metrics and lack of attention to past trauma as impediments to patient care [28:30]; Defining trauma: various types, heterogeneity, and effects on the brain [34:30]; Importance of finding the roots of trauma and understanding the “why” [47:00]; The major challenge of recognizing trauma in patients [55:15]; How shame and guilt are barriers to treatment and healing [1:06:00]; How treating trauma compares to treating an abscess—a powerful analogy [1:11:30]; How evolutionary survival instincts create problems in modern society [1:15:15]; First step toward healing: overcoming the fear of talking about past trauma [1:19:00]; Shame: the biggest impediment to healing [1:25:15]; The antidote to shame and the need for discourse and understanding [1:34:15]; The emotional health component of healthspan [1:41:15]; How to reframe the conversation about mental health for a better future [1:52:00]; The growing impact of trauma on our society and the need for compassion [1:58:45]; Society’s antiquated way of treating manifestations of trauma rather than root issues [2:04:15]; Potential role of psychedelics like psilocybin and MDMA in treating trauma [2:11:15]; Parting thoughts and resources for getting help [2:16:30]; More. Sign Up to Receive Peter’s Weekly Newsletter Connect With Peter on Twitter, Instagram, Facebook & YouTube
Comments (102)

Ruby B

LOVED the mashup format. Much easier to parse out the bottom line opinions that are personally relevant. More, please!

May 10th
Reply

Jay Goldmintz

Excellent podcast. Can someone please explain this to our politicians in Canada.

Jan 3rd
Reply

Mia Teodocio

I loved this episode!

Dec 26th
Reply

Mart

the US Government and the Medical Industry are just as corrupt as you believe China to be... When people realize half of the big pharma companies are worse than Monsanto things may get ugly.

Aug 22nd
Reply

Carlos T.

It was such an amazing conversation! Loved it!

Aug 21st
Reply

km

👎

Aug 3rd
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Brian Dravis

another corrupt journalist who can't separate political bias from the truth.

Jul 24th
Reply

Ali Gangji

Framing it as an issue of Chinese transparency and calling the Chinese government authoritarian a dozen times doesn't make you sound very unbiased. The US government is not and would not be more transparent if the roles were reversed and the Biden administration wants US intelligence to lead the investigation.

Jul 21st
Reply

Maria Prado

That is so wowww conversation for me, my life is tracking my glucose since the beginning of the this year, i dont have diebetes but my mother does and she always saying that i will not get save from that becouse all family has after 60 .. But i will not gonna be diebetic so i eat as one 😂 i am a geek glucose freak.. But my doctor doesnt understands me so i prefer to spend money on ketons and glucose stripes than shoes and clothes... Thanks for Sharing always i make me fell that i am not alone.

May 17th
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Brian Dravis

wow, scary episode. I pray this demonic oligarch is never in a position of power!

May 10th
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Maria Prado

Omg t.. so importante to me to know I am pretty sure thal all my struggles is coming for insuline resistence as a genetic predesposition of bad function of pancreas of my family at in the old age being diabetic and dying with alzaihmer. Thanks Peter 🙏

Mar 1st
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ID19405129

Really informative episode...especially with the “shame/grandiose issue”....thank you!!

Feb 25th
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Christina Totman

Such a powerful story. I was surprised and disappointed that, given the podcast is about longevity, so little attention was given to Neil's heart attack at 36, ostensibly due to unresolved PTSD. The show would have benefitted from further discussion about how those of us with trauma/PTSD need to address the issue in order to live a longer and more fulfilling life.

Dec 28th
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Abio Genesis

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Nov 19th
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Abio Genesis

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Nov 17th
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Abio Genesis

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Nov 17th
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Abio Genesis

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Nov 14th
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Abio Genesis

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Nov 12th
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Abio Genesis

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Nov 12th
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Abio Genesis

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Nov 11th
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