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The Peter Attia Drive

Author: Peter Attia, MD

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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.
154 Episodes
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Lloyd Klickstein is the Chief Science Officer at resTORbio, a biopharmaceutical company that develops medications to target the biology of aging. In this episode, Lloyd discusses his company’s clinical application of rapamycin and its derivatives. He also elucidates details of his 2014 paper—a paper that greatly influenced Peter’s perspective of rapamycin in the context of longevity. Peter and Lloyd go on to discuss the dose-dependent effect of rapamycin on immune function and compare rapamycin, fasting, and caloric restriction.   We discuss: His background and decision to leave academia for translational medicine [6:15]; Translational medicine—bridging the gap between basic science and clinical medicine [10:30]; What prompted Lloyd to focus on mTOR inhibition? [18:00]; Defining mTOR, TORC1, and TORC2, and the consequences of inhibiting them with rapamycin [21:30]; Dose-dependent impact of rapamycin on immune function, mTOR inhibition, and toxicity [42:15]; Lloyd’s 2014 experiment—mTOR inhibition improves immune function in the elderly [53:00]; Insights into autophagy, antigen presentation, and the pleiotropic benefits of a rapalog, and how it compares to fasting [1:13:00]; Lloyd’s 2018 experiment—TORC1 inhibition enhances immune function and reduces infections in the elderly [1:18:45]; Creation of resTORbio, subsequent studies, and takeaways about dosing, TORC2 inhibition, and tissue selectivity [1:29:00]; Comparing the longevity effect of rapamycin, fasting, and caloric restriction [1:40:00]; Excitement around RTB101—resTORbio’s mTOR inhibiting molecule [1:47:00]; Identifying rapalogs selective for TORC1 [1:56:15]; Treating depression with ketamine, an activator of mTOR [2:00:00]; Epigenetic clocks, rapalogs, and metformin [2:03:30]; and More. Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/LloydKlickstein Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.
In this episode, Stanley Perlman shares insights from his impressive career studying coronaviruses—both the common and more deadly ones, like MERS and SARS. In comparing preceding coronaviruses with SARS-CoV-2, Stanley discusses how other coronaviruses can aid our current understanding of, and be used to infer about, COVID-19. He also gives his thoughts on durable immunity, therapeutic strategies, and future outbreak preparedness.   We discuss: His background and early work with coronaviruses [2:45]; The coronavirus family—various types, common traits, and scientific understanding [9:00]; The origin of viruses, animal to human transmission, R_0, immunity, and more [17:45]; Insights from the 2002 SARS outbreak [28:30]; Insights from the 2012 MERS outbreak [35:00]; Comparing SARS-CoV-2 to MERS, SARS, and other coronaviruses [42:00]; COVID-19 survivor potential for long-term damage [53:30]; Using the current pandemic for lessons on future preparedness [57:00]; Genetic drift and the potential for long-term immunity to COVID-19 [1:07:00]; Prevention and treatment strategies for COVID-19 and future diseases [1:22:30]; Alternative hypothesis to the origin of SARS-CoV-2 [1:32:30]; Determining durable immunity to COVID-19 and what a successful vaccine looks like  [1:34:30]; and More. Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/stanleyperlman Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.
Back by very popular demand for a special AMA episode, ketosis expert Dom D’Agostino joins Bob Kaplan, Peter’s Head of Research, to address many lingering questions about the ketogenic diet, exogenous ketones, and exercise for overall health. Dom also shares valuable insights from his personal experience with training, supplements, intermittent fasting, and other nutritional strategies to optimize his own health and performance. 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 the website show notes page. We discuss: Dom’s recent and ongoing projects [3:00]; Benefits of a ketogenic diet for an otherwise healthy person [7:00]; Book recommendations to become more knowledgeable about a ketogenic diet [11:30]; Best devices for measuring ketones [13:45]; Genetic factors that influence how someone responds to the ketogenic diet [24:45]; Ketogenic diet for those with the APOE e4 allele [28:15]; Impact of long-term ketogenic diets on thyroid function [34:25]; Low-carb and ketogenic diets for appetite control and weight management [39:00]; Ketogenic diet and the microbiome [43:00]; Comparing monounsaturated fat versus saturated fat on the ketogenic diet [45:55]; Implications of long-term genetic and epigenetic adaptations to a ketogenic diet [47:45]; Why some people see a rise in LDL-C and LDL-P when on a ketogenic diet and what they can do about it [50:15]; Should someone with familial hypercholesterolemia consider a ketogenic diet? [55:00]; Exogenous ketones—benefits, therapeutic uses, and ketone supplements that Dom has tested [56:45]; Ketogenic protocols for management of traumatic brain injuries [1:06:00]; Comparing the benefits and therapeutic uses of various medium-chain fatty acids—caprylic acid (C8), capric acid (C10), MCT oil, and coconut oil [1:08:45]; Nootropics, caffeine, and other stimulants [1:16:15]; Supplemental use of testosterone, DHEA, and creatine for muscle growth and performance [1:23:45]; Impact of fasted-state training on strength and performance [1:30:15]; Stacking exogenous ketones with MCTs for optimal effectiveness [1:33:30]; BCAA supplements during a fast for muscle preservation [1:35:45]; What app is Dom using to track his macros? [1:42:00]; Getting enough micronutrients while on a ketogenic diet [1:47:15]; Ideal macros and getting enough protein for strength training in ketosis [1:48:15]; Pros, cons, and ideal macros of one meal a day [1:51:15]; Dom’s take on “carb backloading” [1:54:45]; Dom’s take on “carb up” days for ketogenic dieters [2:01:00]; Dom’s thoughts on the carnivore diet and the paleolithic ketogenic diet [2:05:30]; Advantages of the ketogenic diet for extreme endurance athletes [2:10:30]; Impact on strength, power, and performance during the adaptation period of the ketogenic diet [2:14:00]; Fasted-state elevation in growth hormone and its impact on training [2:17:45]; Is it possible to build muscle on a ketogenic diet? [2:23:30]; Why Dom took a year off from weight training [2:28:00]; What does Dom do for cardio exercise? [2:30:45]; Protocols for hard training recovery [2:33:15]; Dom’s personal approach to fasting, time-restricted eating, and sleep [2:35:45]; People, books, and other resources that shaped Dom’s training and nutrition [2:38:45]; and More. Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/domdagostinoama01 Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.
In this episode, David Watkins, professor of pathology at George Washington University, shares how insights from his HIV and Zika virus research could apply to SARS-CoV-2 protection strategies. David introduces monoclonal antibodies as an intervention to prevent and treat COVID-19 infection, and also discusses how they could be used as a hedge to vaccine development. Additionally, David’s immunology tutorial explains the innate and adaptive immune systems and their differentiated responses to viral infection.   We discuss: Background and current interest in immunology [4:30]; Immunology 101—The innate and adaptive immune system [10:15]; Defining antibodies, importance of neutralizing antibodies, and serology testing for COVID-19 [19:00]; B cells—How they fight viruses, create antibodies, and fit into the vaccine strategy [25:00]; T cells—Role in the adaptive immune system and ability to kill infected cells to prevent viral spread [36:15]; Valuable lessons from HIV applied to SARS-CoV-2 [51:00]; Lessons taken from the hepatitis C success story [1:01:30]; Monoclonal antibodies, vaccines, and the most promising strategies for preventing and treating COVID-19 infection [1:04:45]; COVID-19 vaccines in development [1:19:00]; How David’s work with Zika virus informs his thinking on SARS-CoV-2 [1:25:20]; Why a vaccine for COVID-19 doesn’t need to be perfect to be effective [1:27:45]; and More. Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/davidwatkins Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.
In this episode, Eileen White, Chief Scientific Officer at the Rutgers Cancer Institute, describes the fundamental role of autophagy in the maintenance of health and prevention of neurodegeneration, cancer, and other diseases. She also goes into detail about the paradoxical finding that autophagy may benefit an existing cancer cell and help it to survive—a discovery leading to new possibilities in cancer therapy. We also discuss fasting (and molecules that induce autophagy) and the critical need to decode the proper fasting “dose” in order to improve human health. We discuss:   Eileen’s discovery that a specific oncogene blocks apoptosis [3:40]; Defining apoptosis and its role in cancer prevention [10:00]; How cancer cells use the autophagy pathway to survive [17:20]; Stressors that induce autophagy [29:15]; The importance of autophagy in the brain and liver [32:45]; The mechanisms that can trigger autophagy to support longevity [40:00]; Evidence for cancer treatment by blocking autophagy [42:30]; Types of cancer that are most autophagy-dependent [46:45]; The autophagy paradox [52:40]; Finding a molecular signal for autophagy [59:15]; Current knowledge gaps around fasting as a tool for longevity [1:13:00]; Rapamycin, metformin, and other molecules that may induce autophagy [1:22:15]; How to study fasting and exercise as longevity tools [1:32:50]; The Nobel Prize for autophagy research [1:36:45]; Eileen’s future areas of research [1:38:25]; A fasting strategy for Alzheimer’s Disease prevention[1:49:25]; Future study of metabolism and autophagy [1:51:30]; and More.  Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/eileenwhite  Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.
In this episode, I sit down with my daughter to discuss the brutal death of George Floyd, and the aftermath we are watching unfold. Though I have no expertise in race relations, law enforcement, or police brutality, I do have some knowledge in the training of physicians, and it is that training of doctors that I’ve been thinking about lately as it may offer one small insight into this crisis. In this very short discussion, we speak about three types of errors in medicine (and medical training), how to distinguish between the two variants that are acceptable, and the one that is unacceptable. My question, ultimately, is if such a framework can be applied to law enforcement?   Learn more: https://peterattiamd.com/ Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.
Ned David is the co-founder of Unity Biotechnology, a company developing senolytic medicines—molecules that target and destroy senescent cells in the human body. In this episode, Ned explains the science of cellular senescence and how it impacts the aging process. Ned discusses how senolytics may delay, prevent, treat, or even reverse age-related diseases, including cancer, cardiovascular disease, and neurodegenerative disease. As a serial entrepreneur, Ned also provides advice on how to transform a simple idea into the creation of a company.   We discuss: Defining longevity and the principles of aging [2:50]; The control knobs of aging and how we can turn them [15:10]; Role of cellular senescence in aging and cancer [27:00]; History of senescence in scientific study [40:30]; The cellular senescence paradox [46:00]; Developing medicines that target cellular senescence [52:15]; Ned’s lessons on risk analysis in business [1:05:15]; The search for a molecule that could eliminate senescent cells [1:15:15]; Senescent cell elimination example in osteoarthritic knees [1:30:30]; Extending lifespan by removing senescent cells [1:45:00]; Senolytic molecule example in macular degeneration reversal [1:52:30]; The future of senescent cell targeting [1:58:30]; The role of cellular senescence and metabolic syndrome [2:01:30]; The role of cellular senescence and brain health [2:03:30] What prepared Ned to start Unity Biotechnology [2:05:45]; Advice for someone deciding between business and academics [2:08:50]; and More. Learn more: https://peterattiamd.com/ Show notes page for this episode:  https://peterattiamd.com/neddavid Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.
In this “Ask Me Anything” (AMA) episode, Peter explains his framework for understanding what lab tests can (and cannot) inform us as it pertains to overall longevity, with a specific focus on atherosclerosis, cancer, Alzheimer’s disease, and the physical body. Additionally, Peter shares details into two patient case studies around cardiovascular disease, including how the lab results influenced his diagnosis and treatment plan for the patients. Once again, Bob Kaplan, Peter’s head of research, will be asking the questions. 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 #14 show notes page. We discuss: Important lab tests and reference ranges [2:35]; How lab testing fits into the overall objective of longevity [4:25]; A healthcare system set up to react to a disease rather than prevent it [8:00]; The four pillars of chronic disease, and the three components of healthspan [14:30]; Atherosclerosis—How much can labs tell us about risk? [18:00]; Coronary calcium score (CAC)—Interpreting results based on your age [24:15]; Cancer—What lab work can tell you, and the future of liquid biopsies [28:00]; Alzheimer’s disease—What’s driving Alzheimer’s disease, and what labs can tell you about your risk [33:15]; Healthspan and the physical body—Where lab testing fits, the endocrine system, and zone 2 testing [39:00]; Summarizing the usefulness of lab testing—Where it gives great, reasonable, or lousy insight [43:15]; Patient case study—Elevated Lp(a): Understanding ApoB, and how cholesterol levels get reduced [45:30]; Patient case study—Familial hypercholesterolemia [59:30]; Coming up on a future AMA [1:10:30]; and More. Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/ama14 Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.
In this episode, Lew Cantley, Professor of cancer biology and Director of the Sandra and Edward Meyer Cancer Center at Weill Cornell Medical College in NYC, walks us through his amazing discovery of phosphoinositide 3-kinase (PI3K) and the implications for the care of patients with cancer. He explains various combinations of therapies being tested and used, including the possibility of pairing prescriptive nutritional therapies to increase the efficacy of drugs like PI3K inhibitors. Lew also explains the metabolic nature of cancer through the lens of his research into the connection between sugar consumption, insulin resistance, and tumor growth. Additionally, Lew provides some details about his exciting new clinical trial that is just now enrolling patients with stage 4 breast cancer and endometrial cancer.   We discuss: Teaching science through the lens of discovery—A better approach to learning science [5:15]; The metabolic nature of cancer, mitochondria, and a more nuanced explanation of the Warburg Effect [8:30]; The observation that convinced Lew to stop eating sugar [20:15]; The connection between obesity, insulin resistance, and cancer [25:30]; Sugar consumption and tumor growth—What did Lew’s 2019 paper find? [32:00]; Natural sugar vs. HFCS, fruit vs. fruit juice, insulin response and cancer growth [43:00]; Increasing efficacy of PI3K inhibitors with ketogenic diets, SGLT2 inhibitors, and metformin [53:30]; Lew’s clinical trial enrolling stage 4 breast cancer and endometrial cancer patients [1:07:30]; Pairing diet with drug could be the future of cancer treatment [1:09:30]; PI3K inhibitors on the market, alpha vs. delta isoform, and the possibility of pairing them with a food prescription [1:16:15]; What questions will Lew be focused on in the next chapter of his career? [1:22:15]; Lew's early work that ultimately led to the discovery of PI3K [1:27:30]; Studying the mechanism by which mitochondria make ATP [1:30:45]; How understanding the mechanism by which insulin drove glucose uptake into a cell got Lew closer to finding PI3K [1:38:15]; How Lew knew PI3K was important in driving the growth of cancer cells [1:55:00]; Lew’s unlikely observation of phosphorylation at the 3' position of the inositol ring resulting in the formation of phosphatidylinositol-3-phosphate [1:59:00]; and More. Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/lewcantley/ Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.
In this episode, professional archer, John Dudley, shares the many insights he’s gleaned through the process of not only becoming an elite competitor of archery but also an exceptional teacher. John describes how his desire for improvement has cultivated a sheer love of practice, and how pursuing mastery helped put into context how archery is an amazing model system for life. Additionally, John discusses the often misunderstood nature of hunting, but also makes the case as to why one should consider trying archery even if there is no desire to hunt.   We discuss: Why John loves archery, and what it means to be a professional archer [4:50]; How John’s love of practice and training led to archery [10:45]; How an intense desire to improve drove John to quit football and pursue archery [22:00]; A traumatic childhood event that changed John’s course from troublemaker to committed athlete [34:15]; The nuts and bolts of archery—Competitive events, types of bows, hunting, etc. [45:30]; The blissful nature of archery, and the uselessness of anger [57:15]; Hyper-focus and flow states—Did John’s ADD and task-driven personality give him an advantage? [1:07:15]; The common traits found in the most successful people [1:12:45]; The keys to maintaining credibility as a salesman—Integrity, honesty, and straightforwardness [1:18:45]; The coaching technique that makes John a great teacher [1:28:30]; Why you should consider trying archery (even if you never want to hunt) [1:36:15]; Hunting discussion—The morality argument, hunting vs. commercial farming, managing overpopulation, and the unique emotional connection [1:45:00]; Resources for those interested in taking up archery [2:12:00]; and More. Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/johndudley Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.
In this “Ask Me Anything” (AMA) episode, Peter explains some observations he’s noticed since switching to a 3-day fasting cycle from the longer fasts, the various things he’s measuring, and some helpful tips for getting through a prolonged fast. He also discusses the role of exogenous ketones in fasting and ketogenic diets as well as their impact on autophagy, specifically. Finally, Peter provides some practical advice for those looking to fit exercise for longevity into their busy life. Once again, Bob Kaplan, Peter's head of research, will be asking the questions. 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 #13 show notes page. If you are not a subscriber, you'll be able to listen to a sneak peak of this episode. We discuss: Peter’s observations since switching from a 7-day to a 3-day fasting regimen [1:25]; Ketone measuring devices—blood and breath [7:40]; Can zero-calorie sweeteners affect ketone production? [10:40]; Will there be a continuous insulin monitor anytime soon? [11:55]; Exogenous ketones—Role in fasting and ketogenic diets and their effect on insulin, blood glucose, and autophagy [14:10]; 5 tips to help you get through a multi-day fast [25:55]; Relationship between BHB levels, glucose levels, and autophagy—Are high levels of ketones enough to produce autophagy? [34:10]; Why is measuring blood insulin so much harder than blood glucose? [36:55]; Advice and resources for people wanting to stay up to date on developments related to health and longevity (and how to quickly sift through all the bad science) [40:10]; Advice for those looking to fit exercise for longevity into their busy life [51:10]; and More. Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/ama13 Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.
n this episode, John Barry, historian and author of The Great Influenza: The Story of the Deadliest Pandemic in History, describes what happened with the 1918 Spanish flu pandemic, including where it likely originated, how and why it spread, and what may have accounted for the occurrence of three separate waves of the virus, each with different rates of infection and mortality. While the current coronavirus pandemic pales in comparison to the devastation of the Spanish flu, John highlights a number of parallels that can be drawn and lessons to be learned and applied going forward. We discuss: What got John interested in the Spanish flu and led to him writing his book? [2:45]; Historical account of the 1918 Spanish flu—origin, the first wave in the summer of 1918, the death rate, and how it compared to other pandemics [10:30]; Evidence that second wave in the fall of 1918 was a mutation of the same virus, and the immunity immunity protection for those exposed to the first wave [18:00]; What impact did World War I have on the spread and the propagation of a “second wave”? [21:45]; How the government’s response may have impacted the death toll [26:15]; Pathology of the Spanish flu, symptoms, time course, transmissibility, mortality, and how it compares to COVID-19 [29:30]; The deadly second wave—The story of Philadelphia and a government and media in cahoots to downplay the truth [35:50]; What role did social distancing and prior exposure to the first wave play in the differing mortality rates city to city? [44:45]; The importance of being truthful with the public—Is honesty the key to reducing fear and panic to bring a community together and combat the socially-isolating nature of pandemic? [46:15]; Third wave of Spanish flu in the spring of 1919 [51:30]; Global impact of Spanish flu, a high mortality in the younger population, and why India hit so much harder than other countries [55:15]; What happened to the economy and the mental psyche of the public in the years following the pandemic? [59:20]; Comparing the 2009 H1N1 virus to Spanish flu [1:02:10]; Comparing SARS-CoV-2 to the Spanish flu [1:04:20]; What are John’s thoughts on how our government and leaders have handled the current pandemic? [1:08:00]; Sweden’s herd immunity approach, and understanding case mortality rate vs. infection mortality rate [1:10:40]; What are some important lessons that we can apply going forward? [1:13:00]; Does John think we will be better prepared for this in the future? [1:16:00]; and More Learn more: https://peterattiamd.com/ Show notes page for this episode:  https://peterattiamd.com/johnbarry Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.
In this episode, infectious disease and pandemic preparedness expert, Amesh Adalja, M.D., puts the current pandemic into context against previous coronaviruses as well as past influenza pandemics. Amesh also provides his interpretation of the evolving metrics which have contributed to big variations in modeling predictions, whether this will be a seasonally recurring virus, and perhaps most importantly—how we can be better prepared for the inevitable future novel virus. Finally, Amesh explains where he sees positive trends which give him reasons for optimism. We discuss: Amesh’s background in infectious disease [2:40]; When did the virus actually reach the US? And when did Amesh realize it would pose a real threat to the US? [4:00]; Comparing and contrasting COVID-19 to previous pandemics like the Asian flu of 1958 and the Spanish flu of 1918 [8:00]; Will COVID-19 be a recurring seasonal virus every year? [14:00]; Will a future vaccine be specific to this COVID-19 or will it also cover previous coronaviruses as well? [15:15]; What does Amesh think might be the true case fatality rate of SARS-CoV-2? [16:15]; Why did early models over predict infections and deaths by order of millions? [18:30]; Role of government—How does Amesh view the role of local versus central government in dealing with a future pandemic? [21:50]; What went wrong with testing and how could we have utilized it more effectively? [25:15]; Future pandemic preparedness—why Amesh is cautiously optimistic [27:30]; Should there be different policies and restrictions for places like New York City compared to less populated and less affected places across the US? [30:15]; Why mass gatherings might be disproportionately driving the spread of the virus [32:30]; Learning from HKU1, a lesser-known novel coronavirus from 2005 [34:00]; Thoughts on Sweden’s herd immunity approach [36:10]; The efficacy of masks being worn in public and what role they will play as restrictions are slowly lifted [37:20]; What are some positive trends and signs of optimism? [39:15]; and More. Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/ameshadalja Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.
In this episode, psychiatrist Paul Conti, M.D. discusses the impact of the fear and uncertainty surrounding the COVID-19 pandemic and the resulting stress, anxiety, and trauma it may impart on the population. Paul examines how this situation has highlighted the challenges we face at the societal level as well as the individual level, and stresses the importance of seeking absolute truth above personal truth and taking action as individuals as a means to combat many of these pervasive problems. We discuss: Paul’s personal experience with a presumptive case of COVID-19 [2:15]; Through the lens of trauma, Paul’s overall take on the lasting effects of this pandemic on society [4:30]; The imperative to unite as a species given the isolating and suspicious nature of an invisible enemy [8:15]; The indigent population and the affluent population—The commonalities and differences in how both populations have been affected [16:15]; The prevailing feeling of demoralization spanning the population [25:30]; Health care workers—What lingering psychological effects might they suffer from this? [35:00]; Could this pandemic be a catalyst for changing the way people think about science, truth, and logic? [46:30]; How our inability to deal with uncertainty exacerbates the problem, and the need for humility [58:00]; What has been Paul’s recipe for self care during this time? [1:06:45]; The forthcoming challenge of reintegrating back into the world when the quarantines lift [1:14:45]; An urgent need for change which must come through individuals seeking absolute truth and taking action [1:19:15]; and More. Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/paulconti2 Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.
In this episode, Peter sits down with his daughter to answer questions from her and other kids about COVID-19. We discuss: What is a virus? [1:45]; How did this version of coronavirus (SARS-CoV-2) start? [4:30]; How does COVID-19 compare to SARS and MERS (previous coronaviruses)? [6:00]; Will COVID-19 come back again after we resolve the current issue? [7:15]; When will kids go back to school? [7:45]; How has the US surpassed China in total cases, and how could we have been better prepared for this? [8:30]; Should have we started to quarantine sooner than we actually did? [11:45]; What about herd immunity? Would it be easier if we all just got the virus so we could be immune? [13:45]; Which age groups are the least and most at risk for getting a deadly version of the virus? [15:00]; Why do we have to wipe down packages that are delivered to our homes? [16:30]; How a lack of preparation and discipline led to this troubling situation [18:45]; Is China to blame for all of this? [24:15]; What did Olivia think when her parents pulled her out of school before it was mandated? [26:30]; What's been the hardest part of this for Olivia? [27:50]; What does Olivia appreciate now that she probably didn't appreciate in the past? [28:50]; How are Olivia’s zone 2 workouts going? [30:00]; and More Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/covid-19-for-kids Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.
In this episode, originally recorded to be the 100th episode of The Drive, Peter discusses topics that he has changed his mind about since starting the podcast as a result of preparing for interviews as well as from the actual conversations. Peter also reviews some of his favorite moments from the first 99 episodes, shares what books he’s currently reading, and much more. Initially scheduled to be released as episode 100, this was delayed due to recent podcasts covering COVID-19. We discuss: Definition of “strong convictions loosely held,” and the value in trying to shoot down your own hypotheses [2:20]; Metformin—How Peter’s strong convictions have changed since 2018 [8:00]; Getting a dog—Why Peter caved and how it’s going so far [15:45]; Rapamycin—How Peter’s feelings have evolved, and the questions still needing to be answered [20:45]; Archery, the joy of pursuing mastery, and the importance of stillness [26:50]; Zone 2 training—Why Peter has made it a big component of his exercise regimen [37:30]; Deadlifts—Why Peter now believes it’s extremely beneficial to longevity when done properly [41:45]; Read any good books lately? [50:00]; Baby aspirin for preventing blood clotting—Why Peter no longer takes it, and a few alternative options [53:15]; Generic drugs—How and why Peter’s mind has shifted on generic drugs [55:45]; Omega-3 fatty acids, EPA and DHA—How Peter’s long-held views have changed [58:15]; How Peter got better at saying “no” [1:02:30]; Does Peter have any favorite episodes of The Drive? [1:07:15]; and More. Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/strong-convictions-loosely-held Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.
In this episode, Michael Osterholm, Director of the Center for Infectious Disease Research and Policy at the University of Minnesota and author of Deadliest Enemy: Our War Against Killer Germs, provides an overview on the COVID-19 pandemic in regards to what has happened to date, what we’ve learned about how the disease spreads, and his optimism and pessimism about what potentially lies ahead. Michael gives his take on the true case fatality rate, why it differs around the world, and which underlying conditions, such as obesity, impact risk of severe illness and death. We also discuss the outlook regarding vaccines, repurposed drugs/antivirals for treatment, and Michael’s growing concern about supply chain limitations with respect to drugs, vaccines, n95 masks, and testing kits. We discuss: Recapping the brief history of COVID-19 and what potentially lies ahead [2:15]; Some positive news about immunity and reinfection [10:45]; Case fatality rate—The challenge in finding the true rate, difference by country, and the impact of age, underlying conditions, and obesity [13:00]; What has to be true for less than 100,000 Americans to die from COVID-19? [24:30]; How do we best protect healthcare workers? [29:45]; Concerns about testing capability—Reagent shortfall and a supply chain problem [39:30]; Vaccines and antivirals—The outlook, timing, and challenges [47:45]; Long term health of survivors of COVID-19 [56:45]; The impact of comorbidities—Diabetes, obesity, and immunosuppressed patients [59:30]; Understanding R0 and how the disease spreads [1:01:30]; The challenge of forecasting with so many unknown [1:08:00]; What explains the difference in cases and fatalities in different parts of the world? [1:14:30]; Repurposed drugs/antivirals being considered for treatment options—any optimism? [1:16:45]; A parting message from Michael about what lies ahead [1:18:30]; and More. Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/michaelosterholm Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.
Ryan Holiday, bestselling author and author of Daily Stoic, discusses practical ways to find stillness and apply the insights of stoic philosophy in the midst of COVID-19 chaos. Ryan discusses the importance of taking back a feeling of control, the benefits of structure and routine, and the idea of being prepared for anything. We discuss: Using times of adversity to evaluate and reflect how you’ve set up and prioritized your life [2:30]; What insights might the famous stoics provide amidst this COVID-19 pandemic? [8:15]; The possible consequences of the socially isolating nature of a pandemic (and why we need good leaders) [13:00]; Stoicism—what it means and how to apply it [18:45]; Lessons taken from the life of Winston Churchill—stillness, structure, routine, hobbies, empathy, forward thinking, and more [23:30]; Alive time vs. dead time—taking control of your time and making it count [38:45]; Auditing how the world (and its leaders) are handling the COVID-19 pandemic through the lens of stoic philosophy [44:15]; Asserting control and using routine to find stillness in an environment not conducive for it [52:15]; Why you should find a way to exercise, especially now [58:30]; How to find purpose during this time—goal setting, having a project to work on, and the benefits of keeping a journal [1:02:00]; What is Ryan most optimistic about and what is he most concerned about over the next few months? [1:08:45]; How can you follow Ryan’s work and messages about stoicism and stillness? [1:17:45]. And more. Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/ryanholiday2 Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.  
In this episode, Sam Harris, neuroscientist, author, and host of the Making Sense Podcast, joins Peter to discuss this unprecedented coronavirus (COVID-19) crisis. The discussion includes the important distinction between COVID-19 and influenza, the impact on the economy, the dire situation in New York, and the challenge of creating a safe and effective vaccine. Additionally, Sam brings insights from his extensive meditation practice to help those struggling with stress, anxiety, and fear in this extraordinary situation. We discuss: A time unlike any other—why many people don’t seem to fully grasp the magnitude of this situation [2:00]; Why comparing COVID-19 to influenza is a bad analogy [10:45] The impact on the economy of measures like shelter-in-place—Is the “cure” worse than the disease? [16:45]; Why are some places, like New York, getting hit so much worse? [24:45]; The trickle down effect of an overrun healthcare system on non-COVID-19 related health issues [34:45]; How to calm our minds and manage our emotions during this craziness [38:00]; Talking to kids about this situation without burdening them with undue stress [50:15]; Insights from meditation practice—Recognize and unhook yourself from a heightened emotional state [52:00]; How to make the most of a situation where you let your emotions get the best of you [59:15]; What are some potential positive things that Sam hopes could be learned from this crisis and applied to the future? [1:09:30]; The unfortunate politics being layered on top of this crisis [1:15:30]; The challenge of creating a safe and effective vaccine for COVID-19 [1:20:00]; and More. Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/samharris2 Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.
In this episode, Dr. Peter Hotez M.D., Ph.D., Dean for the National School of Tropical Medicine Baylor College of Medicine, returns to continue the conversation on COVID-19. Dr. Hotez informs us on how we can gauge the number of infected people, behaviors to reduce the probability of becoming infected, and the inconsistency of hospitalizations among young adults between different countries.  Dr. Hotez underscores the continued uncertainty in many virus-related developments, but ends with some points of optimism. Disclaimer: This is information accurate as of March 19, 2020, when it was recorded. We discuss: How to gauge true number of infected people [5:45] Reducing the probability of getting infected [22:45] Inconsistency by country in infected young people [27:15] Conferred immunity, seasonality, and repurposed therapeutics [30:30] Vaccine development [39:30] Practical behaviors to reduce risk of transmission [46:00] Mental Health resource and funding [51:00] Points of optimism [56:00]; and More. Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/peterhotez-2 Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.
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Comments (79)

Josh Er

great discussion

Jun 10th
Reply

Jason MB

I have been waiting for this 😮

Jun 8th
Reply

Emmanuel Mendoza

I like the idea of a 3-day fast once a month. I've been trying to convince friends and family of the health benefits from fasting but 5+ days of fasting is intimidating for most and like Dr. Attia stated, sometimes the fast does get in the way of social events.

Jun 6th
Reply

Brian Dravis

lol. this episode belongs on MSNBC. was hoping for facts and data not propaganda!

May 4th
Reply

Jessica Gerberi

Love this thank you both!! 🙏🏻💗🙏🏻

Apr 13th
Reply

Maureen Hubbell

what about advising DNR orders

Apr 2nd
Reply

Laurent Roumieu

around 50' you talk about a supplement to lower down cortisol, I couldn't catch the name. what is it please?

Mar 19th
Reply

Jakaira candland

Great podcast

Jan 31st
Reply

Stu Sheridan

Brilliant episode. What a likeable and smart guy Dom is.

Jan 29th
Reply

Chris Wilson

what an awesome podcast!

Dec 6th
Reply (1)

Jason Thomas

$15 a month subscription. That's more than Netflix.. no thanks

Oct 28th
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Jason Thomas

6:50

Oct 28th
Reply

Pedro Corpuz

Great episode!

Oct 27th
Reply (1)

Jason Thomas

the volume fluctuations through this pod are so look annoying 🤨

Sep 25th
Reply (1)

Jason Thomas

3:57

Sep 25th
Reply

Chris Greive

thanks! My dad died of Alzheimer's so all info from experts is massively appreciated.

Sep 20th
Reply

Richard Ledyard

oh. my. God.

Sep 17th
Reply

fragelicious

That's the recipe for obscurity. Your brand will be limited.

Aug 24th
Reply

fragelicious

You said that the listeners that cant afford the subsciption would still be able to hear the podcast. Three restricted 'Qualies' in a row?

Aug 24th
Reply (1)

Tamás Payer

OMG! One of the bests I have ever heard! Must listen multiple times...

Aug 15th
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