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    #08 - Tom Bilyeu: nutrition, fasting, meditation, mindset, immortality, and the secret formula of fulfillment

    enAugust 06, 2018
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    Podcast Summary

    • Tom Bilyeu: A Passionate Entrepreneur on Empowering Mission-Based BusinessesFollowing your passion and finding fulfillment in your work are essential for personal and professional growth.

      Tom Bilyeu is an incredibly driven individual who is deeply passionate about his work. He created Impact theory to empower mission-based businesses and is always eager to share his knowledge and ideas. One surprising aspect of Tom's character is his commitment to interviewing every person who applied for a job at Quest, regardless of their position. This experience served as a laboratory for his later endeavors and shaped his perspective on growth versus fixed mindsets. Tom's transformation in his views on dieting, fat, and fasting also played a significant role in his personal and professional growth. Overall, this conversation highlights the importance of following one's passion and finding fulfillment in one's work.

    • The Power of Open-Mindedness and Challenging AssumptionsBeing open to new ideas and questioning our beliefs can lead to unexpected positive changes and opportunities for growth.

      Seeking out disconfirming evidence and being open to learning from others can have a profound impact on our lives. Tom Bilyeu shares how meeting someone who was knowledgeable on a particular topic, even though their views contradicted his own, had a fireworks moment for him. He realized the importance of questioning his beliefs and being willing to admit that he may be suboptimal in certain areas. This mindset led him to try a ketogenic diet, despite initially hating it, and he experienced surprising health benefits such as pain relief and weight loss. The takeaway is that being open-minded and willing to challenge our assumptions can lead to positive changes and new possibilities in our lives.

    • Shifting Priorities and the Legacy FallacyLife is about embracing the present moment and the natural progression of different phases, rather than living in fear of regrets or striving for a specific end goal.

      Our perspectives and priorities change as we go through different phases of life. Tom Bilyeu realized the importance of fat in his diet and shifted his focus from strength to aesthetics, eventually realizing the significance of performance. Peter Attia posed an interesting thought experiment about immortality and questioned whether one would still want to live forever knowing that everyone they know will eventually die. This conversation highlights the concept of the legacy fallacy, where people often worry about how they will feel on their deathbed and the regrets they may have. But living life based on fear or striving for a specific end goal takes away from the present moment and the logical movements of each phase we experience.

    • Finding Fulfillment and Purpose in the Present MomentIt's important to prioritize activities and projects that bring us joy and a sense of purpose, rather than relying solely on traditional paths to fulfillment. Maintaining a sense of urgency allows us to continuously grow and stack our passions.

      It is important to optimize for the present moment and find fulfillment in the things that bring us joy and energy. While some people may find deep fulfillment in having children, that is not the only path to fulfillment. We have the ability to construct our lives around activities and projects that bring us a sense of purpose and gratification. It is crucial to prioritize the things that excite us and drive us to keep working or pursuing our passions. The concept of living forever may seem tempting, but maintaining a sense of urgency and purpose in our lives is valuable. We have the opportunity to stack our passions and continuously grow in various areas if we maintain that sense of urgency.

    • Passion and Joy: The Key to a Fulfilling LifeWhen you find true passion and joy in your work, it no longer feels like work. Structuring your life around fulfilling activities brings a sense of purpose and fulfillment.

      Finding true passion and joy in what you do can make it feel like you never have enough time. Tom Bilyeu shares his journey from studying film to starting his own company, where he experiences the thrill of working on projects that excite him. Despite having the resources to live a life of leisure, he finds himself drawn to work on his comic book because it brings him so much joy. This illustrates the importance of structuring one's life around activities that bring fulfillment, even if they are technically work. It's a reminder that when you are genuinely passionate about what you do, it doesn't feel like work at all, and you would choose it over leisure activities without hesitation.

    • Breaking Free from a Fixed MindsetEmbracing a growth mindset allows for personal growth, new opportunities, and ultimately leads to success in entrepreneurship.

      Having a fixed mindset can limit your growth and potential. Tom Bilyeu initially believed that talent and intelligence were fixed traits, leading him to doubt his abilities and feel stuck in remedial jobs. However, through teaching filmmaking and learning from others, he started to realize that he could improve and make progress. He chose to believe in brain plasticity and the idea that he could change and learn at any age. This decision fueled his excitement and determination to pour himself into getting better. By embracing a growth mindset, Tom was able to break free from his fixed mindset, embark on new opportunities, and ultimately become successful in entrepreneurship.

    • The Impact of Environment on Personal Growth and SuccessFind a high-pressure and fulfilling work environment that aligns with your interests and values to maximize personal growth and avoid feeling drained and unfulfilled.

      Finding the right environment can greatly impact personal growth and success. Tom Bilyeu learned the importance of surrounding himself with individuals who pushed him to grow and improve. He found himself thriving in a high-pressure startup setting where he had the opportunity to become the right person for any job in the company. This motivated him to fight and claw his way up, ultimately being the only one left standing. However, Tom also realized the significance of finding fulfillment in his work. He experienced a draining and soul-sucking feeling when he was not passionate about the product or the work he was doing. This highlights the importance of aligning one's interests and values with their career path to avoid feeling drained and unfulfilled.

    • Finding Fulfillment Beyond Financial SuccessTrue fulfillment comes from pursuing passion, building something of value, and prioritizing relationships, rather than solely chasing money.

      Sometimes, even when we have achieved financial success, it doesn't guarantee happiness. Tom Bilyeu realized that money alone wasn't fulfilling him, and he decided to make a change. He walked away from a company he co-founded, even though it could have brought him immense wealth. This bold move allowed him to prioritize something deeper and more meaningful – the brotherhood and camaraderie he shared with his co-founders. It also gave him the opportunity to pursue his passion and make a positive impact on people's lives. Tom's story reminds us that true fulfillment comes from doing something we are passionate about and building something of value, rather than just chasing money.

    • The Importance of Building Community and Creating Value in the Age of Social MediaCompanies should prioritize building authentic connections, creating value, and engaging meaningfully with customers to succeed in the age of social media.

      Building a community and creating value are crucial for the success of any company in the age of social media. Tom Bilyeu's realization that social media could change everything and allow people to build communities paved the way for his company's success. Instead of focusing solely on selling products, Bilyeu wanted to bring people together and help them achieve their goals. By making the mission of their company to end metabolic disease and prioritizing authentic storytelling, they were able to differentiate themselves and attract a loyal following. Additionally, they recognized the power of visual platforms like Instagram in the fitness community and used it to their advantage. The key lesson here is that companies should prioritize building meaningful connections, creating value, and being authentic in their engagement with customers.

    • The Power of Empathy and Making a DifferenceTom Bilyeu's experience with a troubled student taught him the importance of empathy and using his platform to make a positive impact on others' lives.

      Tom Bilyeu's experience with a troubled student in college deeply influenced his future endeavors. Through tutoring this student, he discovered the power of making a positive impact on someone's life. This realization planted a seed that grew over the years. As he built his company, Quest, Tom recognized an opportunity to help those who had also grown up in challenging circumstances. Witnessing the struggles of his employees, many of whom had similar backgrounds to the troubled student he once tutored, Tom felt compelled to create a company culture that supports personal growth and provides opportunities for success. This story reminds us of the importance of empathy, resilience, and using our platforms to make a meaningful difference in the lives of others.

    • Pursuing Passion and Transforming Minds: The Journey of Tom BilyeuEmbrace your true passion and stay true to yourself, even if it means making difficult decisions, as it can lead to personal growth and success.

      Tom Bilyeu realized the power of changing one's mindset and helping others do the same. He went from a point of hopelessness and uncertainty to building a successful brand worth billions of dollars. Through his experiences, he discovered that he had a passion for helping people transform their minds and achieve success. This led him to start a show called "Inside Quest" where he interviewed successful individuals who shared similar principles of success. However, he faced a brand disconnect and decided to part ways with his partners to create a standalone company called Impact Theory. This demonstrates the importance of pursuing one's true passion and staying true to oneself, even if it means making difficult decisions.

    • The Power of Rituals in Personal GrowthTrue transformation comes from within and meaningful rituals can help us embrace important life transitions and redefine ourselves. External factors can't provide the self-worth and fulfillment we seek.

      Transitional rituals can have a profound impact on our personal growth and self-perception. Tom Bilyeu shares his experience of undergoing a ritualistic scarification in the form of a tattoo to mark his transition from being single to being married. This act allowed him to face his biggest fear and challenge his limitations, ultimately enabling him to embrace his new identity as a married man. It highlights the significance of creating meaningful rituals that symbolize important life transitions and help us redefine ourselves. Additionally, the conversation touches upon the misconception that external factors like wealth or material possessions will fundamentally change how we feel about ourselves. True transformation comes from within, and no amount of external success can provide the self-worth and fulfillment we seek.

    • The Power of Money: Unlocking Possibilities and Impacting SocietyMoney, when utilized with purpose and vision, can attract talent, create extraordinary outcomes, and transform society. True fulfillment comes from using money to pursue passion and make a significant impact.

      Money itself is inert, but when used with a clear vision and purpose, it becomes a powerful tool to facilitate solutions to problems. Money can be used to attract intelligent and capable individuals to tackle challenges and create extraordinary outcomes. However, the motivation around money can change over time. Initially, the desire for money may be driven by material possessions and status, but as one grows, they realize that true fulfillment comes from using money to pursue what they love and make a significant impact. Role models like Elon Musk demonstrate the potential of leveraging wealth for maximum impact, such as in his ventures like SpaceX. Money, when used wisely, can unlock endless possibilities and contribute to the transformation of society.

    • Focus, Impact, and Empowerment: Peter Attia and Tom Bilyeu's Approach to Personal Fulfillment and ContributionBy focusing on the present, making positive impacts, empowering others, and exploring unknowns, individuals can find personal fulfillment and contribute to the lives of others.

      Both Peter Attia and Tom Bilyeu believe in the power of focusing on what is happening in front of them and making a positive impact on others' lives. Peter shares his shift of interest from aerospace engineering to what's happening on Earth and in the ocean, emphasizing the importance of exploring and understanding the unknowns that are close to us. On the other hand, Tom expresses his passion for ensuring that no one encounters a disempowering mindset, especially through his work in empowering individuals, particularly those from lower-income backgrounds. He aims to create value and help others achieve their goals, even if it means they move on from his company. Both Peter and Tom's motivations, though partly selfish, demonstrate the potential for personal fulfillment and contribution to others.

    • Breaking Free from Limiting BeliefsExpanding our horizons and surrounding ourselves with ambitious individuals can inspire us to think bigger and achieve extraordinary goals. Don't let your dreams be limited by what you've seen and experienced.

      Our dreams and desires can be limited by what we have seen and experienced. Tom Bilyeu discovered through interviewing hundreds of people that almost everyone wished for a $1,000,000 when asked what they desired from a magic genie. This revelation made him realize that people's aspirations are often constrained by their surroundings and what they believe to be possible. By being exposed only to dreams of a certain magnitude, individuals limit their potential and never aim for truly extraordinary achievements. This highlights the importance of expanding our horizons, seeking out new experiences, and surrounding ourselves with people who dream big, as it can inspire us to think beyond the limitations we have placed on ourselves and reach for grander goals.

    • The Role of Belief and Mindset in Success and FulfillmentSuccess and fulfillment require a strong belief in oneself, a growth mindset, and the ability to think beyond current limitations.

      Belief and mindset play a crucial role in achieving success. Tom Bilyeu realized that his success was not solely dependent on intelligence, but rather on his belief that his efforts would be rewarded. He observed that many people limit their beliefs and only strive for smaller goals, while failing to think big. Bilyeu became obsessed with codifying his mindset and using storytelling to inspire others to think in a way that goes beyond their current reality. Peter Attia also emphasized the importance of fulfillment, which he found to be more challenging to attain than money. This conversation highlights the significance of belief, mindset, and the need for greater imagination to achieve success and fulfillment.

    • Finding Fulfillment through Personal Growth and ServiceTrue fulfillment is achieved by challenging oneself, acquiring valuable skills, and using them to make a positive impact on the world while becoming the best version of oneself.

      Fulfillment and true relational joy come from becoming someone you're proud of and serving others. It is not enough to simply engage in pleasurable activities; fulfillment comes from doing the hard things and building a skill set that benefits not only yourself but also those around you. The feeling of fulfillment ebbs and flows with the movements of a day, but it is attained by working hard, gaining powerful skills, and using them to make a positive impact. The cool stories, the ones that bring true fulfillment, are the ones that involve overcoming challenges and pushing oneself beyond their comfort zone. Ultimately, fulfillment is found in serving and bettering the world while becoming the best version of oneself.

    • The Alarming Connection Between Mental Health and the MicrobiomeMaintaining a healthy microbiome through diet and avoiding excessive antibiotic use may be crucial in the fight against mental health challenges.

      The prevalence of suicide and mental health issues is alarming and widespread. Both Peter Attia and Tom Bilyeu discuss how depression and the feeling that life is not enjoyable has affected countless individuals. They also raise concerns about the microbiome's potential role in mental health, emphasizing its importance and the need for further exploration. Tom's personal experience with his wife's deteriorating health due to the decimation of her microbiome highlights the complex relationship between gut health and neurochemistry. This conversation underscores the significance of maintaining a healthy microbiome through proper diet, avoiding overuse of antibiotics, and not excessively sanitizing. By understanding and addressing these environmental factors, we may have a better chance at combating mental health challenges.

    • The Impact of Loneliness and Work-Life ImbalancePrioritizing self-care and maintaining a balance between work and personal life is vital for overall well-being in today's society.

      There may be psychological and emotional cues in our environment that contribute to feelings of loneliness and disconnection. The camaraderie and shared sense of purpose that was prevalent in the past, such as in fields like medicine and the military, seem to be diminishing in today's society. This loss of community and support can have negative effects on our well-being. Additionally, the pressures and expectations we put on ourselves and future generations continue to stack, leading to a constant drive for success and a lack of playfulness and downtime. It is crucial to recognize the importance of maintaining a balance between work and personal life, as well as implementing routines and rituals that prioritize self-care, such as proper nutrition and regular exercise.

    • Perspectives on the Gym and ExerciseDespite personal preferences, both Tom Bilyeu and Peter Attia recognize the importance of the gym and exercise for strength, longevity, and cognitive optimization. They emphasize listening to your body and making modifications as needed to prevent injuries.

      Even though Tom Bilyeu hates going to the gym, he understands its importance for strength, longevity, and cognitive optimization. He sees going to the gym as a moment filled with pain, disappointment, and limitations, which goes against the things he truly loves to do. On the other hand, Peter Attia enjoys the gym and finds exercise easy for him. He acknowledges that sometimes he lacks the motivation, but overall, it comes naturally to him. Additionally, both individuals highlight the significance of listening to your body and knowing when to abort or modify certain exercises to prevent injuries. Lastly, Tom Bilyeu follows a Whole Foods diet, focusing on variety, including vegetables, eggs, fats from olives and olive oil, and red meat, despite potential concerns.

    • High Fat, Low Carb Diet and Intermittent Fasting: Tom Bilyeu and Peter Attia's ApproachFinding a personalized dietary approach that suits your body and goals is crucial, whether it's sticking to a strict diet or incorporating occasional deviations.

      Both Tom Bilyeu and Peter Attia follow a high fat, low carb diet and practice intermittent fasting. Tom emphasizes the importance of sticking to his diet without cheating, except for rare occasions. He also shares his experience of fasting for 5 days, which initially brings boredom and lack of excitement, but ultimately provides a sense of accomplishment. Tom admits to feeling less energetic during the fasting period but notices fat loss. On the other hand, Peter discusses his preference for carbohydrates despite his knowledge and experience with ketosis. Both individuals highlight the significance of finding a dietary approach that suits their individual bodies and goals.

    • The Importance of Diet, Sleep, and Balance for Cognitive Function and HealthMaintaining a balanced approach to diet and sleep is crucial for optimal cognitive function and overall health. Incorporating protein weeks while alternating between ketosis and intermittent fasting can help maintain muscle hardness. Quality sleep is also vital as insufficient sleep can negatively impact metabolic health.

      Maintaining a balanced approach to diet and sleep is crucial for optimal cognitive function and overall health. Tom Bilyeu shares his personal experience of alternating between weeks of ketosis and protein intake. He notices that staying in ketosis for too long can result in muscle softening, so he incorporates protein weeks to maintain muscle hardness. He also practices intermittent fasting during his ketosis weeks, finding it easier to do so during this time. Additionally, both Tom and Peter Attia emphasize the importance of prioritizing quality sleep. Peter cites a study where participants who had restricted sleep for just two weeks experienced a 50% decrease in glucose disposal, indicating increased insulin resistance. This highlights the negative impact of insufficient sleep on metabolic health.

    • The Impact of Sleep Deprivation on Memory Consolidation and the Benefits of Meditation in Managing Stress and AnxietyGood sleep and meditation are crucial for memory consolidation, stress reduction, and mindfulness.

      Sleep deprivation can greatly impact memory consolidation. The hippocampus, responsible for memory consolidation, is sensitive to sleep deprivation, leading to gaps in memory. Both Peter Attia and Tom Bilyeu share their experiences of fatigue and sleep deprivation affecting their ability to remember certain periods of their lives. However, Tom Bilyeu also highlights the positive impact of meditation on his life, especially during stressful times. He initially resisted meditation, considering it feminine, but after learning about its biological effects, he embraced it as a game changer. Meditation helps him enter a calm state, manage anxiety, and eliminate background stress. The conversation also touches on the significance of mindfulness meditation in staying present and dealing with negatively valenced emotions rooted in the past or future anticipation. Overall, the key takeaway emphasizes the importance of good sleep and meditation for memory consolidation, stress reduction, and mindfulness.

    • Harnessing the Power of the Present Moment and PainBy focusing on the present moment and embracing pain, individuals can effectively control and manage extreme pain through mental techniques, while also inspiring and energizing others to contribute to a shared vision.

      Focusing on the present moment and embracing pain can lead to surprising results. Peter Attia discovered that by shifting his attention to his breath and the pain he was experiencing in the moment, he was able to handle extreme pain more effectively. This finding suggests that individuals have the potential for mind control over pain through mental techniques. However, the conversation later unfolds to discuss a different perspective on mind control. Tom Bilyeu emphasizes the importance of energy output, sharing his vision, and creating an enthusiastic environment to attract like-minded individuals. Rather than using mind control tactics, he aims to inspire and energize others, seeking to work with people who are genuinely excited and willing to contribute to the shared vision.

    • The Power of Sharing Knowledge and Impacting LivesSharing valuable content with authenticity and passion through digital platforms can create profound positive change in people's lives.

      Creating meaningful content and sharing valuable knowledge can have a profound impact on people's lives. Tom Bilyeu expresses his pride and satisfaction in building a successful YouTube channel called Impact Theory, where he interviews inspiring individuals like Peter Attia. Tom shares a heartwarming story of a man who claimed that Tom's content changed his life. This demonstrates the power of the digital age, where extraordinary people can make a difference by sharing their experiences and insights. The conversation highlights the importance of creating content with authenticity and passion, as it can resonate with a wide audience and create significant positive change.

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    George A. Brooks is a renowned professor of integrative biology at UC Berkeley. Known for his groundbreaking "lactate shuttle" theory proposed in the 1980s, George revolutionized our understanding of lactate as a crucial fuel source rather than just a byproduct of exercise. In this episode, George clarifies common misconceptions between lactate and lactic acid, delves into historical perspectives, and explains how lactate serves as a fuel for the brain and muscles. He explores the metabolic differences in exceptional athletes and how training impacts lactate flux and utilization. Furthermore, George reveals the significance of lactate in type 2 diabetes, cancer, and brain injuries, highlighting its therapeutic potential. This in-depth conversation discusses everything from the fundamentals of metabolism to the latest research on lactate's role in gene expression and therapeutic applications.

    We discuss:

    • Our historical understanding of lactate and muscle metabolism: early misconceptions and key discoveries [3:30];
    • Fundamentals of metabolism: how glucose is metabolized to produce ATP and fuel our bodies [16:15];
    • The critical role of lactate in energy production within muscles [24:00];
    • Lactate as a preferred fuel during high-energy demands: impact on fat oxidation, implications for type 2 diabetes, and more [30:45];
    • How the infusion of lactate could aid recovery from traumatic brain injuries (TBI) [43:00];
    • The effects of exercise-induced lactate [49:30];
    • Metabolic differences between highly-trained athletes and insulin-resistant individuals [52:00];
    • How training enhances lactate utilization and facilitates lactate shuttling between fast-twitch and slow-twitch muscle fibers [58:45];
    • The growing recognition of lactate and monocarboxylate transporters (MCT) [1:06:00];
    • The intricate pathways of lactate metabolism: isotope tracer studies, how exceptional athletes are able to utilize more lactate, and more [1:09:00];
    • The role of lactate in cancer [1:23:15];
    • The role of lactate in the pathophysiology of various diseases, and how exercise could mitigate lactate's carcinogenic effects and support brain health [1:29:45];
    • George’s current research interests involving lactate [1:37:00];
    • Questions that remain about lactate: role in gene expression, therapeutic potential, difference between endogenous and exogenous lactate, and more [1:50:45]; and
    • More.

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    The Peter Attia Drive
    enAugust 05, 2024

    #311 ‒ Longevity 101: a foundational guide to Peter's frameworks for longevity, and understanding CVD, cancer, neurodegenerative disease, nutrition, exercise, sleep, and more

    #311 ‒ Longevity 101: a foundational guide to Peter's frameworks for longevity, and understanding CVD, cancer, neurodegenerative disease, nutrition, exercise, sleep, and more

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    In this special episode, Peter provides a comprehensive introduction to longevity, perfect for newcomers or those looking to refresh their knowledge. He lays out the foundational concepts of lifespan, healthspan, and the marginal decade. Additionally, Peter discusses the four main causes of death and their prevention, as well as detailing the five key strategies in his longevity toolkit to improve lifespan and healthspan. Detailed show notes provide links for deeper exploration of these topics, making it an ideal starting point for anyone interested in understanding and improving their longevity.

    We discuss:

    • Key points about starting exercise as an older adult [2:45];
    • Overview of episode topics and structure [1:45];
    • How Peter defines longevity [3:45];
    • Why healthspan is a crucial component of longevity [11:15];
    • The evolution of medicine from medicine 1.0 to 2.0, and the emergence of medicine 3.0 [15:30];
    • Overview of atherosclerotic diseases: the 3 pathways of ASCVD, preventative measures, and the impact of metabolic health [26:00];
    • Cancer: genetic and environmental factors, treatment options, and the importance of early and aggressive screening [33:15];
    • Neurodegenerative diseases: causes, prevention, and the role of genetics and metabolic health [39:30];
    • The spectrum of metabolic diseases [43:15];
    • Why it’s never too late to start thinking about longevity [44:15];
    • The 5 components of the longevity toolkit [46:30];
    • Peter’s framework for exercise—The Centenarian Decathlon [47:45];
    • Peter’s nutritional framework: energy balance, protein intake, and more [58:45];
    • Sleep: the vital role of sleep in longevity, and how to improve sleep habits [1:08:30];
    • Drugs and supplements: Peter’s framework for thinking about drugs and supplements as tools for enhancing longevity [1:13:30];
    • Why emotional health is a key component of longevity [1:17:00];
    • Advice for newcomers on where to start on their longevity journey [1:19:30]; and
    • More.

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    The Peter Attia Drive
    enJuly 29, 2024

    #310 - The relationship between testosterone and prostate cancer, testosterone replacement therapy, and tools for predicting cancer aggressiveness and guiding therapy | Ted Schaeffer, M.D., Ph.D.

    #310 - The relationship between testosterone and prostate cancer, testosterone replacement therapy, and tools for predicting cancer aggressiveness and guiding therapy | Ted Schaeffer, M.D., Ph.D.

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    Ted Schaeffer is an internationally recognized urologist specializing in prostate cancer and a returning guest on The Drive. In this episode, Ted provides insights into the role testosterone plays, or doesn't play, in the initiation and progression of prostate cancer. He unpacks the findings and limitations of the recent TRAVERSE trial, exploring the complex relationship between testosterone and prostate cancer. Ted delves into the molecular nature of prostate cancer, explaining the androgen receptor saturation theory and the potential impact of testosterone on cancer growth. He also discusses the use of the Decipher test to predict cancer aggressiveness and guide targeted treatment. Furthermore, Ted shares how he counsels patients regarding testosterone replacement therapy (TRT), including its safe administration in patients with low-grade prostate cancer. Additionally, he highlights advancements in prostate cancer therapies and biomarkers that help develop precise treatment strategies while minimizing the need for broad androgen deprivation therapy.

    We discuss:

    • Background on the TRAVERSE trial: insights into exogenous testosterone and prostate cancer risk [3:00];
    • The androgen receptor saturation theory: how different organs respond to varying levels of testosterone [10:30];
    • The relationship between testosterone levels and prostate cancer aggressiveness: how aggressive prostate tumors have lower androgen receptor activity and rely on different growth mechanisms [16:15];
    • Using the Decipher score to assess prostate cancer aggressiveness and guide personalized treatment strategies [23:45];
    • Considerations for testosterone replacement therapy: how Ted counsels patients, how TRT can be safely administered in patients with low-grade prostate cancer, and more [31:15];
    • Advancements in prostate cancer therapies and PSA as a biomarker for precise treatment decisions, minimizing the need for broad androgen deprivation therapy [38:30]; and
    • More.

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    The Peter Attia Drive
    enJuly 22, 2024

    #309 ‒ AI in medicine: its potential to revolutionize disease prediction, diagnosis, and outcomes, causes for concern in medicine and beyond, and more | Isaac Kohane, M.D., Ph.D.

    #309 ‒ AI in medicine: its potential to revolutionize disease prediction, diagnosis, and outcomes, causes for concern in medicine and beyond, and more | Isaac Kohane, M.D., Ph.D.

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    Isaac "Zak" Kohane, a pioneering physician-scientist and chair of the Department of Biomedical Informatics at Harvard Medical School, has authored numerous papers and influential books on artificial intelligence (AI), including The AI Revolution in Medicine: GPT-4 and Beyond. In this episode, Zak explores the evolution of AI, from its early iterations to the current third generation, illuminating how it is transforming medicine today and unlocking astonishing possibilities for the future. He shares insights from his unconventional journey and early interactions with GPT-4, highlighting significant AI advancements in image-based medical specialties, early disease diagnosis, and the potential for autonomous robotic surgery. He also delves into the ethical concerns and regulatory challenges of AI, its potential to augment clinicians, and the broader implications of AI achieving human-like creativity and expertise.

    We discuss:

    • Zak’s unconventional journey to becoming a pioneering physician-scientist, and his early interactions with GPT-4 [2:15];
    • The evolution of AI from the earliest versions to today’s neural networks, and the shifting definitions of intelligence over time [8:00];
    • How vast data sets, advanced neural networks, and powerful GPU technology have driven AI from its early limitations to achieving remarkable successes in medicine and other fields [19:00];
    • An AI breakthrough in medicine: the ability to accurately recognize retinopathy [29:00];
    • Third generation AI: how improvements in natural language processing significantly advanced AI capabilities [32:00];
    • AI concerns and regulation: misuse by individuals, military applications, displacement of jobs, and potential existential concerns [37:30];
    • How AI is enhancing image-based medical specialties like radiology [49:15];
    • The use of AI by patients and doctors [55:45];
    • The potential for AI to augment clinicians and address physician shortages [1:02:45];
    • The potential for AI to revolutionize early diagnosis and prediction of diseases: Alzheimer’s disease, CVD, autism, and more [1:08:00];
    • The future of AI in healthcare: integration of patient data, improved diagnostics, and the challenges of data accessibility and regulatory compliance [1:17:00];
    • The future of autonomous robotic surgery [1:25:00];
    • AI and the future of mental health care [1:31:30];
    • How AI may transform and disrupt the medical industry: new business models and potential resistance from established medical institutions [1:34:45];
    • Potential positive and negative impacts of AI outside of medicine over the next decade [1:38:30];
    • The implications of AI achieving a level of creativity and expertise comparable to exceptional human talents [1:42:00];
    • Digital immortality and legacy: the potential to emulate an individual's personality and responses and the ethical questions surrounding it [1:45:45];
    • Parting thoughts [1:50:15]; and
    • More.

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    The Peter Attia Drive
    enJuly 15, 2024

    Zone 2 training: impact on longevity and mitochondrial function, how to dose frequency and duration, and more | Iñigo San-Millán, Ph.D. (#201 rebroadcast)

    Zone 2 training: impact on longevity and mitochondrial function, how to dose frequency and duration, and more | Iñigo San-Millán, Ph.D. (#201 rebroadcast)

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    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 [2:00];
    • Metrics for assessing athletic performance in cyclists and how that impacts race strategy [7:30];
    • The impact of performance-enhancing drugs and the potential for transparency into athletes’ data during competition [16:15];
    • Tadej Pogačar’s race strategy and mindset at the Tour de France [23:15];
    • Defining Zone 2, fat oxidation, and how they are measured [26:00];
    • Using fat and carbohydrate utilization to calculate the mitochondrial function and metabolic flexibility [35:00];
    • Lactate levels and fat oxidation as it relates to Zone 2 exercise [39:15];
    • How moderately active individuals should train to improve metabolic function and maximize mitochondrial performance [51:00];
    • Bioenergetics of the cell and what is different in elite athletes [56:30];
    • How the level of carbohydrate in the diet and ketogenic diets affects fuel utilization and power output during exercise [1:07:45];
    • Glutamine as a source for making glycogen—insights from studying the altered metabolism of ICU patients [1:14:15];
    • How exercise mobilizes glucose transporters—an important factor in diabetic patients [1:20:15];
    • Metrics for finding Zone 2 threshold—lactate, heart rate, and more [1:24:00];
    • Optimal Zone 2 training: dose, frequency, duration, and type of exercise [1:40:30];
    • How to incorporate high intensity training (Zone 5) to increase VO2 max and optimize fitness [1:50:30];
    • Compounding benefits of Zone 2 exercise and how we can improve metabolic health into old age [2:01:00];
    • The effects of metformin, NAD, and supplements on mitochondrial function [2:04:30];
    • The role of lactate and exercise in cancer [2:12:45];
    • How assessing metabolic parameters in long COVID patients provides insights into this disease [2:18:30];
    • The advantages of using cellular surrogates of metabolism instead of VO2 max for prescribing exercise [2:25:00];
    • Metabolomics reveals how cellular metabolism is altered in sedentary individuals [2:33:00];
    • Cellular changes in the metabolism of people with diabetes and metabolic syndrome [2:38:30]; and
    • More.

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    The Peter Attia Drive
    enJuly 08, 2024

    #308 - AMA #61: Sun exposure, sunscreen, and skin health: relationship between sun exposure and skin cancer, vitamin D production, and photoaging, how to choose a sunscreen, and more

    #308 - AMA #61: Sun exposure, sunscreen, and skin health: relationship between sun exposure and skin cancer, vitamin D production, and photoaging, how to choose a sunscreen, and more

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    In this “Ask Me Anything” (AMA) episode, Peter delves into two topics that have generated a lot of questions over the years: skin cancer and sunscreen. He begins by exploring the basics of UV radiation, discussing its effects on vitamin D conversion, photoaging, and its role in skin cancer. He examines various skin types, discussing their implications for sun exposure and vitamin D levels, as well as how to determine where you fall on the skin type scale. He then delves into the various types of skin cancer, with a particular emphasis on melanoma, exploring its complex relationship with UV exposure and other contributing risk factors. Additionally, he covers tanning beds, the importance of early skin cancer detection through regular skin checks, and the often confusing topic of sunscreen. He explains how sunscreen affects UV radiation and skin cancer risk, what SPF levels to choose, the differences between organic and mineral sunscreens, and what to consider when selecting the best sunscreen for your needs.

    If you’re not a subscriber and are listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or our website at the AMA #61 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.

    We discuss:

    • The impact of UV radiation on the skin [2:00];
    • Understanding solar UV: from the electromagnetic spectrum to skin health [3:45];
    • The role of sunlight in vitamin D production [8:30];
    • Factors contributing to vitamin D deficiency: insufficient UV exposure, magnesium levels, and more [9:45];
    • Sun exposure needs for different skin types, and the limitations of current studies in defining vitamin D deficiency [12:45];
    • The acute and long-term effects of excessive UV exposure: sunburn, photoaging, and the increased risk of skin cancer [15:30];
    • Types of skin cancer and associations with UV exposure [17:45];
    • The complex relationship between melanoma and UV exposure [22:15];
    • Why UV exposure alone doesn’t necessarily explain the risk for melanoma [25:15];
    • Other risk factors for melanoma [29:15];
    • Tanning beds and skin cancer risk [34:45];
    • Balancing sun exposure: benefits and risks [38:15];
    • Tattoos and sun exposure [40:30];
    • The importance of regular skin checks, dermatologists, and emerging technologies showing promise for early detection of cancer [41:45];
    • Self-skin checks: what to look for [46:30];
    • Prevalence of skin cancer and the importance of early detection [49:30];
    • Summary of the major risk factors for melanoma [54:15];
    • The role of sunscreen in reducing skin cancer risk [55:45];
    • How sunscreen works, the differences between chemical and mineral sunscreens, an explanation of SPF, and more [58:30];
    • How to determine the appropriate sunscreen SPF to use based on the UV index [1:04:45];
    • Choosing the right sunscreen for your individual needs [1:07:00];
    • The impact of water and perspiration on sunscreen effectiveness [1:12:00];
    • Chemical vs. mineral sunscreens: safety concerns and recommendations [1:14:00];
    • Concerns about hormone effects from chemical sunscreens [1:19:15];
    • Sunscreen summary: skin types, key considerations, recommended brands, and more [1:23:15]; and
    • More.

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    The Peter Attia Drive
    enJuly 01, 2024

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