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    #105 - Paul Conti, M.D.: The psychological toll of a pandemic, and the societal problems it has highlighted

    enApril 10, 2020

    Podcast Summary

    • Sharing Personal Experiences of COVID-19 and Mental HealthContracting COVID-19 can lead to severe symptoms and mental health challenges. Open conversations and support systems are crucial during these challenging times.

      The ongoing pandemic is causing widespread anxiety, trauma, and uncertainty, affecting individuals in various ways economically, socially, and politically. Dr. Paul Conti, a returning guest on The Drive podcast, shares his personal experience of contracting COVID-19 and the severe symptoms he and his family experienced. Paul also discusses the importance of addressing mental health concerns during these challenging times, emphasizing the need for open conversations and support systems. The podcast episode offers valuable insights into coping mechanisms and societal issues, making it a must-listen for those seeking guidance on managing stress and anxiety during the pandemic.

    • Finding Meaning and Purpose Amidst Uncertainty: A Psychiatrist's Perspective on Pandemics and TraumaAmidst the uncertainty of pandemics, a psychiatrist shares concerns about societal errors, misuse of technology leading to deep trauma, and the importance of learning from past experiences to prevent future existential threats.

      The current global situation, specifically the ongoing pandemic, has left many people feeling helpless and uncertain about their role in the world. Dr. Sussman, a psychiatrist, shares his personal struggles with finding meaning and purpose during this time. He believes that the predictability of societal errors and misuse of technology have paved the way for deep trauma, both individually and collectively. As the virus recedes, difficult decisions lie ahead, and Dr. Sussman expresses concern that we may not learn from this experience, potentially leading to further trauma and even existential threats. The literature suggests that pandemics may have unique psychological effects compared to other stressors, as they can be isolating rather than uniting. Dr. Sussman invites further discussion on this topic and the potential ways to mitigate the negative impacts of these stressors.

    • Fear of the unknown and need to identify an enemy during a crisisThe COVID-19 pandemic has brought out our deep-rooted fear of the unknown and our inherent need to identify and target an enemy. It's easier to unite against a common enemy, but bridging divides and fostering global cooperation remains a challenge.

      The global response to the COVID-19 pandemic has highlighted our deep-rooted fear of the unknown and our inherent need to identify and target an enemy. This fear can lead to suspicion, xenophobia, and a dangerous sense of separation among people. If we could have turned back the clock to the early stages of the outbreak and fostered complete cooperation and information sharing among nations, we might have mitigated some of the devastating consequences. However, history shows us that it's much easier to unite against a common enemy than to recognize our shared humanity in the face of a faceless threat like a virus. The challenge for us now is to find ways to bridge the divides that have grown wider during this crisis and to remember that, despite our differences, we are all suffering and deserving of compassion and solidarity. Unfortunately, our ability to do so may be outpaced by our capacity for destruction, making true global cooperation a formidable challenge.

    • Exposed deep-rooted issues in reacting to threatsThe current crisis underscores the importance of empathy, collaboration, and equitability in addressing health and economic challenges, recognizing their interconnectedness and creating a safety net for all.

      The current global crisis has exposed deep-rooted issues in how individuals and societies react to threats. The middle school playground mentality of blame and denial, fueled by social media, has hindered our ability to collaborate and address common threats. Simultaneously, many people are facing unprecedented economic vulnerability, which amplifies their fears and uncertainty. The socioeconomic divide has become more pronounced, leaving a large portion of the population in a precarious position. This crisis has highlighted the need for a more empathetic, collaborative, and equitable approach to addressing both health and economic challenges. It's essential to recognize the interconnectedness of these issues and work towards creating a safety net that supports all members of society.

    • The global situation has intensified the sense of desperation and fear for vulnerable populations and the economically stable alikeThe societal focus on fear and insecurity has led to heightened anxiety and discomfort for all, regardless of economic status, due to the complex systems that no longer ensure safety

      The current global situation has exacerbated the desperation and sense of being left behind for indigent populations dealing with substance abuse and other medical and psychiatric issues. At the same time, even those with more economic stability are experiencing heightened fear and insecurity, leading to a constant state of hypervigilance and discomfort. The societal emphasis on fear and insecurity, as seen in the news and economic systems, has mutated into drives that make little sense for individuals or groups. This pervasive sense of fear, even for those with economic means, is a result of the insecurity created by complex systems that no longer keep people safe.

    • Feelings of insecurity and fear during crises can impact mood and motivationDuring crises, feelings of insecurity and fear can increase stress hormones, affecting mood and motivation. Seek healthy coping mechanisms and recognize personal efforts and external limitations.

      The ongoing global crisis, such as the COVID-19 pandemic, can lead to feelings of insecurity and pervasive fear, which in turn can result in irritability, demoralization, and a lack of interest in life. These feelings can affect individuals regardless of their socio-economic status. The brain's natural response to keep us safe can paradoxically make us feel more vulnerable. Neurobiologically, this can manifest as an increase in stress hormones, which can impact mood and motivation. It's important to recognize these feelings and seek healthy coping mechanisms, such as exercise, mindfulness practices, and connecting with others. Additionally, recognizing the utility of personal efforts to improve one's situation and the limitations of our control over external events can help mitigate feelings of demoralization.

    • Feeling powerless in a changing worldDespite our best efforts, the current global situation can leave us feeling vulnerable and uncertain, highlighting the importance of building resilience and adapting to change

      The current global situation can leave people feeling vulnerable and demoralized, despite their best efforts to stay safe and contribute positively to the world. This sense of powerlessness is not limited to any particular socio-economic group and stems from the belief that we should live in a world where we have some control over our health and safety. However, the erosion of expertise and the dominance of opinions over facts can challenge this expectation, leading to a sense of instability and uncertainty. This is not a political issue but a societal one, where social forces evolve to produce outcomes that may not align with individual expectations. It's important to acknowledge these feelings and work towards finding ways to build resilience and adapt to the changing world around us.

    • Our defenses are weaker than we think, especially in healthcare and socioeconomic risksThe hurricane metaphorically illustrates society's inadequate responses to crises, revealing concerns for healthcare workers' physical and moral risks, the trauma's generational impact, and the healthcare system's inefficiencies and lack of intelligence

      Our society's defenses, whether it be in healthcare or socioeconomic risk, are not as robust as we believe them to be. The hurricane metaphorically illustrates this, as not everyone comes to help during times of crisis, and there's a lack of acumen and resolve to make effective decisions on a larger scale. This issue is not just limited to health matters but extends to socioeconomic risks as well. Regarding healthcare workers, their increased physical risk and the moral insult of caring for their own colleagues who have fallen ill are significant concerns. The trauma experienced by this population could be pervasive and even generational, affecting not only the healthcare workers but also their families. Moreover, the healthcare system's inefficiencies and lack of intelligence in its operations have been laid bare, pushing people to their limits and extracting profit while neglecting their well-being. The consequences of this compounded ignorance could be dire and far-reaching.

    • Addressing Trauma Caused by COVID-19Recognize experiences, atone for systemic failures, make changes to prevent long-term psychological harm, and advocate for acknowledgement and transformation.

      Acknowledging and addressing the trauma caused by the COVID-19 pandemic is crucial for individual and societal healing. We must validate people's experiences, atone for the systemic failures, and make meaningful changes to prevent long-term psychological harm. This includes recognizing the interchangeability of employment in healthcare and rethinking our approach to resource allocation. Failure to do so may result in rising rates of alcoholism, domestic violence, suicide, and disengagement from important aspects of life. It's essential to have the courage of our convictions and advocate for change, focusing on the need for acknowledgement and transformation rather than fine-tuning existing systems. The specifics of what this looks like five years from now may be unclear, but the commitment to change and healing is the first step.

    • Forming an 'alliance of common sense' for future crisesTo effectively address future crises, prioritize truth over personal interests with influential leaders, acknowledge systemic failings, and embrace science as a tool for absolute truths.

      To better prepare for future crises like pandemics, we need an "alliance of common sense" where people prioritize truth over personal interests. This alliance should include individuals with influence who can lead the way in acknowledging systemic failings and working towards improvements in public health, social, and economic systems. It's crucial to recognize that lies and falsehoods hinder progress and create animosity, and it's essential to distinguish between personal truths and absolute truths, especially when it comes to scientific facts. Science, as a toolkit for testing hypotheses and examining absolute truths, plays a significant role in this process. The current crisis may serve as a catalyst for fostering a greater appreciation for truth and evidence-based decision-making.

    • Blurred distinction between truth and emotionsPrioritize logic and facts over emotions to avoid disregard for facts and potential superstition

      Our society's blurred distinction between absolute truth and personal truth, fueled by social media, can lead to the subjugation of logic and absolute truth by emotional responses. This can result in a dangerous disregard for facts and potentially lead us down a path towards superstition. To counteract this, it's crucial that we prioritize logic and facts, even when our emotions may conflict with them. This can be achieved through forming alliances of common sense and engaging in thoughtful, fact-based conversations. Failure to do so could result in catastrophic consequences, as seen in historical examples where science and logic were disregarded.

    • Managing Emotions in a Logical WorldTo manage emotions in a logical world, we need to develop better control mechanisms and create systems that encourage logical thought and discourage the spread of emotional responses based on feelings rather than facts.

      While emotions have been driving humans for most of our evolutionary history, the recent development of logical thinking and scientific methodology gives us the ability to overcome our primal instincts and make informed decisions. However, the rapid spread of emotional responses through social media and other communication channels has outpaced our ability to control these emotions, leading to destructive outcomes. To win this "fight," we need to develop better control mechanisms and create systems that encourage logical thought and discourage the spread of emotional responses based on feelings rather than facts. In essence, we need to grow up and act like adults in the face of differing opinions and beliefs. The odds may be stacked against us, but with preparation, cooperation, and a commitment to logical thinking, we can successfully swim against the current.

    • Embracing humility in the face of complex issuesEffective control mechanisms are crucial to combat misinformation and establish reliable sources of truth. Humility and carefulness help navigate complex issues like uncertainty and emotional intensity.

      In the face of complex issues like misinformation, uncertainty, and emotional intensity, it's crucial to acknowledge the limits of our knowledge and promote humility and carefulness. The speaker emphasizes the need for effective control mechanisms to combat misinformation and establish reliable sources of truth. He also highlights the challenges of dealing with uncertainty and probabilities, especially when it comes to topics like climate change and health crises. Ultimately, recognizing that we don't have all the answers and approaching discussions with humility can help us navigate the overwhelming amount of information and emotions we encounter daily.

    • Striving for truth over personal biasesTo make progress, separate emotions and personal biases from objective truth, admit what we don't know, and work together to find answers.

      The current state of societal discourse, fueled by anger, trauma, and a lack of humility, often leads to politicization of issues that should be based on logic and truth. This trend of personal truth versus real truth can be detrimental to progress and collaboration. Instead, we should strive for humility, admit what we don't know, and work together to find answers. The fear of being wrong or humiliated often prevents us from engaging in important conversations. It's essential to separate our emotions and personal biases from the objective truth of systems and issues. By doing so, we can make progress towards solving complex problems and fostering alliances based on common sense and logic, rather than personal allegiances.

    • Appreciating relationships during hardshipsRecognizing the value of relationships and prioritizing them can help us find meaning, ease suffering, and foster resilience during challenging times.

      Focusing on what truly matters in life, such as relationships with loved ones, can help individuals find meaning and ease suffering during challenging times. The speaker emphasizes the importance of recognizing the immediacy and value of these connections, which can provide a sense of practicality, humility, and overall well-being. Although we cannot change the external circumstances, we can shift our mindset to appreciate and prioritize the people and things that bring us joy and comfort. This realization can help us navigate through difficult times and foster resilience.

    • The Importance of Connections and Finding Inner PeaceValuing relationships and generative activities promotes well-being and purpose, providing strength and meaning during challenging times. Changing perspective and prioritizing healthy coping mechanisms can help overcome lingering fears and anxiety post-quarantine.

      Focusing on meaningful connections with others and finding peace within ourselves can help us navigate through challenging times. Our need for love, relationships, and generative activities is essential for our well-being and gives us a sense of purpose. These connections provide strength and meaning, allowing us to keep moving forward despite feelings of demoralization or fear. The speaker emphasizes the importance of changing our perspective and valuing these connections, as well as working towards changing social systems to better support them. After the quarantines lift, we may see lingering fears and anxiety, but it's crucial to prioritize healthy coping mechanisms and maintain our connections to overcome these challenges.

    • Acknowledging and addressing pandemic traumaRecognize pandemic trauma, provide support, and take action for change on individual and societal levels

      The pandemic has caused widespread trauma, leading to increased substance abuse, depression, and accidents. This trauma is not new, but the pandemic has made it worse, and we need to acknowledge and address it. Change is necessary on both an individual and societal level. Trauma victims need support and validation, and we must work to change systems that allow trauma to occur. We cannot pretend everything is okay, as this will not lead to healing. It's important to remember that political discussions are not the focus, but rather, taking action to bring about change. Those of us who are not in positions of leadership must become the catalysts for change. We cannot just sit and talk about the issues; we must take action. The pandemic has shown us that things don't have to be this way, and we have the power to make a difference.

    • Taking Action is CrucialDiscussing issues is important, but taking action is crucial for bringing about change. Be willing to challenge the status quo and take on uncomfortable tasks to make a difference.

      While it's important to talk about issues and be open about what we believe is right and wrong, taking action is crucial. We've discussed various topics, from date rape culture to social support networks, and while these conversations are valuable, they won't bring about change on their own. We need to be willing to take unpalatable actions, just as we would when unclogging a garbage disposal. Society has developed in a way that requires us to challenge the status quo and enter politically charged areas, even if it's uncomfortable. We all have a role to play in making a difference, and while it's essential to help in ways that align with our skills and comfort, we must also be prepared to take on the unpleasant tasks. By doing so, we can contribute to meaningful change.

    • Join The Drive membership program for exclusive benefitsListeners can access in-depth show notes, private podcast feed, monthly AMA episodes, discounts, and more by joining The Drive membership program.

      Peter A. Morgan offers a membership program for his podcast, The Drive, which provides exclusive benefits such as in-depth show notes, access to a private podcast feed, monthly AMA episodes, discounts on recommended products, and more. These perks aim to give members more value than the cost of the subscription. Listeners can learn more and subscribe at peteratiamd.com/subscribe. Morgan emphasizes that the content in the podcast is for general informational purposes only and does not constitute medical advice. He also discloses potential conflicts of interest and encourages listeners to seek professional medical advice for any health concerns.

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    • Practical strategies for managing MAFLD [1:45:30];
    • The impact of fructose consumption on liver health and the challenges of disentangling its effects from other factors like obesity and insulin resistance [1:52:45];
    • The potential of GLP-1 agonists for the treatment of MASLD [1:57:45];
    • How the four stages of liver disease have evolved [2:00:30];
    • Increased cancer and heart disease risk associated with early-stage MAFLD [2:05:15];
    • Emerging drugs and therapies for addressing fat accumulation and fibrosis related to MAFLD [2:12:15];
    • Peter’s major takeaways [2:18:45]; and
    • More.

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    The Peter Attia Drive
    enMay 20, 2024

    #301 - AMA #59: Inflammation: its impact on aging and disease risk, and how to identify, prevent, and reduce it

    #301 - AMA #59: Inflammation: its impact on aging and disease risk, and how to identify, prevent, and reduce it

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    In this “Ask Me Anything” (AMA) episode, Peter delves into the often misunderstood concept of inflammation. He first defines inflammation and differentiates between acute inflammation and chronic inflammation, the latter of which is linked to aging and a plethora of age-related diseases. Peter breaks down the intricate relationship between chronic inflammation, obesity, and metabolic health, and highlights the signs that might suggest someone may be suffering from chronic inflammation. From there, the conversation centers on actionable advice and practical steps one can take to manage and minimize chronic inflammation. He explores how diet plays a crucial role, including the potential benefits of elimination diets, and he examines the impact of lifestyle factors such as exercise, sleep, and stress management. Additionally, he discusses the relevance of food inflammatory tests and concludes by examining the potential benefits and drawbacks of drugs and supplements in managing inflammation.

    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 #59 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.

    We discuss:

    • Defining inflammation (and the cultural impact of Napoleon Dynamite) [1:45];
    • Acute vs chronic inflammation [8:00];
    • The connection between chronic inflammation, aging, and age-related diseases [11:00];
    • The impact of inflammation on metabolic health [18:30];
    • Understanding and diagnosing chronic inflammation: blood tests and other approaches, and challenges with measurement [20:00];
    • Factors that contribute to low-level chronic inflammation [28:00];
    • Minimizing inflammation through diet [29:45];
    • The important role of fiber for gut health and inflammation [33:45];
    • A closer look at the impact of trans fats and saturated fats on overall health [34:45];
    • Why Peter prefers dietary fiber from food sources over supplements [38:30];
    • Debunking “superfoods”: emphasizing proven methods over marketing claims for reducing inflammation [39:00];
    • Is there any value in over-the-counter food inflammatory tests? [42:30];
    • Food elimination diets: how they work, symptoms and markers to watch, challenges and limitations [45:15];
    • Identifying dietary triggers for gut-related symptoms through low-FODMAP diets like the “carnivore diet” [51:15];
    • Dairy: the complex role of dairy on inflammation and individual responses [55:00];
    • Wheat: the complexities and conflicting evidence around wheat's inflammatory effects [57:45];
    • How exercise influences inflammation [1:02:00];
    • How sleep quality and duration impacts inflammation [1:07:00];
    • The potential impact of chronic psychological stressors on inflammation [1:13:00];
    • The impact of oral health on inflammation and overall well-being [1:15:00];
    • The role of medications in managing chronic inflammation [1:18:15];
    • Supplements: evaluating the efficacy of various anti-inflammatory supplements [1:22:15];
    • Parting thoughts and takeaways [1:27:00]; and
    • More.

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    The Peter Attia Drive
    enMay 13, 2024

    #300 - Special episode: Peter on exercise, fasting, nutrition, stem cells, geroprotective drugs, and more — promising interventions or just noise?

    #300 - Special episode: Peter on exercise, fasting, nutrition, stem cells, geroprotective drugs, and more — promising interventions or just noise?

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    In this special edition celebrating 300 episodes of The Drive, Peter discusses a variety of popular topics and health interventions and classifies them based on their level of evidence and relevance using the following categories: proven, promising, fuzzy, noise, and nonsense. Peter first delves into the topic of geroprotective molecules, covering rapamycin, metformin, NAD and its precursors, and resveratrol. Next, he explores the significance of metrics like VO2 max and muscle mass, as well as emerging concepts like blood flow restriction and stem cells. The conversation extends to nutrition, addressing questions surrounding long-term fasting, sugar consumption, sugar substitutes, and the contentious role of red meat in cancer. Peter not only provides his current stance on each topic—most of which have been covered in great detail in the previous 300 episodes—but also reflects on how his opinion may have evolved over the years.

    We discuss:

    • Defining the categories of “proven, promising, fuzzy, noise, and nonsense” [3:15];
    • Rapamycin [9:30];
    • Metformin [17:00];
    • NAD and its precursors [24:30];
    • Resveratrol [32:45];
    • The importance of VO2 max, muscle mass, and muscular strength for lifespan [38:15];
    • Blood flow restriction (BFR) training [44:00];
    • Using stem cells to treat osteoarthritis or injury [51:30];
    • Fasting as a tool for longevity (and why Peter stopped his fasting protocol) [55:45];
    • The energy balance theory [1:06:30];
    • The idea that sugar is poison [1:12:00];
    • The idea that sugar substitutes are dangerous [1:22:15];
    • The debate on red meat and cancer [1:28:45]; and
    • More.

    Connect With Peter on TwitterInstagramFacebook and YouTube

    Special episode with Dax Shepard: F1 and the 30th anniversary of Ayrton Senna’s death

    Special episode with Dax Shepard: F1 and the 30th anniversary of Ayrton Senna’s death

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    This is a special episode of The Drive with Peter’s friend and fellow car enthusiast Dax Shepard. In this podcast, which commemorates the 30th anniversary of the death of Brazilian Formula One legend Ayrton Senna, Dax sits down with Peter to better understand what made Senna so special and why Peter remains an enormous fan. This conversation focuses on Senna’s life, the circumstances of his death, and his lasting impact and legacy on the sport of F1.

    We discuss:

    • Peter’s interest in motorsports began as a child [2:30];
    • The drama and dangers of F1 [6:00];
    • What made Senna special [13:00];
    • What Senna meant to Brazilians [24:00];
    • The cause of the fatal crash [28:15];
    • Why Peter is obsessed with Senna [40:30];
    • Being the best versus having the best record [43:30];
    • Senna’s unique driving style and incredible intuition about automotive engineering [46:30];
    • Back to the day of the dreadful race [53:00];
    • What Peter believes caused the crash [1:02:45];
    • Views on dying young, in the prime of life [1:13:00];
    • Senna lives on in his foundation and in safety changes adopted by F1 [1:21:00];
    • Statistics aren’t enough for fandom, and why people like who they do [1:24:15];
    • The biggest difference between F1 today and F1 in the 80s [1:28:30];
    • Senna’s driving superpower [1:30:30];
    • The fastest drivers currently in F1 [1:38:30];
    • Current F1 obsessions [1:45:00];
    • How hard it is to do what the top F1 drivers do [1:50:15];
    • Dax’s love of motorcycles and his AMG E63 station wagon [1:52:15];
    • Awesome Senna mementos from Etsy [2:01:15];
    • What makes specialists interesting, and Max’s devotion to F1 [2:10:15];
    • What Senna might have done if he had not died that day [2:14:00];
    • Michael Schumacher and Max Verstappen are also top F1 drivers [2:17:30];
    • Interlagos in Sao Paulo Brazil is always an incredible experience [2:18:45]; and
    • More.

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    #299 ‒ Optimizing muscle protein synthesis: the crucial impact of protein quality and quantity, and the key role of resistance training | Luc van Loon, Ph.D.

    #299 ‒ Optimizing muscle protein synthesis: the crucial impact of protein quality and quantity, and the key role of resistance training | Luc van Loon, Ph.D.

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    Luc van Loon is an internationally renowned expert in skeletal muscle metabolism. In this episode, Luc starts with an exploration of the roles of insulin and triglycerides in endurance exercise, highlighting their impact on skeletal muscle metabolism, and he offers profound insights into the significance of protein in this context. He elucidates how different protein types and forms influence muscle protein synthesis rates, exploring the nuances of protein absorption, digestibility, amino acid quality, and their implications for performance and recovery. Delving deeper, he differentiates between animal and plant protein sources, unraveling the distinctive properties of various protein types, from the differences between whey and casein to the emerging trends in collagen protein supplementation. Moreover, Luc dissects the intricate connections among physical activity, lean muscle mass, muscle protein synthesis induced by resistance training, and dietary protein.

    We discuss:

    • Luc’s background and insights about fuel selection during exercise [3:30];
    • Fuel utilization during endurance exercise [9:30];
    • Fat metabolism, intramuscular lipids, and the nutritional dynamics of endurance sports [17:15];
    • The optimal window for replenishing intramuscular fat stores and glycogen post-exercise [25:15];
    • Luc’s interest in protein metabolism and exploration of amino acids' dual role as building blocks and signaling molecules in driving muscle protein synthesis [32:15];
    • How protein metabolism differs between sedentary individuals and those engaged in predominantly strength training or endurance training [38:45];
    • The basics of how proteins are digested and absorbed, and how muscle protein synthesis is measured [50:30];
    • How factors like food texture, cooking methods, and protein composition impact muscle protein synthesis, and the importance of protein distribution throughout the day [59:45];
    • Differences in whey and casein proteins, and the ability of ingested protein to stimulate muscle protein synthesis [1:03:30];
    • Dietary protein distribution and quantity for the maximization of muscle protein synthesis [1:09:00];
    • Muscle loss with age and inactivity and the importance of resistance exercise to maintain type II muscle fibers [1:17:15];
    • Differences between whey and casein proteins, and the importance of both quantity and quality of protein sources [1:28:30];
    • Optimizing muscle protein synthesis: exercise, timing of protein intake, protein quality, and more [1:37:00];
    • How to preserve muscle while trying to lose weight [1:46:00];
    • Anabolic resistance and overcoming it with physical activity [1:55:45];
    • Importance of protein intake and physical activity in hospitalized patients [2:06:30];
    • Reviewing the efficacy of collagen supplements [2:13:30];
    • Plant-based diets: how to ensure a balance of amino acids, and other considerations [2:20:30];
    • Future research: understanding protein metabolism in the brain [2:23:45]; and
    • More.

    Connect With Peter on TwitterInstagramFacebook and YouTube

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