Logo
    Search

    #251 - AMA #46: Optimizing brain health: Alzheimer's disease risk factors, APOE, prevention strategies, and more

    enApril 17, 2023

    Podcast Summary

    • Brain Health and Preventing Alzheimer's DiseaseKnowing your ApoE gene and utilizing blood-based biomarkers can predict Alzheimer's disease risk. Maintaining a healthy lifestyle through exercise, nutrition, lipid management, brain games, sauna use, oral health, and hearing loss can also prevent neurodegeneration.

      In this episode of the Drive Podcast's Ask Me Anything series, Peter Atia and Nick Stenson discuss brain health and ways to prevent Alzheimer's disease and neurodegeneration. They explain the importance of knowing your ApoE gene, and how blood-based biomarkers can predict the risk of Alzheimer's disease. The conversation delves into various aspects of brain health, including exercise, nutrition, lipid management, brain games, sauna use, oral health, and hearing loss. As anyone with a brain is at risk, this episode is relevant to all. The full video is available for subscribers, and a sneak peek is available on the podcast's YouTube page.

    • Understanding Alzheimer's Disease: Diagnosis and Risk FactorsAlzheimer's disease is the most common neurodegenerative disease and the most common cause of dementia, but there are other causes. It's important to understand the diagnosis process and risk factors, as everyone should care about brain health.

      This podcast episode will focus on Alzheimer's disease, the most common neurodegenerative disease and the most common cause of dementia. However, it is important to note that there are other causes of dementia and other neurodegenerative diseases, such as vascular dementia and Parkinson's disease. The hosts have collected questions from their audience and will provide valuable information for anyone concerned about their brain health and the risk of Alzheimer's. Everyone should care about this topic, regardless of family history or personal risk factors. It will be helpful to understand the diagnosis process for Alzheimer's disease, as it will be discussed throughout the episode.

    • Diagnosing Alzheimer's DiseaseAlzheimer's disease is diagnosed through clinical evaluation and symptoms, but confirmatory biomarkers may help. Diagnosis can only be confirmed through autopsy, and ruling out other causes is essential. New developments in biomarker sensitivity are offering hope.

      Alzheimer's disease is diagnosed through a clinical evaluation of a patient and close observation of their symptoms. This includes difficulty remembering events, confusion with location or time, language problems, and reduction in vocabulary. Biomarkers, such as serum amyloid and tau, can help confirm a diagnosis, but traditional methods, like a lumbar puncture, are not practical for real-world diagnosis. While Alzheimer's does not have a clear-cut biomarker for predicting risk or diagnosis, developments in biomarker sensitivity are providing new ways to identify the disease. It's important to rule out other causes before concluding a diagnosis and understand that it can only be definitively confirmed through an autopsy.

    • The C2N Amaloid Score for Alzheimer's Disease Risk PredictionThe C2N biomarker test uses a patient's age, ApoE variant, and AB ratio to predict Alzheimer's disease pathology; it is one tool among others which doctors use to assess a patient's risk. Changes in the C2N score can help determine if interventions to reduce risk are working.

      The C2N developed Amaloid score is a biomarker test that predicts the probability of Alzheimer's disease (AD) pathology. It uses a patient's ApoE variant, AB 40 to 42 ratio measured in plasma, and patient age to determine risk. It is one tool used in conjunction with other risk factors such as family history, genotype, metabolic health, and cognitive testing to assess a patient's overall risk of AD. The C2N score is still relatively new and has yet to be fully validated. It is currently being used on patients with the highest pre-test probability of AD to increase the odds of accurate results. As we make interventions to reduce risk, we can track changes in the C2N score to see if it predicts an improvement.

    • Understanding Genetic Testing for Alzheimer's DiseaseGenetic testing for Alzheimer's disease is uncertain and should only be used on those at highest risk. The presence of certain genes, such as PSEN1, PSEN2, APP, and APO-E4, can increase the risk, but it does not guarantee the development of the disease. It's crucial to interpret the results carefully.

      The C2N test for Alzheimer's disease has a high level of uncertainty and should only be used on those at highest risk of developing the disease. There are three genes, PSEN1, PSEN2, and APP, that are considered deterministic and account for 1% of Alzheimer's cases. The other 99% of cases do not have these genes but about two-thirds have at least one copy of the APO-E4 gene, which increases the risk of developing the disease. However, having this gene does not guarantee that someone will develop Alzheimer's, as many people without the gene still develop the disease. It is important to understand the limitations of genetic testing and interpret the results carefully.

    • The Impact of ApoE4 Gene on Alzheimer's DiseaseWhile having two copies of the ApoE4 gene increases the risk of Alzheimer's disease, it is not a guarantee. Other genes and factors can also play a role, and whole genome sequencing is a more accurate way to identify relevant genes.

      ApoE4 is a gene that is highly associated with Alzheimer's disease, but having two copies of the gene is rare and only affects about 2% of the population. However, this small group makes up two-thirds of all Alzheimer's cases. It's important to note that ApoE4 is not a deterministic gene, meaning that some people with one or two copies of the gene may never develop dementia. Other genes, such as cloth, can attenuate or amplify the risk of Alzheimer's disease. While some commercial genetic tests can detect ApoE4, whole genome sequencing is more accurate in identifying other relevant genes. There are three alleles for the ApoE4 gene: E2, E3, and E4. None of these are considered mutations.

    • Understanding the Role of APA we for Alleles in Alzheimer's DiseaseGenetics play a role in Alzheimer's disease, with the APA we for gene being the most common associated with risk. While testing for all genes involved is not feasible, understanding prevalence can aid in managing the disease.

      Alzheimer's disease is influenced by a person's genes, with APA we for being the most common gene associated with the risk. The three different APA we for alleles are e2, e3, and e4, with e3 being the most prevalent, followed by e4 and then e2. These alleles can combine in up to six ways, influencing a person's risk of developing Alzheimer's disease. However, it is challenging and not yet feasible to test for all the genes involved in Alzheimer's disease. Contrary to the belief that APA we for is deterministic and a fate of complete for Alzheimer's disease, there is a lot that can be done to delay onset and/or reduce the risk. Understanding the prevalence of these genes can allow for better planning and management of the disease.

    • Women Have a Higher Risk of Developing Alzheimer's DiseaseWomen are twice as likely to develop Alzheimer's disease, with a higher risk associated with the 4-4 genotype. Prevention is possible and ongoing research is crucial.

      Women are twice as likely to develop Alzheimer's disease than men, and this is likely due to a combination of individual risk factors and the fact that women tend to live longer. A study analyzing the 10-year risk of Alzheimer's disease, vascular dementia, and all types of dementia found that the 4-4 genotype has a significantly higher risk of developing Alzheimer's disease. Women, in general, are about 20% more likely than men to develop Alzheimer's disease in a given decade. While there may be backlash against testing for APEWY status, prevention of Alzheimer's disease is possible and an important part of ongoing research.

    • Modifying Behaviors to Reduce Alzheimer's RiskEngaging in healthy lifestyle behaviors may help reduce the risk of cognitive decline in seniors, regardless of genetic factors. Healthy lifestyle factors are crucial for cognitive health associated with aging.

      The focus of this AMA is on the modifiable behaviors that can reduce the risk of Alzheimer's disease. Unfortunately, most of the data on this topic comes from epidemiological studies, like the Chicago Health and Aging Project, which followed nearly 4,000 seniors for over 20 years to assess their cognitive health based on certain healthy lifestyle factors. Those who had zero to one healthy lifestyle factors had a steeper cognitive decline compared to those who had four to five healthy lifestyle factors, regardless of their ApoE genotype. While there are limitations to the study, the takeaway is that engaging in healthy lifestyle behaviors may play a role in reducing the risk of cognitive decline associated with aging.

    • Lower education can lead to more cognitive decline, but healthy behaviors can offset the risk, especially for those with the E4 gene.Maintaining a healthy lifestyle can help prevent Alzheimer's dementia and keep the brain healthy, regardless of genetic risk or education level. Joining the program offers exclusive content to learn more.

      The level of education can be a predictor of cognitive decline, with lower education leading to more decline. However, healthy behaviors can offset much of this risk, particularly for those with the E4 gene. The difference in cognitive decline between those with E4 and healthy behaviors and those without E4 and unhealthy behaviors is minimal. This suggests that there are things individuals can do to prevent Alzheimer's dementia and keep their brains healthy, such as maintaining a healthy lifestyle. Becoming a member of the program can help access more in-depth and exclusive content on this topic.

    Recent Episodes from The Peter Attia Drive

    #307 ‒ Exercise for aging people: where to begin, and how to minimize risk while maximizing potential | Peter Attia, M.D.

    #307 ‒ Exercise for aging people: where to begin, and how to minimize risk while maximizing potential | Peter Attia, M.D.

    View the Show Notes Page for This Episode

    Become a Member to Receive Exclusive Content

    Sign Up to Receive Peter’s Weekly Newsletter

    In this special episode, Peter addresses the common questions about starting or returning to an exercise routine over the age of 50. Individuals in this age group have frequently reached out with questions about whether it's too late to start exercising and often express concern over a lack of prior training, a fear of injury, or uncertainty about where to begin. Peter delves into the importance of fitness for older adults, examining all four pillars of exercise, and provides practical advice on how to start exercising safely, minimize injury risk, and maximize potential benefits. Although this conversation focuses on people in the “older” age category, it also applies to anyone of any age who is deconditioned and looking to ease into regular exercise.

    We discuss:

    • Key points about starting exercise as an older adult [2:45];
    • Why it’s never too late to begin exercising and incorporating the four pillars of exercise [5:45];
    • The gradual, then sharp, decline in muscle mass and activity level that occur with age [10:00];
    • The decline of VO2 max that occurs with age [15:30];
    • Starting a training program: exercise variability, movement quality, realistic goals, and more [18:30];
    • Improving aerobic capacity: the malleability of the system, the importance of consistency, and setting long-term fitness goals [25:15];
    • Starting cardio training: base building, starting with low volume, and zone 2 training [30:45];
    • The critical role of VO2 max in longevity [36:45];
    • How to introduce VO2 max training to older or deconditioned individuals [46:15];
    • Options for performing zone 2 and VO2 max training [53:45];
    • The ability to make gains in strength and muscle mass as we age [57:00];
    • How to implement strength training for older individuals [1:01:00];
    • Advice for avoiding injury when strength training [1:07:30];
    • Risk of falls: the devastating consequences and the factors that increase fall risk [1:12:15];
    • Mitigating fall risk: the importance of foot and lower leg strength, ankle mobility, and balance [1:19:45];
    • Improving bone mineral density through resistance training [1:24:30];
    • The importance of protein in stimulating muscle protein synthesis, especially in older adults [1:31:00];
    • Parting advice from Peter [1:34:00]; and
    • More.

    Connect With Peter on TwitterInstagramFacebook and YouTube

    The Peter Attia Drive
    enJune 24, 2024

    #306 - AMA #60: preventing cognitive decline, nutrition myths, lowering blood glucose, apoB, and blood pressure, and more

    #306 - AMA #60: preventing cognitive decline, nutrition myths, lowering blood glucose, apoB, and blood pressure, and more

    View the Show Notes Page for This Episode

    Become a Member to Receive Exclusive Content

    Sign Up to Receive Peter’s Weekly Newsletter

    In this “Ask Me Anything” (AMA) episode, Peter provides insights on a broad range of important topics. He delves into the prevention of cognitive decline, the link between cardiovascular disease and Alzheimer's disease, and methods to lower blood glucose, insulin, and apoB. He also addresses nutrition-related queries, exploring the impact of dietary habits on weight loss and longevity, how a person can identify the best diet for themselves, and common nutrition myths. Additional discussions include optimal blood pressure, daily step goals, the benefits of standing versus sitting desks, and much more.

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

    We discuss:

    • Overview of topics and episode format [1:40];
    • Preventing cognitive decline [5:00];
    • How to lower blood glucose and insulin [13:30];
    • The relationship between lipids, CVD, and Alzheimer’s disease, and whether statins can increase the risk of neurodegenerative disorders and AD [23:15];
    • Reducing apoB levels through exercise and diet [31:45];
    • Pharmacological options for lowering apoB [38:00];
    • How nutrition impacts longevity via metabolic health, muscle mass, BMD and more [40:15];
    • How can someone determine the best diet for themselves? [43:45];
    • Nutrition myth: All weight loss is good [46:45];
    • Nutrition myth: Metabolic rates are dramatically different among individuals based on genetics [49:00];
    • Nutrition myth: Losing weight after a brief period of overeating is impossible [53:45];
    • Nutrition myth: GLP-1 agonists are a replacement for a healthy lifestyle [57:45];
    • Nutrition myth: There is a single best diet for weight loss [1:03:00];
    • Nutrition oversimplification: All calories are created equal [1:05:45];
    • Daily step goals [1:06:45];
    • The benefits of standing versus sitting throughout the day [1:10:45];
    • How to identify the most impactful and easiest-to-implement ways to improve your health [1:12:30];
    • The critical importance of emotional health [1:14:30];
    • Why supplements should be considered as supportive aids rather than primary solutions in one’s strategy to improve longevity [1:18:00];
    • Strategies for reducing high blood pressure [1:20:45];
    • Peter’s biggest frustrations with "mainstream health advice" [1:28:00];
    • Peter’s chaotic, yet cherished, morning routine [1:31:00]; and
    • More.

    Connect With Peter on TwitterInstagramFacebook and YouTube

    The Peter Attia Drive
    enJune 17, 2024

    #305 ‒ Heart rate variability: how to measure, interpret, and utilize HRV for training and health optimization | Joel Jamieson

    #305 ‒ Heart rate variability: how to measure, interpret, and utilize HRV for training and health optimization | Joel Jamieson

    View the Show Notes Page for This Episode

    Become a Member to Receive Exclusive Content

    Sign Up to Receive Peter’s Weekly Newsletter

    Joel Jamieson is a conditioning expert who developed Morpheus to give people a smarter way to build their conditioning regimen and improve their recovery. In this episode, Joel dives deep into the world of heart rate variability (HRV), explaining its scientific foundation, how it measures the balance between the sympathetic and parasympathetic nervous systems, the various methods of measurement, and how it can guide healthier lifestyle choices and improved training performance. He explores the nuances of HRV calculation, the impact of aging on HRV, and the roles of genetics, exercise, and other lifestyle factors in this process. He also covers Morpheus, the innovative training tool that won Peter over after his initial skepticism, highlighting its practicality and effectiveness in guiding training and optimizing fitness outcomes.

    We discuss:

    • Heart rate variability (HRV): evolution, science, and practical applications of HRV in athletic training [4:00];
    • Methods of measuring HRV: EKG, wrist-based sensors, and more [11:30];
    • How HRV is calculated from the data [22:30];
    • The role of the autonomic nervous system (ANS) in regulating HRV [25:45];
    • The decline in HRV with age, and the mitigating effects of fitness and other lifestyle factors [33:30];
    • The role of genetics in HRV, the modifiability of HRV, and a comparison of VO2 max and HRV as predictors of mortality [37:00];
    • How aging affects HRV and sympathetic drive, and the importance of spontaneous movement and exercise in maintaining the body's adaptability [43:30];
    • How Morpheus measures HRV using RMSSD and normalizes it to a 100-point scale for easier interpretation [49:45];
    • The Morpheus system: development, integration with various metrics, and personalized daily training recommendations to optimize fitness and recovery [51:30];
    • The benefits of morning HRV readings for assessing daily readiness compared to overnight HRV measurements [1:03:00];
    • Why Morpheus recommends using a chest strap rather than an arm band [1:10:00];
    • The impact of consistent exercise, stress, alcohol, and other lifestyle factors on HRV [1:11:15];
    • Optimizing zone 2 training with Morpheus [1:18:15];
    • Using heart rate recovery (HRR) as an indicator of athletic conditioning and the balance between aerobic and anaerobic systems [1:22:45];
    • The importance of tracking HRV trends over time rather than focusing on data from a given day [1:29:00];
    • Effect of GLP-1 agonists on heart rate and HRV [1:34:45];
    • Where HRV belongs in the hierarchy of health metrics [1:42:00];
    • Parting thoughts [1:46:30]; and
    • More.

    Connect With Peter on TwitterInstagramFacebook and YouTube

    The Peter Attia Drive
    enJune 10, 2024

    #304 – NEW: Introducing quarterly podcast summaries - Peter shares his biggest takeaways on muscle protein synthesis, VO2 max, toe strength, gut health, and more

    #304 – NEW: Introducing quarterly podcast summaries - Peter shares his biggest takeaways on muscle protein synthesis, VO2 max, toe strength, gut health, and more

    View the Show Notes Page for This Episode

    Become a Member to Receive Exclusive Content

    Sign Up to Receive Peter’s Weekly Newsletter

    In this quarterly podcast summary (QPS) episode, Peter introduces a new format aimed at summarizing his biggest takeaways from the last three months of guest interviews on the podcast. Peter shares key insights from each episode, covering diverse topics such as protein and muscle building with Luc van Loon, toe strength with Courtney Conley, VO2 max with Olav Aleksander Bu, liquid biopsies for cancer with Alex Aravanis, gut health and probiotics with Colleen Cutcliffe, and road safety with Mark Rosekind. Additionally, Peter shares any personal behavioral adjustments or modifications to his patient care practices that have arisen from these engaging discussions.

    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 episode #304 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.

    We discuss:

    • How Peter keeps track of his takeaways from each podcast episode [5:15];
    • Luc van Loon episode: fat utilization, muscle protein synthesis, dietary protein, aging and inactivity, and more [8:45];
    • Behavioral changes that have come about from the conversation with Luc van Loon [23:45];
    • Courtney Conley episode: importance of toe strength and the impact of dedicated foot training [26:45];
    • Olav Aleksander Bu episode: the importance of VO2 max for lifespan, and the practicalities of measuring and improving VO2 max [36:45];
    • Behavioral changes that have come about from the conversation with Olav [56:00];
    • Alex Aravanis episode: liquid biopsies for cancer detection [1:01:30];
    • Colleen Cutcliffe episode: the importance of gut bacteria balance, and the potential therapeutic uses of probiotics, particularly Akkermansia [1:16:45];
    • Mark Rosekind: the significant issue of road fatalities and injuries, their causes, and practical safety measures to reduce risks [1:27:00]; and
    • More.

    Connect With Peter on TwitterInstagramFacebook and YouTube

    The Peter Attia Drive
    enJune 03, 2024

    #303 - A breakthrough in Alzheimer’s disease: the promising potential of klotho for brain health, cognitive decline, and as a therapeutic tool for Alzheimer's disease | Dena Dubal, M.D., Ph.D.

    #303 - A breakthrough in Alzheimer’s disease: the promising potential of klotho for brain health, cognitive decline, and as a therapeutic tool for Alzheimer's disease | Dena Dubal, M.D., Ph.D.

    View the Show Notes Page for This Episode

    Become a Member to Receive Exclusive Content

    Sign Up to Receive Peter’s Weekly Newsletter

    Dena Dubal is a physician-scientist and professor of neurology at UCSF whose work focuses on mechanisms of longevity and brain resilience. In this episode, Dena delves into the intricacies of the longevity factor klotho: its formation and distribution in the body, the factors such as stress and exercise that impact its levels, and its profound impact on cognitive function and overall brain health. Dena shares insights from exciting research in animal models showing the potential of klotho in treating neurodegenerative diseases as well as its broader implications for organ health and disease prevention. She concludes with an optimistic outlook for future research in humans and the potential of klotho for the prevention and treatment of Alzheimer’s disease.

    Disclosure: Peter is an investor in Jocasta Neuroscience, a company working to develop klotho as a therapy for people with Alzheimer’s disease.

    We discuss:

    • Dena’s fascination with aging and how she came to study klotho [3:30];
    • Biological properties of klotho: production, regulation, decline with age, and factors influencing its levels [11:45];
    • Potential benefits of klotho on brain health [22:00];
    • The relationship between soluble klotho protein, platelet factors, and cognitive enhancement [33:45];
    • The role of platelet factor 4 (PF4) and it’s interaction with GluN2B in mediating cognitive enhancement [46:45];
    • Benefits of klotho observed in a mouse model of Parkinson’s disease [55:45];
    • Benefits of klotho observed in a mouse model of Alzheimer’s disease [1:03:00];
    • Promising results of klotho in primate models, and the importance of finding an appropriate therapeutic dose before moving to human trials [1:08:00];
    • Speculating why a single klotho injection has such long-lasting effects [1:25:30];
    • Potential cognitive benefits of klotho in humans, the impact of the KL-VS genetic variant on klotho levels, and the need for human trials to confirm these effects [1:27:45];
    • The interaction between the KL-VS genetic variant and APOE4 and how it impacts risk of Alzheimer’s disease [1:34:45];
    • The significance of klotho levels: studies linking lower levels to increased mortality and the broader implications for organ health and disease prevention [1:47:15];
    • Measuring klotho levels and determining an individual’s KL-VS status [1:52:15];
    • The promising potential of klotho for Alzheimer’s disease treatment, and the importance of philanthropy for funding research [1:58:00]; and
    • More.

    Connect With Peter on TwitterInstagramFacebook and YouTube

    The Peter Attia Drive
    enMay 27, 2024

    #302 - Confronting a metabolic epidemic: understanding liver health and how to prevent, diagnose, and manage liver disease | Julia Wattacheril, M.D., M.P.H.

    #302 - Confronting a metabolic epidemic: understanding liver health and how to prevent, diagnose, and manage liver disease | Julia Wattacheril, M.D., M.P.H.

    View the Show Notes Page for This Episode

    Become a Member to Receive Exclusive Content

    Sign Up to Receive Peter’s Weekly Newsletter

    Julia Wattacheril is a physician scientist and director of the Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD) program at Columbia University Irving Medical Center. In this episode, Julia delves deep into the complex world of liver health, beginning with a foundational overview of liver physiology. She provides an in-depth look at how alcohol impacts liver function, breaking down the metabolism of ethanol and its detrimental effects. Julia then shifts the focus to understanding liver function tests and optimal enzyme levels, providing a detailed explanation of AST and ALT and elucidating why fluctuations in these levels may or may not be concerning. She provides a primer on the four major stages of liver disease, discussing risk and emphasizing the importance of early diagnosis. Julia highlights the role of liver disease in increasing the risk of cancer and cardiovascular disease and covers in detail the various strategies for diagnosing, treating, and preventing the progression of liver disease.

    We discuss:

    • Julia’s training, the importance of liver health, and the challenges and innovations of hepatology [3:15];
    • The complex and crucial functionality of the liver, its four most essential functions, and more [8:45];
    • Liver injuries: historical and evolving understanding of causal factors, and the progression to liver diseases and cancer [13:15];
    • How the liver metabolizes nutrients and what happens in the presence of excess calories or alcohol [24:45];
    • Methods of diagnosing liver disease and how insights guide treatment and management strategies [33:30];
    • The poisonous nature of ethanol to the liver [40:30];
    • Varied responses to alcohol, damaging effects of alcohol beyond the liver, and the process of advising patients on their alcohol consumption [47:15];
    • Understanding liver enzymes AST and ALT—interpreting levels, lifestyle factors that affect them, and diagnostic approaches [58:30];
    • Interpreting liver function tests for fatty liver disease, and the challenges of diagnosing liver pathologies, particularly in children versus adults [1:13:15];
    • Comprehensive liver health assessments via imaging and various diagnostic tools to prevent overlooking potential liver pathologies [1:18:45];
    • Potential impact of recreational drugs, statins, and other medications on liver function test results [1:26:45];
    • Shifting nomenclature from NAFLD to MASLD to reflect accuracy in the underlying pathophysiology and understanding of liver diseases [1:30:30];
    • Pathophysiology of MASLD, the need for proactive screening, and the significance of liver fat percentage as an indicator of metabolic health [1:36:30];
    • The importance of screening for rare conditions alongside common metabolic diseases associated with fatty liver accumulation [1:42:45];
    • 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.

    Connect With Peter on TwitterInstagramFacebook and YouTube

    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

    View the Show Notes Page for This Episode

    Become a Member to Receive Exclusive Content

    Sign Up to Receive Peter’s Weekly Newsletter

    In this “Ask Me Anything” (AMA) episode, Peter 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.

    Connect With Peter on TwitterInstagramFacebook and YouTube

    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?

    View the Show Notes Page for This Episode

    Become a Member to Receive Exclusive Content

    Sign Up to Receive Peter’s Weekly Newsletter

    In this special 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

    View the Show Notes Page for This Episode

    Become a Member to Receive Exclusive Content

    Sign Up to Receive Peter’s Weekly Newsletter

    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.

    Connect With Peter on TwitterInstagramFacebook and YouTube

    #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.

    View the Show Notes Page for This Episode

    Become a Member to Receive Exclusive Content

    Sign Up to Receive Peter’s Weekly Newsletter

    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

    Related Episodes

    S01E07 “People don’t see them ill”: Stigma and invisibility of neurological disorders

    S01E07 “People don’t see them ill”: Stigma and invisibility of neurological disorders

    1 in 3 people will at some point in their life suffer from a brain disorder, according to the Global Burden of Disease report and this number might be growing. Understanding these conditions has, therefore, become more important than ever.

    Donna Walsh, a patient advocate, tells us about daily challenges of people suffering from brain diseases and neurological conditions, including productivity issues and mental illness stigma. She also discusses the broader socioeconomic implications, and the technologies that can help.  

    Donna Walsh is the executive director of EFNA (European Federation of Neurological Associations), an organization with a mission to improve the life quality for patients in Europe by influencing policy makers and the general public, and facilitating access to necessary healthcare. 

    What makes EFNA special is that they focus on what is common to various disorders, like multiple sclerosis, Parkinson’s disease, stroke, brain tumor, epilepsy, Alzheimer’s disease, etc. The approach is apparent in their campaigns on Twitter, Facebook and Instagram, like:

    #UnderTheUmbrella
    #BrainLifeGoals
    #BrainMindPain

    Kim Baden-Kristensen is the co-founder and CEO of Brain+, a digital therapeutics company that helps people with brain disorders and injuries to recover their fundamental cognitive brain functions and daily life capabilities by using an app-based cognitive rehabilitation platform, which is developed in close collaboration with patients, clinicians and researchers.https://www.linkedin.com/in/kbadenk/  
    Alessia Covello is a life science IT consultant working in the field of healthcare technology implementation, and advocating for better services for people with brain conditions and learning disabilities.https://www.linkedin.com/in/alessiacovello/ 

    The talking points:

    5:06 The concept of patient advocacy and EFNA’s mission 

    8:30 Overcoming the stigma of neurological disorders

    11:32 How common are brain disorders, what is the burden on society, and how important is it that brain disorders are addressed on a large scale? 

    15:00 Chronic and fluctuating conditions - what makes neurological disorders different and what impact they have in patients’ professional lives?

    20:14 Developing a community of patients and a common agenda

    27:56 Patient advocate training and how it relates to treatment accessibility

    31:50 The role of digital technology in treatment of neurological disorders

    35:40 Take-home messages to policy makers, medical and clinical community, research community, the industry, and patients and their families

    Disclaimer:

    All references to products, companies, and organizations in this podcast and the article that accompanies it are included with the purpose to inform, rather than promote or advertise. The podcast authors do not receive financial compensation for any of these references.

    Making Walking Awesome. My Life series part 4

    Making Walking Awesome.  My Life series part 4

    In this episode of the My Life series, I talk about how I make walking awesome! A whole episode on walking? Yes. Well, sort of. I work quite a bit into my walks, as you will hear in the show. Here are some of the points covered:

    • The health benefits of walking
    • The best way to lose fat and build muscle
    • Life hacks that give you the time needed to fit walking into your life
    • The importance of posture
    • Going barefoot or wearing minimalist shoes vs wearing traditional shoes
    • Improving memory and brain health
    • The benefits of sprinting
    • How to increase human growth hormone levels by 771%!!!
    • All this and more!

     

    Purchase The Sitting Solution here:

    http://affiliate.lxntracker.com/rd/r.php?sid=79&pub=240237&c1=&c2=&c3=

     

    Shop Amazon with these links and help out the show!

    USA:
    https://www.amazon.com/ref=as_li_ss_tl?ie=UTF8&linkCode=ll2&tag=choicecon-20&linkId=1f6f703e9797258e86fd161ec82a2fb4
    Canada:
    https://www.amazon.ca/ref=as_li_ss_tl?ie=UTF8&linkCode=ll2&tag=choicecon-20&linkId=1f6f703e9797258e86fd161ec82a2fb4


    My Life series:
    http://choiceconversations.com/life-hacks-for-a-great-nights-sleep-my-life-series-part-1
    http://choiceconversations.com/my-morning-routine-my-life-series-part-2
    http://choiceconversations.com/mindful-eating-my-life-series-part-3

    Articles mentioned during the show:
    http://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/walking/art-20046261
    http://www.arthritis.org/living-with-arthritis/exercise/workouts/walking/wow-of-walking.php
    http://www.kurzweilai.net/memory-problems-go-climb-a-tree
    http://www.rewildthyself.com/sprinting-human-growth-hormone/
    http://main.poliquingroup.com/ArticlesMultimedia/Articles/Article/989/Eight_Reasons_Everyone_Should_Do_Sprints.aspx

     

     

    Please subscribe, rate and review on itunes:
    https://itunes.apple.com/us/podcast/choice-conversations/id315666764?mt=2

    Join my new facebook group: https://www.facebook.com/groups/1741413262765523

    Like my facebook page and share with your friends:
    https://www.facebook.com/ChoiceConversationsPodcast

    Follow me on twitter and please retweet: https://twitter.com/ChoiceConvo

    Subscribe to my youtube channel. Like and share my videos:
    http://www.youtube.com/c/ChoiceConversations

    Follow me on Google Plus and share with your friends:  https://plus.google.com/u/0/b/113389589018857326194/+ChoiceConversations

     

    Bumper music: https://www.youtube.com/watch?v=yiKiNecNBiY&list=PLoe-H2xJOW56v_XOx1oJnZXOfCIr4YfSy

     

    #194: Fundamentals of Alzheimer’s disease with Dr. Dale Bredesen

    #194: Fundamentals of Alzheimer’s disease with Dr. Dale Bredesen

    Maintaining and optimizing brain and cognitive function is a key goal behind the H.V.M.N. community.

    In this episode, Geoff brings on Dr. Dale Bredesen, a top researcher of neurodegenerative diseases to talk everything about cognitive health, cognitive decline, the fundamentals of Alzheimer’s disease, and a potential path to combat it**.**

    H.V.M.N. Podcast Fam: We're giving you an exclusive offer. You guys are some of our most loyal fans and we want to give you a special reward. Use GEOFF10 to get 10% off your KFB order: https://hvmn.com/discount/GEOFF10

    Learn More About H.V.M.N. here: https://hvmn.com/pod

    Join the Official H.V.M.N. Podcast Discord Community by filling out this quick survey: https://go.hvmn.com/discordsurvey

    Send a message to podcast@hvmn.com with feedback, questions, and guest suggestions!

    JEM June 2018 Podcast Summary

    JEM June 2018 Podcast Summary

    Podcast summary of articles from the June 2018 edition of Journal of Emergency Medicine from the American Academy of Emergency Medicine.  Topics include Head and Neck CT in trauma, lactate as a marker of short term mortality, an emerging pathogen in cat and dog bites, acute cholecystitis management, 4 factor PCC in brain bleeds, and board review on diplopia.  Guest speaker is Dr. Colin Crowe.