Joe Rogan Experience #1108 - Peter Attia

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apod
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Joe Rogan Experience #1108 - Peter Attia

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Peter Attia is the founder of Attia Medical, PC, a medical practice with offices in San Diego and New York City, focusing on the applied science of longevity. The practice applies nutritional biochemistry, exercise physiology, sleep physiology, techniques to increase distress tolerance, lipidology, pharmacology, and four-system endocrinology to increase lifespan (primarily by delaying the onset of chronic disease), while simultaneously improving health span (quality of life). Peter trained for five years at the Johns Hopkins Hospital in general surgery, where he was the recipient of several prestigious awards, including resident of the year, and the author of a comprehensive review of general surgery. He also spent two years at NIH as a surgical oncology fellow at the National Cancer Institute where his research focused on immune-based therapies for melanoma. He has since been mentored by some of the most experienced and innovative lipidologists, endocrinologists, gynecologists, sleep physiologists, and longevity scientists in the United States and Canada. Peter earned his M.D. from Stanford University and holds a B.Sc. in mechanical engineering and applied mathematics.
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Re: Joe Rogan Experience #1108 - Peter Attia

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apod; thanks for sharing Dr A's background. It explains A LOT! This is a 2+ hour recording - is he discussing the science, his personal approach to eating and exercise, or cuff links? I am trying to use my time wisely... 8-)
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Re: Joe Rogan Experience #1108 - Peter Attia

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slacker wrote:apod; thanks for sharing Dr A's background. It explains A LOT! This is a 2+ hour recording - is he discussing the science, his personal approach to eating and exercise, or cuff links? I am trying to use my time wisely... 8-)
Here's a good link for some podcast notes. http://podcastnotes.org/2018/04/27/attia-2/

He's more or less shooting the breeze with Rogan on this interview, but it does have some interesting tidbits. He notes that he usually eats one meal a day (22:2 IF), where this one meal a day is often around 3,000 calories with a bit of starch included (rice, potato, etc.) He mentions that a 3,000kcal meal is actually pretty tame for him, and these meals can be a disgustingly large volume of food to grazing onlookers -- it's the kind of thing where you go out to dinner and order 3 or 4 entrees for yourself. I found the bit on metabolic therapy (~2h19m) particularly interesting, where he put a patient on a keto FMD for the first 5d of each month followed by a time-restricted keto diet for the rest of the month, for something like 6 rounds.
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Re: Joe Rogan Experience #1108 - Peter Attia

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Really liked this podcast and really like Peter Attia. I think partly because he doesn't over sell anything or claim to have all the answers but is diligently working to find them and tweak his own way of thinking about longevity as the evidence comes in.
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Re: Joe Rogan Experience #1108 - Peter Attia

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I like Peter Attia too and thoroughly enjoyed this podcast. Of particular interest was his short explanation of his own teams finding with regards to IGF-1. I reference this post where it was discussed and where it was also mentioned that apparently Gundry likes to keep it lower: https://apoe4.info/forums/viewtopic.php?f=4&t=2918

Attia mentions that when you break it out by disease, HIGHER IGF has a reduction in risk for Heart Disease and Alzheimer's and a slight increase with regard to Cancers. Even mentions that low IGF = High mortality. He does admits that this was contrary to his original beliefs on IGF but still more to be learned. If you start listening at the 2:07 mark, its where starts talking about it.
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Re: Joe Rogan Experience #1108 - Peter Attia

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Thanks for highlighting the IGF-1 info, Ski. I still have to listen to the whole thing, but that alone really resonates with me. According to Attia, the bulk of evidence for both CAD and AD shows a correlation between low IGF-1 and those pathologies. That's huge and very different than what Drs. Gundry and Bredesen both promote. They're using longevity as an endpoint as oppose to the diseases that they're trying to prevent.

It seems like we need to find the right balance between autophagy and muscle maintenance. Too much of one, without the other, might create the imbalance Dr. Bredesen describes in his theory :idea: I'd love to see IGF-1 research just focused on our genotype...
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Re: Joe Rogan Experience #1108 - Peter Attia

Post by Rainbow »

Thanks apod, this was really fun to listen to! I also like the fact that Peter Attia doesn't try to oversell anything. Incidentally, I read on his website that he'll be starting a podcast this year. It might be worth checking out.

His comments about IGF-1 are very interesting. I definitely have a lot to learn about IGF-1 and mTOR.
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Re: Joe Rogan Experience #1108 - Peter Attia

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Here's a followup on Bulletproof Radio: :)

It’s Not Dementia, It’s Distraction: Dr. Peter Attia # 493
https://blog.bulletproof.com/peter-attia/

Transcript: https://blog.bulletproof.com/wp-content ... ay2018.pdf
Podcast Notes: http://podcastnotes.org/2018/05/18/attia-3/
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Re: Joe Rogan Experience #1108 - Peter Attia

Post by Julie G »

Thanks, apod! Really interesting. Attia is a deep thinker who's careful not to overstate his case. I didn't listen, but instead skimmed the transcript. He talks about a little of everything. He dives pretty deeply into atherosclerosis and tackles the question of whether or not dyslipidemia without any elevation of inflammatory markers is a concern. He suggests it IS... only because he wants to further extend longevity. He suggests "cholesterol" is a meaningless term; as useful as eye color in predicting heart disease. Instead, he outlines 4 specific markers that he uses to evaluate heart health:
  • 1.)Lp(a)
    I don't wanna know the mass of LPa, and I don't wanna know the cholesterol content of LPa. I wanna know the number in nanomole per liter of LPa particles.
    2.)LDL-P/LDL-C discordance as per the MESA & Framingham studies.
    3.) Small LDL-P
    4.) VLDL remnant
He then goes on to suggest that the lower the LDL-P and ApoB the better for cardioprotection... UNTIL it affects cognition. He claims that happened to him as a vegan. I found interesting that he uses daily mild ketosis (like many of us) for the cognitive benefit.

It would be interesting to dive more deeply into the studies that suggest high "cholesterol" is associated with longevity and evaluate the specific biomarkers Attia uses. Would a deeper dive change that hypothesis?
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