Episode 050 Peter Attia

Summary

• Peter Attia is a doctor, ultraendurance athlete, and cofounder of the Nutrition Science Initiative (NuSI).
• NuSI is a project to do nutrition science at a higher level than is currently possible.
• Peter has a range of experience, including working at McKinsey & Company, five years at Johns Hopkins Hospital, two years at the National Institutes of Health, and degrees from Stanford.
• Peter and Gary Taubes founded NuSI in 2012 to ask questions that challenge the conventional point of view on nutrition and diet.
• The project is funded by the Arnold family, and the scientists involved have different points of view.
• Peter earned his MD from Stanford, as well as mechanical engineering and applied mathematics degrees.
• Peter Attia grew up in Canada and was obsessed with boxing and martial arts from the age of 13.
• He trained hard and ate 67 thousand calories a day to maintain a 27inch waist and 4% body fat.
• In his 30s, his obsession shifted to ultralong distance swimming, and he was spending 34 hours a day in the pool.
• Despite his hard work, his weight was increasing and his blood tests showed he was prediabetic.
• He was motivated to find a better way to optimize his health and performance.
• He was introduced to the concept of synthetic ketones and began testing them to see how they impacted his performance.
• Ketones are molecules that the human body produces when fasting or eating a lowcarb, lowprotein diet.
• Ketones can be used as fuel for the brain, which ordinarily functions exclusively on glucose.
• George Cahill conducted experiments in the 1950s and 1960s that showed ketones can be used as fuel for the brain.
• Synthetic ketones are available in liquid form and can be consumed as a supplement.
• Synthetic ketones have a very unpleasant taste, described as similar to jet fuel or diesel.
• Peter Attia and Tim Ferris discuss the potential benefits of consuming synthetic ketones.
• Ketosis and ketoacidosis are related but not the same. Ketoacidosis is a dangerous state that occurs in people with Type 1 diabetes and is treated with IV fluids, glucose, insulin, and potassium.
• Nutritional ketosis is a state that occurs when someone with a normal working pancreas has ketone levels of 6 millimolars or lower.
• Peter Attia and Gary Taubes founded NuSI to fund experiments that examine whether obesity is caused by consuming too many calories or the type of calories consumed.
• Metabolic chambers are used to measure nondeliberate energy expenditure.
• Peter Attia participated in experiments to measure energy expenditure in airtight chambers.
• Macronutrients are used to distinguish between different foods, but they also impact hormones and enzymes in the body.
• Two ways to measure energy expenditure are doubly labeled water and indirect calorimetry.
• Peter Attia repeated the experiment in a number of chambers, consuming the same meals and performing the same exercises.
• Results showed that his resting energy expenditure was higher than expected, and tables used to understand metabolic behavior were found to be inaccurate.
• Peter Attia conducted an experiment to measure the impact of exercise on lipoproteins, glucose levels, triglycerides, insulin levels, CRP, LDL cholesterol, and LDL particle number.
• He found that exercise had a significant impact on these biomarkers.
• Peter Attia also discussed the difficulty of finding uncontaminated indigenous populations to study.
• Tim Ferris raised the question of how our ancient predecessors managed to get the nutrition they needed, and whether modern man is exposed to various contaminants that create deficiencies.
• Peter Attia suggested that it is important to consider the big picture when looking at a single snapshot of a patient's biomarkers, as there may be external factors that influence the results.
• Gastroenterologist hypothesized that there are likely many unknown communicable diseases that could be transmitted through fecal matter transplants
• Importance of standardizing time for any type of trending
• Peter Attia's manifesto on hacking lifespan and performance and how to choose the appropriate blend of the two for yourself
• Balance between desire to live longer and desire to enjoy life and perform well
• Avoiding ejaculation and castration have been shown to increase longevity in animal models
• Distinguishing between cellular health and organism health
• 80/20 pieces, bootstrapping, and empirical feedback needed to find balance between delaying dying and optimizing living
• Mention of IV glutathione and explanation of IGF1
• Main Points:
• 80% of deaths in people over 40 are due to cardiovascular disease, cerebrovascular disease, cancer, or neurodegenerative disease.
• Caloric restriction has been shown to increase longevity in animals, but it is unclear if it is the reduction in calories or a subset of the type of calorie that is driving the increase.
• Exogenous growth hormone use is not recommended, as it could be problematic for susceptible individuals.
• HIV wasting patients have been shown to recover with high doses of anabolic steroids and growth hormones.
• Atrial fibrillation is an irregularly irregular beat of the heart that can be dangerous for older patients and those with lack of blood flow to the heart.
• James O'Keefe has suggested that long, exhausting cardiac activities can create a stretch in the heart that the right side can't compensate for as well as the left.
• This can lead to atrial fibrillation or worse fatal dysrhythmias, although it is rare.
• Peter Attia is hypocritical in his approach to cycling, as he acknowledges there is no upside and only downside, but he continues to do it for the pleasure it gives him.
• Peter Attia emphasizes the importance of balancing one's own happiness and sanity with the desire to live as long as possible.
• He recommends high intensity, heavy strength training as the most important type of exercise for metabolic health and aging.
• Strength is a combination of firing of the transmitter in the brain, impulse down to the motor end unit, and contraction.
• Strength deteriorates due to lack of use and aging, but can be delayed with specific training.
• Glute medius exercises are a good example of how conditioning deconditioned muscles can improve stability and make one feel younger.
• Summary:
• Peter Attia and Tim Ferris discuss the importance of managing stress in order to live a long, productive life. Peter Attia initially tried open monitoring and focused attention meditation, but found it too difficult. He then tried transcendental meditation, which was recommended to him by a mutual friend, and is still exploring it. Tim Ferris also found transcendental meditation to be the most useful technique for him. They both agree that it is important to find the type of meditation that works best for each individual.
• Peter Attia and Tim Ferris discuss the benefits of transcendental meditation and how it has been the most successful form of meditation for Tim.
• Tim found it helpful because he was held accountable, had a financial and social cost to not doing it, and it was made winnable.
• Peter's best $100 spent recently was on a rickshaw ride for his daughter, which gave her a look of joy.
• When asked who the first person that comes to mind when thinking of the word "punchable," Peter said he would like to punch the system of healthcare delivery in the United States.
• When asked who comes to mind when thinking of the word "successful," Peter mentioned two friends, John Griffin and Dennis Calabrese, who have achieved success in their careers and personal lives.
• Peter Attia is a doctor and lawyer who is passionate about longevity and fatherhood.
• He has written a "Longevity Manifesto" and is currently working on a "Fatherhood Manifesto".
• He is currently working on the "Fatty Liver Project" with NuSI, which is a nutritional experiment to see how diet affects children with fatty liver disease.
• The experiment is estimated to cost $1.2 million and is funded by 20 people donating $50,000 of their favorite appreciated stock.
• Fatty liver disease affects 7 million children and 40 million adults in the US, according to the CDC.
• The experiment could lead to more research on different types of visceral fat and metabolic conditions.
• Tim Ferris and Peter Attia discuss the concept of citizen philanthropy as it relates to science.
• People can become involved in giving to causes and organizations, and donating appreciated assets can be a more efficient way to do this.
• Peter Attia's blog, Eating Academy, has information about ketosis, exercise, science, and nutrition.
• People can learn more about Peter Attia and NuSI at NuSI.org.