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View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter Andy Galpin is a Professor of Kinesiology at California State University at Fullerton, where he studies muscle adaptation and applies his research to work with professional athletes. In this episode, Andy sets the foundation for the conversation by discussing the anatomy, microanatomy, and physiology of the muscle, including explaining what it actually means to undergo hypertrophy of the muscle. He then explains the difference between power, strength, speed, and hypertrophy and how those differences relate to what's happening at the cellular level and the functional unit level. Additionally, he discusses energy sources for muscles, the importance of protein for muscle synthesis, the various types of muscle fibers, and the factors that determine one’s makeup of muscle fibers. Finally, Andy wraps the conversation with how he would design a program for an untrained person committed to adding muscle and functional strength for longevity. We discuss: Andy’s path to expertise in exercise [3:30]; Contrasting strength, power, and force production and how they inform us about training for longevity [9:30]; Muscle energetics: Fuels that provide energy to muscles, and the importance of protein [17:45]; The structure and microanatomy of muscle, muscle fibers, and more [29:30]; Energy demands of skeletal muscle compared to other tissues in the body [39:45]; How a muscle contraction works and why it requires ATP [48:00]; Muscle fibers: modulation between fiber types with movement and changes in fibers with training and aging [53:15]; Andy’s study of twins demonstrating the difference in muscle fibers between a trained and untrained individual [1:02:30]; Microanatomy of fast-twitch and slow-twitch muscle fibers [1:11:15]; Factors that determine one’s makeup of muscle fibers and how adaptable they are with training [1:22:15]; Hypertrophy and what happens at the cellular level when a muscle grows [1:30:00]; How athletes quickly cut water weight and the rehydration process [1:37:30]; Different types of athletes [1:47:30]; Training advice for a hypothetical client who’s untrained and wants to add muscle and functional strength for longevity [1:49:45]; Changes in muscle and muscular function that occur with aging [1:53:45]; Training plan for the hypothetical client [1:59:30]; What drives muscle hypertrophy? [2:12:15]; How to properly incorporate isometric exercises into a workout [2:19:00]; Additional training tips: movement patterns, how to finish a workout, and more [2:25:45]; Ways to incorporate high heart rate exercise into a workout plan [2:28:45]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
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 answers questions related to the leading cause of death in both men and women—atherosclerotic cardiovascular disease (ASCVD). He highlights the most important risk factors for ASCVD, such as apoB, LDL, hyperinsulinemia, and Lp(a), and explains the mechanism by which they confer risk and how these factors are interrelated. Peter also dives deep into the data around apoB to try to answer the question of how much residual risk is conferred for ASCVD through metabolic dysfunction once you correct for apoB. He also looks at the data around lifetime risk reduction of ASCVD in the context of low apoB. 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 #42 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here. We discuss: A racecar analogy for understanding atherosclerotic cardiovascular disease [2:00]; Defining and differentiating apoB and LDL-C [10:00]; The interrelated nature of insulin levels, apoB, triglycerides, and ASCVD parameters [13:00]; Another way that hyperinsulinemia plays a role in endothelial dysfunction [18:00]; Why Peter uses the oral glucose tolerance test (OGTT) with all patients [20:15]; Is there any evidence that hyperinsulinemia is an independent contributor to ASCVD? [23:00]; Thinking through risk in the context of high-fat diets resulting in improved metabolic metrics but with an elevation of apoB/LDL-C [27:30]; Thinking through risk in the context of low apoB but higher than normal triglyceride levels [32:15]; The importance of lowering apoB for reducing ASCVD risk [38:15]; Data on men and women with familial hypercholesterolemia that demonstrates the direct impact of high apoB and LDL-C on ASCVD risk [47:45]; Importance of starting prevention early, calcium scores, and explaining causality [52:30]; Defining Lp(a), its impact on ASCVD risk, and what you should know if you have high Lp(a) [56:30]; Lp(a) and ethnic differences in risk [1:00:30]; Why someone with elevated Lp(a) should consider being more aggressive with apoB lowering strategies [1:05:00]; Addressing the common feeling of hesitancy to taking a pharmacologic approach to lower ASCVD risk [1:07:15]; Peter’s take on the 2022 Formula 1 season and thoughts on 2023 [1:15:15]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter Bill Perkins is one of the world’s most successful hedge fund managers and entrepreneurs, and the author of the bestseller, Die With Zero. In this episode, Bill unpacks the Die With Zero philosophy which challenges conventional thinking related to the balance between health, wealth, and time—the three variables important for fulfillment. Bill makes the case that we should strive for maximum net fulfillment rather than net worth (or even health). He argues that we need to optimize our life to have memorable experiences before it’s too late and that most people are over-saving and under-living. Bill also explains how one can apply the principles in Die With Zero to break out of “autopilot” and optimize their life to achieve maximum net fulfillment. We discuss: Bill’s upbringing, background, and first job on Wall Street [3:15]; A missed experience and feeling of regret that shaped Bill’s thinking [14:15]; Thinking in terms of time, and the relationship between money, time, and health [17:00]; Solving for net fulfillment and allocating your time based on the seasons of life [27:15]; How Bill thinks about risk, opportunity costs, and the difference between fear and risk tolerance [35:30]; Optimizing for fulfillment, finding purpose outside of work, and more [41:45]; Thinking about the order of experiences you want to have based on seasons of life [50:00]; Bill’s unique perspective on philanthropy and a more impactful way to give money away [54:45]; Applying the principles in ‘Die With Zero’ to maximize fulfillment [1:04:00]; How to break out of living life on autopilot [1:14:30]; When should your net worth peak? [1:18:00]; Taking calculated risks [1:21:30]; Bill shares a lesson from his incredible birthday [1:25:15]; How Bill’s philosophy has evolved since writing Die With Zero [1:34:00]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter Kellyann Niotis is a neurologist specializing in risk reduction strategies for the prevention or slowing of neurodegenerative disorders. In this episode, Kellyann provides an overview of the various diseases associated with neurodegeneration, including, but not limited to, Alzheimer’s disease, Lewy body dementia, and Parkinson’s disease. She goes in-depth on Parkinson’s disease, explaining its pathology, role in movement capacity, very early warning signs, and the role of anxiety and sleep. Similarly, she provides an in-depth discussion of Alzheimer’s disease, including the latest in screening, genetics, and tools/strategies for prevention. She ties the discussion together by explaining the differences and commonalities among the various diseases of neurodegeneration and the potential causative triggers, and she highlights the importance of early screening, cognitive testing, and taking the proper steps to lowering the risk of disease. We discuss: Kellyann’s background, training, and interest in the brain [2:30]; A primer on neurodegeneration: different types, prevalences, interventions, and more [5:30]; Overview of Parkinson’s disease and neuromuscular disorders including ALS [16:00]; Parkinson’s disease: early signs, diagnosis, genetics, causative triggers, and more [17:30]; Interventions to delay or avoid Parkinson’s disease, and the role of sleep and anxiety [31:15]; The challenge of standardizing early interventions for Parkinson’s disease without a clear biomarker [39:45]; Alzheimer’s disease: pathophysiology and the role of the amyloid and tau proteins [47:45]; Can PET scans be informative for diagnosing Alzheimer’s disease? [51:15]; Tau accumulation in the brain, tau scans, serum biomarkers, and possible early detection of Alzheimer’s disease pathology [57:00]; Cognitive testing explained [1:03:30]; The challenge of identifying the stage of the disease and why drugs have not shown efficacy [1:14:45]; The association between hearing loss and dementia [1:17:45]; The relationship between oral health and neurodegenerative diseases [1:21:30]; Genetic risk for Alzheimer’s disease [1:24:45]; What one’s mitochondrial haplotype can reveal about their risk of neurodegenerative disease [1:32:30]; The positive impact of exercise on brain health [1:37:00]; High blood pressure as a risk factor [1:40:00]; Why women are disproportionately affected by Alzheimer’s disease [1:44:15]; Final takeaways: the future of understanding neurodegenerative disease and further reducing risk [1:46:45]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter James Clear is the author of the New York Times bestseller Atomic Habits. His extensive research into human behavior has helped him identify key components of habit formation and develop the “Four Laws of Behavioral Change.” In this episode, James provides insights into how both good and bad habits are formed, including the influence of genetics, environment, social circles, and more. He points to changes one can make to cultivate more perseverance and discipline and describes the profound impact habits can have when tying them into one’s self-identity. Finally, James breaks down his “Four Laws of Behavioral Change” and how to use them to create new habits, undo bad habits, and make meaningful changes in one’s life. We discuss: Why James became deeply interested in habits [1:45]; Viewing habits through an evolutionary lens [6:00]; The power of immediate feedback for behavior change, and why we tend to repeat bad habits [9:15]; The role of genetics and innate predispositions in determining one’s work ethic and success in a given discipline [14:30]; How finding one’s passion can cultivate perseverance and discipline [23:15]; Advantages of creating systems and not just setting goals [29:15]; The power of habits combined with self-identity to induce change [36:30]; How a big environmental change or life event can bring on radical behavioral change [50:30]; The influence of one’s social environment on their habits [54:15]; How and why habits are formed [1:00:30]; How to make or break a habit with the “Four Laws of Behavior Change” [1:09:30]; Practical tips for successful behavioral change—the best strategies when starting out [1:16:15]; Self-forgiveness and getting back on track immediately after slipping up [1:30:30]; Law #1: Make it obvious—Strategies for identifying and creating cues to make and break habits [1:39:45]; Law #2: Make it attractive—examples of ways to make a new behavior more attractive [1:47:45]; Law #3: Make it easy—the 2-minute rule [1:58:45]; Law #4: Make it satisfying—rewards and reinforcement [2:03:30]; Advice for helping others to make behavioral changes [2:06:00]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter Layne Norton holds a Ph.D. in nutritional sciences and is a physique coach, natural bodybuilder and powerlifter, and two-time previous podcast guest. In this episode, Layne discusses his training as a powerlifter and shares training principles that non-powerlifters can apply to improve muscle strength and mass. Layne goes in-depth on creatine supplementation, including the benefits for lean mass and strength, and addresses the common arguments against its regular usage. Additionally, Layne touches on many areas of nutrition, including how his opinions have changed on certain topics. Layne also touches on the subjects of protein, fiber, and fat in the diet, as well as the different tools and dietary approaches for energy restriction. We discuss: The sport of powerlifting and Layne’s approach during competitions [2:30]; Training for strength: advice for beginners and non-powerlifters [13:15]; Low-rep training, compound movements, and more tips for the average person [23:15]; How strength training supports longevity and quality of life: bone density, balance, and more [28:15]; Peak capacity for strength as a person ages and variations in men and women [33:00]; Effects of testosterone (endogenous and exogenous) on muscle gain in the short- and long-term [36:45]; How Layne is prepping for his upcoming IPF World Masters Powerlifting competition [44:00]; Creatine supplementation [54:30]; How important is rep speed and time under tension? [1:05:30]; Validity of super slow rep protocols, and the overall importance of doing any exercise [1:12:45]; Navigating social media: advice for judging the quality of information from “experts” online [1:23:00]; Layne’s views on low-carb diets, the tribal nature of nutrition, and the importance of being able to change opinions [1:34:45]; Where Layne has changed his views: LDL cholesterol, branched-chain amino acid supplementation, intermittent fasting, and more [1:42:00]; The carnivore diet, elimination diets, and fruits and vegetables [1:55:15]; Fiber: Layne’s approach to fiber intake, sources of fiber, benefits, and more [2:00:15]; Confusion around omega-6 polyunsaturated fatty acids and the Minnesota Coronary Experiment [2:05:00]; Layne’s views on fats in the diet [2:13:00]; Flexible dieting, calorie tracking, and the benefits of tracking what you eat to understand your baseline [2:18:00]; The nutritional demands of preparing for a bodybuilding show [2:30:45]; The psychological effects of aging and changes to one’s identity [2:42:00]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter Chris Hemsworth, best known for his role as Thor in the Marvel movies, joins Peter to discuss his recent work in the docuseries called Limitless. In the docuseries, Chris undertook extreme challenges to explore his physical and emotional limits and gain insights into longevity. In this episode, Chris discusses these many challenges—from fasting to arctic swims to 100-foot rope climbs—as well as the insights that he gained from each. Peter, who also played a role in the docuseries, guides Chris through the science of longevity, including what Chris’s APOE-ε4 genotype means for his risk of Alzheimer’s disease. Additionally, Chris describes how his outlook on health, happiness, work-life balance, and more have changed from his experience on Limitless. We discuss: Limitless: how Chris got involved and his overall experience filming the docuseries [3:00]; “Fasting” ‒ ep. 3 of Limitless in which Chris attempts a 4-day fast [8:15]; “Shock” ‒ ep. 2 of Limitless in which Chris swims in the Arctic Ocean [12:15]; Cold exposure: the potential physical and mental benefits [19:30]; “Strength” ‒ ep. 4 of Limitless in which Chris explores how muscle can improve longevity [21:15]; The APOE-ε4 genotype and Alzheimer’s disease risk [31:30]; How Chris uses sauna [39:45]; “Acceptance” - ep. 6 of Limitless in which Chris explores the meaning of life by contemplating death [42:15]; Chris’s new perspective on work-life balance [52:00]; “Stress-Proof” - ep. 1 of Limitless in which Chris learns about the impact of stress and how to manage it [54:30]; Chris reflects on his intrinsic motivation driven by both fear and purpose [58:00]; Chris reflects on his career arc and how his presence as an actor has evolved [1:01:15]; How Chris’s outlook has changed since filming Limitless [1:05:00]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
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 answers a number of questions on optimizing sleep. He describes his pre-bedtime routine, how he utilizes a sauna, and his current regimen of medicines and supplements for improving sleep time and quality. He goes in depth on each of the molecules that have shown promise in boosting sleep, including their mechanisms of action as well as any noteworthy contraindications. Peter also discusses sleep wearables, including both the positives and potential negatives of using such trackers, 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 on our website at the AMA #42 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here. We discuss: Peter’s current pre-bedtime routine [3:30]; Sauna: Peter’s routine, sleep benefits, and tradeoffs [10:45]; Importance of keeping an open mind as new information arrives [16:15]; Importance of reducing stimulation leading up to bedtime [19:30]; Medications that can enhance sleep: mechanisms of action, contraindications, risks, and Peter’s regimen [20:30]; Why medications can enhance sleep, but should not replace good sleep habits [34:45]; Sleep supplements: mechanisms of action, contraindications, and Peter’s regimen [37:30]; Temperature during sleep, cooling devices, mattresses, and more [53:00]; A tip to help avoid straining your back in the morning [59:15]; Contrasting polysomnography with wearable sleep trackers [1:00:45]; Sleep tracking wearables: interpreting metrics, and the pros and cons of trackers [1:04:30]; Final takeaways on sleep [1:16:30]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter Alton Barron is an orthopedic surgeon specializing in the shoulder, elbow, and hand. In this episode, Alton breaks down the anatomy of the upper extremities and discusses the most common injuries associated with this area of the body. He explains in detail how he examines the shoulder, elbow, and hand to find the source of the pain and lays out the non-surgical and surgical treatment options as well as the factors that determine whether surgery is appropriate. Additionally, Alton describes the surgical procedures that, when done appropriately, can lead to tremendous reduction of pain and improvement in function. We discuss: Alton’s path to orthopedic surgery [3:45]; Evolution of orthopedics and recent advances [8:45]; Anatomy of the upper extremities [13:30]; Rotator cuff injuries, shoulder joint dislocation, and more [21:15]; Peter’s shoulder problems [31:30]; The structure of the biceps and common injuries [35:30]; Labrum tears in the shoulder and natural loss of cartilage with usage and time [38:15]; Shoulder evaluation with MRI vs. physical exam, diagnosing pain, and when to have surgery [41:30]; How anatomical variation can predispose one to injury and how screening may help [50:30]; Pain generators in the shoulder, and the important nuance of the physical exam [56:00]; Frozen shoulder [1:05:15]; Shoulder pain that originates in the neck [1:11:15]; Surgical treatments for a labral tear, and factors that determine whether surgery is appropriate [1:16:00]; Repairing the rotator cuff [1:29:15]; Are platelet-rich plasma (PRP) injections or stem cells beneficial for healing tears? [1:38:15]; Repair of an AC joint separation [1:45:15]; Total shoulder replacement [1:55:45]; The elbow: anatomy, pain points, common injuries, treatments, and more [2:05:30]; How Tommy John surgery revolutionized Major League Baseball [2:17:15]; History of hand surgery and the most significant advancements [2:22:15]; The hand: anatomy, common injuries, and surgeries of the hand and wrist [2:29:30]; Carpal tunnel syndrome [2:40:00]; Other common injuries of the hand and forearm [2:47:15]; Grip strength [2:55:15]; Arthritis in the hands [2:59:30]; Trigger finger [3:07:45]; Nerve pain, numbness, and weakness in the upper limbs [3:14:00]; The Musician Treatment Foundation [3:22:00]; Gratitude and rucking [3:34:15]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter Gerald Shulman is a Professor of Medicine, Cellular & Molecular Physiology, and the Director of the Diabetes Research Center at Yale. His pioneering work on the use of advanced technologies to analyze metabolic flux within cells has greatly contributed to the understanding of insulin resistance and type 2 diabetes. In this episode, Gerald clarifies what insulin resistance means as it relates to the muscle and the liver, and the evolutionary reason for its existence. He goes into depth on mechanisms that lead to and resolve insulin resistance, like the role of diet, exercise, and pharmacological agents. As a bonus, Gerald concludes with insights into Metformin’s mechanism of action and its suitability as a longevity agent. We discuss: Gerald’s background and interest in metabolism and insulin resistance (2:30); Insulin resistance as a root cause of chronic disease (6:30); How Gerald uses NMR to see inside cells (10:00); Defining and diagnosing insulin resistance and type 2 diabetes (17:15); The role of lipids in insulin resistance (29:15); Confirmation of glucose transport as the root problem in lipid-induced insulin resistance (38:15); The role of exercise in protecting against insulin resistance and fatty liver (48:00); Insulin resistance in the liver (1:05:00); The evolutionary explanation for insulin resistance—an important tool for surviving starvation (1:15:15); The critical role of gluconeogenesis, and how it’s regulated by insulin (1:20:30); Inflammation and body fat as contributing factors to insulin resistance (1:30:15); Treatment approaches for fatty liver and insulin resistance, and an exciting new pharmacological approach (1:39:15); Metformin’s mechanism of action and its suitability as a longevity agent (1:56:15); and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
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 answers a wide variety of questions, starting with a discussion on the evolution of medicine and the hopeful transition to “Medicine 3.0.” Peter recounts his unique career path and explains how he assesses risk and utilizes frameworks for decision-making. He also describes how he prioritizes his health while navigating the stresses of life, and he reviews the most exciting developments in the aging and longevity space. He finishes with some rapid-fire questions on cold plunging, strategies for lowering apoB levels, designing an exercise program for beginners, and 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 on our website at the AMA #41 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here. We discuss: The evolution of medicine and the transition to “Medicine 3.0” [3:00]; Peter’s unorthodox career arc and what led him to this point [11:45]; What does Peter consider to be his superpowers? [22:15]; How Peter thinks about risk and explains it to his patients when making medical decisions [26:45]; The advantage of using frameworks for decision-making [37:00]; What advice would Peter give his 30-year old self? [42:15]; Why longevity is such a hard problem to solve [42:30]; The most impactful developments in the field of longevity and aging in the last 5 to 10 years [46:15]; What is Peter most excited to see develop in the health and longevity space in the next few years? [51:30]; Prioritizing healthy habits while navigating the stresses of life and time constraints [53:45]; How Peter navigates periods of high stress [58:00]; What fitness watch did Peter recently purchase? [1:03:45]; Potential benefits of cold plunging [1:05:15]; Advice for someone beginning an exercise program [1:07:30]; Strategies and tactics to lower apoB levels [1:09:00]; Interesting studies and books Peter has recently read [1:11:30]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter Erin Michos is an internationally-known leader in preventive cardiology and women’s cardiovascular health. In this episode, Erin discusses current trends in cardiovascular disease (CVD) through the lens of female biology and the observation that major adverse cardiac events in both sexes are on the rise. She walks through risk factors including LDL-cholesterol, apoB, and Lp(a) and makes the case for the importance of early preventative measures. She explains various interventions for reducing risk including a discussion of statins, GLP-1 agonists, PCSK9-inhibitors, and drugs that lower Lp(a). She goes in-depth on female-specific factors that contribute to CVD risk such as pregnancy, grand multiparity (having five or more children), oral contraceptives, menopause, and polycystic ovary syndrome (PCOS). Additionally, she explains her approach with patients as it relates to the use of hormone replacement therapy and provides advice for people wanting to lower risk both through lifestyle changes and medications. We discuss: Erin’s background in preventive cardiology and women’s health [2:30]; Recent trends in cardiovascular disease in women, mortality data, and how it compares to cancer [5:15]; Why early preventative measures are critical for cardiovascular disease risk [13:15]; ApoB as a causal agent of CVD, and why high apoB levels are not being aggressively treated in most cases [19:45]; The rising trend of metabolic syndrome and other factors contributing to the regression in progress of reducing cardiac events [27:00]; GLP-1 agonists—Promising drugs for treating diabetes and obesity [33:30]; Female-specific risk factors for ASCVD (pre- and post-menopause) [37:15]; Polycystic ovary syndrome (PCOS): prevalence, etiology, and impact on metabolic health, lipids and fertility [47:00]; The effect of grand multiparity (having 5+ children) on cardiovascular disease risk for women [52:30]; The impact of oral contraceptives on cardiovascular disease risk [55:00]; The effect of pregnancy on lipids and other metabolic parameters [58:45]; The undertreatment of women with familial hypercholesterolemia (FH) and how it increases lifetime risk of ASCVD [1:02:00]; How concerns around statins have contributed to undertreatment, and whether women should stop statins during pregnancy [1:09:45]; How Erin approaches the prescription of statins to patients [1:16:00]; PCSK9 inhibitors and other non-statin drugs [1:21:15]; Advice for the low- and high-risk individual [1:28:30]; The impact of nutrition, stress, and lifestyle on lipids and CVD risk [1:31:00]; Lp(a) as a risk enhancer for cardiovascular disease [1:41:15]; The effect of menopause on cardiovascular disease risk [1:50:30]; How Erin approaches decisions regarding hormone replacement therapy (HRT) for her patients [1:55:30]; The urgent need for more data on women’s health [2:03:30]; Erin’s goal of running a marathon in every state [2:09:45]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
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 of The Drive, we have pulled together a variety of clips from previous podcasts about cardiovascular disease to help listeners understand this topic more deeply, as well as to identify previous episodes which may be of interest. In this episode, Peter highlights the importance of understanding cardiovascular disease and why early intervention is critical. He also provides a primer on lipoproteins and explains the fallacy of the terms “good cholesterol” and “bad cholesterol.” Allan Sniderman discusses the metrics measured in routine blood work – along with the limitations of those standard panels – before explaining why apoB is a superior metric for determining risk. Additionally, Tom Dayspring explains the causal role of apoB in atherosclerotic cardiovascular disease (ASCVD) and the therapeutic goals for apoB concentration, and Peter explains how early and aggressive lowering of apoB could change the landscape of cardiovascular disease prevention. We discuss: The importance of understanding atherosclerosis early in life [2:25] Defining ASCVD, its causes, and the role of cholesterol [8:00]; Why early prevention of atherosclerosis is critical [13:45]; Preventing atherosclerosis—two fatal flaws with the “10-Year Risk” approach [16:00]; Intro to lipids and lipoproteins: why there is no “bad” or “good” cholesterol [23:00]; Limitations of standard blood panels [35:45]; How Mendelian randomization is bolstering the case for apoB as the superior metric for risk prediction [39:30]; Therapeutic goals for apoB concentration [58:15]; How early and aggressive lowering of apoB could change the course of ASCVD [1:10:45]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter Holly Baxter is an accredited practicing dietician (APD), competitive bodybuilder, fitness and nutrition educator, and coach. In this episode, Holly discusses her experience as an athlete and competitive bodybuilder. She also opens up about her struggles with mental health, her long battle with an eating disorder, and the important steps she’s taken in her road to recovery. From there, she explains how she would design a nutrition and training program for a hypothetical female client wanting to improve her physique through the addition of lean muscle and loss of body fat. She explains reasonable expectations for gaining muscle and the value of a “reverse diet” for maintaining weight loss, and she shares her favorite exercises. She also talks through some female-specific training considerations such as programming, reps, volume, hormone replacement therapy, and more. We discuss: Holly’s background and passion for sports and nutrition [2:00]; Holly’s struggle with depression and an eating disorder [4:30]; Reflecting on her eating disorder, body image, and a wake up call [18:15]; Road to recovery: therapy, meditation, self-compassion, and a breakthrough [27:45]; The effect of competitive bodybuilding on women [39:00]; Holly’s competition prep and how she guides her clients wanting to improve their physique [46:45]; Training principles for muscle hypertrophy [57:00]; Training advice for an inexperienced person wanting to build muscle [1:01:30]; Training program for a hypothetical woman wanting to add lean muscle and lose body fat [1:04:15]; Lower body lifts: Holly’s approach to leg workouts with clients [1:14:00]; Upper body exercises: Holly’s approach with her clients [1:24:45]; Importance of nutrition and protein during the muscle building phase [1:34:00]; Changes to nutrition and training during a fat loss phase [1:40:30]; A “reverse diet” after a cutting phase to help prevent weight gain [1:49:45]; Female-specific training considerations: programming, reps, volume, sex hormones, and more [1:53:15]; Holly’s future in bodybuilding and helping struggling women [2:05:45]; Looking forward: Holly’s focus on longevity, bone mineral density, and wellness [2:08:15]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
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 discusses the importance of understanding body composition and explains how to interpret the most important metrics revealed by a DEXA scan, such as lean muscle tissue mass, visceral adiposity tissue mass, bone mineral density, and more. He discusses common concerning trends in these metrics as well as strategies to address them. He goes through DEXA scan results of both male and female patient case studies and explains the prescribed intervention for each patient. Additionally, Peter answers numerous questions about dietary protein including how much we need, when we need it, and how intake should be divided throughout the day to optimize muscle protein synthesis. Finally, Peter provides his updated point of view on time-restricted feeding and fasting and how his personal approach and recommendations for patients has evolved. 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 on our website at the AMA #40 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here. We discuss: Interpreting DEXA scans: important metrics, radiation levels, and more [2:15]; DEXA metrics: Bone mineral density (BMD) [12:00]; DEXA metrics: Visceral adipose tissue (VAT) [14:30]; DEXA metrics on lean tissue: appendicular lean mass index (ALMI) and fat-free mass index (FFMI) [20:45]; Concerning trends in BMD, VAT, & muscle mass revealed through DEXA scans [24:15]; Muscle and lean tissue loss with age and how to overcome anabolic resistance [29:15]; Female patient case studies: DEXA scan results and prescribed interventions [35:00]; Male patient case studies: DEXA scan results and prescribed interventions [42:45]; Protein consumption: recommended daily intake, Peter’s personal approach, timing around workouts, and more [48:15]; What to look for with protein supplements [53:15]; Protein intake: optimal timing and how it should be divided throughout the day [55:30]; Time-restricted feeding (TRF): Peter’s updated perspective [57:45]; Three strategies for reducing energy intake in over-nourished patients [1:03:15]; Prolonged fasting: potential benefits and tradeoffs [1:07:15]; A protein-supplemented version of time-restricted feeding (TRF) [1:09:30]; Theories about time-restricted feeding (TRF) and its positive influence on sleep and circadian rhythm [1:12:00]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter Arthur Brooks is a social scientist, professor at Harvard University, a columnist for The Atlantic, and the bestselling author of From Strength to Strength. In this episode, Arthur explains how intelligence changes as we get older, and how to take advantage of this to maximize our happiness and success. He distills truths about the meaning of happiness and its three main components: enjoyment, satisfaction, and purpose. He goes into detail about many of the keys to a happy life, including the importance of cultivating virtuous relationships. On the flip side, Arthur warns of the dangers of social comparison, “success addition,” and the four worldly idols—money, fame, power, and pleasure—that drive many of us. Additionally, Arthur provides examples of exercises that can guide one in the right direction, overcome fear, and cultivate habits that can lead to a happier life. We discuss: Insights from Arthur’s career as a professional French horn player [2:15]; A radical shift away from music to a Ph.D. in quantitative policy [12:00]; Personal experience with shifting intelligence: fluid vs. crystallized intelligence [16:45]; An epiphany from a chance encounter on an airplane that shaped Arthur’s thinking [22:00]; The three main “macronutrients” of happiness [25:00]; Exploring the “purpose” component of happiness [29:00]; The importance of having a partner and true friendships [32:00]; The makeup of a true friendship, and why men tend to struggle with making real friends [36:45]; The “satisfaction” component of happiness and the importance of “wants management” [42:15]; The tyranny of social comparison [47:45]; Insights into happiness through Chinese art, and the concept of a “reverse bucket list” [51:45]; An exercise demonstrating the importance of relationships with others and the need to work on them [55:30]; The four main idols that drive us: money, fame, power, and pleasure [1:01:15]; Success addiction, workaholism, and their detriment to happiness [1:04:00]; A radical approach to overcome fear—the antithesis to love and happiness [1:14:00]; Ancient Hindu advice for the perfect life [1:26:30]; The end result of getting caught in the 4 idols [1:31:45]; The complexity of happiness [1:33:30]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter Michael Easter is the author of the bestseller, The Comfort Crisis. He’s also a journalist, Professor of Journalism at UNLV, and a leading voice on how humans can integrate modern science and evolutionary wisdom for improved health, meaning, and performance in life and at work. In this episode, Michael first talks about his upbringing, including his parents' struggle with alcoholism, his father leaving when he was young, and how these things impacted Michael's own struggle with alcoholism. He explains what led to his realization that we are in a “crisis of comfort” and how the removal of many of life’s discomforts through advancements in modern society may actually be a leading contributor to many of our most urgent physical and mental health issues. He explains the benefits of challenging oneself and the immense positive carryover which can come from doing things we find difficult. He describes the consequences of technology like smartphones, which have effectively eliminated boredom—a discomfort that comes with many benefits. He tells the story of a profound experience at an elk hunt that changed Michael’s thoughts around life and death, how happiness can thrive in places without all of the modern comforts of the West, and why we’re hardwired for stress and what to do about it. They conclude with a conversation around rucking, an activity with many physical and mental benefits. We discuss: The value in doing something difficult [2:30]; Michael’s upbringing with a single parent and alcoholism [5:45]; Michael’s battle with alcoholism and his experience with quitting drinking [10:00]; Origin of the idea that we are in a crisis of comfort [20:30]; The death of boredom in modern society [28:45]; The benefits of boredom [36:00]; The value of disconnecting and being in nature [39:15]; Changing the dynamic of how we think about food and the story of Peter’s daughter’s first hunt [43:45]; How a profound experience at an elk hunt changed Michael’s thoughts about life and death [49:15]; How happiness can thrive in places without all of the modern comforts of the West [57:15]; Why we’re hardwired for stress, and the responsibility that comes with our level of comfort [1:05:30]; How perspective on the timescale of our lives in relation to history can impart positive changes [1:14:00]; The benefit of challenging oneself and the positive carryover it can have [1:19:45]; The many benefits of rucking [1:28:45]; Tips for rucking: ideal load, type of pack, and other considerations [1:38:00]; Parting thoughts on the downside of comfort and benefits of difficult things [1:43:00]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter Don Layman is a Professor of Food Science and Human Nutrition at the University of Illinois Urbana-Champaign. He has spent the past 40 years investigating the role of dietary protein in muscle protein synthesis. In this episode, Don describes how his decades of research have shaped his thinking around protein, muscle, anabolic factors, metabolism, and more. He explains the recommended dietary allowance (RDA) for protein: what it is, how it came about, and how it should serve only as a guide for the minimum protein necessary for survival rather than as an optimal level of protein intake. He provides an overview of the essential amino acids, explains the nuances of animal versus plant protein, and provides insights for determining protein quality, absorption rates, and how to best track your intake. He discusses the ideal timing of protein intake in relation to resistance exercise, how protein should be distributed among meals, and how limitations in protein utilization per sitting can impact those practicing time-restricted eating. Additionally, Don shares results from his clinical trials, including how a high-protein diet fared in terms of fat loss, and explains the differences in protein utilization between adolescents and adults and how the problem of reduced efficiency of protein utilization in older adults can be overcome. We discuss: Don’s background: from growing up on a farm to studying nutritional biochemistry [2:30]; Don’s philosophy on nutrition, muscle, and metabolism [6:30]; The controversial relationship between saturated fat and atherosclerosis [18:15]; The basics of protein and amino acids [25:45]; Origin and limitations of the current recommended dietary allowance (RDA) for protein intake [32:15]; Protein sources: determining quality, absorption rates, and how to track intake [41:15]; Leucine, lysine, and methionine: three important essential amino acids [48:00]; The vital role of ruminant animals in the production of quality protein [53:15]; The differing needs and impacts of dietary protein for a 16-year old compared to a 65-year old [59:30]; Consequences of protein deficiency in childhood [1:06:30]; Muscle protein synthesis: ideal timing, small meals vs. big meals, and more [1:12:45]; Protein needs of children [1:19:45]; How important is timing protein intake around training? [1:24:15]; The role of leucine in fatty acid oxidation by muscle [1:28:15]; High protein diets for fat loss: Results from Don’s clinical trials [1:31:30]; Influence of industry funding on nutrition studies [1:43:45]; Don’s thoughts on plant-based and synthetic “meats” [1:48:45]; Problems with epidemiological studies of dietary protein [1:56:30]; More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
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 describes what it means to exercise with the goal of longevity in mind, including his personal goals, exercise framework, and how he is optimizing for what he refers to as the “Centenarian Decathlon.” He explains the various types of cardiovascular training and how to partition your time between intensity levels (i.e., zone 2 training vs. zone 5 training) to optimize cardiorespiratory benefit. Additionally, Peter dives deep into questions around VO2 max, such as why it’s critical for longevity, how to improve it, and the value in starting VO2 max optimization early in life. 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 on our website at the AMA #39 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here. We discuss: Exercise topics to be discussed [1:45]; Peter’s exercise goals, and the Centenarian Decathlon [4:00]; Peter’s exercise framework, and how he tracks his MET hours [8:30]; How to partition your time between low and high intensity exercise to optimize results [13:15]; Zone 2 exercise: ideal training methods and how to determine your zone 2 level [23:15]; Rucking as a versatile mode of exercise [31:45]; Zone 5 exercise: modalities of training, time per week, and other considerations [34:30]; The importance of knowing your VO2 max, and methods for estimating it [38:15]; Training methods for improving VO2 max, and realistic targets for improvement [46:00]; Relationship of VO2max with age and the required fitness levels for daily life activities and exercise [52:30]; The training necessary to maintain an elite VO2 max throughout life [58:45]; The value in starting early: the compounding nature of fitness [1:01:45]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter Dr. Matt Kaeberlein is a globally recognized expert on the biology of aging and recurring on The Drive. In this episode, Matt explains his research findings on nutrition as it relates to aging and longevity, including the results from his recent review article in Science. From there, he and Peter dive deep into the literature on calorie restriction (CR), explaining the nuance, benefits for lifespan and healthspan, and potential downsides of CR. He discusses the epigenetic changes that occur with age and potential benefits and downsides of epigenetic reprogramming, often viewed as a panacea for reversing aging. Matt also explains the impact of dietary protein on aging, including the interesting dichotomy around how protein, a critical macronutrient, and rapamycin, a geroprotective molecule, have opposite effects on mTOR. Additionally, he talks about low-protein vs. high-protein diets and their effects on muscle mass and mortality, as well as the impact of IGF-1 signaling and growth hormone on lifespan. We discuss: Challenges with understanding the effects of nutrition and studying interventions for aging [3:30]; How Peter’s and Matt’s convictions on nutrition and thoughts optimal health have evolved [8:15]; Calorie restriction for improving lifespan in animal models [16:15]; Utility of epigenetic clocks and possibility of epigenetic reprogramming [22:00]; Mutations and changes to the epigenome with aging [31:45]; Epigenetic reprogramming: potential benefits and downsides and whether it can work in every organ/tissue [35:15]; First potential applications of anti-aging therapies and tips for aging well [43:00]; Impact of calorie restriction on the immune system, muscle mass, and strength [47:00]; Insights from famous calorie restriction studies in rhesus macaques [55:00]; An evolutionary perspective of the human diet [1:03:45]; Antiaging diets: Separating fact from fiction—Matt’s 2021 review in Science [1:12:30]; Mouse models of time-restricted feeding in the context of calorie restriction [1:19:30]; Nutritional interventions that consistently impact lifespan in mice, and concerns around efficacy in humans [1:27:00]; Differing impact of calorie restriction when started later in life [1:31:00]; Lifespan extension with rapamycin in older mice [1:37:15]; Relationship between protein intake and aging, and mouse studies showing protein restriction can extend lifespan [1:43:30]; Impact of protein intake on mTOR, and why inhibition of mTOR doesn’t cause muscle loss [1:50:45]; Low-protein vs. high-protein diets and their effects on muscle mass, mortality, and more [1:55:30]; The impact of IGF-1 signaling and growth hormone on lifespan [2:06:30]; Parting thoughts on the contribution of nutrition to healthspan and lifespan [2:19:45]; More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
Comments (105)

Ryan Wanner

Fantastic episode. Very eye opening.

Jul 6th
Reply

JoJosXKeto -bio

I love this and I hope you do these more often!

Jun 8th
Reply

snsɐuɐ ƃuǝɥɔ

What a great way to offer an overview of your content. I'm very disciplined at listening to the full episodes however I know a lot of people aka my husband who cannot seem to digest the whole thing. These snippets make the whole topic super eqsy to understand and, furthermore, to incentivize acquiring more knowledge. Can't wait for the digital curriculum! ♡

Jun 7th
Reply

Ruby B

LOVED the mashup format. Much easier to parse out the bottom line opinions that are personally relevant. More, please!

May 10th
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Jay Goldmintz

Excellent podcast. Can someone please explain this to our politicians in Canada.

Jan 3rd
Reply

Mia Teodocio

I loved this episode!

Dec 26th
Reply

Mart

the US Government and the Medical Industry are just as corrupt as you believe China to be... When people realize half of the big pharma companies are worse than Monsanto things may get ugly.

Aug 22nd
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Carlos T.

It was such an amazing conversation! Loved it!

Aug 21st
Reply

km

👎

Aug 3rd
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Brian Dravis

another corrupt journalist who can't separate political bias from the truth.

Jul 24th
Reply

Ali Gangji

Framing it as an issue of Chinese transparency and calling the Chinese government authoritarian a dozen times doesn't make you sound very unbiased. The US government is not and would not be more transparent if the roles were reversed and the Biden administration wants US intelligence to lead the investigation.

Jul 21st
Reply

Maria Prado

That is so wowww conversation for me, my life is tracking my glucose since the beginning of the this year, i dont have diebetes but my mother does and she always saying that i will not get save from that becouse all family has after 60 .. But i will not gonna be diebetic so i eat as one 😂 i am a geek glucose freak.. But my doctor doesnt understands me so i prefer to spend money on ketons and glucose stripes than shoes and clothes... Thanks for Sharing always i make me fell that i am not alone.

May 17th
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Brian Dravis

wow, scary episode. I pray this demonic oligarch is never in a position of power!

May 10th
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Maria Prado

Omg t.. so importante to me to know I am pretty sure thal all my struggles is coming for insuline resistence as a genetic predesposition of bad function of pancreas of my family at in the old age being diabetic and dying with alzaihmer. Thanks Peter 🙏

Mar 1st
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ID19405129

Really informative episode...especially with the “shame/grandiose issue”....thank you!!

Feb 25th
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Christina Totman

Such a powerful story. I was surprised and disappointed that, given the podcast is about longevity, so little attention was given to Neil's heart attack at 36, ostensibly due to unresolved PTSD. The show would have benefitted from further discussion about how those of us with trauma/PTSD need to address the issue in order to live a longer and more fulfilling life.

Dec 28th
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Abio Genesis

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Nov 19th
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Abio Genesis

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Nov 17th
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Abio Genesis

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Nov 17th
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Abio Genesis

+

Nov 14th
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