Bernoulli's Fallacy
I've recently finished listening to an audio book called Bernoulli's Fallacy by somebody called Aubrey Clayton, who claims that the current model of null hypothesis significance testing is logically incoherent because it ignores the prior probability of the truth of the hypothesis. He further goes on to claim that this is creating significant problems for medical research. We'd be really interested to get Peter's views on this in an AMA.
Exercise depleted sleep....
I'm a strength and conditioning coach and I usually start work at 7am, to facilitate my bike training I rise at 4am 5/day a week, walk my dog and then hop on my stationary bike for at least 30mins for a HITT & Hills ride. Even with going to sleep at 9, after having dinner and spending time with my family, I rarely hit the 6hr mark of quality sleep. My question is should I prioritize sleep over exercise(which would be very hard for me to do, LOL) or assume the reason for me not getting enough sleep by exercising outweighs the detrimental effect of being moderately sleep deprived? Thanks for your input! I've been a long time admirer & subscriber and heading into my 73rd year, so every little thing I do that can make my healthspan better I'm all in!
Living at Altitude
Hi Peter, I've really enjoyed your discussions on altitude, particularly Episode #77 on sleep at altitude, Episode #85 with Iñigo San Millán on "live high, train low," and Episode #199 with Ryan Hall, where he described growing up at altitude, training at sea level twice a week, and later sleeping at 9,400 feet in Crested Butte while preparing for marathons. I live year-round at 9,200 feet in Colorado and travel to Dallas frequently for work, so I unintentionally follow a similar "live high, train low" approach. I'm a recreational endurance athlete, running several 10Ks and a couple of half marathons each year, with an occasional marathon. Like you've discussed, I consistently see lower overnight oxygen saturation at home, my sleep feels less restorative, and my hematocrit runs around 50%. My resting heart rate and HRV often improve when I'm at lower elevation, although not always. The performance benefits of altitude seem clear, but I'm less certain about the long-term health implications. If your primary goal were maximizing healthspan rather than athletic performance, would you choose to live at 9,200 feet or at sea level for the next 30 years? How do you personally think about the tradeoff between the cardiovascular and performance benefits of chronic altitude exposure versus the potential downsides of poorer sleep, chronic nocturnal hypoxia, increased hematocrit, and sympathetic activation? Are there specific biomarkers or tests you would monitor in someone like me to know whether altitude is helping or hurting long-term health? As a second question, many friends and family from lower elevations struggle when they visit us. Even climbing a flight of stairs can be surprisingly difficult for the first day or two. We've found that hydration, pacing themselves, and even canned oxygen seem to provide some temporary relief, and I've personally found that Excedrin helps with altitude headaches. What evidence-based advice do you have for people visiting high elevations like 9,200 feet? Are there interventions—such as acetazolamide, supplemental oxygen, specific supplements, hydration strategies, or other approaches—that you think are genuinely effective, and which commonly recommended remedies are mostly placebo?
You keep mentioning progressive overload. What is it?
For someone who is 70+ what does progressive overload mean? Supposing that I can just manage 3 X15 with a weight (say 35lbs). Does that mean that I should go up to 40lb and try to do 3X10? I can certainly exhaust myself by trying 3 X16 at the old weight. So how does one manage the number of reps vs weight?
Aging Athlete- Bradycardia & heart health
I am a 57 year old female and have a low resting heart rate (50 and dips into 40s when sleeping) combined with low blood pressure 105/60. These have been my vitals for the past 10+ years as a result of cardio training (which I continue to do but not as long or vigorous as when I was younger. I do lift weights as well). I’ve read that bradycardia from athletic training can lead to afib as you age. Is that true? Are there other potential heart conditions tied to bradycardia that I should pay attention to as I age?
Adjunctive lifestyle care for people already diagnosed with cancer
Adjunctive lifestyle care for people already diagnosed with cancer is so poorly addressed: using exercise, nutrition, muscle preservation, and carefully supervised metabolic interventions to improve treatment tolerance, quality of life, recurrence risk, and longevity. can you provide some guidance in this area. It would be valuable to so many.
GLP-1
Now that there is multi-year history and usage data on use of GLP-1 inhibitors for weight loss, is there an updated view on the overall risk-reward? The 2023 podcast had highlighted significant side-effects and seemed less keen on use of GLP-1 inhibitors for weight loss. Is there an updated view on the topic?
Kidney stone ama
Hi. I have reviewed the ama back catalog and cannot find an ama or guest episode dedicated to this topic. As a someone who has had multiple stones in the past and knowing the high prevalence of this issue, is Peter and the team willing to do an amazing job episode or guest discussion on this topic?