Nasal breathing
I'm a 73 year old who cycles, hikes and cross-country skis. After reading MInd, Body, Sport by John Douillard a few years ago I was influenced to try nasal breathing while I'm engaged in the above mentioned activities. It took quite a while to get accustomed to the nasal breathing but now I do it when working out solo, as opposed to doing above activities with my buddies when we're likely to be chatting along the way. I'm not looking for better performance necessarily from nasal breathing. I'm really wondering if it's more beneficial health-wise than regular breathing. I'm very interested in your thoughts. I've learned so much from your podcast. Thank you for your work!
Is it better for skin health not to use anti-perspirants?
Some research groups claim these products negatively affect the local skin microbiome and it is better for skin health not to use them. How does that balance against "social" aspects of stronger/bad body odor? Links: https://biblio.ugent.be/publication/5737464, https://www.sciencedirect.com/science/article/pii/S2405844024105804
As a follow up on the episode on facial skin care: what are optimal strategies to care for and protect the skin of the body?
care encompasses: cleaning, moisturising, hair removal (risks of certain techniques?), use of deodorant (beter not to?), hand and foot care protection encompasses: from sun, from heath/cold/dryness, from contact with DIY or household products (chemicals that irritate/burn or are taken up via the skin such as solvents, cancer-causing substances, endocrine disruptors,…), from contact with microbiological risks (via pets/plants/dirty water, illness causing skin fungi,…)
Weight gain from insulin
Dear Dr. Attia, I am a 32 year old male, recently diagnosed with type 1 diabetes. Within just a few weeks of regular insulin injection/blood glucose management, I have gained about 10 lbs. I am extremely active and have previously maintained my body weight (165 lbs) since high school. Can i expect this weight gain to stabilize? What is the mechanism for this sudden gain? Love your work and especially the AMA episodes Thank you
Thyroid function impact on longevity
Any studys showing low T3 can improve longevity. I am managing hypothyroidism with levothyroxine. Currently have slightly elevated TSH and low normal T3/T4. Generally symptom free but have increased symptoms and long recovery now that I increased exercise. Considering increasing levothyroxine but wondering if low T3 may actually have a benefit and should just add more time to recover after exercise
Epigenetic memory of fat cells
I'm 61. I've gained and lost large amounts of weight 2x in my life. The weight has come back each time after I cut back or stop cycling (7 hours/week). Both times the reduction in cycling was due to knee issues which are induced by larger cycling volumes. My question is this. How much the epigenetic memory of fat cells be altered so that weight gain is not so easy? Is it possible to kill off unused, depleted fat cells. Some studies suggest that fat cells hang out for 10 years or more after being depleted, possibly leading to easier weight gain? In the case of Angus Barbieri, he fasted for 382 days and follow ups suggested he never regained the weight. Is it possible that fasting say 3 days every time you lose 10 lbs might help the body dispose of the fat cells which are no longer used via autophagy? In mouse studies, mice who where obese at one time had a greater tendency to gain more weight and gain it faster when ad libitum feeding returned. Also is there there any research concerning how fat cells might be removed short of surgery? All this is assuming of course that fat cells control or contribute to the desire for more feeding. Thanks and sorry for another fasting question, but I have never heard this addressed anywhere.
Differences between Type 1 diabetes and Type 2 diabetes in healthspan goals and metrics
Hello, Type 1 diabetes and type 2 diabetes are often times lumped together under the catch all term "diabtes". However, both diabetes types differ significantly in pathogenesis and overall therapeutic goals. Many of the goals established for a Type 2 diabetic e.g prevent hyperinsulinism, mitigate insulin resistance etc., don't necessarily apply to a Type 1 diabetic. How does one parce the recommnedations for a Type 1 diabetic vs a type 2 diabetic?
seborrheic dermatitis, what works and what doesn't? ...and will there ever be a cure?
seborrheic dermatitis is such a common condition and yet the best we can seem to do is treat it with a combination of ketoconazole to kill off the malassezia yeast and hydrocortisone to reduce redness. There's some mention of prebiotics/probiotics possibly contributing to reducing inflammation's, but do these work? ..and Is there anything we can do to improve the body's ability to manage malassezia overgrowth? is that the solution/cure everyone is looking for?
How to interact with someone with Alzheimers
It’s difficult to know how to interact with someone who has Alzheimer’s. There are various examples, but for example, the person is somewhat aware of where they are and who surrounds them one day, and another day where they are aggressive. What and how is their brain functioning? Are there resources and guides , for not making things worse for facility caretakers and the patient
Traumatic (Brain) Injury
I was involved in a serious vehicle accident (not my fault). I have been rehabilitating. I have been a listener for 3 years and have changed my life for the better with integrating all of the exercise, sleep and life perspective that The Drive offers and teaches. I have been told by multiple surgeons that worked on me to keep doing whatever I was doing before my accident because it helped me survive and thrive through multiple bone fracture surgeries and has made my rehabilitation exceed all expectations and projections. Thank you to Peter for what you gave me in a most unexpected need! I have been reading and studying what will best fit for my particular needs. Part of my list of injuries was a severe TBI. I have read from multiple sources that protein is an important nutrition for TBI. It looks like protein as an essential ingredient for much of the brain including neurotransmitters and hormones and enzymes. Pardon my questions on “nutrition” but what ingredients should I be consuming to nourish my TBI inflicted brain while my body is also healing bones and trying to grow back muscle that was consumed in trauma and atrophied in a month of lying down in hospital? Thank you for all you do and what you have given me.
Skinny fat
What do people do who are skinny fat, thin all around but stomach visceral fat. Bulking up gains more stomach fat and thinning down fasting looks better but expense of overall muscle mass (although fat % goes down and muscle % goes up if you weight train and eat protein). Nobody address this esp for 50 year old guys I have found . Thank you
Resistance training and zone2
When I'm doing resistance training I notice that my heart rate is in Zone 2 much of the time. Does time spent resistance training count as a form of Zone 2 exercise? Obviously, this would make a huge boost in efficiency for weekly workout goals. If it doesn't county, why not? Thanks.
Niacinamide / Nicotinamide for skin cancer prevention
The recent guest episode on skin health was a great follow-up to your AMA episode earlier this year. The information about different topicals - different retinoids and Vitamin C was excellent, and the discussion about WHY to use mineral sunscreen instead of chemical sunscreen is immediately helpful! I'm surprised there was no discussion about using oral and / or topical niacinamide or nicotinamide (NOT plain niacin which is an important distinction) for preventing non-melanoma skin cancer, especially in people who have had BCC or SCC in the past and intervention for AK lesions, helping to repair DNA damage from UV rays.
Follow-up’s about chemical sunscreen and tick bites.
Two follow-up questions regarding recent posts/episodes. First, how should we think about using chemical sunscreen vs mineral sunscreen? I recall a 2024 AMA that concluded that adherence is the most important consideration, but that one might be prudent to avoid oxybenzone. However, in the recent episode with Tanuj and Suzan, I was surprised to hear them completely brush off chemical sunscreen without hesitation. Like Peter, I’m a long-time Elta MD user and the one I use is not strictly “mineral,” though it does have lower concentrations of certain organic compounds (and does not include oxybenzone) which I imagine helps reduce risk. Second, is there a reason not to keep ticks after removing them from the body? I was surprised the recent article suggested throwing them in the toilet. I am a serious hiker and, ultralight as I try to be, I always carry a small vial and tweezers (as well as doxy) so I can carry it out and get it tested if I do get a tick.
Skin fitness
You know what the bes thting about the Peter Attia podcast is? You end up listening to things outside your area of expertise with rapt fascination, both for the new knowledge and the areas of relevance and overlap to my own field (physiological fitness and preventative medicine). So I found myself listening to recent skincare ( The Drive #355) with expert Drs Nakra and Obagi. In it they discuss the importance of UV protection both for cancer prevention and aging mitigation. I fully support this, but their strategy is one of unidirectional reduction of exposure. I find this absolute approach not feasible for a couple of reasons, and suggest a better, more practical one to suggest to patients. Reason 1) As you’ll know, Vitamin D3 is activated in the skin in response to UV exposure, without a comparably efficient exogenous supplemental route. You’ll also be aware of the critical nature of vitamin D in calcium homeostasis, with relevance to bone health and falls risk limitation and as well as calcium availability for muscle contraction and its immune supportive role. Clearly a significant allies player in planning the centenarian decathlon. There’s also n the risk that huge numbers of high/low latitude Caucasian skinned patients are probably Vitamin D deficient. Proabably, because no international consensus has been reached as to a normal (read aspirational) range. Without clear vitaminosis syndromes and reducing fracture and infection risk at higher levels, it’s one of the rare cases where more really does seem to be better. 2. Extending the logic of fitnes In all other realms of medicine I can think of, ‘fitness’ involves adaptation to external stressors. Be it to mechanical or metabolic stress, given in right dose we adapt to cope with it. The melanocytic sun shading of nuclei in response to UV could be regarded in the same frame, making us more resilient to future UV exposure (note here the reduced absolute risk of melanoma in Black skin, as well as the maintenance of elastin and collagen as referred to with ‘black don’t crack’). What I advise patients in such situations then, is that slow, progressive exposure to sunlight (similar to training/rehab, while avoiding the ‘shock’ loading of burning (overtraining/overload)) is the healthiest approach, and our strategies should support this. I would love to hear your thoughts in your next AMA. Also, I’m unashamedly a huge fan of what you’re doing - if your team would ever like to connect, or I can in anyway contribute, I would jump at the chance. Best wishes
Suboxone and Testosterone (HRT)
My ADD patient (male 40, on Adderall and Suboxone) has been prescribed HRT/testosterone, with his GP. His husband tells me that lately his testosterone levels are lower than before he started HRT. If he has increased the Suboxone, on his own, can that account for his levels going way down? Thanks.
Suggestions for microphone use in the podcast
Peter/team, I am a big fan of what you do. So impressed with Outlive that at my wife and I’s 50th birthday party last year, I gave copies to all our friends who had travelled from around the world to join us. It's remarkable to see one team making such significant impact. Much of that goes to how thoughtful you all are in designing the experience from the deep research into the guest’s specialization, the thoughtful questions and now to the new set, lighting, videography and sound. However, I've noticed a slight mismatch in the aesthetic harmony of your setup, particularly with the microphone stands. While the SM7b microphones and their accompanying boom arms fit the popular 'podcast' look and might have worked with your home studio and car memorabillia, they seem somewhat overwhelming and overly industrial compared to the rest of your current decor, especially the horizontal boom, which can overshadow the speaker or distract from their facial expressions in some shots. While the SM7B microphone excels at noise cancellation, I personally find it best suited for recording specific audio tasks, like my daughter's vocals or bass, rather than for meetings or videos. A more streamlined option, such as a Shure tabletop microphone, or a shotgun microphone that is outside the camera angle could offer a more intimate feel. I had made a similar suggestion to Steven on DOAC and the new look is much cleaner https://www.youtube.com/watch?v=VHUrdELKjDw Btw - if you really want to test out car control, come join me in MN - and bring along Sanjay as well. In winter, we make a road course on a frozen lake and race on it. https://www.youtube.com/watch?v=jHIFAII3ibw . The Audi club does most of work but other clubs join in. Till recently I used a 330xi with standard winter tires. Though the nut jobs race older 944s or civic type Rs with Benhur like wheels that have snowmobile studs sticking out and great stuff foam instead of air in ‘em. Please take these suggestions for what they’re worth. Wishing you continued inspiration, success and forever in Chardi Kala
Are at-home red light masks effective for anti-aging?
Hi Peter! The podcast with skincare exp was great and I appreciate your excellent questions! This is the question I hoped would be asked, but wasn’t. Is there a way you can email them for their opinions and product recommendations? Many thanks for your excellent work!