The Peter Attia Drive - #80 - Celebrity AMA #1: Fasting, rapamycin, performance vs. longevity, and more

Episode Date: November 18, 2019

In this special, bonus celebrity AMA episode, Peter answers questions from former Olympians and past guests, Apolo Ohno and Sasha Cohen, on a wide range of subjects including fasting, learning, training for performance versus longevity, and much more. This bonus AMA is available in full to everyone. Apolo's questions begin [1:45]; Why women may have a harder time fasting, and tips for those who are struggling [2:10]; Is there any place for fasting as part of a nutritional strategy in adolescents? [6:15]; Tips for learning and retaining large amounts of new information (and the best nutritional approach) [9:15]; Must read books of 2019 [14:45; If you could only keep a few watches for the rest of your life which would they be? [16:45]; What workout would Peter do inside a hotel room? [22:15]; What is Peter’s ultimate gorge meal? [23:45]; How do you foresee fasting as a mechanism for performance in athletes? [25:30]; What is driving Peter to strive for excellence? [33:30]; Sasha's questions begin [38:40]; What are you most excited about in the longevity space? [38:45]; At what point do you see enough data or proof that a new drug, or type of fasting is worth trying it out for yourself? [41:30]; Is it possible to obsess so much about your health that it becomes a negative stressor? [46:45]; Which tests are worth doing if you want to be proactive about your health? [48:15]; Are there any supplements Peter things are beneficial to be taking? [55:15]; How does Peter’s training differ when optimizing for performance versus longevity? [56:30]; How does taking testosterone and growth hormone affect performance versus longevity? [59:15]; and More. Learn more: https://peterattiamd.com/ Show notes page for this episode:https://peterattiamd.com/celebrityama01 Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.

Hey everyone, welcome to the Peter Atia Drive. I'm your host, Peter Atia. The drive is a result of my hunger for optimizing performance, health, longevity, critical thinking, along with a few other obsessions along the way. I've spent the last several years working with some of the most successful top performing individuals in the world, and this podcast is my attempt to synthesize what I've learned along the way to help you live a higher quality, more fulfilling life. If you enjoy this podcast, you can find more information on today's episode and other topics at peteratia-md.com.

Do a special bonus ask me anything episode and what we are likely to call celebrity AMA number one. In this and future celebrity AMA bonuses, instead of being asked questions by my head research analyst Bob Kaplan, I'll be asked questions by guests, either future guests, special guests or just other guests on the podcast. So for celebrity AMA one, I'm joined by Olympians Apollo Ono and Sasha Cohen. In this episode, we talk about fasting. We talk about the role of nutrition during periods of study, and this is prompted by something that Apollo is about to embark on. We talk about exercise,

the ultimate gorge or feast meal, and we talk about watches, which really, I think, was the question I struggled with the most. From there, Sasha takes takes over and she asks me about things that excite me the most in longevity. We talk about mTOR and RAPA MISIN, how to measure results when you're doing a lot of interventions, blood tests, and supplements, along with a few other things. As a reminder, AMAs are for subscribers only. If you're not a subscriber, you'll only be able to hear a preview of the AMA here. If you are a subscriber and hearing this, it means you have yet to download our members' only podcast feed. With this members-only feed, you'll be able to subscribe to the drive in your podcast player to get every episode of the drive without the subscriber call out, plus full episodes

of the AMA podcast directly, along with other exclusive content. You can learn more about it at pteratiamb.com forward slash members. To become a subscriber to have access to the members only podcast feed, as well as other benefits such as detailed show notes and member-only discount codes in the products I believe in, you can visit pteratiamb.com forward slash subscribe. We'll continue to pull these questions from the AMA forum and we encourage all subscribers to participate, ask questions as we hope to get to all of your questions in time through future AMAs. So without further delay, I hope you enjoy celebrity AMA number one. Mipala Ono 8 time on the big metalist spent about 15 years in my life previously pursuing the sport of short track speed skating and I have the pleasure of doing a AMA with Peter Atia, my good friend,

and I've got some interesting questions here and hopefully you haven't answered all of them before in the past. I try to do as much to do and just I could. I would love to expand upon some of these further. So thanks for having me on Peter to interview you. You're having me on so take it away man. Yeah let's jump right in. So my first question is centered around women and fasting. And to give it some context, my girlfriend, she has a very difficult time doing water only fasts. It gets dizzy, feels like she needs some sort of sugar, some kind of just anything, any type of caloric intake, and where I can do seven plus days, kind of no problem most of the time.

So what is the difference here, and is there a separate protocol that you've seen for maybe perhaps clients who are female? I have definitely noticed over the past few years that even when it comes to time restricted feeding, so not even getting to the point of a fast, but just saying, not eating for 18 hours a day, that there appears to be a gender difference.

I could sort of concoct a bunch of evolutionary answers that may or may not be true. Certainly, one of the ones I'll come back to if we have a moment is to talk about the impact of fasting on fertility in women. So my point being is, I definitely appreciate what you're saying, and we see it clinically with our patients. Now that said, I also have seen many female patients who can fast independent of body habitus because obviously

Beyond guy is tiny and maybe that plays a role, but I don't think that that's it because I think there there might be something else going on. So I think I don't know the answer, but what I would say is it might just mean that for some people they need more time to work up to a fast, which means longer stretches of time restricted feeding. And then what we would typically do is progress patients through something as follows. So once a person can pretty consistently go 18 hours with a six hour feeding window, you then move to one meal per day. Can she do one meal per day?

Absolutely. And in the afternoon, she feels totally fine. No problem. Okay. So then the next thing I typically try is a 36 hour fast where you'll do like dinner Monday, lunch breakfast, Wednesday, so you go a night and then a full day and then into the next day.

Is that something she's tried? Yeah, she can do the 48 hour fast. Anything past, I would say 72, really difficult for her. She just is not able to physically, basically can't leave the house. Is she experiencing lightheadedness, cramps? No cramps, but definitely lightheadedness, severe lack of energy, and just doesn't have the cognitive ability to do anything that would require semi-deep thought. Yeah, again, it's hard to know. I mean, does she check her glucose

and ketone levels all the way through this? No. Sometimes that provides a bit of an insight. You and I have talked about this a bunch, but I find going into ketosis the week before makes that transition a lot easier. So much easier. And I've sometimes done the exact opposite and gone right into a fast out of a bender. And that's, I mean, you'll pay the filler all day long.

The other thing that I think is important for everybody to understand is one, I'm glad to hear that when she feels that way she stops because I do think it's important for people to not hammer through fasts no matter what. You can quote unquote fail at a fast 99 times and come back on the hundredth and be successful and in my mind they're all successful. So so I think it's really important that people get it through their mind that hey if this isn't feeling right or going right I stop and I eat again. The second thing is a lot of people don't realize how much food contains water. So when you're not eating, you have to make up that water that you're not getting from

food in addition to what you think you normally would need to drink. So if you're a person who normally gets by sort of drinking, call it four liters of water, they say a gallon of water. You're going to need more than that for two reasons. The first is when you're fasting, your body is typically excreting sodium at a higher rate, so that's creating what's called a dioresis. So you have to compensate for that, and then you also have to compensate for the fact that you're not getting the water in the food. So that might be the other thing to think about. And the easiest way, I mean, there's some technical ways that one can sort

of measure the volume balance, but honestly, just looking at your end output is a great way to do it. I mean, when I'm fasting fasting one of the things I'm thinking about is how often am I going to the bathroom? If I don't get up to pee about every 90 minutes, I'm not drinking enough. Got it. That's great. The other thing by the way, is she a caffeine drinker normally? She's not. Okay, because that's the other thing that you always want to think about in people is sometimes when they stop caffeine as well The one-two punch of no food no no caffeine can be really devastating. And in those patients, I generally think it makes sense to probably allow them to continue to drink black coffee or high caffeine tea or whatever to sort of pick and choose your battle.

Okay. Thank you for that. Let's move to number two. So, my other question is, you have kids. So what are your thoughts on adolescent fasting? And is there a place for it routinely? I.e. do you think that in 20 years, it'll be a regular part, 50 years of a curriculum or a dietary program. So I'm talking mid-teen to late teen. Boy, that's an interesting question, and it really depends, I suspect, on the health of the

child. So there are probably certain situations where it could make sense. Unfortunately, today we're in kind of an epidemic of obesity type 2 diabetes, non-alcoholic fatty liver disease amongst kids and adolescents. And certainly in kids with metabolic conditions under the right supervision, I think one could make the case that some form of fasting, whether it be time restriction feeding or even hypochaloric periods of time, for example, several days at a time with an energy input that's below requirement could have enormous medical benefit. But at the same time, one has to be very careful about threading this needle because they're

still basically supposed to be in anabolic mode. A 14, 15, 16 year old adolescent is still growing. And so a lot of times, doctors who take care of kids that age that have obesity have a different goal, which is not weight loss per se, but actually weight stability. So let them grow into this weight. Now, that's a bit of a sort of hokey concept because as an athlete, you'll appreciate that weight is not really the issue. The issue is fat mass versus muscle mass. And in the end, what we're talking about is potentially a treatment for excessive fat mass. The other thing, of course, that has to be really considered is, I do believe, and I don't have great evidence

to suggest this. This is really based on discussions with endocrinologists, my own personal experience in interacting with patients that have had eating disorders. But I think there is a critical window during which deprivation of food can be potentially harmful. And I think that's why I've certainly seen a subset of people who have had disordered eating or eating disorders during adolescence. And it has sort of imprinted their endocrine system in a way that's come back to haunt them as an adult.

So kind of a long-winded answer, which is to say, I think we don't know the safety of that yet. My view is that unless you're an adult, really this isn't something that should be considered as a regular part of how you eat, but that's also acknowledging the fact that I know evolutionarily it's tolerated because obviously we came from our ancestors

who, whether they be children or adults, would have gone through periods of time with that food. So, yeah, I don't know. I think this should be studied though, because it's important and I wouldn't want to just speculate from, or extrapolate rather from adults. Okay. That's a long list, man.

That is a lot of questions I'm looking at over there, dude. You went whole hog on this. Holy cow. You took it seriously. And I apologize everyone who was listening. Some of these are selfishly because I just really want to know for myself. And speaking of that, I'm going back to school this fall.

And. Wait, I didn't know this. I did know this. Yeah, yeah, so I'm doing this program at Wharton this fall. OK, that's what I was asking you about, because I thought you were going to be in Philly this week. Yeah, basically in a couple weeks. Oh, all right.

So in lieu of that, what is your preferred diet for consuming large amounts of information retaining it while still being alert? Because the influx of information and critical thinking is going to be at an all-time high for me for approximately eight weeks straight. You can find all of this information and more at peteratia-md.com forward slash podcast. There you'll find the show notes, readings, and links related to this episode. You can also find my blog at peteratia-md.com.

Maybe the simplest thing to do is to sign up for my subjectively non-lame once a week email, where I'll update you on what I've been up to, the most interesting papers I've read, and all things related to longevity, science, performance, sleep, etc. On social, you can find me on Twitter, Instagram, and Facebook, all with the ID Peter, a TF, MD. But usually Twitter is the best way to reach me to share your questions and comments. Now for the obligatory disclaim. This podcast is for general informational purposes only and does not constitute the practice

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