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April 24, 2018 - The Joe Rogan Experience
02:51:28
Joe Rogan Experience #1108 - Peter Attia
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joe rogan
46:43
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peter attia
02:02:35
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Speaker Time Text
unidentified
Four, three, two, one.
joe rogan
Hello, Peter.
peter attia
Hello, Joe.
joe rogan
What's going on, man?
peter attia
A whole lot.
joe rogan
You were just telling me something that is one of the most ridiculous things I've ever heard, that you swam from Maui to Lanai.
peter attia
Right.
joe rogan
And you're the one of the only humans to ever do that.
peter attia
I'm told I was the first person to swim from Maui to Lanai and back.
The one-way is a pretty famous swim race that's done every year.
joe rogan
You're the first person to do it.
And go back.
Fuck, dude.
Why'd you do that?
peter attia
How long you got?
joe rogan
It started when I was a boy.
They told me I couldn't do it.
What made you want to do that?
peter attia
That's a ridiculous proposition.
So I got into, I decided in, this is going to sound silly.
I read a book in January of 2004 about this woman named Penny Dean, who still to this day holds the record for the fastest crossing of the Catalina Channel.
So swimming from Catalina Island to San Pedro to not, you typically swim to Point Vicente.
And she had done it in like seven hours and 20 minutes.
And I was like, that's amazing.
joe rogan
How far is that?
peter attia
As a crow flies, it's 21 miles.
With the currents, it's a little longer.
And I was like, you know, I really want to do this, but I got to learn how to swim first.
joe rogan
That's three miles an hour swimming?
peter attia
She is a phenom.
Penny Dean had a stroke rate of 90 strokes per minute, which, I mean, that might not mean anything to someone who doesn't swim, but like to turn, to have a hand hit the water every, you know, third of a two-thirds of a second is a remarkable thing.
Yeah, I can't hold a cadence of that for 100 yards.
unidentified
Wow.
joe rogan
And she did it for 20 miles?
peter attia
Yeah.
joe rogan
What a beast.
peter attia
She's out of control.
joe rogan
There's certain people like that, man, that freak me out.
peter attia
I think marathon swimming might be one sport where if you just look at the numbers, I think women are better than men.
joe rogan
Well, there's that woman who swam from Cuba to the United States, right?
She was the first person ever to do it.
peter attia
Diana Niad.
joe rogan
And didn't she do it at a fairly advanced age?
peter attia
Yeah.
I mean, she's, of course, got an amazing pedigree of swimming, and this wasn't her first rodeo.
joe rogan
Right, right, right.
Why do you think women are better than men at that?
peter attia
I mean, those of us that I'm not a member of this community anymore, but when I was, it was one of our favorite topics of discussion.
I think opportunities or ideas that were put forth were higher pain tolerance, something about being, you know, evolving to be able to give birth, just means they can tolerate pain a lot higher.
I think another thing I've heard is buoyancy.
You know, women are naturally going to have more body fat, which provides insulation.
When you do these swims, you're not allowed any wetsuits or aids of any sort.
No shorts.
You're in a speedo and a single latex cap, and that's it.
And so if you can have a little, and so I think women's hips, because they're going to have more fat on their hips, it corrects one of the big buoyancy issues that we have in swimming.
We didn't evolve to swim.
We're horrible at it naturally because we swim like this.
We drag our hips through the water.
And if you think about the importance of aerodynamics in most of the things that we think about, whether it be archery or race car driving or cycling, in water, it's that much more important because the density of water is thousands of times greater than air.
So swimming is just 100% about avoiding drag.
joe rogan
Wow.
So, well, that totally makes sense.
I just have been fascinated forever with people that are capable of pushing their brain to do things that other people just don't think are possible, like a Bigfoot 200 race or any of those things.
But the swim one is particularly crazy because you can't stop.
peter attia
Right.
joe rogan
Right.
Like if you're running an ultra marathon and you just want to sit down for a couple minutes and just take a break, you can do that.
But if you're swimming, there's no damn thing you can do.
peter attia
You could tread water is about as good as it gets.
But you can't touch the boat or the kayak or it's an immediate disqualification.
joe rogan
Oh, God.
That's so crazy, man.
That is such a...
So you heard about this woman doing it.
peter attia
I read this book and I was like, I really want to do this.
At the time, I was actually in my residency in Baltimore.
And I was like, you know, I really want to do this.
And I'm going to have to learn how to swim to do it.
So I started taking swimming lessons.
And then, I mean, to make a very long story short, basically by about the summer of 2005, I entered my first swim race, which was a two-mile swim race in Lake Reston, Virginia.
And I did it.
And I was like, oh, my God, I just swam two miles in the open water.
You know, it was hard, but I was like, okay, that's the proof of concept.
Now you just got to figure out how to make it 20, 25 miles.
And so I just, you know, went completely psycho and ratcheted up the training.
And then in October of 2005, I did my first Catalina swim.
Wow.
joe rogan
That's got to be a pretty good feeling, though, when you're done, that you are capable of pushing yourself to what most people think is an impossible distance.
peter attia
Yeah, I mean, people, you asked a moment ago, why do you do this?
I would say that in life, velocity means very little.
Acceleration means everything.
So what do I mean by that, right?
Like, if you're going 650 miles an hour in an airplane, you don't actually feel it.
You only feel when speed changes.
unidentified
Right.
peter attia
So I've always had this theory that emotionally that's also true.
Like happiness is only interesting when it's juxtaposed with sadness.
And so the feeling of crawling on the shore after you've been swimming for 12 to 14 hours is amazing.
But what makes it especially amazing is that six hours earlier, you thought you were going to die.
So you start these swims in the middle of the night to avoid the shipping traffic.
So that first swim, boat drops you off at Catalina Island.
It's midnight.
That's a darkness you can't imagine.
Like you can't even see LA from Catalina.
You have to swim for six hours before you even see the lights of Los Angeles.
joe rogan
Really?
peter attia
Yeah.
joe rogan
What do you see?
peter attia
The stars and the phospho-like bioluminescent organisms in the water.
unidentified
Whoa.
peter attia
Which is incredible.
I mean, that's worth the price of admission.
So every time your hand comes through the water, you're pulling and ripping these little things and you're seeing the sparks.
And you can't tell where the water ends in the sky starts.
In other words, the stars and the bioluminescence look like one cylinder.
unidentified
Wow.
peter attia
So for the first few hours, that's cool.
But then, you know, on my first swim, the water was incredibly rough.
I had only swum in the ocean for two weeks before the swim.
I did all my training in a swimming pool in a lake on the East Coast.
So now I wasn't used to how to keep the saltwater out of my mouth.
unidentified
Right.
peter attia
So then I was like puking my guts out.
And then my while you were swimming, you're puking your guts out?
Yeah, yeah, yeah.
joe rogan
How does that work?
peter attia
You just stop and puke and then keep swimming.
unidentified
Wow.
peter attia
And then, but then my tongue started to get really swollen from the saltwater.
Because again, as I would learn later on, I would go on to do many more of these swims.
But what I learned is the importance of spitting the water out of your mouth very quickly.
So in a freshwater pool or lake, you get away with more.
But in the ocean, you swallow that salt water.
You're going to get sick as hell.
So all this stuff's going on.
So by five in the morning, you've been swimming for five hours.
You're getting cold.
You're, I mean, you know, frankly, just physiologically, like your cortisol levels are at a neader.
You're just, you feel horrible.
It's like, it's a really bad feeling.
And you're not even halfway there.
And it's like, you don't know if you can do it and blah, blah, blah, blah, blah.
Well, if six hours later, you're now crawling out of the water feeling like you've done this amazing thing, that's emotional acceleration.
That's like the greatest contrast.
joe rogan
I know what you're saying.
I mean, I've never experienced that, but I was explaining the other day to a friend of mine about this camping trip that we went on in Montana when it was like nine degrees outside.
It was freezing cold.
We stayed out there for five, six days.
And then when we finally got to a hotel room, I took a shower and it was the most amazing shower I've ever experienced in my life.
And that's a small thing.
peter attia
Right, I know, but you take a shower every day and it's like a big deal.
But when you do it in that setting, or think about the meal you've had if you've been in a similar situation or starving or lost at sea.
joe rogan
Yeah.
I can't imagine.
That's a so now that you've done, how many of these have you done?
These crazy swim races?
peter attia
Or swim several.
Yeah, usually these major, major ones are not racist.
You're on your own.
You have to, you go to the federation that oversees that body of water and you say, hey, I want to do this.
And then you, you know, you go through all the channels to do it.
Like they have to have an observer there and they follow these official rules.
joe rogan
So that you can be registered as someone who's actually completed it.
peter attia
Right.
And someone's there to make sure you didn't, you know, you did it correctly.
I don't know.
I've probably done all in, probably like a dozen of these, but probably like six of them really long ones.
joe rogan
What's the longest?
peter attia
Well, that's a good question.
joe rogan
What is the Maui one was 20 miles there and back?
So 40 miles total?
peter attia
No, no, no.
The Maui Channel is a 10-mile channel, so round trip is 20.
The bigger question is time in the water because you rarely get to swim these in a straight line.
So the Maui Lanai one, I wanted to go Maui, Lanai, Molokai, Maui to do the triangle.
And that would have been 30 miles as a crow flies.
But we just, you know, boat captain wasn't willing to do it at night because of the tiger sharks.
And during the daytime, we couldn't physiologically figure out how one could suffer against the wind because the wind gets so brutal in the middle of the day.
So even the one that I did, which was just the there and back, I ended up swimming for 12 hours because the first way crossing where there was no wind took me four hours.
And then it took eight hours to get back because I was swimming like the hypotenuse of a triangle, right?
Like the current's going this way.
So I had to swim this way just to go in a straight line.
And I still kidding, I almost missed Maui.
joe rogan
Jesus Christ.
peter attia
So I almost got swept out to Molokai just because the current was about 1.7 knots, which is about as fast as I can swim.
Maybe two knots.
joe rogan
Fuck.
That is a ridiculous thing, man.
Why are you doing this?
This is maniacal.
peter attia
Well, I don't do it anymore.
I mean, it was certainly, it was an amazing season of my life, but I think once my daughter was born, which was 10 years ago this summer, that's when I only probably did two of these after she was born because then the training just got so I just you got to live in the water if you want to do this sport like you got to including the winter you know like you know even in San Diego where I live it's still you know 55 degrees in the water and
You're going to spend three, four hours a day in the water freezing.
You know, it's just so I was like, you know, I just don't have the drive to spend 25 hours a week swimming.
joe rogan
What was the what was going on in San Diego when that guy got bit in half by a shark a couple of years back?
They were training for something.
peter attia
Yeah, that's funny.
You remember that.
That was May of 2008.
I remember that like it was yesterday.
So at the time I lived in San Francisco.
And this is actually just before I swam the Maui thing.
Now that I think about it, that was 10 years ago.
I swam the Maui thing in June of 06, June of 08.
So I'm doing all my training in a swimming pool up in San Francisco because I don't want to acclimate to very cold water.
I actually want to be in warm water.
But I needed one long ocean swim of like 14 or 15 miles as my like last training swim.
So I came down to San Diego to do it.
And just by bad luck, I came down a few days after that guy was killed.
Now, this was a guy.
I didn't know him, but he was a triathlete training with a triathlon group that they would go out and swim every morning.
And I know the beach exactly where it happened in Solana Beach.
And unfortunately, like most people who get attacked by great whites, they have a very – they always attack the same way, which is below and behind, stealth bite, up and – and then they retreat.
So they're trying to basically injure the prey so their prey exsanguinates and then they take off and then they wait until you bleed out.
So they never saw the shark, but you could tell from the bite marks it was.
I actually had a friend who was on the beach and saw him when he came out.
And he was basically dead when he got to shore.
He had bled to death.
The problem is – so in this case, the shark had bit him and cut through his femoral arteries and veins.
And the salt water prevents you from having any hemostasis.
So it exacerbates the blood loss.
So that's generally how folks perish when they're bit by great whites.
How did they get him out of the water?
A bunch of other swimmers came to his rescue.
And luckily, that commotion prevents the sharks from wanting to come back.
So three days later, I go out and I'm swimming at that beach because I swam from – my training swim was La Jolla up to Solana Beach and back.
And I got to tell you, like three days after a guy dies where you're swimming, it is – it was about one of the most mentally challenging training swims to be like.
Because you can't see.
Like the water at that part of the beach is so murky.
You know, and you're only a couple hundred yards offshore that – like you can barely see your hands when you're swimming.
And so you're just thinking, is this the day?
joe rogan
Oof.
unidentified
Dude.
Yeah, I'm not interested in that.
peter attia
Gee, I can't see why.
joe rogan
Yeah, there's just something about sharks too.
I mean, they're, to me, one of the most terrifying things.
But first of all, we're so inept in the water.
I mean, even a person like you who's a great swimmer.
peter attia
Yeah, yeah, we're a joke.
joe rogan
Yeah, what we are in comparison to what they are, it's just – you're throwing yourself into the world of a super predator.
And to know that one just jacked a person just a few days before and you're out there swimming around.
peter attia
Yeah, although I will say this.
You know, when it's all said and done, all of the close encounters I've had, probably the scariest moment I've ever had in the water was doing a swim from Santa Rosa to Santa Barbara.
So Santa Rosa Island, which is the second furthest north channel island.
You've got San Miguel, Santa Rosa, Santa Cruz, and Anacapa represent the top four channel islands.
So we did this November swim.
It was a nighttime thing again, swimming from Santa Rosa Island to Santa Barbara.
And at about five in the morning, maybe six in the morning, you're just starting to get enough light where you can see and you're out there.
So you really have amazing visibility.
And I look down probably 40 feet and I see this enormous thing swimming like this, which is how sharks swim.
And I see the dorsal fin and the position that freaks me out and the tails this way.
All of that is shark.
joe rogan
Right.
peter attia
And I like, you know, like lift up out of the water, kind of hyperventilate for a second.
And I'm thinking to myself, all right, you got to make a judgment call here.
If that's really a great white, you probably ought to get out of the water.
But if you, the moment you're out of the water, that's it.
The swim is over.
Like you just spent like months doing this.
Like it's done.
So then I convinced myself and I think I'm right.
I think it was a dolphin on its side because a dolphin on its side would, its fin would, its tail fin would be the same way and it could swim that way.
So in the end, I just kept swimming.
But I mean, that scared the shit out of me.
joe rogan
Well, they have seen quite a few of them off the coast of Malibu.
peter attia
There's a, oh, there's tons.
There's no question that like they're, they're, they are way more plentiful than we realize.
And all you can do is talk to the fishermen.
Like the fishermen will tell you they're like, you're like off Coronado.
I mean, it's like there's nonstop great whites.
joe rogan
Really?
unidentified
Oh yeah.
joe rogan
Why are you freaking me out, Peter?
peter attia
The good news is they see us all the time and most of the time they realize we're not what they want.
joe rogan
Yeah.
They want seals.
unidentified
Yeah.
peter attia
Whenever they attack us, they're making a mistake.
joe rogan
Now, is there a, like a suit you can wear, like a Kevlar suit to protect, protects you from getting bitten in half?
peter attia
No, but this is so funny you bring this up.
I became obsessed with this thing called the, uh, oh, what was it called?
Christ.
You, you, you'd put the thing on your ankle.
Like you had like a little Velcro thing.
You'd wrap it on your ankle and had a tail, like this long, you know, like four foot long thing.
And it was charged and it sends out an electrical impulse that, um, disturbs the shit out of the sharks.
The shark's nose is an organ that senses electricity.
So when a shark, like it could be pitch black, it could be soot water and they can still scope you, you know, from hundreds of yards away based on the electrical activity of your heart.
And that organ is their nose.
So this little thing, I forget what it was called, like the shark taser or some shit.
It puts out a signal that like tases them and they don't want to get within like.
joe rogan
Oh, there it is.
What's it called?
Up here.
The world's first shark deterrent band.
It's called the shark bands.
One on the wrist or ankle.
Is it?
peter attia
I don't know.
I thought it had a different name, but because the one that I was going to get and did a ton of research into had a really long tail hanging off it.
And that became the problem.
joe rogan
It uses patented magnetic technology to repel sharks.
So the tail was a problem because of the drag?
peter attia
No, because it would sound silly, but it would come up and zap you in the nuts.
So you'd be like, so it became unbearable to practice swimming in this thing because you're like everything.
37 seconds, you'd get zapped by the tail.
And I was just like, yes.
joe rogan
I like how it says reduce the risk.
unidentified
Oh, yeah.
joe rogan
Can I get some numbers, please?
unidentified
I don't want to just hear reduce.
joe rogan
By how much?
By 1% statistically.
And it also is a leash for your surfboard, too.
You can use one of those to strap it to your ankle.
unidentified
Yeah.
joe rogan
No.
peter attia
It's going to come to me like in an hour.
I'll remember what this silly thing was called.
joe rogan
Jamie, you'll probably find it.
Off of Catalina, I know it's one of the best shark fishing places in the world.
I have a friend of mine who told me that if you think about like wild places on earth that are just overrun with predators and terrifying like predator prey activity, Catalina Island is one of the top spots in the world.
I was like, what are you talking about?
He's like, I'm telling you, man, the shark fishing off Catalina Island is fucking insane.
And then I watched a television show, just, you know, synchronicity a couple days later.
And it was these guys shark fishing off of Catalina.
I was like, what in the fuck?
I could have never guessed.
They're catching makos mostly.
peter attia
Yeah, and it's actually my recollection, because we swam around Catalina once as well.
The back side is way more aggressive than the front side.
joe rogan
The side that faces the Pacific rather than faces Los Angeles.
That's right.
peter attia
Yeah, there's way more crazy stuff out there.
joe rogan
Yeah, I think that's exactly where they were.
Yeah, it looked pretty nuts.
I mean, they were bringing in these 15-foot sharks.
I mean, I was like, what in the fuck?
These are just floating around out there.
You know, it's, I mean, I guess, of course they are, right?
peter attia
mean it's a there's a lot of fish out there as well so i'm sure catalina is amazing Pretty crazy.
I'd swum to it.
I'd swum from it.
I'd swum around it.
I'd done a million thing, and I'd never stepped foot on it except at the beginning or end of a swim until five years ago.
I went there for a vacation.
Like, actually, just went to Avalon for, you know, three days.
I'm like, it's not a place I could live.
It's a little, you know, too quiet, but for three or four days, it was amazing.
joe rogan
I think people hunt on Catalina.
peter attia
They've got huge buffalo there.
joe rogan
Is that what it is?
peter attia
Yeah, so apparently there was a movie that was made there back in the 20s or something like that.
joe rogan
They just let a bunch of buffaloes.
peter attia
Well, they had a bunch of buffalo, yeah, for the movie, and I guess they never corral it or some sort of shit.
So it's totally overrun with buffalo.
joe rogan
Well, there was one of the Channel Islands that they had actually turned into a bow hunting destination.
Like they had brought in a bunch of deer.
I think they brought in stags and a bunch of weird exotic shit, and they put them on this island.
I think they even had elk.
And then biologists just weren't having it.
They're like, this is just so out of whack.
And so they had them eradicated.
And the way they do that is it's pretty gruesome.
They just gun down from the air and just leave the bodies.
Yeah.
They just decided that they were an invasive species, regardless of how valuable they might have been to people that wanted to go there and eat them.
You know, they just decided just for the ecosystem alone.
And there's no predators there.
And they weren't going to turn the fucking island into wild kingdom and bring wolves or something in there, which would be pretty goddamn crazy.
Imagine if there was an island you could go and they just had wolves and elk running around on an island.
peter attia
Well, I mean, I'm surprised they would gun them all down.
At least say make it open season for hunting or something like that.
They could have been productive about it.
joe rogan
That's an interesting perspective.
So biologists look at it in terms of the entire ecosystem, right?
They look at it in terms of the plants, the amount of waste, fecal waste that these animals are leaving behind, the fact that they're literally eating everything that they can on this island.
They're not supposed to be there.
And then they're competing with whatever things are native to that island.
And probably, I mean, if you've got a thousand-pound elk, it's not supposed to be on a fucking island.
And this thing is just eating everything it can.
And they don't have a winter either.
So it's just like the whole, like, they're just not supposed to be there.
peter attia
The Channel Islands themselves are kind of amazing.
I mean, most people know of Catalina, but you know, there's eight of them.
Now, two of them you can't step foot on.
No, San Clemente and San Nicolas.
They're military bases.
joe rogan
Oh, okay.
peter attia
So we tried to do a swim from San Nicolas back to Los Angeles.
This was a relay swim because it's like an 85-mile swim.
And I spent like six months researching it, speaking to a bunch of naval officers.
I was like, hey, is there any way we can, because you officially have to start a swim, you have to be able to touch dry land and be out of the water.
And they're like, yeah, you can't come on the island.
So in the end, what we decided was we were just going to do a stealth landing.
You know, by the time they came down and screamed at us and shot at us, we'd have been off the island.
But then we got to the island.
Now, the other big thing about San Nick is that's real shark territory because that's where the elephant seals live.
And so when we got out there, we literally could not get to shore because of the elephant seals.
Like we're 200 yards off San Nick.
And this is after it taken a full two days to get out there.
I mean, this place is really hard to get to because the water is brutal and you're not in a huge boat.
And yeah, you're looking at like thousand-pound elephant seals that are just like licking their chops, looking at you trying to get in the water.
joe rogan
What would they do with you?
peter attia
I didn't want to find out.
joe rogan
But they're not predatory, right?
peter attia
I mean, I don't think.
No, I think they're aggressive as hell.
joe rogan
Did you see that video of the little girl that's sitting on a dock and a seal jumps up and grabs her in the ass and pulls her into the water?
Did you ever see that, Jamie?
Yeah, I didn't think that seals ever did something like that before.
peter attia
I don't know.
I did see a special once about how dolphins could be kind of aggressive with each other.
Like, they could harm.
joe rogan
Look at this.
So this seal is sitting there, and this girl, a sea lion, actually.
Look at this.
It comes up and they think the sea line is.
peter attia
I think it's all cute.
unidentified
He's like, I'm thinking about the amount of magical.
Oh, my God.
joe rogan
But I think it was probably looking for a handout, and these people weren't giving it to her.
peter attia
Oh, and then she turns her butter.
unidentified
Oh, my God.
joe rogan
Oh, my God.
peter attia
Jesus.
joe rogan
Yeah, fuck that thing.
I'd be like, I'd be right back.
Fill that fucking puddle with lead.
Imagine that bit, your kid.
peter attia
Oh, yeah, yeah.
joe rogan
Yeah, they jumped up fast.
Yeah, they're predators.
I mean, they eat things.
You know, they're not eating plants in the water.
They're eating fish and shit.
Whatever they can get a hold of.
They probably eat birds and stuff, too.
They're probably used to scooping things up.
But I bet that what that's from is them getting too acclimated to people, people feeding them.
peter attia
Oh, for sure.
joe rogan
Yeah, they have an issue in Boulder where Boulder is.
Have you ever been, Colorado?
peter attia
Yeah.
joe rogan
Yeah.
Beautiful, right?
Gorgeous.
Super liberal.
Like as progressive as it gets, right?
peter attia
You haven't been to San Francisco.
joe rogan
Oh, I have.
Yeah.
I think Boulder is right up there, but there's less people.
And everyone's real healthy and active and hiking and stuff like that.
They don't allow hunting for mountain goats on the weekends because there's so many people hiking and going, they don't want people killing these mountain goats in front of them because people freak out.
Even though they have decided that they have to control the population and kill a certain number of them to keep the.
But so many people go out there that these things aren't scared of people.
So it's created this really weird situation where if you are hunting them, you're almost hunting something that's domesticated.
People feed them Cheetos.
So much so that a friend of mine was talking about it that he was up there with his daughter.
His daughter opened up a bag of Cheetos and the goat walked right to a wild goat, lives out in the fucking woods, walked right up to his daughter and they were laughing.
She opened up the bag of Cheetos and put it, and he stuffed his head in the bag of Cheetos.
He knew what to do.
And this guy who was talking about this is a hunter.
And he's like, this fucking goat has like Cheeto dust all over its face.
Like it's the craziest thing.
Its face is all red with Cheeto dust and it's sitting there chewing these cheetos.
Like it's done it before.
peter attia
Yeah, yeah.
joe rogan
And it's just.
peter attia
That goat had diabetes, I think.
joe rogan
Probably eventually, right?
Yeah, I was in Costa Rica.
There's another similar situation.
And we were staying at this Four Seasons out there.
And the monkeys have gotten very accustomed to people being there.
And so they come by and they hang out and they're like trying to get things from you.
And my daughter opened up a package of Oreos and the monkey just jumped onto this little ledge like a couple feet away from her.
And my wife was like, I really don't think it's a good idea that we feed this thing Oreos.
And I said, well, you know, it's probably going to get eaten by a fucking crocodile anyway.
I mean, are we poisoning it?
Is that what you're thinking?
I mean, it's not going to eat this every day.
It's not going to be a normal part of its diet.
But we hand the monkey an Oreo.
It pops open the Oreo and starts chewing on the frosting like a little kid.
And then we're like, oh, this little fucker probably gets these things every week.
unidentified
Right.
peter attia
So it begs the question, does he know how to do that because he's watched some human do it?
Or are we innately wired to do that with Oreos?
unidentified
Ooh.
joe rogan
I think he knows how to do it because someone's given him Oreos so many times that he knows that's the good stuff.
The good stuff's the middle.
They should just sell that in a paste.
peter attia
I don't know.
I think the middle's only good because you can contrast it.
It comes back to the contrast thing.
joe rogan
Exactly.
I think you're right.
I think you're really right.
peter attia
I think if it was just pure middle, it'd be pretty gross.
joe rogan
Yeah, if they probably sold pure middle, nobody would buy it.
But if they sold those black cookies by themselves, no one would buy those fucking gross things either.
unidentified
No.
joe rogan
Like shitty ass tea biscuits.
They're the worst cookies.
unidentified
Once you eat the white stuff, you're like, all right, I'll eat this stupid ass black cookie.
peter attia
It's the sunk cost.
joe rogan
It's like a coal cookie.
Here it is.
Here's a little monkey doing it.
Look, they grab it from you, and they just fucking love.
Oh, yeah.
Look at them opening it up immediately.
Open it up and start chewing that white stuff.
unidentified
I love it.
Yeah.
joe rogan
Crazy.
We had, there's a thing that is called Kawada Mundi.
Have you ever heard of those?
It's related to the raccoon.
It's this weird animal that lives mostly in Central and South America.
And it has a northern range that extends into Arizona, all the way up into Mesa, I think.
Like it gets into the areas where it gets cold.
But Arizona, I think, is the only state in the U.S. that has it.
But it's this weird-looking monkey raccoon thing that is so domesticated that we gave it some grapes.
Here it is.
We gave it some grapes.
And this little fucker, there it is.
I mean, look at that weird little thing.
It came and sat.
We had like a little patio area in the hotel room.
And it came and sat down with us and so calm that it sat and went underneath one of the chairs and took a nap after we gave it some grapes.
Like while we're hanging around, my daughters are running around making noise and this thing's just chilling.
unidentified
It's like a pet.
joe rogan
It was a total pet.
It was a total pet.
Yeah, there they are.
They're cool, man.
Weird-looking things.
People eat them, apparently.
unidentified
Apparently they hunt them in Arizona.
peter attia
Nachos.
joe rogan
Yeah.
I mean, after seeing this, I was just like, I don't think I can hunt that.
I'd have to be pretty hungry to eat one of those.
They're so cute.
Look at the little face.
Weird little animal, man.
peter attia
Really interesting.
joe rogan
Yeah, our relationship with animals is very odd when they get into close proximity.
unidentified
Yeah.
peter attia
Yeah.
We've got a wicked coyote problem in San Diego, at least in the part I live in.
And, you know, it's just one of those things.
Once we got rid of mountain lions, because nobody wants mountain lions around, the coyotes run amok.
joe rogan
Is that what it is?
peter attia
I think, I mean, I was talking to a friend of mine about this the other day, actually, and he was saying that there's probably only, like, in our neighborhood, there's probably only like two mountain lions left.
And the coyotes just, they've exploded.
There's so many of them around.
And it doesn't really bother me that much.
I mean, I actually kind of like listening to them howl.
But, you know, if they get into your chicken coop.
joe rogan
Yeah, I had one kill chickens just a few weeks ago.
Yeah, yeah.
I have got video of a dead chicken.
It was such a bummer, man.
We chased it away.
It was on the roof of the chicken coop.
The way they jump is so stunning.
Like, they're so graceful.
Like, I've never seen anything that moves like that in the wild the way a coyote does.
There's a six-foot fence.
It's on the ground.
It jumps to the top of the six-foot fence almost like it's under different gravity rules than us and touches the top of the fence and then boom, it's on the top of the chicken coop.
I mean, in like a second.
peter attia
I haven't seen that.
joe rogan
That would be...
I have video of one of them jumping my fence.
I caught one of them with a chicken in his mouth, jumping the fence, jumped a six-foot fence with a chicken in his mouth.
Just jump, boing, touch the top of the fence with his front paws, back paws went over right behind it, and it was gone.
It's crazy.
But, you know, look, we need them.
We need them to kill the rabbits and the rats.
And if we didn't, we'd have a giant.
peter attia
Well, that's what I tell my daughter because she gets all stressed out that there's coyotes walking around our house.
And I was like, well, first of all, they're pretty skittish of us.
And boy, they keep those rodents under control.
joe rogan
They really do.
You need them for that.
But there's a coyote problem across the country.
They're the only animal that's in every single state and every single city now.
Every single city.
There's coyotes in Manhattan.
unidentified
Come on.
joe rogan
I'm not bullshitting.
peter attia
In the park?
joe rogan
They found them in the park.
They found them in the Bronx.
They found them in abandoned buildings.
Yeah, there's a great book I read called Coyote America by a past guest of the podcast named Dan Flores.
He's a wildlife historian.
It's fascinating.
They're a really, really unusual animal in that when you shoot one, they yell out, here's this, what's this?
Coyotes in New York City.
Look at this.
In fucking New York City, dude.
In New York City.
New York City Police Department, coyote running down the street.
peter attia
Unbelievable.
joe rogan
They're everywhere, man.
They have a real problem with them in Chicago.
peter attia
I thought I could escape them when I'm in New York.
joe rogan
No, you can't escape them anywhere.
They're in all 50 states now.
They've completely extended their range.
And the reason why they extended their range is because we went after them.
We hunted them down.
You know, they were able to eradicate wolves.
And the way they were able to eradicate wolves is they would kill the alpha.
And then they would take an animal like a horse, they would shoot it, and then they would fill it up with strychnine.
And so then they would rub the alpha, the body of the alpha, all over this carcass of the horse.
And then the other wolves would come and smell that the alpha had been there, and then they would eat the wolf or eat the horse rather and die.
And so they were able to do this and essentially use this method plus shooting them and things like that to eradicate them from the West because of ranchers and cattle farmers.
They've never been able to do that with coyotes.
When you shoot a coyote, if they do roll call, like when you hear them howling, if one of them is missing, it sends the females, it sends some sort of a signal where their bodies produce more pups.
So if one's missing, instead of having like three pups, you'll have six.
So you make more coyotes when you kill them, and they extend their range.
When you persecute them, they just extend their range.
They're a fucking crazy animal.
They are wicked smart, man.
They've been chewing at the roof of my chicken coop, trying to get in.
I came outside the other night.
My dog, I have three dogs, but one of them is a golden retriever.
And that dog has fucking zero instincts.
I mean, it is just a, it's a little human.
It's like, it's like.
peter attia
It's a little marshmallow.
joe rogan
It's just a, yeah, he's fun to go running with and stuff.
He's a great dog, sweetheart of a dog, great pet.
But like, he's like, what's going on over there?
You know, what's happening?
There's a fucking coyote on the roof, dude.
What do you mean what's going on over there?
They're literally chewing the shingles off the roof outside.
peter attia
You have one job to do.
Go bark.
joe rogan
He's not interested.
He's just, well, he's only a year old, too, but he's just curious.
It's very weird living in proximity with all these things because where I live, we have a lot of hawks, a lot of owls, a lot of coyotes, and occasionally a mountain lion.
And I've seen, I saw a bobcat once, which is pretty interesting.
peter attia
I've never seen one of those.
joe rogan
They're weird looking.
It's a weird looking thing to see.
One of a friend of mine, I put it up on Instagram.
See if you can find it.
It's fucking old.
It's an old one on Instagram.
A friend of mine had a coyote or a bobcat break into her chicken coop and kill every one of her chickens.
And the coyote, there it is.
Look at that fucking freaky bitch.
How'd you find it so quick?
You're an animal.
peter attia
He's a bobcat.
joe rogan
He's got the best searching skills of all time.
But look at that.
That's in my friend's chicken coop.
A bunch of murdered chickens scattered around it.
The look in that thing's face.
peter attia
Yeah.
joe rogan
Fuck that.
peter attia
That look is fuck you.
joe rogan
Yeah, that look is fuck you, lady.
Yeah, it killed your chickens.
Why you have them outside?
Crazy, man.
So, how do you know Jocko?
This is how we got connected.
peter attia
Yeah.
joe rogan
Tell the folks at home.
Jocko's like, prepare to get your brain blown out.
I'm going to send my friend over.
I was like, all right, let's do it.
peter attia
So I met Jocko through one of my really close friends, a guy named Kirk Parsley, who's also a Navy SEAL, a former SEAL.
And Kirk said, hey, you got to meet my friend Jocko.
Basically, it was just like, you just got to meet Jocko.
You just have to experience Jocko.
That was basically what he was.
joe rogan
It was like a ride.
peter attia
Yeah, yeah, yeah.
So I met Jocko.
We obviously connected pretty quickly.
And then I think, oh, this was before Jocko's book had come, his first, first book had come out.
And I said, I got to introduce you to one of my best friends, this guy Tim Ferriss, who obviously you know Tim.
And because Tim's always looking for a great guest on a podcast.
And so I called Tim and I said, look, you got to just trust me on this one.
Sight unseen.
Just have Jocko come to San Francisco next week.
Just, I don't need to say anything else.
It will be worth it.
And luckily, I had enough credit in the bank with Tim.
I've been successful on enough sight unseen recommendations, but I think the Jocko one was the best one ever because he called me after.
He called me while Jocko was still there and he's like, yeah, that was pretty intense.
joe rogan
Yeah, I sent him an email after that podcast.
I'm like, that's one of the best podcasts I've ever heard in my life.
And I made a post about it.
Jocko responded to the post.
And then I got Jocko on.
And then I and Tim convinced Jocko to do his own podcast.
And now it's huge.
I mean, his podcast, I get text messages all the time from people thanking me for telling them to listen to it.
And then I get tweets from people thanking me for talking Jocko into doing it because it's just, there's outliers in this world, you know, in everything.
There's outliers in athletics.
But when it comes to discipline and motivation and just when you look at someone who's just undeniable, like Jocko's one of those guys.
He's just undeniable.
peter attia
He's a specimen.
He's definitely off the graph.
joe rogan
Yeah, I met him a long time ago when he was training with Dean Lister and Dean was fighting in the UFC.
I remember meeting him and I'm like, what's that guy's deal?
There's certain dudes that have got a whole lot of shit going on behind their eyes.
You're like, okay, that guy's seeing some stuff.
You know?
peter attia
Yeah, I'll tell you, I'll tell you a funny Jocko story.
I don't think I, I guess I can tell this story in public.
It's pretty funny.
So Jocko is in New York just after his book came out.
And, you know, and I was like, look, I want to introduce you to some of my buddies who run hedge funds here because a lot of what Jocko does is they, you know, he and his partner, like, they consult with guys like this doing leadership stuff.
And so we went up to the offices of one of my friends who has this very famous hedge fund.
And his office is like on the 50th floor on park.
And it's looking, it's like a beautiful view down park.
And we're just sitting there in his office just shooting this shit.
And I forget how it came up, but somehow we were just talking about like, how good is a sniper?
Like, what does it actually take?
And then, of course, we're talking very specifically about, I can't believe I'm blanking on his name.
Chris, Bradley Cooper played him in.
unidentified
Chris Kyle.
peter attia
Yeah, Chris Kyle.
Because Chris Kyle had been part of Jocko's team.
I forget which SEAL team.
Maybe it was when he was SEAL team two.
But in fact, I think Jocko said, he goes, you know, yeah, Chris was a part of my team for more of his kills than any of his other kills.
And so then we were like, like, what sets him apart?
I mean, obviously, any Navy SEAL sniper has got to be amazing.
But Chris took it to another level.
What was it?
And he said, okay, let me show you what it was.
So he said, so he walked us over to the window and he goes, okay, you see that guy in that hat over there, like about a mile down the, you know, you could basically see it because it was like a pink hat or something.
I said, yeah.
He goes, okay.
If you're a sniper, you got to be able to lay down, not move, and put your eye up against this thing and like look out at him.
And you can't, if you ever take your eye off that, you're going to lose the sight.
So you've got to be able to stay in that position and not move and do it.
He goes, and I forget what the number was, but Jocko said, the average Navy SEAL sniper can stay in that position without moving, eye glued to the sight for X number of minutes.
And I forget what the number was.
Maybe it was like 15 minutes.
He's like, Chris could do that for two hours.
He could lay in that position, not moving and not taking his eye off that thing with one eye shut for hours.
And he just had a different gear.
And it was just an amazing, I mean, those are some of my favorite moments with Jocko is when he can tell you something that is like, there are like maybe three people in the world that would understand why that matters.
joe rogan
Sniping is really fascinating, right?
Because just sharpshooting, just being able to shoot something at a distance and long distance shooting is a big sport.
I mean, in terms of target shooting.
I mean, there's guys that are out there, they're shooting 1,500 yards and doing it competitively.
That's a crazy distance.
peter attia
It's amazing.
joe rogan
It's a crazy distance.
But when you think about it, you got a rifle.
It's on a rest.
You're sitting.
You're either on a bench or you're prone or whatever it is.
You're lying down most of the time.
This is all it is.
It's this with your finger.
Pull, pull, pull, pull, pull, boom.
Some people are way better at that.
Just think of that.
Coordinating your vision, getting the reticle set on the target, pulling that and without movement.
The outliers are the people who can do that.
And you got to think, like, when you break down physical movements, right?
Like you watch a gymnastics routine of the Olympics, like, holy shit, and it flips and land and they stick.
And it's incredible.
But now break it down to just the movement of your trigger finger.
Pull, pull, pull, pull, pull, bang.
No movement.
You know, I mean, it's, I'm sure you've shot guns, but it's hard to, like, if you shoot pistols and you have dummy rounds, you know, like a lot of people, they mix in dummy rounds so that they find out they're jerking the trigger.
peter attia
Yeah.
joe rogan
And when you see, like, I was watching a video with Tim Kennedy, and Tim Kennedy was shooting at the range, and he's pulling, bang, bang, bang.
And it goes click, and he goes, woo, look at that trigger control.
Like, because it was, he, the way he pulled it, it didn't go off target.
It didn't move.
It was, there was no punch to it.
You know, but you, you got to fucking practice forever just to be able to do that, just to not anticipate the recoil of the gun and yank and move and twitch and just controlling the mind.
I mean, it's a fascinating thing to me that just pulling this one finger.
You would think fucking anybody could do that.
I could show you how to do that.
You know, like, like I've had friends that say they want to go hunting.
You know, I want to go hunting.
You know, what do I do?
Where do I get a bow?
I'm like, slow down.
Let's get your rifle because I could teach you how to shoot a rifle.
We could get someone, we could sight in your rifle, we'll go to the range, we'll sight it in at 100 yards, get you a good, accurate rifle, and then all you have to do is kind of keep it together.
A rifle, we get into 100 yards of a wild pig, you're going to be able to kill this thing 100%.
You got years before you're going to be able to shoot that thing with a bow.
I mean, fucking years.
First of all.
But it is.
peter attia
And the bow is like, my wife said this to me a while ago.
She said, of all the things you do, she's like, archery seems to be the only one where even if you don't have a good day, you're still happy.
Like, if I'm on the racetrack and I'm driving a race car or if I'm, you know, swimming or whatever, and I just have a bad day, like, I don't, I'm just not firing on all cylinders.
Like, it, you know, it just kind of pisses me off.
unidentified
Right.
peter attia
There's something about archery where even if I'm not having a good day, like, maybe it's an extension of what you're talking about with the trigger finger.
So for me, I got into archery because of Tim.
And the story that the thing that he told me, which obviously for anyone who told me that immediately made me be like, I want to do this, was just anything that requires that much perfection just seems great.
And he was like, yeah, you don't take a shot unless you can kill the animal.
Like, you know, and so like you might take one shot in two days.
Like it's got to be a kill shot and the kill shot's got to look like X, Y, and Z. And I was like, oh, that's like, you've got to be dialed in.
So it was this idea of back tension.
You know, it was sort of like, wow, if you're taking a perfect shot, like it's all in the rhomboids.
You know, it's all back here.
And you've got to be able to do, as you said, you've got to completely be able to eliminate any anticipation, any of this business.
And so I think that I think of archery for me as almost like a meditation.
Like I'm talking in the way like Sam Harris would talk about sort of consciousness and the way you are so hyper-aware of what you're doing that yes, you can daydream and your mind can wander, but if you actually start to imagine the sensations of every part of archery, in many ways it feels like meditating.
So I think that's why I'm just like, you know, and I never really thought about it with shooting a rifle because I don't have much experience with guns, but I'm guessing it's very similar.
But as you said, like the difference between the good and the great in that is less obvious, you know, at a distance.
joe rogan
Yeah, I think offhand, shooting a rifle and shooting a bow, I bet I'm just as accurate at 60 yards as the average person is, not a sniper, but the average person with a rifle.
You can be pretty fucking accurate.
You can't off a bench.
So there's some similarities.
There's a similarity to having the, you have to have perfect technique, you have to have the right stance, you have to make sure that everything's locked in and your structure is correct.
But I agree with you that I think it's some sort of a meditation.
I also think there's something to hitting a target that is in our DNA that's connected to hunting, that's connected to survival, that's connected to the thousands of years that people threw arrows and fucking, what is that thing called?
What's that thing called?
unidentified
Adelateral thing.
joe rogan
Yeah, is that how you say it?
Adelateral, right?
Yeah.
You know what I'm talking about?
unidentified
Yeah.
joe rogan
Yeah, that's like an advanced spear throwing thing.
And then archery and just, I think when a person would hit a deer, they knew their tribe was going to eat.
And so there's this like charge.
And you get a small amount of that juice when you hit a target.
peter attia
Yeah, no, I'm sure there's, there's got to be dopamine that's being secreted every reason you do that.
It's the greatest feeling in the world.
joe rogan
Yeah, it doesn't, it shouldn't make sense.
Like when you're looking at someone doing it, you're like, what do you give a fuck if that arrow goes in there?
It doesn't make any sense.
Like, why does it make sense?
But there's a fucking sad, like, Jamie laughs at me because I'll hit the bullseye from 45 yards and I'm like, yes.
It's like, you get this little, whoa, you get a little burst, man.
peter attia
I just like the whole experience, even the sound.
So sometimes like when my veins get holes in them, like sometimes you put a broadhead through, or you put like a field tip through another one.
Now, obviously, sometimes if you trash the vein, the arrow doesn't work.
But like usually just a single hole in a vein will produce a sound that is the greatest sound you've ever heard when that arrow leaves.
joe rogan
The whistle?
unidentified
Yeah.
Oh, I love it.
joe rogan
That's the problem with certain broadheads.
Certain vented broadheads, they whistle.
peter attia
They whistle too much, they give the animal the heads up.
joe rogan
Yeah.
peter attia
So that whole experience of like the perfect release, you know, even when you surprise yourself, like I've been, I switched over to this Carter Evolution release about back tension release.
It's the most pure back tension.
It's better than the honey because the honey, you could still cheat a little bit.
You know, if you were getting lazy, you could twist.
You could twist it.
Exactly.
But the evolution, there is no cheating.
joe rogan
Right, you can't.
peter attia
So you can surprise yourself with a shot.
joe rogan
Yeah, so there's no anticipation.
peter attia
Yeah.
joe rogan
Yeah.
peter attia
You can't explain this to people who don't do it.
Have you noticed that?
joe rogan
No, you can't.
They're like, what are you rambling about, boring the shit out of me?
peter attia
I have tried to explain this to people who don't know what I'm talking about.
joe rogan
I was trying to explain it to Alexander Gustafson, who's in here the other day, and he's a hunter too.
But he only hunts in Sweden.
You can't bow hunt.
It's not legal.
And he wanted to learn how to shoot a bow.
And so I was explaining that I put my finger on this trigger.
My finger sits on the trigger.
I use a card or two.
I use First Choice.
That's the name of the race.
I go, my thumb is on the trigger, but I never squeeze it.
The squeezing is all done with my back.
As I pull, then it just goes off.
And like you can see his head was like, why?
Why would you, but you could just do that, right?
Yeah, I can just do that.
You know, you don't.
peter attia
It's so counterintuitive.
But once I got into it, Tim actually sent me this book on back tension.
And then I just devoured it.
I mean, it was sort of like the reading the Penny Dean book.
joe rogan
Is Tim doing this a lot now?
peter attia
Not as much as he should be.
joe rogan
Is he trying to hunt with it?
peter attia
Yeah, Tim will hunt.
And he's actually done it so far?
joe rogan
I know he's hunting only with rifles.
peter attia
No, no, he's been on bow hunting trips.
That's in fact what got me into it because about two years ago, he was getting ready to go to a trip, do a five-day trip in Colorado, and he called me and said, hey, I want to talk with you about some training and some nutrition to get ready for this because it's going to be kind of an extreme whole deal.
You're at altitude, you're running around like crazy.
You've got to be able to sprint and then be totally relaxed.
And so he's like, can you help me think about how to train and what the nutrition would be?
And I said, okay, tell me more about what the demands are.
And the more he told me, the more I was like, why am I not doing this?
unidentified
This sounds really freaking awesome.
peter attia
And he's got an awesome video of this.
He took, I mean, probably, he only took one shot in the whole five-day trip and it was a perfect kill.
joe rogan
What did he kill?
peter attia
It was a huge bird, and I can't even remember what it was.
Yeah.
Yeah.
It was like a bird on the ground, like some huge ass bird.
But it wasn't a turkey.
It was like, I don't remember what it was.
But the shot, he was like, you know, it was one of those things where it was like, because, you know, like all my practice is on stationary targets, right?
So it's a totally new dimension when it's like the thing's doing this.
joe rogan
Oh, so it was flying?
peter attia
It was like kind of like either running on the ground or about to fly or something.
But he hit it in motion.
I mean, it was a great shot.
joe rogan
That's crazy.
peter attia
Yeah, yeah, yeah.
joe rogan
I wonder what the fuck that would be.
peter attia
I don't know what it was.
I'll have to ask.
joe rogan
A big bird in North America.
Did he shoot a fucking eagle?
Is he shooting powder?
peter attia
It definitely wasn't eagle.
joe rogan
What the hell is he doing, man?
Yeah, I was reading something about the goose problem about how the goose population has exploded because of farmlands and that they literally don't know what to do with the certain population of different kinds of geese that are flying into this country from Canada.
peter attia
It's funny to say this.
I was in Toronto three weeks ago, which is where I'm from.
And though I don't go often, and I was with my brother and we were up, taking the kids to some place.
And sure enough, we're walking from one area to the other and these geese come up and they kind of start posturing.
And I'm thinking, what the fuck?
And my brother's like, get moving.
Clearly, one of us is near one of their eggs.
And I was like, what?
He's like, oh, yeah, yeah.
He goes, these are the most aggressive creatures.
And they're big.
joe rogan
Yeah.
unidentified
They're pretty big.
peter attia
So I was like, fair enough.
Let's just keep walking.
Don't make eye contact.
joe rogan
They're big, but you can cook them.
So fuck them.
Get out of here.
Goddamn geese.
Yeah, there's a certain type of geese that they call ribeye in the sky because they have a delicious red meat to them.
What is that called?
Which fucking.
God damn it.
But they're very plentiful in Texas.
Yeah, they hunt them in Texas and they literally.
peter attia
What's the meat like?
Is it markabled?
joe rogan
It looks like a riot.
It's crazy.
unidentified
Sandhill crane.
joe rogan
Thank you.
Sandhill crane.
That's what it is.
peter attia
Is there anything you don't know?
joe rogan
He's a fucking wizard with the Google.
Seriously.
With Google, everyone is a wizard, but Jamie's an extra wizard.
He's really good.
peter attia
He's a ninja.
joe rogan
Yeah, but that is what they called him.
So it's actually a common phrase because I've had friends that say it might be the most delicious meat in the world.
I mean, it tastes like a wagoo ribeye.
And it's flying around.
And you could shoot like fucking 10 a day.
It's crazy.
Like, I have friends that hunt these things and they're fucking.
peter attia
And they're mostly in Texas?
joe rogan
I don't know where they are, but my friends who have hunted them hunted them in Texas.
I mean, I'm sure they fly all across the country.
But yeah, it's a crane.
It's not a goose.
Yeah, I've never been, I've only been bird hunting twice.
I went once with Anthony Bourdain for his TV show.
We hunted pheasants, and he shot one, and we cooked it and ate it.
That was fun.
I shot at one and missed.
And then I shot a turkey once, which is pretty interesting.
Wild turkeys, very good, very delicious.
But, you know, it's when I like mammals.
I like eating mammals.
I prefer red meat.
I think it's just better for you.
I think it's more nutritious.
It's more exhilarating.
There's something about the meat itself.
Just it tastes better.
peter attia
I haven't met too many foods I don't like.
joe rogan
Really?
You just say an eater?
Well, with the kind of exercise that you do, I'm sure you almost have a voracious appetite.
peter attia
I mean, I do, but nothing like what I used to.
I mean, I fast pretty much every day.
joe rogan
Are you doing 16 hours?
peter attia
What are you doing?
It depends.
So when I'm in, I split my time between New York and California.
When I'm in New York, it's absolutely one meal a day, no ifs, ands, or buts, because it's just the schedule is such that I'm seeing patients in the morning and afternoon, and I don't want to do, I don't want to waste time to eat.
So what are you doctoring?
That's a good question.
I mean, I trained as a surgeon and did cancer surgery, but my practice is based on longevity.
So it's sort of how do you apply nutrition, exercise, sleep, stress management, endocrinology, lipidology, supplements, hormones, all that stuff.
Like, how do you engineer how to make somebody live longer is my clinical interest.
So, yeah, so in New York, I eat one meal a day.
So it's basically like a 22-hour fasting window, and then I'm feeding within a two-hour window.
unidentified
Wow.
peter attia
When I'm here, it's about the same.
Well, I mean, yesterday and today, it's the same.
Like, you know, today has just been kind of a busy day.
I won't eat till dinner tonight.
But my short fast would be 16 hours where I would eat kind of.
joe rogan
That's a short fast.
peter attia
That would be a short fast.
joe rogan
That's a long one for me.
peter attia
Really?
Dude, you got to get in touch with your evolutionary self.
I had this discussion with a friend this morning because he was saying to me he can't do 16 hours.
joe rogan
Well, he's a pussy.
peter attia
No, and I was like, oh, I said he's a pussy.
You just told him.
No, but I said, you got to understand, if our ancestors couldn't function when they were hungry, we wouldn't be here.
So it's not just that starvation, a short-term adaptation to starvation is necessary.
It's probably beneficial.
In other words, during these short periods of deprivation of food, we get just a little bit more epinephrine and norepinephrine.
We just get a little bit sharper, a little bit better.
I can't even remember what it's like to eat three meals a day.
It's been so long.
unidentified
Really?
joe rogan
How long have you been doing this?
peter attia
I mean, I've been doing crazy shit for 10 years, nutritional-wise.
Like, I spent three years in ketosis where we spent a one day.
I was in ketosis for three years.
Lots of fasting, but I think intermittent fasting or time-restricted feeding, probably at least five years.
joe rogan
And for people listening, what are the benefits of that?
peter attia
Well, I mean, if we're going to get really technical, we have to be clear that I think a lot of the benefits are overstated.
And a lot of the benefits are things that we've only studied in animals.
So there's a guy named Sachin Panda at the Salk Institute in San Diego who's, I think, one of the world's experts on time-restricted feeding.
But, you know, for example, a 16-hour fast in a mouse produces unbelievable results.
If you take a group of, you know, certain types of mice or strains of rats or other rodents and you, in a 24-hour period, deprive them of any nutrient for 16 hours, but then for eight hours let them eat whatever the hell they want, they can't gain weight.
So the reason we think is that once you give a long enough period of time when the animal can ramp up its enzymes in the liver that are responsible for fat oxidation, I mean, they just basically become fat-burned.
I hate that term fat-burning machine.
It's so overused.
But they basically just become unbelievably efficient at metabolizing fat.
So we have to be careful, though, when we extrapolate that, because you and I have a very different metabolism than a mouse.
Like a 16-hour fast to a mouse is much longer than it is to us.
So I don't know if those benefits would extend.
Also, it's not entirely clear that time-restricted feeding will produce the longevity benefit that we see in other sort of fasting or fasting-mimicking types of diets.
So for me, what it comes down to is, I mean, honestly, it's just an easier way.
It gives me much more liberty with what I eat during my feeding window.
I don't have to be nearly as restrictive when I'm feeding if I have that period off.
It just, just in terms of like my physiologic response.
Secondly, there's a convenience thing.
Like I kind of hate being tethered to eat.
Like knowing that, hey, if I get into a pinch, like I don't have to eat right now.
If I'm sitting on the airplane and they're serving dog shit, I don't have to eat.
I can wait another five hours until I eat.
I also just feel much more steady in my energy levels.
I kind of vaguely remember like 10 years ago when I was kind of like eating a normal diet, how I always had this lull in energy after lunch.
Like there was the post-lunch pre-dinner, I just don't feel good.
Like, not that I feel bad, but like, I'm not sharp.
I'm not in my A game.
And I don't even remember what that feels like anymore, which is not to say I feel great all the time, but I definitely don't have that vacillating energy level.
joe rogan
Yeah, I've said that to people when I eliminated most carbs from my diet.
You know, and I have a friend of mine who talked to his trainer about that.
This trainer's like, you're crazy, eat bread, eat pasta.
Don't listen to him.
I'm like, no, don't listen to him.
Like, just Google it.
That stuff's fucking terrible for you.
If you want to eat carbohydrates, get it from fruits.
You know, get it from some natural sources.
But just, if you have a trainer that's telling you to eat bread, get a new fucking trainer.
Because it's just, it's not what you need.
I mean, it's nothing wrong with eating it if you want to occasionally and in small doses.
But when I eliminated most of that stuff from my diet, I felt the exact same thing.
I felt that midday nap desire go away.
And then just the fogginess about it.
Like at the end of the day, you're like, oh, God, I'm fucking tired.
And then I'd have to drink a cup of coffee to get ramped back up again.
And this is like never-ending cycle of having this insulin spike and then this crash.
And that is, that's from carbohydrates.
It's from refined carbohydrates and, you know, having too much fucking sugar in your body.
And everybody does it.
peter attia
It's like, all right, so this will be funny for your.
So Google my name and just put like Peter Atia fat.
And you're going to see a picture of me when I was a swimmer.
Because all this time we were talking about me swimming, you're assuming like I'm a fit dude.
I was a fit but fat dude.
joe rogan
Fit but fat.
peter attia
Fit but totally fat.
And this is.
joe rogan
What were you eating?
peter attia
Oh, non-stop carbs.
Look, there I am.
See on the left there.
joe rogan
Well, I wouldn't say you're fat.
I would say you got a little paunch on you.
peter attia
I don't know.
Wait, wait, there's another picture after I swam across Lake Tahoe.
Go to that one right there.
Yeah.
joe rogan
Got a little gut there, fella.
peter attia
Yeah, I don't know.
joe rogan
It's like you're boozing it up.
peter attia
Yeah.
joe rogan
But it's also the way you're sitting down.
Like if you stood up and sucked it in for a picture on Instagram, you might look okay.
peter attia
I don't know.
I was definitely, you know, probably what, maybe 30 pounds heavier.
unidentified
Wow.
peter attia
But body fat was much greater.
joe rogan
And what were you eating?
peter attia
Oh, I mean, I probably went through three or four bottles of Powerade a day because you're training all day.
And, you know, every post-workout was a carb refeed.
And so you're in sort of this vicious glycogen-dependent state.
unidentified
Yeah.
joe rogan
And people that it's, it's crazy that there's so many folks out there that are living their life that don't even understand that this is a process they're going through.
They just think this is eating and exercise.
This is what happens.
But it's not.
Your body, if you shut, cut that off, push it away, enter into a completely different food source.
Just change the way you eat, your body will change.
And just that concept, the people, that sounds like horseshit.
It sounds like, what are you saying?
What are you offering some miracle cure?
No, I'm saying you will change the dimension of life that you operate in.
It will change because you won't be the same person.
You won't be like who you are is dependent upon a lot of things.
But one of them is how much energy you have, how you feel, whether you're crashing.
If you change the way you eat, you change the energy you have.
You change the way you feel.
It'll change your behavior.
It'll change your choices.
It'll change your ambitions.
It'll change your potential.
I mean, there's so many things that will change.
peter attia
But there's an interesting question, which I spend some time thinking about, and I've sort of accepted the fact that we might not know the answer, which is when I was growing up, I was exercising like crazy.
Not as much as I was when I was swimming, but I mean, I'm sorry, more than I was when I was swimming.
But I ate, like I had the world's worst diet growing up.
So I would eat, breakfast was a bowl of like a box of cereal.
So I'd take like one of these Tupperware bowls that was this big and fill it with a full box.
So each day I would have just a box of cocoa puffs or whatever I would start the day with.
And then lunch was a full loaf of bread, which would seven sandwiches, plus a plate of fries, plus a big tub of like, like a two liter jug of orange juice.
But I was training six hours a day, right?
So I would, you know, run 10 miles in the morning in the gym, you know, boxing.
Like it was, you know, you know what that shit's like.
I mean, it's ridiculously energy expending.
But the point is, I had a hard time holding my weight.
I mean, I was a middleweight, 160, walked around at 158.
Who walks around below their fight weight?
So, you know, my waist was 28 inches.
I was probably 4.5% body fat.
And I was eating anything and everything you could put in front of me.
And then something happened in medical school where that shit just stopped.
And I wasn't even eating as badly at the time.
But all of a sudden, the metabolic adaptation just vanished.
And, you know, I mean, I wish someone could study this, meaning you would have to take a group of individuals and do muscle and fat biopsies over the course of their life, or at least during this window when we think this is happening.
And I think for many of my patients or just even friends, like it seems that this happens kind of in your 30s if you're a guy.
For women, it's harder for me to tell because I think pregnancy can interfere with this.
So sometimes we get a bit of a skewed answer.
But if I had to hypothesize, I think that we go from having a lot of lipoprotein lipase on muscle cells and not much on fat cells to the reverse.
So when I was 16 and invincible, my muscles had a lot of this enzyme, LPL, on it, that could just absolutely take whatever I was throwing at them and churn it into energy for the muscle.
Whereas when that LPL exists on a fat cell, you're basically just going to store more fat.
And now why that would happen over time, I mean, we could guess reasons, but I'd love to know if that's the case.
Because I still can't really figure out, like, why is it today I am so carbohydrate sensitive when there was a day when I could eat, you know, I was probably eating 7,000 or 8,000 calories a day, of which 80% were probably carbohydrates when I was growing up and was lean and mean.
joe rogan
Did you experience a crash at all in the post-afternoon crash, post-lunch crash?
peter attia
That's a good question.
Back then, I don't think I did that much back in the day, which would also speak to the idea of better fuel partitioning.
Fuel partitioning meaning this sort of technical term for where your body knows to go to excess energy.
You know, are you going to glycogen?
Are you going to the fat?
And then where are you storing energy?
So I suspect I was just better at fuel partitioning as a kid, which I'm sure most of us were.
Anyway, it's kind of, of course, the real question, the reason we care about this is like, what could you do about it, right?
Like what, you know, for example, like that's probably one of the reasons why testosterone, as testosterone goes down, you're going to get fatter, all things equal.
And part of the reason is testosterone upregulates LPL and hormone-sensitive lipase and all of these other enzymes in the direction of making you leaner versus fatter.
So, but I just don't think that that's enough of it, you know.
I think there's something else that's going on that's triggering that decline.
joe rogan
So for you with this 22-hour window of not eating, what do you think the benefits are other than your energy and slight spikes in norepinephrine and some other hormones?
peter attia
Well, I don't think there's sufficient evidence at this point in time that time-restricted feeding is going to impact my longevity.
So I think that's the big claim.
And it's the big claim that you're going to be- What is the claim?
joe rogan
What are they saying?
peter attia
Oh, I mean, I think the claim would be that fasting mimicry, which could be, you know, like what, say, Walter Longo talks about, where you do a five-day hypocaloric diet of 750 to 1,000 calories a day for five days, followed by 25 days of ad libidum feeding, meaning eat whatever the hell you want in terms of total caloric content.
You know, the claim is, well, that's going to enhance longevity.
And or, you know, doing a 16-8 or 18-6 is going to enhance lifespan.
So just to take a step back, I am only aware of three things that have universally extended lifespan across all model organisms.
So if you think of like all eukaryotes, right, if you go from yeast to worms to flies to mammals, the only things that uniformly extend life or almost uniformly is caloric restriction and or dietary restriction.
So total reduction in calories during the lifetime and or reduction of certain subsets of those calories.
So there's a super famous experiment that was done.
Actually, if anyone's interested, I wrote about it.
It's on my blog somewhere.
But it's basically this, the best experiment ever done in caloric restriction was between monkeys.
And there was a group at the NIH and a group at the University of Wisconsin.
And it was like a 19-year experiment or something like that.
So you could really study the impact of caloric restriction over these things.
And that experiment showed us that caloric restriction extended lifespan if you had a really shitty diet and it did not extend lifespan if you had a really good diet.
Counterintuitive, but it also spoke to the idea that dietary restriction probably mattered.
So, in other words, if you're eating a regular diet of McDonald's every day, and then we put your counterpart eating 70% of McDonald's every day, that's going to move the needle.
But in the Wisconsin and in the NIH experiment, when you took the monkeys that were eating kind of, it wasn't their natural food, but it was less horrible food, the caloric restriction did not extend lifespan.
So, that threw a wrench in everyone's understanding of caloric restriction.
And there are certain strains of mice that also don't seem to be enhanced in terms of lifespan, meaning just time on Earth.
But for the most part, nutrient deprivation pretty ubiquitously extends life.
The second thing that uniformly extends life across this is a drug called rapamycin, which is kind of like my favorite drug in the whole world.
I mean, meaning it's like, I think it's the most important drug in terms of this space.
Not necessarily because it's a drug that we'll all be taking, though I do believe that is the case, but more importantly, because of what it's taught us about the nutrient sensing pathway and its target, which is this protein called TOR, the target of rapamycin, or mTOR, as you probably heard of it, is mechanistic target of rapamycin.
And rapamycin inhibits that.
Now, it's a bit complicated because there's two variants of it.
There's something called mTOR complex 1 and mTOR complex 2.
And if you take rapamycin day in and day out every day, which, for example, transplant patients do, it's an immune suppressant, that doesn't seem to really extend lifespan.
But if you take it in a pulsatile way, you selectively get this mTORC 1 inhibition without the MTORQ2 inhibition, that seems to produce longevity big time.
joe rogan
And how does that work?
How would you take it selectively?
peter attia
Well, this is sort of one of my main clinical interests because I obviously am waiting for the day when I can start taking it and ultimately, you know, feel that it's safe enough that I could give it to patients.
If I'm extrapolating from all of the best data out there, so that's looking at the work that's come out of a guy named David Sabatini's lab.
David's a guy at MIT.
He's a professor.
He's actually the guy that when he was a medical student doing his PhD in 1994, actually discovered how rapamycin works in mammals.
He's actually the guy that coined mechanistic target of rapamycin, M-Torque, as a name.
And so now, whatever we are, almost 25 years later, you know, he's still running the powerhouse lab that understands it.
So if you look at all of the literature that's coming out of their lab, coupled with a guy named Matt Caberlin at the University of Washington who's doing rapamycin studies in dogs, along with the work done by someone named Joan Manick, who was at the time at Novartis, is now at a company called Restore Bio, and a few other people.
My intuition is that somewhere between two to six milligrams every five to seven days is probably the sweet spot.
But, you know, am I confident enough in that to say that we should all be taking it?
Not yet.
There's a couple things that like I want to be able to measure before we do that.
But in the animal data, this stuff's remarkable.
If you look at Matt Caberlin's dog data, it's remarkable.
joe rogan
Like, what are they doing with that?
peter attia
Well, so for, so you own a dog, you know this, right?
I mean, if you look at outside of euthanasia or accidents, how do dogs die?
They basically die of cancer and heart, and they get dilated cardiopathy.
So it's a different type of heart disease than humans get.
They don't get atherosclerotic disease.
They get heart failure.
Their hearts just get too, too, too big, and their ejection fraction, which is the amount of blood, the percentage of blood that leaves the ventricular chamber with every contraction, as that number goes down, bad things happen.
Now, to put that in perspective, you and I sitting here, a couple of normal fit dudes, we probably have a resting ejection fraction of 60%.
And if we went out there and like killed it and worked out as hard as we could at peak, we might get that up to 80, 85% ejection fraction.
So once the ejection fraction gets below 30%, you know, a person starts to become very symptomatic.
Well, Matt took these dogs that had low ejection fractions to begin with, and I forget what the exact number was, but it might have been like below 40% or below 30%, put them on rapamycin for 12 weeks, and in just 12 weeks saw an absolute 10% improvement.
So that means that's not going from 30 to 33, that's going from 30 to 40 percent EF improvement.
In other words, it's hard to measure an effect in 12 weeks of a drug.
And certainly you're not going to be able to measure a longevity impact over that.
So much of the study that's being done with this is looking at surrogate markers that we assume would portend longevity.
So Matt's work focusing on the ejection fraction.
Manic's work was focused on immune response, which again was, so this was the turning point for me.
This was like December of 2014 was like when everything in my professional world shifted in terms of my interest towards like rapamycin as the thing I want to know everything about.
Because when I was a surgical resident, you know, we used to give rapamycin out like it was cotton candy to all the transplant patients.
It was an amazing drug that revolutionized transplant physiology because it had far fewer side effects than massive doses of prednisone and things that we used to have to give patients.
Now you could give them much less prednisone and you could give them rapamycin or cousins of rapamycin like FK506.
joe rogan
And what you're doing with that stuff is you're suppressing the immune system so the body doesn't reject the organ.
peter attia
Exactly.
joe rogan
Now when you do that, does that leave them susceptible to illness or disease?
It does.
Would that be the case with rapamycin in person taking it for longevity?
peter attia
And that's the million dollar question.
And so I think in two, so in a moment, I'll tell you the story of how rapamycin came to be because I think it's the most interesting story in biology, certainly in the last 25, 30 years.
But when it was approved in 1999 by the FDA, it was for this indication.
It was an immune suppressant.
It was 10 years before anybody figured out that, oh, wait, this could also extend life.
And therein you had this paradox, which was, wait a minute, how can an immune suppressant extend life?
I mean, everybody acknowledges that immunity is a core element of health.
And so in December of 2014, I feel like it was like almost Christmas Day.
I remember thinking this is like the best present I've ever got.
Manic's group published this paper, which they did in a group of about 320 65-year-olds-ish.
So they put them into four groups.
There's a placebo group.
There was a group that got, and it wasn't actually rapamycin, it was Evrolimus, which is an analog of rapamycincin.
It's basically the same drug.
So there's a group that got one milligram every single day, five milligrams once a week, 20 milligrams once a week.
They did this for something like eight to 12 weeks, and then they washed out, meaning they got nothing for eight to 12 weeks, and then they were hit with a flu vaccine, and then the scientists measured the immune response, doing these really complicated assays where you look at T cell function.
So relative to the placebo, paradoxically, all groups, and I say paradoxically because even the group that got one milligram once a day all saw an increase in immunity, which is a good thing.
But the 5 and 20 group saw an even bigger response.
The people who just got 5 once a week or 20 once a week saw an even bigger response.
But the group that took 20 once a week had more side effects.
And the biggest side effect of rapamycin acutely is these awful, awful mouth sores called apthos ulcers.
They're nasty.
They're brutal.
I used to get them all the time just from, I think, sleep deprivation or any, you know, something that was weakening my immune system.
joe rogan
So it's an internal sore, not like a cold sore?
peter attia
No, no, no.
joe rogan
It's like usually a canker sore.
peter attia
It's a really nasty type of canker sore, yeah.
So once I had one so bad that I was like, this is when I was in residency and I was like, it was just driving me nuts.
So I went to the OR and I got a bunch of lidocaine, which is a local anesthetic, and I went into the call room and I just grabbed my tongue and just injected like lidocaine in it.
And just when I did that, somebody walked in and I've got like blood dripping down from my mouth and I've got a needle in my mouth.
And they're like, and I'm like, no, no, no, it's not what you think.
It's not what you think.
I swear, it's lidocaine.
They're like, dude.
We got to get you into help.
We're support groups for people like you.
joe rogan
Lidocaine is disgusting.
I had my deviated septum fixed and they shoved the lidocaine up there.
It's harsh stuff.
And the rest of the day, I just felt like shaky and just weird.
And then I realized, oh, this is like almost like a cocaine type thing.
Like it's not.
peter attia
Do you know why we have lidocaine?
joe rogan
Because of cocaine.
unidentified
Yeah.
peter attia
It's a guy named William Stewart Halstead, who was so near and dear to my heart because he was the original, he was the founding surgeon at Johns Hopkins and one of the original four horsemen.
So the four main physicians that basically have shaped medicine in this country all started out at Hopkins.
Osler in medicine, Hopkins in surgery, and two other guys, Walsh and I'm blank and Kelly was the third one.
And he basically figured out, because you got to remember, like there was a day when surgery was staggeringly barbaric.
Like prior to ether, surgery was like, all right, can you hold them down?
Like gag them, get them drunk, gag them, and like we're going to do our thing.
joe rogan
Sorry, fucking love.
peter attia
Yeah, it's just crazy.
So, God, I used to know all of this shit.
I don't remember any of the exact dates anymore, but it was like kind of like mid-1800s to late 1800s when up at Massachusetts General Hospital, I forget the name of who it was, but someone basically came up with ether.
So ether became the first form of anesthetic.
But you were sort of knocking people out.
Well, it was, you know, fast forward probably 20, 30 years when Halstead figured out that this thing called cocaine could provide local anesthetic.
So he began experimenting with like crazy and of course in the process became like patently addicted to it.
So you have this entire generation of surgeons at Hopkins from that early era that were completely coke addicted.
So Halstead and all of his first generation of residents.
And then of course from that we got lidocaine, bupivacaine, all of these things that don't have the same properties.
But to this day, cocaine is still used and most people don't realize it, but cocaine's a Schedule II drug, meaning it actually has a medical application, unlike heroin, which is Schedule I in the DEA.
joe rogan
And marijuana.
peter attia
That's right.
But cocaine is Schedule II and it is still used in some ENT surgery because it has some favorable properties over even lidocaine and bupivacaine for nasal surgery.
joe rogan
Did you know that they still use cocoa leaves for flavor in Coca-Cola?
They actually extract the cocaine from it, use the cocoa leaves, and the cocaine goes to medical for this.
peter attia
I had cocoa tea for my first time this summer, like real cocoa de latte.
unidentified
But like brought up from mate de coco, that's what it is.
joe rogan
Oh, yeah, it's great.
peter attia
I could not get enough of that stuff.
joe rogan
You can't shut the fuck up on it, though.
It's a weird sort of high.
It's a very strange thing.
It's very talkative, sort of high.
peter attia
I thought it was just, everything about it was like just such a cool taste.
joe rogan
You ever done that?
Like in Peru?
peter attia
No, no.
joe rogan
I've never done it either, but apparently it's really interesting.
It's like a coffee sort of a thing, and it's got flavonoids.
It's actually, it's actually probably healthy for you.
peter attia
I just love plants in general.
joe rogan
Yeah, but we think of the coca leaves as producing cocaine.
Cocaine, we think of as inherently negative.
But the leaf itself, like if you just don't extract it, it's actually really good for you.
peter attia
Well, that's the thing.
I mean, even like thinking about the difference between eating fruit versus eating Oreos.
joe rogan
Yeah.
Super sugar.
Yeah, yeah.
peter attia
Nature's pretty good at regulating how fast this stuff.
So in the case of fruit, like how quickly does fructose hit your liver?
There's a sort of governor built into it if you're eating raspberries.
Like, could you get non-alcoholic fatty liver disease from eating enough raspberries?
Yeah, probably.
It's like you need to become a full-time job.
joe rogan
Or you could just drink a giant gallon of orange juice every day.
unidentified
Right.
joe rogan
That would do it.
That would do it.
It would be a lot quicker.
Because most people think of fresh, squeezed orange juice as being, oh, you're eating healthy.
peter attia
Yeah.
joe rogan
Look at you over there with your fresh squeezed orange juice.
peter attia
Yeah, you're juicing.
It's totally healthy.
joe rogan
Super healthy.
Meanwhile, you're just drinking a big old glass of sugar.
Literally, your body doesn't know the difference between that and a Coca-Cola.
peter attia
Very little difference between the two.
joe rogan
Well, Coca-Cola's got some other stuff in there, caffeine, but other than that, just the sugar itself.
peter attia
Yeah, your liver would have a hard time telling the difference.
joe rogan
So crazy.
Most people would think a glass of orange juice at breakfast is a healthy choice.
peter attia
Yeah.
joe rogan
Well, it's a glass of sugar.
peter attia
Have a mountain dew.
joe rogan
Yeah.
Might be better.
Might get more shit done.
Yeah.
So this the dosage of one, five, and then 20.
peter attia
So that study, I remember reading that and thinking, okay, so if you looked at that study, you realized if you're going to be in the placebo, the one a day, the five once a week, or the 20 once a week, the five once a week was the way to go.
joe rogan
Sweet spot.
peter attia
That's right.
You got all the benefit of 20, more benefit than one, and the fewest side effects.
joe rogan
And how long is this study?
peter attia
That was an eight-week intervention with an eight-week washout was enough to see the enhanced immunity.
joe rogan
Do you think that a longer-term study is necessary to see whether or not the body adapts?
peter attia
Yeah, absolutely.
I mean, all this stuff is in its infancy.
Now, my shtick is, so right now, rapamycin's off patent, right?
So the drug was approved in 99 by the FDA, but this is after an unbelievable, amazing story of like how, you know, this drug almost got lost forever.
Like, you know, so there's no economic incentive for a company to, you know, figure out how to do this thing with rapamycin.
And even Everolimus, I think ultimately Novartis.
And I'm saying this with no actual knowledge other than just my own speculation, but I suspect Novartis was like, well, you know, we're not going to play this game just with Everolimus.
And that's, I think, why it probably spun into this other company, RestoreBio, to sort of combine it with other agents.
But at an N of one level, what I'm kind of interested in doing is, You know, using myself as a guinea pig to start to measure the benefits of it, because my hypothesis is three things have to be true if rapamycin is working.
Now, I could be wrong, but this is my hypothesis, and this is what I test with other scientists: if you were taking rapamycin at the right dose, so assume you're not getting all the nasty side effects, you're not getting the mouth sores and stuff like that.
Three things have to get better.
One, your glucose metabolism should at least get no worse, but potentially better.
I suspect it's a function of where you start.
So, there is one doctor in New York who has like a rapamycin practice.
I think he's in the Bronx, actually.
And I've talked to him a bunch, and when he started it himself, he said like the improvements were remarkable just in terms of glucose metabolism.
But I think he was starting at a pretty bad spot.
But if you or I took it, we might not notice much getting better, but we definitely should not get worse.
So, that's easy to measure clinically.
You do an oral glucose tolerance test would give you that answer.
But two things should get significantly better.
The first is immune function should get better, not worse.
There's no clinical way to measure that, but we do know how to measure it.
I mean, when I was doing my postdoc, it was in an immunology lab.
Like, I know how to do that assay.
I just don't have like a million dollars worth of equipment to measure it.
joe rogan
What is the difference in the dosage, even in the high end, at 20 versus what you would give someone if they got a kidney transplant?
peter attia
Yeah, yeah, typical transplant dose would have been like two, three milligrams every day.
joe rogan
Okay, so it's quite a bit different.
peter attia
It is, and it's different on two levels because when you're giving it every day at a lower dose, you still end up producing tissue levels that might even be comparable to where that person was getting with the spike of 20.
And in general, this isn't always true, but in general, in pharmacology, side effects are the result of certain side effects, are the result of the nadir dose, and certain side effects are the result of the peak dose.
So, with every drug, you kind of have to understand this a little bit.
But going back to this rapamycin thing, the third thing that has to be true, in my opinion, I could be full of shit, but I think the third thing that has to be true if you're taking the right dose is you need to see an uptick in autophagy.
And so, just as if you autophagy is this process where the body cells start eating themselves, so it's kind of like a programmed cell death, although technically we reserve that term for something called apoptosis.
But when you're fasting, why would fasting produce a benefit?
I mean, I think the most logical explanation is enhanced autophagy.
So, the body basically has to prioritize in the absence of nutrients.
The underperforming cells are basically told, eat yourself.
And, you know, we can recycle some of your components.
Maybe this mitochondria is worth saving.
This Golgi apparatus is worth saving.
And then we selectively, when we refeed, repopulate the better cells.
And in many ways, I think rapamycin can do that in a pill.
So, the problem is we don't have a blood test to measure autophagy.
So, in the lab, when you measure autophagy, you need muscle biopsies, or they typically even just sacrifice the animals.
This has become a very hot area.
So, the Nobel Prize in Medicine and Physiology was awarded for the genetic, basically the elucidation of the genetic regulation of autophagy in actually, it was 2016, so it's very recent, about a year and a half ago.
This is what the Nobel Prize was awarded for.
But what I'm hoping is that we can develop a signature for autophagy with a blood test.
So, I believe that you should be able to look at someone's blood and look at all of the metabolomics, all of the small molecules, all of the proteome, and there should be a signature.
It should look different from the way we look when we're fasted or sorry, fully fed.
joe rogan
Otherwise, would you just take a sample of the muscle tissue, like punch something out?
peter attia
Yeah, and I'm willing to do it all, and I probably will.
We're just trying to get what's called an IRB, an institutional review board.
So, to do these kinds of studies in humans, even if I'm the only subject and it's just like, I don't care what you do to me kind of thing, we still have to get an IRB.
So, we're working on getting an N of one IRB so that we can take muscle biopsies, fat biopsies from me, blood tests, and then start to actually look for that signature.
joe rogan
Would it vary in where you got it from?
Like, would you want to get more than more than one muscle group?
peter attia
That's a very good question.
I don't know the answer.
I probably have to talk to people who have a lot of experience doing this with animals.
But it actually wouldn't surprise me.
Like, if I were going to do it, I would just start in the legs because the muscles in the legs tend to be the harbinger of what's going on in the body.
So, for example, one of the first signs of diabetes, like a decade before you get diabetes, one thing that if you're actually doing this kind of testing in people, you'll notice glucose, like insulin resistance in the muscles of the legs.
So once the legs start to get insulin resistant, you're on a glide path to bad things happening.
joe rogan
I'm fascinated by legs.
First of all, from years of martial arts, but also because over the last year or so, I've been doing a lot of running, and it's one of the only muscle groups that I can work out every day.
I can run hills every day, and I'm not sore.
Like, that's not even possible for any other group.
I mean, I can kind of do that with boxing.
You can hit the bag.
But as far as like running hills is essentially like plyometrics.
Like you're pushing your entire weight up and then you're catching it with the other leg and pushing it up.
You can't do that.
You can't bench press every day.
Your fucking arms will fall off.
I mean, there's probably someone out there doing it that's proven me wrong, but there's nothing like the amount of endurance that you have in your legs.
peter attia
It could just be an adaptation that you've had as well.
I mean, when I was a competitive cyclist, I mean, there were definitely days when I would – especially when we did like multi-day events.
Like there were days when it's just like – Yeah, yeah, yeah.
You're going to learn in the first 10 minutes.
Like everybody else is riding together.
You're riding alone today.
joe rogan
The fatigue level, though, is significantly different than it different than it would be if you were doing something with your arms every day.
It seems like your ability to recruit.
peter attia
You can definitely recruit more.
That's probably part of it.
joe rogan
So there's more tissue.
peter attia
I think you have more options.
Like you can, you know, especially if you really have good proprioception.
For example, like if you're deadlifting, you know, I actually think if you so you know how you have like the positive and negative motion, concentric, eccentric motion of a weight?
If you're willing to do away with the negative, you can lift heavy every single day.
So there's this guy named Ryan.
Oh, unfreaking believable bad.
joe rogan
I've seen people doing that.
You know who I saw that Andre Galvao on his Instagram the other day was doing deadlifts and just dropping the weight.
And I was like, that seems weird to me.
peter attia
So when I was a cyclist, this was my training.
And it was all put together by this guy named Ryan Flaherty, who actually introduced, that was another one of my sight unseen introductions to Tim for a podcast.
It's a great podcast with Ryan Flaherty on.
And he's, I call him the guru of speed.
This is a guy who like single-handedly, I shouldn't say single-handedly, I mean, he's on the shoulders of many other people who have done great work, but has really done an amazing job of figuring out how to make people run fast.
And it's a very long story, and I mean, he does such a great job on the podcast, I won't go into it.
But for the purpose of this discussion, one of our interests was, hey, could we translate everything you've learned about sprinting into cycling?
And his biggest observation was the following.
If he took 100 runners and lined them up and knew, like before they ran, knew how hard they could hit a force plate treadmill, he could predict the order in which they'd finish the race.
So a force plate treadmill, as its name suggests, a treadmill, but it's a special treadmill where it measures the force that you hit.
And the higher that number divided by your body weight, that became what he described as mass-specific force.
That number, if you rank order it, is the order in which people would finish the run.
So it kind of makes sense if you think about it, right?
The harder you can hit the ground relative to your own weight, the higher you go.
And the higher you go, the longer you travel with each stride.
So Usain Bolt has the highest ever force plate measurement calculation.
And it's, I forget what his ratio is.
I want to say he's like 6.9 or 7 times more force than his body weight every time he hits.
Friggin' staggering.
unidentified
Wow.
peter attia
So then Ryan's, once he figured all this stuff out, his next question, this is when he was working at USA Track.
His next question was, could you train this?
In other words, like, okay, if Joe runs a 4.940 and we want to get that down to a 4.5, can that be done?
And it turned out the answer was categorically yes.
You have to do two things.
You have to get stronger and you have to get lighter.
So how do you do that?
And that's when he came up with this idea of we do hex bar deadlifts.
We lift really heavy.
So you're only doing fives, fours, threes, or twos, never more than five reps.
And so you'll do five sets every single day and you'll pick it.
So some days it'll be five sets of three, some days it's five sets of five, whatever it is.
And they're very well prescribed, like, you know, at what percentage of your one rep max you're doing these at.
unidentified
And it's up, drop, up, drop, up, drop.
peter attia
So you're never getting the actin-myosin filament to tear past, because that's what's happening in the negative, is the actin and the actin is coming off the myosin, and that is creating a micro tear in the muscle, and that's what the muscle rebuilds.
That's why we get larger when we lift weights.
But when you drop it, you unload the muscle when you're relaxing it.
So the muscle's not going to get bigger.
So you're getting all the benefits, all the strength, which is primarily around the type 2B muscle fiber and without the size.
So anyway, when I asked Ryan, hey, could we do this in cycling?
We did this experiment, which was he kind of came up, this was for me and two other guys who were very good cyclists.
Like I was like, I'm a popper, but these guys were like cat one, cat two, collegiate cyclers, but cyclists, but they were like my training partners.
So we did this thing where we did the same routine that he had the sprinters doing.
And it's a bit more complicated than I've described because you're also juxtaposing the positive only with something called a post-activation potentiation, which you may have already experienced this, but I don't know if you've ever tried to do plyometrics after deadlifting, but it seems counterintuitive that you'd be able to do more, but you can.
joe rogan
Really?
unidentified
Yeah.
peter attia
It has to be a heavy deadlift.
joe rogan
More in terms of numbers or more in terms of 10.
peter attia
No, more in terms of distance, like more in terms of vertical.
unidentified
Really?
peter attia
So your highest plyometric jump is going to come after you've done like, you know, three sets of three at 95% of your one rep max.
joe rogan
And three sets of three dropping or using eccentric.
peter attia
No, definitely dropping.
Absolutely, yeah.
joe rogan
Huh.
Wow.
peter attia
And so we would superset the plyometrics with the deadlifts.
And you would do this every day.
And so Ryan, you know, he runs a training camp where he has typically the top 10 college prospects every year just before the NFL Combine come down.
And I mean, the changes he makes in their time.
Like Johnny Menzel was one of them.
So obviously Johnny Menzel has obviously, you know, not panned out in the pros, but most people kind of forget how good an athlete he was.
And when he showed up to camp, I forget what his time was, but I want to say it was about, I don't know, you could probably look this up for me.
You know, it was three-tenths slower than what he ultimately ran at the Combine.
And I think he had the fastest or second-fastest quarterback time at the Combine after just 12 weeks of doing this.
unidentified
Wow.
peter attia
I mean, it was unbelievable how fast he can get these guys to run.
joe rogan
I saw something the other day that I'd never seen before.
It's an eccentric bike.
It changes back and forth.
peter attia
I've heard of this thing.
You're the second person to tell me about this.
joe rogan
I think I saw it yesterday, in fact.
Now that I think about it, it was eccentric and concentric, but it alternates.
peter attia
Yeah, yeah, yeah.
joe rogan
And it looked really weird.
It forces movement, and you're resisting the movement.
See if you can find that, Jamie.
It's like an eccentric, I forget what it's called, but like someone sent me this, like, hey, this thing's amazing.
I was like, it's a bike.
What the fuck are you talking about?
It looked different than that.
peter attia
The one I saw was also different.
It was a recuit.
I think it was like a recumbent.
joe rogan
Yeah.
Yeah, that's what I saw too.
Eccentric.
Yeah, you're spelling it wrong.
Oh, it says geccentric.
Oh, okay.
Huh.
Eccentric exercise bike?
Try that.
But the thing is, it alternated between eccentric and concentric.
It wasn't just...
The one with the red on the top row looks like it.
What is that?
Pediatric ergometer.
No, that's not it.
It's for little kids.
Well, whatever.
I wish I had saved it because I was like, I'm never buying this.
But, you know, it just looked interesting.
It's just like, there's always these new methods of stimulating the body and tricking it into doing things.
And I guess that's essentially what a lot of people, the way a lot of people think of intermittent fasting, you're kind of stimulating the body.
You're hacking it.
You're tricking it, you know.
peter attia
And I wonder, you know, one of the things that Ryan and I talked about was, could we ever adopt his training system to swimming?
And in running and cycling, it's primarily going to be quads, hams, glutes have to be the muscles that do it.
joe rogan
And throw things?
peter attia
Well, we were talking about like, you really got to be able to get the lats fired, but how do you get the lats to fire at such a weight and then without having to do the negative as well?
So we just couldn't really kind of figure out how to do it.
So we adapted part of his technique to swimming, which was the actual training routine.
Meaning, so one of the big misconceptions if you're trying to go fast is that you need to still train slow.
But the reality of it is like, you know, if you're trying to run a marathon at, you know, call it a pace of 215, you know, world-class marathon runner, there's not a lot of benefit to spending much time running at a pace slower than that.
If anything, you want to be running slightly faster than that.
You know who Meb is, the American marathoner who won the Boston Marathon three years ago?
joe rogan
No.
peter attia
So amazing marathoner.
I think he's the only person to have won the New York Marathon, the Boston Marathon, and to have won an Olympic medal in marathon.
He won a silver medal in the 2004 Athens Games.
But when he won the Boston Marathon, he was like 38 years old, which in marathon parlance is like, you might as well be 100.
And he had not really had a great race in the previous few years.
So he had been effectively written off in the sport.
And Ryan actually helped train him.
And all they did was apply this principle of sprinting into marathon running, which was, all right, Meb, if you want to win the Boston Marathon, you need to be able to travel like four inches further with every step you take, taking the same number of steps at the same cadence that you currently run.
And they, you know, Ryan did the math and said, That means your force number has to go from where it is now, which I think was 1.7, meaning he could only deadlift 1.7 times his body weight.
You have to get that up to like 2.6 or something.
And so when Meb trained for the Boston Marathon, he was focusing heavily on these deadlifts and doing much shorter, faster runs.
And, you know, I mean, if you watch the video of his Boston Marathon win, it's incredible.
Like, you know, he just takes off and like leaves everybody behind him.
And they're like, yeah, there's no way he'll be able to keep that up.
We'll let him go.
And they couldn't rein him in.
unidentified
Wow.
joe rogan
Do you think that someone's going to be able to break two?
That's the big, we were just talking about the other day.
Some guy got really close.
Would you say he hit Jamie, like 206 or something?
peter attia
I think someone's gone closer.
Didn't that guy in Germany last year go even closer?
joe rogan
I think it was 202 or something along those lines.
And you think that this sort of method is what they're using?
peter attia
So I don't know if I'm allowed to talk about this stuff publicly.
Uh-oh.
joe rogan
Don't worry.
No one's listening.
peter attia
So short answer is yes.
I think this can be done.
Everything has to be perfect, right?
Meaning you have to have the perfect athlete trained to peak at the right time.
You need the right humidity.
Like everything has to fire on all cylinders.
But just as there was nothing physiologically special about a four-minute mile when Roger Bannister broke it, it was more of a psychological barrier.
You know, I'm not suggesting for a moment that this will be easy, but, you know, we're going to get there.
I mean, like, this can happen.
joe rogan
That is incredible if you think about how fast you're running to run 26 miles in two hours and two minutes.
peter attia
It's staggering.
I don't think people understand like what a I mean, I was never a great runner.
I was about a 250 marathon, 255 marathon when I was a boxer, but never trained as a runner.
Like it was just, I just ran so much and I was pretty fast.
But like when I think about how hard I would have to run to bust out a 250 to 255 and to think like, was there any chance I could have ever got that down to a 230?
It's a that is such an enormous change in pace.
joe rogan
Yeah.
peter attia
It's it's I don't know that I ever could have done that regardless of all the training tricks in the world.
joe rogan
And what kind of diet are those guys following?
peter attia
Well, I know Meb personally.
I can't speak to what the other guys do, but I think a lot of those guys are frankly in the state of where I was when they were younger.
Meaning like they can probably get away with a lot more.
If you look at the physiques of most of these guys, they're perfectly built.
Like I'm talking elite level.
I'm not talking about like anyone who go runs a marathon, but if you're talking about like the people who are going to win the marathons, they are basically all engine and then chassis in the right place.
That's basically all they come down to, right?
I mean, they are enormous cardiovascular system, very strong quads, hams, glutes, and then everything else is very tiny.
joe rogan
When you say enormous, like is literally the size of their lungs different?
peter attia
Yeah, you actually look at, well, I mean, it's all relative, but when you look at their frame, their thorax is going to be larger.
joe rogan
And is it expanded because of the training?
peter attia
I think so.
I mean, you never know cause and effect sometimes.
You could argue, like, maybe these guys were, maybe the people who are drawn to those sports are the ones that are, you know, or drawn to be elite in those sports, already had a genetic predisposition.
That's sort of my feeling is it's a bit of a case with Lance Armstrong.
unidentified
Like, doesn't he have a very large heart?
peter attia
I don't know.
I think what Lance had that was pretty unique, even amongst the world's best, which is what he competed with, of course, I think his lactate threshold was a lot higher than most people.
joe rogan
Genetically.
peter attia
Yeah.
And then, of course, and again, you know, I mean, I know it's such a controversial topic, although my view is I think that every single cyclist, at least from 1991 till 2011, was on highly, highly, you know, augmented programs.
So, you know, that Lance won seven of those years in that context just tells me that he was, you know, training harder and being more specific to the race.
I mean, what people don't understand is like, I mean, Lance only peaked for one race a year.
Like everything that that team, U.S. Postal, did, was geared for that one race.
And also, when you really look at how much doping they did, it actually wasn't that much.
Like, you know, when they were blood transfusing, it might have been two units over the course of a race.
And I'm not saying that that wouldn't help.
It would help a lot.
But that's nothing compared to what people were doing just a few years before Lance came along.
So Lance won, I think, his first one in 99.
The guy who won before that in 98 was Marco Pantani.
Before that was a game of Jan Ulrich in 97.
And before that was a guy named Bjorn Rees.
Bjorn Rees' nickname was Mr. 60 because his hematocrit was always over 60.
That's freaking staged.
Like how that guy didn't die of a stroke, I don't know.
joe rogan
Is that from EPO?
peter attia
Yeah.
Lance never had a crit over 50, to my knowledge.
They would basically always titrate with Epo and or hemoglobin up to 50, which was the trigger.
So, you know, but I think, and again, I've never, I don't know Lance at all, so I certainly don't know anything about him beyond like the little bits that I have read over time, but I do think his lactate tolerance was remarkable.
Meaning, you know, we measure lactate in athletes, swimmers, and cyclists when they're, you know, trying to figure out what their performance is.
And as far as I can tell, there seem to be these two phenotypes.
There's the one phenotype where people can tolerate staggeringly high amounts of lactate.
And again, it's not lactate per se that is causing the pain that you're experiencing.
It's the hydrogen ion that accompanies the lactate.
So lactic acid, the acid part of that is the hydrogen ion.
And that's actually what's poisoning the muscle and preventing the muscle from having this effortless actin myosin act, you know, contract, release, et cetera.
But we use lactate as a proxy because where lactate is high, the hydrogen ion is high.
And there are some people who can just tolerate like incredible doses.
I used to work with Olympic swimmers.
And I mean, there were just a couple of these guys.
Like they could actually be standing with a lactate of 24.
I mean, when I was competing, if I had a lactate above 16 or 17, I couldn't be standing.
Like, that was just too much pain.
Like, I was on the floor.
If I was over 17, I was puking.
And I saw dudes that could stand there at 24.
In fact, one of my good friends, he won a gold and a silver medal in the Sydney Olympics and retired from swimming in 2004, then came back to swim masters.
He actually was trying to make a comeback to make the 2012 Olympic team.
And when he was training for that, I would poke him between races.
And I saw him get out of a 400 individual medley race, which is the hardest swim race of them all.
The 400 IM is, I mean, you might as well just shoot yourself.
It's so painful.
He got out of that, had a lactate of 18.
Two minutes later, not two minutes later, maybe seven minutes later, jumped on the blocks and won 100 breast race, came out with a lactate of 21, that kind of thing.
So there are those guys.
And then I think at the other end of the spectrum, the word on the street is guys like Michael Phelps are at the opposite end of that, where they are so efficient at shuttling lactic acid out of the cell back to the liver, where this thing called the Cori cycle actually turns lactate back into glucose that they never have high levels of lactate.
Now, again, all of this is sort of speculation because I think they were very hush-hush about Phelps' numbers.
But I heard from reliable and reasonable sources that he would rarely have a lactate above 8.0, including when he's breaking world records.
unidentified
Whoa.
peter attia
Which for me at 8.0, like I'm smoking and joking.
Like that's fine.
But for, you know, he was so efficient at getting rid of it that, yeah, he could, you know, set the world record in the 400 IM and have a lactate of eight.
Again, I don't know if this is true, but I've there's certainly a plausible mechanism by which it could be.
joe rogan
Well, it's fascinating that this could potentially all be engineered, right?
That like through use of CRISPR or something else, you could take all these various facets of performance-enhancing modalities, extend a person's ability in so many different ways and create a superperson.
peter attia
Yeah, of course, it's interesting, right?
Once you start genetically doing it, if you could, does it become cheating in the same way?
joe rogan
Well, does it if you have someone like Phelps who has this genetic predisposition to getting rid of lactose, lactate, and you take someone like me who probably has none of that and you juice me up to his level?
Is that cheating?
peter attia
I mean, it is.
I don't know.
I mean, those are the questions.
I mean, this is why people like Daniel Coyle, who are so critical of Lance Armstrong, say, because on the one hand, you'll have camps that say, look, it's the great equalizer.
Like, why don't we just let everybody dope?
joe rogan
That's a steroid argument with MMA as well.
peter attia
Well, and frankly, it's more my argument.
But I have a different reason for arguing that way, which is I think having done these sports and nowhere near at the high level that those guys do it, I just know how destructive they are.
Like, the Tour de France is the most unhealthy thing on the face of the earth.
joe rogan
I've heard that it's healthier to do the Tour de France on steroids than it is to do it off steroids.
peter attia
Absolute fucking lootly.
When those guys finish the Tour de France, they are osteopenic.
I mean, their bone density has eroded.
They have lost so much muscle mass.
I mean, it is a devastating, grueling event.
Now, nothing's going to completely ameliorate that.
But like, if we think that watching these guys kill themselves riding six hours a day, hitting peak thresholds of, you know, six watts per kilogram, if we think there's anything physiologically reasonable about that, we're out to fucking lunch.
joe rogan
But is that the point?
I mean, isn't that the point is that you can push your mind to do something your body absolutely doesn't want to do, so you should be rewarded for that.
peter attia
And these guys are in a league of their own.
I mean, professional cyclists are some of the toughest athletes out there.
I mean, obviously, every athlete at the peak of their game is remarkable.
And no disrespect to like the best running back in the NFL, but like you can't even compare that to what a guy does to the business.
joe rogan
For workload, for sure.
peter attia
Yeah, for just the pain, like the absolute sheer discomfort and the physiologic torture and the duration of it and all these other things.
joe rogan
Well, you see it in their faces, too.
Those guys, like when they retire, they look like they're 10 years older than they are.
peter attia
Yeah, yeah, yeah.
They've lost all of the fat.
A lot of them, you know, they just, if you don't have fat in your face, I mean, you age really dramatically.
joe rogan
They just look exhausted, too.
I mean, it looks like it's just drained them.
Like they've forced to live 30 years inside of 10.
peter attia
Yeah, so it's like, what if we just say, guess what?
Everybody's allowed to use whatever amounts of EPO, blood, testosterone to be at the 80th percentile of what we consider normal.
So everybody's allowed to walk around with a hemoglobin of 14.7 or up to 14.7 or 15.
joe rogan
People would cheat that, right?
Wouldn't they?
I mean, if you allow people to use a certain amount.
peter attia
But I also think like the testing on this stuff is so, like, it's so JV.
Now, there's this idea called the biological passport that was introduced many years ago, which basically said, look, we're going to develop a signature for every person.
And now, if you deviate much from your signature, that'll be the trigger.
And the argument, again, by certain people, and I think Daniel Coyle argued this a lot in one of his books that he wrote, Ripping Apart Lance, was the reason doping is unfair, because the everybody does it argument doesn't hold water, is because if you're a person who naturally lives at a hematocrit of 47, you're only getting a slight improvement going from 47 to 50.
If you're a person who naturally lives at 43, you going from 43 to 50, you get a much bigger advantage.
To which I say, yeah, but that's true on a relative basis, but at an absolute level, if everybody's walking around with a hematocrit of 48 to 50, they still have the same oxygen-carrying capacity.
It does level the playing field.
joe rogan
The concern, though, isn't, I would believe the concern is you don't want people to think that the only way to do this sport is to take drugs.
peter attia
Well, absolutely.
And it's also worth putting in mind that, and this is sort of my pet peeve with this whole drug and sport thing is like, I mean, personally, I don't really give a shit.
I mean, I just have bigger things I care about than like how many steroids Barry Bonds took to hit all those home runs.
But what really does chap my ass is when people don't actually understand how steroids work, right?
Like it bugs the shit out of me when people assume that if you take steroids, you will have, you know, you will hit that many, you know, home runs or you will run this fast or lift this much.
The only thing that steroid is doing is enabling you to recover faster from the brutal work that it takes to actually do those things.
So, you know, if I shot myself full of EPO, I mean, you've probably seen Icarus, right?
I mean, I thought that was, I thought he did it.
I thought Brian.
Yeah, I thought Brian Fogel did a really good job of showing, like, I mean, and he was a pretty good responder to the EPO.
I think he did growth hormone, testosterone, and EPO.
I mean, you saw in the end of the day, he finished worse the second year round.
joe rogan
Yeah, but his bike ran out of juice.
peter attia
Exactly.
That's my point.
You see, like, people don't realize, like, one little thing makes all the difference.
From a performance standpoint, yeah, he probably would have done a little bit better, but it's not because the drugs were in him per se.
It's because the drugs that were in him allowed to train more.
So the reason he was a fitter rider the second year was because his watts per kilo were higher because of how much more he trained.
The drugs enabled him to train that much harder.
joe rogan
Yeah, that's what it does.
It allows you to train harder so you recover better so you have more output.
peter attia
Correct.
joe rogan
But we don't want young kids to think that the only way to do this is start taking steroids and fuck up your endocrine system.
peter attia
No, of course not.
But we also want to keep in mind, like, see, it almost requires like a broader discussion, which is like, why do we care?
joe rogan
Well, we care in combat sports because it allows you to inflict more damage on the future.
unidentified
No, no, no.
peter attia
I'm saying like, why would why do, why, let's just say I'm not a professional athlete.
joe rogan
Okay.
peter attia
Why do I actually care how fast I run or how fast I ride or any of these other things?
joe rogan
Well, because you want to brag about it.
unidentified
Okay.
joe rogan
So maybe you're a weight loss.
unidentified
Right.
peter attia
So maybe therein lies the problem.
I mean, I mean, I, you know, when I stopped cycling competitively, I think a big part of it was I just realized that performance and longevity stopped being collinear.
They started to become somewhat orthogonal.
They started to deviate.
In other words, the things that I was doing that were enhancing my performance.
And I'm not even talking about drugs.
I'm just talking training-wise.
It seemed to come at the expense of what I believed was going to make me live longer.
So specifically, the thing I cared most about was cardiovascular health.
Now, the incidence of atrial fibrillation in highly trained athletes is 10 times higher than that of non-athletes.
So like that's a little counterintuitive, right?
Like why would people who have such amazingly fit cardiovascular systems have 10 times the risk of this horrible condition called atrial fibrillation, which yeah, many people have it, but not young.
You're not supposed to have that when you're 40.
And it's usually associated with cardiovascular disease.
And yet people are, you know, showing up with these.
I mean, I have four patients who have had to get ablations for atrial fibrillation.
joe rogan
What is an ablation?
peter attia
An ablation is a procedure where they stick a catheter up through the femoral artery or in the vein and then they burn pieces of the heart, specifically around the pulmonary veins.
And they basically are trying to burn away and create or remove the ability of the electrical system to move in this way.
So what's basically happening with this type of athlete's heart is when your heart is constantly being exposed to that high stretch, high ejection fraction load, you're basically stretching out the electrical system because the electrical system of the heart runs within its muscles.
So as you stretch it out, a certain group of people, and we don't know why certain people are susceptible and certain or not, but they just develop this dysrhythmia.
joe rogan
So you're soldering the motherboard, as it were?
peter attia
Yeah, yeah, you can effectively think of that, right?
You're like creating new lines to block the connection.
unidentified
Whoa.
joe rogan
That's fucking crazy.
peter attia
Yeah, so think about it.
joe rogan
Someone said once, and I don't know if this is true, maybe you would be able to have some insight, that there's a concept that your entire life you have a certain amount of heartbeats.
Does that make sense?
peter attia
Oh, no, of course.
I've heard it many times.
I don't know if that's correct.
joe rogan
That's fucking scary.
peter attia
Yeah, I don't tend to agree with that because you can't compare one beat to the other.
I mean, you can't, you know, it's hard for me to say that, you know, an 80 to 90% ejection fraction beat under incredible load is the same as the beat that I'm, you know, like is beat per beat the same as the beat I experience when I'm sleeping and my heart's rating, you know, my heart's beating at 40 beats per minute.
I think maybe there's a directional truth to that, but I feel like when you're talking about human longevity, it's a game of inches.
And that is like something that's probably directionally true within a mile.
joe rogan
Now, when you're talking about human longevity and you're thinking about all these different things that you could do to extend, how much of that is supplementation?
And do you supplement?
Like, are you a person who takes colloidal minerals?
Or are you a person that is interested in antioxidants?
Like, what do you do in terms of that?
peter attia
So my view on longevity is it's the hardest problem there is.
And so you got to have every, like, I'm agnostic about what the approach is.
So I want to understand everything that you can do with respect to, you know, food, drugs, supplements, hormones.
And to be clear, the only difference between a drug and a supplement is one's regulated and one is not.
But, you know, I have patients that will say things like, oh, you know, doctor, I don't want to take that drug.
I'd rather do it naturally.
Can I do it?
And it's sort of like, well, okay, you don't want to take a statin, but you do want to take red yeast rice.
Well, they both inhibit HMG-CoA reductase, the enzyme that catalyzes the first step of cholesterol synthesis.
You're willing to take one that you buy in a drugstore that's totally unregulated and you're not willing to buy the one that comes from a drug company where the FDA has their foot up the ass of the company making it to make sure it's perfect.
That just strikes me as a false equivalent.
So I only say that to just say like, I think everything should be on the table.
And then the question should be, how do you decide what to do?
So there are absolutely a bunch of supplements that I take, but I don't have kind of a one-size-fits-all approach to it because I think you've got to be able to kind of measure what's going on in a person, get a baseline and figure it out.
So, you know, I mean, my guess is you've had a million people on the show that can talk your ears off about, you know, which people should take methylated vitamins versus which shouldn't.
And if you have this MTHFR mutation versus this one, should you be taking this versus that?
I think all those things are valid.
Some of the stuff that I find even more interesting is actually a lot less sexy, and I don't have a good answer for it.
But, you know, looking at, for example, vitamin D levels.
So, you know, you see a huge disparity in the vitamin D levels people have.
And it begs the question, do all people run effectively at the same vitamin D level?
And is that a function of not just their own individual, like how much sun they're getting, but more importantly, like potentially genetically where they're from.
So I'm starting to feel like people who have northern European blood might actually run better at a lower vitamin D level than people like me who, you know, come from places near the equator where maybe I just evolved to see more sunlight and have more vitamin D. What's your ancestry?
My parents are both from Egypt.
Oh, interesting.
So, and the range, like when you look at a laboratory test, when you check somebody's vitamin D, like the range that's offered is 30 to 100 is optimal.
joe rogan
That's a big range.
peter attia
Yeah, I'm like, that's probably not the range.
So I personally think the range is probably 40 to 60, but I also measure something called parathyroid hormone that allows me to further titrate that range and stuff like that.
joe rogan
Well, when you're talking about this, it's really obvious, really clear, that there's so much data to go through.
We're learning this.
I don't want to say it's at its infancy, but if we look back a thousand years from now, we will most certainly say that your understanding of this science is at its infancy.
peter attia
Yeah, for sure.
I mean, the issue is how do you make sense of a problem or how do you try to solve a problem which is unsolvable?
And the reason I say that is the following.
You know, you have what I call kind of the medicine 1.0 world, which was, I define that as everything that took place before Francis Bacon.
You can probably tell me when that was.
I'm going to guess Francis Bacon is like 1650 to 1670 or something like that.
But that was basically the first person to come along and codify the scientific method.
So anything that came along before the scientific method may have been correct, meaning there were things that were certainly done back then that proved helpful, but they weren't grounded in a principle of science.
In other words, even a blind squirrel is going to find nuts sometimes.
And then we basically, through, following the codify, you know, the elucidation of a scientific method, the development of statistics to actually make sense of data, we then got into the sweet spot where I think we are now, which is medicine 2.0.
And to me, medicine 2.0 is really good at solving problems that are amenable to relatively short, simple clinical trials.
And there has been no better example in this space than infectious diseases.
So if you think about the unbelievable improvement in human longevity that has come from antibiotics, antiviral therapy for HIV, I mean, remember, 30 years ago, HIV was a lethal, no questions asked lethal condition.
Today it's a chronic disease.
For virtually every patient with HIV, it's a chronic disease today, meaning you will die with HIV, not from HIV.
That is, that's almost hard to fathom when you consider how shitty we are at addressing other chronic diseases like heart disease, cancer, Alzheimer's disease.
So the problem is, if you want to know the answer, should I eat this way or that way?
Should I exercise this way or that way?
Should I take this drug or that drug or this supplement or that supplement to live longer?
We can never know the answer in humans because there is no clinical trial that can answer that question.
Now, we can do that experiment in everything that's not human, but we've already learned the hard way that what happens in not humans doesn't necessarily extrapolate to humans.
And we can do things to be slicker about it.
You know, when you study rhesus monkeys for 20 years, it's certainly more interesting than studying mice for one year.
But in the end, they're still animals in captivity.
They're still not in the same environment and all these things.
So my view on this topic is the only way to go to this kind of medicine 3.0 is you've got to have kind of a strategy around how you think about it.
And so in many ways, that's what I spend most of my time dealing with is what is a strategy for longevity that becomes a scaffolding upon which you anchor every new piece of data.
Because, I mean, I know things today from a data standpoint, I didn't know 10 years ago.
And to your point, even in five years, we'll look back at stuff we're doing today and think, God, we have more data.
Is that still the right thing to do?
And so that strategy to me is sort of fundamentally based on three bodies of literature.
And the first is like, what did we learn from centenarians?
So the people who naturally live to 100, they have the advantage, or that body of literature has the advantage of being based on humans.
It has the disadvantage of it not being experimental.
So we, you know, like, we don't know like what cause and effect was.
And then secondly, if you look at all of the animal literature or non-human literature where you can actually do the experiments, what's common there?
And then if you look at the underlying molecular mechanisms.
So I feel like if you tie those three together, you come up with a general scaffolding for what it means to live longer and live healthier, then we can try to look at one thing at a time and say, hey, vitamin D, yay or nay.
Antioxidant, yay or nay.
joe rogan
So when you're, it's got to be very time consuming for you.
peter attia
I have a research team.
I mean, that's, when I started this practice about three years ago, I realized like I was losing the battle.
My ability to sit down and read scientific papers was like shrinking.
So I hired an analyst.
You know, he had worked with me in the past.
He was amazing.
I brought him over full-time to do this.
Then another one, then another.
I mean, now I have four full-time analysts.
And I mean, as this practice grows and or whatever, I have the revenue to justify it.
Like, I'll have 10 analysts one day in this practice.
And even that's not enough.
I mean, approximately 100,000 papers are published every month on PubMed.
joe rogan
Jesus Christ.
peter attia
So I forget I did the math on that once.
I think it's like three papers a minute.
joe rogan
It's pretty stunning when you think about the amount of human achievement that we've experienced just in our lifetime in that regard.
Like how many people are working on understanding just the mechanisms of the human body and this data is just piling up as we speak.
peter attia
Yeah, but the problem is the signal to noise ratio is almost zero.
So I would say conservatively 90%, if not 99% of that is completely useless.
joe rogan
Really?
peter attia
Absolutely.
I actually wrote about this once.
So when a paper comes out, if it is never cited again, meaning for the remainder of time, no one ever even goes back to reference that paper, you could probably make the case that that paper is not relevant.
And if you then further strip out auto citations, meaning the only time it's ever cited is when the author then goes back and cites his or her own paper, something like 70 or 80 percent of papers never get cited outside of an auto citation again.
joe rogan
Is this because they're not relevant or is it possible to get lost in the shuffle?
peter attia
Like some of them might be worth probably possible, but I would bet it is much, much more the former than the latter.
And then on top of it, a lot of stuff comes out and then years later you realize it was wrong.
And that's more often the case that it was wrong through an honest mistake than wrong through a dishonest mistake.
But there's still a lot of wrong through dishonest mistake stuffs coming out there as well.
joe rogan
So how much of this data is forcing you or causing you to alter your own patterns?
peter attia
Well, we believe internally that probably 100 papers a month enter the literature that are relevant to what we do.
Meaning, some of the literature that comes out, like the rheumatology literature, might be relevant to them, but that's not what I do.
joe rogan
Even that's crazy.
It's more than three a day.
peter attia
Yeah, yeah, yeah.
So that's why when I say I want 10 analysts, you see why.
It's like it's you got it, because first of all, it's finding those papers too.
So how do you do that?
Like, well, we subscribe to a whole bunch of services that basically pre-filter a bunch of shit for us.
And then we have a system where we go about kind of pulling that stuff.
joe rogan
So you get those three a day, and then they bring them to you.
How do you have the time?
peter attia
No, so that's the thing.
And it's funny you say that.
I was like, literally, as I was driving here today, I was talking to a buddy of mine and I was like, dude, I'm the fucking bottleneck, and I hate it.
Like, I'm now the bottleneck because the analysts are now churning out stuff faster than I can even provide ancillary feedback.
Because my job is like, you know, you hire great people who are smarter than you and like you just guide them.
You just point them in the right direction.
So what we mostly do is create programs where we're going out and looking for new knowledge.
So for example, one of the questions that is tormenting me right now, because I still don't know the answer, is is there any benefit to taking human growth hormone from a longevity perspective?
There's clearly a performance benefit.
Growth hormone is probably the single most abused drug in all of sports.
There's no question about that.
But is there a way to take it where it makes you live longer?
I've never prescribed growth hormone to a patient because frankly, I'm not yet confident that I know the answer to that question.
But I feel like it's worth knowing, right?
Because I can certainly make a teleologic argument for why growth hormone could be helpful, but I can also make a teleologic argument for why it could be harmful.
And so, like many things, your knee-jerk reaction to something can often be wrong.
And my knee-jerk reaction to growth hormone has historically been causes cancer.
Because why?
Well, growth hormone tells your liver to make IGF, insulin-like growth factor, and two-thirds of tumors seem to thrive on IGF.
So ostensibly, you would think, well, growth hormone can't be right.
But then one of my analysts, Bob Kaplan, pointed out to me a year ago, he's like, you know, Peter, I've been thinking about this.
And he's like, given how ubiquitous growth hormone is in sports and how long it's been ubiquitous in sports, like, I mean, this was the drug that turned around U.S. Olympic athletes in the late 70s, early 80s.
He's like, where's the body count?
Like, where are all of these people dying of cancer from all these years of staggering growth hormone use?
We don't really see it.
When we went back and looked at literature, I mean, we found that the data on growth hormone and IGF are not nearly as straightforward as people have made it out to be.
In fact, there's, I mean, I could draw it actually for you.
Not that anyone will necessarily see this, but at least you'll see what I'm talking about.
If this is percentile, so higher, and this is IGF level, right?
So IGF level.
joe rogan
Most people are listening to this.
Well, actually, it's getting a lot of people.
peter attia
We were actually talking about that before, yeah.
So the overall mortality curve for IGF and growth hormone is like a J curve, meaning low IGFs, really high mortality.
Yes, as you go from about the 70th or 80th percentile up to the 90th percentile, there's a slight increase in mortality.
But this is not what you would think of.
Like you would sort of, if you were just reading the headlines, you would think it looks like this.
unidentified
Right.
joe rogan
So there's a sweet spot.
peter attia
Not only that, this is overall mortality.
What if you parse this out by disease?
Well, that's when it gets really interesting.
So cancer's curve looks like this.
joe rogan
Very similar.
peter attia
Yes.
But Alzheimer's curve looks like this.
Heart disease curve looks like this.
joe rogan
So describe that to people that are listening.
peter attia
Well, so what that means is, so for example, Alzheimer's disease and heart disease have an almost monotonic reduction in risk as IGF gets higher and higher and higher.
It's only cancer that seems to have that uptick where risk starts to actually rise once you cross past the, call it 70th percentile.
And so when you integrate all of these curves together, that's why you see this slight uptick.
Now, again, this is epidemiology, so one has to take this with a grain of salt.
But this is, to me, when I saw this graph, which Bob put together, I don't know, a while ago, I was like, wait a minute, this doesn't jive with my preconceived notion of like growth hormone is bad.
This warrants way further exploration.
And so what that basically turned into is now an enormous internal project that will take us probably a year to complete and will constantly be updated.
Like we did this already with testosterone two years ago.
We put together like a 40-page white paper on the topic.
And then at least once every two weeks, it gets updated every time a new paper comes out.
Basically asking the question, like, is testosterone replacement beneficial or harmful?
And under what situations should it be considered versus not?
And again, the goal is to do this unemotionally.
And that's hard to do because for reasons I'm not entirely clear on, basically everyone's kind of just emotional about this stuff.
joe rogan
Well, they're emotional about steroids because of all the press about Barry Bonds and, you know, all the different baseball players.
But why do you think that is?
peter attia
Is it the cheating aspect of it?
joe rogan
100%.
Yeah.
Yeah, I think that's exactly what it is.
I think people consider taking any kind of hormone, whether it's growth hormone or testosterone, as cheating.
Even if you're talking about older people that take it.
Like I was looking at one of those ads.
You know, they have those ads for hormone replacement.
This is really old looking.
peter attia
Oh, yeah, Jeffrey Life, I think is his name.
Dr. Life.
unidentified
Jack.
joe rogan
I mean, he's fucking, he's got a full six.
He's out of control.
He's still like a gorilla.
And my friend was like, God, that can't be healthy.
I'm like, what the fuck are you talking about?
Look at him.
I go, what do you think a 70-year-old dude is supposed to look like?
They're supposed to be knocking on death's door.
That guy looks like he could fuck his way through a building full of teenage girls.
You know, he's like, I shouldn't say teenage, 20-year-old, 21.
peter attia
Or 19.
joe rogan
He looks like a man who's really fit and healthy with an old guy's head.
peter attia
Yeah.
joe rogan
It's weird.
And I was like, you know, if it's not healthy, then what is it?
If that's not healthy, like, oh, he's going to die of cancer.
He's going to die of a heart attack.
He's going to die, period.
If you look at his head, how much time would you give him?
I gave you a, if I gave you a bet, okay, we have a million-dollar bet, give you an over-under of 10 years.
How many years are you going to give this guy?
Are you going to give him 20?
You're going to give him 30?
peter attia
Oh, wait, wait, you're moving the over-under.
You said I had a 10-year window on that.
joe rogan
Right.
You get a 10-year-old.
peter attia
I'll take over on the 10-year.
unidentified
Okay.
joe rogan
How many years you give him?
peter attia
Impossible to know.
Am I allowed to talk to him first?
unidentified
No.
peter attia
No.
No fucking clue.
joe rogan
You're looking at a magazine, right?
peter attia
No, no, no, I can't because I got to know his family history.
I mean, honestly, your parents will tell me more about how long you'll live than what you look like.
joe rogan
But 70 in America is basically death's door.
peter attia
No, I think today, well, so this is a complicated question, actually, which actually prompts another analysis that we just kicked.
joe rogan
I think it's in the 10-year range.
peter attia
Yeah, no, so it depends how you ask the question.
So the question is, what is the average life expectancy of a man and a woman today in the United States?
And I mean, someone's going to correct me, so I feel like it doesn't matter what I say.
I think it's 79 and 81, respectively, for a man and a woman today.
But the more interesting question is this one, which is, so what year were you born?
joe rogan
67.
peter attia
Okay.
So in 1967, what was the annual life expectancy or the average life expectancy of a man and a woman?
And we could look that up, but I'm guessing it would have been, let's see, life expectancy has been going up at 0.3 to 0.6% per year.
We could back out that Kager and let's just say for shits and giggles, like the number was 69 or 73 or something like that.
I promise you, you were going to live longer than that.
What was it?
joe rogan
67.
peter attia
67.
All right.
So would I take the bet that you're going to live longer than 67, even though that was the median life expectancy the year you were born?
unidentified
Hell yeah.
peter attia
I'll take that all day long.
And so what we're actually putting, this is just a dumb analysis.
I don't even know why we're doing this.
Sometimes we just do dumb shit that has no bearing.
But what I want to do is create a graph of actual life expectancy as realized versus projected life expectancy in the year of birth.
My hypothesis is that is always a positive number.
What I want to know is what's the derivative on it?
Is it increasing or decreasing?
So I think that science is accelerating our longevity.
And that's one of my proof points is that we are constantly underestimating how long we can live.
Now, on the other end of that spectrum, I am not one of these futurists who thinks like there's immortality out there.
I would be, if right now I could sign a piece of paper that would say, Peter, are you willing to commit to a lifespan right now?
So you're willing to acknowledge that if there's some major breakthrough, you'll miss out on it.
But I guarantee you this duration.
Like what would you take right now?
If I said, Joe, you can be 100 and be fully functional at 100.
So when you're 100, you're going to – So you could run at 100.
Yeah.
You're going to be like a fit 60-year-old at 100.
So you're still working out.
You're still shooting.
joe rogan
Pretty good.
peter attia
Yeah, would you take it?
joe rogan
Nope.
peter attia
In other words, you're willing to bet that by the time we get there.
joe rogan
Yeah, because when it's over, it's over anyway.
peter attia
Yeah.
joe rogan
Yeah.
peter attia
So, I mean, to me, I think most people have a greater sense of confidence about where technology goes.
Now, I think there've really only been a handful of step function changes in longevity.
So, you know, the reduction of infant mortality was huge.
Like, once we actually figured out how the fuck to deliver babies and not kill moms, like, that was a big deal.
That had a step function improvement in human longevity.
The next one was really sanitation.
Like, once we figured out that, like, don't shit where you drink, huge improvement in human mortality.
joe rogan
Is that hilarious?
peter attia
It's amazing, right?
We take that shit for granted now, right?
And then the third one was basically germ theory.
You know, starting with Lister and going all the way to Fleming when we figured out, like, you know, if you if you cut open a cadaver and then go and deliver a baby, that's bad.
Um, because there are these microscopic things that none of us anticipate, right?
We haven't had a step function improvement in mortality in nearly 100 years.
So what's next?
Now, I think there are a couple of potentials for that.
But what I don't know is if like they're going to happen in my lifetime or in your lifetime.
But I want to buy the optionality to stick around for it by doing all this incremental little shit.
joe rogan
Yeah, well, these three plus papers a day, the options are increasing.
It just seems to me that there's a trend, right?
The trend is, as you're saying, there is an increase of longevity, but it's not a huge increase.
Right.
But our understanding of the human body is, that seems to me pretty radically improving.
Especially in terms of nutrition, nutritional absorption, the mechanisms behind nutrition.
peter attia
On some level, yeah.
On some level, I still feel like we're in the dark ages.
joe rogan
Right, because you recognize the potential or you don't have to do that.
peter attia
Well, no, because I think I'm just humbled by how hard it is to actually take care of people.
Like, I think, so I was about, I'm about as good a responder as you're going to have to carbohydrate reduction.
So, doing something as simple as just not eating carbs and not eating sugar, like, completely changed my health.
I mean, at 40, if you compare the 40-year-old me to the 30-year-old me, Like the 40-year-old is like literally twice as healthy as the 30-year-old me.
And that was through something as simple, conceptually simple, as making this radical dietary shift.
joe rogan
And by what standards are you saying that you're twice as healthy at 40 than 30?
How old are you now?
peter attia
45.
And but what, what is the I mean, again, I'm speaking a bit glibly.
Well, even let's just talk objective.
Yeah, yeah, yeah.
So, like, what would be my lipid levels?
What would be my triglyceride levels?
How much body fat do I have?
What's my VO2 max?
Like, by all of those metrics, like, everything was just so much better at 40.
I mean, and so I've, but yet I've seen a lot of patients where you take the carbs out of their diet, doesn't matter.
You know, you make them fast, you do this, you die, the other thing, you just can't fix some of the underlying metabolic problems.
joe rogan
Like, what kind of problems?
peter attia
No, I think some people are just so insulin-resistant that it becomes really hard to fix them without doing draconian stuff.
I mean, I have one patient who is really now, I think, going to, in many ways, become the poster child for he's definitely the toughest case I've ever had.
And why he's such an amazing guy is he was actually able to do something that's really hard to do, which is stick to something with complete blind faith in me, even when it didn't feel good, even when I knew it would take a long time to see the results.
So, he's probably 5'8, weighs 235 at the start.
So, 5'8 ⁇ , 235, metabolic syndrome, huge amount of fatty liver disease.
Not the typical patient in my practice.
Most of my patients are kind of young, healthy people who want to like, you know, want this immortality thing.
But this is someone who doesn't fit that description, probably 70 years old, on like, you know, four drugs for blood pressure, 10 drugs.
joe rogan
It's very heavy for a seven-year-old.
unidentified
Yeah, it is.
Yeah, yeah.
peter attia
Oh, and his, and he just had a hip replacement.
He basically couldn't walk.
Everything was...
And we had tried carbohydrate restricting him before...
It just didn't work.
And part of it was, I don't know how he just, it was hard for him to stick to it and blah, blah, blah.
So I just said to him, look, man, I want to try something completely fucking extreme.
And I want to try it for six months.
Every five days, pardon me, every month, you're going to spend the first five days eating 500 calories a day of a ketogenic diet.
And it's basically just going to be like vegetables, oil.
Like you're basically eating a bunch of salad.
And then for the next 25 days, you're going to do a time-restricted ketogenic diet where you're only going to eat in that eight-hour window.
And then you're going to repeat that every month for six months.
And he was like, I won't be able to do it.
And I was like, I know, I know.
It seems crazy.
I think you will be able to do it.
Because remember, all that time that you're not eating, your body's going to have to start eating itself.
And so you'll be all right.
And I'm giving you a grossly oversimplified version of what we did, but it was much more complicated than that.
There's a bunch of other stuff that we had to do to manage it as well.
Well, I mean, he just sent me, I mean, we were in touch all the way along.
So it was clear that this was working, but it was just kind of amazing to get a picture from him two weeks ago as we just passed that six-month mark.
He weighs $1.75.
joe rogan
Whoa.
peter attia
That's 60 pounds in six months.
joe rogan
Holy shit.
peter attia
His liver, this is, I mean, and that's interesting, but not nearly as interesting to me as the fact that his transaminases, which are the enzymes that the liver makes in response to how much fat is accumulating, you know, normal is like less than 40.
He was like in the hundreds, and the ultrasound showed it was just a bunch of fat, and he doesn't drink alcohol, so we knew it was fatty, non-alcoholic-fatty liver disease.
You know, now he's in the 20s and 30s.
Blood pressure.
joe rogan
What was his previous diet?
What was he eating?
peter attia
He's the normal dude.
Yeah, just to say.
He wasn't a particularly junk food.
He wasn't a junkie guy.
The problem is he was metabolically broken.
So I'll come back to why I felt like this was a necessary intervention, despite how draconian it was.
He's on a treadmill 30 minutes a day now.
He couldn't walk before.
I mean, you take 60 pounds off of him.
joe rogan
When you say treadmill, you mean walking around.
peter attia
Yeah, but he walks on a treadmill now.
joe rogan
Yeah.
peter attia
Yeah.
joe rogan
He walks briskly.
Once you get the hip replacement.
peter attia
Yeah, he's got the hip replacement, yeah.
So it's just, it's basically reprogrammed him.
And so the reason I have occasionally pulled that trick out, although it hasn't always worked, is based on this case study I read that's very famous.
I'm sure there's got to be someone on this show who's talked about it.
But it was a paper was published in either the early 70s or late 60s, but it was the longest ever medically supervised fast.
So it was this guy who weighed somewhere between 375 and 400 pounds.
He did a 382-day inpatient medical fast where he had only water and minerals.
At the end of that, something like 382 days, he was down from, call it 400 to $1.65.
This paper was published seven years later.
He weighed like $1.70, $1.75.
joe rogan
The crazy thing about that guy is his skin shrank, too.
So he didn't have that problem that a lot of people have when they lose a lot of weight, where they have all this extra skin.
His skin went along with his body.
peter attia
Yeah, and I wonder if that's just due to genetic elasticity.
Yeah, exactly.
joe rogan
I would like to know.
I would like to know if he had stretch marks when it shrank.
peter attia
You know, it's funny.
I've never tried to figure out whatever came of that patient.
I can't imagine he'd be alive now, though I know he was young at the time.
But the part that interested me was that he didn't regain all the weight seven years later.
And that suggested that there was a, like, it was a reprogram.
He got the blue screen of death on the computer.
He did the hard reset.
He got to be a new person again.
Because I'm not of the camp that thinks like that guy got to be 400 pounds just because he was a glutton and a sloth.
Like something fundamentally broke in that dude.
And what broke was he basically lost the ability to partition fuel correctly.
Now, could food play a role in that?
Absolutely.
Certainly if you eat enough shit, that can happen.
But I think it's more complicated than that.
I think it could be epigenetic, if not outright genetic, but probably more epigenetic.
And so I'm interested in this idea of how do you reset people?
And again, this is all kind of a long-winded way of saying, like, one of the advantages of practicing medicine is you get to, you say humble because every time you think you're smart and you're like, I got this shit figured out, like, you don't.
There's like some patient who's got a problem that you can't figure out and it just, you know, drives you nuts.
But you realize like, I mean, even just today I was talking to a friend of mine.
He's not a patient, but I mean, my God, he's just going through like this devastating health situation.
He's been, he has seen every doctor.
He's been to Mass General.
He's been to Stanford.
He's been to Hopkins.
He's been to the best hospitals in this country.
They can't fucking come close to figure out what's wrong with this guy.
And so as bad as that is for him, I think that level of humility is actually good for the profession.
joe rogan
It's good to— What is going on with him that they can't figure out?
peter attia
He's having these horrible neurologic symptoms where he gets these fasciculations and muscle weakness.
And obviously the big concern about six months ago when this started was he was presenting like he had Lou Gehrig's disease, which, you know, obviously is about as bad a fate as you can have.
Luckily, that has been ruled out, and they've done a million muscle biopsies and all these other things, but they don't know what's going on.
joe rogan
Has he altered his diet?
peter attia
Is he taking no, no, we don't know what's going on.
This is certainly far outside of my area of expertise.
I mean, what we talked about today was, look, man, all we really need to be doing is fixing your symptoms at this point.
In other words, there's understanding what's causing this and then managing the symptoms around it.
I think the smartest people in the country have figured out they have no goddamn clue what's going on.
Let's now figure out how to manage your symptoms, your energy levels, your mood, all of these other things.
joe rogan
What has he done for that?
peter attia
Well, I told him today, I was like, look, I'm going to send you a kit.
We're going to do a certain blood test on you and a certain urine test on you.
And I want to just figure out what's going on with your four hormone systems.
There's basically four hormone systems that play a pretty big role in how we feel.
And adjusting those doesn't, I'm not convinced it necessarily makes you live longer, but it can certainly make you live better.
So I want to kind of understand, I suspect he's not firing on all cylinders on that dimension, whether it's a result of whatever is going on that nobody can figure out or not.
But I'd rather focus on something that I think we can fix.
joe rogan
Yeah, the change in diet thing with that guy where he went and fasted for 360 plus days.
What did he eat when he got back on food?
peter attia
Great question.
I do not know the answer.
Now, it might be that that just, I don't recall that being in the paper, but if it wasn't, I don't know if anybody did the follow-up.
But that's, to me, that's the interesting question, too.
joe rogan
That guy's got to feel amazing.
Like, he got his life back, right?
peter attia
And my recollection is he was a young man.
He was in his late 20s, I think.
joe rogan
Yeah, I believe I remember that as well.
I think I would like to find out what he's eating now to keep his weight at the same level.
I mean, he must just be so thankful.
First of all, he might be like, I mean, I have friends that are pretty overweight and one that died pretty recently, who was really big.
And he just had this feeling when he would meet people.
I mean, he talked about it a little bit.
He was just obese.
It was just this thing where you're just, oh, look at this enormous fat guy.
And then to go from that to, oh, there's a guy.
There's a normal guy.
That's just a guy.
That's a 168-pound guy.
Normal.
No difference between a handful.
peter attia
And I got to tell you, I know we love to, we love to beat up on fat people.
We love to turn it into a character defect.
But I got to tell you, virtually every fat person that I know or that I've taken care of, they are not disproportionately eating more than their peers.
In some cases, yes, but not on balance.
The problem is that they simply do everything incorrectly metabolically.
joe rogan
So their body is functioning correctly.
peter attia
Yeah, and it's, you know, I think there's a genetic component.
I think there are dietary exacerbations.
I think certainly not exercising makes things worse.
So there are lots of predisposing factors.
But at the end of the day, what's happening is when you and I eat, like let's take a meal that, like if you had pancakes, bacon, and scrambled eggs, that would be like a really good mix of, that'd be a third carbs, a third protein, a third fat.
So that's like a shit ton of nutrient, right?
If you or I ate that, yeah, it probably wouldn't be that good for us.
But like we, you know, let's say we just finished a workout or something, like we're going to partition such that that glycogen will first and foremost go to replace the muscle and liver stores of glycogen.
Because we have bigger muscles and our muscles are more insulin sensitive.
We can actually disproportionately put more glycogen into our muscles, into the leg muscles, because you'll have done that run up the hills, right?
And then furthermore, when we want to recruit energy again, we'll have the ability to actually go back and get fat.
In other words, break down fat at lower ATP demands than necessarily always going to glycogen.
So in other words, we partition fuel in a smarter way.
And these patients, I mean, you can measure this clinically using something called RER and of course doing other blood tests.
Like they just, they just, they can't break down their own fat.
joe rogan
So their body is essentially broken in that regard, and that can be fixed with diet.
peter attia
It's a hard problem because the way I explain it to people is, and I'm, so clinically, I'm not interested in weight loss, right?
I mean, that's just not, I'm much more interested in longevity.
And yes, sometimes weight loss comes with that, but I, like, if I ever get stuck doing, you know, weight loss, like, I'm doing the wrong thing for my interest.
But the way I say to people when they want to lose weight is, look, you don't want to lose weight.
You want to lose fat.
Let's be very clear on our semantics.
Weight is irrelevant, right?
Unless you're a cyclist or some athlete for whom the actual scale means something.
But for people like us, you want to lose fat, not weight.
And then when you say you want to lose fat, what does that mean in English?
Well, do you want fewer fat cells or do you want each fat cell to be smaller?
Those are totally different questions.
If you want fewer fat cells, have liposuction.
But we know that that doesn't fix you metabolically.
So if you want fewer, if you want to be less fat, you have to have smaller fat cells.
Now, a fat cell, conceptually, has two inputs and one output.
So now I say, let's reframe the question.
You've got a room with 100 people in it.
You want fewer people in the room.
What has to happen?
More people have to leave the room than enter the room.
So similarly, if you have a fat cell and you want it to be less fat, you've got to get more fat out of it than enters it.
And the fat that exits the cell exits via a process called lipolysis.
And the inputs to a fat cell are something called de novolipogenesis, which is turning carbohydrates into fat, and reesterification, which is turning fat, like in a free fatty acid, into a triglyceride back into a fat cell.
Each of those three doors is controlled by hormones.
And so the purpose of nutrition or fasting or exercise or drugs or hormones or all these things is to manipulate those hormones in the direction of what I call negative fat flux or what would be referred to in the literature as fat balance, negative fat balance.
And the hormones that drive that are many.
Insulin, hormone-sensitive lipase, testosterone, estrogen, cortisol being the five most important, in my opinion.
Maybe someone will disagree with that, but I think those are the five that rule the roost.
And so, you know, how do you manipulate those?
Well, insulin seems to be the most important of the five.
And there's no better way to lower insulin than to not eat.
So the first thing that happened to that dude who went 382 days without anything but water and minerals is he basically had very low insulin levels.
In fact, once he got into raging ketosis, which he got into by about day seven, his insulin came up only to prevent him from going into ketoacidosis, which was what would happen if he had no insulin response.
In other words, if he was a type 1 diabetic, he would have died of ketoacidosis because he wouldn't have had the insulin to regulate the uptick of ketones.
But if you or I did this, because we have a normal pancreas, we would actually make just enough insulin to suppress ketogenesis and keep that beta-hydroxybutyrate level in the, you know, kind of in the neighborhood of probably seven or eight millimolar, as opposed to getting north of 12 to 15, which is when you get into trouble.
So, you know, how do you manipulate insulin?
Nutrition is the first way.
If you can't fast, the next best thing is to reduce carbohydrates.
Carbohydrates, obviously, are the most insulogenic of food.
Although protein can be quite insulogenic as well.
It has a different response.
And then that's when you start to think about these other things.
You know, I've seen patients where they just can't lose weight.
And I watch what they're doing, and they're doing everything right, but they just can't lose weight.
But then you notice their cortisol levels through the roof.
It's hard to get rid of fat when you have lots of cortisol.
Cortisol is a very anabolic hormone to fat and a very catabolic hormone to muscle, which is the exact opposite of what we want.
Testosterone, of course, is the exact opposite.
Testosterone is catabolic to fat, but anabolic to muscle.
And then, of course, women have a harder time because once women go through menopause, they lose all the estrogen and all the testosterone.
And so now they lose two hormones that play a very important role in regulating this.
joe rogan
So for these people that are having the issue with cortisol levels, that's exacerbated by stress, right?
unidentified
Yes.
joe rogan
So stress actually exacerbates your weight gain.
peter attia
Absolutely.
unidentified
Wow, that's interesting.
peter attia
In addition to a whole bunch of other stuff.
joe rogan
You could literally eat the same diet and gain more weight because of stress.
peter attia
Absolutely.
unidentified
Wow.
peter attia
Again, hormones are what's driving fuel partitioning.
You know, you're responsible for what you put in your mouth.
But in many ways, at that point, like the hormones take over and decide where it's going.
unidentified
Wow.
joe rogan
That's fasting.
Now, you yourself, what's your diet like?
I mean, you told me you only eat once a day, but...
peter attia
Yeah, one meal a day or sometimes two meals a day.
joe rogan
How many calories are you taking in?
peter attia
You know, nowhere near what I used to.
I just don't train that much anymore.
I mean, I kind of lift three days a week and then I ride like a stationary bike, like a Peloton, or I prefer this thing called a Wahoo kicker where you actually put your bike on it.
So I'll do that three or four times a week.
I would guess when I sit down to throw down, it's probably 3,000 calories.
joe rogan
That's so hot in one meal, huh?
peter attia
Yeah, although the problem is I'm a fucking pig.
Like, I'm kind of disgusted.
Like, I can eat a lot.
It's gross.
Like I gross people out how much I can eat.
It's pretty like for me to only eat 3000 calories in a sitting is like tame.
joe rogan
Really?
peter attia
Yeah, yeah.
No, I have an eating disorder.
Really?
I mean, sort of.
I think I have disordered eating.
Yeah.
joe rogan
Seems like you just enjoy it because you do it once a day.
peter attia
No, under any circumstance.
Like, I stress eat.
I do get a dope.
Like, I don't get a dopamine high from gambling or, you know, alcohol.
Like, I don't, like, those things are not things that I can abuse.
Like, when I'm really in a shitty place in life, like, I soothe and punish myself with food.
joe rogan
A lot of people do.
So you could relate.
And as a thin man, you know, when you're talking to people that are large and have the same issue, it's got to be a little bit more.
peter attia
Yeah, no, no, it's totally, I mean, I completely understand what these people are going through, at least in as much as what the, as the physiologic desire for it.
I mean, obviously they will experience something even worse because there's the, like, I can, like, look, I don't have abs on, I don't have veins on my abs anymore.
I used to.
When I was in a ketogenic diet, you know, I was 7% body fat.
I was completely ripped.
I'm not ripped anymore, you know, relative to that.
That kind of bugs me, but like, nobody really knows that.
I mean, nobody really gives a shit.
So I can still look like a super healthy dude, a super lean dude, even if I'm not.
But oh my God, like when shit's going wrong, like I want to eat some of the worst foods that have ever been created.
You know what I mean?
joe rogan
Why is that instinct there?
Why is the instinct that when you're not feeling like for me, it's tired?
Like if I'm tired, like if I'm coming home from a gig and it's 2 o'clock in the morning, it's very difficult for me to drive past Wendy's.
You know, I want to go to Wendy's.
peter attia
And that could be an adrenal issue.
So a lot of times we'll see when people either turn to sugar or salt in times of fatigue, a lot of times it can be, you know, they don't have the right level of free cortisol at that moment in time.
joe rogan
I've always feel like it's a willpower issue because if I could just get home, I'll cook something healthy.
And then I have victory.
You know?
peter attia
Yeah.
joe rogan
Because if I get home, I know I've got healthy food at home.
I'll eat something really good and it's just as good.
But there's something about also, there's like you're doing something you know you shouldn't do.
There's a little weird little charge there.
peter attia
Yeah, that's interesting.
I mean, I guess it's different for different people.
I think for me, if I'm really going to be brutally honest about it, I think it's that I like, I sometimes just want to punish myself.
And I'm like, you know, like eating bad food is like, when you're bad, you eat bad food.
unidentified
Do you give yourself a cheat day?
peter attia
You know, I don't, not really.
I mean, I think these days, and, you know, you've got kids, so you know it.
I mean, cheat days just present themselves often enough for other reasons.
And unfortunately, I think for me, the cheat meals are a lot of times cleaning up the kid's plate or something like that.
You know, like, I mean, the funny thing is I just, I really, I don't know why.
I just like shitty food.
Like, I like macaroni and cheese.
joe rogan
I do, of course.
peter attia
Like, I just, if they don't eat their macaroni and cheese, I got to eat it.
joe rogan
My kids asked me to make them peanut butter and jelly the other day, and they don't eat shit.
peter attia
Which is really good.
joe rogan
It's fucking fantastic, especially with a glass of milk.
They don't eat the crusts.
And I'm like, well, these crusts shouldn't go away.
peter attia
Oh, God.
There's kids in Africa that should eat that crust.
joe rogan
So I ate the crust.
And then I thought about all the bread with peanut butter and jelly I ate in those crusts.
I basically ate a fucking sandwich.
It's like I'm pretending that I'm just eating a little crust.
unidentified
I ate a lot.
peter attia
I'm worse than you, dude.
You know what I would have done in that situation?
I would have been like, peanut butter and jelly sandwich.
Well, I would have started by saying, there's not enough peanut butter and jam on these crusts.
I don't have the right ratio.
So I would have got out the peanut butter in the jam and dipped the crust in there.
And then I would have probably made a sandwich.
joe rogan
I'm just happy that I didn't eat a sandwich of my own as well as the crusts.
Because I probably could.
Once the fucking gates are open, once I'm out there making spaghetti and meatballs, like, all right, let's get some fucking ice cream in this mix, too.
You know, once I'm already fucking off.
So what do you, what do you eat?
Like when you sit down for these 3,000 calorie meals?
peter attia
So if I'm in control of the meal, which I usually am, I'm super boring, dude.
So I like to have a salad in a bowl that's larger than my head.
So I always refer to that as a manly bowl.
That's the definition of a manly bowl.
So it's got to be like a staggering amount of salad.
And my salad is the same every freaking day.
It's romaine lettuce.
It's, you know, tomatoes, mushrooms, cucumbers, carrots.
And then the dressing is just extra virgin olive oil, freshly squeezed lemon, salt and pepper.
So it's a pretty bland salad in that sense, but I mean, I can eat that all day every day.
And then it's a serving of protein, and I usually cycle through salmon, pork, steak, you know, some gamey meat, like whatever.
I just sort of cycle through that.
And then I usually have some sort of starchy vegetable to go with it.
So potato, rice.
You know, lately, the last couple of weeks, I've been skipping the starch and just mainlining extra salad and extra protein.
But, you know, that's insane.
That's when I'm in San Diego, where I have control over what I eat more.
In New York, I never eat in my apartment.
Like, I just never cook.
So I always go out.
And there, it's a little less regulated.
So, I mean, I just love Indian food.
I love Persian food.
I love food that unfortunately has, you know, got more carbs in it than I'm probably suited for.
But I try to modify.
So like last week, I had this Bob, who's actually one of my, my head analysts, he lives in Boston.
He came down to New York for a couple of days.
We were doing some work.
And we went out for, he loves Indian and I love Indians.
We went out for Indian one night and we hadn't eaten all day.
So we ordered, I think, seven or eight entrees.
And the waiter's like, you know, you guys know you ordered seven or eight entrees, right?
We're like, yeah, yeah, yeah, we got it.
we got it.
We're good.
And so, you know, we sort of skipped the non or maybe had one non to split Instead of normally, I would have had like four naans.
It only had one bowl of rice.
joe rogan
It's still a lot of carbs.
peter attia
It is, yeah, yeah, yeah.
joe rogan
That naan bread is insane.
unidentified
Yeah.
peter attia
Luckily, Bob ate more of it than I did.
And he's way more jacked than me, so he can get away with eating way more naan than me.
But yeah, that night, I mean, also those sauces are like so fatty.
Like, I'm sure that was a 4,000-calorie throwdown.
The other thing I'm pretty good about is when I'm done, I'm done.
So that's the other thing about time-restricted feeding that I think I get away with more because like when I go back to my apartment, I will rarely have another bite.
And when I wake up in the morning, it's like black coffee.
You know, I'm not sneaking little shit in throughout the day.
Like, whereas if I'm not fasting, it's just too easy for me to just like sneak stuff in.
unidentified
Oh, yeah, yeah, yeah.
joe rogan
Snack.
peter attia
Like in my office, like I share my office in New York, I share with another doctor who, it's his office, actually.
I kind of sublet an office there.
But like, I've never seen more shit in my life, like than the stuff patients bring for him to eat.
joe rogan
Patients bring him city food?
unidentified
Non-stop.
joe rogan
To a doctor?
unidentified
Of course.
joe rogan
Were they trying to torture him for torturing them?
peter attia
I don't know, maybe.
But it's like, you know, or drug reps will bring stuff by or something like that.
There's just like, there's an endless barrage of bad food to eat.
But it's like good bad food.
joe rogan
Delicious.
peter attia
Like if they were bringing like Oreos, that actually wouldn't tempt me, despite the monkey.
joe rogan
Home cooked brownie.
peter attia
Yeah, exactly.
I forget the name of, God, I can't even remember the name of some of these bakeries up there.
But yeah, there's like some ridiculous shit that shows up.
And every once in a while, like, I'm like, okay, the fast is breaking at 4 o'clock today.
Give me one of those scones.
joe rogan
But as long as you do it with moderation, you think you're okay.
peter attia
Yeah, except that my motto in life is moderation is the only thing worth doing in moderation.
So the problem is once I start, like, it's usually the wheels come off the bus pretty quick.
joe rogan
Do you try to mitigate that with exercise?
Like, do you say that I went off the rails today, so let's hit the gym and go hard?
peter attia
It's less that.
It's usually I anticipate it.
And so like, so last week, a buddy of mine went to see the David Bowie exhibit.
Did you see it, by the way?
The Brooklyn Museum?
unidentified
No.
peter attia
Are you a Bowie fan at all?
joe rogan
Yeah.
peter attia
Oh, dude, it's there till mid-June or July.
joe rogan
It's in Brooklyn?
peter attia
Yeah, it's at the Brooklyn Museum.
unidentified
It is.
joe rogan
I was in Brooklyn a couple of weeks ago, but I was only there for two days for the UFC, and I had a show out there.
peter attia
So probably one of the best shows I've ever seen in my life.
joe rogan
Really?
peter attia
Yeah.
Unbelievable.
I didn't realize it, but like it closed at 11 p.m.
And they just didn't have the heart to tell me.
So I was there till midnight before they finally came and like escorted me out of the building.
They're like, sir, we closed an hour ago.
I was like, damn, sorry, man.
joe rogan
So what is it?
peter attia
It's like an exhibit of all of his art, all of his music, all of, and it's like, it's done.
You know, when you go to museums and they put the headphones on you and you have to like push the button to hear the thing, it doesn't work that way.
Like whatever you stand near, you get the music associated with that, plus or minus a narrative as necessary.
But it was like I've never, like they, I think they had every one of his costumes.
joe rogan
Wow.
peter attia
I mean, it was, it was epic.
So anyway, that night, I knew we were going to go out for a killer dinner before in Brooklyn, before we went to the show.
And so normally I exercise in the morning, but that day I was like, look, I will, your muscles will be a little bit more insulin sensitive if you can exercise about 30 minutes before you eat.
That's probably about the sweet spot.
So if I were to ride at like 8 in the morning and then not eat until 7 at night, I mean, I would still eventually get the glycogen there, but it wouldn't be quite as easy.
It would require a little bit more insulin.
So in that case, I just modified my day and was like, you know, made my schedule such that I could ride at 5 p.m. in anticipation of that.
And I also rode a little longer and a little harder, just, you know, like, let's really crush this session so that, you know, I can go and enjoy dinner a little bit more.
joe rogan
Well, it sounds like you enjoy a lot of things.
You have a lot going on.
You've got your medical practice.
You have, I mean, all these different things you participated in as far as athletics, boxing and swimming and cycling.
What jazzes you up now?
Like, what do you, like, how do you, you obviously have a mind that requires a lot of stimulation.
Like, what, what keeps you going?
peter attia
I mean, I think, I think this longevity thing is the perfect culmination of all of my previous lives in terms of professional lives.
So, I mean, I used to be an engineer and then I went into surgery and then I left that and went into management consulting and had nothing to do with medicine for several years.
I just worked in credit risk modeling.
And so in many ways, like when you combine medicine with engineering, with risk management, that is what longevity is all about.
Like if you want to take the practitioner's, you know, the roll-up-your-sleeves approach, that's what it is.
So I think that scratches that itch.
But I think for me, like, I have to be sort of mastering something.
So that's where archery and race car driving today become just total obsessions.
And like when we were talking earlier, it's like, yeah, I mean, I don't know that I'll ever go hunt because I don't know that I want to spend three days, you know, taking 10 shots when I could be spending, you know, three days taking 300 shots in my backyard.
Like in the end, I think what I really just obsess over is trying to get better at something.
And the nice thing when you start things late in life, like I didn't get my racing license till three years ago, and I've only picked up archery two years ago or maybe a year ago.
Like when you suck so much, like the opportunity to get better is awesome.
So I think the bigger itch for me is not intellectual.
I think it's like tinkering.
It's like figuring out how to do shit better.
joe rogan
Yeah, I share a similar interest in things I suck at.
And that's one of the things that was so compelling to me about archery.
peter attia
When did you start?
joe rogan
2013, I think I bought.
Well, I bought a bow before that, but I didn't really use it.
2013, I think, is right when I got pretty serious about it.
peter attia
You had John Dudley on your show once, didn't you?
joe rogan
Yeah, a couple times.
peter attia
Dude, he took time.
I mean, that shot through the handle of the kettlebell.
unidentified
Yeah.
peter attia
Was that 100 yards?
joe rogan
I think it was a little more, but yeah.
Yeah.
peter attia
That is, that's one of my favorite things in the world.
joe rogan
He's helped me a lot.
He's a remarkable archery coach and just a great person, too.
Just a great coach.
peter attia
I once saw on Instagram him and Jocko in the, like, they bumped into each other in an airport.
And so, like, I saw Jocko like two days later.
We had coffee one day.
To be clear, Jocko had tea.
I had coffee.
Jocko's a tea guy.
But I was like, dude, I can't believe you know John Dudley.
He goes, I don't know him.
He just grabbed me in the airport and I was like, dude, I would have been shot.
Dude, I want to see this.
joe rogan
And he did it with a lighted knock.
peter attia
Yeah, he had a lit knock.
joe rogan
Good God.
Damn.
People don't have any idea how crazy that shot is.
peter attia
They cannot fathom what he just did.
unidentified
Yeah.
joe rogan
I've seen him do some ridiculous shit.
He's a bad motherfucker when it comes to archery, that's for sure.
And he's helped me tremendously.
peter attia
Where does he live?
joe rogan
He lives in Iowa.
He moved to Iowa just so he can kill big giant deer because he literally bought a farm in Iowa, a giant chunk of land and raises it for, he has, he does do some farming, but essentially what he does is raises deer.
He doesn't raise them.
Like there's no fence, but he makes it very make it favorable for them to be there.
He has food plots that he grows.
And I mean, I hunted on this place a couple years ago.
It's amazing.
It's an incredible place.
He loves it.
peter attia
I just, I remember when I bought my bow, like I just sort of, you know, went into the archery, like performance archery in San Diego.
It's like the place to go, right?
joe rogan
Yeah.
peter attia
Went in there and was like, okay, here's what I want to do.
joe rogan
They're like, why?
peter attia
I'm like, just want to do it.
Like, okay, great.
And then I remember when I, you know, got all my kit and my setup and they're like, all right, you got to go to knock on.
Like, you got to just watch this dude's videos.
And yeah.
joe rogan
No, he's literally the best in terms of like the average person who's interested in it.
He's got a great podcast about it, knock on podcast, but he gets so geeky and technical in his descriptions and his understanding of it.
I mean, he constantly obsesses about form and structure and, you know, archery.
To me, my history as a martial artist, it really jives with me.
It makes sense.
Because you could muscle things and do them wrong and develop bad habits and you'll never reach your full potential.
Or you could do things correctly and be very, very disciplined and focused and understand why you're doing something and then really actually reach your full potential.
There's really no other way.
And with archery specifically, it's so satisfying.
Like as we were saying before, when you do pull it off and you do execute that perfect shot with your rhomboids and the hand goes over the back shoulder and you watch that arrow shunk go right into that bullseye.
You're like, yes.
peter attia
I have my daughter come out and do the slow-mo shot of me from behind.
I've got like a hundred of these dumb things on my phone and it's just like I can watch them all day and it's like, did I do it?
Did I do it?
Nope, not there.
Oh, yeah, look at that.
unidentified
Oh, sweet.
joe rogan
A lot of it is elbow position too.
The height of the elbow, the elbow has to be in line with the arrow.
And sometimes people are pulling, but they're pulling and their elbows up here instead of way back here.
peter attia
Yeah.
You know?
And I think that's an interesting point about certain things, right?
So to me, the other thing I like about archery and race car driving is you have to learn some emotional discipline.
So you can't get pissed off and work your way through either of those things.
You can sort of get pissed off on the bike and it can actually charge you, which is not to say that cycling doesn't have technique in it, but it plays a much smaller role.
And in the end, the Gur factor can out-trump it.
But you can't gir your way out of a shitty shot.
And you cannot, in a car, if you start getting pissed, you're done.
Absolutely done.
joe rogan
Same thing could be said for a lot of things, I think.
Pool is one of them.
peter attia
Yeah.
joe rogan
It's a big one.
peter attia
Golf.
joe rogan
Yeah.
peter attia
Which I don't do, but yeah.
joe rogan
Yeah.
Listen, Peter, we just did three hours, believe it or not.
peter attia
I don't believe that.
joe rogan
It's 2:30.
peter attia
Huh.
joe rogan
Isn't that crazy?
peter attia
Look at that.
joe rogan
This place is a time warp.
It really is.
But I really appreciate this conversation, man.
It was really fun.
peter attia
So thank you.
joe rogan
If people want to get a hold of you on Twitter, give them your Twitter address, your website, all that stuff.
peter attia
Yeah, yeah, yeah.
Peter Tia M D. A-T-T-I-A.
joe rogan
I-A.
All right.
Thanks, man.
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