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Nov. 17, 2021 - The Joe Rogan Experience
03:21:31
Joe Rogan Experience #1735 - Peter Attia
Participants
Main voices
j
joe rogan
01:24:14
p
peter attia
01:50:13
Appearances
j
jamie vernon
01:20
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Speaker Time Text
unidentified
The Joe Rogan Experience Train by day, Joe Rogan Podcast by night, all day Hello Peter Hello, Joe.
joe rogan
Good to see you.
unidentified
Likewise.
joe rogan
We're fucking neighbors, man.
How are you liking the move?
peter attia
Loving it.
joe rogan
You've been here a year now, right?
A solid year?
peter attia
A little over, yeah.
joe rogan
Loving it?
peter attia
I don't know what took so long.
joe rogan
Yeah, it's a different world, right?
peter attia
Yeah.
joe rogan
When you live in a place that only has a million people, it's like, oh, like, wow, this is, uh, you could do everything here.
peter attia
If I'd done this three years earlier, I could have paid half as much for my house, too.
That's the other thing.
joe rogan
Right.
It's so smart to have done this in 2017. Well, lucky you did it then and not now, because now it's even harder.
It's harder to find a house.
It's almost impossible.
Yeah.
peter attia
Yeah.
I mean, every person we introduce to our real estate agent says the same thing, which is like...
joe rogan
You have to build.
peter attia
Yeah.
joe rogan
Yeah.
It's that wild, which is, I guess, good.
I don't know.
It's tricky because Google's building their...
They have this gigantic sail-looking building near the river.
Have you seen it?
peter attia
Oh, yeah.
joe rogan
Yeah, so there's going to be a bunch of wokesters running around from that place.
They're going to have to fill that building up.
Is there a more woke corporation than Google?
peter attia
Yes.
joe rogan
Which one?
peter attia
Microsoft.
joe rogan
Really?
Oh, I did see that!
peter attia
Did you hear that thing Ben Shapiro did?
joe rogan
No.
peter attia
Oh my god.
joe rogan
I didn't hear it.
What did he do?
peter attia
It's so funny that I went and listened to it again, recorded it on my phone off my computer just so I could text it to my friends.
So they had this thing where...
joe rogan
I saw the thing.
peter attia
Where they introduced...
Everyone introduced themselves.
joe rogan
With their pronouns and they described themselves.
peter attia
You're right.
So I would say, hi, my name is Peter Atiyah.
I'm a light-skinned guy with a shaved head wearing a green shirt.
I go by he, him.
joe rogan
Yeah, and you would say Caucasian probably.
peter attia
Yes, yes, I would, I would, right.
But then one of the women said, before we begin, I would just like to state that our land, the land that this building sits on was actually once owned by her, you know, and she rattled off 17 tribes.
joe rogan
Yes.
peter attia
At which point, like, my brother was like, well, just show me the title deed.
Like, is it yours or is it theirs?
Because if it's theirs, you really should give it back.
joe rogan
What is happening?
What's going on?
But Microsoft, which is interesting, they were never like this.
Like, all of a sudden, they went full tilt.
They just went from zero to 11. Right.
Right?
They don't have a history of, like, ads that were woke.
peter attia
I don't know.
It has provided...
joe rogan
Like, give me some volume on this because it's so stupid.
unidentified
...and lots in store for you.
First, we want to acknowledge that the land where the Microsoft campus is situated was traditionally occupied by the Sammamish, the Duwamish, the Snoqualmie, the Suquamish, the Muckleshoot, the Snohomish, the Tulalip, and other Coast Salish peoples since time immemorial.
A people that are still here, continuing to honor and bring to light their ancient heritage.
My name is Allison Wines.
I'm a senior program manager in our developer tools division.
I'm an Asian white female with dark brown hair wearing a red sleeveless top.
joe rogan
I'm watching this.
unidentified
And I'm Seth Juarez, program manager in the AI Platform Group.
I'm a tall Hispanic male wearing a blue shirt, khaki pants.
Today we kick off two days of learning more about the latest solutions, exploring how these key innovations can empower you to do great things and connecting with peers around the world.
joe rogan
They didn't tell their pronouns.
The other folks told their pronouns.
jamie vernon
Is that for hearing impaired people?
peter attia
No, it's for visually impaired, which is the greatest irony, right?
It's like, we want the people who can't see our color to know our color.
joe rogan
Ooh, right.
peter attia
Like, it literally is the most logically inconsistent thing you could ever have with what we think are the right values.
joe rogan
That's interesting.
Like, how much racism is there amongst visually impaired people?
peter attia
Well, apparently there'll be more now because we get...
joe rogan
But, I mean, if you really stop and think about it, like, they can't make that distinction.
They can only judge people based on how the people communicate with them.
They can't look at someone and prejudge.
They're probably the least racist people alive.
peter attia
Well, we're going to fix that.
joe rogan
But all the fucking shit about...
The thing that's ironic is she's describing all the different tribes that have owned the land.
Well, why do you think there's so many?
It's because they killed each other and stole the land from each other.
Like, what the fuck are you saying?
Michael Knowles had this conversation I watched on YouTube where this professor, this woke professor, was trying to say that we should give back land to native tribes.
And he was like, okay, but which ones?
You got to decide which ones, because the Comanche took it from the Apache, took it from the...
And he was going through the history of it.
It's like, how do you decide?
Like, do you go back, well, the Comanche took it from you, but you took it from the Navajo, but the Navajo took it from the Pawnee, and they're like, oh.
peter attia
I'm going to ask her, because she'll know.
joe rogan
It's so exhausting.
What is happening to us?
This wokeness.
peter attia
You know, it's easy to say the pendulum's going to swing the other way, and it probably will.
And my brother actually said this, and I think he's accurate.
It's not a pendulum.
It's a wrecking ball.
A pendulum implies just this benign little thing that's going to go back.
But it's not.
It's going to go.
And it's going to kill a bunch of people and ruin a bunch of lives and careers on the way back to some reasonable equilibrium.
joe rogan
I think the only reasonable equilibrium is mind reading software.
I really do.
I think the reasonable equilibrium is going to be something that allows us to read each other's minds so that there's no confusion whatsoever about what your intent is.
peter attia
Although, did you hear the person...
I forwarded this article, so I have a group text with a bunch of friends and my brother where we just...
This is our only outlet for this insanity.
And someone wrote, actually, Jon Stewart defended Dave Chappelle after the special and said, look, his intent was X, right?
And this person, I don't remember who it was, I don't remember what, you know, it was in The Independent or something like that, wrote this whole thing saying, intent is bullshit.
Intent means nothing.
And it was so ridiculous because the argument she gave was homicide.
She's like, even if you don't mean to kill somebody, it's still manslaughter.
To which we're all at the same time like, yeah, and there's a difference between first degree, second degree, involuntary.
Like, of course intent matters.
joe rogan
Of course it matters.
peter attia
Yeah.
But the point is there are people now arguing intent is irrelevant.
joe rogan
That's the dumbest thing ever because like what if someone if you can be charged with manslaughter if you get in an argument with someone like say if you are in a situation with someone and They bump into your car and you yell at them and they get in your face and take a swing at you And you knock them out and they fall and hit their head and die you can get charged with manslaughter for that That is so much different than breaking into someone's house and shooting them in the face.
It's so much different.
Like plotting out.
So the intent is everything.
peter attia
Absolutely.
joe rogan
And the idea of communication is always, it's always, I want to express my thoughts to you so you can better understand what I'm thinking.
And we can figure out what's right and what's wrong.
We can hash things out.
We can work on a plan.
If you don't know what the fuck a person really means and you're only going by words, are we code now?
Intent doesn't matter.
Emotions don't matter.
Thoughts don't matter.
Of course it matters.
It's like the only thing that makes us human.
It's so dumb, but it's people taking advantage of what the internet provides, which is this ability to communicate and express outrage and push buttons, right?
So because we have this new ability to do this, there's a lot of bad actors that use that, that use that ability to communicate, to find things to complain about that are really not relevant.
They're not really something you should be complaining about.
And if you do complain about it, it's really because you don't have any legitimate problems in your real life.
peter attia
Well, I think the other thing is there's an insecurity.
Actually, there's an opinion piece in the Wall Street Journal today about this, right, which is what was the title of the article was something along the lines of why the woke can't take a joke.
And what it basically came down to was the – and this was quoting guys from like 100 years ago making the same thing when it came to jokes about religion.
And the idea was if you aren't comfortable in your position – You're going to be easily offended when somebody rattles you, when somebody pokes fun at you.
If I came here and said, oh, hunters are wankers, blah, blah, blah, blah, blah, it wouldn't offend you because you're very comfortable in your position, in your beliefs, and it's like, hey, if you don't like hunting, that's cool, but that says nothing about me.
joe rogan
Well, it definitely wouldn't come from you because you're a hunter.
You know what I'm saying?
Like, if you came to me and said, bow hunting is bullshit, I'd be like, haha.
peter attia
But if anybody said it to you, it wouldn't faze you.
joe rogan
Well, it wouldn't, but it would be a conversation where I would probably, if I respected that person, I would want to either defend it or explain my position.
peter attia
But you wouldn't be offended is the point.
You could engage with them as opposed to throwing up a flag.
joe rogan
Yeah, yeah.
I mean, it's a weird thing that we're doing right now with words.
This is a strange time where we're trying to ban words, and we're trying to change the meaning of words and eliminate nuance in conversations.
And again, we're doing it because of social justice, right?
And the people that use social media to try to enact social justice, which really doesn't change.
It's not really getting anybody justice.
It's just getting the rocks off of these people that enjoy complaining, and most of them really should be doing something else.
Most of the people on Twitter should be doing something else.
I have, like, radically reduced my amount of time on Twitter.
But every now and then, I open it up, and it's like watching a fucking, like, a room that's, like, five by five, filled with 400 chickens.
And they're just squacking each other and pecking each other.
It's like, Jesus...
This is horrible.
It's so bad for your mental health.
It's just people arguing and dunking on each other all day long.
peter attia
Even outside of that, my roommate from med school, who's a urologist, called me yesterday because he couldn't wait to tell me this ridiculous story.
So a colleague of his, this female urologist who's a badass surgeon, was giving a lecture to the medical school, which is common, right?
You'll always have the surgeon will come in or the doctor will come in.
And before she got up to give her lecture, the dean said to her, and I'm not making this up, this is a urologist giving a lecture to a group of medical students, said, I would appreciate it if you would not use the word penis during this lecture.
joe rogan
He said it before the lecture?
unidentified
Yeah.
peter attia
She said, it's an anatomic term.
I'm a urologist.
What would you like me to say?
And he came up with some idiotic, oh, he said, maybe you could call it male erectile tissue.
unidentified
Yeah.
peter attia
And she was like, well...
She's now fucking with him.
She's like...
But...
joe rogan
What if it's flaccid?
peter attia
Wouldn't the use of mail also be kind of triggering in that sense?
I mean...
joe rogan
Good point.
unidentified
Yeah.
peter attia
I mean...
And she basically told him to piss off.
joe rogan
And what did this...
This guy was the dean?
peter attia
The dean of the medical school.
joe rogan
And I assume he's a doctor as well?
peter attia
He should be.
Yeah, yeah.
If he's the dean of the medical school, he would be an MD. What in the fuck is wrong with people?
joe rogan
One of my favorite videos is there's a communist meeting, a meeting of these student communists and they're like criticizing each other for various things and one of them gets up and tells everybody that please keep the chatter to a minimum and be respectful for people that are easily distracted And then another one gets up and they yell out to stop using gendered language because he said,
guys, can you guys please do this?
And so he gets up and says, can you stop using gendered language?
It's just like, you guys are like LARPers.
It's like live action role play.
You're playing like you're in a different dimension.
Want to hear it?
It's hilarious.
unidentified
And to win socialism.
Thank you so much.
Great.
Quick point of privilege.
Quick point of personal privilege.
Guys, first of all, James Jackson, Sacramento, he, him.
I just want to say, can we please keep the chatter to a minimum?
I'm one of the people who's very, very prone to sensory overload.
There's a lot of whispering and chatter going on.
It's making it very difficult for me to focus.
Please, can we just...
I know we're all fresh and ready to go, but can we please just keep the chatter to a minimum?
It's affecting my ability to focus.
Thank you.
Thank you, comrade.
Okay, is there a speaker against name, chapter, pronoun?
Point of personal privilege?
Yes.
Please do not use gendered language to address everyone.
joe rogan
And she calls everyone comrades, too.
It is adorable.
These fucking kids are doomed.
They're doomed.
They're all gonna have to join the military.
There's no way to save them.
Oh my god.
It's just so weird.
It's like it happened so quick.
peter attia
Yeah, that's the thing.
I keep saying to myself, where was the inflection point and how did I miss it?
joe rogan
Well, I didn't totally miss it because I had a lot of people on that were, you know, six years ago, seven years ago giving me warnings of, like, what's going on in the universities.
But I didn't think the spillover would be so broad that it would, like, really make its way into corporations.
And I thought, like, there would be a barrier.
peter attia
Yeah, because there would be a containment sort of.
joe rogan
Particularly with corporations because I thought they weren't going to tolerate that shit because it's going to affect their bottom line.
But then they realize that you can sort of do what Microsoft is doing.
Placate and play to the woke.
And then it will somehow or another help you financially?
But I don't think it does.
You know, Apple's looking pretty good after that fucking commercial.
peter attia
Which one?
I didn't.
joe rogan
The Microsoft one.
peter attia
Oh, yeah, yeah.
joe rogan
The Squamish and the Chumash.
peter attia
Well, hey, just wait.
I'm sure they'll come up with their own version.
joe rogan
I don't think they will.
I don't think they'll go that far.
I mean, they're pretty woke.
But they seem a little bit more reasonable.
The craziest thing is that all of this is coming through devices that are made by slave labor.
At the end of the day, it's so hypocritical that all these people tweeting about social justice and all the wrongs of the world, you're doing it on a fucking device that's made by child slaves.
Like, sorry!
You want to buy an iPhone?
You've got to get something that's essentially made by people that are getting slave wages.
They're working 16 hours a day in a building that has nets around it to keep suicide people from jumping off the roof.
That's Foxconn.
That's where they make them.
They don't make them here.
They're not making them in Ohio with folks that are in a union that get paid great wages and benefits and can take care of their families.
Uh-uh.
No.
No.
We want to try to keep the bottom line nice and low.
So in order for you to tweet about social justice, you have to do it on a device that's made by people that are not much better than slaves.
Not more well off.
They're really not.
It's fucked.
It's crazy that there's no outrage to that.
peter attia
Well, the outrage is silent.
That's the problem.
I mean, we're all, you know, I guess I should be more vocal about it.
You should be more vocal about it.
Everybody should be more vocal about it.
Because there's no way the majority of people are looking at this and thinking it's reasonable.
joe rogan
No, they're not.
peter attia
But we're not doing enough about it.
joe rogan
We're not doing anything about it.
No one has made a push to make a phone in America.
Unless there's something I don't know about.
Is there a phone made in America?
Let's see if there is a phone made in America.
I bet there is not one.
I'm willing to bet there's not one.
And if it is, it's a piece of shit.
I heard Elon's thinking of making a phone.
There's some talk of a Tesla phone.
If that happens, he might be like the only one.
If Tesla does that, they might be the only ones that could sway people from iPhones.
peter attia
Yeah, I think you're right.
unidentified
Right?
joe rogan
If anybody can, because it's hard.
Like Samsung has some amazing phones.
The cameras are incredible, but people look at that green text coming in, they're like not doing it, you know?
But if like someone like Elon convinced people to switch over to Signal, Which is probably better for everybody anyway, to have some peer-to-peer encrypted application.
Librem 5 USA. This is a Linux phone, isn't it?
jamie vernon
Yes.
joe rogan
Made in the USA. Electronics with a secure supply chain.
What does that mean?
Made with a secure supply chain.
What does that mean?
jamie vernon
If you want a smartphone built outside China and the walled gardens of Google and Apple, this may be for you, according to the register.
joe rogan
So it's real?
jamie vernon
Yeah, I just Googled.
There's a...
joe rogan
32 gigabytes?
Get the fuck out of here.
My phone has a terabyte, you fucking idiots.
unidentified
There you go.
peter attia
It's the equivalent of your flip phone.
joe rogan
What else is in there?
peter attia
It's for essential communications.
joe rogan
Scroll back up so I can see the stats.
Look at that.
5.7 in screen.
Okay, it's kind of small.
3 gigabytes of memory.
Piss poor.
32 gigabytes of storage.
That's terrible.
But 4,500 milliamp battery is substantial.
jamie vernon
And replaceable.
joe rogan
Ooh, that's nice.
The big battery is substantial.
But that probably means that it's not water resistant if it's got a replaceable battery.
unidentified
Hmm.
joe rogan
So pure OS is what it runs.
jamie vernon
It would be a phone.
joe rogan
That's made in America.
jamie vernon
Right.
According to this.
joe rogan
Hmm.
jamie vernon
Unless there's some sneaky stuff, too.
joe rogan
Well, what I'm worried about is I think they said they used supply chain.
jamie vernon
Yeah.
joe rogan
Secure U.S. supply chain smartphone.
You're not saying what I want you to say.
What I want you to say is everything is made in America.
jamie vernon
All fabrication and manufacturing done at the Purism facility.
joe rogan
Fabrication and manufacturing.
Individual components used in the fabrication are sourced direct from the chip market.
That means they're from other countries.
We use U.S. companies with U.S. fabrication whenever possible, but that doesn't mean it's from the U.S. Most distributors are based in the U.S. Most, with the exception of Large integrated circuits that are made in a variety of countries where those companies do fabrication, U.S., Taiwan, South Korea, Japan.
Well, those companies, at least those countries that they just listed aren't using slave labor.
As an example of NXPCBU used from their fabrication in South Korea, while we source chips made from the U.S. wherever possible, chip country of origin is not nearly as meaningful as country of board fabrication, especially when all chips are verified.
Hardware circuits that are driven by free software in the kernel.
Yeah, these kernel motherfuckers, these Linux guys, they start talking kernel and my eyes gloss over.
jamie vernon
There's a chip shortage, too, right?
unidentified
Yeah.
jamie vernon
Whatever that means.
I don't know exactly what that means.
joe rogan
It means it's hard to get a car.
jamie vernon
Yeah.
joe rogan
Yeah, I had a friend who was trying to buy a Ford Raptor.
He couldn't get one.
peter attia
Oh, yeah.
I ordered my pickup truck.
I wanted to get one in a manual, so I had an old Tacoma, gave it to my brother-in-law.
joe rogan
You wanted to get a pickup truck and a manual transmission?
peter attia
There's only two that are still made.
joe rogan
Who makes it?
peter attia
Tacoma makes a limited edition Pro Sport.
unidentified
Really?
peter attia
And the Jeep pickup truck comes in a manual.
unidentified
Oh.
joe rogan
Well, the Jeep kind of makes sense.
I can't believe Tacoma still does that.
Why do you want a manual pickup truck?
peter attia
I want my daughter to be able to drive manual.
unidentified
Oh.
peter attia
And I just miss driving manual.
jamie vernon
Really?
peter attia
I grew up driving manual.
And about six years ago when all cars went to dual clutch, like when sports cars went to dual clutch, I basically get up.
So I still drive manual on the track, but I kind of miss it on the road.
And I do want my daughter to drive a manual.
I feel it'll keep her...
Well, also, it'll be texting less and screwing around less.
I hope.
joe rogan
Maybe not.
peter attia
But anyway, the point is, I ordered the thing like six months ago, and it's always like a month away.
It'll be a month away for another year.
joe rogan
Yeah, I have manual cars.
I have a bunch of manual cars, but they're older cars.
Like, I have a 2007 Porsche GT3 RS. That's a manual.
The Gunther Works Porsche is a manual.
I got a 70 Chevelle.
That's a manual.
69 Camaro.
That's a manual.
I got a bunch of manual cars.
peter attia
That 69 Camaro is a four-speed?
Or is it a...
joe rogan
No, it's a resto mod.
peter attia
It's a six-speed.
Oh, okay, okay, okay.
joe rogan
With an 850 horsepower engine.
peter attia
The 07 GT3 must be nice.
joe rogan
Oh, it's fun.
Yeah, it's really fun.
It's a Shark Works car, too.
peter attia
Oh, yeah.
Great sound.
joe rogan
It's got 518 horsepower.
unidentified
That's...
peter attia
Because of the exhaust, it's boosting it that much?
joe rogan
No, they bore it out to 3.9 liters from 3.6.
unidentified
Oh, okay.
peter attia
Yeah, yeah.
joe rogan
You know Shark Works?
peter attia
Of course.
Yeah, yeah, yeah.
I almost had it on mine.
joe rogan
Oh, really?
peter attia
Yeah.
joe rogan
Yeah.
They make awesome stuff.
And...
They're a big fan of manuals.
They don't really particularly like dual clutch cars either.
So they particularly like Gen 1 and Gen...
997, Gen 1 and Gen 2 RSs that you could really juice up.
peter attia
Yeah.
I mean, you know, it's funny.
I wanted to get a GT3 in the 992.1, and the Porsche dealer here said, no problem.
We have an allocation.
We can get you one, but you're going to spend $75,000 over MSRP. And I was like, wait a minute.
You're going to charge me?
The dealer is going to charge me $75,000 over the MSRP? No chance.
joe rogan
That's so much more.
peter attia
You can buy a 991.2 RS for less.
joe rogan
Yeah, that's dumb.
Yeah, I'll give you a taste.
You can get a taste.
You get a little bit.
You can't ask for $75,000.
That's just hoping that someone's a rich asshole and they're just willing to throw the money down to have it.
But you can get them from other states.
peter attia
I actually called three other dealers and the lowest premium I was getting was 40k over.
joe rogan
Really?
peter attia
But I was just on principle.
I'm like, I'm not doing it.
It's the same reason there's certain watches I just won't buy because I'm not willing to pay the premium over when it's based on a false scarcity.
joe rogan
Right, right.
peter attia
It just irks me.
joe rogan
The watch market is very weird with that.
There's some watches that you see them and you're like, why is that $100,000?
Help me out.
peter attia
I have sold more watches in the last few years, and I'm wearing like a $100 G-Shock that I love.
joe rogan
Are you trying to get away from the watch fetish?
peter attia
No, I mean, I have...
joe rogan
Do you drink caffeine?
peter attia
Yeah, yeah.
No, I mean, I think I just...
I had too many, and I wouldn't wear them all, and it just didn't make sense.
And so I kind of...
I still have a lot of old watches that I really like, like kind of 60s, 50s.
unidentified
Oh, really?
joe rogan
You collect them?
peter attia
Yeah.
joe rogan
What do you got?
What kind do you like?
peter attia
So I like Rolexes in that vintage, right?
So kind of the Daytona, the no-date subs, and the GMTs in that first iteration.
So the gilt version, which is kind of the yellow, like it has the brighter marks on it.
So I got a few years ago, before they got really silly in pricing, A guy that I work with, his name's Andrew Scheer in New York, who does just vintage Rolex.
He calls me up, and I had told him for about a year and a half, I wanted a certain, I wanted a Gilt 1675 GMT. And he, I remember I was getting on a plane, I was at Newark just leaving, and he goes, sends me a picture, and I'm like, Dude, that's like new old stock.
He goes, yeah.
It was like some guy bought it in Hong Kong in 1967. It sat in a shoebox till now.
joe rogan
Wow.
So it doesn't have any patina, no fade, no nothing?
peter attia
It actually still has a little bit of a patina just based on how old it is, but it's in perfect condition.
I love that watch.
joe rogan
You know what I don't like?
I like some of the watches, but I don't like that they're doing this.
They're doing a faux patina on some watches.
peter attia
Yeah.
joe rogan
It's so weird.
I got the Omega.
I'm a big Omega fan.
And I got the James Bond No Time to Die.
peter attia
Yeah, yeah, yeah.
Did you get the one with the metal bracelet?
joe rogan
Yeah.
peter attia
Yeah, I just got that too.
joe rogan
It's amazing.
It's a beautiful watch.
I'm a big fan of their...
I'm actually wearing one of their dime watches.
But that one, they used that faux patina, and I'm like, why did you do that?
This is one thing that kept it from being perfect.
peter attia
It is beautiful.
I love tropical dials, and that's what makes that watch to me so beautiful.
unidentified
Tropical?
joe rogan
What do you mean?
peter attia
Like that brown color.
joe rogan
Oh, that's tropical?
peter attia
Yeah, so tropical is like kind of one of the most sought-after thing in a Daytona.
If you get an old Daytona with a tropical face, they're hard to find, but they're gorgeous.
Yeah.
joe rogan
Hmm.
Watches are weird because there's something about it that appeals to men more than it does to women.
I know there's a lot of women that are watch collectors, but it seems if I'm paying attention to the internet and watching videos, it's a male-dominated jewelry thing.
peter attia
Totally.
joe rogan
Which is the only male-dominated jewelry thing that I could ever really think about.
I don't think there's another one.
Because it's weird, because it's a jewelry thing, but it's also a mechanical thing.
There's something about the engineering of the devices.
peter attia
I think that's why.
It is our jewelry, but the mechanics of it are beautiful.
If you like Omega, which I'm also very partial to Omega, The Ed White re-release Speedmaster 321 caliber is unbelievable.
joe rogan
Which one's that?
peter attia
It's my favorite Omega.
joe rogan
What does it look like?
I have a couple of Speedmasters.
peter attia
So it looks just like a pretty regular Speedmaster, except that it has the caliber 321, which was the up to 1969 caliber.
So this is the Moonwatch.
So after 1969, they discontinued the caliber 321 and they went to the caliber 1861, which is what they basically rode up until a few years ago.
But the purist loves that 321. The problem is if you go back and buy one from the 60s, I have one.
I have an old one as well.
They're not the most reliable in the world.
They're hard to service, you know, all sorts of things.
So when they redid this, they had to basically, they didn't even have the original drawings for it anymore.
They had to go back and look at existing watches and kind of extrapolate from the wear in the existing watches to what the movement did.
unidentified
Oh, wow.
peter attia
That's amazing.
joe rogan
So they had to back engineer it?
peter attia
Yep.
They had to reverse engineer it.
joe rogan
Is that it right there?
peter attia
Yep.
So there you go.
joe rogan
That's pretty.
I love watching those little things move around because you realize that they figured this out in the 1800s.
peter attia
Yeah.
joe rogan
Or probably even before, right, with pocket watches?
unidentified
Yeah.
joe rogan
When was the first pocket watch?
peter attia
That's a good question.
joe rogan
Let's take a guess before we Google it.
Jamie, what do you think?
First pocket watch.
jamie vernon
With mechanics that work like that?
joe rogan
Yeah.
Wind-up.
They were all wind-up ones.
jamie vernon
I'm going to go old 15...
No, let's say before that, so like 1450-ish.
joe rogan
Really?
jamie vernon
They had to use something like that probably for maneuvering the oceans, I'm guessing.
joe rogan
How would they even agree to what time it was?
jamie vernon
I don't have any idea.
joe rogan
Before they agreed to what time it was, no one had a fucking clue.
unidentified
Right?
peter attia
They're using sundials and things like that.
joe rogan
There was a time in history where no one agreed what time it was.
jamie vernon
Well, like, how old's Big Ben?
Like, that's probably the first agreement, because they're like, hey, that's the fucking time right there.
joe rogan
Right, that's a good point.
Big Ben.
I'm going to guess Big Ben is from 1800. All right, I was not too far off.
peter attia
I'm going to go a little earlier.
unidentified
Really?
joe rogan
Okay, hit me with it.
1510. 1510 is the first watch?
jamie vernon
German watchmaker Peter Heinlein.
joe rogan
So he's like, this is the time...
jamie vernon
By utilizing...
unidentified
It's here!
joe rogan
This is it!
He's like decided.
He's the first guy to decide what the time is.
Because everybody else is like, well, fuck you.
I don't think that's the time.
Like, you could decide.
Right?
If you go back to caveman days, there's no time.
And then as...
Like, no one has any idea what the time it is.
But as time moves forward, and we get closer and closer to modern era, there had to come a point in time where they decided, alright, this is what noon is.
Right here.
peter attia
Yeah.
I love the way in which, like, how accurately we can record time now, right, with atomic clocks.
That's kind of mind-boggling to me.
joe rogan
Is it confusing us, though?
Because we're, instead of looking at actual time, which is a thing that's existing right now only, there is the past and there is the future, but actual real time is just this.
You can measure how long things take, but is it confusing us as to what time actually is?
Because what we're really doing is measuring time on devices.
We're measuring seconds that go by, hours that go by, minutes that go by.
It's not giving you an excuse to not be prompt, but it's really kind of bullshit.
peter attia
Well, I don't know, but I will say this.
Not having a watch on feels great sometimes.
Not having a phone with you feels great.
And, you know, being in nature.
Like, when you're hunting, I do wear a watch, but only because I want to know where we are in relation to sunup and sundown.
joe rogan
Yes, me too.
peter attia
But outside of that, like, you have no care in the world.
You care about wind.
You care about scent.
You care about other things.
joe rogan
Did I tell you about the mountain lion I saw?
peter attia
No.
joe rogan
I didn't tell you.
When we were in Utah, I saw a giant mountain lion.
Fucking giant.
Like as big as me.
unidentified
It was huge.
It was huge.
peter attia
How far from you?
joe rogan
We were in a truck, luckily, and it was about 30 yards away.
My friend Colton spotted it.
We were driving, and he hits the brakes.
He goes, that fucking mountain lion!
And I'm like, where?
And then I see its eyes.
Because it was starting to get dark out, but it was still light, and its eyes were glowing.
And I put up the binoculars to take a look at it closer through the windshield, and I was like, holy fuck.
It was huge.
peter attia
I did not know they got that big.
joe rogan
Oh, they get to 200 pounds.
The one that I saw previously, I saw one in Santa Barbara, and it was probably like 70 pounds, 60 pounds.
It was pretty small.
And then I saw another one in Colorado, but it was so brief.
It was hard to tell, and that one seemed the same size.
It seemed like a smaller juvenile one.
This was not a juvenile.
This was a 100% full-grown tom.
With a big old pumpkin head and huge paws.
And the forearms were wild.
Like, that was the weirdest thing.
Like, looking at his...
His forearms were as big as my thighs.
I was like, fuck, look at this fucking thing.
peter attia
Elk killer.
joe rogan
It was just looking at us, you know, and it was under a tree.
And, you know, we opened up the car door and tried to, like, get film of it and look at it closer and it took off.
And it was so big.
Because I was thinking, like, if I was out there on my own, you know, because people do that all the time.
They hunt solo, and they don't carry a weapon.
You know, like, Colton didn't have a weapon.
I only had a bow and arrow.
And here's this giant-ass fucking cat.
Like, if we zigged when we should have zagged, and all of a sudden we're on top of this thing, and it decides to pounce on us, fuck.
peter attia
That better be a good tri-pin.
joe rogan
Yeah, did you see that video of the guy who shot the mountain lion in the face?
peter attia
No.
unidentified
Jamie.
joe rogan
He's hunting, too.
And he's got a Glock out, and he's telling this mountain lion, hey, back up, back up.
And it's not even, it's a smaller one, like a 90-pound one.
But he's saying to it, hey, fuck off.
Get out of here.
And then it makes a move on him.
And, you know, he drops his phone.
You hear a crack, crack.
You hear one shot, one shot.
And then you see the thing twitching on the ground.
It's got a bullet hole in its face.
unidentified
Wow.
joe rogan
Yeah, but doesn't have that gun he's fucked because occasionally they will jump on people and that's the situation is this guy was in like look at this Give me some volume rewind it and give me the volume because the when it's looking at its face you get back look at that you get back You get back You get back You get back Back!
unidentified
No!
peter attia
No!
unidentified
Motherf***er.
I just had to shoot this f***ing mountain lion.
They f***ing pounced at me and I popped it in the f***ing face.
Holy s***.
joe rogan
Holy s***.
That is wild, right?
unidentified
Oh my god.
joe rogan
At least he's got like 100% proof of self-defense, man.
I mean that thing was like 10 feet from him.
unidentified
Wow.
joe rogan
And apparently it went, look at that, that's where he shot it.
Right through the face.
Apparently it was about to pounce.
What do you do?
peter attia
You gotta do that, man.
joe rogan
Yeah, but I don't bring a pistol with me when I want.
peter attia
Oh, no.
But, I mean, you know, it's funny.
I never thought about it except if you're hunting boars, right?
That's the one time when you're like, you have to have a gun with you if you're shooting a boar.
joe rogan
They will charge you.
Yeah.
And they'll charge you if you hit them, they'll charge you if you don't, like if you're bow hunting.
I was watching a show once where the guy was packing, and he shot a pig, a wild boar, with a bow and arrow, and it came charging full clip at him with the arrow hanging out of its body, and he had to shoot it.
peter attia
Speaking of shooting, this range down the street from you is incredible.
joe rogan
Which range?
peter attia
The, whatever, the Austin Gun Club.
joe rogan
Oh, the range.
unidentified
Yeah, yeah, yeah.
joe rogan
The range, the indoor range.
peter attia
Yeah, it's great.
joe rogan
Yeah, that place is really good.
peter attia
Yeah, I just went there for the first time today.
joe rogan
Yeah, it's really good.
Yeah, we have a corporate membership there.
It's nice.
Everybody can go, go, bang, bang.
It's good.
You know, it's like shooting guns is something you really have to do on a fairly regular basis.
peter attia
What do you think the frequency is?
Because it's not as frequent as archery.
I mean, archery, if I go two days without shooting my bow, I notice a difference.
unidentified
Really?
peter attia
Yeah.
What do you figure it is?
Like, you got to do it once a month, twice a month?
joe rogan
I think once a month is reasonable as long as you really do take time and you make a lot of shots and you have good form and you're really paying attention to what you're doing, you know?
I think there's just too many people that have a gun and think that they're safe and they don't know how to use it at all.
They don't practice with it.
Like, it's really kind of strange.
You could just buy a gun.
Like, you don't really have to have...
Like, to get a concealed carry permit, you have to show competency.
But you don't really have to do that for a regular...
I mean, the first time I bought a gun was in 1994 when I first moved to California.
And I just walked into a gun shop.
And I said I want to buy a pistol.
So I bought a Glock.
I still own it.
And I paid for it.
They did a background check.
I think it was like a few days.
I got the gun.
That's it.
You don't have to know shit.
I mean, I shot it at that range, but you don't really have to know much.
And when I shot it at the range, nobody taught me how to shoot it.
I just shot it.
I'm just like, okay, you put the bullets here, and this is where the trigger is, and point it down there.
Okay, bang, bang, bang.
peter attia
And now, at least with YouTube, there are some people out there putting really good content out where you can, if you're a newbie, you can say, okay, well, show me what's the right technique, what are the mistakes that people make here, and stuff like that.
But yeah, back in the day, I mean...
joe rogan
You really should get, I think you should get one-on-one instruction if you can afford it.
I don't know how much it costs to get someone to teach you how to shoot a gun correctly, but someone should show you how to hold it, you know...
Where to place your hand, and where you should put the pressure, and which hand should be relaxed, and how to line your sights up correctly.
That's something that's a little tricky to do in a video, you know?
peter attia
For me, the long range stuff is, I just bought an Accuracy International 300 Norma mag, like super, super long range rifle.
And for me, which, and it's actually too big a gun for hunting.
So it's not, it's really, it serves, yeah, yeah, yeah.
It's just a little too long.
joe rogan
Like the long barrel?
peter attia
It's just too heavy a gun to take into the field.
Amazing weapon for hunting because the.300 Norma mag is a ridiculous caliber.
Like that'll knock an elk over if you hit it in the shoulder.
At a thousand yards.
unidentified
Wow.
peter attia
But this is a gun that you can work your way out to shooting a mile, you know, shooting a dinner plate at a mile.
Which is just, again, that to me is the joy, right?
Like, that's the fun, is learning the wind and learning the technique.
Because it is in the sense like archery.
You know, in archery, if you can't control the pressure of your hand on the riser, you know, at 20 yards it doesn't matter, but at 80 yards it matters everything.
joe rogan
Yeah.
peter attia
And it's the same thing with those guns.
If you're not on the clavicle the right way and your face is not on this the right way and your trigger isn't pulling back perfectly, all of that stuff just amplifies mistakes.
So for me, that's the most fun thing, is those otherwise not particularly helpful long-range rifles.
joe rogan
Yeah, when you really get into archery, long-range shows you where your mistakes are.
I was talking to Lee Lukoski.
And he was saying that, for people who don't know, Lee Lukoski is a very famous bow hunter.
And he was telling me that if he shoots 100 arrows, 99 of them are at 100 yards.
peter attia
Wow.
joe rogan
He says, that's how you find out where your form is.
And he goes, and that's how it's repeatable.
Because he shot an elk at a pretty far distance this year.
And he was explaining it to me.
He said, I have a whole process that I do when I shoot in the field versus when I shoot at a target.
Like, it's the same process.
So he just does exactly what he does at home, and he's done it so many times that he's very confident that if he does have an 80-plus yard shot on an elk, that he can make it perfectly.
peter attia
What is your comfort range in the field, not at home?
joe rogan
I've shot a lot of elk at 60 yards, 67 yards.
I shot one at 75 yards.
peter attia
That was the one in California, right?
joe rogan
Yeah.
peter attia
Yeah, that guy was bedded for a while.
Yeah.
joe rogan
But I was relaxed and I had been shooting at 75 yards a lot.
And I felt comfortable.
Like, there was no wind.
I was comfortable.
And, you know, an elk is a large target.
If I was gonna shoot a deer, it'd be significantly less.
peter attia
I shot an axis once at 69, but it was a good situation.
He was 100% broadside and not at all jumpy.
I mean, I had no clue I was there.
But in retrospect, I still think that's a bit...
I don't know that I would take that shot again.
69 doesn't leave you much margin for error on a deer.
They're not that big.
The axis deer especially.
joe rogan
Yeah, what do they weigh, 120 pounds, like a big one?
peter attia
I mean, the biggest one I've ever shot was 200. 200, really?
Yeah.
joe rogan
He was a beast.
Oh, wow.
What island was this?
peter attia
Maui.
joe rogan
Oh, no kidding.
I've never been hunting on Maui.
peter attia
You gotta come, man.
I think it's 10 times better than one eye.
joe rogan
Really?
Why?
peter attia
The terrain.
You're up on the volcano, right?
joe rogan
That makes sense.
peter attia
Haleakala is, I mean, the density of deer is not as high as lanai, of course, but the terrain is insane.
And the bucks are huge.
Like, there are lots of 30-inch bucks out there.
joe rogan
Oh, wow.
Well, the density in Lanai is almost like a problem.
peter attia
Right.
It's like too many eyes on you.
joe rogan
It's just too weird.
It's also too weird.
I kind of feel like you could just close your eyes and draw back and launch into the sky and you might hit something.
You know?
I mean, there's so many deer out there.
For people who don't know what Lanai is, it's a very small island in the Hawaiian Islands chain and it has 30,000 deer on it, which is so crazy to say.
peter attia
Right.
I think...
joe rogan
3,000 people.
peter attia
That's right.
And Molokai has 70,000.
joe rogan
What?
peter attia
It's crazy.
joe rogan
That's insane.
peter attia
Yeah.
And Maui has the most, I believe.
But obviously it's a bigger island.
joe rogan
Maui has more than 70,000?
peter attia
I used to know the numbers for each of the three islands, but I think Maui might have like 100,000.
joe rogan
Are they as jumpy in Maui as they are in Lanai?
Because in Lanai, they're so pressured, because they hunt them so often.
peter attia
I mean, that's the funny thing with them.
Even when you're up in Haleakala, they're still jumpy, and I keep thinking, like, why?
They haven't been around humans, but their evolution is so strong.
I guess when you spend half a billion years getting away from tigers, You don't turn that off in 50 years.
joe rogan
No.
I mean, that is the fucking animal, right?
peter attia
Yeah.
joe rogan
If there's one animal that you evolved to get away from and you have to be fast, I mean, the way they can jump a string is so crazy.
Like, the bow goes off and they hear the sound and they're gone.
peter attia
It's amazing.
joe rogan
It's so weird to see them move like that.
It's like, how does...
The central nervous system must be just so fucking tight and wired like a drum.
unidentified
Right.
peter attia
They need some stress management techniques.
joe rogan
I know.
But it's weird because they seem so peaceful until that moment.
They're like immediate to 100. Because they don't seem jumpy until they jump.
peter attia
Yeah, it's amazing.
joe rogan
Well, it's like, what else are they going to do?
This is the problem with Australia.
It's the problem with New Zealand.
In Australia, they've made giant mistakes with that where they brought in other animals to try to mitigate the...
The number of, you know, this or that, and then those animals wind up wiping out native populations of nesting birds, like cats, like feral cats in Australia.
It's a giant problem.
peter attia
What the Axis deer are doing in Hawaii is brutal for Hawaii.
joe rogan
It's crazy.
peter attia
It's just killing that state.
unidentified
And what can they do other than hire people to shoot them?
peter attia
I mean, at this point, you know, Jake Mews, my friend who runs that company out there that's Maui Nui Venison, these guys that are making, you know, commercializing, they have a USDA grade commercial program for making axis deer.
And they're about as efficient as they get.
He does not think they're...
They're not even going to be able to flatten the population curve till 2030. Whoa!
joe rogan
So it's going to continue growing till 2030. Are they just making those venison sticks?
Are they selling steaks and roasts?
unidentified
Everything.
peter attia
Chef boxes, everything.
joe rogan
Oh, that's great.
How does someone...
Let's tell...
How does someone get a hold of that?
Because that is a great opportunity for you to get actual, real, legitimate wild game.
And it happens to be one of the most delicious wild games.
unidentified
Yeah, yeah.
peter attia
I mean, if you go to...
I assume...
And by the way, I should just disclose I'm an investor, so...
But Maui Nui Venison, if you just...
I think you just order online.
joe rogan
How do you spell that?
peter attia
Maui Nui Nui Venison.
joe rogan
See if you could find that.
peter attia
Yeah, see what...
joe rogan
Yeah.
This is, I mean, I can't recommend venison from Axis Deer enough.
It is so delicious.
Okay, so this is nice.
peter attia
I usually get boxes for friends as a gift when they're being introduced to Wild Game.
joe rogan
I'm like, Oh, they have bone broth too.
peter attia
Dude, it's insane.
The bone broth is next level.
joe rogan
This is amazing.
peter attia
The company that we had do the analysis on the protein content repeated the analysis twice because they didn't believe how much protein it had in it.
joe rogan
25 grams of protein in a fucking bone broth?
peter attia
Yeah.
joe rogan
Whoa.
peter attia
They were like, yeah, yeah, this is 2x every other animal we've ever seen.
There must be a mistake.
They just repeated it over and over again.
joe rogan
Look how delicious that must be.
Let me see that.
peter attia
I'll tell you, you use this as your stock and make rice?
It's insane.
joe rogan
Oh, nice.
How much does that shit cost?
peter attia
I don't know.
joe rogan
I just bought it as part of it.
Oh, 125 bucks.
peter attia
For 8 bags.
joe rogan
Oh, 8 bags.
Oh, 15 ounces each.
Oh, that's nice.
I'm in!
peter attia
So, but what's amazing about this, and I think this is why it tastes so good, it tastes better than when you and I shoot one.
Because when you and I shoot an axis deer, even if it's a perfect shot, that animal still takes a minute to die.
In other words, there's still a minute of stress in its life.
joe rogan
Oh, these guys, they headshot them.
peter attia
They headshot them at night.
So they're using night vision.
They're 200 yards away.
Silencers.
Yep, it's...
And it's, the animals are so unstressed that if there's like, they'll shoot a group, there'll be 12 of them there, right?
And they'll have the sniper.
He shoots one.
Billy goes down.
The other 11 don't even move.
unidentified
Wow.
peter attia
Yeah.
Where'd Billy go?
I don't know.
unidentified
Boom!
peter attia
And the next guy gets it.
joe rogan
Billy's taking a nap.
peter attia
Yeah.
joe rogan
Yeah.
unidentified
Wow.
peter attia
And then they process on site.
So there's a USDA inspector with the sniper for every single shot.
Every carcass is examined.
It has to be a perfect kill.
joe rogan
That's a great way to get meat.
It really is.
If you want to think about an ethical way for you to consume meat, if you're one of those people that doesn't want to buy factory farmed meat, get some of that.
I mean, next to hunting, that is about as good as you can get.
peter attia
Do you find your taste for non-wild game has gone down?
joe rogan
Well, when I eat a fatty piece of domestic beef, I think of it like a sloppy, lazy person.
You know what I mean?
If I see an athlete, and then I go, wow, that guy looks like he's in shape, and then I see a sloppy, lazy person, I'm like, oh, poor sloppy, lazy person.
peter attia
I just find that, and again, we're lucky, right?
We get to hunt these animals, we get to eat the elk, we get to eat the axis deer.
These are, along with maybe Pronghorn and a few others, this is about as tasty as it gets, but...
Boy, I find that even a really nice ribeye just doesn't taste as good as it did to me five years ago.
joe rogan
Yeah, well, it's missing a lot of nutrition.
If you look at the dark red meat of elk, like a backstrap from elk, It's a dark red, like I took a photo a couple days ago of some back strap from the elk I shot in California this year.
I just cooked it up.
peter attia
This was your 415. Yeah, that giant one.
unidentified
Amazing.
joe rogan
Yeah, it was huge.
This is so much meat.
What I do is I'll cook like a bunch of pieces like that and then I'll eat it throughout the week.
peter attia
How did you prep that?
Did you do that on the Traeger?
joe rogan
Yes.
I cook it on a Traeger at 265 degrees.
I've tried a bunch of...
The reason why it's blackened on the outside is I'm using a rub called Traeger's Saskatchewan...
I think it's blackened Saskatchewan rub.
That's one of my Yeah, it's my favorite for elk.
And so that's not like burnt on the outside.
That's the actual rub itself.
So I take it and I bring the internal temperature up to 120 degrees and then I sear the outside on a cast iron pan.
I usually do maybe a minute and a half on a really hot cast iron pan with beef tallow.
I use grass-fed beef tallow.
And then I pull it, I let it rest, I slice it, and then my family, we ate a lot of it, and then the rest of it I put in like a Tupperware, and then I'll eat it throughout the week.
Because in the morning it's hard for me to get everything in, all the stuff that I do and work out, and then I'm...
Pretty religious about my sauna and cold plunge.
So I'm doing, I have to allocate 40 minutes to that.
And so between my workouts and everything and I'm getting up at 7 in the morning and then I'm out here doing the podcast, I got to get everything in.
So I want a meal that I could just pull out of the fridge and in 10 minutes I'm done.
Sit down, eat it, take my vitamins, go.
And so that's my move.
I take that.
peter attia
I mean elk is absolutely bananas.
joe rogan
I also like it with, I use, do you ever use any of Mark Sisson's stuff, his Primal Kitchen stuff?
peter attia
I know my kids love his mayo.
joe rogan
Yes.
peter attia
The avocado mayo, I think it is.
joe rogan
That's exactly what I was going to talk about.
He's got this Chipotle avocado mayo.
And it's all avocado oil and it's like a chipotle pepper seasoning to it.
And I just take some of that and I put a fucking pile of it on the plate and I dip the elk in that.
So I'm getting my fats that way.
You're not getting much fat in the elk.
Yeah, it's no fat.
There's no fat in it.
That's the only thing that's missing from Wild Game is the fat content, so you gotta get your fat content from somewhere else.
And I'm changing my diet a lot lately, and I've basically decided that my love for pasta and my love for bread and sugar, it's not worth it.
Like, when I go long stretches of time without eating that stuff and then I eat it, the impact is so tangible.
It's so obvious.
But it's so casual when you eat it all the time.
When you eat it all the time, you're always eating bread, you're always eating pasta.
It's like you're used to feeling like shit.
But if you go like three or four weeks with just eating like, I'll eat like potatoes, tubers, I'll eat meat, I'll eat salads.
I like, you know, salads with, I almost always just have olive oil and some sort of a vinaigrette, some sort of vinaigrette.
And when I eat like that, I feel so much better.
So I've decided, like, I'm not gonna eat any other way anymore.
Like, I will give myself, like, one cheat meal a week.
But the rest of the week, I'm not eating like that.
Like, last night, somebody brought cheeseburgers from Golden Tiger to the show at the Vulcan, and I was like, I'm not eating that.
I'm not eating it.
peter attia
Did you do a similar set to the one a couple weeks ago that I saw?
unidentified
Yes.
peter attia
Dude, that is insane.
joe rogan
Thank you.
peter attia
You know, to this day, my wife and I still make some of those.
I don't want to let any of the jokes out, but you know the one I'm talking about.
unidentified
Yeah, yeah, yeah.
joe rogan
Yeah.
peter attia
Once a day we make that joke.
joe rogan
It's because this is a set that's essentially...
Well, there's some new stuff in it because there's a lot of COVID stuff.
But it's basically like the really strong pits are two and a half years old.
Because usually they would have been on a special by now.
But because of COVID, because COVID fucked everybody's tour schedule up and everything just got really polished and tight.
peter attia
Dude, I don't know if you could hear me, but I was literally embarrassing myself how much I was cackling in the back there.
joe rogan
I was like, That's a great room, too.
The Vulcan Gas Company on 6th Street.
It's a great room.
peter attia
Hey, speaking of, did you end up getting that comedy club?
unidentified
Yeah, yeah, yeah.
joe rogan
Don't say anything, though.
I haven't announced where it is or what it is, but yeah, I got that.
peter attia
The one in Santa Barbara.
joe rogan
No!
No, it's on the moon.
peter attia
No, I'm kidding.
Yeah.
joe rogan
No, I did.
I'm excited.
I'll show you.
I'm taking Ron White on a tour of it this afternoon if you want to come.
peter attia
I'd love to see it, man.
joe rogan
That's awesome.
You have the best backyard range I've ever seen, ever.
peter attia
Dude, it just got better, too.
joe rogan
How did it get better?
peter attia
I just bought more.
joe rogan
Peter has this range in his backyard, because Peter's an archery nut like me, and he basically has a professional archery range in your backyard.
It's like you have hundreds of yards to shoot.
peter attia
Well, we just bought the lot next to us, so now it's like we could literally set up a tack.
joe rogan
Oh, wow.
That's cool.
peter attia
And so what I've done now is I got now elk in the woods.
That's what makes it better.
So now when I was preparing for the elk hunt this year, I was doing most of my shooting was in between trees.
Trying to build my confidence at if you want to shoot something 50 yards away, but you got two trees like this and a branch going like this.
joe rogan
Right.
peter attia
Now you have to judge like, well, can I make that shot because of the arc of the arrow?
joe rogan
Do you have a full draw four?
peter attia
I do.
joe rogan
You do?
Those are the shit.
The Leupold has, for people that don't know what we're talking about, Leupold has a range finder that you put in the weight of your arrow, the weight of the bow, the length of your peep sight, everything.
You have to put in everything.
Is it a peep sight?
Is that calculated in?
peter attia
I think it's peep height elevation.
joe rogan
Yeah?
peter attia
Yep.
joe rogan
Okay.
So you calculate all those things and it will literally show you how high your arrow will be at the peak.
So if you range something, which is what you do, and you dial it in on your site, it'll show you if you're going to hit a branch or not.
peter attia
Yeah, it's...
joe rogan
Pretty sweet.
peter attia
It is.
And they really took care of me because I had the...
I don't know which one.
I had one that came out a few years earlier and it was okay.
And then it just stopped working one day.
It like...
Literally, it would only range something that was perfectly dark, but anything that had even a bit of brown in it wouldn't range.
And I sent it back to them and I was like, hey, can you guys fix it?
And they're like, they just sent me a full draw four, no charge.
unidentified
Wow.
peter attia
Which was like, I mean, that's a really expensive rangefinder.
joe rogan
It's kind of wild that someone figured out that you could shoot a laser at something and then it'll report back to you how far that laser is touching something.
peter attia
Well, I mean, that's amazing, but the fact that they can just do angle compensation is awesome.
joe rogan
Yeah.
Yeah, for people who don't know what we're talking about, because we went into the full archery nerd mode, angle compensation means if you are shooting 50 yards, right, if the object is 50 yards, but it's 50 yards uphill, You will really be shooting more for like, probably 57 yards.
You'll have to, because you're fighting against gravity.
And if you're shooting downhill 50 yards, you're really probably shooting 20 yards.
Because you have no problem with gravity.
It's non-existent.
So you have to use an angle compensating range finder that tells you, based on how you're turning the range finder, which direction it's going, whether or not you need to add or subtract yards.
And it does it all internally.
It calculates everything.
peter attia
And the first shot I ever took in my life at an animal went a foot over his back because I had been doing all my practicing with a compensated range finder.
And this was out in Molokai and it was an axis deer and my guide is behind me and he ranges it but he is using an old school range finder that doesn't have angle compensation.
joe rogan
What?
peter attia
Yeah.
joe rogan
How's he doing that?
peter attia
Because he's old school.
joe rogan
That's dumb.
peter attia
So this animal was, you know, probably 20 yards, 20 degrees down.
joe rogan
Right.
peter attia
So I just took the distance and assumed it was compensated for and shot and it was like, I was like, That was a perfect shot.
Why did it go a foot over that animal?
joe rogan
Yeah.
peter attia
And I was like...
joe rogan
Let me see that.
peter attia
Let me see that rangefinder.
Yeah, yeah, yeah.
And I realized, I said, Wayne, you don't have angle compensation on here.
He's like, no.
I was like...
Hey, from now on, can you hold my rangefinder?
joe rogan
Yeah, the amount of technology that's involved in bow hunting, and just hunting in general now.
I mean, people have watches that have GPS on them, and you could put waypoints, and you could track on your phone exactly where the hit was, and then from there on you could mark where each drop of blood you find is.
peter attia
So I learned something last year that blew my mind.
My wife, as a gift, got me a framed picture of Matthew McPherson's patent for the compound bow.
And I was like, oh, this is so beautiful.
So it hangs up in my archery room.
But here's the thing that blew my mind.
What year do you think that patent was?
I kind of gave it away because I told you it was Matthew McPherson, so you know it.
joe rogan
I don't know who he is, so you didn't give it away.
unidentified
Okay.
joe rogan
Compound bow.
I've seen some old shitty ones, and they look like they're from the 60s.
So I'm gonna say...
55?
peter attia
Yeah, that's what I'm gonna guess.
It's 87. Whoa!
Yeah, the patent for the compound bow is 1987. Wow!
That's amazing when you think of how far that...
Yeah, there it is.
unidentified
That's it?
peter attia
There it is.
joe rogan
So you got that at your house?
peter attia
Yep.
joe rogan
What kind of a fucking wizard figured out a cam for a bow like that and figured out all those strings?
peter attia
Dude, I think it's the same guy who makes Matthews bows.
joe rogan
Really?
peter attia
Yeah, isn't that who Matthew McPherson is?
joe rogan
It must be Matthews.
So that's the original bow?
peter attia
Yeah.
joe rogan
They still make one of the best bows in the world right now.
You ever shot one of them?
peter attia
I have never shot one, but it looks amazing.
Just such a perfect hunting bow, such a short axis, so compact.
joe rogan
Yeah, the new ones are incredible.
Shane Dorian shoots with one.
He loves it.
He was telling me how incredible it is.
There's so many bows now that are just top of the food chain.
I just got the new PSE, the carbon fiber one I was telling you about.
It's incredible.
It feels so light.
It feels fake.
It's weird.
peter attia
When I go back and shoot my RX-3, which is only three years old, it feels horrible compared to my NTN. Isn't that crazy?
The cam is so miserable to me.
joe rogan
We only needed a lot of people with this podcast.
I bring on a doctor.
He wants to talk about bow cams.
peter attia
Alright, we're done with that.
joe rogan
We can talk about anything.
I don't give a fuck.
It doesn't bother me.
Is there any new...
Information in the world of longevity and the world of health or anything that you know of that is exciting?
peter attia
I mean, there are two extremes, right?
joe rogan
I think on the one end- Tell everybody what kind of medicine you practice just so they know.
peter attia
Oh, so I mean, my practice is basically trying to figure out how to help people live with a greater lifespan.
So how do you add 10, 15 years to how long a person's going to live?
And then how do you improve health span?
So how do you improve?
joe rogan
And your degree is in what kind of medicine?
peter attia
So I did surgical oncology.
I did general surgery and oncology.
But I left medicine in 2006 and went, you know, did finance and other stuff and completely went away from it until I kind of came back to it about 10 years ago.
joe rogan
Why did you leave it?
peter attia
I mean, truthfully, I was super frustrated.
In cancer surgery, you're doing kind of like very heroic operations.
I mean, the most technically challenging types of operations.
But, you know, half the people still die, right?
So 50% of people who are going to have surgery, and in some cases more, if you're talking about pancreatic cancer, 80% of the people whose pancreas gets removed for cancer are going to be dead in five years.
unidentified
Wow.
peter attia
So, you know, I just felt like, in all regards, I just felt like there wasn't enough in the way of prevention.
And in some ways, that is necessary.
I mean, because I trained at Hopkins, which is in the inner city, it's a lot of trauma surgery.
So every third night for five years, you're taking care of gunshot wounds.
And we had so many.
I mean, Baltimore averaged, at Hopkins, we averaged, at the time, I don't know what it's like today, at the time, it was 16 penetrating traumas a day.
So 16 gunshot wounds or stab wounds a day.
So as a trainee, that's amazing, right?
Like, that's what you're there for.
That's why I went specifically to that program, was to be able to learn to operate on people who are shot or stabbed.
But, you know, it does take its toll on you, right?
You just feel like there's no end to this.
Like, I mean, it's a war zone out there, and...
I remember there were times when you'd be a part of a heroic rescue of somebody and they go out the door and they come back a week later with a gunshot wound to the head and they're dead.
And you're like, ugh.
I mean, come on.
So yeah, I was just frustrated with everything in medicine when I left.
I was super pissed.
My wife was like, you know, you bitch and moan about this so much, I think you have two choices.
You should either fix it or leave.
And I was like, well, I can't fix it, so I'm leaving.
So I left and joined a company called McKinsey and was recruited there to do healthcare, but ended up, because my background's in math, doing credit risk.
And this was like the two years building up to the mortgage meltdown.
So that became my day job and my night job.
I mean, that was all consuming for two years.
joe rogan
What was your night job?
peter attia
No, meaning like we work 24-7.
I would run a team of analysts in India during the night and then a team in San Francisco during the day.
And all day, all night, we were kind of trying to basically figure out how bad this thing was going to be.
joe rogan
So you saw it coming?
peter attia
Oh, yeah.
How far out?
So by August of 2007, it was clear that the prime market was going to implode.
And I still remember the day, Thursday, November 15th, 2007, is when I had a sense of what the magnitude was going to be.
The thing I didn't know was when.
I knew it was going to be the next 18 months, but it wasn't like I could say in September, which is when it ended up happening, right?
It was 10 months later.
I couldn't say in September the bottom is going to fall out.
joe rogan
Was there anything that could have been done that would have mitigated the impact on the economy and society and repossessions?
peter attia
Yeah, I mean that's a really good question because at the time in November of 07, we – and I want to also be clear.
The reason we knew with such clarity how bad this was is we had a client.
Our client was the largest – I guess I could – probably the largest U.S. home lender in prime real estate and we had all the data.
So we're able to see stuff that's not publicly available.
But they didn't see it.
But when we went back and looked at the analysis, we figured out that starting in 2004, starting in the second quarter of 2004, every loan that was being originated was behaving differently than the entire history of mortgages.
So this is a really interesting analysis.
It's called a vintage analysis.
If you bundle mortgages together and look at how they behave, for all of time, they behave in a certain way.
For about the first 18 months, none of them default.
So 18 months after a person buys a house, historically, there's no chance of default.
Then defaults start to rise.
And they rise for about the next two to three years.
And then they never default again.
So the vintage curve looks like this.
This is cumulative loss rate.
So what's the reason for that?
So the reason nobody defaults in the first 18 months is because historically you really make sure that the person who you're selling a house to or giving a loan to can afford it.
You do a really extensive background check on them.
And if something's going to go wrong, it's unlikely to go wrong in that first 18 months because of how much you've documented their income and employment and stuff like that.
Then you get into an area where some people are going to default.
And then the reason three, four years out there's no more defaulting is because by that point people have enough equity in their home that if they run into trouble they can always sell the home and the bank gets their money back.
So, again, you go back in time, every vintage curve for every single mortgage looked like this.
Really boring.
We went back and plotted all the vintage curves going back to the year 2000, and they all looked do-do-do-do-do-do.
And then in Q2 2004, so you plot these in three-month vintages, they started doing this.
joe rogan
Explain to people that are just listening.
peter attia
Meaning they started to, instead of going up and then flat again, they just kept going up and up and up and up and up.
But they actually did it at an exponential rate.
So they didn't just go up straight.
They would go up exponentially.
In other words, there was no end in sight to the explosion of losses.
So the losses started happening immediately and they never slowed down.
They accelerated with time.
So this is looking at a chain reaction.
And this was one of five models that we built to try to understand what was going on.
And they all pointed in the same direction, which was catastrophic outcomes, basically for loans that became originated after 2004. So by the time we're in 2007, when we show all this data to them, Obviously, they didn't believe it, right?
They said – well, because the punchline was horrible.
The punchline was you're going to lose more in the next 18 months than you've made in the last 10 years.
And that was like – they were like, that's not possible.
And I had to be the one to tell the head of the bank, right?
Because – and even though I was only like – there's a hierarchy at McKinsey.
There's like senior partners, junior partners.
And I was just like a lowly manager who ran the analysts.
And the senior partner would normally be the one to present such an outrageous finding to the board of a bank.
But he was like, you should present this.
And I said, why?
And he goes, well, you understand the technical details of the model better.
And also, you used to be a cancer surgeon, so you're used to giving bad news.
I think this is not going to go very well.
So you do this.
And it did not go well.
It was not well received.
They could have done something.
Yes, they absolutely could have done something.
It wouldn't have stopped us.
All the damage, but it would have minimized the damage.
Because remember, there was still another 10 months of horrible loans being originated, horrible loans being securitized, and they were mispriced.
I mean, ultimately, that's the problem with this.
It was just a mispricing game.
They didn't know how to price the risk of the loans they were making.
joe rogan
Trevor Burrus And how many people were predicting this the way you were?
peter attia
Well, look, a lot of people way smarter than me were predicting it.
Remember, I was an idiot.
All I knew was how bad this was.
I had no clue how one could make money off this because I wasn't thinking about it through that lens.
joe rogan
Oh, I see.
Remember.
Some folks were.
peter attia
Yeah, if you saw The Big Short, did you ever see that movie?
joe rogan
No, I did not.
peter attia
Oh, so I think it's called The Big Short, right?
It was...
Is that it, Jamie?
Yeah.
Great movie because it was actually very accurate.
joe rogan
Who was in that movie?
jamie vernon
Christian Bale plays the guy, the main...
peter attia
That's right.
jamie vernon
Kind of found the stuff.
peter attia
Yep, yep.
jamie vernon
A lot of people are in it.
Steve Carell is in it too.
peter attia
Brad Pitt was in it, if I recall.
There's a lot of people in it.
It was a really good movie.
It was actually super accurate in terms of describing what was going on.
And I remember when it came out, I was able to finally explain to my wife why we weren't billionaires.
Because she's always like, dude, you knew this was happening, and yet, like, why do I hear about guys like John Paulson and all these hedge fund guys that made $3 billion on this?
And I said, ah, this movie will explain why.
If you know this is happening, and the only instrument you have in your mind to make money on it is shorting equities, you can't make money.
Right.
In other words – and by the way, ethically I couldn't have done this because I had inside data of a bank.
I couldn't have done anything with that information.
But let's just assume that I could have shorted all the other companies.
joe rogan
You couldn't have done anything legally or ethically according to your own feeling and standards.
peter attia
Certainly not ethically.
I don't know about legally.
But I could never have shorted this company that I knew inside and out.
But I could have shorted others.
But even still, I wouldn't have made a lot of money because one – Shorting equities is really expensive when you don't know when the shoe is going to fall.
Because you have to make a margin call over and over and over again.
It's not leveraged, right?
What these brilliant guys did was they figured out that they could short an option on what was going to happen.
They could basically short an insurance contract.
And that was super cheap.
You're leveraged 1,000 to 1 at this point, meaning you only have to put a dollar at risk to get $1,000 back.
On something you know is going to happen and you don't have to really concern yourself with exactly when it's going to happen.
At least not in the same cost inefficient way that you have to with equities.
So that's what Michael Burry is the guy's name by the way that Christian Bale played.
That's what the Michael Burry's of the world did.
And there were a handful of these guys that were like, we're going to make up these contracts.
So they went to banks and said, I want you to sell me a contract that says this thing is going to happen.
And the banks were like, wait, you want me to sell you a contract that's saying mortgage defaults are going to go up?
We'll do that all day because that's never happened before.
Happily.
Happily I'll sell you that contract.
And they price them horribly, meaning in favor of the traders.
joe rogan
Right.
peter attia
Yeah.
unidentified
Wow.
joe rogan
It's such a complicated world and I don't know how else you would sell houses to people.
Unless they had enough money to just pay cash for a house, which nobody does.
unidentified
How else would you sell a house to people?
peter attia
It's sort of funny.
When the whole thing blew up, people said, well, this is because interest rates have been too low for too long.
So Alan Greenspan became the very convenient bad guy for all of this.
And it's true.
Interest rates were a little bit too low for too long.
But we know today that that's categorically not the thing that drove it.
Low interest rates are simply the oxygen that's necessary for a fire.
But we're sitting in a room right now with lots of oxygen.
There's no fire going on.
Clearly, oxygen is not the root cause of the problem.
The root cause of the problem was the absolutely inept lending standards.
What fostered it was the ability to securitize loans.
So once you could make a horrible loan and you didn't have to live with it on your books, you could actually sell it to someone else who didn't understand what you were selling, then it just became out of control.
joe rogan
It was a scary time, because it was also a scary time where we were really worried that banks were going to fail.
And there was a lot of people that were saying, let them fail.
The banks should fail, because we shouldn't prop up these banks.
And meanwhile, these people that are these CEOs, they're going to give themselves bonuses.
Which is so insane.
Even though they lost all this money and they had to be bailed out by the government, these people still got bonuses.
And I was like, explain to me why they get bonuses.
They're like, well, these people are very talented and if they don't give them bonuses, they're going to go somewhere where they do get bonuses.
I'm like, what the fuck does that mean?
You guys are a bunch of crooks.
How did you rig this thing where you fail miserably and yet you still get a bonus?
I thought you only get a bonus if you're successful.
peter attia
Yeah.
joe rogan
And you got a bonus from taxpayer money?
But then someone explained to me that the banks paid those loans back quite quickly.
Is that true?
peter attia
It is.
The TARP program made money for the government.
So the government extracted a pound of flesh on those loans.
joe rogan
So the people that said that we should have just let the banks fail, that's not correct.
peter attia
In my opinion, that is not correct.
The collateral damage of that would have been devastating.
But your other point is also notable.
So let's not confound two things.
So if you let the banks fail, everything goes to hell in a handbasket.
You have a recession that rivals that of 1929. That's a bad scenario.
The way that the TARP program was engineered was to prevent that from happening, but also it wasn't a gift.
It was, you're going to pay these loans back, which they did.
unidentified
Okay.
peter attia
But there still, in my opinion, could have been and should have been more clauses in that program that permitted some of the really flagrant abuses that came down the line, like the AIG guys getting bonuses that they probably shouldn't have got.
In other words, I think the government basically...
Made the argument, which was, well, if we don't pay these people, they're not going to stick around and we need them to clean up this mess.
And my view is, I bet enough good people would have stuck around without having to pay so many people so much.
And by the way, the people that really needed the bonuses were not the CEOs.
Like, they're not the ones doing the work, right?
joe rogan
Right.
Yeah.
And so you do this, and how do you change?
unidentified
Oh, yeah, yeah.
peter attia
So basically, actually, everything for me changed when my daughter was born.
So my daughter was born 13 years ago, and I'm 35. And I mean, I'm sure you can relate to this, but at least for me, that was the moment when I first cared about living longer.
It was the first moment I had a thought beyond myself and thought, like, oh, my God, like, I remember when my wife was pregnant, I was not that excited about it.
I was kind of like...
We had a cat at the time, and I loved this cat.
And I remember saying to my wife, I'm like, I don't know if I'm going to love our daughter as much as I love Midnight, our little cat.
My wife was like, are you crazy?
And of course, the second Olivia was born, I was obsessed with her.
And then I was like, I've got to figure this out, because every male in my family has died of heart disease except one.
I have horrible genes for heart disease.
joe rogan
What causes heart disease genetically?
Like, what is it?
peter attia
Well, the most common genetic driver of heart disease is something called LpA.
So one in about 10 people, somewhere between one in eight and one in 12, so call it one in 10 people, 10% of people have a gene called Lpa that makes too much of this lipoprotein called LpA, which you've heard of LDL, right?
So LDL is this atherogenic lipoprotein.
LP little A is an LDL that has another protein wrapped on it called APO little A, and it makes it much worse.
So the single most common genetic, the single most common hereditary driver of cardiovascular disease is elevated LP little A. And the tragic thing is most doctors don't even know what it is.
So this is one of the things I, I have more podcasts on this topic than any other because It's inexcusable to me that a patient doesn't know that they have an elevated LP little a.
This is a screening test we should do on children.
So that's number one.
After that, it gets much more complicated.
Heart disease is wildly polygenic.
So LPA is one rare example that's not polygenic, meaning there is just one gene that drives LPA. But when you start to get into something like familial hypercholesterolemia, which is also kind of common, that's any set of genes.
And there are over 3,000 mutations that produce elevated LDL through one form or another.
That becomes another huge driver of genetic inheritance.
But what's scary, at least for someone like me, is it's really clear when you look at my family history, heart disease is a problem.
I don't have anything recognizable, meaning I don't have LP little a, I don't have familial hypercholesterolemia, I don't have any of the few known genes that are really driving this.
My cholesterol levels were never really that heavy to begin with.
with, my LDL, which is kind of an irrelevant, stupid metric anyway, but even if you looked at my APOB, which is the metric you're supposed to be looking at, it was never through the roof.
But when I was 35, I went and had a calcium scan.
So it's a CT scan, looks at your heart.
And I had a score of six.
Now, six is not a high number on a calcium scan, but when you're 35, that places you at the 90th percentile.
So that was like the, I gotta figure this shit out.
I'm gonna devote the rest of my life to understanding how to not die of heart disease.
And then ultimately, so my first focus became an obsession with cardiovascular disease.
Which lasted about four years.
And then I realized, well, there's no benefit in not dying of cardiovascular disease if you're going to still die of cancer or dementia or something like that.
So then my obsession and interest just expanded through all of that.
joe rogan
What did you do to keep yourself from being at the risk of dying from cardiovascular disease?
peter attia
Well, I mean, it came down to reverse engineering what is driving cardiovascular disease, which is the most ubiquitous killer, right?
So there's no developed nation for which cardiovascular disease isn't the number one killer.
Really?
Yeah, so hands down.
joe rogan
Only developed nations?
peter attia
Yeah, once you get out of developed nations, infections and other things sort of start to overcome that.
joe rogan
Do they suffer from cardiovascular diseases when you're dealing with tribal communities?
peter attia
Yeah, definitely not to the same extent.
joe rogan
What's the factor?
peter attia
Well, I mean, I think there's a couple things, right?
One could be they're not living as long, so we're not seeing it as much.
And we don't really have great autopsy data on people who are dying in their 40s and 50s from infections and other things like that.
But, you know, it could be, you know, that obviously they just don't have the same toxins in their food system that we do, right?
They're probably not eating half the refined crap that we eat.
joe rogan
Yeah, that's what I was going to get to.
Like, how much of an impact do you think that stuff does have?
peter attia
I think it has a significant impact, for sure.
Yeah.
So atherosclerosis is really driven by lipoproteins first and foremost.
So anything that carries this ApoB protein on it, so that's an LDL, an LP little a, a VLDL, that's the synquinone.
That is the necessary but not sufficient element to drive atherosclerosis.
Anything that impairs endothelial function, so high blood pressure, high glucose, high insulin, high homocysteine, all that stuff, problematic.
Yeah.
Anything that amplifies inflammation, all the things.
So basically, I just said, okay, well, we're just going to take a no-holds-barred approach to addressing all of those things.
And that's why I sit here today and I can say, look, between now and when I'm 60, the one thing I know I'm not going to die of is atherosclerosis.
I would say that in the next 10 years, my greatest risk of death is motor vehicle accident and cancer.
Those would be the two hardest things to mitigate.
unidentified
Right.
joe rogan
Now, why is it so difficult to mitigate cancer?
peter attia
Well, for one, of the big diseases, it's the one for which I think we have the least idea of what the risk factors are.
So the big three, in terms of death, is atherosclerosis, cancer, and neurodegeneration.
With cancer, it's also very polygenic and...
joe rogan
What's that mean?
peter attia
Lots of genes are involved.
So if I did a genetic test, if I had your entire genome in front of me, it wouldn't tell me much about your risk for cancer.
So the genes that are driving it are also not germline, they're somatic, meaning they're inherited mutations.
So one of the few things we know about cancer is...
The earlier you can detect it, the better.
That's a truism that is becoming almost impossible to argue.
So you're always better off finding a cancer when you have 100 million cells that are cancerous versus 10 billion cells that are cancerous.
And our tools for screening are somewhat limited.
Now, they're getting better.
So to your question earlier, what's one of the things I'm excited about?
I think liquid biopsies are something in the last year that we have become very excited about.
So all of our patients get these things called liquid biopsies, which is a blood test that measures something called cell-free DNA. So we're looking for tumor DNA in the bloodstream.
So meaning at very low levels of tumor burden, you can still pick it up by getting some of this cell-free DNA floating around your bloodstream.
So it's literally like you take a tube of blood and you can say, oh, there's actually like some pancreatic cancer here or some colon cancer here or breast cancer here.
And then you go looking for that cancer.
joe rogan
Wow.
peter attia
Because there are false positives, of course, when you do these things.
So you can't think of screening as just one thing you do.
It's got to be layered, kind of like a Swiss cheese approach.
You want to have as many pieces of Swiss cheese lined up as possible so that one and only one pencil fits through the hole.
And you know you get a signal with your cancer detection.
joe rogan
So this one test just from a tube of blood, how new is this?
peter attia
I don't even know if it's technically approved yet.
I know that we're doing it.
Certain physicians are being allowed to do it in the context of having a very comprehensive approach to follow up with patients.
So, because our patients are doing it in the context of a billion other things, so there's not as much of a concern from the part of the FDA. But I don't think this is fully FDA approved yet.
But it's very recent.
We've been doing it only six months.
I mean, I did mine in April.
I was probably one of the first people to do it.
joe rogan
Did you get nervous?
peter attia
I mean, no.
I mean, I was kind of like, look, it's so much more important to me to know I have cancer than to put my head in the sand and not know.
joe rogan
Right.
peter attia
Yeah.
joe rogan
Right.
Of course.
peter attia
But every time I go and get this diffusion-weighted image MRI, which is this very particular type of MRI that's uniquely tuned to detect cancer and getting a blood test like this or getting a colonoscopy, which I'm very aggressive with, all of these things, yeah, there's always a moment of just let me come out clean.
joe rogan
Yeah.
Yeah.
So you have these concerns about longevity.
You have these concerns about cardiovascular health and cancer.
And so what prompts you to start your practice and re-emerge into medicine?
peter attia
I just – there was nothing else I could think about.
Like at the time, I had left that one company where I was doing all the energy stuff – or where I was doing all the finance stuff and I went to join an energy company.
So now I was like working on like a – A renewable form of oil.
A renewable form of oil?
Yeah.
So this is a company that was using, we were using algae and genetically programming the algae to spit out a fungible form of oil.
unidentified
Wow.
peter attia
So meaning it would produce a distillate, a cut of distillate that could be refined into gasoline and jet fuel.
unidentified
Whoa.
joe rogan
From algae?
peter attia
Yeah.
joe rogan
How effective is that?
peter attia
Well, ultimately, it could not be done at cost.
So, I mean, I left after four years.
That company went on for another four years, but it just couldn't be done at the price of where oil was, which at the time was like 50 bucks a barrel.
joe rogan
I wanted to talk to you about, this is a little bit of a deviation, but it's not really.
I wanted to talk to you about Theranos.
Because I am fucking completely obsessed with that lady and her scam company.
peter attia
Dude, did you know that I was almost the chief medical officer of that company?
joe rogan
No!
peter attia
Yeah, dude.
So in 2006, my McKinsey office, which was in Palo Alto, was on Page Mill, which was one street over from where Theranos was located.
So Theranos at the time was a super small company.
So a good friend of mine...
His father-in-law was on the board and knew Elizabeth Holmes very well.
He was her professor at Stanford.
And the company was small at that time.
It was like maybe 30 people there or something like that.
And he said, look, I want you, my friend, to potentially look at this company because they could really use a CFO. And he was in private equity at the time, really smart guy.
And to make it long so short, I got introduced to Elizabeth.
So I went down and had lunch with her one day.
joe rogan
Did you ever catch her talking in a real voice?
peter attia
You know, it's so fun.
I met her later, and she already had the fake voice.
But I can't remember that day what her voice was like.
I wish I could remember, but, you know, it's like 15 years ago, right?
joe rogan
I would remember if it was weird.
peter attia
I don't think it was.
I think it must have been a real voice.
joe rogan
If she talked like this, I would say, what is going on?
unidentified
Yeah, yeah, yeah.
joe rogan
Have you had throat cancer?
peter attia
What are you doing?
I think she must have been talking in a normal voice.
But here's what interested me.
I sat down in the office and she pulled out a black box that was, I don't know if it was called Edison at the time or if it was the precursor to what would become Edison.
Diagnostics is not something I knew a ton about.
But, you know, I'd spent two years at the NIH, and I certainly understand how chemical reagents work, and I understand how chemical assays work.
And I know how, for example, an ELISA works.
An ELISA is a type of assay that you do to measure something, but it requires a lot of washing and rinsing and repeating.
And I know that many biomarkers that are of interest, for example, something like insulin, you know, if you want to measure a person's insulin level, you have to do these types of assays, right?
So, I was saying to her, you know, Elizabeth, I don't understand how you could put a drop of blood in here and get anything out that's more interesting than glucose, hemoglobin, sodium, and potassium.
The really simple things that can work, you know, that can be measured off a drop of blood.
And she kind of gave me some answer, and I said, well, can I see the inside of the box?
And she said, absolutely not.
And I said, well, I've signed an NDA, you know, I had to sign an NDA to get in the building, so, and she was like, no.
So I just decided I wasn't interested in the company because I couldn't get sort of straight answers from her.
So I ended up not doing it.
So fast forward to 20, this was 2006. Fast forward to 2015, she's now on the cover of Forbes.
And you're like, hmm.
Well, no, no.
I remember one day saying to my wife, because she was on the cover of Forbes and the company was valued a little over $9 billion.
And I said to my wife, Do you know how much we would be worth if I had taken that job now?
And she's like, how much?
And I told her, and she's like, good God!
And so I'm at the Vanity Fair event in San Francisco.
I didn't know it at the time.
This was a week before the Wall Street Journal article would fall, John Cario's article that was the one that kind of unraveled all of Theranos in October of 2015. How did he figure it out?
joe rogan
How'd this one guy figure out that it was all...
peter attia
So I haven't read his book, Bad Blood, but I saw the documentary, so that's like a poor man's version of it, but basically just interviewing people who were formerly employees of the company.
joe rogan
Oh, so they were bean spillers.
peter attia
Yeah, and they were basically like, yeah, this is a total scam.
joe rogan
Oh my god.
peter attia
And so sure enough, I'm at this reception, and she's the speaker of the event.
So it's a four-day conference, and she's the one everyone is there to see.
So I'm sitting at a table, and I'm having a cocktail, and she walks up, and she...
And I said, hey, Elizabeth, you probably don't remember me.
She goes, no, I remember you exactly.
And she remembered my name and even remembered how I had been introduced to her.
I was like, really blown away.
We exchanged pleasantries.
She gave me her card.
And then a week later, it all unraveled.
And it's really funny.
I still have the card.
joe rogan
You should frame it.
peter attia
Yeah, yeah, yeah.
joe rogan
She must have known that the shit was hitting the fan.
peter attia
No, no, she totally did.
Yeah, yeah, yeah.
Because the shit was hitting the fan six months earlier.
joe rogan
What does one do?
And it's not like you can liquidate, right?
Like, if you're worth $9 billion, but it's all stock, and you know the product is nonsense, you can't even get out.
peter attia
Well, it's a private company, so at best, you know, she could have, along the way, been doing secondaries off her take.
joe rogan
Oh, so it wasn't even, yeah.
Jesus Christ, that was wild.
It's just, I'm obsessed with this podcast that's out now called The Dropout, and they update weekly with the trial results.
peter attia
Oh, I need to check that out.
It's great.
Yeah, yeah.
So tell me this, how is it looking?
Is the prosecution looking like they're going to win this?
joe rogan
Oh, yeah.
Yeah, they have falsified documents.
They pretended that they got a document from Pfizer.
They put Pfizer's name on a document.
And it was an internal document.
And it was basically substantiating the machine, the Edison machine, and all the possibilities that it could...
She also lied about military use, the Department of Defense contracts.
Yeah, they have her on the stand lying or have her on the stand admitting that she lied because there was recordings.
peter attia
Has she taken the stand yet?
joe rogan
I believe so.
I mean, there's definitely moments in the podcast where she's being interviewed, where she's being forced to answer questions.
peter attia
Oh, but this might have been the civil deposition.
joe rogan
Yeah, maybe.
I don't know, but this is in the middle of the current trial, so I'm not sure.
Because it's a really well-produced podcast and it has narration and music and all this stuff.
peter attia
The Dropout.
joe rogan
Yes, it's very good.
And it also predates.
See, they picked up when the trial came back.
So the beginning episodes of the Dropout all detail the scam and all detail all the stuff that was going on.
The people that were working, they were slowly figuring out, like, what the fuck are we doing here?
And then it went away for a while and then came back during the trial.
So now it's detailing all the things that the prosecution is finding.
Oh, so it must be.
No, it's not the civil trial.
It is the current trial.
Because they were specifically discussing these documents that they had put Pfizer's label on.
So they made it look like this document was coming from Pfizer.
Like saying, oh, this stuff is amazing.
But really, it was just internal from Theranos.
It's wild.
One of the things that I love about it is I'm always fascinated by con artists and cult leaders and people who manage to pull the wool over people's eyes.
But when people do it in a clumsy way and still get really far, she was clumsy.
She wasn't just a little clumsy.
You know how I got obsessed with this?
This is really weird.
She was giving a speech, and this was before I had any idea that there was anything wrong with the company.
peter attia
Oh, so this is pre-15.
joe rogan
Yes, yes, yes, yes.
Before she got caught, she was giving some speech at some women's group.
Some exceptional women were all getting together, and she gave us this speech.
And the speech was so bad.
That I was fascinated.
I was like, that's a moron.
This is not a smart person.
This is a dumb, clunky speech.
Because I'm a professional orator.
That's what I do.
I talk.
And so when I see someone that's talking and she's basically, these women are amazing.
All you amazing women.
I'm just so pro amazing women.
Is that the speech?
Let me hear this dumb speech.
unidentified
I am so incredibly humbled and...
So honored to be with this incredible group of women.
I want to just take a minute to say, especially to the young women in the room here, do everything you can to be the best in science and math and engineering.
It's our actions that will determine this new stereotype around women being the best in science and technology and engineering, and it's that That our little girls will see when they start to think about who do they want to be when they grow up.
joe rogan
Okay, I saw that.
I'm like, that's a moron.
That's a moron.
You want women to be the best at science and engineering and math?
Like, what the fuck are you talking about?
You want one gender to be the best at science and engineering and math, and you want women just do your best to be the best.
I was like, oh my god, that's an idiot.
And so I got obsessed with her.
So when that was going on, that's when I got obsessed.
And then when the fucking scam got released, was it the Washington Post?
Wall Street Journal.
I was like, aha!
I fucking called it!
I knew something was off.
I remember watching that and going, what is, what, how?
unidentified
How?
peter attia
Like, I would hear Steve Jobs talk.
The one thing I could never understand, but it wasn't enough, I just didn't care enough, but in retrospect, it was so obvious.
There was not a single person who understood the laboratory space on her board.
joe rogan
Oh.
peter attia
So remember, her board was the who's who, right?
You had General Mattis, you had Henry Kissinger, you had Dick Kovacevic.
I mean, she had the most all-star corporate board in the history of boards.
Not one of these guys knew the difference between a pipette and a microscope.
unidentified
Ooh.
peter attia
Like, that's a red flag.
joe rogan
Yeah, that's smart, though.
That's the smart con.
The other thing that got me was the affectation.
The detail of the wardrobe and the outfit.
peter attia
She was a little Jobs.
joe rogan
Yeah, she was clearly a little.
But when you heard Steve Jobs talk...
Steve Jobs had a vision.
Here's my vision.
This is what I think can happen.
And he would talk and he'd go, well, that's a brilliant, completely obsessed man.
Like, this person is very brilliant and it makes sense that this is the head of this incredibly innovative company.
When I heard her talk, I was like, who's this idiot that you have talking?
This is not a person that spent a lot of time thinking, right?
If you went to college for a long period of time and really worked on your grammar and your understanding of the correct use of language to inspire and challenge people's ideas, that's not the fucking speech you'd give, right?
peter attia
That was pretty bad.
joe rogan
It was terrible!
But it wasn't just terrible, it was clunky.
And there was something about it for me that made me think, like, what's going on here?
That doesn't make any sense.
And I thought, well, maybe she's just awkward when she speaks publicly.
You know, you have those initial impressions, and you go, well, maybe I'm just fucking reading into it wrong.
Because I've been wrong before, but not that time.
I'm fascinated that she wouldn't let you look into the box.
Because I guess if you looked into the box, you would immediately be able to be...
peter attia
I don't know that I would have.
I don't want to overstate my credentials.
I'm not a clinical chemist.
She could have duped me, I'm sure.
And again, we're under NDA. We're talking about me joining her company as a chief medical officer.
How are you not going to let me see inside this freaking box?
Like, what do you want?
How am I going to do my job?
joe rogan
How could she have duped you, though, if she's not technically astute?
Like, she doesn't really understand it.
peter attia
I don't know if she could.
I mean, look, she presumably duped people smarter than me, right?
joe rogan
I think she duped...
This is what drives me crazy.
I think she duped people from the image.
I think they wanted to believe...
They wanted to believe that there was this female wonderkind who left Stanford at 19 years old, dropped out of school, and figured out this amazing technology and along the way became, at least until she got busted, the richest self-made woman ever.
She was worth, I think, like her own personal- Four and a half billion.
Yeah.
peter attia
Crazy.
joe rogan
And she just faked it.
And one of the ways she got busted was people from college that she went to school with were like, why are you talking like that?
Like, what's happening?
And then people started hearing that that wasn't her real voice.
And then people started, like, rumors and murmurs.
There's so many layers to that story.
peter attia
Oh, man, no doubt.
joe rogan
Yeah, it's a fascinating one.
It really is.
It's such an interesting story.
So, for you, when all that was going down, that must have been incredibly sweet.
Because now you don't have to think, man, I missed out on all that money.
peter attia
Yeah, for sure.
And I was also, I felt a little bit validated.
Like, okay, there was a reason she didn't want to show me the inside of the box.
joe rogan
Right.
Yeah.
Yeah.
peter attia
It might have been empty.
It literally might have been empty.
joe rogan
There was candy in there.
peter attia
It's a giant little thing.
joe rogan
Dude, she got so many people.
She got Betsy DeVos for like $100 million.
peter attia
And poor General Mattis.
The guy didn't have two nickels to rub together when he gets out of the military.
He put like a couple hundred K in or something obscene for him.
unidentified
Yeah.
joe rogan
Crazy.
Whenever someone comes to me, like some guy came to me with some crazy, I mean, I don't know if it's real, so I don't want to talk about it, like say it specifically, but if it's true, it sounds like this guy's going to revolutionize a form of travel.
And so he's telling me about this.
I was like, wow.
And then I said to my business manager, who was with me at the time, I go, don't ever forget about Theranos.
Whenever someone tells you something, the moment someone tells me, I go, yeah, yeah.
When it happens, I'll believe you.
I don't want to be involved in any groundbreaking shit before it actually launches, especially in some area where I'm completely ignorant.
And what am I going to do?
Just start going to school?
Try to figure out engineering?
Think of this guy saying something that's actually possible and plausible?
Nah, can't do it.
Not interested, buddy.
So for you, though, when it did come out, though, there had to be like a cool feeling of satisfaction.
There had to be a little something there.
peter attia
I mean, the first person I called was my buddy, the guy who had introduced me to her way back.
And I was like, dude, what are the dinner conversations like?
And he's like, oh, dude, it's not good.
Because his father-in-law was still in the believing camp.
joe rogan
Oh, no.
Oh, yeah.
They talk about him in the...
Yeah.
Oh, fuck.
peter attia
So it was...
joe rogan
So he got duped long after the jig was up, right?
peter attia
Yeah.
Again, I don't know the details, but it was...
I was like, man.
joe rogan
Fuck.
peter attia
It's good that we didn't do that, but...
joe rogan
It's one of the great scams of our time because you have to wonder how they ever thought they were going to get away with it.
There really was no technology.
There really was nothing that was capable of doing what they were saying it was going to be able to be done.
peter attia
Yeah, there's an interesting psychology there, right?
Yeah.
Which is, on any given day, it's not a crisis, right?
Like, you can always fake it for one more day, right?
unidentified
Right.
peter attia
So, what's the end?
Like, what's the end game?
joe rogan
How do they not have cancer?
Like, if stress gives you cancer, imagine the stress of, like, duping people out of nine billion, and you're sitting around knowing that your voice is fake, and you're wearing a black turtleneck, and people that you went to college with are like, hey, that bitch doesn't even talk like that.
peter attia
I hear the text messages between her and Sunny were pretty funny.
Because I read an article that said, if you really want to incentivize people to not commit crime, just let them know that all of their cheesy text messages are going to be made public.
joe rogan
Oh, wow.
peter attia
Apparently, there's just some super embarrassing idiotic text messages.
joe rogan
He drove a Lamborghini to the office, too, which is also hilarious.
It's just so crazy.
But it just shows you that there is this incredible market for people to try to optimize their health and try to figure out what's wrong with them.
And if you can make it...
It's more simple than it actually is.
Which is really...
peter attia
Except I don't even think...
That's the other thing about it.
It wasn't that freaking interesting.
joe rogan
Right.
peter attia
Like, who cares if there's a little box that I can put a drop of blood on that tells me what my CBC and Chem 7 and, you know, pick your other panel.
It's not that interesting.
Okay, yes, it's a little more convenient than going to LabCorp and giving a tube of blood.
What's interesting is what you do with that knowledge.
What do you do with that information?
joe rogan
Well, I think what was interesting for what she was providing was Safeway was going to buy into it.
Was it Walgreens?
Yeah, Walgreens.
Walgreens, I believe, backed out.
I think they realized somewhere along the line that she was full of shit, and there was some text messages and emails that they read out from the CEO, because he had retired before it ever came to fruition, and then they backed out of it.
But Safeway wanted to put them all in the stores and so you could be able to go shopping for food get your blood taken a little tiny pinprick and find out if anything's wrong with you right there and then But again, it still comes down to having somebody that can actually tell you what's wrong.
peter attia
And by the way, the stuff that was relevant, it's not like they're going to measure LP little a.
It's not like they're going to tell you your APOE4 status.
It's not like they're going to tell you, like, of the 10 most relevant things that I would look at in somebody's blood, they weren't measuring any of them.
Is APOE4 the stuff that makes you more susceptible to CTE? It probably makes you more susceptible to CTE. It definitely makes you more susceptible to Alzheimer's disease.
But today we know it's more nuanced.
We know that there are other genes that can be protective and can completely abrogate the effect of APOE4, which is the gene that's the more risky one.
joe rogan
When you hear about, I don't know what the gene is, but there is a gene that predisposes someone to breast cancer.
BRCA. Is that what it is?
unidentified
Yeah.
joe rogan
And when Angelina Jolie actually had her breast removed as a preemptive measure, does that make sense to you?
peter attia
Yeah.
joe rogan
Really?
peter attia
Yeah.
unidentified
Wow.
joe rogan
So it's that possible?
peter attia
It's depending on, there's two variants of the gene, but it can have up to a 80 or 90% lifetime incidence of breast cancer.
unidentified
Wow.
peter attia
And what's even more frightening is the ovarian cancer.
Because, you know, a woman suffers far more from a prophylactic oophorectomy than a mastectomy.
And from an endocrine perspective.
I mean, socially, obviously, there's challenges of a mastectomy.
But from an endocrine perspective, if you took a 35-year-old woman and just took her ovaries out, you're putting her in menopause.
joe rogan
Wow.
peter attia
So the consequences are huge.
joe rogan
As far as the way she feels, mood swings, behavior.
unidentified
Oh, my God.
peter attia
It's devastating.
Yeah.
joe rogan
Yeah.
That gene that predisposes a woman to breast cancer, would you say it was again?
BRCA. How common is that?
peter attia
Oh, that's a good question.
It's not that common.
It is not remotely common as far as the leading.
Breast cancer is obviously a pretty common cancer to women.
I would guess that 5% maybe would be BRCA associated, if not less.
joe rogan
And is her action of doing that, is that a common move now?
peter attia
I'm certainly seeing more women who are BRCA positive undergoing prophylactic mastectomy.
joe rogan
And when they undergo this prophylactic mastectomy, they actually can retain the initial appearance of breast now.
So they do it knowing that they're going to do that and then they replace it with a breast, an artificial prosthesis.
Fuck, that's one thing that dudes don't have to think about.
Breast cancer.
peter attia
Yeah, I mean I guess the equivalent for males is prostate cancer in terms of like a gender specific cancer.
And so if you look, like lung cancer is the number one killer for both men and women in terms of death rate.
joe rogan
More than heart attacks?
peter attia
Oh, no, no.
I'm sorry.
Within cancers.
Heart attack is still number one.
But, you know, breast and prostate are very high up on the list of killing along with colon cancer.
Those are sort of your big three.
Prostate cancer is a bit complicated because every man will die with prostate cancer.
Some will die from it.
unidentified
Whoa, every man will die with some- Yeah, if you live long enough, absolutely.
peter attia
By the time you're 50, like you and I, there's a greater than 50% chance one of us has prostate cancer right now.
joe rogan
Holy shit!
peter attia
So if you and I were killed in a car accident tomorrow, and they took our prostates out and sectioned them up, the likelihood that they would find prostate cancer cells in one of us is at least 50%.
joe rogan
And those cells may or may not be a problem.
peter attia
Statistically speaking, they're not going to be a problem.
Because remember this, with the exception of the brain, you don't die from cancer unless it spreads.
So the brain is the one exception to that rule, right?
If you have brain cancer, it can kill you just staying in your brain.
But if you have lung cancer, or let's use prostate cancer or breast cancer, a woman never dies because breast cancer invades her breast.
She dies because it spreads to her brain, her bones, her lungs, her liver.
Same with prostate cancer.
Prostate cancer almost always spreads to the bone, and that's the only time you die.
So if prostate cancer stays in the prostate, there's no death.
joe rogan
If someone has a very small amount of prostate cancer, is there a thing that they can do to mitigate its spread?
peter attia
Oh, absolutely, yeah.
So you can remove the prostate surgically.
This is a technique that was pioneered by a guy named Pat Walsh at Johns Hopkins in the 1980s.
It wasn't that taking out the prostate was hard, it was taking it out while preserving sexual function was really hard.
Because the neurovascular bundle of Walsh, which now bears his name, which is what controls erectile function, wraps around the thing you're trying to cut out.
So it's like, how do you cut this gland out without taking out all of the nervous tissue that you need to maintain an erection?
And so basically, prior to Walsh, you were almost guaranteed to never be able to get an erection after you had your prostate taken out.
So you were staring down the barrel of not two very attractive choices.
joe rogan
How many guys went out in their shield?
I'm keeping my heart out.
I'll die young.
peter attia
So the goal is to basically identify a guy with prostate cancer who has the variant that's going to spread.
So today, this has been, I mean, there's been so much progress in this field.
So we use a blood test called a 4K score.
So you know what a PSA is?
You've probably had your PSA checked a bunch of times.
PSA by itself is not a great blood test.
You have to use more information than just the PSA. You have to know the PSA velocity and the PSA density.
So the velocity is what's the rate of change of the PSA, and the density is dividing the PSA by the prostate volume.
So if you get an MRI or an ultrasound, you can tell the volume of the prostate in grams, or the volume, and then you can turn it into grams.
So you normalize PSA to volume or mass, and you have a density.
And those two things become more suggestive.
So once the PSA starts to look a little bit suspicious, and once it gets over about four, we do this 4K blood test, which is another form of liquid biopsy.
And that gives you a much more interesting number.
It basically tells you what's the probability that this person is going to have metastatic prostate cancer, not just prostate cancer.
And if that 4K number is above a certain threshold, I think 7.5%, the probability that they're going to have metastatic prostate cancer approaches 85-90%.
joe rogan
What are your thoughts on ketogenic diets in relation to cancer?
Like, there's been a lot of articles written about the idea that cancer needs glucose to survive and then if you can keep your body functioning off of ketones, it's less likely that you get cancer.
Does that make sense?
peter attia
Yeah, no, definitely.
You know, I was on a ketogenic diet for three years.
joe rogan
Yeah, I know you were.
peter attia
And so I was super steeped in all of this stuff.
joe rogan
What made you get off of it?
peter attia
It became just really difficult.
I mean, I was so strict.
I didn't take a day off.
I took one day off in three years.
But the stuff I had to give up, like even, like one of my favorite things is stir fry.
Like I love huge curry stir fry that I make.
And even something that's that, it's just vegetables, but it was still too much to keep in.
It was too much carbohydrate to stay in ketosis.
So I just kind of missed.
And also at that point I was switching more from ultra distance swimming and stuff into shorter distance swimming.
Like I was doing more, you know, pool racing and more just shorter distance stuff.
Also on the bike, I was going less from ultra-distance bike stuff to a 20-kilometer race or a 40-kilometer race.
So as you move towards that new energy system, you just need more carbohydrates.
But anyway, to your question, I think there's an awesome theoretical argument for it, but it's also important to understand that even when you're on a ketogenic diet, your glucose isn't zero.
It's all about probabilistic reduction, right?
It's keeping insulin lower.
That probably has a greater effect than keeping glucose lower.
Because if you're on a ketogenic diet and you're not on a ketogenic diet, we're talking about a difference of one millimolar in glucose.
So it's probably more the presence of the ketone, the reduction of the insulin, if anything, that's having a role.
What I think is most interesting is not just a ketogenic diet.
It's when you combine it with a drug called a PI3 kinase inhibitor, which is a drug that blocks a very important pathway for cancer to grow, but has one escape valve, which is it raises insulin.
So that's a bad thing if you're trying to minimize cancer.
So when you combine a ketogenic diet with a PI3 kinase inhibitor, at least in animal studies, which is about the extent of where this has been studied so far, the results look really good.
Because PI3 kinase inhibitors by themselves have not panned out, even though theoretically they should.
They should be amazing for cancer.
They haven't been great.
And it's been speculated that that's because of that escape valve, which is it pops off to a higher insulin level.
So when you layer on top of that a ketogenic diet, it seems to work really well.
And anecdotally, one of my good friends from med school, his wife has metastatic breast cancer.
She was diagnosed, God, probably seven or eight years ago.
So metastatic breast cancer is a death sentence.
It's unsurvivable.
She was enrolled in a clinical trial in Boston that was using PI3K inhibitors.
And so she got one of these drugs.
She's the only woman to this day that's still alive.
unidentified
Whoa.
peter attia
And she went on a ketogenic diet.
Now, again.
joe rogan
How many years ago?
peter attia
Seven or eight.
joe rogan
And what is the usual lifespan of someone who gets diagnosed?
peter attia
I mean, five years, maybe.
Less, probably.
joe rogan
And is she deteriorating?
Is she maintaining?
unidentified
Yeah.
peter attia
No, she literally has this one little foci of metastatic disease in her hip still, so this one little nubbin of potential cancer inside her hip bone, but it's stayed static.
I mean, it's causing some structural issues.
Obviously, her hip's weaker, but it's kind of amazing.
Her story is actually kind of one of the things that's got some of the people who develop these drugs thinking about this idea of combining ketogenic diets with PI3K inhibitors to try to squash the insulin level and minimize basically that escape route for cancer.
joe rogan
Wow.
peter attia
And there's other ways to do this pharmacologically, right?
Like you could argue combining it with metformin or something else that's going to lower insulin would also potentially work.
joe rogan
And metformin is that anti-aging drug that's fairly controversial as well too, right?
peter attia
Yeah, I don't know if it's that controversial.
I mean, it's...
joe rogan
It is in terms of human performance.
peter attia
Well, yeah.
So the reason I stopped taking it three years ago, I took it for probably eight years, but three years ago I stopped because it does impair mitochondrial function, at least at the level that I can measure it.
So I measure my lactate levels when I'm exercising in a certain type of exercise every day.
And I'm basically trying to generate the highest amount of power I can generate on a bike while keeping lactate below 2 millimole.
And that's like the limit of my mitochondrial throughput as kind of my maximum aerobic efficiency.
And when I was on metformin, I just noticed like...
I was hitting that lactate level higher than I believed I should hit it, just based on my fitness.
joe rogan
Is lactate...
Is that lactic acid?
Is it the same thing?
peter attia
Synonymous, yeah.
joe rogan
So you would develop more with metformin.
peter attia
That's right.
joe rogan
So it would make your performance less effective, but...
What if you took the metformin after exercise?
peter attia
It stuck around too long.
So I had tried all that stuff.
I would take the metformin immediately.
Exactly.
You said I'd take it immediately after exercise, but it would still be in my system.
joe rogan
24 hours later.
peter attia
Yeah.
So I then said, well, what if I stopped metformin altogether?
joe rogan
What if you intermittently took metformin and intermittently exercised?
peter attia
All great questions.
joe rogan
Is there a half-life in terms of?
peter attia
Eventually it'll wash out, but I think exercise is the single most important longevity drug we have, bar none.
If you said, I want to go deep down the rabbit hole of living longer, what do I need to do?
It's a super well-crafted exercise program that is geared towards strength, muscle mass, and cardiorespiratory fitness.
joe rogan
So it's all of the above.
It's not just one.
peter attia
Right.
I mean, the hazard ratios for each of these are pretty interesting.
This has become like each year I try to bring one new focus into our practice.
And the past 12 months, the focus has been entirely around taking exercise to a new level in terms of our understanding of how to fine-tune it.
And the data are unbelievable, right?
So everybody knows that if you smoke or have diabetes, your risk of death goes up a lot.
But your risk of death from having high cardiorespiratory fitness goes down by much more than your risk of death goes up from smoking or diabetes.
So smoking and diabetes will double or triple your risk of death depending on the time frame you're looking at.
Having very high cardiorespiratory fitness, so having a VO2 max that is elite, we would define that as the top 2.5% of the population, compared to below average, is a five-fold reduction in all-cause mortality.
unidentified
Wow.
peter attia
Death from any kind.
joe rogan
Whoa.
peter attia
I mean, we don't have drugs that have a 5X reduction in mortality.
joe rogan
That's incredible, and that's just elite cardiovascular health.
peter attia
Right.
And then when you layer in strength and muscle mass, we actually now have pretty good data as to the fact that strength is more important than muscle mass.
Muscle mass is a good proxy for strength, but if you just focus on strength, that's the metric that matters.
It's about a threefold reduction in all-cause mortality when you compare high strength to low strength.
And the tests are, you know, we're talking, it's not like how much you can squat and deadlift.
It's like grip strength, dead hang, how long can you do like an air squat?
You know, like what's your quad strength?
How quickly can you do five reps up and down from a chair?
I mean, it's relatively simple stuff, but when you stratify people by those metrics and you compare the highest to the lowest performers, there's just no comparison.
joe rogan
Is there a point of diminishing returns, though, where you just get really, really strong, but it's not helping you any more than being fairly strong?
peter attia
On the strength data, we don't see it because the data have only been parsed out as high to low.
On the cardiorespiratory, there is a point of diminishing return.
So remember I said elite is the top 2.5%.
So we break them into five categories, but they're not equal in bucket size.
You get most of the benefit, honestly, by going from not fit at all to average fit.
That gives you three of the 5X. Yeah.
Now that said, I hold myself and my patients to a way higher standard, which is we have a chart that shows all the data by age, by gender, and by VO2 max.
And I would say, if you're a 52-year-old male, I'm asking you to have the VO2 max of an elite 42-year-old male.
So I want you to be a decade younger elite.
And then we do the same thing with strength metrics.
joe rogan
And when you prescribe that, like say if you take a 52-year-old male that doesn't have a history of cardiovascular activity, maybe they lightly work out at the gym or something like that, what particular exercises do you think are the best to achieve that result?
peter attia
So we'd start with a base of zone 2. So this zone 2 is that lactate thing I was talking about.
So your zone 2 is defined as the highest level of aerobic output that you can generate while keeping lactate below 2 millimole.
So I think a bike is the easiest way to do this because...
joe rogan
Stationary or...?
peter attia
Stationary just because you can keep it steady state.
When you're on the road, you're all over the place.
So if you're on a stationary bike, and also wattage is such an easy metric for people to understand.
So how many watts are you putting out, right?
So the first thing we would do is say you probably need to be doing at least three hours a week of that zone two, which is building an aerobic base.
So four 45-minute sessions at zone two, constantly driving it up.
And honestly, one session of VO2 max training per week, and the best protocol for that is the 4x4 protocol.
So that's four minutes at the highest output you can sustain.
So here you could do it on an air bike or something, right?
So you could do what's the highest wattage you can hold for four minutes, and then four minute recovery, and do five of those sets once a week.
joe rogan
So when you're doing that, do you think that the best is like an airdyne that works the arms and the legs?
Or do you think just a regular bike that just works the legs?
Like what is...
peter attia
For zone two, I mean, it really just matters that you're consistent.
But I think most people find you can do a higher output when you're on an air bike in terms of absolute wattage because you are leveraging upper and lower body.
It really doesn't matter that much.
I mean, you can do this on a treadmill.
You can do this on a stair climber.
You can do this on...
joe rogan
Any kind of cardiovascular activity, but you need 45 minutes four times a week.
peter attia
That seems to be the minimum effective dose on Zone 2. Now, if someone's super deconditioned, it can probably be three 30-minute sessions to start, and they'll see benefit.
joe rogan
Interesting.
And then as far as a strength program, do you recommend specific exercises?
Is it like squat, deadlift?
peter attia
Well, this is where it gets very dependent on the person.
So we have a test that we put our patients through that's 10 exercises.
And they're all basically normalized to your body weight and gender.
So like a dead hang.
So how long can you hang from a bar dead?
joe rogan
How long should you be able to hold?
peter attia
Well, we hold males to the standard of two minutes and females to a minute and a half at the age of 40. So then it gets discounted by decade.
joe rogan
You know, what's interesting, when we were hosting Fear Factor, Dead Hang was one of the stunts.
These people hung from a chin-up bar that was over a bridge into a river.
peter attia
Do you remember how long people could go?
joe rogan
No, but the women won.
peter attia
Interesting.
joe rogan
Yeah.
We had a big jack guy.
He was fucking pretty stout.
And he fell into the water quicker.
I think it's weight, body weight.
peter attia
Oh, it's harder the more you weigh, of course, but the idea is, in theory, you should be stronger if you're a man as well.
joe rogan
Yeah, but if you're a 250-pound man and you're carrying all that extra weight because you've been doing bodybuilding-type exercises, and especially if you use straps and you don't have that grip, two minutes is a long fucking time, though.
peter attia
The very first time I did it, I did it after deadlifting.
So my grip was a little taxed and I only got to 126. And then about a week later I tried again and I got to two minutes.
My longest is a little over three minutes now.
I do it twice a week.
joe rogan
How much do you weigh?
Like 171. And as you get heavier, your hand strength must really need to be a giant factor.
If you're dealing with a guy who should be 171, like if you decided to bodybuild and you went to 250, that would probably radically decrease your amount of time.
peter attia
Yeah, although to your point, I would hope that I was using my grip strength to make that happen.
I mean, grip strength is probably one of the most correlated indices with longevity.
joe rogan
Yeah, I've heard that, but I don't know why.
Why is that?
peter attia
There's probably two reasons.
One is I used to think it was the obvious reason, which is look at Look at the causes of mortality.
We have this thing in our practice called the death bars.
So one of my analysts, Bob Kaplan, about a year ago, I said, Bob, I want you to make these five graphs for me.
And they're basically everything about the causes of death.
So one of them is just show me all cause mortality by decade.
Now break it down into the subsets.
And one of the most common things is accidental deaths.
And this is the most interesting trend is accidental deaths change so much by age.
So in our age group, So by the way, accidental deaths are uniform across the population, but they become a much bigger source of death on a per capita basis as you get older because there are fewer older people.
In our demographic, most accidental deaths are overdoses.
When you're older, they become virtually all falls.
90% of accidental deaths are falls.
So a fall is a very lethal thing by the time you're 75. Like you and I don't think about it.
By the time you're 75, falling is a devastating consequence.
unidentified
Isn't that wild?
peter attia
So think about how strong grip versus weak grip would impact your ability to tolerate a fall.
It's, can you get your hand down?
Can you grab something when you're falling?
All of those things matter a lot.
The second reason I think grip strength matters a lot is it is such a good proxy for strength.
Because one of the things I've learned in the past year becoming so obsessive with grip strength is how as my hands have gotten stronger, it's alleviated all the shoulders.
Like I have a torn labrum here from my swimming days that is so painful.
I thought I would never be able to do a dead hang pull up again.
Because whenever I was in this full position, I'm putting so much stress on the labrum.
So I would just, I was doing pull ups to here, right?
Like I would, you know, I'd go from here to here.
And then Beth Lewis, this person in our practice who is kind of like our strength guru, she was convinced that if I could just get my grip stronger, I would fix this.
And I was like, Beth, that doesn't even make freaking sense.
Like, why does having more grip fix my shoulder?
But I just started doing everything she said, like all of these dead hang finger exercises and all this other stuff.
And now, when I do a pull-up, I can dead hang with zero pain, and I'm just putting all this extra pressure in my finger.
And I think the reason is, it is allowing us to potentiate force more stably from our scapula all the way through.
And so much of the instability we have in shoulders and all these injuries is just because we don't transmit force correctly.
So I think something about having really strong grip just basically fixes so much of the upper body strength imbalances that we have.
And again, it's a proxy for people who don't fall.
It's a proxy for other things.
It is a proxy for muscle mass.
The more muscle mass you have, the more glucose you dispose of, the more metabolically healthy you are.
So that's my best guess for it.
joe rogan
And what exercises do you do besides dead hang?
peter attia
So the other things we have people do is...
So another important principle of aging...
So think about hunting, right?
So where are you more likely to hurt yourself?
Walking down a steep hill or walking up a steep hill?
joe rogan
Down.
peter attia
Absolutely.
Brakes is everything in life.
Eccentric strength matters more than concentric strength.
Concentric strength is important, but we overemphasize it.
We don't train eccentric strength enough.
So a big part of this program is how do you train eccentric strength?
So one of our metrics is you have to be able to step down from a 16-foot block and take more than three seconds.
So you're 16 inches on a block, and you're gonna put one step down, but you have to do it in more than three seconds.
So think about how much control you need in the supporting quad to put yourself down that slowly.
That's how you walk down stairs and don't hurt yourself.
That's how you have the ability to stop yourself if you lose balance.
We have eccentric modes as well.
So you have to be able to hold 50% of your body weight and do a certain number of box step ups.
You have to be able to farmers carry with 75% of your body weight.
So we have a whole bunch of other things that have to do with ankle mobility.
It's a lot of non-sexy stuff that is our top 10. And, of course, deadlifting and things like that are super important because that's a big part of how you train those things, but we also don't fixate on it.
Like, my wife has scoliosis, and if she deadlifts, like, it just puts a little too much stress on her back, so she does hip thrusters instead.
And you can get most of the hip hinge benefit using a hip thruster without having to deadlift.
joe rogan
What about kettlebell swings?
peter attia
Amazing exercise, right?
joe rogan
Is that good enough as a hip hinge?
peter attia
Yeah, I mean, I think if you're good, I mean, the problem with a kettlebell swing is it requires a ton of technique and coordination.
And I think most people don't do it incorrectly.
Most people do it incorrectly.
But if you're doing it right, it's an amazing exercise.
joe rogan
Yeah.
So what is your routine?
Like, what are the things that you concentrate on?
I know I watch your Instagram.
You've been doing deadlifting.
peter attia
I love deadlifting.
But I don't deadlift heavy these days.
Like, I've been deadlifting relatively light, but I do it with, like, a...
I do a very heavy focus on eccentrics.
I do a no-touch deadlift where I'm only letting 50% of the weight down in between reps, so kind of more staying under constant tension as I lift.
Ton of single leg stuff.
You can use a fraction of the weight.
I started about six months ago doing a lot of blood flow restriction stuff as well, so you're really going light.
unidentified
Interesting.
joe rogan
The blood flow restriction stuff is very interesting.
peter attia
Have you done it?
joe rogan
No, I haven't, but I've heard great things about it.
But I wanted to ask you this before I forget.
You had written something once about, I meant to talk to you about this, about deadlifts actually decompressing the spine, which I found so counterintuitive.
So how does that work?
How are you getting deadlifts to decompress you?
peter attia
And this is easiest in a hex bar deadlift.
It's much easier with a hex bar deadlift than a sumo deadlift.
joe rogan
That's what I use anyway.
peter attia
The reason is if you have enough intra-abdominal pressure and you're putting your spine at just the right amount of extension, You're actually extending your spine when you lift because of the position of your hip.
So it's hard to explain without feeling it, and it took me a really long time to feel this.
But have you heard of dynamic neuromuscular stabilization?
joe rogan
No.
peter attia
DNS? So it's this discipline that really taught me how to do this kind of intra-abdominal pressure.
Where you put a huge amount of pressure in your pelvis, basically.
So you ever notice how the really good power lifters have huge abdomens?
joe rogan
Yeah.
peter attia
And this is a big part of it, is they can generate so much pressure in their abdomen that they're basically stretching out their spine, pushing out everywhere.
So they have kind of a cylinder inside their body.
And if you can't do that, you almost have like a triangle in your body with the diaphragm being the top and the pelvis being the bottom.
So the force is not going out in all directions in the same way.
So what you want is this force to be going out equally.
And when I do that with a hex bar deadlift, I can hear my spine actually going like an adjustment.
Just the same as when I'm dead hanging.
You can sort of hear a crack.
unidentified
Yeah.
joe rogan
So, what is the steps?
Like, how do you start it?
peter attia
You start on the ground.
It's the easiest to do when you're on your back and you have somebody who knows how to cue it initially.
So, you know the two hip bones here?
joe rogan
Yes.
peter attia
This is called your anterior superior iliac crest.
So, I go about two finger breaths in.
Two finger breaths down, and as I'm laying on my back, I'm trying to put as much air into there as possible.
And you want to imagine that your shorts, which have, you know, the ring that the waistband of your shorts make, you want to make it as big as possible in all directions.
So you're trying to get air out into your back, you're trying to get air into your pelvis.
So the first step is just being able to do that.
And then eventually you want to be able to do that while breathing.
Meaning you want to be able to get that pressure out and then take a breath.
Because at first you won't be able to do that.
At first you'll just blow out and you'll be holding your breath.
So the next thing you want to do is be able to hold that while you breathe.
And then we do some other exercises before we would go to deadlifting.
So now you want to be able to get into certain positions where you're on your front and you're in opposite support.
So the obvious one is like a bare position where you're on all fours, but then ultimately we get into these really complicated positions where you're on one elbow and the side of one knee, but you're keeping your pelvis totally level.
jamie vernon
Like these?
peter attia
Yes, exactly.
So for example, basically what DNS comes down to is modeling the neurodevelopment of an infant.
So basically, if we're not messed around with when we're kids, we will develop perfectly normally for the first two years of our life.
jamie vernon
These are the exercises I use to fix my back, Joe.
joe rogan
Really?
jamie vernon
Without even knowing.
That's what it was called, yeah.
The doctor, it took her a couple weeks to figure it out, but that first thing with like getting, trying to find like this position here where her back is up and her legs are like that, that's basically what fixed it.
And just trying to get that breathing in after a couple weeks, all the pain kind of just kind of went away.
peter attia
So you see the one that's four to five months there, where she's in an eight, so where her left leg is out?
unidentified
Yes.
peter attia
So that's, to me, that is the gangster position that gets you ready to deadlift.
When you can do what she's doing and now pick your hips up off the floor and stay perfectly level with only your left leg down and your right elbow down, and you'll feel, your spine will just go.
You feel this total expansion, that tells you you have the intra-abdominal control to deadlift.
joe rogan
So left leg down, right elbow.
peter attia
Yep, right elbow down.
Yep.
Opposite, opposite.
She's not doing it fully right now, but that's the precursor to that position.
joe rogan
And so that's how you start to learn.
So then there's expanding in those images right there.
You see how they're using, is that the diaphragm that they're using?
peter attia
Yep.
joe rogan
To push out?
peter attia
Yep.
joe rogan
And so that is what expands your back.
unidentified
Yep.
joe rogan
Do you do any decompression in terms of like, you ever use one of those teeter decks tables?
Do you know what I'm talking about?
peter attia
Yeah, I do.
joe rogan
Not the ones that hang by your ankles, but the one where you hinge from the waist?
peter attia
No, the only thing that I do decompression for is my neck.
So I have a device at home every day.
I do 10 minutes of neck traction.
joe rogan
Oh, you do one of those?
peter attia
Yep.
joe rogan
Do you do one with the inflated one that you pump up, or do you do the hang one?
peter attia
Neither.
So it's called a Sanders machine.
You lay in it, and it grabs your mandible and your occiput, and it pulls you up, and you adjust the poundage.
So I do 25 pounds for 10 minutes.
joe rogan
What's the machine that you use?
What's it called?
peter attia
It's called a Sanders.
I bought it.
There it is.
joe rogan
Oh.
Interesting.
Because I have one where I hang.
That looks safer.
peter attia
This is much safer.
Because you would start somebody out at a much lower pounded...
joe rogan
Jamie, will you send me this link?
Thanks.
peter attia
But you don't have any cervical disc issues, do you?
joe rogan
I have.
I've had them.
Yeah, I had bulging discs.
peter attia
So I would do this under the guidance of a physical therapist just to make sure that they tell you how...
I mean, are you literally hanging by your neck right now?
joe rogan
No, not fully.
peter attia
But do you know how much weight are you...
joe rogan
I just have one of these things that it hooks onto a door, the top of the door, and I pull the thing like this, click, click, click, click, click, click.
peter attia
Oh, okay, okay.
joe rogan
And then I can choose to lean into it and put more weight, like let it make my neck decompress more.
And then I can pull it up more until it gets to like this.
peter attia
I got it.
joe rogan
But it feels good.
peter attia
Where is the pressure being applied?
More in the front or more in the back?
joe rogan
Kind of like the bolt.
peter attia
Okay.
joe rogan
It's a strap and you tighten it down with Velcro and it's like...
peter attia
So the other thing that DNS that I do every day for DNS is...
So there are muscles that run on the front of your vertebral bodies and your cervical spine.
And they're called deep neck stabilizing muscles.
And one of the challenges that most of us have who all have sort of cervical neck issues is those muscles aren't strong enough.
They're not fully engaged enough.
So another exercise I do when on my back in that position with the intra-abdominal pressure is kind of look down at my chest and without lifting my head up, go through the initiation of a lift up.
And to do that, you basically will end up using these deep neck stabilizers as opposed to the scalenes, right?
You don't want to be moving your neck or stabilizing your neck with these muscles that are outside.
You want to be doing it with the muscles inside.
And that's what's extending the spine.
You can't feel these muscles.
Everything you're feeling right now is sort of superficial.
joe rogan
Do you use anything to strengthen your neck, like an iron neck or anything like that?
peter attia
Have you ever?
I did when I was boxing, of course.
joe rogan
You ever use an iron neck?
peter attia
I don't know.
I used to do the thing that you wrap around your head and wrap a plate to it.
joe rogan
But the issue with that is that it puts an unnatural amount of leverage on the disc itself.
The iron neck is a halo.
Do you know what it is?
peter attia
No.
joe rogan
I'll give you one.
We have a stack of them.
They sent me a bunch to give away.
But you have a halo, and you pump it up like a Reebok pump.
It fits tight to your head, and then there's a 50-pound bungee cord.
And so you pull back so that you're under tension, and then you can adjust the amount of tension.
See, that guy's using it there.
There's a video of the...
Oh, there's a video of me with it on.
There's a video of me doing it, too, because the guy who...
peter attia
Yeah, this would be kind of cool for driving, because that's a thing in a race car, right?
Your neck is under a lot of G-force.
joe rogan
Well, the idea behind it is there's the guy who invented it.
Is it Mike Jolly?
Is that his name?
I think so.
He's a former NFL player, big fucking stout fella, and he developed this to aid in people, there's Tom Papa too, to keep people from, there's a lot of folks that get head injuries, and a lot of it is from the weakness of the neck.
And that makes your head snap.
Yeah, I'd love to try it.
But with jujitsu, it's gigantic.
Because there's no real safe way to train your neck.
But with that, my mind...
peter attia
We used to do neck bridges rolling, all this idiotic stuff.
joe rogan
Yeah, we used to do that too.
But this iron neck thing is way better.
Because you don't really do that.
But you do do this.
So the halo's on, the bungee cord's on, and I go like this.
Twist here, twist here, twist here, twist here.
And then I turn around, I do it backwards, and then I do it sideways, so I have it going to my right side, I have it going to my left side, and then I do what they call the Stevie Wonder.
So I do this thing like this.
And the whole idea is that you're not putting that unnatural hinge on your discs.
And all of this muscle tissue...
It's gotten so much stronger because of it.
My neck is bigger.
I mean, I haven't measured it, but I mean, shirts that I used to wear, I can't fit anymore.
But it's just, it's stronger.
It's more stable.
peter attia
Yeah, I'd love to try it.
joe rogan
You can have it.
I have one for you.
There you go.
peter attia
JRE swag.
joe rogan
So I'm going to have to try that with the hex bar.
I mean, it seems like I'm going to have to...
peter attia
I mean, start with the positions on the ground.
It's easier to show you if I was actually putting you on a mat and having you do it.
joe rogan
Well, we'll do that someday.
Yeah, yeah, yeah.
And so you do that.
You do those...
peter attia
So I do my four days a week.
I do four sessions a week of the 45-minute zone two.
So that's the...
I'm titrating my wattage to keep lactate at two millimole.
I do one session a week of a higher-end anaerobic exercise.
I typically do it on a stair machine, you know, those rotating stair machines where I just do, like, I'll do a one-minute sprint, a two-minute easy climb, one-minute sprint, two-minute easy climb, or four-on-four off on a bike, and then four sessions of strength a week, four strength sessions a week, and that's it.
Like, I mean, this is the least I've ever exercised in my life.
I exercise a total of 10 or 11 hours a week.
Which is still, you know, a lot by most people's standards.
joe rogan
By most people's standards, it is a lot.
peter attia
But by my standards, that's like nothing.
joe rogan
Well, people need to understand that you're a fucking maniac.
And you swam all the different...
You swam in between all the islands of Hawaii.
peter attia
No, no, no, no.
Just Maui and Lanai.
joe rogan
But you were trying to do...
What was there?
There was something going on where they wouldn't let you do it at night, right?
peter attia
Yes.
That was that swim.
Those are the tiger sharks.
joe rogan
What?
peter attia
Because at night it's so dark, you have to pin a glow stick to your bathing suit.
And they're like, the boat captain, like I'm going to start at midnight to avoid the wind.
And he's like, dude, you'll be like chum out there with a little glow stick on your butt.
joe rogan
Really?
They would come for you?
peter attia
Yeah, they would love that.
joe rogan
Tiger sharks are dangerous, huh?
So, for you, 11 hours a week is not a lot.
For most people, that's a big commitment, because it's more than an hour a day, seven hours a week.
peter attia
And we'll say to our patients, like, look, what can you do?
Can you do six hours a week?
But at some point, you've got to do it.
Like, you just...
You can't say, I want to live long.
I want to be a kick-ass 85-year-old and not train for it.
It's so logically inconsistent.
And I want to be able to hunt when I'm 80. And I want to drive a race car when I'm 80. And if I want to do that, I have to put in a lot of time right now to make sure I'm strong enough to do those things.
joe rogan
Yeah, there's no other options, you know, especially for bone density and maintaining muscle mass.
There's no other way to do it.
peter attia
Yeah, the data is overwhelming, right?
So there's a study that was done that looked at 60, I want to say 65-ish year old folks, and it put them on a super high strength training program.
And in six months, they added one, I want to say 1.7 kilos of muscle mass.
unidentified
Wow.
peter attia
That's pretty good.
That's like three and a half pounds of muscle.
joe rogan
For an old person, that's very good.
peter attia
Six months of super dedicated training, and I forget exactly how much more protein they were feeding them, but so high protein diet, high training.
A separate study took people of basically the same age and put them on 10 days of bed rest.
They lost 1.5 kilograms of muscle.
Wow.
joe rogan
1.5 kilograms of muscle in 10 days of bed rest and did they get it back quickly?
No.
That was it.
peter attia
It takes a very long time to get it back.
joe rogan
And you could lose it all in 10 days of bed rest.
peter attia
You could lose in 10 days what you got in 6 months.
joe rogan
God damn it.
peter attia
So, I mean, it's like, you know, it's this non-sexy, like, don't stop exercising.
Don't ever get out of shape.
And avoid injury like the plague.
And as you get older, this loss of muscle mass, what we call sarcopenia, is an enormous killer.
unidentified
Hmm.
joe rogan
So sarcopenia is like one of the primary indicators that someone's unhealthy.
peter attia
Yes.
Sarcobesity, which is a term that I don't know who coined it, is like the worst of all, right?
So that's high amounts of fat, low amounts of muscle.
And that's, I mean, that's going to happen to a person naturally, right?
You're going to lose about...
You're going to lose about a pound of muscle a decade, a little bit more than that, probably two pounds of muscle.
No, no, I'm sorry.
You're going to lose about, I want to say lose a pound of muscle, gain two pounds of fat every couple of years by the time you're 40 if you don't make it, if you're not super diligent about avoiding it.
joe rogan
And do you have a body fat percentage that you like to maintain?
peter attia
For me or just for our patients?
For anybody?
No.
So I think superficial or subcutaneous body fat is so highly genetic that we don't really tend to fixate on it that much.
So in other words, for an individual, we care about what their trend is.
But like, you know, I'm not that lean anymore.
I'm 14, 13% body fat, you know, for me to be below 10% body fat, I have to really, you know, change what I'm eating.
joe rogan
And you were at your leanest when you were keto?
peter attia
Yeah, well, as an adult.
I was probably leaner when I was boxing.
But when I was, like, as an adult, my leanest was 7% when I was keto by DEXA. And that was actually not that hard because, but I was exercising like a fiend and, you know, eating this stupidly strict ketogenic diet.
But what I care much more about is visceral fat and what's called ALMI, Appendicular Lean Mass Index.
And you can get both of these numbers off of DEXA. So visceral fat is how many pounds of fat do you have around your organs?
And that's a far more important predictor of your lifespan.
joe rogan
And what causes fat to accumulate around the organs versus subcutaneous?
peter attia
Well, the subcutaneous fat is sort of just, it's your excess depot.
I mean, you can store an infinite amount of weight there.
The visceral fat probably has to do with hepatic fat.
You know, our liver produces a lot of fat.
And I mean, if we're unhealthy, right?
So the liver will start to store fat.
Drunks.
joe rogan
People drink a lot.
peter attia
Yeah, alcohol is a huge contributor to it, but of course now there's something called non-alcoholic fatty liver disease, NAFLD, which is probably the leading indicator for liver transplant in the United States now.
And that seems to be mostly driven by fructose.
joe rogan
Fructose.
peter attia
Yeah.
joe rogan
Goddamn corn syrup.
peter attia
Yeah.
joe rogan
People want to pretend that all fucking sugars are created equal.
They're not, are they?
peter attia
No.
God, no.
joe rogan
Isn't that a weird thing, though?
Why do people want to say that?
It seems like whether they're contrarian or they want to have knowledge that counteracts the narrative that people keep hearing.
The narrative that we keep hearing from people like yourself or from a lot of experts is that particular...
Particularly high fructose corn syrup is just really bad for you.
peter attia
I mean, I think Rick Johnson's data shows, Rick Johnson is, I think, the world's expert on fructose.
What his data show is that there's nothing worse than drinking fructose.
Like, if you really want...
unidentified
Orange juice.
peter attia
Yeah, I mean, if you want to drink your sugar...
You're putting it on the fast track to the liver.
joe rogan
Because your body does not normally encounter that.
Your body normally encounters fruit with fiber.
peter attia
There's the speed with which it basically hits the liver is too high.
For the liver to process it correctly?
Yeah, and also it gets into other parts of the intestine that it wouldn't get to if you were eating it.
So if you took 100 grams of sugar and you ate it in a solid food versus if you drank it, There's actually pretty interesting animal data that the fructose that you drink is making it all the way into the colon, and it's actually increasing the risk of colon cancer in a way that you wouldn't get it through solid consumption.
joe rogan
So what about fructose from fruit?
Is there any danger in that, or is it just...
peter attia
On a per-molecule basis, it is the same fructose, but the dose, I mean, it's like...
You know, one of my favorite drinks is a Paloma, like in far as like a summer cocktail, right?
So I noticed this summer when I started making them, like how many grapefruits do I need to squeeze to get a 500 ml thing of grapefruit juice?
And it's about 10 grapefruits this big.
It kind of occurred to me.
I was like, it is so easy for me to drink this thing.
Like, I can drink 500 ml of grapefruit juice.
So, assume it's orange juice.
I could drink 500 ml of orange juice in one chug.
I don't have to think about it.
joe rogan
Right.
peter attia
Could you eat that many oranges?
It'd be hard.
joe rogan
You would really have to be motivated.
peter attia
Yeah.
So that's why it's just better to eat fruit than drink fruit.
joe rogan
Just because of basically the lower dose.
peter attia
The dose and the velocity.
joe rogan
You know, I noticed when I was on the carnivore diet for a while.
peter attia
How long were you on it, by the way?
joe rogan
Just a month.
I did it one month.
No, I did it twice.
peter attia
This was like three years ago, two years ago?
joe rogan
Yeah, about three years ago and then I did it again a year later.
Again, a month.
One thing it does do is you lose weight because you just don't eat anything else other than meat and your satiety levels are reached far quicker.
You feel satiated in terms of like you don't want to eat any more steak.
But if somebody pushed a bowl of pasta in front of me and said you could eat that too, I'd be like, oh, I'll fucking eat that whole thing.
It's weird.
peter attia
And you did it super strict.
You didn't have a single vegetable.
joe rogan
No vegetables.
I just ate steaks.
I ate mostly ribeye steaks for a month.
And I lost 12 pounds.
I got ripped.
peter attia
How did you feel?
joe rogan
I felt good.
I felt a little aggressive.
That was what was odd.
It was like I was a little extra aggro.
Not aggro in a negative way.
Like I was more like, argh!
Like I had more grrr.
peter attia
How were your workouts?
joe rogan
Not that good.
The workouts were not that good.
peter attia
Even the pure strength workouts?
joe rogan
They were okay.
peter attia
Like grappling would be horrible, right?
joe rogan
Right.
That's what I'm saying.
They were okay, but my ability to maintain for long periods of time was not so hot.
Whereas, I could do like a Pavel Tatsylin type workout where I'm doing low reps, large amounts of rest in between the reps, but like rounds in the bag were horrific.
It was not good.
It was like I got drunk the night before or something, like I was hungover.
I go like, oh, fucking push.
I was trying to push.
But mental clarity was very high.
Mental clarity was fine.
peter attia
How was your sleep?
joe rogan
Not bad.
peter attia
Sleep is good.
joe rogan
No different.
Sleep is fine, rather.
Mental clarity was high.
But I do feel like I had a little bit more grr.
Like, I'm a little bit more like, I gotta go out and fucking get shit done.
Like, I had good energy.
Which is odd that it didn't translate into the workouts.
Because it really didn't.
peter attia
Well, you were glycogen depleted.
You were down to 40% glycogen in your muscles.
unidentified
I'm sure.
joe rogan
But why did I have mental clarity?
peter attia
You probably had ketones floating around and you had no glucose fluctuation.
joe rogan
No glucose fluctuation, I think, is it.
Is that a negative way to eat?
peter attia
A carnivore?
Yeah.
Look, I haven't done it.
It just strikes me as unnatural, but I'm sure there are some people for whom it's a reasonable way to go about it.
It's hard for me to understand, though.
joe rogan
Is it unnatural?
peter attia
Look, the Maasai are largely carnivores, right?
So there are clearly some civilizations who have done it.
But we have to distinguish between it can be done from it is optimal.
Those are not the same thing.
joe rogan
And we're clearly omnivores in your eyes.
And so if one was going to do- Just like a vegan diet at the other end of the spectrum.
peter attia
Can it be done?
Sure.
Is it better than the standard American diet?
Sure.
Is it necessarily the optimal diet?
No.
Why is it necessarily the optimal diet?
You know, just because some guy's telling us it is.
joe rogan
Well, the idea is that I think the vegan diet is the only diet that comes with sort of a moral imperative.
peter attia
That's right.
joe rogan
And I think these folks that do it, they're saying, listen, I care about A, climate change, B, the animals, all the above, whatever it is.
So that's a different, like, can you do it and survive and thrive?
Yes, you can.
When you're doing the carnivore diet, I think their idea is that they're trying to avoid plant chemicals that plants release when they're being consumed by predators, which does happen, right?
peter attia
Yeah, I guess I just – I have to feel like we have evolved enough tools to thrive despite plants.
joe rogan
Like, I just – Well, isn't it also true that there's an effect that when you're taking in these plant compounds that are, you know, designed to ward off predation, that your body has a sort of hermetic effect?
And it's actually somewhat beneficial to have those.
That's Rhonda Patrick's take on things like broccoli sprouts and things along those lines, right?
peter attia
I don't have a point of view on it.
I mean, clearly hormesis is an important part of our existence, but I don't know.
My null hypothesis would be we evolved to eat plants.
Right.
joe rogan
And vegetables, fruits, and meat as well.
unidentified
But we're also super versatile.
peter attia
We can do a lot.
joe rogan
I don't know any elite athletes that do just straight carnivore.
But I do know a lot that do carnivore-ish.
So they do mostly meat and then they supplement it with fruits.
And so they'll eat like apples and pineapples and things along those lines.
And they get their glucose essentially from fruit and they basically avoid all plant matter.
I also take athletic greens.
I take that supplement.
peter attia
Dude, I'm freaking obsessed with it.
joe rogan
It's great stuff, right?
I feel good when I take it.
I go off of that, you know?
peter attia
That's interesting.
Could you do carnivore with AG? I'd feel a lot better if I did that.
Psychologically.
I don't think I'd feel right if I was not eating any vegetables.
joe rogan
I like them.
That's the problem.
If I have a nice salad with tomatoes and onions and olive oil and vinegar, I look forward to that.
I like it.
I like to start off a meal with a good salad.
It tastes good.
I like it.
It's one of those things where I'm not sure that's bad for me.
I think when I have a bowl of pasta, I like that too, but I'm like, oh, you fucking idiot.
After I eat it, I'm like, oh, dummy, what have you done?
I never feel like that after I have a salad.
After a salad, I'm like, good.
It was good.
I liked it.
But that's my optimal meal.
My optimal meal is a good salad and a piece of meat.
That's what I like the most.
And maybe some sort of a starch, like my favorite sweet potatoes.
Sweet potatoes are yams.
Those are my favorite.
Because I feel like with those, I'm getting all the benefits.
And I do know that you can take potatoes and boil them and then cool them off and then whatever it is that happens to the potato, you lose a lot of the negative effects.
peter attia
Yeah, there's this whole resistant starch argument.
Again, for me, I take a much simpler empirical approach to this, which is I have in my mind a predefined set of metrics around how high I want my glucose to be, how much I want it to vary, and where I want it to average, and I titrate my intake to that.
joe rogan
And you wear a constant glucose monitor, right?
peter attia
Yeah, yeah.
joe rogan
I saw it on your arm.
peter attia
Yeah, yeah, yeah.
So my activity and my sleep basically determine what I eat.
joe rogan
And is that monitor working with an app?
peter attia
Yeah.
joe rogan
What's the app?
What's it called?
peter attia
This monitor's called Dexcom, so it just works with the Dexcom app.
And there's another one called Libre, the Abbott version of this.
But it's a bit more cumbersome.
joe rogan
How much do you find it varies throughout the day, your glucose levels?
peter attia
Quite a bit, and it varies a ton with sleep and stress.
So if you have a bad night of sleep, like I don't even wear this when I go hunting.
joe rogan
Because you don't want to know your data?
peter attia
Well, first of all, there's a part of me that's perhaps naively worried that any sort of Bluetooth signal out there in the field is being picked up by a deer.
joe rogan
What about your phone?
peter attia
I always have it on airplane mode.
joe rogan
Oh, okay.
unidentified
Do you think a deer can pick up a Bluetooth signal?
peter attia
I have no idea.
But it's like, if I'm going to wear a stupid hex suit, I'm going to...
unidentified
Do you buy into that hex suit thing?
peter attia
Um, I don't think so, but it's like, it's one of those things where it's like the downside of it, you know?
joe rogan
It clearly works with fish.
peter attia
Really?
joe rogan
Yeah.
Yeah.
It seems to really work with fish.
I've, uh, I've talked to people that understand, like- Have you bow hunted fish yet out here?
No, I have not.
I've heard it's awesome though.
peter attia
Yeah.
joe rogan
I think spearfishing is the move.
I got to get that going.
That seems like the move.
peter attia
You should come to Maui with us in June.
We're going to go out there.
Justin Lee and Mark Healy.
Do you know those guys?
joe rogan
Yeah, I know Mark.
peter attia
You know Mark.
He's a great guy.
So they're going to teach me and another buddy some serious diving and spearfishing in June.
joe rogan
Yeah, that's like hunting underwater.
unidentified
Yeah.
peter attia
Those guys are...
I mean, that looks incredible.
It looks so...
And for someone who's been so comfortable in water, they keep telling me, like, they said...
Justin told me that within a couple hours, he'll have me down to 75 feet.
And I'm like...
That can't be possible.
There's no way I could go to 75 feet.
And he's like, of course you can.
You can swim 25 yards of a pool holding your breath, like there and back, which I can.
And he's like, how could you not do it?
And I was like, well, when you put it that way, but still, it seems so hard.
joe rogan
How do you get down there, though?
Do you have to have a weight on or something?
peter attia
I think they do.
Yeah, they use long fins and a slight weight.
And you titrate the weight to a certain level of buoyancy, like a slight negative buoyancy, I think.
joe rogan
And if you're panicking, you can release the weight?
peter attia
Yes, I believe you can.
joe rogan
And how much weight is it?
peter attia
That's funny.
I asked Justin about this.
Now, of course, it depends on how thick your wetsuit is, if you're wearing a wetsuit and things like that.
But it wasn't, I want to say it was like eight pounds or something.
It wasn't like some staggering sum of weight.
joe rogan
You know the guy who has the world record in the static hold?
He might have to quit his career because he got myocarditis from being vaccinated.
peter attia
Oh really?
joe rogan
Yeah, unfortunately.
He's one of the rare few that gets it and he lost like 30% of his ability to hold his breath.
See if you can find that guy's story.
Somebody just shared it with me.
But some of these guys can hold their breath for seven, eight.
peter attia
Yeah, I was going to say, what's the static apnea record now?
It's probably approaching 10. Oh, no, but I think if you preload with oxygen, it's different, right?
joe rogan
Oh, that's cheating.
That should be cheating.
I want to know what can a person just go and hold their breath.
And the preloading with oxygen, I think...
David Blaine did something insane.
peter attia
He went like 10 minutes or something crazy.
joe rogan
He's a fascinating guy.
peter attia
He sure is.
joe rogan
Have you ever met him?
peter attia
No.
Spoken on the phone to him.
Never met him.
joe rogan
My goodness, dude.
When you watch him do magic, you're just like, what the fuck did I just see?
How would you do that?
He did some crazy shit with us with his sleeves rolled up.
He wanted us to know that his sleeves are rolled up.
He's making cards disappear.
And Jamie and I were like, what the fuck did we just see?
Where did that go?
It's really weird.
peter attia
He is pretty amazing.
joe rogan
Beyond.
And that whole world of magicians and people who understand how to distract you in a way that you don't notice what they're doing while they're doing it, but they have this insane hand dexterity, so they're moving in a way that a normal person can't even imagine that your hands can move.
And they're shuffling these cards in front of you.
You're not even seeing what's happening.
peter attia
Did you see that movie with Hugh Jackman and Christian Bale, The Prestige?
joe rogan
What's this here, buddy?
jamie vernon
This is his post about it.
I was trying to go to the source.
joe rogan
Okay.
So this is from his Instagram.
It says, I want to share my annoying experience after vaccination and perhaps have some testimonials from similar stories from freedivers.
Did you get better?
He said, after my second dose of the vaccine...
I noticed my heart rate was way higher than normal and my breath hold capacity went down significantly during sleep I'm at 65 to 70 beats per minute instead of 37 to 45 beats per minute during the day I'm now over Wow, I'm now always over a hundred beats per minute instead of 65 Even when I sit down and relax once I even reached reached 177 beats per minute while having dinner with friends three exclamation points Ten days after my second
jab, I went to see a cardiologist and he told me it's a common side effect of Pfizer vaccine.
Nothing to worry about.
Just rest.
It will pass.
Forty days after the second jab, I had no progress.
So I went to see another cardiologist and got diagnosed with myocarditis and trivial mitral regurgitation.
Which is basically an inflammation of the heart muscle caused by the immune system and some tiny leaks of blood from the valves that no longer close properly.
I'm now struggling to reach 8 minutes breath hold, which is hilarious.
That sounds amazing.
150 meter DYN, I don't know what that means.
And even have, what is 150 meter DYN? Do you know what that is?
peter attia
I don't know if that's dying, as in, I don't know.
joe rogan
And even have a strong urge to breathe doing 40-meter dives.
30% decrease in my diving performance, roughly.
My first thought and recommendation to freedivers around the world is to choose a vaccine which is done the old-fashioned way like Sputnik, Sinovac, Sinopharm, etc., instead of the new mRNA vaccines.
It's weird because he spells vaccines wrong every time.
Does he have not spellcheck?
Is he from another country?
peter attia
Yeah.
joe rogan
Oh, so they spell things wrong.
They spell like tire with a Y in England.
What's that guy's name?
It's Mr. Ten Minutes.
jamie vernon
Florian Doggery.
joe rogan
Mr. Ten Minutes is his...
jamie vernon
I was going to say it.
joe rogan
Yeah.
unidentified
Wrong.
joe rogan
World record holder for apnea, diagnosed myocarditis and paracarditis.
jamie vernon
1031 was his time, I think.
joe rogan
1031. Jeez.
That's so long.
Meanwhile, he's complaining he can only hold his breath for eight minutes.
I'm like, bitch, that's so long.
peter attia
Stop bragging.
I was just talking about this with a friend yesterday.
I do...
A year and a half ago, I remember thinking, you know, one silver lining of COVID is going to be that science will regain its place as, you know, an important part of our civilization, right?
Like there was a day in the 1960s when a scientist and engineer was really respected and the best and the brightest kids wanted to go into those professions.
And I don't think that's necessarily the case anymore, right?
I mean, if you're a super bright kid today, you're going to go want to work at Goldman Sachs or something like that.
And I remember thinking like, God, you know, if they develop a vaccine to this and, you know, develop a vaccine in a year, which is unheard of, it's going to really impress people.
People are really going to think science is amazing.
And instead...
I think the exact opposite has happened, right?
I think that there has been a fundamental confusion between science and advocacy.
And I think it has done a huge disservice to science in the short term.
And I don't know where it's going to shake out.
I wish I had something I could go into a crystal ball and look back and say in 10 years, how will this have panned out?
Guys like this, I completely believe that and I absolutely think that there are lots of side effects to vaccines.
I still think for most people, vaccines are a net positive.
But I think that there's been so much discussion of anything that talks about anything about a vaccine that's bad, we can't talk about because we've taken this advocacy view, right?
So again, the difference is A scientific discussion is one that says, let's just talk about the facts, let's look at all of the facts, and let's speak with varying degrees of certainty and uncertainty.
An advocacy view says, I have a point of view about what is important for your health, what I believe is important for your health, and if the message is, get vaccinated, then we're going to talk about that at the expense of talking about anything else.
joe rogan
Including the negative effects of the vaccine.
peter attia
Including the negative effects of the vaccine.
Or being able to talk about it in a nuanced way.
Now, this is going to probably get me in a million piles of shit, but I'm not excited about getting my four-year-old and seven-year-old vaccinated.
Because I don't see...
So I look at everything through a two-by-two lens of risk and reward.
So you're either picking up pennies or Bitcoins, and you're picking them up in front of tricycles or trains.
So that's your risk-reward trade-off.
So if you're an 80-year-old person, getting vaccinated is like picking up a Bitcoin in front of a tricycle.
joe rogan
It's a no-brainer.
peter attia
It's a no-brainer, right?
The reward, the Bitcoin, is so worth it compared to the downside of getting hit by a tricycle, which would hurt.
If you're five years old, I mean, the risk of dying from influenza is five times higher than the risk of dying from COVID. So if we knew the vaccine was 100% safe and we had a million patients that had taken it and we could clearly document what the risk was, maybe it's worth it.
But I don't know that today.
Right?
Now, for me, yeah, it makes sense.
Like, the risk of me getting myocarditis from long COVID is higher than the risk of me getting myocarditis from a vaccine.
joe rogan
Do you think that's true still?
Because it probably was true before the advent and the use of monoclonal antibodies.
peter attia
Yeah, it's a good question.
You know, I just had a patient who got COVID two weeks ago, and so I'm one of his doctors, and then he has a primary care doctor as well.
And, you know, we wanted to put him on monoclonal antibodies.
His primary care doctor didn't want to put him on monoclonal antibodies.
Why?
His risk was too low to justify it, given the side effects of MABS, but the risk of MABS are pretty darn low.
So in the end, we get monoclonal antibodies.
joe rogan
But what is the risks?
peter attia
Oh, I mean, you can have a hypersensitivity reaction to it.
Very small risk.
And also, especially if you're monitoring a person while they're getting it, it's basically a non-existent risk.
So, you know, my view was, yeah.
And by the way, have you seen the new Pfizer drug that came out, this protease inhibitor that was just approved or given a UA? I mean...
That thing is remarkable.
joe rogan
Yeah.
peter attia
Like, stupidly remarkable.
And again, it wasn't a huge trial, so I want to see more data.
But in the roughly 2,000 people that got this that were divided into two groups, in the placebo group, so meaning the people who weren't getting an actual drug, the risk of adverse reaction was something like 6%.
In the drug group, it was 2%.
No adverse reactions.
The mortality difference was 12 people versus one people.
So it was a 91% reduction in death and about a 63% reduction in hospitalization.
This is a protease inhibitor.
So it's a slightly different mechanism from the Merck one that is a nucleotide inhibitor.
So, yeah, I mean, today, with that drug, with monoclonal antibodies, with fluvoxamine...
joe rogan
Yeah, fluvoxamine, which is fascinating, which is an antidepressant, right?
Yeah, it's an SSRI. And what is the mechanism?
peter attia
I don't know.
And that's not to say one doesn't know, but I don't know.
joe rogan
Dr. Drew was explaining it to me, but I forgot.
peter attia
I mean, we...
We became interested in it based on really early reports that suggested that it was minimizing long-term neurologic fog that some people were experiencing.
And then there was a JAMA trial and then very recently a Lancet trial that was a bigger trial, a very well-done trial.
And it, on an intention-to-treat basis, so meaning for all the people who took the drug versus those who didn't, and it's 10 days, 100 milligrams twice a day, it's about a 67% reduction in death and hospitalization.
Just from an off-the-shelf SSRI. That's fascinating.
joe rogan
So a cocktail or a stack of fluvoxamine, monoclonal antibodies, this Pfizer drug, all those things.
I had great results with the monoclonal antibodies.
All anybody focused on was ivermectin when people were upset at me.
I said that casually with a list of all the other things.
I didn't even promote it.
But for whatever reason, there's been some sort of a demonization of that particular drug.
Make of it what you will.
peter attia
Which, by the way, you know the safety profile of ivermectin, right?
I mean, it's just a horribly dangerous drug.
joe rogan
Tell me about the safety profile because it is kind of hilarious.
Tell everybody, I should say.
peter attia
Yeah, so the WHO estimates that ivermectin has been dosed 4 billion times since its inception.
Though not necessarily 4 billion people, but 4 billion doses of this drug have been administered.
And in that time, there are a total documented number of 28 adverse neurologic responses.
This is one of the safest drugs ever.
There's no antibiotic that I'm aware of that has a better safety profile than this.
joe rogan
When you saw that goofy Rolling Stone article that claimed that there was a hospital in Oklahoma and that they had gunshot victims that were waiting to get into the emergency room because there were so many people who overdosed on ivermectin, What did you think of that?
peter attia
I didn't see the article.
joe rogan
You didn't see that?
It is a 100% fake story, but Rolling Stone printed it, and Rachel Maddow tweeted it, and then doubled down afterwards, and was claiming that there was calls to poison control.
Like, which means jack shit if the drug isn't poison, you fucking idiot.
Like, it's a dumb, that's a dumb thing to say.
Like, poison control?
It's not poison.
peter attia
I mean, look, we had used ivermectin in some patients six months ago.
We don't use it today.
So we use fluvoxamine today.
And I'm waiting to see if more data emerge.
There are five clinical trials registered on clinicaltrials.gov that are looking at it.
The problem is most of the trials on ivermectin to date have been very small, and they've looked at many different things.
So when these people do meta-analyses to combine them, the trials are so heterogeneous.
So they have different endpoints.
They have different doses.
They have different durations.
They're combined with different drugs.
joe rogan
It's messy.
peter attia
It's so messy.
And then there was that one very, very fraudulent trial from Egypt.
And that really diluted things.
joe rogan
Wasn't there another one that was fraudulent?
peter attia
Possible.
joe rogan
I feel like there was one that...
I want to see.
Was it Argentina?
peter attia
There was one in Brazil that got a lot of talk, but I don't know if that was it, but...
joe rogan
So the data's messy, and it's also...
peter attia
If you look at the Andrew Hill revised meta-analysis, and I think his is probably the best, and I think it came out in August, it looked at, if you included all those studies, including the fraudulent one, it looked really good.
Ivermectin, with a p-value of less than 0.01, had a 90% reduction in hospital admission and death.
Now, the minute you stripped out that one fraudulent study, the results became way less impressive.
It went to a 38% reduction with a p-value of 0.05, which is right on the cusp of not even being statistically relevant.
joe rogan
What about in use of prophylaxis?
peter attia
That's the problem.
That study included both prophylactic use and treatment use.
joe rogan
What is more, is one or the other more promising?
peter attia
That's a good question.
I don't know what's being tested in those five studies today, but I've, so I shouldn't speak because it's just not something I'm, I don't know the data well enough.
joe rogan
What I was going to say is that the cocktail that I used, what I called the kitchen sink, was monoclonal antibodies, ivermectin, IV drips with a high dose of vitamin C, glutathione, zinc, and then I did NAD every other day.
peter attia
And you didn't do fluvoxamine?
joe rogan
No, I did not.
No.
I didn't know about it at the time.
peter attia
You should have called me, dude.
joe rogan
I should have.
I was sick and...
unidentified
September?
joe rogan
September?
unidentified
No.
peter attia
Wait, was this before your Alcon?
joe rogan
Yeah, it was before the Alcon.
Quite a bit before the Alcon.
We're in November now.
So it must have been August when I got sick.
Yeah.
Yeah, it must have been August.
But I was better very quickly.
And I think...
peter attia
How symptomatic were you?
Did you...
joe rogan
I knew when I was coming home something was wrong.
I was in Florida, which is the, you know, at the time it was a hotbed.
And I was doing arenas.
So I was doing stand-up in an arena.
And I'm doing it in the round.
And so this is what it's like.
So I'm on stage in the round.
Around me it's 15,000 people.
They're screaming.
It's a COVID cloud.
And then I go through the audience to leave.
I go through the audience to get to the stage, and I go through the audience to leave.
And as I'm walking through the audience, people are screaming, and they're high-fiving me, and they're like, thank you, thank you.
I'm shaking people's hands, and then I go into the back room.
So I did that, and then the second night, I went to a pool hall.
I met my friend John Shulman, who's like a...
A legendary pool cue maker.
And we played pool till like 3 o'clock in the morning.
3.30 in the morning.
And I had a bunch of margaritas.
I was hammered.
And I was tired.
I was really tired.
And then I started feeling like shit.
And I was like, oh my god, I feel terrible.
But I just thought I was hungover.
peter attia
Yeah.
joe rogan
And then the next day, I had a headache and I was like, ugh.
I feel like garbage.
But I didn't know if I was sick or if I was just hungover.
I thought I was just hungover.
Drank a lot of water, ate a bunch of food, had another show that night.
No problem.
Killed.
Had a great show.
A lot of fun.
Flying home, I started to feel shitty.
But again, I wasn't sure because I was pretty fucking drunk on Friday night.
And I was like, maybe that was it.
Maybe I need to just go home, get in bed, go to sleep.
But when I got home, I said to my wife, I said, I feel I feel odd enough that I'm going to separate from everybody.
And my kids were already asleep because I got home really late at night.
My wife's already had COVID and so I just avoided her and went right to bed and then I was sweating.
I was sweating in the middle of the night.
I was like, this is not good.
So then I got tested the next day.
peter attia
Are you vaccinated?
joe rogan
No.
Positive, tested, and then right after I got tested that day, I got IV vitamin drips, and then the next day, I got monoclonal antibodies.
Within a day of getting the monoclonal antibodies, I felt pretty fucking good.
That would be a Tuesday.
By the end of Tuesday, I felt pretty good.
By Wednesday, I made that video that went viral.
peter attia
Right, I remember that.
joe rogan
That was Wednesday.
So that was like three days after, and I was like, I feel pretty good.
And then by Friday, I was testing negative.
By Thursday, I tested negative on one of those over-the-counter tests, but not like a PCR. Not a PCR. Friday, I tested negative, and then Saturday, I was working out.
peter attia
I mean, I'd put, of your cocktail, to me, the Mabs were, that's the linchpin.
joe rogan
I think so, too.
That's what I've been telling everybody, that when people get sick, like, I don't know if you've been paying attention to this Aaron Rodgers thing.
peter attia
Yeah, a little bit.
Yeah.
joe rogan
He asked me what to do, and I... Look, in any other world, when a friend calls you up and you've been sick with something, you know, hey man, I got the thing that you got, what did you do that helped you?
And I said, I really think the monoclonal antibodies helped.
And I said, do you have access to those?
And he did.
And then I recommended the vitamin drips, IV vitamin drips and, you know, and be really aggressive with it.
And then I also recommended NAD and he did those and he also got better very quickly.
It shouldn't be controversial to tell someone what you did.
I'm not offering unsolicited medical advice.
I'm not telling people, do this and don't do that.
What's odd about his case is that he told people he had been, in quotes, immunized.
I wasn't aware of this until later.
He had done some sort of a homeopathic, which to me always sounds like voodoo.
When someone says homeopathic, I go, oh, you do voodoo.
I don't think that's real, right?
peter attia
One part per billion?
joe rogan
What is homeopathic?
What is that?
What does it even mean?
peter attia
It's nonsense.
It means giving a dose that is so diluted that it's non-existent and claiming that there's some benefit from it.
joe rogan
But what does it mean?
Why is it homeopathic?
What is even the definition of that?
peter attia
I don't know what the entomology of that word is.
joe rogan
Somebody gave me some homeopathic medicine once, and it was fucking sugar.
When I'm taking it, it was like these little pills.
I was like, this is sugar.
It tastes so sweet.
It seems like sugar.
And they're like, no, no, no, it's Arnica, or whatever the fuck it was.
And I was like, bro, this is sugar.
This is not fixing anything.
But anyway, he did some protocol that some homeopathic doctor put him on.
I don't know what the protocol was.
I don't know if that would even...
How could you even do it?
Like, what could immunize you?
So he was telling people he had been immunized.
peter attia
He was given one copy of the virus.
joe rogan
Right.
I don't even think he was given that.
But he has an allergy to...
What is this stuff called again, Jamie?
Is an allergy to...
It's an ingredient that is in the mRNA vaccines that specifically says on the CDC website that if you have this...
I have it in my phone...
If you have this allergy, you actually should not take the mRNA vaccine.
It says it on the CDC website, in which case he would have to take the Johnson& Johnson.
peter attia
Yeah, so why didn't he take that one?
joe rogan
I don't know.
I think he was worried about blood clots because it was like right around the time where people got blood clots, where they pulled it for blood clots.
peter attia
Which is so ridiculous.
I mean, there's another reason.
Yeah, six people.
Six people out of, I mean, I don't remember.
I did the math on it at the time.
I mean, it was just another example of failing to basically communicate nuance.
joe rogan
Is that what all it is?
peter attia
Yeah, totally.
joe rogan
Now, when it comes to VAERS, like VAERS reports, like how underreported are they?
peter attia
It's a good question.
I mean, I think they're more reported now because I think we're realizing that there could be more things going on, right?
Like at the time, put it this way, when a drug hits the market, the insert, the package insert basically says, these are the side effects we saw in the trial.
These are the things you should be aware of.
Well, at some point, the real world application of that is going to be greater, meaning the number of people that take it is going to be greater than what you see in the clinical trial.
So We should see more side effects as time goes on.
And obviously it's important that they're all reported because most of them are probably unrelated to the drug.
I mean, we know that from clinical trials.
Like if the placebo people are having more reactions than the drug people, but only by kind of capturing all of them will we see if a pattern's emerging.
I think that's, I don't know.
I mean, that to me is what's disappointing in all this is just that somehow this has turned into anything that questions the safety of this or the benefit of that somehow means you're anti that.
I mean, I'm a very pro-vaccine person, but I still think to not ask the questions about the risk versus reward trade-off.
Financial Times did a really nice analysis a few months ago that plotted by decade what the risk reduction was from the vaccine.
So if you were 85, it took you from a risk of 2% down to a risk of 0.05% or something like that.
And it did this if you're 80, 70, all the way down to 20%.
And the first thing that jumps out at you, so their purpose of doing this analysis was to show that an immunized 80-year-old has the same risk as an unimmunized 50-year-old, which is pretty cool, because a 50-year-old's in pretty good shape.
So if you're 80 and you get the vaccine, you're now like a 50-year-old walking around.
But two things I found interesting about this.
The first was everybody experienced about a 1.5 log reduction in risk.
So a log is 10x.
Two log is 100x.
So 1.5 log, just call it directionally, a 20x reduction in risk.
So at the surface, that says everybody should get vaccinated because the risk is always a 20x.
But if you don't know the harm of the thing...
Then that risk at some point won't be worth it.
The risk reduction.
Because a 20x reduction when you're starting at 2% means you only need to treat 100 people to get the benefit.
But if you're a 40 year old or a 30 year old And your starting point of risk is so low, a 20x reduction requires you to treat 10,000 people to see a benefit.
So at some point, these curves intersect.
The curve of risk from the vaccine and the curve of benefit from the vaccine.
joe rogan
And that's where children come into play.
peter attia
And that's where, by my math, below the age of 13, I'm having a hard time seeing the data with the limited data set we have.
joe rogan
I only have anecdotal evidence based on my own children.
They both got COVID and it was nothing.
I know that children have died from COVID, but I also know that those children, almost all of them, had pretty severe comorbidities.
peter attia
Yeah, I mean, I don't know the latest data.
I know the New York database, which, you know, again, we're talking about, I mean, kids are dying way more commonly from influenza, from rotavirus, from other things like that.
So again, look, if in a year we have enough evidence where that vaccine is just as safe as the MMR vaccine, great, let's do it.
I'm just saying, like, it's not as pressing as it was for someone I thought even though my risk from dying of COVID was really low, I was more concerned with sort of the comorbidities of COVID. Right.
joe rogan
There's been talk of people getting vaccinated and then catching COVID afterwards being one of the best ways To get really strong immunity.
Because if you get vaccinated, you have a protection from death and hospitalization.
And then if you get COVID, then you get the much more robust immunity that's imparted by the actual natural immunity from the infection.
peter attia
I think probably you're also getting, vaccines are, depending on which one you get, are typically highlighting B-cell or T-cell response.
So the mRNA vaccines are really good at inducing B-cell immunity, which is antibody-based immunity.
The adenovirus vaccines are better at inducing T cell immunity.
Totally different type of immunity.
joe rogan
What is more effective at stopping the virus?
peter attia
It's not clear, but my two cents on this as a former immunologist, but speaking like out of his ass a bit, is I think the best way to vaccinate will be one of each.
I think that if you got an mRNA vaccine, and we don't have data on this yet, but I hope that we do have data to test this hypothesis.
joe rogan
So you would get like one shot of the J&J, wait a while, and then one shot of the Pfizer.
peter attia
Exactly.
So my plan is to probably wait until Novavax gets approved in the U.S. before I get a booster and then boost with that or J&J. And what is Novavax?
I think it's an adeno.
joe rogan
What's the difference between that and the adeno that we have now?
peter attia
It just seems more effective.
So if you look at the European data, it seems more effective than even the mRNA vaccines.
joe rogan
Now, when you see people getting myocarditis and pericarditis and strokes and what have you, do you think some of that has to do with not aspirating?
Like, if someone is shooting the vaccine directly into a vein inadvertently because they didn't aspirate, do you think that that could be causing some of these side effects?
Because even when they did Joe Biden on television, they did not aspirate.
And I was shocked.
I'm watching this.
I'm like, I can't believe they just shot that into his arm.
Like, that's crazy.
You're supposed to aspirate, correct?
peter attia
Yeah, although typically with these intramuscular injections, they don't really aspirate.
I mean, you know, I remember the first time I would teach a patient how to inject testosterone, for example, if they're doing it in the upper part of their glute, which is where you're supposed to do it, I would say, look, there's enough blood vessels there and it's a big enough needle, even though it's like a 23 gauge or maybe a 25, just do a quick aspiration.
Typically, in the deltoid, you know, there's not really huge blood vessels there, but I don't know.
I mean, that's an interesting hypothesis.
joe rogan
Yeah, because it's a limited number, right?
And if this stuff is causing this problem, like, why is it causing this problem with some people and not others?
And if you're supposed to aspirate, but no one does, like, is that, I mean, there are blood vessels there, right?
peter attia
Yeah, I mean, they're tiny at that point, right?
Because they're typically jabbing you with a little needle like this.
What's more interesting is, has anybody looked at the amount of muscle mass in the different people who are getting this?
In other words, are you more likely to get this?
Are you less likely to get it in a muscular person because there's such a big target and you're almost guaranteed to be putting it right into the muscle?
joe rogan
That's an interesting question.
That makes more sense.
That actually does make sense, right?
peter attia
Again, it's wild speculation, but worth testing.
joe rogan
To me, when I hear about therapies now, I feel like it's a shame that the only thing that gets discussed is the vaccine.
And in particular, wanting people to get vaccinated that have already recovered from COVID seems asinine to me.
It doesn't make any sense.
When we have these therapies that are available, these therapeutics, whether it's the new Pfizer stuff or for sure the monoclonal antibodies, which are very effective, why would anybody be continually pushing the vaccine on people who have already had COVID and recovered?
peter attia
I don't know.
And I think what's even more hard for me to understand is why people are still being told to wear masks.
I mean, it's so logically inconsistent with what is so obviously inevitable.
SARS-CoV-2 is never going away.
It's never going away, right?
In 50 years, this virus in one form or another will be a part of our ecosystem.
So when I see the head of the CDC talking about the importance of wearing masks, I'm saying to myself, is the implication of what you're saying that we will wear masks forever?
Because if it's important to wear a mask today for some reason that I can't understand, it will presumably be just as important in 50 years.
So is that just the new world order?
Masks everywhere?
I'll never be able to go to an airport again without wearing a mask?
You know, I mean, we should just accept the fact that this virus is here to stay.
So let's worry more about the resilience that we're going to develop around this, as opposed to, quote unquote, containment.
joe rogan
Do you know Naval?
He tweeted something I thought that was very appropriate.
He said, this pandemic is not going to end when everyone is vaccinated.
It's going to end when everyone's infected.
peter attia
Everyone will be infected.
There's zero doubt in my mind everyone will get this virus.
joe rogan
And you haven't gotten it yet?
peter attia
Not to my knowledge.
joe rogan
Have you checked your antibodies?
peter attia
Oh, yeah, yeah, yeah.
Constantly.
joe rogan
Yeah?
unidentified
Yeah, yeah, yeah.
peter attia
I get tested all the time for whatever reason.
I mean, gonna get tested again tonight.
I got tested here.
I'm gonna go get tested in an hour.
unidentified
Oh, that's right.
joe rogan
So you're gonna go to, you're going to Formula One in Brazil?
peter attia
Yeah.
joe rogan
Wow, you're wild, man.
peter attia
Oh, Brazil's an amazing circuit.
joe rogan
Oh, I've been to Brazil.
You've been to Aerolagos?
I've never been to the circuit, but I've been to Brazil for the UFC multiple times.
Yeah, yeah, yeah.
peter attia
How did you like the F1 here this year?
joe rogan
It was pretty wild.
peter attia
Have you been to many races?
joe rogan
No, that's the first one I've ever been to.
peter attia
What corner did you sit at?
joe rogan
I can't imagine that—I don't know.
I was in the Goldman Sachs fucking thing.
But I can't imagine that this is the only Formula One race course in America.
peter attia
It's the only built-for-purpose one like this.
I mean, the U.S. almost has always had a Grand Prix.
joe rogan
But they do it in streets, right?
peter attia
Yeah.
Or Watkins Glen was an actual circuit or street circuits.
But Coda's amazing.
I mean, that was sort of one of the huge perks of moving to Austin for me was to have this circuit in my backyard.
joe rogan
Well, you're a freak when it comes to racing.
I mean, you love that shit.
That is your thing.
peter attia
I freaking love it.
Look, my son is named after the greatest driver of all time.
joe rogan
What's your son's name?
peter attia
My youngest son is Ayrton.
joe rogan
Oh, Ayrton Senna.
unidentified
Yeah.
joe rogan
Okay.
I watched that documentary on him.
peter attia
Amazing.
joe rogan
It's wild.
Yeah.
The video that you were showing me today of your little Formula One car.
peter attia
That's Formula Three.
joe rogan
Formula Three car, whatever the fuck it is.
That thing, that little tiny car that you're whizzing around in, that's a wild video.
peter attia
I mean, it is...
joe rogan
Where do you store that thing?
Do you have that at your house?
peter attia
No, no, no.
So I actually rent that car from a guy who has it stored in Houston.
Because the real thing with those cars is you have to have an amazing mechanic.
Like you have to have a person who...
Because you're always fixing something in those cars, right?
They're not that expensive to buy, but they're expensive to run.
joe rogan
Right.
peter attia
It's not just the tires.
It's like, I mean, just the other day, that video from that day, I mean, like the auto blip stopped working.
So the first session I was out there, you know what auto blip is, but just for someone listening.
So when you're downshifting a manual car, you have to rev match.
You have to be able to As the clutch is in, you have to be able to hit the throttle a little bit so that the RPM goes up.
And then as it's winding its way down is when you want to drop the gear so that you've rev matched so that you don't engine brake and unnecessarily slow down.
So in formula cars, they auto blip because you're using paddle shifters now.
And that means anytime you do a downshift, the sensor knows it and just hits a little blip.
So I'm out there driving and like at the high gears when I'm going six to five and five to four, it's working.
But when I'm going three to two, I'm not shifting.
I'm just staying in third.
And it's like there's enough slow corners at Coda where it's a total disaster.
Like the guys behind me are going to bump into me because I can't accelerate off the line.
So after two sessions of this, we're looking at the telemetry, we're looking at the data to see, why am I not doing this?
And we can't figure it out.
We're like, maybe I'm, you know, I'm thinking I'm making a mistake.
And then we finally figured out, no, the auto blip sensor stopped working.
joe rogan
They use auto blip on a lot of new cars, like new manual cars.
peter attia
Yeah, yeah, yeah.
And Formula One cars are all auto blip.
Which is interesting because when I learned to drive paddle shift, I always blipped myself because you left foot brake.
joe rogan
So you heel toe.
peter attia
No, you don't have to.
In my MX-5, I have to heel toe because I still have a clutch.
joe rogan
Oh, okay.
peter attia
In the Formula car, you only need the clutch to get into first gear and reverse.
Once you're into first, you don't need to clutch anymore, so I left foot brake.
joe rogan
Oh.
Boy, my left foot is a dummy.
My left foot, I've tried to hit the brakes before.
My left foot's like...
peter attia
I have no nuance with my left foot.
joe rogan
It's...
peter attia
On a street car, I still right foot brake.
And anytime I try to left foot brake, I do the same thing.
I'm like, dude, what is wrong with you?
joe rogan
It's so bad.
peter attia
It's crazy.
But somehow in a formula car, I feel very comfortable left foot braking.
joe rogan
Maybe it's just like your brain tells you, we're racing now.
We're on a racetrack.
Because when I try to hit the brakes with my left foot, I'm like, you don't know what you're doing.
peter attia
Well, you just don't have the feel for it.
joe rogan
I know, but it's crazy how bad it is.
Because my right foot is so adept at it.
peter attia
But I have a simulator too, so most of my reps are in a simulator.
joe rogan
Well, yeah, you have this amazing system at your house, and I'm very jealous.
I need to get one of those.
peter attia
Dude, I have a new one.
You should come over and check it out.
joe rogan
I'm scared.
I'm scared I'll be fucking racing with you.
peter attia
You don't get motion sick, do you?
joe rogan
No, I don't.
peter attia
Because that's the only thing.
I have put friends in there, and they get sick as shit.
joe rogan
Oh, that sounds awesome.
No, I don't get motion sick, luckily.
But that system that you have, like, I should tell everybody, Peter has this thing where you have, like, a steering wheel that's a yoke, right?
Which is, by the way, I have that on my Tesla.
I'm getting used to this yoke, which is...
peter attia
It's a formula wheel, yeah.
joe rogan
I'm not a fan for a fucking street car.
I think it's goofy.
But that's how the car comes.
Yeah, yeah.
But then you have this huge screen that's kind of curved, right?
Is it curved?
peter attia
I have three screens that are wrapped around me, yeah.
joe rogan
And then you have a real clutch and a real brake and a real accelerator.
So you're treating this like you're essentially seeing a very close simulation to what you would be seeing on a racetrack.
peter attia
Yeah.
I mean, the simulators come in all shapes and sizes.
You can spend a million dollars on a simulator, right?
If you're a Formula One team, that's what they're spending, right?
The F1 teams have million-dollar simulators.
joe rogan
What does that look like?
peter attia
It's a real car, and it has six degrees of movement.
So it moves this way.
joe rogan
Oh my god, pull that up.
peter attia
It moves up and down, and it moves this way.
joe rogan
Oh boy, so you get to simulate every aspect of it.
peter attia
That's right.
joe rogan
So it's like a flight simulator for a combat pilot.
peter attia
That's right.
So you've got that end, right?
joe rogan
And what is the visuals?
What are they seeing?
peter attia
It's still three screen.
So VR, last year I... No, actually earlier this year I did the VR experiment.
So I bought the four best VR devices on the market.
Like I said, cost is irrelevant.
I don't care.
Just let me get the best four.
Tried each of them out.
Total garbage.
joe rogan
Really?
peter attia
Yeah, total crap.
unidentified
Return them all.
joe rogan
For someone like you that knows how to race?
peter attia
No, no.
I think for any car simulator.
joe rogan
So this is it?
Whoa!
So this does not look like three screens.
This is like a giant screen.
peter attia
This isn't typically the ones that...
joe rogan
This is fucking wild.
So this seems like this guy is really driving.
peter attia
Oh, he has one huge curved screen, yeah.
joe rogan
That is wild.
That's a million dollar racing simulator, it says.
So he's got the full cage, he's in a car.
Oh my god, this is fucking incredible.
This is incredible!
peter attia
It's insane.
joe rogan
You can never have too much money, Peter, because this is one of the things you want.
peter attia
You know what's funny about this simulator, or these ones in general, is the size of the room you need to put them in.
joe rogan
So this guy's experiencing shake in his hands and everything.
peter attia
Oh, as do I. So that's the thing I was going to say.
So you don't have to spend a million dollars to get a really good simulator, right?
If you go away from motion, just the pedals, the wheel, and the belts can provide a ton of sensory feedback.
joe rogan
But it feels like that would really make you a better racer.
Hit that shit again.
Let me see that from the beginning again.
Just take it back to where it was or anywhere.
When I'm watching this guy do this, it's like, that seems like, when you're looking at it through his POV, that seems like that would really make you a better racer.
Like, look at that.
That's wild.
It seems like you're racing.
peter attia
The sim is everything.
joe rogan
And the sim is calculated to the grip of the tires and the amount of g-force you can generate?
peter attia
The software I'm using is so good that when I get in the car and pull out and do an outlap, it knows the tires are cold.
If I push it, I crash.
joe rogan
That's crazy.
peter attia
Oh, yeah, yeah, yeah.
And not only that, it has built-in tire wear.
So, for example, if I'm driving the McLaren MP430, which is a Formula One car in the simulator, it has the Pirelli softs on it.
I know that the first three laps, I can't go very fast.
I have to get temperature in the tire.
I hit my peak time, laps four through seven, and then the tire degrades.
unidentified
Wow.
peter attia
Yeah, it's just, it's super precise.
joe rogan
So then what do you do?
You pull in and restart the game?
peter attia
Yeah.
joe rogan
Restart the simulator rather?
peter attia
Yeah.
Or I just drive cars with tires that have a longer life so I can get 15 laps or 25. There's some tires I can get 35 laps out of.
joe rogan
But they will have a commensurate- But they have lower performance.
Yes.
unidentified
Wow.
peter attia
You won't have peak stickiness.
joe rogan
That's crazy that it's just like the actual tire in the real-world application.
peter attia
You adjust everything.
We adjust the light.
So, for example, at Coda, if you ever run first thing in the morning, when you're going into turn six, you're freaking blind.
So I want to simulate that.
So I will tell it, show me sunrise.
Let me go do 10 laps at sunrise.
And I have to now pick new reference markers to turn because I know I can't see turn six and I can't see turn...
Actually, late in the day, you can't see turn 10. You have to take turn 10 blind at sunset.
unidentified
No!
peter attia
Yeah, you have to take turn 10, which is, by the way, a flat-out corner blind.
joe rogan
Oh my god, that's so crazy.
Now, are you wearing glasses?
peter attia
No, I'm just in my monitors.
joe rogan
But when you're driving, are you wearing any kind of sunglasses?
peter attia
I just have a visor, and I have multiple visors.
joe rogan
Is the visor...
peter attia
It's UV protectant, but I generally like wearing my clear visor, not my blacked-out visors.
joe rogan
Because you just want to be able to see everything.
peter attia
I want maximum acuity, yeah.
unidentified
Wow.
peter attia
Yeah, this is the one that I normally used to see.
joe rogan
Okay, this one's bullshit, though.
peter attia
That one depends if it's moving.
joe rogan
Oh, see, this one I know that I'm in a race simulator.
This one's fucking weak.
peter attia
But you're still getting a ton of value out of this because, remember, the big part of the simulator is learning the track, is learning the line, and learning the steering control and the throttle control.
unidentified
Well, this looks pretty dope right here.
joe rogan
It's enough.
It'll get you enough.
So it's like you're looking through a weird windshield or something.
peter attia
Yeah, the problem with VR... That's 2009. Is it just...
Yeah, that was the Williams FW16. That was the FW16, yeah.
So the refresh rate is not fast enough and the resolution's not high enough.
So it's...
I think VR is probably awesome for a flight simulator because things aren't moving that fast in a flight simulator.
Even though you're traveling fast, your relative distance is not.
But in a car...
You know it's like driving a car fast.
Things are happening like that.
joe rogan
What kind of refresh rate are those monitors?
peter attia
My monitor is refreshing at 320 frames per second.
joe rogan
Wow.
It's not in Hertz?
peter attia
Well, Hertz is...
joe rogan
That's what it is?
Hertz is frames per second?
peter attia
Hertz is 1 over 60, but yeah.
joe rogan
Oh, okay.
peter attia
They talk about it in frames per second.
joe rogan
So it's smooth, even though you're...
peter attia
I can run...
With my computer, I can run at the maximum capacity of the simulator.
unidentified
Wow.
joe rogan
That's wild.
peter attia
But what do I not have?
I don't have movement.
I don't have yaw.
joe rogan
Right.
peter attia
And yaw is the single most important feeling for a driver to develop.
joe rogan
The ability to recognize the G-force on your body?
peter attia
No, it's the ability to know the difference between front and rear grip.
joe rogan
Oh, and the simulator doesn't have that?
peter attia
Mine does not.
If I want that, I have to spend 10 times as much.
joe rogan
Okay, so that's those million-dollar ones.
peter attia
So for me, I know that I'm oversteering only by vision.
unidentified
Oh.
peter attia
So if I'm driving the carousel at Coda, right, and that's a corner where you, in a high downforce car, can go flat out.
You can be pedal to the metal around 16, 17, 18 of Coda, that curve at the end.
But in most cars, you can't.
And in the Formula 3 car that I showed you the video of, you can't be flat out in that corner.
It doesn't have enough downforce.
joe rogan
And you judge the grip of a car, the ability around a corner.
It's based on feel, correct?
unidentified
Yes.
joe rogan
And that's what's missing from the simulator.
peter attia
So what happens in the simulator is I'm pushing.
How hard can I go?
And I know I've gone too far when I see, uh-oh, my back is spinning out from under me.
The problem is...
That's happening a split second after I would have felt it.
So in the simulator, it's actually harder to correct oversteer than in a real car.
joe rogan
So it's only giving you like 70% knowledge or something like that.
peter attia
When it comes to oversteer.
Understeer is different.
Understeer is a visual thing.
So the simulator is perfect for understeer, but it is limited in oversteer.
joe rogan
Wow.
There's too many things in this world.
You could get really excited.
You are like me, that you don't want to try to play golf for the same reason.
peter attia
I'm never going to play golf.
joe rogan
Well, I see how you've taken to bow hunting, and I see how you've taken to racing.
Yeah, there's too many things in this world.
I should probably wrap this up.
We're more than three hours in.
Isn't that wild?
Fucking time warp in this room, right?
peter attia
It's the lack of light.
It's like a casino.
No windows.
joe rogan
It's a little bit of that, but it's just an interesting conversation, you know?
peter attia
How do you like this studio?
I love it.
Compared to your last one.
joe rogan
Yeah, the last one, which is right next door.
peter attia
No, no, I mean the one in LA, I'm sorry.
joe rogan
Oh, this is like the same.
It's not much different in terms of like the inside of it.
I like this one better than the one that I had in LA. But in terms of the studio space, like where I'm at, Now that I'm putting a gym here, it's great.
I loved having the gym there and having a sauna.
peter attia
Are you going to bring the archery simulator thing?
joe rogan
Yep.
Yeah, I'm going to bring that next time.
peter attia
I want to try that.
joe rogan
Yeah, it's fun.
You'll love it.
peter attia
You don't shoot your arrow, do you?
joe rogan
Yeah.
You shoot everything, you just take out your regular field tips for a flathead tip that looks like the head of a nail.
peter attia
Okay.
joe rogan
And you're shooting it into a Kevlar screen.
And it's all HD animals roaming around, and they scream, and they do everything, like the elk bugle, just like a real elk does.
It's amazing.
Yeah.
unidentified
All right.
joe rogan
Yeah, you'll love it.
I'll get that in soon.
Next time you're here, we'll do that.
peter attia
Awesome, man.
joe rogan
Thank you, brother.
I appreciate you.
peter attia
Thank you, Jamie.
joe rogan
Tell everybody your Instagram and all that jazz.
peter attia
Peter Atiyamd.
joe rogan
A-T-T-I-A-M-D. A-T-T-I-A-M-D. That's Instagram and Twitter as well.
Same thing.
peter attia
And the podcast is The Drive.
joe rogan
The Drive.
And that's on everything?
peter attia
Every single Monday, all on health and longevity.
unidentified
All right.
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