Joe Rogan Experience #1108 - Peter Attia

1. 0:02 – 0:46

   The Maui–Lanai round-trip swim: why attempt something that extreme?

   1. JRJoe Rogan0:02

      Four, three, two, one. (claps) Hello, Peter.

   2. PAPeter Attia0:07

      Hello, Joe.

   3. JRJoe Rogan0:07

      What's going on, man?

   4. PAPeter Attia0:09

      A lot.

   5. JRJoe Rogan0:10

      You were just telling me something that wa- is one of the most ridiculous things I've ever heard, that you swam from Maui to Lanai.

   6. PAPeter Attia0:18

      Right.

   7. JRJoe Rogan0:18

      And you're the one- only human to ever do that.

   8. PAPeter Attia0:21

      I'm told I was the first person to swim from Maui to Lanai and back.

   9. JRJoe Rogan0:26

      Oh.

   10. PAPeter Attia0:26

       The- the one-way is a pretty famous swim race that's done every year.

   11. JRJoe Rogan0:30

       You're the first person to do it-

   12. PAPeter Attia0:31

       The round trip.

   13. JRJoe Rogan0:31

       ... and go back? Fuck, dude. Why'd you do that? (laughs)

   14. PAPeter Attia0:36

       How long you got?

   15. JRJoe Rogan0:37

       (laughs)

   16. PAPeter Attia0:37

       (laughs)

   17. JRJoe Rogan0:38

       "It started when I was a boy. They told me I couldn't do it."

   18. PAPeter Attia0:40

       (laughs)

   19. JRJoe Rogan0:42

       (laughs) What- what made you wanna do that? It's a ridiculous proposition.

2. 0:46 – 1:59

   From non-swimmer to Catalina: the Penny Dean inspiration and rapid progression

   1. PAPeter Attia0:46

      Um, so I got into ... I decided in ... (laughs) This is gonna sound silly. I read a book in January of 2004 about this woman named Penny Dean who, uh, still to this day holds the record for the fastest crossing of the Catalina Channel, so swimming from Catalina Island to San Pedro or, uh, or, uh, to, uh ... Not, you typically swim to Point- Point Vicente. And she had done it in, like, seven hours and 20 minutes, and I was like, "That's amazing. I want-"

   2. JRJoe Rogan1:14

      How far is that?

   3. PAPeter Attia1:16

      As the crow flies, it's 21 miles.

   4. JRJoe Rogan1:18

      Whoo.

   5. PAPeter Attia1:18

      With the currents it's a little longer. And I was like, "You know, I really wanna do this, um, but I- I gotta learn how to swim first." That seems-

   6. JRJoe Rogan1:26

      So that's three miles an hour swimming?

   7. PAPeter Attia1:28

      She is a phenom. Penny Dean had a stroke rate of 90 strokes per minute, which, I mean, I know that might not mean anything to someone who doesn't swim, but like, to turn, to have a hand hit the water every, you know, third of a, two thirds of a second is a remarkable pace.

   8. JRJoe Rogan1:45

      That's insane.

   9. PAPeter Attia1:45

      Yeah, I- I can't hold a cadence of that for 100 yards.

   10. JRJoe Rogan1:49

       Wow. And she did it for 20 miles?

   11. PAPeter Attia1:52

       Yeah.

   12. JRJoe Rogan1:52

       What a beast.

   13. PAPeter Attia1:53

       She's outta control.

   14. JRJoe Rogan1:54

       (laughs)

   15. PAPeter Attia1:56

       Yeah.

   16. JRJoe Rogan1:56

       There's certain people like that, man, that freak me out.

3. 1:59 – 8:57

   Why marathon swims feel transformative: pain, darkness, and “emotional acceleration”

   1. PAPeter Attia1:59

      I- I think, I think marathon swimming might be one sport where if- if you just look at the numbers, I think women are better than men.

   2. JRJoe Rogan2:06

      Mm. Well, there's that woman who swam from Cuba to the United States, right? She was the first person ever to do that.

   3. PAPeter Attia2:10

      Yeah, Diana Nyad.

   4. JRJoe Rogan2:11

      And she, didn't she do it, like, at a fairly advanced age?

   5. PAPeter Attia2:14

      Yeah. I mean, she's of course got an amazing pedigree of swimming, and-

   6. JRJoe Rogan2:17

      Right.

   7. PAPeter Attia2:17

      ... this wasn't her first rodeo.

   8. JRJoe Rogan2:18

      Right, right, right. Why- why do you think women are better than men as that?

   9. PAPeter Attia2:22

      I- I mean, those of us that ... I- I'm not a member of this community anymore, but when I was, it was one of our favorite topics of discussion. I think, uh, think opportunities or ideas that were put forth were higher pain tolerance, something about being, you know, evolving to be able to give birth-

   10. JRJoe Rogan2:39

       Mm.

   11. PAPeter Attia2:40

       ... um, just means they can tolerate pain a lot higher. Um, I think another thing I've heard is buoyancy. You know, women are naturally gonna have more body fat, which provides insulation. When you do these swims, you're not allowed any wetsuits or aids of any sort. So-

   12. JRJoe Rogan2:55

       Just shorts.

   13. PAPeter Attia2:56

       You're, like, you're in a-

   14. JRJoe Rogan2:57

       Swimsuit.

   15. PAPeter Attia2:57

       ... Speedo and a-

   16. JRJoe Rogan2:58

       Right.

   17. PAPeter Attia2:58

       ... single latex cap and that's it. And so if you can have a little ... And- and so I think women's hips, because they're gonna have more fat on their hips, they- they ... It corrects one of the big buoyancy issues that we have in swimming.

   18. JRJoe Rogan3:10

       Mm.

   19. PAPeter Attia3:10

       We- we- we didn't evolve to swim. We're horrible at it naturally, um, because we swim like this. We drag our hips through the water.

   20. JRJoe Rogan3:17

       Mm-hmm.

   21. PAPeter Attia3:18

       And if you think about the importance of aerodynamics in most of the things that we think about, whether it be archery or race car driving or cycling, you know, in water it's that much more important 'cause the density of water is, you know, thousands of times greater than air. So swimming is just 100% about avoiding drag.

   22. JRJoe Rogan3:37

       Wow. So the ... Well, that totally makes sense. Um, I just have been fascinated forever with people that are capable of pushing their brain to do things that other people just don't think are possible, like a, you know, Big Foot 200 race or-

   23. PAPeter Attia3:52

       Mm-hmm.

   24. JRJoe Rogan3:53

       ... like a- any of those things. But the swim one is particularly crazy because you can't stop.

   25. PAPeter Attia3:59

       Right.

   26. JRJoe Rogan3:59

       Right? Like, if you're running an ultra-marathon and you just wanna sit down for a couple minutes and just take a break, you can do that. But if you're swimming, there's not-

   27. PAPeter Attia4:08

       You've gotta, the- the-

   28. JRJoe Rogan4:08

       ... a damn thing you can do.

   29. PAPeter Attia4:09

       You could tread water is about as good as it gets.

   30. JRJoe Rogan4:11

       (laughs)
4. 8:57 – 11:49

   Navigation, currents, and the real distance: why channels don’t swim straight

   1. JRJoe Rogan8:57

      Yeah. Yeah. I can't imagine. That's a g- ... So now that you've done ... And how many of these have you done, these crazy swim races? Or swim ... What would you call them?

   2. PAPeter Attia9:06

      I mean, se- several. Yeah, they're, the ... Usually, these major, major ones are not races.

   3. JRJoe Rogan9:10

      Right.

   4. PAPeter Attia9:10

      You, you're, you're on your own. You have to ... You go to the federation that oversees that body of water and you say, "Hey, I wanna do this." And then you, you know, you go through all the channels to do it. Like, they have to have an observer there and they ... You follow these official rules.

   5. JRJoe Rogan9:22

      So that you can be registered as someone who's actually completed it.

   6. PAPeter Attia9:25

      Right. And someone's there to make sure you didn't, you know, you did it correctly. Um, I don't know. I've probably done, all in, probably like a dozen of these, but probably like six of them really long ones.

   7. JRJoe Rogan9:37

      What's the longest?

   8. PAPeter Attia9:39

      Well, I th- ... That's a good question. The long-

   9. JRJoe Rogan9:41

      What is the m- ... The Maui one was 20 miles there and back, so 40 mer- miles total?

   10. PAPeter Attia9:45

       N- no, no, no. It's, uh-

   11. JRJoe Rogan9:46

       Or no, 20 total?

   12. PAPeter Attia9:46

       The Maui channel is a 10-mile channel, so round trip is 20. The bigger question is time in the water, because you rarely get to swim these in a straight line. So the Maui-Lanai one, I wanted to go Maui, Lanai, Molokai, Maui, to do the triangle.

   13. JRJoe Rogan10:01

       Mm-hmm.

   14. PAPeter Attia10:02

       And that would've been 30 miles as a crow flies. But we just, you know ... Boat captain wasn't willing to do it at night 'cause of the tiger sharks. And during the daytime, we couldn't physiologically figure out how one could f- uh, suffer against those, the wind. 'Cause the wind gets so brutal in the middle of the day. So even the one that I did, which was just the there and back, I ended up swimming for 12 hours because on the, the, the first way crossing where there was no wind, it took me four hours. And then it took eight hours to get back because I was swimming like the hypotenuse of a triangle, right? Like, the-

   15. JRJoe Rogan10:38

       Mm-hmm.

   16. PAPeter Attia10:38

       ... current's going this way, so I had to swim this way just to go in a straight line. And I still couldn't. I almost missed Maui.

   17. JRJoe Rogan10:47

       Jesus Christ.

   18. PAPeter Attia10:47

       So I almost got swept out to Molokai just because the current was about 1.7 knots, which is about as fast as I can swim. Maybe two knots.

   19. JRJoe Rogan10:57

       Fuck! (laughs)

   20. PAPeter Attia10:58

       (laughs)

   21. JRJoe Rogan11:00

       That is a ridiculous thing, man. Why are you doing this? This is-

   22. PAPeter Attia11:04

       (laughs)

   23. JRJoe Rogan11:04

       This is maniacal.

   24. PAPeter Attia11:06

       Well, I don't do it anymore.

   25. JRJoe Rogan11:07

       Right.

   26. PAPeter Attia11:07

       I mean, it, it was certainly, uh, it was an amazing season of my life, but I think ... Once my daughter was born, which was 10 years ago this summer, that's when I ... I only probably did two of these after she was born, because then the training just got so ... I just ... You gotta live in the water if you wanna do this sport. Like, you gotta ... E- including the winter, you know, like, you know. Even in San Diego where I live, it's still, you know, 55 degrees in the water and you're gonna spend three, four hours a day in the water, freezing, you know. It was just, uh, so I was like, you know, I just don't have the, the, the drive to spend 25 hours a week swimming.

5. 11:49 – 20:34

   Shark reality in open water: attacks, near-misses, and deterrent tech

   1. JRJoe Rogan11:49

      Yeah, what was the ... What was going on in San Diego when that guy got bit in half by a shark couple years back? They were training for something.

   2. PAPeter Attia11:56

      Yeah. That's a, it's funny, funny you remember that. That was May of 2008. I remember that like it was yesterday. So at the time, I lived in San Francisco. And this is actually just before I swam the Maui thing. Now that I think about it, that was 10 years ago. I swam the Maui thing in, uh-... June of '06, uh, June of '08. So I'm doing all my training in a swimming pool up in San Francisco because I don't want to acclimate to very cold water. I actually wanna be in warm water. But I needed one long ocean swim of like 14 or 15 miles as my, like, last training swim. So I came down to San Diego to do it. And just by bad luck, I came down a few days after that guy was killed. Now, this was a, a guy, I didn't know him, but he was a triathlete training with a triathlon group that they would go out and swim every morning. And I know the beach exactly where it happened in Solana Beach. And, um, unfortunately like most people who get attacked by great whites, they have a very ... They, they always attack the same way, which is below and behind, stealth bite, up and, and then they, they retreat. So they're trying to basically injure the prey so that their prey exsanguinates and then they take off and then they wait till you bleed out. So they never saw the shark, but you could tell from the bite marks it was. Um, I actually had a friend who was on the beach and saw him when he came out, and he was basically dead when he got to shore. He had, he had bled to death. The, the problem is ... So in this case, the shark had bit him and cut through his femoral arteries and veins. And the salt water prevents you from having any homeostasis, so it exacerbates the blood loss.

   3. JRJoe Rogan13:29

      Whew.

   4. PAPeter Attia13:30

      So that's generally how folks perish when they're bitten by great whites.

   5. JRJoe Rogan13:34

      How did they get him out of the water?

   6. PAPeter Attia13:35

      Um, a, you know, a bunch of other swimmers came to his rescue and luckily that commotion prevents the sharks from wanting to come back. So, so three days later I go out and I'm swimming at that beach, 'cause I swam from ... My, my training swim was La Jolla up to Solana Beach and back. And I gotta tell you, like three days after a guy dies where you're swimming, it is, it was about one of the most (laughs) uh, mentally challenging training swims to be like ... 'Cause you can't see, like the water at that part of the beach is so murky, you know, and you're only a couple hundred yards offshore that, like you can barely see your hands when you're swimming. Um, and so you're just thinking, "Is this the day?"

   7. JRJoe Rogan14:20

      Oof. Dude.

   8. PAPeter Attia14:22

      (laughs)

   9. JRJoe Rogan14:23

      Mm. Yeah, I'm not interested in that.

   10. PAPeter Attia14:25

       (laughs) Gee, I can't see why.

   11. JRJoe Rogan14:26

       Yeah, there's just something about sharks too. I mean, they're, to me, one of the most terrifying things. Because first of all, we're so inept in the water. I mean, even a person like you who's a great swimmer-

   12. PAPeter Attia14:37

       Yeah, yeah. We're, we're a joke.

   13. JRJoe Rogan14:38

       Yeah. What we are in comparison to what they are, it's just, you're, you're throwing yourself into the world of a super predator. And to know that one just jacked a person just a few days before and you're out there swimming around.

   14. PAPeter Attia14:52

       Yeah. Although I will say this, you know, when it's all said and done, all of the close encounters I've had, probably the scariest moment I've ever had in the water was doing a swim from Santa Rosa to Santa Barbara. So Santa Rosa Island, which is the second furthest north Channel Island, you've got San Miguel, Santa Rosa, Santa Cruz and Anacapa represent the top four Channel Islands. So we did this November swim, it was nighttime thing again, swimming from Santa Rosa Island to Santa Barbara. And, uh, at about 5:00 in the morning, maybe 6:00 in the morning you're just starting to get enough light where you can see and you're out there so you really have amazing visibility. And I looked down probably 40 feet and I see this enormous thing swimming like this, which is how sharks swim. And I see the dorsal fin in the position that freaks me out and the tail's this way. All of that is shark.

   15. JRJoe Rogan15:45

       Right.

   16. PAPeter Attia15:47

       And I like, you know, poof, like lift up out of the water, kind of hyperventilate for a second and I'm thinking to myself, "All right. You gotta make a judgment call here. If that's really a great white, you probably oughta get out of the water." But if you, the moment you're out of the water, that's it, the swim is over. Like you just spent like months doing this, like it's done.

   17. JRJoe Rogan16:04

       Right.

   18. PAPeter Attia16:05

       So then I convince myself, and I think I'm right, I think it was a dolphin on its side. Because a dolphin on its side would, its fin would, its tailfin would be the same way and it could swim that way. So in the end I just kept swimming, but I mean that scared the shit out of me.

   19. JRJoe Rogan16:18

       Well, they have seen quite a few of them off the coast of Malibu. There's, uh, some-

   20. PAPeter Attia16:22

       Oh, there's tons.

   21. JRJoe Rogan16:23

       Yeah.

   22. PAPeter Attia16:23

       There's no question. The, like they're, they're, they are way more plentiful than we realize.

   23. JRJoe Rogan16:28

       (laughs)

   24. PAPeter Attia16:28

       And all you gotta do is talk to the fishermen. Like the fishermen-

   25. JRJoe Rogan16:30

       Okay. (laughs)

   26. PAPeter Attia16:30

       ... will tell you. They're like-

   27. JRJoe Rogan16:32

       Cool.

   28. PAPeter Attia16:32

       You know, like off Coronado? I mean, it's like there's nonstop great whites.

   29. JRJoe Rogan16:36

       Really?

   30. PAPeter Attia16:36

       Oh, yeah.
6. 20:34 – 36:10

   From Channel Islands to city streets: predators, ecosystems, and human proximity

   1. JRJoe Rogan20:34

      I think people hunt on Catalina.

   2. PAPeter Attia20:37

      They've got huge buffalo there.

   3. JRJoe Rogan20:38

      Is that what it is?

   4. PAPeter Attia20:39

      Yeah. So apparently, there was a movie that was made there back in the '20s or something like that and-

   5. JRJoe Rogan20:43

      They just let a bunch of buffalo loose?

   6. PAPeter Attia20:44

      Well, they had a bunch of buffalo, yeah, for the movie and I guess they never like-

   7. JRJoe Rogan20:47

      (laughs)

   8. PAPeter Attia20:47

      ... corral them or some such shit. So it's totally overrun with buffalo.

   9. JRJoe Rogan20:51

      Well, there was one of the Channel Islands that they had actually turned into a bow-hunting destination. Like, they had brought in a bunch of deer. I think they brought in stags and a bunch of-

   10. PAPeter Attia21:02

       Mm-hmm.

   11. JRJoe Rogan21:03

       ... weird exotic shit and they put them on this island. I think they even had elk. And then biologists just weren't having it. They're like, "This is just so out of whack."

   12. PAPeter Attia21:12

       Yeah.

   13. JRJoe Rogan21:12

       And so they had them eradicated and-

   14. PAPeter Attia21:15

       Mm-hmm.

   15. JRJoe Rogan21:15

       ... the way they do that is, it's pretty gruesome. They just gun down from the air and just leave the bodies.

   16. PAPeter Attia21:21

       Geez.

   17. JRJoe Rogan21:21

       Yeah. They just decided that they were an invasive species regardless of how-

   18. PAPeter Attia21:25

       Yeah, yeah.

   19. JRJoe Rogan21:25

       ... valuable they might have been to people that wanted to go there and eat them. You know, they just decided, just for the ecosystem alone, to just ... And there's no predators there. They weren't gonna turn the fucking island to Wild Kingdom and bring wolves or something in there-

   20. PAPeter Attia21:38

       Yeah, yeah.

   21. JRJoe Rogan21:38

       ... which would be pretty goddamn crazy. Imagine if there was an island you could go and they just had wolves and elk running around on an island, just-

   22. PAPeter Attia21:45

       Well, that's it, I'm, I'm surprised they would gun them all down. At least, say, make it open season for hunting or something like that. They could have been productive about it.

   23. JRJoe Rogan21:51

       Well, they ... That's an interesting perspective. So biologists look at it in terms of the entire ecosystem, right? They look at it in terms of the plants, the-

   24. PAPeter Attia22:01

       Sure, sure.

   25. JRJoe Rogan22:01

       ... amount of waste, fecal waste, that these animals are leaving behind.

   26. PAPeter Attia22:05

       Yeah.

   27. JRJoe Rogan22:05

       The fact that they're, they're literally eating everything that they can on this island. They're not supposed to be there. And then they're competing with whatever things are native to that island.

   28. PAPeter Attia22:15

       Yeah.

   29. JRJoe Rogan22:16

       And probably, I mean, if you got a 1,000-pound elk, it's not supposed to be on a fucking island. This thing is just eating everything it can. And they don't, they don't have a winter either. So it's just like the whole ... Like, they're just not supposed to be there.

   30. PAPeter Attia22:28

       The, the Channel Islands themselves are kind of amazing. I mean most, most people know of Catalina, but, you know, there's eight of them and now two of them, you can't step foot on. Uh, I think San-
7. 36:10 – 54:24

   How Peter knows Jocko: discipline culture, snipers, and precision skills

   1. JRJoe Rogan36:10

      (laughs) Ooh. Yeah, crazy man. (sniffs) So, uh, how do you know Jocko? This is how we got connected.

   2. PAPeter Attia36:16

      Yeah, yeah.

   3. JRJoe Rogan36:16

      Tell the folks at home.

   4. PAPeter Attia36:17

      So, uh-

   5. JRJoe Rogan36:18

      Jocko's like, "Prepare to get your brain blown out."

   6. PAPeter Attia36:20

      (laughs)

   7. JRJoe Rogan36:21

      "I'm gonna send my friend over." I was like, "All right, let's do it."

   8. PAPeter Attia36:23

      So, uh, I met Jocko through one of my really close friends, a guy named Kirk Parsley, who's a ... also a Navy SEAL, a former SEAL. And, um-... Kirk said, "Hey, you gotta meet my friend Jocko." Basically it was just like, "You guys, you just gotta meet Jocko. You just have to experience Jocko."

   9. JRJoe Rogan36:40

      (laughs)

   10. PAPeter Attia36:40

       That was basically what-

   11. JRJoe Rogan36:41

       He's like a ride. (laughs)

   12. PAPeter Attia36:42

       Yeah, yeah, yeah. So, so I met Jocko. We obviously connected pretty quickly. And then, um, I think ... Oh, this was before Jocko's book had come ... His first, first book h- had come out. And I said, "I gotta introduce you to one of my best friends, this guy Tim Ferriss," who ob- obviously you know Tim, and, um ... 'Cause Tim's always looking for, you know, a great guest on a podcast. And so I called Tim and I said, "Look, you gotta just trust me on this one. Sight unseen, just have Jocko come to San Francisco next week. Just ... I don't need to say anything else. It will be worth it." And I, luckily, I had enough credit in the bank with Tim. I'd-

   13. JRJoe Rogan37:20

       (laughs)

   14. PAPeter Attia37:20

       ... done ... I'd, I'd been successful on enough sight unseen recommendations, but I think the Jocko (laughs) one was the best one ever, 'cause he, he called me after. Or he called me while Jocko was still there and he's like ... Yeah, that was pretty intense.

   15. JRJoe Rogan37:32

       Yeah, I sent him an email after that podcast. I'm like, "That's one of the best podcasts I've ever heard in my life." And I, I made a post about it, and Jocko responded to the post, and then I got Jocko on. And then I and Tim convinced Jocko to do his own podcast.

   16. PAPeter Attia37:44

       Yeah.

   17. JRJoe Rogan37:44

       And now it's huge. I mean, his podcast, I get text messages all the time from people thanking me for telling them to listen to it, and then I get tweets from people thanking me for talking Jocko into doing it. Because it's just, there's that, just, just, there's outliers in this world, you know? In, in everything. There's outliers in athletics, there's out ... But in, when it t- comes to like discipline and motivation and just, just when you look at someone who's just undeniable-

   18. PAPeter Attia38:12

       Mm-hmm.

   19. JRJoe Rogan38:13

       ... like Jocko's one of those guys.

   20. PAPeter Attia38:14

       Yeah.

   21. JRJoe Rogan38:14

       He's just undeniable.

   22. PAPeter Attia38:16

       He's, he's a specimen. He's definitely (smacks lips) off the graph.

   23. JRJoe Rogan38:21

       Yeah, I'd met him a long time ago when, uh, he was training with, uh, Dean Lister, and Dean was fighting in the UFC.

   24. PAPeter Attia38:27

       Hmm.

   25. JRJoe Rogan38:28

       I remember meeting him and I'm like, "What's that guy's deal?" (laughs)

   26. PAPeter Attia38:32

       (laughs)

   27. JRJoe Rogan38:32

       You know? (laughs) There's certain dudes that have got a whole lot of shit going on behind their eyes. You're like, "Okay, that guy has seen some stuff."

   28. PAPeter Attia38:39

       (laughs)

   29. JRJoe Rogan38:39

       You know?

   30. PAPeter Attia38:40

       Yeah, I'll tell you, I'm gonna tell you a funny s- Jocko story. I don't think I, I guess I can tell this story in public. It's pretty funny. So Jocko was in New York, uh, just after his book came out, and, um, you know, e- this ... And I was like, "Look, I wanna, I wanna introduce you to some of my, my, my buddies who run hedge funds here." Because some, a lot of what Jocko does is that, you know, he and his partner, like they, they consult with, with guys like this doing leadership stuff. And so we went up to the offices of one of, uh, my friends who has this very famous hedge fund, and his office is like on the 50th floor on Park. And it's looking, it's like a beautiful view down Park. And we're ju- and we're just sitting there in his office just shooting the shit. And I forget how it came up, but somehow, um, we were just talking about like, like how good is a sniper? Like, what does it actually take? And, um, and then of course we're, we're talking very specifically about, um ... Uh, I can't believe I'm blanking on his name. Um, Chris, um ... Bradley Cooper played him in ...
8. 54:24 – 1:06:38

   Intermittent fasting and carb restriction: benefits, limits, and personal experiments

   1. PAPeter Attia54:24

      Uh, I mean, I do, but nothing like what I used to. I mean, I, I fast pretty much every day. Like I'm-

   2. JRJoe Rogan54:29

      Are you doing 16 hours? What are you doing?

   3. PAPeter Attia54:31

      Um, depends. So when I'm in... I split my time between New York and California. When I'm in New York it's absolutely one meal a day, no ifs, ands, or buts, 'cause it's just the schedule is such that, you know, I'm seeing patients in the morning and afternoon and I don't wanna do... I don't wanna waste time to eat. So it's-

   4. JRJoe Rogan54:46

      What are you a doctor in?

   5. PAPeter Attia54:47

      Uh, that's a good question. I mean, uh, I trained as a surgeon and did cancer surgery, uh, but I, my practice is based on longevity. So it's sort of how do you apply...... nutrition, exercise, sleep, uh, stress management, endocrinology, lipidology, supplements, hormones, all that stuff. Like, how do you engineer how to make somebody live longer is-

   6. JRJoe Rogan55:10

      Hmm.

   7. PAPeter Attia55:10

      ... is my clinical interest. Um, so, yeah, so in New York, I eat one meal a day. So it's basically like a 22-hour fasting window, and then I'm feeding within a two-hour window.

   8. JRJoe Rogan55:19

      Wow.

   9. PAPeter Attia55:20

      When I'm here, um, it's about the s- well, I mean, yesterday and today it's the same. Like, you know, today has just been kind of a busy day to, you know... I won't eat till dinner tonight. But, um, my short fast would be 16 hours, where I would eat kind of-

   10. JRJoe Rogan55:33

       That's a short fast?

   11. PAPeter Attia55:34

       That would be a short fast.

   12. JRJoe Rogan55:34

       That's a long one for me.

   13. PAPeter Attia55:36

       Really?

   14. JRJoe Rogan55:37

       (laughs) Yeah.

   15. PAPeter Attia55:37

       Dude, you gotta get in touch with your evolutionary self.

   16. JRJoe Rogan55:40

       (laughs)

   17. PAPeter Attia55:40

       I had this discussion with a friend this morning, 'cause he was saying to me he can't do 16 hours.

   18. JRJoe Rogan55:44

       Well, he's a pussy.

   19. PAPeter Attia55:45

       No, and I was like, no-

   20. JRJoe Rogan55:46

       Tell him I said he's a pussy.

   21. PAPeter Attia55:46

       (laughs) You just told him.

   22. JRJoe Rogan55:48

       (laughs)

   23. PAPeter Attia55:48

       No, but I said, "You gotta understand, if, if our ancestors couldn't function when they were hungry, we wouldn't be here." So it's, it's not just that starvation, uh, uh short-term adaptation to starvation is, is necessary. It's probably beneficial. Uh, in other words, you know, during these short periods of, of, of deprivation of food, you know, we get just a little bit more epinephrine and norepinephrine. We just get a little bit sharper, a little bit better. Um, I, I can't even, I can't even remember what it's like to eat three meals a day, it's been so long.

   24. JRJoe Rogan56:19

       Really?

   25. PAPeter Attia56:19

       Yeah.

   26. JRJoe Rogan56:19

       How long you been doing this?

   27. PAPeter Attia56:22

       I mean, I've been doing crazy shit for 10 years, nutritional-wise. Like, I mean, I spent three years in ketosis where was, was different than one day I was in ketosis for three years. Um, lots of fasting, but I think intermittent fasting, or time-restricted feeding, probably at least five years.

   28. JRJoe Rogan56:40

       And what a- for people listening, what are the benefits of that?

   29. PAPeter Attia56:44

       Well, I mean, if you're g- if we're gonna be, uh, really technical, we have to be clear that I think a lot of the benefits are overstated. And a lot of the benefits are things that we've only studied in animals. So there's a guy named Satchin Panda at the Salk Institute in San Diego who's, I think, one of the world's experts on time-restricted feeding. But (clears throat) you know, for example, a 16-hour fast in a mouse produces unbelievable results. If you take a group of, you know, certain types of mice or strains of rats or other rodents, and you, in a 24-hour per- period, deprive them of any nutrient for 16 hours, but then for eight hours let them eat whatever the hell they want, they can't gain weight. So, um, and the, and the, and the reason, we think, is that it, once you give a long enough period of time when the, um, animal can ramp up its, uh, the, like the enzymes in the liver that are responsible for fat oxidation, it, I mean, they just basically become fat burn- I hate that term fat-burning machine, it's so overused. But they, that's, they, they basically just become unbelievably efficient at, at metabolizing fat. So, um, we have to be careful though when we extrapolate that, 'cause you and I have a very different metabolism than a mouse. Like, a 16-hour fast to a mouse is much longer than it is to us. So I don't know if those benefits would extend. Um, also, it's not entirely clear that time-restricted feeding will produce the longevity benefit that we see in other sort of fasting or fasting-mimicking types of diets. Um, so for me, what it comes down to is, I mean, honestly, it's just an easier way ... It gives me a much more liberty with what I eat during my feeding window. I don't have to be nearly as restrictive when I'm feeding, um, if I have that period off. It just, just in terms of like my physiologic response. Secondly, there's a convenience thing. Like, I kind of hate being tethered to eat.

   30. JRJoe Rogan58:26

       Mm.
9. 1:06:38 – 1:28:05

   Longevity levers: caloric restriction, rapamycin, autophagy, and measuring what matters

   1. PAPeter Attia1:06:38

      Well, I don't think there's sufficient evidence at this point in time that time-restricted feeding is gonna impact my longevity. So, I think that's the big claim and if the big claim is being-

   2. JRJoe Rogan1:06:47

      What is the, what is the claim? Like what are they saying?

   3. PAPeter Attia1:06:49

      Oh, I mean, I think the claim would be that fasting mimicry, which could be, you know, like what, say, Valter Longo talks about, where you do a five-day hypocaloric diet of 750 to 1000 calories a day for five days, followed by 25 days of ad libitum feeding, meaning eat whatever the hell you want, um, uh, in terms of total caloric content, um...... you know, the claim is, well, that's gonna enhance longevity. And, uh, or, you know, doing a 16:8 or 18:6 is going to enhance lifespan. So just to take a step back, um, I, I am only aware of, uh, three things that have universally extended lifespan across all model organisms. So if you think of like all eukaryotes, right? If you go from yeast to worms to flies to mammals. The only things that uniformly extend life, um, or almost uniformly, is caloric restriction and or dietary restriction. So total reduction in calories during the lifetime and or reduction of certain subsets of those calories. So there's a super famous experiment that was done. Um, actually if anyone's interested, I wrote about it. It's on my blog somewhere. But it's basically this, the best experiment ever done in caloric restriction was between monkeys and there's a group at the NIH and a group at the University of Wisconsin. And it was like a 19-year experiment or something like that, so you could really study the impact of caloric restriction over these things. And that experiment showed us that caloric restriction extended lifespan if you had a really shitty diet, and it did not extend lifespan if you had a really good diet.

   4. JRJoe Rogan1:08:22

      Hmm.

   5. PAPeter Attia1:08:23

      Counterintuitive, but it also spoke to the idea that dietary restriction probably mattered. So in other words, if you're eating a regular diet of McDonald's every day, and then we put your counterpart eating 70% of McDonald's every day, that's going to move the needle. But in the Wisconsin, uh, in, in the NIH experiment, when you took the monkeys that were eating kind of ... It wasn't their natural food, but it was less horrible food, the caloric restriction did not extend lifespan. So that threw a wrench in everyone's understanding of caloric restriction, and there are certain strains of mice that also don't seem to be enhanced in terms of lifespan, meaning just time on, on Earth. Um, but for the most part, nutrient deprivation, um, pretty ubiquitously extends life. The second thing that uniformly extends life across this is a drug called rapamycin, which is kinda like my favorite drug in the whole world. I mean, meaning it's like I think it's the most important drug in, in terms of this space, not necessarily because it's a drug that we'll all be taking, though I do believe that is the case, but more importantly because of what it's taught us about the nutrient sensing pathway and its target, which is this protein called TOR, the target of rapamycin, or mTOR, as you've probably heard of it, is mechanistic target of rapamycin. And rapamycin inhibits that. Now it's a bit complicated because there's two variants of it. There's something called mTOR complex 1 and mTOR complex 2, and if you take rapamycin day in and day out every day, which, for example, transplant patients do, it's an immune suppressant. That doesn't seem to really extend lifespan. But if you take it in a pulsatile way, you selectively get this mTORC1 inhibition without the mTORC2 inhibition, that seems to produce longevity big time.

   6. JRJoe Rogan1:10:06

      And how does that work? How would you take it selectively?

   7. PAPeter Attia1:10:10

      Well, um, this is sort of one of my main clinical interests and, um, because I, uh, obviously am waiting for the day when I can start taking it and ultimately, you know, feel that it's safe enough that I could give it to patients. Um, ex- if I'm extrapolating from all of the best data out there, so that's looking at the work that's come out of a guy named David Sabatini's lab. David's a, a guy at MIT. He's a professor. He's actually the guy that when he was a medical student, um, doing his PhD in 1994 actually discovered how rapamycin works in mammals. He's actually the guy that coined mechanistic target of rapamycin mTORC as a, uh, name. And so now whatever we are, almost 25 years later, um, you know, he's still running the powerhouse lab that understands this. So if you look at all of the literature that's coming out of their lab, coupled with a guy named Matt Kaeberlin at the University of Washington who's doing rapamycin studies in dogs, along with the work done by someone named Joan Manick, who was at the time at Novartis, is now at a company called restorbio, and a few other people, uh, my intuition is that somewhere between two to six milligrams every five to seven days is probably the sweet spot. Um, but, you know, am I confident enough in that to say that we should all be taking it? Not yet. There's a couple things that, like, I want to be able to measure before we do that. But, um, you know, in the animal data, this stuff's remarkable. If you look at Matt Kaeberlin's dog data, it's remarkable.

Episode duration: 2:51:39