By playing, you agree to uListen's Terms and Privacy Policy and YouTube's Terms of Service.
Peter Attia MD#20 – Tom Dayspring, M.D., FACP, FNLA – Part I of V: an introduction to lipidology
Summaries, chapters, transcripts, and FAQs on this page are made by uListen, not YouTube.
CHAPTERS
- 0:04 – 7:21
Week of Tom: Series Overview and Tom Dayspring's Bio
Peter Attia explains that this seven-hour interview is split into five parts released over a week. He gives Tom Dayspring's credentials and background, and says Part I is the softer, warm-up episode before the technical material.
- •The interview is split into five parts released Monday through Friday
- •Dayspring's credentials: fellow of the ACP and NLA, board certified in internal medicine and clinical lipidology, nearly 40 years in practice
- •He has given about 4,000 lectures and received the 2011 NLA President's Award
- •Attia's Straight Dope to Cholesterol series relied on Dayspring's help
- •Dayspring edited and corrected the transcript, and a corrected version is in the show notes
- 7:21 – 16:48
Dayspring's 67-Pound Transformation Through Modified Fasting
Dayspring describes how he lost 67 pounds over 11 months after hearing Attia's talk on longevity. He followed a monthly five-day modified fast with carbohydrate restriction, and his orthopedic symptoms and lab results improved.
- •Dayspring had long lived with obesity, insulin resistance and cardiometabolic disarray
- •He does one week a month at 700 calories or less with significant carb restriction
- •Hunger fades after day three, and he can now walk without his previous limitations
- •His lab report went from yellow and red to 100% green, and his liver enzymes normalized
- 16:48 – 20:48
Motivation, Adherence, and Why Attia Champions Fasting
Attia explains how he designed the modified fast, loosely based on Valter Longo's fasting-mimicking diet, and why he sees caloric restriction as a cornerstone. Dayspring talks about his motivation and the support of Nicole and his wife. Attia admits his own motive was selfish: keeping Tom around.
- •Attia adapted Longo's five-day FMD with stricter calories, monthly repetition and carbohydrate restriction
- •Dietitian Nicole and Dayspring's wife helped him manage the logistics
- •Attia calls caloric restriction the most powerful way to deplete glycogen and reduce insulin
- •Dayspring was motivated by fears of cognitive decline and by wanting to stay for his son
- •Attia hopes his own father will try this too
- 20:48 – 30:25
Firefighting Obsession and the Honorary Battalion Chief Award
Dayspring describes growing up as a firefighter's son in Paterson, New Jersey, and the historical fire department website he runs. He recounts how his research led the department to add a firefighter's name to its monument and name him honorary battalion chief, and how this connects to Sister Loretta Agnes.
- •His father was a Paterson firefighter and chief for 30 years
- •He runs patersonfirehistory.com and collected firematic antiquities
- •His archival research found Edward Moore, who died in 1938, and got his name added to the monument
- •He was made an honorary battalion chief, and Sister Loretta Agnes was the only other honorary chief
- •Sister Loretta let him hang out in the emergency room as a medical student
- 30:25 – 39:32
Hockey Fandom and Memories of the Original Six Era
Attia and Dayspring trade stories about hockey. Dayspring tells of his first Rangers game at the old Madison Square Garden, teaching himself to skate, and watching his son play hockey through college. Attia recalls growing up in Toronto as an Oilers fan and a goalie.
- •Dayspring was a Yankees fan until a friend took him to a Rangers game in 1962
- •He taught himself to skate on a pond and played until he was 50
- •His son was a lifelong hockey player and team captain
- •Both describe sneaking down to better seats late in games
- 39:32 – 44:19
Dayspring's Path from the ER to Prevention and Lipids
After agreeing to move into lipids, Dayspring explains how emergency room and coronary care experience in the 1970s pushed him toward prevention. He and Attia discuss how acute MIs have changed since then.
- •Acute MIs were rampant during his training, and many patients died overnight
- •Being called back at 3 a.m. for MIs made him turn to prevention
- •Early prevention meant not smoking, avoiding obesity and controlling blood pressure
- •Attia notes that physicians of Dayspring's generation describe far fewer severe MIs now
- •Dayspring says MIs are different today because patients go straight to the cath lab
- 44:19 – 51:29
Self-Taught Lipidology and Early Mentors
Dayspring says he discovered lipids on his own as the epidemiologic trials came in, and cites Dan Rader and others as influences. Attia describes how Dayspring's 2011 document on NMR lipoprotein testing first got him interested.
- •Dayspring turned to lipids in the 1980s after being focused on hypertension
- •Mentors and influences included Dan Rader, Tony Gotto, Virgil Brown, Alan Sniderman and Ron Krauss
- •It took about ten years of serious reading before it all made sense
- •Attia was captivated by a dense 2011 Dayspring document and read it repeatedly
- •Dayspring never planned to become a leading lipid educator
- 51:29 – 57:15
Teaching Through Illustration and Lipidholics Anonymous
Dayspring explains that he learns visually and built his lipoprotein graphics in PowerPoint. He describes the NLA President's Award, his Twitter handle, and his weekly Lipidholics Anonymous case newsletter. Attia then raises the point that facts have half-lives, using HDL cholesterol as an example, and Dayspring says it should not be used to judge risk.
- •Dayspring draws graphics to understand material and credits visuals for his success as an educator
- •Mike Davidson told him that many people joined the NLA after hearing his lectures
- •He wrote the free weekly Lipidholics Anonymous newsletter on real cases for 10-15 years
- •Attia says facts have half-lives, and Dayspring calls HDL-C as a risk marker one of the facts that disappeared
- •Dayspring says no one should judge cardiovascular risk from HDL cholesterol
- 57:15 – 1:03:34
What Is a Lipid? Fatty Acids, Glycerides, and Phospholipids
Attia asks for definitions, and Dayspring explains that lipids are hydrophobic molecules. He covers cholesterol, fatty acids, esterification and glycerides, then phospholipids as amphipathic molecules found on lipoprotein surfaces and cell membranes. He adds that cells make their own cholesterol and must efflux the excess.
- •Lipids are molecules not soluble in water, with differing degrees of hydrophobicity
- •Triacylglycerols are three fatty acids esterified to a glycerol backbone
- •Phospholipids are amphipathic and form lipoprotein surfaces and every cell membrane
- •Most phospholipids are made in the liver or intestine
- •Every cell makes its own cholesterol, and excess cholesterol is toxic, so cells must efflux it
- 1:03:34 – 1:07:27
Saturated vs. Unsaturated Fats and Why Cholesterol Needs Lipoproteins
Attia clarifies saturated, monounsaturated and polyunsaturated fat in terms of double bonds and chain length, and notes that fatty acids ride on albumin. He asks why cholesterol and phospholipids cannot do the same. Dayspring replies that lipoproteins mainly deliver energy as triglycerides and phospholipids rather than cholesterol.
- •Attia defines fats by double bonds and chain length
- •Fatty acids can be transported on albumin
- •Dayspring says delivering cholesterol is the last purpose of lipoproteins
- •Triglycerides carry energy to muscle or fat tissue
- •Phospholipids sit in the lipoprotein surface, so larger particles carry more of them
- 1:07:27 – 1:14:34
Lipolysis, Phospholipid Transfer, and Membrane Function
Dayspring describes how lipoprotein lipase shrinks triglyceride-rich particles and how the surface phospholipids released go to cells or to HDL via phospholipid transfer protein. He explains how the fatty acid makeup of phospholipids shapes membrane fluidity, lipid rafts and receptor placement, and why he thinks HDL functionality and the lipidome will matter.
- •Lipoprotein lipase hydrolyzes core triglycerides, and surface phospholipids are shed as the particle shrinks
- •Phospholipid transfer protein hands phospholipids to baby HDL so it can mature
- •Saturated fatty acids give structure, while double bonds change membrane shape
- •Lipid rafts determine where receptors can sit and signaling can occur
- •HDL functionality may depend on its phospholipid fatty acid makeup
