#304 – NEW: Introducing quarterly podcast summaries – Peter shares his biggest takeaways on muscle protein synthesis, VO2 max, toe strength, gut health, and more

Getting a high VO2 max and being very strong are very hard to do. They take a long time. Everybody can do them, but they can't be done quickly and easily, so therefore, they are the tip of the spear.” —Peter Attia

Read Time 47 minutes

In this quarterly podcast summary (QPS) episode, Peter introduces a new format aimed at summarizing his biggest takeaways from the last three months of guest interviews on the podcast. Peter shares key insights from each episode, covering diverse topics such as protein and muscle building with Luc van Loon, toe strength with Courtney Conley, VO2 max with Olav Aleksander Bu, liquid biopsies for cancer with Alex Aravanis, gut health and probiotics with Colleen Cutcliffe, and road safety with Mark Rosekind. Additionally, Peter shares any personal behavioral adjustments or modifications to his patient care practices that have arisen from these engaging discussions.

If you’re not a subscriber and listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or on our website at the episode #304 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.

We discuss:

  • How Peter keeps track of his takeaways from each podcast episode [5:15];
  • Luc van Loon episode: fat utilization, muscle protein synthesis, dietary protein, aging and inactivity, and more [8:45];
  • Behavioral changes that have come about from the conversation with Luc van Loon [23:45];
  • Courtney Conley episode: importance of toe strength and the impact of dedicated foot training [26:45];
  • Olav Aleksander Bu episode: the importance of VO2 max for lifespan, and the practicalities of measuring and improving VO2 max [36:45];
  • Behavioral changes that have come about from the conversation with Olav [56:00];
  • Alex Aravanis episode: liquid biopsies for cancer detection [1:01:30];
  • Colleen Cutcliffe episode: the importance of gut bacteria balance, and the potential therapeutic uses of probiotics, particularly Akkermansia [1:16:45];
  • Mark Rosekind: the significant issue of road fatalities and injuries, their causes, and practical safety measures to reduce risks [1:27:00]; and
  • More.


How Peter keeps track of his takeaways from each podcast episode [5:15]

  • Peter appreciates that our podcasts are long and quite deep (that’s by design), and he personally doesn’t have time to go back and listened to most of them
  • He’s not capable of assimilating everything that comes out of a podcast
  • Over the past year, he has gotten into a habit of feverishly taking notes when the guest is speaking
    • That seems to be the best time for him to get insights out of the episode
  • Then immediately following the podcast, almost always on that day, he resynthesizes these notes on 5×8” index cards
    • The goal here is to minimize the cards because he wants the cards to be the highest yield thing that 6 months or 6 years from now he would go back to, and that captures the salient essence of what he learned
    • It’s always an eye towards something he didn’t know before or something he didn’t realize how important it was
  • Peter is always looking for something that’s going to change his mind or change his practice
  • We will look at some recent episodes from 2 realms
    • 1 – Peter’s most important takeaways, insights, and biggest learnings
    • 2 – If Peter has changed his mind, changed his behavior, how he works with himself, how he works with patients


Luc van Loon episode: fat utilization, muscle protein synthesis, dietary protein, aging and inactivity, and more [8:45]

#299 ‒ Protein: optimizing muscle protein synthesis, quality sources, quantity needs, and the importance of resistance training | Luc van Loon, Ph.D. (April 22, 2024)


  • Luc’s episode wasn’t the only episode focused very heavily on protein
  • Despite that, the richness of this episode surprised Peter

We talked a lot about something called the Fat/Athlete’s Paradox 

  • There’s this idea that when you look at the muscle of an athlete and you look at the muscle of someone with type 2 diabetes, you are going to see large stores of intramyocellular lipids (lipid within the muscle)
    • You’re looking at 2 opposite ends of the metabolic spectrum
  • Peter remembers hearing this before, but he thinks what came into focus was the idea that this is one of the limitations of static information

{end of show notes preview}

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  1. Peter and Nick, these are great. Enjoyed it much. It does function as a good roundup every quarter with pertinent takeaways from a bucket of episodes. That being said, I do love the depth, length, and technicality of your podcasts, for example the podcasts with Olav and Gerald Shulman. Please keep this up as well. Amazing work by your team on everything.

  2. Thank you very much for putting together this group of takeaways. I found it to be a nice review (there were plenty of things I had already forgotten) and very helpful. I will probably read it again in the future!

  3. I echo the many comments. This was a great review and I especially valued learning which aspects Peter has put into his own practice and in some instances has modified. Thank you. Please do this again. And again.

  4. Loved the new format. One nit pick:

    As you are a self proclaimed “f=ma” guy, I had to go back and make sure I heard you correctly when you said “2 cars at 60mph in a head on collision is like hitting a wall at 120mph[sic]”. The mass decelerating is the same (constant) and the acceleration to 0 from 60mph is the same if you’re hitting another car traveling in the opposite direction at the same speed or if you’re heating a brick wall going 60mph. 120mph is doubling the force of your story.

    The point stands either way, I just thought it was a funny slip up from someone so clearly proud of the physics exam strategy of writing f=ma!

  5. I strongly echo all the other positive comments — this is perhaps the most important and useful experiment you’ve done with The Drive. Hearing what you’ve changed your mind about, especially if it is something you wrote about in your book, is especially useful.

  6. This was a great podcast! It is often difficult to assimilate the quantity of great information in the original podcast and to provide review and analysis after a period of time is most beneficial especially for us that are at an age where our minds may not be quite as efficient as they used to be!
    Keep up the great work

    Also on another note, I know that inactivity is detrimental as we age. I would be interested in a podcast of recommendations when we are injured or have had surgery to try to maintain as much muscle mass and strength as possible. I feel that our medical community does not deal with this at all, especially in the world of corporate healthcare!!!

  7. Enjoyed this style of podcast. Any chance you can put together a deal for sunscribers on the VO2 Master? I want one so bad, but it’s just so expensive. I feel like if there were enough of us that would commit to ordering one, they might throw us some kind of discount with your backing. Thanks again for all the great content!

  8. I loved this format. I have listened to all of the podcasts that you reviewed but found reminders and new info this time. A great reminder for me to add foot strengthening exercises in, and to keep the toe spacers working.
    The VO 2 max discussion was also a great reminder for me to get moving on zone 5, not just zone 2.

  9. I loved the new format, and it’s nice to hear that Peter is also learning something from the podcasts.

  10. Echo other comments, this new format is an excellent review and primer to go back to episodes I have missed. Keep it going please.

  11. A small additional note – in the part regarding the Luc van Loon episode, the following was mentioned: ”What was highlighted for Peter was that total protein quality plays a big role in myofibrillar protein synthesis, and exercise plays the biggest role in generating contractile tissue protein synthesis”… I was initially a bit confused because the myofibril is the part of the muscle containing contractile protein filaments, so wasn´t sure how myofibrillar and contractile tissue were different. But going back the original episode, I saw it was connective tissue of the muscle that was being referred to, so all clear now. I only bring it up in case it confused anyone else too…and it is an interesting note in the discussion, as it seems maybe collagen could still have a place to support tendons, ligaments and bones….but not for the connective tissue within the muscle itself.

  12. Mark me down as another two thumbs up for this format! Like many others, I listen to the full podcast but found the review. Very helpful.
    Please continue!!!

  13. The quarterly format is a great idea, I hope it catches on and becomes a regular, dare I say, a quarterly event! It highlighted some episodes I haven’t heard yet and I’ll be listening to them knowing they’ll address some of the points covered in the quarterly. Keep it up!

  14. I enjoyed this format. Having Peter’s notes on the podcasts helps me understand the big takeaways from each show. I listen to The Drive in the car or when I’m walking so I don’t have notes to look back at. And if Peter thinks it’s worth remembering, then I need to take notice. Please do more of these.

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