April 6, 2020

Treatments

#103 – Looking back on the first 99 episodes: Strong Convictions, Loosely Held

"I reserve metformin prescriptions for patients who obviously are in need of it from the standpoint of glucose and insulin regulation, but I don't view it really as a pro longevity agent yet." — Peter Attia

Read Time 17 minutes

In this episode, originally recorded to be the 100th episode of The Drive, Peter discusses topics that he has changed his mind about since starting the podcast as a result of preparing for interviews as well as from the actual conversations. Peter also reviews some of his favorite moments from the first 99 episodes, shares what books he’s currently reading, and much more. Initially scheduled to be released as episode 100, this was delayed due to recent podcasts covering COVID-19. 

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We discuss:

  • Definition of “strong convictions loosely held”, and the value in trying to shoot down your own hypotheses [2:20];
  • Metformin—How Peter’s strong convictions have changed since 2018 [8:00];
  • Getting a dog—Why Peter caved and how it’s going so far [15:45];
  • Rapamycin—How Peter’s feelings have evolved, and the questions still needing to be answered [20:45];
  • Archery, the joy of pursuing mastery, and the importance of stillness [26:50];
  • Zone 2 training—Why Peter has made it a big component of his exercise regimen [37:30];
  • Deadlifts—Why Peter now believes it’s extremely beneficial to longevity when done properly [41:45];
  • Read any good books lately? [50:00];
  • Baby aspirin for preventing blood clotting—Why Peter no longer takes it, and a few alternative options [53:15];
  • Generic drugs—How and why Peter’s mind has shifted on generic drugs [55:45];
  • Omega-3 fatty acids, EPA and DHA—How Peter’s long-held views have changed [58:15];
  • How Peter got better at saying “no” [1:02:30];
  • Does Peter have any favorite episodes of The Drive? [1:07:15]; and
  • More.

§

Definition of “strong convictions loosely held”, and the value in trying to shoot down your own hypotheses [2:20]

  • During the pre-show preparation and during conversations with podcast guests, Peter will often shift his thinking about a topic
  • And in most cases it leads to positive behavior changes
  • This episode is about sharing some of those situations where Peter’s thinking has changed

“Strong convictions loosely held”

  • This is a phrase that exists in various forms (e.g., strong opinions loosely held, strong opinions weakly held, strong convictions weakly held, etc.)
  • But this particular this version was something one of Peter’s patients told him was a guiding principle at a very successful hedge fund where they would make bold investments based on strong convictions but they were very loosely held convictions and they were always looking for ways to change their information
  • Bob points out that especially in science and medicine, the ability to change your mind is a “feature and not a bug”
  • In his book, biochemist Richard Feinman (not to be confused with Richard Feynman) quoted his colleague, Izja Lederhendler, who said, “What you do in science is, you make a hypothesis and then you try to shoot yourself down.

 

Metformin—How Peter’s strong convictions have changed since 2018 [8:00]

How has Peter’s strong convictions about Metformin changed since he started the podcast in the summer of 2018?

-Peter had been personally taking metformin for about 7 years

-Peter said the benefits of metformin were clear for:

{end of show notes preview}

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  1. Peter,
    Thank you for your website.
    Do you know if anyone has studied Covid-19 and how heat therapy , i.e. sauna therapy impacts its it, given the virus is suspected to retreat in the summer?
    Is the virus impacted by environmental heat , internally generated from exercise or from sauna, or perhaps a mix of both?, …. or perhaps heat generated from exercise, short term HIIT or low and slow exercises , e.g. “Walk at Home by Leslie Sansone” or programs like “Allblanc TV”, both on YouTube?
    Thanks
    Rod
    Fergus, Ontario

  2. I liked this. It was fun and light.

    Always a god sign when people can not only change their minds but be ready at all times to have it changed.

    I’d love to try archery one day. So many wants, so little time.

  3. I am a retired electrical engineer with very strong feelings about the major theme of this podcast, changing one’s beliefs based on new experience or information. I think one makes the best decision one can with the available information, but those decisions should always be reevaluated as new information is received. Many times in my career design decisions were made at the beginning of a program that made sense at the time, but 2 or 3 years later events had proven that changed decisions would be better. Too many technical leaders would not make those changes, unfortunately. Objectivity and a clear evaluation of the available data is what is needed and changes in direction as a result should be welcomed and not criticized. Your objectivity is one of the main reasons I listen to you, keep it up!

  4. Great Podcast and great mentality given this polarized political world we live in.
    With respect to Metformin, I am always critical of the chemical aspect since I was a synthetic chemist in a much earlier life. . Given the nature of the synthesis ( well known and old) and its isolation as a sold hydrochloride ( for solubility in water), Im always suspicious of its purity and where it was made. Furthermore it is a guanide , lots of possible nitrogenous impurites that could raise havoc in the body, and its the liver that comes to mind from my perspective, I guess if its needed thats everything… but I always worry about the purity of whatever I take….

  5. Please consider developing a partner to formalized actual program to help us work on the centenarians olympics. I would suggest Mark Wildman in LA. He has a good series using kettlebells and clubs.
    While using big bars for deadlift may work for Peter or younger people who can go to the gym, some of us can do this. Kettlebell sumo lift and other versions could give similar benefit, plus we can have it in our home.
    Pavel Tsatsouline has an interesting story on the development of Kettlebells and would be an option to have on the show.

    Further explanation and demonstration on DNS would be helpful.

  6. Peter,

    Can you recommend a provider of rapamycin, and discuss the dosage that you have been suggesting for your patients?

    Thanks.

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