Dr. Peter Attia on Life-Extension, Drinking Jet Fuel, Ultra-Endurance, Human Foie Gras, and More

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Tim Ferriss and Peter Attia

“How do you balance the desire to live longer with the desire to perform well?” (Tweet It)
– Peter Attia, MD

This episode delves into all types of performance enhancement and tracking — optimizing blood testing, drinking “jet fuel,” training for ultra-endurance sports, consuming synthetic ketones, using metabolic chambers, extending longevity by avoiding certain types of exercise, and much more.

Peter Attia is the co-founder and current president of the Nutritional Science Initiatives (NuSI).

He is an ultra-endurance athlete, compulsive self-experimenter, and one of the most fascinating human beings I know. Peter also earned his M.D. from Stanford University and holds a B.Sc. in mechanical engineering and applied mathematics from Queen’s University in Kingston, Ontario, Canada. He resided at John Hopkins Hospital as a general surgeon, then conducted research at the National Cancer Institute under Dr. Steve Rosenberg, where Peter focused on the role of regulatory T cells in cancer regression and other immune-based therapies for cancer.

PLEASE:  Join Peter and I (I’m matching up to $50,000) in supporting this high-leverage project, ideally before the end of December.

This episode is brought to you by Onnit. Joe Rogan introduced me to Onnit, and since then, my garage has resembled a showroom. I own Onnit supplements (like chewable melatonin for jetlag and flights), maces, battle ropes (not “battle robes,” as I first heard it), kettlebells, and enough gear to ensure a lifetime of self-inflicted torture and higher performance.

This podcast is also brought to you by 99Designs, the world’s largest marketplace of graphic designers. Did you know I used 99Designs to rapid prototype the cover for The 4-Hour Body? Here are some of the impressive results.

QUESTION(S) OF THE DAY:  What counter-intuitive physical “hacks” or dietary approaches have been most impactful in your life? Please let me know in the comments.

Scroll below for links and show notes…

Enjoy! Read More

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Human Foie Gras — A Golden Opportunity

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foie-creative-commons

To kick things off, what is foie gras?

It can be explained with a short missive from our friend Wikipedia:

The California foie gras law, California S.B. 1520, is a California State statute that prohibits the “force feed[ing of] a bird for the purpose of enlarging the bird’s liver beyond normal size”…

Former Senator John Burton called foie gras production “an inhumane process that other countries have sensibly banned.”

Given this outrage related to mistreating birds, you might be surprised to learn that human foie gras industries are booming.  Children’s livers are apparently particularly tasty. Not unlike veal, I suppose.

I’m putting $50K of my own money into related investments, but we’ll get back to that in a minute. First, some background…

For most of the 20th century, fatty liver and liver cirrhosis had two primary causes: drinking too much alcohol (e.g. Mickey Mantle) or hepatitis B or C (via IV drug use, unhygienic tattooing, tainted blood transfusions, etc.).

But in the last few decades, even infants are showing up with livers that should belong to hardcore alcoholics.  And the numbers aren’t small.

It’s estimated that one in ten American children now suffer from non-alcoholic fatty liver disease (NAFLD), alongside 40 million affected adults. If you’re an obese Mexican-American boy, the odds are 50-50 (!) that you have NAFLD, thanks to genetic predisposition (PNPLA3 gene).

15 years ago, this disease was unheard of.  In 10 years, it’s projected to be the #1 cause of liver transplants. Put another way — In 2001, NAFLD was the reason for 1 out of every 100 liver transplants; by 2010, it was up a ten-fold to 1 in 10; by 2025, assuming nothing stems this tide, there could be five million Americans who need new livers because of it.

Who are driving this trend?

Some point fingers at good folks such as Coca-Cola, juice “cocktail” manufacturers, and the like.  Given that many researchers blame fructose, it’s not a huge stretch. Personally, the whole thing makes me sick.  I’d like to sic the best scientists in the country on them.

Ah, and this is where the good news comes in.

There is a way, albeit an indirect way, to do this. I implore you to read on and bear with me.  This is where it gets exciting.

The NIH alone has spent $155 billion on cancer research since 1972, and cancer survival is up a paltry 3% as a result. The US government spends over $25 billion EACH year on HIV/AIDS. That’s a lot of money.

One might assume fatty liver disease would require similar sums. After all, more American adults have NAFLD than prostate cancer, Alzheimer’s disease, heart disease, or type 2 diabetes.

NAFLD

That’s the disconnect…and the opportunity to be part of history.

Enter the “Manhattan Project of Nutrition”

The Nutrition Science InitiativeNuSI–has been called the “Manhattan Project of nutrition.” They are run like a lean startup, and I’m proud to be a part of their advisory board.

They don’t take industry money, so they have no interests to protect.

They believe the NAFLD epidemic can be curtailed for a total of $50 million, but the whole domino effect starts with just $1 million.  It is a rare day in science when fundamental questions about an epidemic can be answered with such little money (respectively). It’s an incredible Archimedes lever.

For context, NuSI argues that there are dietary triggers of diseases, including obesity, type 2 diabetes, cancer, and fatty liver disease. To determine what the triggers are, NuSI assembles teams of the best scientists in the country (e.g., from Stanford, Harvard, Columbia, NIH, UCSF, UCSD, Emory, etc.) to fund and execute the kind of research nobody else is willing (or able) to perform.

For NAFLD, NuSI’s team of experts have designed three trials to determine the respective roles of too many calories, too many carbohydrates, and too much sugar–the leading three hypotheses–as dietary triggers.

In early 2015, this team will begin the first ever controlled clinical trial to see if removing sugars from the diet can reverse fatty liver disease in children.

40 kids with NAFLD will be split into two groups, with 20 simply observed on their normal diet as controls, and 20 provided with a diet that’s identical to what they usually eat, but completely devoid of added or refined sugars. The scientists’ hypothesis is that the sugar-free diet will at least stop the progression of NAFLD in these kids, and may even reduce the amount of fat in their livers.

If that’s the case, it’ll be the best evidence we have linking sugar to fatty liver disease.

My $50,000 Challenge…And How to Get Involved

I’m personally matching up to $50,000 for whatever is raised through this blog post, and every donation–big or small–makes a major difference.

[UPDATE: An anonymous donor — a generous reader of this blog — has offered to match up to another $150,000. That means that if you all help donate or contribute just $200,000, another $200,000 will be matched for a total of $400,000!]

Any donation is also a tax write-off, as NuSI is a non-profit organization (of course, speak with your tax advisor). Perfect for end-of-the-year giving.

NuSI is looking to raise $1 million dollars for the first of these three trials—the one that determines how the rest get done.  The snowball that starts the avalanche. There are few chances in the world to have this type of impact for this type of money.  Could it end up forcing labeling changes, product modifications, obligatory package warnings, policy shifts, and more?  I believe so.

Supporting this campaign very easy, and remember–I’m excited to be putting my own skin in this game.  I sincerely hope you join me.  Every bit counts.

There are three options:

1. Donate by credit or debit card. Visit: http://nusi.org/donate. Enter your donation amount, indicate “NAFLD — Tim Ferriss” in the message field, and click “Donate.”  Done.

2. Donate by check. Send your check to: NuSI, attention: Lacey Stenson, 6020 Cornerstone Court W. Suite 240, San Diego, CA 92121. Be sure to write “NAFLD – Tim Ferriss” in the memo line.

3. Donate by transferring securities (stocks, etc.). Email TimFerriss1million@nusi.org [remember the double “r” and double “s”] and they’ll do as much heavy lifting as possible.

Thank you for reading, and thank you for supporting if you’re able.  This is a good fight.

If you’d also like to hear a fascinating chat with Peter Attia, MD, co-founder of NuSI, I interview him here on radical sports experimentation, synthetic ketones, meditation, and more. He’s a competitive ultra-endurance athlete, MD, surgeon, and obsessive self-tracker, so we get along great :)


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Relevant reading and citations:

Browning JD et al. Prevalence of hepatic steatosis in an urban population in the United States: Impact of ethnicity. Hepatology, 2004.

Welsh JA, Karpen S, Vos MB. Increasing prevalence of nonalcoholic fatty liver disease among United States adolescents, 1988-1994 to 2007-2010. Journal of Pediatrics, 2013.

Targher G, Day CP, Bonora E. Risk of cardiovascular disease in patients with nonalcoholic fatty liver disease. The New England Journal of Medicine, 2010.

Dudekula A et al. Weight loss in nonalcoholic fatty liver disease patients in an ambulatory care setting is largely unsuccessful but correlates with frequency of clinic visits. PLoS One, 2014.

Kawasaki T et al. Rats fed fructose-enriched diets have characteristics of nonalcoholic hepatic steatosis. The Journal of Nutrition, 2009.

Sanchez-Lozada LG et al. Comparison of free fructose and glucose to sucrose in the ability to cause fatty liver. European Journal of Nutrition, 2010.

Best CH et al. Liver damage produced by feeding alcohol or sugar and its prevention by choline. British Medical Journal, 1949.

Ouyang X et al. Fructose consumption as a risk factor for non-alcoholic fatty liver disease. Journal of Hepatology, 2008.

Abid A et al. Soft drink consumption is associated with fatty liver disease independent of metabolic syndrome. Journal of Hepatology, 2009.

Abdelmalek MF et al. Increased fructose consumption is associated with fibrosis severity in patients with nonalcoholic fatty liver disease. Hepatology, 2010.

Assy N et al. Soft drink consumption linked with fatty liver in the absence of traditional risk factors. Canadian Journal of Gastroenterology, 2008.

Stanhope KL et al. Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans. The Journal of Clinical Investigation, 2009.

Maersk M et al. Sucrose-sweetened beverages increase fat storage in liver, muscle, and visceral fat depot: a 6-mo randomized intervention study. The American Journal of Clinical Nutrition, 2012.

Browning JD et al. Short-term weight loss and hepatic triglyceride reduction: Evidence of a metabolic advantage with dietary carbohydrate restriction. American Journal of Clinical Nutrition, 2011.

Vos MB, Lavine JE. Dietary fructose in nonalcoholic fatty liver disease. Hepatology, 2013.
Chung M et al. Fructose, high-fructose corn syrup, sucrose, and nonalcoholic fatty liver disease or indexes of liver health: a systematic review and meta-analysis. The American Journal of Clinical Nutrition, 2014.

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Is Beet Juice Really a Performance-Enhancing “Drug”? Digging In…

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(Photo: Foodthinkers)

The following is a guest post by Mark McClusky, the editor of Wired.com and founding editor of Wired Playbook. Previously, he was a reporter at Sports Illustrated and a member of the baseball analytics collective, Baseball Prospectus.

Can “juicing” for performance enhancement sometimes involve juice alone?  Beet juice, spinach, celery, or chard, perhaps?  In this post, we look at fact versus fiction, dosing, and results you can potentially replicate.

I’ve added some thoughts of my own in brackets. In other random news, I’m finally on Instagram! Here I am, and here is a pic of Tony Robbins palming my entire face.

Now, back to our piece…

Enter Mark

The latest craze in sports drinks for Olympic athletes isn’t something citrusy from one of the big sports labs. It’s not chocolate milk, which has been shown in study after study to be a great, low-cost drink for muscular recovery… Read More

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Are Saunas the Next Big Performance-Enhancing “Drug”?

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Preface by Editor

This post will explain how heat can be used to increase growth hormone, muscular hypertrophy, endurance, and otherwise aid performance.

It’s authored by Rhonda Perciavalle Patrick, Ph.D, and it’s comprehensive. But before we get started, you need to read some background and warnings…

Heat is no joke.

Ever since I was a premie, overheating and thermo-regulation have been my arch-enemies. On a few occasions, I’ve been hospitalized for heat stroke symptoms, and the symptoms hit suddenly and without warning. I’m extremely lucky I didn’t smash my skull on the ground after the collapses.

To delve into this handicap, I even became a test subject at Stanford University in 2005.

I underwent military-related heat marches to exhaustion, capturing data the entire time. Here are some choice pics.

It was as fun as it looks (I’ll share videos another time, as they’re hilarious):

After each session, I was so incapacitated that I couldn’t do any work for 8-12 hours. I often had to simply go home and sleep, even at 11am. These issues led me to eventually leave the study.

Heat is serious fucking business, m’kay?

People can die from excessive heat (sauna example here, recent running death here), so read these warnings carefully… Read More

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Potential Tactics for Defeating Cancer — A Toolkit in 1,000 Words

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(Photo: Irina Souiki)

I’ve wanted to publish this post for years.

It will propose a few simple approaches for minimizing the occurrence of cancer.

With 19 billion capillaries in our bodies, on average, virtually 100% of us have microscopic cancers by the time we’re 70 years old, more than 40% of us by age 40. There’s a good chance you have pinhead-size cancers in your body right now. These “cancers without disease” aren’t typically a problem, as they can’t grow larger than 0.5 mm without a blood supply.

But if cancer cells gets constant blood and glucose? That’s when you can end up dead.

That’s not where I want to be, and it’s not where I want you to be.

A Little Backstory…

While at the annual TED Conference in 2010, I learned that two close friends had been diagnosed with cancer. The year before, another friend had died of pancreatic cancer in his early 30’s.

This all made me furious and sad. It also made me feel helpless.

As luck would have it, TED in 2010 was abuzz about someone named Dr. William Li. His 24-minute presentation had introduced the crowd to “anti-angiogenesis therapy”: in plain English, how to starve cancers of blood. Dr. Li specializes in inhibiting cancer-specific blood-vessel growth, which ostensibly keeps abnormal growth in check. The simplest “drug” he recommended was tea. Drinking a daily blend of white tea (specifically Dragon Pearl jasmine) and green tea (Japanese sencha).

I started drinking the cocktail immediately, but it was just a first step… Read More

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Soylent: What Happened When I Stopped Eating For 2 Weeks

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Shane Drinking Soylent

Tim Ferriss Intro

Hundreds of people have asked me about Soylent, a controversial Silicon Valley team trying to replace food with a grayish liquid.

“Does it really deliver all the nutrients the human body needs?”
“Is it safe?”
“Why hasn’t anyone tried this before?” [Hint: they have]
And most often: “What do you think of Soylent?”

Serendipitously, four or so weeks ago, I received an e-mail from Shane Snow, a frequent contributor to Wired and Fast Company:

I’m sure you have seen the buzz about the food-hacking movement, where a couple of Silicon Valley techies have been creating Matrix-style food replacement formulas for “optimum” chemical nutrition. Soylent.me, in particular, has been buzzing like crazy, having raised $800k in a Kickstarter-like campaign.

But nobody (besides the creators) has gotten his or her hands on any yet.

Except me.

Naturally, we had to do an experiment.

This post describes the longest non-employee trial of Soylent to date (two weeks without food), including before-and-after data such as:

- Comprehensive blood panels
– Body weight and bodyfat percentage
– Cognitive performance
– Resting heart rate
– Galvanic skin response
– Sleep

I share my thoughts in the AFTERWORD and occasionally in brackets, but this article focuses on Shane’s experience and data.  Please also note that this is *not* a Soylent take-down piece. I hope they succeed.

That said, there are some issues. I expect the debate on Soylent to be fierce, so please leave your thoughts in the comments. I’ll encourage the Soylent founders to answer as many questions as they can. From all sides, I’m most interested in studies or historical precedent that can be cited, but logical arguments are fine.

Also, a quick clarification: There is a bit of soy lecithin (an emulsifier) in Soylent, but soy is not a main ingredient, which is understandably confusing.

Enjoy the fireworks… Read More

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Ketosis and Athletic Performance: More Than Fat Loss

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The above video is a presentation by Peter Attia, M.D.

His talk is somewhat technical, but I always write blog posts hoping 20,000 people will *love* them, not that 1,000,000 will *like* them.

In this presentation, you will learn (in my words, not Pete’s):

- More about nutrition than most MDs learn in med school.
– How ketosis-adapted performance can aid fat loss and high-altitude resilience.
– Why the calorie estimates on treadmills and stationary bikes are complete BS.
– The three primary systems of energy production and basic organic chemistry, both of which aid understanding of all athletics.

Even if you struggle a little with vocabulary, the first 30 minutes are well worth watching a few times.

This talk made me immediately want to jump back on the Cyclical (or “Cyclic”) Ketogenic Diet (CKD), which was conceptually introduced to me in 1996-1998 by the writing of Lyle McDonald, Dr. Mauro Di Pasquale, and the late Dan Duchaine. It’s incredible for simultaneous fat loss and lean muscle gain, though perhaps needlessly complicated for non-athletes.

I usually limited the carb-reloading period to 12-18 hours after a glycogen depletion workout on Saturdays, though I experimented with moderate Wed night carb-ups while training for sports like kickboxing.

If you’ve experimented with ketosis, what was your approach and experience? Pros and cons?

For additional reading, I suggest the following posts by Dr. Attia:
http://eatingacademy.com/nutrition/ketosis-advantaged-or-misunderstood-state-part-i
http://eatingacademy.com/nutrition/ketosis-advantaged-or-misunderstood-state-part-ii

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Odds and Ends:
This week, I’m using my birthday to change the world with @charitywater. Please click here to take a look. You could do the same.

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