324‒Metabolism, energy balance, and aging: the impact of diet, calorie restriction & macronutrients

[@PeterAttiaMD]

We discuss: 0:01:34 - Eric’s background and current work metabolism and measuring energy expenditure 0:07:18 - The science behind metabolic chambers for measuring energy expenditure, and the complexities of indirect and direct calorimetry 0:17:47 - The body's regulatory systems for maintaining energy balance and the primary influence of energy intake on body weight 0:25:00 - The epidemic of obesity and a discussion of resting metabolic rate 0:29:15 -The impact of exercise, appetite, gut hormones, and eating patterns on weight regulation 0:40:11 - Experiments looking at how macronutrient composition affects energy expenditure 0:54:05 - The challenges of studying diet in real-life settings, the potential of personalized nutrition, and how public health policy could play a role in guiding nutritional habits 1:13:27 - The importance of protein in the diet, the limitations of dietary data collection, and how AI could potentially transform nutrition science 1:21:30 - How Eric’s interest in caloric restriction (CR) began with Biosphere 2, metabolic efficiency's role in aging, and goals of the CALERIE study 1:35:20 - The CALERIE study: exploring the real-world impact of caloric restriction 1:49:16 - Notable findings from the CALERIE study after two years: sustained weight loss, participant retention, and more 1:57:21 - The effect of caloric restriction on the hallmarks of aging 2:07:07 - The challenge of applying CR to the general population, the potential of drugs and exercise to mimic the effects of CR 2:15:08 - Upcoming study comparing caloric restriction to time-restricting eating, and Peter’s takeaways from the discussion

[@michael5679]

Exactly what many people don't want to hear. Your exercise routine keeps you fit, but it's your diet that will keep you trim.

[@wendyvg1225]

I've been doing CR + OMAD for 4 years now. I eat about 1000- 1200 calories a day (5"2, 110 lbs). I do resistance training 3 times a week for 30/40 minutes, and Zone 2 training 3 times a week for 45 minutes. I feel amazing in every way. I've never been more emotionally and physically healthy and truly believe that even, pr maybe especially the deprivation part can be very useful for feeling well cognitively and emotionally. It's awesome to no longer be a slave to hunger and cravings. I think more people would opt for this if only they could experience the outcome for a week or so. Unfortunately, it did take me at least 6 months to really settle in into this life style and to feel this good. It's hard to convince others to give it a serious try, since so few are willing to stick through the rough part. But I did finally got my husband to do it and his experience is the exact same as mine :-)

[@robertbrown6531]

Thanks for that, its a really useful observation, thinking of trying CR myself, but not with OMAD. Your calories seem really low, do you know by what sort of % your are restricting calories based on your non CR daily calorie intake? If you still have plenty of energy for exercise it must be enough. I'm thinking about aiming for modestly undercutting calories, no more than 20%.

[@adunn7272]

I love this episode so much; not only is it incredibly insightful. It’s just an honest update on where we are with understanding how our body processes energy. No matter what recent podcast you’ve listened to on nutrition, body, composition, fitness. It just has to start with an understanding of energy balance. thank you Peter and thank you Eric (yes I’m on a first name basis bitches)

[@mikaelajasonnn3]

I started questioning everything, especially government health advice! After reading "Health and Beauty Mastery" by Julian Bannett, I completely changed my habits. This book reveals so many shocking truths about the health industry!

[@AnnaLorris]

totally agree

[@ivanf2782]

Book only sales on a website for a reason. Is a typical scamy non scientific thing people want you to feel fomo so you buy it. No reviews of the book anywhere and no info on any university of the writer of the book. So people. Please. Do yourself a favor and stay with info from real researches like in this podcast. And don't giveaway your money to people advertising the "secret book to now really finally understand everything". But good try

[@GenuinePluko]

Here is my question. Person A eats 1500 kcals strict 100% tracked and sits on couch all day. Person B eats 1500 kcals strict 100% and does 1 hour bike ride everyday. Person B is surely going to lose more weight? As with the calories being tracked there's no change in appetite or not eating differently after exercise etc???

[@resistapathy]

My appetite reduces with exercise- aerobic and anerobic. It used to take 3 months of eating the same thing but running 30 minutes a day to see a big change. Now in my late 50s it might take 6 months. Changes in appetite brought about by exercise is probably also very individual and for me is tied to blood sugar regulation.

[@cyclamen831]

Excellent interview. I really appreciate when true scientists are invited and it becomes obvious the limitations of today's scientific discoveries and implementation in the free living environment. The idea of the benefit of CR is obvious, provided you are applying it to the right population, but the fact that this was experimentally studied with its findings makes the implementation of CR even more compelling. But how? I am in support of free market but it was well presented the fact that this is the price to pay for living in such environment of abundance: obesity, DM, CVD, ESRD, etc. Taxes on UPF, no advertisements targeted to children, revamping school lunches, mandatory PE at school, and more can all be tools while we help our patients for now with GLP-1 RA.

[@StephenB_IndependentThought]

Absolutely fantastic discussion of the complexities and current state-of-the-art in nutrition science for optimal longevity. One of the best dicussions I've seen in many years as a longevity enthusiast. The amount of variables involved and their interactions is staggering. I love the power of Science! Thanks Peter and Eric!

[@leslieabbott6119]

Thank you. And Peter, it was good to be reminded to eat slowly and let the body catch up. I just did my workout and after felt like I could eat a house! I tied on the food bag...it is hard to stop! I didn't slow down and consumed way too many calories!

[@ReadingDave]

I did count calories both eaten and expended for a while and the value of doing so was when I saw a net gain of calories I would compinsate with extra exersise that day. I charted calories and weight.

[@MarthaHenson-zp1kw]

Well I try to eat as my great grand and grands ate. Real food, prepared at home, twice a day...no snacking. Physical movement most of the day. So far so good...no meds, lean weight, I'm in my 70s. Good luck to all in your health journey.

[@scottpierce9195]

There may not be one perfect diet for everyone. Fortunately I have found the perfect diet for me 😊. I eat about half a pound of bacon and half a dozen eggs everyday after my morning walk, and then eat a pound or two of beef every evening. I only drink coffee with stevia as well as water throughout the day. I do not snack at all, that is all I eat. Fortunately I am never hungry enough to feel the need to snack, I feel satiated throughout the day. I am a 54 year old male. I lost over 60 lbs in 6 months, and have maintained it for nearly a year. I look and feel better than I have since I was in my 20s. All of my aches and pains have disappeared, I feel mentally sharp, and I am energetic throughout the day.

[@Find-Your-Wellness-With-Me]

If you don't have mental health nothing is going to help you. When that message crosses our minds...

[@aryangod2003]

Peter, I am a physician, I think you’re making the controversy bigger than it is. There’s actually a lot more agreement in the nutritional biochemistry community than disagreement. While there’s no "perfect diet" for everyone, we can agree that too much red meat-even if it’s grass-fed-can raise LDLc /ApoB levels (to varying degree based on your genetics). Fruits and veggies, especially cruciferous and leafy greens, are generally good for most people. Similarly sugar, and UPF on Supermarket aisles are terirble. The Mediterranean diet works well for many, too. For those who are metabolically unhealthy, a low-carb Mediterranean diet with wild salmon, sardines, and avocados can be a good option. But severe carb restriction over time is risky for many people. Let’s focus on these solid guidelines! Eat in small quantities, mostly plants/nutrient dense vegetables and grains, avoid sugar/alcohol, whole grains and healthy carbs unless you are metabolicaly unhealthy etc(quinoa/Sweet potatoes) and healthy fats (Omega 3 Rich PUFA and Monounsaturated like EV olive oil, Sardines, Wild Salmon, Avocadoes, Chia/flax). Also Lentils/Beans well soaked.

[@lonnieraesmith2482]

Metabolically unhealthy people represent over 85% of our population. With that in mind we should all continue to learn and perhaps relearn focusing on diets that will help heal and bring life to our bodies. This varies dramatically from person to person especially as we address our unhealthy population. Hypervigilance and being keenly aware keeping an open mind and being astute is a must especially in these times. Let's NEVER think we've arrived. Thank you Peter!

[@resistapathy]

“But severe carb restriction over time is risky for many people.” Why do you say that? Are you familiar with Dr Richard K Bernstein and his recommendation of 6 g carb breakfast and 12 g carb for lunch and dinner respectively as advocated in his book The Diabetes Solution?

[@him-hk7ii]

I was once an obesed fat double boarded physician who even worked as a Bariatrics Hospitalist part time. I could not lose weight until I started extended fasting. Now my biomarkers are top 5% for 67yo including Vo2max. Thank DR J FUNG

[@nichtsistkostenlos6565]

There are a bunch of things here that you've said here that are very controversial. 1. By "too much red meat" what do you mean? Is the problem with red meat saturated fat, or are you implying that absent saturated fat intake there is a problem with red meat specifically? This distinction is highly controversial, especially since lean cuts of red meat can be quite low in saturated fat. 2. The idea that sugar is inherently bad is very controversial. Excess sugar intake for sure, but just generally consuming moderate amounts of sugar doesn't seem to have negative health outcomes whatsoever in the literature in already healthy individuals. 3. There is lots of controversy around having a diet high in protein or animal products regardless of their source. Salmon specifically being called out because of its high fat content. Vegetarian and vegan nutrition advocates would debate this to the bitter end. Also, there is a lot of debate around low carb/high fat vs. high carb/low fat. I've seen no indication of broad agreement on any of these things among nutritionists or biochemists. Half of what you recommend (while I agree with most of it) is debated all day every day in the nutritional space.

[@MiamiMichele]

I’m a registered dietitian and totally agree!

[@kshamadatar4662]

Fantastic information, one of your best podcasts! Thank you!

[@coach9363]

Have always seemed to have a weight set point throughout my life. Weight had minimal fluctuations around those set points for years. Recently reduced my “set point” down about 30 lbs. It’s been relatively constant the last 2 years. Think this last change in weight “set point” has been from making a very conscious effort to meet my protein macros.

[@adunn7272]

Oh my Lord, the theory of oxidative stress and rate of life just blew my mind as such a top level insight into the scope of all this

[@davidbright8978]

Would love to see a study on military recruit blood, v02 and other metabolic markers at the start of bootcamp vs 3 months later. I mean you have almost completed control of them and their diet.

[@carolesteinberg7463]

I’m 65 eat a mixed diet of mostly whole unprocessed food. I lift weights 5 days a week and run or do cardio and walk the dog. I feel really good blood work good except high ferritin. Lower side of normal bp. I eat about 2200-2600 cals. I’m on the lean side but I’m ok with that.

[@sylviedesjardins7612]

I do enjoy all the info, thanks. My stomach tells me what it wants to eat and I trust him. So far...😊

[@ReadingDave]

I find that when I exersise and try to lose weight, my body is long adapted to eating lesser of calories and also adapts to exersise by building muscles which makes me heavier. So, at first, exersise is difficult to account by weight alone. Body part sizes might be a better measure as well as a test of mobility. My strategy right now is to get myself more mobile and then be more physically active consistantly through the day.

[@HarryMiller-g4c]

Regarding bad government policy, what about subsidizing overproduction of corn which is turned into artificially cheap sugar - corn syrup - which is a primary ingredient in the isles and isles of inexpensive, low protein,high calorie processed foods in the supermarket? Then there's soda. Im old enough to remember when a 12 oz Coke was an occasional treat. Now 32oz is "medium". Love these podcasts but I wish Dr Peter would restrain from interrupting and let his guests finish their thoughts.

[@RobertBurg-o1z]

Instead of standing off and throwing verbal hand grenades at each other, please find a conversation where a carnivore advocate and a whole food plant based (WFPB) advocate have a meaningful discussion about how they arrive at what appear to be opposite successful approaches to long-term (10+ years) healthspan. Does epigenetics explain how some people decline on a WFPB diet and thrive long-term on a carnivore diet while other people decline on a carnivore diet and thrive long-term on a WFPB diet?

[@robertbrown6531]

it seems its almost impossible to have a sensible discussion on the real benefits of one of these diets versus the other and how they both affect longevity. I find the antagonistic calling out by each side so unhelpful in trying to decide the optimum long term diet for me. I would like to try WFPB but know of some people, who really did do it properly, who's health did go downhill after a number of years yet some of the long term plant doctors (campbell, esselstyn, etc) still seem to be thriving into their 90's. As for carnivore, short term very positive results, long term? a game of russian roulette on current evidence and terrifying the threat of increasing heart disease and cancer risk with lots of red meat.

[@Dr_Boult]

great discussion overall. But I do ML/computer vision, and I don't expect photos will EVER give you caloric intake in a photo. Nor would xrays or other imaging. No way to tell the level of ingredients -- how much oil/butter or sugar is invisible. It might get better with multispectral, but even there, it is probably not all visible, just the surface. It would work for whole natural food but not processed stuff.

[@EVanDoren]

~7:00 You will eventually oxidize every amino acid you consume (minus the lost cells with feces/skin, as well as hair). We are more or less in nitrogen balance after we are fully grown, so the same amount of amino acids you consume will be degraded.

[@LauraDeVasconcelos]

1:02:41 also for women in their follicular fase is advised to eat Keto or low carb for oestrogens anyway

[@JPWestmas]

We fatigue faster than we can burn the meal we eat. That is why exercise is not the primary tool to use to keep metabolic health intact. It's more important to strengthen your body with exercise than to worry about your rate of weight loss through exercise.

[@orbifold4387]

As a mathematical problem, is the problem of predicting the onset of obesity more similar to long term weather forecasts or more similar to climate change?

[@Alaski]

We are wired for scarcity and live in abundance. Makes sense to tap into the way we are wired a little more. PS we are also wired to be social and help others.

[@Answeriz42]

2:10:51 I completely agree with the sirtuins not having to do with metabolic benefits of CR, HOWEVER it’s inappropriate to disregard sirtuins as useless things to things to study. Sirtuins role in cellular+DNA repair still are worth studying with respect to things like cancer prevention/treatment.

[@shred3005]

Just my subject matter for my stage of life. !

[@erwin_888]

same..

[@smooth_pursuit]

I didn’t notice the personalised medicine during covid.

[@salemameen]

Thank you

[@mflynnnj1]

One size does not fit all ----I wish more DRs would realize this.

[@jennakericson]

"when leptin was discovered it was a haha moment." So funny!

[@eamonnw]

01:03:40 how about stopping/restricting eating if you go over your 5 day average weight

[@susymay7831]

The Calorie study participants both restricted calories and included regular strength training ❤

[@suefonder7468]

personalized medicine doesn't exist on Medicare in Nebraska.

[@him-hk7ii]

This man is awesome!!!! Why you been keeping this OG to yourself.Lol

[@michaelwatts1186]

When i think of Biosphere 2 i think of Bio Dome the movie with Pauly Shore. Hilarious.

[@SR-fm1ft]

How does altitude affect or change metabolism and metabolic health? Like for example groups of people living in regions of higher altitude vs other groups living at sea level.

[@Varn5150]

Peter, Can statins disrupt Leptin signals that might cause people to gain weight or prevent weight loss?

[@HeatherQ333]

Come on. If nothing else, can't we all agree that a WFPB diet is what is best for the planet. ? We know! We already know. 😊

[@ReadingDave]

Would you please explain to me what you would wish AI to do? I imagine something to be done, but I don't have the vision of how to change nutrition science.

[@tonydelatorre7265]

I’ve literally been weighing 99% of my food for 7month 😂 call me weird but it works for me dropped 20 lbs of fat and added 6 lbs of muscle by eating 215 grams of protein and cutting carbs to 40 - 70 grams

[@teresarommel]

Dang I wish I like protein more. Ugh!

[@jackien4959]

I agree there is not a diet good for everyone but I think there is a diet bad for everyone… the SAD

[@jaymckoskey25]

The question of the lipid panel results was never answered. Dr. Attia asked it several times and Dr. Ravussin changed the topic each time. Very disappointing and a glaring omission in an otherwise exceptional presentation.

[@paulevans2246]

👍

[@libragoddess333]

My biggest crush is you Amazing Human…P A✨🙏🏻🤣

[@jimschaffner1]

I'm not sure why you have to make things so difficult. Look at the relative lack of obesity 50 or more years ago. What was the difference? People ate less and moved more. Very simple. You really want the answer? Stop drinking Mountain Dew and quit eating Cheetos and Ben and Jerry's, skip the drive thru line and walk inside, leave the car at home and walk, etc. Why so complicated?

[@nichtsistkostenlos6565]

We're not aiming to be as healthy as we were 50 years ago. This channel is about long term health optimization. We're striving to be as healthy as possible for as long as possible. Not drinking Mountain Dew and eating Ben & Jerry's doesn't even get you 1/10th of the way to your health potential.

[@MsKelle123]

They smoked too.

[@Ahdbfbfbeh]

Can we explain and figure out this lean mass hyper responder shit. ?

[@EVanDoren]

There is nothing unusual going on. Consume a shitty diet, get a shitty lipid levels.

[@smooth_pursuit]

@@EVanDoren then why do Oreos solve the problem?

[@nichtsistkostenlos6565]

It's a hypothesis that needs more long term and ideally some Mendelian randomization studies to prove out. There's not much to talk about at the moment until we have real data.

[@RecicledCanadian]

I'm a carnivore ,65 years young individual. I'm healthy as I have never been and laughing at our "science".🤣🤣🤣🤣🤣🤣🤣🤣

[@aa-xn5hc]

Bad interviewee..