Dr. Peter Attia: Supplements for Longevity & Their Efficacy

Added: Jul 30, 2024

The NAD Pathway and Its Relevance to Aging

The discussion delves into the NAD pathway, explaining that NAD is present in virtually every cell of the body except red blood cells. It plays a crucial role in energy production and mitochondrial function, acting as a coenzyme in over 500 cellular pathways. NAD levels decline with age, particularly in the skin, leading some researchers to hypothesize that boosting NAD levels could potentially slow aging. However, both doctors express skepticism about this approach, noting that the body tightly regulates NAD levels and that simply increasing NAD may not necessarily produce beneficial effects.

Sirtuins and Caloric Restriction

The conversation shifts to sirtuins, a class of proteins involved in cellular regulation and aging. Dr. Attia recounts the history of sirtuin research, explaining how early studies in yeast suggested a link between sirtuins, caloric restriction, and longevity. However, subsequent research has shown that these pathways are likely independent. He emphasizes that while caloric restriction has been shown to extend lifespan in various organisms, its effects in humans are less clear and may come with significant downsides.

NAD Precursors: NR and NMN

The doctors discuss the use of NAD precursors like nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) as supplements. They explain that these molecules are marketed as ways to boost NAD levels in the body. Dr. Attia points out that while these supplements can indeed increase NAD levels in the blood, there's little evidence to suggest this translates to meaningful health or longevity benefits. He cites the Interventions Testing Program (ITP), which found no lifespan extension in mice given NR supplements.

Clinical Studies and Health Claims

Dr. Attia reviews several human clinical studies on NAD precursors, including one looking at fatty liver disease and another examining glucose disposal. While some statistically significant results were found, he argues that these were likely not clinically significant. Both doctors agree that the evidence for NAD-boosting supplements improving healthspan or lifespan is currently weak.

Personal Supplement Regimens

Despite their skepticism about NAD-boosting supplements, both doctors share their personal supplement regimens. Dr. Attia takes rapamycin, fish oil, thiamine, vitamin D, methyl folate, methyl B12, magnesium, ashwagandha, creatine monohydrate, and a probiotic called Pendulum. Dr. Huberman's regimen includes AG1, fish oil, vitamin D3, methyl B12, Tongkat Ali, green tea extract, NMN, creatine monohydrate, magnesium, and various sleep-supporting supplements. Both emphasize that these choices are personal and based on their interpretation of available evidence, not necessarily recommendations for others.

Exercise and Energy Levels

The conversation turns to the importance of exercise for maintaining energy levels and overall health as one ages. Dr. Huberman shares his observation that exercising early in the morning seems to provide more energy throughout the day. Dr. Attia agrees that exercise timing can be important but suggests that the ability to exercise early might also be a result of high energy levels, rather than solely a cause. Both doctors stress the critical importance of regular exercise for healthspan and lifespan.

Biological Age Testing

Dr. Attia expresses skepticism about the current state of biological age testing, arguing that these tests lack the precision and reproducibility needed to be truly useful. He points out that chronological age remains a better predictor of lifespan than any current biological age test. While he acknowledges that such tests might become more valuable in the future, he cautions against putting too much stock in them at present.

Radiation Exposure and Health Risks

In response to a question about radiation exposure from air travel and medical scans, Dr. Attia provides context on typical radiation exposure levels. He explains that the radiation from air travel and most medical scans is relatively low and unlikely to pose significant health risks for most people.

The Importance of the 50s to 70s Decade

Dr. Attia highlights the importance of the period from one's 50s to 70s as a critical window for establishing habits and physiological reserves that will impact health in later decades. He emphasizes the need to build and maintain muscle mass, strength, and overall fitness during this time, as it becomes increasingly difficult to do so later in life.

Concluding Thoughts on NAD and Supplements

In their concluding remarks, both doctors express skepticism about the importance of NAD-boosting supplements for longevity. Dr. Attia uses a vivid analogy, comparing the choice of supplements to deciding between lobster and steak on the Titanic, while fundamental lifestyle factors like exercise, sleep, nutrition, and emotional health are akin to the ship's direction relative to the iceberg. Both agree that these fundamental factors are far more important for health and longevity than any supplement regimen.

Dr. Attia states clearly that he does not take NAD-boosting supplements and has no plans to do so based on current evidence. However, both doctors remain open to changing their minds if compelling new data emerges in the future. They stress the importance of prioritizing lifestyle factors over supplements for those seeking to improve their healthspan and lifespan.