#207 - AMA #35: "Anti-Aging" Drugs — NAD+, metformin, & rapamycin

The Peter Attia Drive

Peter Attia, MD

Health & Fitness, Medicine, Fitness

4.7 • 7.3K Ratings

🗓️ 16 May 2022

⏱️ 31 minutes

🔗️ Recording | iTunes | RSS

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Summary

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In this “Ask Me Anything” (AMA) episode, Peter is joined by special guest, Dr. Matt Kaeberlein. Together they answer many questions around the field of aging with an emphasis on three specific molecules—NAD, metformin, and rapamycin—and their purported geroprotective qualities. They first discuss aging biomarkers and epigenetic clocks before breaking down the advantages and limitations of the most common experimental models being used today to study aging and pharmacological possibilities for extending lifespan. Next they dive deep into NAD and the much-hyped NAD precursors, nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN). They compare data from NAD precursors to studies on metformin and rapamycin, assessing how they stack up against each other and using the comparison as an opportunity to illustrate how to make sense of new experimental data and make smart decisions about how to approach future research.

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 AMA #35 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.

We discuss:

Logic behind comparing NAD precursors to rapamycin and metformin [3:40];
Aging biomarkers: current state, usefulness, and future promise [7:00];
Epigenetic clocks: definition, use case, and limitations [14:45];
Advantages and limitations of studying aging in non-humans and the strengths and weaknesses of different model systems [26:30];
Aging studies: importance of control lifespans and the problems with reproducibility [34:15];
Intro to NAD, potential role in aging, relationship to sirtuins, and more [48:15];
NAD precursors (NR and NMN): current data [1:10:00];
Human studies with NAD precursors [1:25:45];
Comparing NAD lifespan data to data from metformin and rapamycin [1:28:30];
Defining a “clean drug” and a “dirty drug” [1:38:00];
Reason for the lack of rapamycin studies in humans compared to NAD and metformin [1:41:00];
Ranking the geroprotective molecules in terms of risk and reward [1:48:00]; and
More.

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Transcript

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0:00.0	Hey everyone, welcome to a sneak peek, ask me anything, or AMA episode of the Drive Podcast.
0:16.5	I'm your host, Peter Atia.
0:18.3	At the end of this short episode, I'll explain how you can access the AMA episodes in full,
0:22.9	along with a ton of other membership benefits we've created.
0:25.9	Before you can learn more now by going to peteratia-md.com forward slash subscribe.
0:31.5	So without further delay, here's today's sneak peek of the Ask Me Anything episode.
0:36.5	Welcome to Ask Me Anything Episode 35.
0:42.7	This is a special AMA where, in addition to being joined by Nick Stenson, I'm also joined
0:47.4	by a previous guest, Matt Kaberline.
0:49.0	Matt's been a previous guest on the podcast twice, actually, with the most recent one being
0:53.1	I believe in September of last year.
0:55.8	He's a professor of laboratory medicine and pathology, an adjunct professor of genomic
0:59.2	science and an adjunct professor of oral health science at the University of Washington.
1:02.7	His research interests are focused on the basic mechanisms of aging in order to facilitate
1:06.6	translational interventions that promote health span and improve quality of life.
1:11.5	Wanted Matt to join for this one because I knew we were going to go into a lot of different
1:17.2	subjects where he would provide insight into the questions that many of you have asked.
1:23.0	So in this episode, we focus on answering questions around the field of aging, but specifically
1:29.0	looking at three-giriprotective molecules.
1:31.6	These are the three molecules that I get asked about the most.
1:35.8	The first is all things that have to do with NAD and that usually implies its precursors
1:42.7	NR and NMN, but also sometimes NAD itself.
	...

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