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The Peter Attia Drive

#312 - A masterclass in lactate: Its critical role as metabolic fuel, implications for diseases, and therapeutic potential from cancer to brain health and beyond | George A. Brooks, Ph.D.

The Peter Attia Drive

Peter Attia, MD

Health & Fitness, Medicine, Fitness

4.77.3K Ratings

🗓️ 5 August 2024

⏱️ 126 minutes

🧾️ Download transcript

Summary

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George A. Brooks is a renowned professor of integrative biology at UC Berkeley. Known for his groundbreaking "lactate shuttle" theory proposed in the 1980s, George revolutionized our understanding of lactate as a crucial fuel source rather than just a byproduct of exercise. In this episode, George clarifies common misconceptions between lactate and lactic acid, delves into historical perspectives, and explains how lactate serves as a fuel for the brain and muscles. He explores the metabolic differences in exceptional athletes and how training impacts lactate flux and utilization. Furthermore, George reveals the significance of lactate in type 2 diabetes, cancer, and brain injuries, highlighting its therapeutic potential. This in-depth conversation discusses everything from the fundamentals of metabolism to the latest research on lactate's role in gene expression and therapeutic applications.

We discuss:

  • Our historical understanding of lactate and muscle metabolism: early misconceptions and key discoveries [3:30];
  • Fundamentals of metabolism: how glucose is metabolized to produce ATP and fuel our bodies [16:15];
  • The critical role of lactate in energy production within muscles [24:00];
  • Lactate as a preferred fuel during high-energy demands: impact on fat oxidation, implications for type 2 diabetes, and more [30:45];
  • How the infusion of lactate could aid recovery from traumatic brain injuries (TBI) [43:00];
  • The effects of exercise-induced lactate [49:30];
  • Metabolic differences between highly-trained athletes and insulin-resistant individuals [52:00];
  • How training enhances lactate utilization and facilitates lactate shuttling between fast-twitch and slow-twitch muscle fibers [58:45];
  • The growing recognition of lactate and monocarboxylate transporters (MCT) [1:06:00];
  • The intricate pathways of lactate metabolism: isotope tracer studies, how exceptional athletes are able to utilize more lactate, and more [1:09:00];
  • The role of lactate in cancer [1:23:15];
  • The role of lactate in the pathophysiology of various diseases, and how exercise could mitigate lactate's carcinogenic effects and support brain health [1:29:45];
  • George’s current research interests involving lactate [1:37:00];
  • Questions that remain about lactate: role in gene expression, therapeutic potential, difference between endogenous and exogenous lactate, and more [1:50:45]; and
  • More.

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Transcript

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0:00.0

Hey everyone. Welcome to the Drive Podcast. I'm your host Peter Attia. This

0:15.7

podcast, my website, and my weekly newsletter all focus on the goal of

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translating the science of longevity into something accessible for everyone.

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If you want to learn more about the benefits of our premium membership,

0:58.0

head over to Peter AttiaMD.com

1:01.0

forward slash subscribe. My guest this week is George Brooks. George is a

1:06.8

professor in the Department of Integrative biology at UC Berkeley and is the

1:10.3

director of the exercise physiology lab. You may recognize George's name as it's come up a couple of times in interviews with Inigo-Sond-Malan.

1:18.6

I also wrote about George briefly in Outlive when I referred to his work in Lactate. George was the scientist who first proposed

1:26.4

the Lactate Shuttle Theory in the 1980s, arguing that Lactate was actually a fuel source rather than an unfortunate byproduct of exercise.

1:34.3

His research has focused on the metabolic adjustments to exercise and explores many topics

1:39.5

surrounding exercise physiology, including the pathways and controls of lactate formation and removal

1:45.0

before, during, and after exercise.

1:47.2

My conversation with George dives deep into all things lactate.

1:51.8

It's a little bit technical but again not particularly egregious relative to the

1:56.4

depth that we normally will cover things but I do encourage you to stay with this even if at times

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