#35 - Nir Barzilai, M.D.: How to tame aging

The Peter Attia Drive

Peter Attia, MD

Health & Fitness, Medicine, Fitness

4.7 • 7.3K Ratings

🗓️ 7 January 2019

⏱️ 168 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this episode, Nir Barzilai, director of the Institute for Aging Research and expert in the genetics of longevity, discusses the evidence that metformin and rapamycin have anti-aging properties and how his TAME study aims to support this hypothesis in humans. Additionally, he describes the role of genetics in lifespan/healthspan and how it might affect important pathways such as IGF and insulin sensitivity.

We discuss:

Nir’s background and interest in aging and endocrinology [3:30];
History of metformin, and understanding the mechanism [11:15];
Attempting to define insulin resistance [21:15];
Metformin as a possible anti-aging drug [48:45];
The TAME trial: Targeting Aging with MEtformin [57:45];
Why Nir believes metformin can slow aging [1:16:30];
The genetic gift of centenarians [1:28:00];
IGF/GH and its impact on aging and chronic diseases [1:34:15];
Genetics/epigenetics of centenarians, gene sequencing, CETP-VV, Lp(a) [1:49:15];
Should you be taking HGH? [2:05:30];
NAD and NAD precursors (NR and NMN) [2:30:00];
Parting thoughts on metformin [2:36:15];
Possible blind spots in Nir and Peter’s thinking? [2:43:00]; and
More.

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Transcript

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0:00.0	Hey everyone, welcome to the Peter Atia Drive. I'm your host, Peter Atia.
0:10.0	The drive is a result of my hunger for optimizing performance, health, longevity, critical thinking,
0:15.7	along with a few other obsessions along the way. I've spent the last several years working
0:19.6	with some of the most successful top performing individuals in the world, and this podcast
0:23.8	is my attempt to synthesize what I've learned along the way to help you live a higher quality
0:28.3	and more fulfilling life. If you enjoy this podcast, you can find more information on today's
0:32.5	episode and other topics at peteratiamd.com.
0:41.6	Hey everybody, welcome to this week's episode of the drive. Happy New Year to everyone. We took
0:45.8	a week off, as you probably noticed. So hopefully everybody's ready to jump back into this fun stuff.
0:51.7	My guest this week is near Barzalai, and if you're at all into the space of longevity,
0:57.6	he'll be no stranger to you. Near is the founding director of the Institute for Aging Research,
1:03.5	the Nathan Shock Center of Excellence in Basic Biology at Albert Einstein. He's completed two
1:09.3	fellowships, one in metabolism at Yale, the other in endocrinology and molecular biology at Cornell.
1:16.6	He directs the longevity genes project, and in my estimate near is probably the most knowledgeable
1:22.7	person ever on the genetics of longevity, and we talk a ton about that during this episode.
1:28.9	He also is leading the effort to test metformin in a prospective clinical trial for non-diabetics
1:37.0	with respect to aging, and this is referred to as the tame trial. We get into that obviously in
1:42.6	detail here, and also will use a lot of the data for that in the show notes. This is in many
1:49.5	ways I think near is probably one of the most insightful people when it comes to understanding the
1:53.2	clinical benefits of metformin, and we talk about that a ton. We also talk about insulin resistance.
1:57.9	I can't resist the urge and upon intended, I guess, to get into sort of a detailed discussion on
2:03.4	what IR is with sort of people who are really deep in the space. We talk a lot about IGF and growth
	...

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