#333 ‒ Longevity roundtable — the science of aging, geroprotective molecules, lifestyle interventions, challenges in research, and more | Steven Austad, Ph.D., Matt Kaeberlein, Ph.D., Richard Miller, M.D., Ph.D. | The Peter Attia Drive - Private Subscriber Feed (🔓 for Vijay Khakhria)

In this inaugural roundtable episode of The Drive, host Peter Attia is joined by Drs. Steve Austad, Richard Miller, and Matt Kaeberlein to discuss geroscience and longevity science. The conversation begins with the surge in public interest in longevity, followed by a discussion on healthspan versus lifespan, and the challenges of defining healthspan. The experts then explore reasons for the lag in translating discoveries into mainstream practice, NIH funding for aging research, and whether aging should be classified as a disease. They further discuss the concepts of biologic versus chronologic age, the utility of epigenetic clocks, and the hallmarks of aging. The panel also discusses interventions like GLP-1 agonists, the role of senescent cells, and the potential of metformin and canagliflozin as geroprotective drugs, and the potential of parabiosis.

Outlines

Part 1: Introduction, Definitions, and Public Interest

Part 2: Funding, Politics, and Research Challenges

Part 3: Measuring Biological Age and Epigenetics

Part 4: Proactive Medicine and Public Education

Part 5: Biomarkers, Animal Models, and Exercise

Part 6: Evaluating Interventions: GLP-1 and Senolytics

Part 7: Pharmacological Interventions: Metformin and Rapamycin

Part 8: Supplements, Blood Factors, and Future Outlook

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#333 ‒ Longevity roundtable — the science of aging, geroprotective molecules, lifestyle interventions, challenges in research, and more | Steven Austad, Ph.D., Matt Kaeberlein, Ph.D., Richard Miller, M.D., Ph.D.

The Peter Attia Drive - Private Subscriber Feed (🔓 for Vijay Khakhria)

Part 1: Introduction, Definitions, and Public Interest

00:10Introduction to Geroscience and Longevity Research

Introduction to Geroscience and Longevity Research

03:42The Healthspan vs. Lifespan Debate and the Rise of Longevity Interest

The Healthspan vs. Lifespan Debate and the Rise of Longevity Interest

07:30Factors Delaying Progress in Longevity Research and the Healthspan-Lifespan Relationship

Factors Delaying Progress in Longevity Research and the Healthspan-Lifespan Relationship

11:14Defining Healthspan and the US Healthcare Paradox

Defining Healthspan and the US Healthcare Paradox

15:13The Uselessness of the Term Healthspan and Personalizing Longevity Goals

The Uselessness of the Term Healthspan and Personalizing Longevity Goals

Part 2: Funding, Politics, and Research Challenges

19:21Factors Driving Mainstream Longevity Interest and NIH Funding Challenges

Factors Driving Mainstream Longevity Interest and NIH Funding Challenges

23:36The Political and Reputational Challenges to Aging Research Funding

The Political and Reputational Challenges to Aging Research Funding

27:39The Disconnect Between Aging as a Risk Factor and Research Funding

The Disconnect Between Aging as a Risk Factor and Research Funding

31:03The Reactive Nature of Clinical Medicine and the Question of Aging as a Disease

The Reactive Nature of Clinical Medicine and the Question of Aging as a Disease

Part 3: Measuring Biological Age and Epigenetics

34:46Biological vs. Chronological Age and the Reality of the Aging Process

Biological vs. Chronological Age and the Reality of the Aging Process

39:07The Limitations of Current Biological Age Tests and the Messiness of the Industry

The Limitations of Current Biological Age Tests and the Messiness of the Industry

43:01The Predictive Value of Biological Age and the Role of Epigenetics

The Predictive Value of Biological Age and the Role of Epigenetics

47:46The Causal Role of Epigenetic Changes and the Hallmarks of Aging

The Causal Role of Epigenetic Changes and the Hallmarks of Aging

52:30The Limitations of the Hallmarks of Aging and the Need for Discovery Science

The Limitations of the Hallmarks of Aging and the Need for Discovery Science

57:31The Complexity of Epigenetic Change and the Importance of Specificity

The Complexity of Epigenetic Change and the Importance of Specificity

1:01:08The Potential of Epigenetic Reprogramming and the Downstream Effects of Biological Aging

The Potential of Epigenetic Reprogramming and the Downstream Effects of Biological Aging

Part 4: Proactive Medicine and Public Education

1:05:04Integrating Medicine 2.0 and 3.0 and the Political Challenges to Funding Reallocation

Integrating Medicine 2.0 and 3.0 and the Political Challenges to Funding Reallocation

1:09:21The Importance of Public Education and the Role of the Private Sector

The Importance of Public Education and the Role of the Private Sector

1:13:03The Importance of Immune Function and the Need for Aging Rate Indicators

The Importance of Immune Function and the Need for Aging Rate Indicators

Part 5: Biomarkers, Animal Models, and Exercise

1:17:14Biomarkers vs. Aging Rate Indicators and the Challenges of Human Studies

Biomarkers vs. Aging Rate Indicators and the Challenges of Human Studies

1:21:40The Importance of Animal Models and the Challenges of Clinical Trials

The Importance of Animal Models and the Challenges of Clinical Trials

1:25:33The Challenges of Defining Aging and the Importance of Mechanistic Connections

The Challenges of Defining Aging and the Importance of Mechanistic Connections

1:29:21The Importance of Mechanistic Connections and the Limitations of Current Interventions

The Importance of Mechanistic Connections and the Limitations of Current Interventions

1:33:03The Potential of Exercise and Molecular Markers of Aging

The Potential of Exercise and Molecular Markers of Aging

Part 6: Evaluating Interventions: GLP-1 and Senolytics

1:37:36The Need for More Research and the Potential of GLP-1 Agonists

The Need for More Research and the Potential of GLP-1 Agonists

1:41:11The Challenges of Testing GLP-1 Agonists and the Need for More Resources

The Challenges of Testing GLP-1 Agonists and the Need for More Resources

1:44:33The Economic Impact of Geroprotective Drugs and the Senescence Debate

The Economic Impact of Geroprotective Drugs and the Senescence Debate

1:48:01The Problems with Senescent Cells and Senolytic Drugs

The Problems with Senescent Cells and Senolytic Drugs

1:52:26Defining Senescent Cells and the Value of Studying Them

Defining Senescent Cells and the Value of Studying Them

1:57:20The Importance of Specificity and the Broader Impact of Senescence Research

The Importance of Specificity and the Broader Impact of Senescence Research

Part 7: Pharmacological Interventions: Metformin and Rapamycin

2:01:11The Uncertainties of Metformin and the Importance of Observational Data

The Uncertainties of Metformin and the Importance of Observational Data

2:04:06The Rationale for Metformin and the Importance of Cellular Specificity

The Rationale for Metformin and the Importance of Cellular Specificity

2:07:20The Mechanisms of Metformin and the Potential of Canagliflozin

The Mechanisms of Metformin and the Potential of Canagliflozin

2:11:11The Importance of Clinical Trials and the Dosing of Rapamycin

The Importance of Clinical Trials and the Dosing of Rapamycin

2:14:27mTORC1 vs mTORC2 and the Complexity of Rapamycin's Effects

mTORC1 vs mTORC2 and the Complexity of Rapamycin's Effects

2:18:01Synergistic Effects and the Evolution of Rapamycin Dosing