[Summary] Nir Barzilai, M.D.: How to tame aging

🔑 Key Takeaways

Nir Barzilai, a leading expert in aging biology, discusses the potential benefits of metformin and its effects on lifespan and health, providing valuable insights for those interested in longevity.
Understanding the aging process requires a comprehensive perspective, not just focusing on hormones, but examining various factors that contribute to aging.
Hormonal effects and drug approval require considering age, context, extensive research, and evaluation for effective and safe interventions.
Metformin's association with lactic acidosis is not solely due to the drug itself, but is influenced by other factors such as kidney failure or heart attacks. The negative side effects of drugs like metformin are often intertwined with pre-existing conditions in patients. Additionally, metformin's benefits for type 2 diabetes extend beyond glucose control, as it also improves muscle insulin sensitivity and glucose disposal.
Metformin, a drug used for diabetes, may have potential benefits for the aging process. Its effects on insulin resistance and lifespan suggest it has broader applications beyond diabetes treatment.
Removing visceral fat in rats led to longer lifespans and improved health, highlighting the importance of reducing visceral fat for longevity and overall well-being.
Insulin resistance is a stress response that safeguards the body by redistributing excess glucose, but it may contribute to health issues like diabetes and aging-related complications.
Understanding insulin resistance and sensitivity is crucial for maintaining good health and increasing longevity. Interventions like rapamycin can increase lifespan in rodents but also cause insulin resistance. Exercise and alternative glucose uptake mechanisms play a significant role in managing insulin resistance.
Understanding metabolism is a challenging task, and comprehensive testing is needed to assess insulin sensitivity and glucose uptake in muscles as clinical indicators.
Measuring insulin levels helps in understanding glucose disposal, managing diabetes, and preventing other diseases like heart attacks or strokes. Understanding insulin signaling and glucose transport enhances healthcare approaches.
Metformin, a drug commonly used for diabetes, has shown potential for extending life and improving health in individuals without diabetes, making it a possible anti-aging treatment.
Metformin, a drug commonly prescribed for type 2 diabetes, has been found to significantly reduce mortality rates and prevent aging-related diseases, highlighting its potential for improving health outcomes and slowing down the aging process.
Metformin, a freely available diabetes drug, shows promising results in preventing various age-related conditions, emphasizing the need for funding and regulatory approval to further study its potential benefits for aging.
Addressing the biology of aging can help prevent various age-related diseases and improve overall health outcomes.
By shifting focus from individual diseases to targeting aging itself, there is potential to optimize health span and extend overall lifespan, necessitating collaboration and a broader approach in research. Aging should be seen as a treatable condition.
Despite budget constraints, the National Institute of Aging is making efforts to secure funding for their study on aging, aiming to improve health outcomes for older individuals.
Metformin, a diabetes drug, may have anti-aging properties due to its activation of AMP Kinase and epigenetic changes. Its effects extend beyond the liver and include both AMP and mitochondrial-dependent actions.
Metformin, a commonly prescribed drug for type 2 diabetes, may have potential anti-aging effects by activating AMPK and reducing inflammation, but more research is needed to fully understand its role.
Metformin, though not perfect, is a useful starting point in targeting aging. With ongoing research, better drugs and therapies can be developed to extend human lifespan beyond the current limits.
Delaying the onset of chronic diseases through healthier living can extend functional life, improve quality of life, and reduce healthcare costs.
The levels of IGF-1 in centenarians may not always accurately reflect their health or aging status, indicating the complexity of genetic factors influencing longevity. Further research is needed.
Low IGF levels in women may be associated with better cognitive health, highlighting the importance of considering sex differences and genetic mutations in understanding the role of IGF in aging.
A specific genetic mutation resulting in low levels of IGF may offer health benefits, including a lower incidence of age-related diseases and a taller stature, challenging previous assumptions about genetics and health.
Genetic mutations, overexpression of microRNA clusters, and mutations in specific genes contribute to cellular processes and regulation, affecting aging and longevity. Understanding these factors can aid in studying and promoting healthy aging.
Genetic variations are just one piece of the puzzle, and many diseases are influenced by both genetic and environmental factors. The overemphasis on genetics can lead to misconceptions and frustration. Lifestyle choices and longevity genes also play a significant role in determining health.
The CTP VV gene is associated with better health outcomes in centenarians, but the persistence of LP little a (LPA) after age 80 raises questions about its role in longevity.
Further research is needed to understand why some individuals with high levels of Lp(a) do not develop heart disease, and to improve testing methods for accurate risk assessment and treatment decisions.
Amgen's modified drug has potential for increasing lifespan and improving health in aging individuals, but more research is needed to confirm its effectiveness and ensure safety.
While growth hormone treatment shows benefits for females, its effects on males are inconclusive. More research is needed to understand the relationship between inflammation, IGF levels, and sex hormones, and to explore alternative treatment options.
Adopting a cyclic approach to IGF levels through fasting and intermittent fasting may have significant impacts on health and longevity, potentially improving overall well-being through enhanced autophagy.
More research is needed to determine the full effects of time restricted feeding and metformin on human health and aging.
Metformin, a medication for type 2 diabetes, can potentially lead to weight loss and anti-aging effects through changes in metabolism and gene expression, but further research is required for a complete understanding.
Clinical studies help validate claims about therapies and products, while objective data collection through tools like Fitbit aids in personal health monitoring, but caution is needed in interpreting personal experiences without clinical evidence.
Comprehensive clinical research is necessary to fully understand the impact of NAD on humans and to explore alternative methods of delivery for more efficient cellular absorption.
This ongoing research explores the potential benefits of metformin in non-diabetic individuals, but it is crucial to await completion and clinical evidence before drawing any conclusions. Further investigation is needed.
Engaging dialogue and shared optimism between Peter Attia and Nir Barzilai highlight the interconnected nature of aging pillars and the potential for effective age-related treatments.

📝 Podcast Summary

Exploring the Genetics of Aging and the Benefits of Metformin in Relation to Longevity

Nir Barzilai is a leading expert in the field of longevity and the genetics of aging. He has extensive knowledge about the clinical benefits of metformin, a drug being tested in a clinical trial for non-diabetics in relation to aging. Barzilai also provides insights on insulin resistance, IGF, growth hormone, and their potential effects on lifespan and health. The discussion covers various topics including autophagy, caloric restriction, and NAD. While the episode delves into technical details, it remains accessible to a wider audience. Overall, Barzilai's expertise in the field of aging biology offers valuable insights and clarifications, making the conversation insightful for anyone interested in longevity.

Exploring the Biology of Aging: A Holistic Approach

Aging and the biology of aging have long been subjects of interest and exploration for Nir Barzilai. His curiosity was sparked by observing his aging grandfather and questioning the difference between chronological age and biological age. As a physician, Barzilai recognized the role of endocrinology in the aging process and the potential of hormones to impact aging. However, he also saw that the effects of aging extended beyond just hormone changes, and that there were various factors at play. This broader perspective led him to approach the study of aging from a more holistic viewpoint. It highlights the importance of considering multiple factors and not relying solely on hormone replacement when it comes to addressing the aging process.

Age and context impact the effectiveness of estrogen and the challenges of approving new drugs.

The effectiveness of estrogen varies based on age and context. While estrogen showed positive effects in younger animals when it came to stroke prevention, it had the opposite effect in older animals. This demonstrates the need to consider age and other factors when studying hormones and their impact. Additionally, the discussion highlights the lengthy process and challenges of bringing a drug like metformin to the United States. The FDA required extensive studies and evidence before approving metformin for use in the US, including understanding its mechanism of action. This conversation emphasizes the importance of thorough research and evaluation when introducing new drugs.

Understanding the Complexities of Metformin-Associated Lactic Acidosis

Metformin, a widely used drug for type 2 diabetes, has been associated with a condition called metformin-associated lactic acidosis (MALA). However, it is now recognized that MALA may not be solely caused by metformin itself, but rather a combination of factors, including kidney failure or heart attacks. This association has led to a shift in understanding, emphasizing that the negative side effects of drugs like metformin and rapamycin are often difficult to isolate from pre-existing conditions in patients. Furthermore, it is interesting to note that metformin can improve type 2 diabetes not only by controlling glucose levels but also by increasing muscle insulin sensitivity, leading to enhanced glucose disposal.

Metformin: A Promising Anti-Aging Drug

Metformin, a drug commonly used to treat diabetes, has potential benefits for the aging process as well. Initially, there was a focus on insulin resistance as the root cause of diabetes, but it is now understood to be a collaboration of factors. Metformin primarily affects hepatic glucose production, but it also acts as an insulin sensitizer in muscle tissue. Insulin resistance is a complex concept that involves the inability of certain cells, such as muscle cells, to respond effectively to insulin. The liver's role in insulin resistance is particularly complicated. Furthermore, research on nematodes has shown that decreasing insulin sensitivity can lead to increased lifespan. This suggests that metformin's effects on aging may go beyond its diabetes-related properties.

The Link Between Visceral Fat and Lifespan

Removing visceral fat in rats extended their lifespan and improved their health. The experiment showed that rats who underwent surgery to remove their visceral fat lived significantly longer compared to rats with intact visceral fat. Although the rats with removed visceral fat did not live as long as rats on caloric restriction, they still experienced a 20% increase in lifespan. Additionally, these rats maintained better health and did not experience weight loss in their later years like the rats with intact visceral fat. This suggests that reducing visceral fat can have a positive impact on longevity and overall health.

The Protective Role of Insulin Resistance and its Relationship with Aging.

Insulin resistance is a protective mechanism and a stress response in the body. The experiment with the Zucker rats showed that when these obese rats had their visceral fat removed before puberty, they did not develop diabetes. However, when the fat grew back, they became diabetic. Furthermore, the removal of visceral fat in rats that already developed diabetes did not reverse the condition. This led to the realization that insulin resistance is a mechanism to protect the body. The muscle becomes insulin resistant when there is an excess amount of glucose, redirecting it to other organs like the liver and fat. This understanding provides insights into the relationship between insulin resistance and aging.

The Impact of Insulin Resistance and Sensitivity on Health and Lifespan

Insulin resistance and insulin sensitivity have significant impacts on lifespan and health. By studying animals with insulin resistance and sensitivity, researchers have discovered that interventions like rapamycin can cause insulin resistance but also increase lifespan in rodents. Insulin resistance can occur throughout the body, including in muscles, liver, and the brain. Insulin receptor substrates like IRS 1 and IRS 2 play key roles in glucose uptake by the muscles, which can occur both passively and through non-insulin mediated mechanisms. Exercise and AMP kinase may enhance non-insulin mediated glucose uptake. This conversation highlights the importance of understanding insulin resistance and sensitivity in relation to overall health and longevity.

Exploring the complexity of metabolic processes and the role of glucose and insulin in different parts of the body.

Metabolic processes are complex and interconnected. The researchers discuss the role of glucose and insulin in various parts of the body, particularly the hypothalamus, liver, and muscles. They highlight the importance of the vagus nerve in connecting the central nervous system to the periphery, like the liver. The concept of insulin resistance is also discussed, with a focus on glucose uptake in the muscle as a clinical indicator. The researchers also emphasize the need for comprehensive testing, such as oral glucose tolerance tests, to understand insulin sensitivity. Overall, the conversation shows that understanding metabolism is challenging, and there is still much to learn in this field.

Importance of Measuring Insulin Levels and Understanding Glucose Disposal

Measuring insulin levels in patients, especially those with type 2 diabetes, can provide valuable insights into their glucose disposal and overall health. The difference in hyperinsulinemia between individuals may play a significant role in insulin resistance and the development of other diseases like heart attacks or strokes. Understanding the insulin response and its impact on glucose disposal is crucial in managing and preventing these conditions. The liver's role in glucose production and its sensitivity to increasing glucose concentrations highlight its importance in maintaining proper bodily function. By exploring and comprehending the intricacies of insulin signaling and glucose transport, we can gain a deeper understanding of our bodies and enhance our approaches to healthcare.

The Potential of Metformin as an Anti-Aging Drug

Metformin, a drug commonly used for diabetes, has shown potential for extending life and improving health in individuals without diabetes. Studies in rodents and nematodes have demonstrated that metformin can increase lifespan and improve healthspan by around 50%. The initial hypothesis for using metformin in aging research was not related to glucose metabolism, but rather the potential anti-cancer effects observed in animal models. However, further studies showed that even mild effects on insulin can significantly improve health and increase lifespan. The decision to conduct a study with metformin in humans was motivated by a UK publication that analyzed prescription data and observed a correlation between metformin usage and decreased mortality. This highlights the potential of metformin as an anti-aging drug that can enhance both lifespan and healthspan.

The Potential of Metformin in Improving Health and Slowing Aging

Metformin, a commonly prescribed drug for type 2 diabetes, has shown to have a significant effect on reducing mortality and preventing aging-related diseases in humans. A study compared 78,000 individuals on metformin with diabetes to a control group without diabetes and found a 17% lower mortality rate among those on metformin. Despite having more diseases and obesity, the metformin group had a lower mortality rate. However, the study did not validate the optimal dose or the duration of metformin use for achieving these benefits. Additionally, multiple studies have shown an association between metformin use and a reduced risk of various cancers, excluding prostate cancer. These findings highlight the potential of metformin in improving health outcomes and slowing down aging.

Exploring the Potential of Metformin in Targeting Aging

There is a study called Tame (Taming or targeting aging with metformin) that aims to prove the concept that aging can be targeted. One of the challenges of this study is finding funding since aging is not considered a disease by the NIH and there is no way to make money from it for pharmaceutical companies. Metformin, a free drug used to treat diabetes, has shown promising results in preventing cancer, cardiovascular disease, and even improving cognitive function. It is seen as a safer option compared to rapamycin, which has potential side effects. The professors involved in the study are advocating for a new indication for metformin and have even gone to the FDA and Senate with their proposal.

Targeting Aging for Disease Prevention

Targeting the biology of aging can help prevent a range of age-related diseases. The FDA initially questioned the importance of preventing aging, but the discussion highlighted how slowing down the aging process can have significant implications for diseases like cardiovascular disease, cancer, Alzheimer's, and even diabetes. The FDA's focus on short-term costs and complications associated with diabetes was counterintuitive, as the long-term cost burden of diabetes becomes much more elaborate. This conversation emphasized the need to redefine aging in clinical studies and consider the correlation between different diseases and aging. Ultimately, by addressing the underlying biology of aging, we have the potential to prevent a variety of diseases and improve overall health outcomes.

Rethinking Aging: A Paradigm Shift in Addressing Aging and Disease

The approach to addressing aging and its associated diseases requires a shift in mindset. The traditional focus on individual diseases overlooks the potential benefits of targeting aging itself. By treating aging as a composite outcome and delaying its onset, there is an opportunity to optimize health span and extend overall lifespan. This paradigm shift challenges the siloed thinking of specific disease areas and necessitates a broader approach. It also highlights the importance of collaboration and breaking down barriers between different research fields. While there may be practical challenges such as funding and study design, the conceptual leap in seeing aging as a treatable condition is crucial to advancing the field and developing effective interventions.

Challenges faced by the National Institute of Aging in securing funding for important research on aging and disease.

The National Institute of Aging is facing budget constraints, which poses a challenge for funding important research on aging and disease. Nir Barzilai and his team are working tirelessly to gather the necessary funds for their study on aging, which amounts to $70,000,000. They have managed to raise half of the required amount through philanthropic sources, but the remaining funding is contingent upon commitments from other institutes like NCI and HLBDK. While these institutes haven't made a concrete commitment yet, there is hope that they will provide the necessary funds. Additionally, alternative non-profit organizations could step in to support the study if the NIH deems it too risky. Despite these challenges, Barzilai anticipates starting the study in early 2019 with 14 centers and 3,000 subjects aged 65 to 80. The study aims to target aging and improve health outcomes for older individuals.

Metformin's Potential Anti-Aging Effects Explored

Metformin, a drug commonly used to treat diabetes, has potential anti-aging properties at the cellular level. The drug exerts its effects through the activation of AMP Kinase (AMPK) and also through epigenetic changes, such as histone deacetylation. These mechanisms are believed to contribute to the beneficial effects of metformin on aging. Additionally, metformin enters cells through a transporter called OCT 1, which is not uniformly expressed in all cell types. While there is a higher concentration of OCT 1 in the liver, metformin's effects are not limited to this organ. The study aims to investigate the impact of metformin on aging and longevity, considering both its AMP-dependent and mitochondrial-dependent actions.

Potential Anti-Aging Effects of Metformin

Metformin, a commonly prescribed drug for type 2 diabetes, may have potential anti-aging effects. Metformin works by activating AMPK (adenosine monophosphate-activated protein kinase), which is responsible for nutrient sensing and exercise-mimetic pathways in the body. The drug also has an impact on mitochondria, inhibiting oxidative pathways and reducing ROS (reactive oxygen species) production, resulting in less inflammation. However, the exact mechanism and optimal dosage for aging benefits are still not fully understood. Additionally, metformin can lower insulin levels and decrease inflammatory factors. This multi-faceted approach illustrates the complexity of biology and highlights the need for comprehensive research to fully understand the role of metformin in aging.

Metformin: A Valuable Tool in Fighting Aging, but Only the Beginning

Metformin, despite not being a perfect drug, is a valuable tool in the fight against aging. It may not excel in any particular aspect, but it does multiple things reasonably well, making it a useful starting point to demonstrate the possibility of targeting aging. Its extensive safety and efficacy data, gathered from billions of patient years, further emphasize its value. However, it's important to recognize that Metformin is just the beginning. There is potential for much better drugs and combination therapies in the future. With approximately 35 years of life beyond the age of 80, there is still low-hanging fruit to be explored in extending human lifespan. While the future holds promise, paving the road starts with utilizing the tools available to us, such as Metformin.

The Longevity Dividend: Delaying Chronic Diseases for a Healthier Life

Centenarians, despite their longer lifespan, still experience chronic diseases such as heart disease, cancer, and Alzheimer's. However, their genetic gift allows them to delay the onset of these conditions, giving them a 20 to 30-year bonus of functional life. This phenomenon is known as a phase shift in when they develop chronic diseases. Moreover, research suggests that centenarians experience a compression of morbidity, meaning they have a shorter period of ill health before passing away. This information supports the concept of the longevity dividend, which explores the potential benefits of healthier aging. By living healthier and delaying chronic illnesses, individuals can not only improve the quality of their lives but also reduce healthcare costs significantly.

The Role of the IGF Axis in Centenarians and Longevity

The growth hormone IGF axis plays a crucial role in the genetic differences observed in centenarians and their offspring. Approximately 60% of centenarians have genomic alterations related to this system. The aging process is associated with a decline in both growth hormone and IGF-1 levels. However, it is important to note that measuring IGF-1 levels alone may not always accurately reflect an individual's health or aging status. Association studies have revealed that among centenarians, those with the lowest IGF-1 levels tend to live longer, particularly among women. These findings shed light on the complexity of genetic factors influencing longevity and suggest that further research is needed to fully understand the relationship between the growth hormone IGF axis and aging.

Sex differences and genetic mutations play a crucial role in understanding the effects of IGF and GH on aging and cognitive health.

The levels of IGF (insulin-like growth factor) and GH (growth hormone) differ between men and women, and these differences have significant implications for aging and cognitive health. The researchers discovered that studying only males in their labs was a mistake, as they missed crucial insights into the sex-specific effects of these hormones. They found that low IGF levels in women were associated with fewer cognitive problems compared to those with higher levels. Additionally, they identified clusters of functional mutations in the IGF receptor, demonstrating that these specific mutations are more relevant to human aging than generalized genomic findings. This highlights the importance of considering sex differences and genetic mutations in understanding the role of IGF in aging.

The Impact of Genetic Mutation on Health Outcomes

Individuals with a specific genetic mutation in the growth hormone receptor, resulting in low levels of IGF (insulin-like growth factor), may experience certain health benefits. Despite having high levels of growth hormone, which is not effectively expressed through the liver into IGF, these individuals have lower IGF levels. Interestingly, research has shown that these individuals have a lower incidence of age-related diseases such as cancer and diabetes. Additionally, it was found that they have a taller stature, contrary to what one would expect. Further studies are needed to replicate these findings in other populations. This highlights the complexity of genetics and their impact on health outcomes, challenging previously held assumptions.

Genetic and epigenetic factors influencing longevity

There are genetic mutations and epigenetic factors that play a significant role in longevity. Through various studies and replication of data, it has been found that individuals who live the longest have specific mutations in the growth hormone receptor. These mutations affect the activation and proliferation of lymphocytes, leading to changes in cellular processes. Additionally, the overexpression of certain microRNA clusters and mutations in the FOXO3A gene have been observed in centenarians. These genetic and epigenetic factors contribute to the regulation of cellular homeostasis and play crucial roles in aging and longevity. Understanding these pathways and genetic variations can help further research on longevity and potentially lead to interventions for promoting healthy aging.

The complexity of genetic analysis and the importance of a holistic approach

Genetic analysis is complex and often misunderstood. While certain genetic variations may be significant, it is important to recognize that they are just one piece of the puzzle. Many diseases and conditions are multifactorial, meaning they are influenced by a combination of genetic and environmental factors. Simply having a complete sequence of one's genes does not equate to having a deterministic relationship with a disease. The overemphasis on genetic analysis can lead to frustration and misconceptions. Additionally, the study of centenarians reveals that even individuals with numerous genetic mutations can live long, healthy lives, suggesting that other factors such as longevity genes and lifestyle choices play a significant role. Overall, understanding genetics requires a holistic and nuanced approach.

The role of genetics in longevity and the mystery of LP little a (LPA)

There is a protective gene called CTP VV that is found in centenarians. This gene is associated with higher levels of HDL, larger lipoprotein particle size, and lower CTP levels. People with the CTP VV phenotype have a lower risk of age-related diseases, including cognitive decline. However, what is still unclear is why the concentration of LP little a (LPA) doesn't flatline after the age of 80, despite the protective effects of the CTP VV gene. Further research is needed to understand the role of LPA in longevity and its interaction with other genes. Overall, this conversation highlights the importance of genetic factors in determining longevity and the need for further exploration in this field.

Exploring the complexities of Lp(a) and heart disease

There is a need for further research and understanding when it comes to certain health conditions. Specifically, the discussion revolves around Lp(a) and its association with heart disease. It is observed that some individuals with high levels of Lp(a) do not develop premature heart disease, while others do. This leads to the question of whether there are different phenotypes of Lp(a) that have varying levels of virulence. Additionally, the conversation highlights the limitations in current testing methods, such as the lack of an HDL functional assay, which hinders accurate risk stratification and treatment decisions. Further investigations involving gene to gene interactions, phenotyping, and proteomics are necessary to better comprehend these complexities and improve patient care.

Amgen's cancer drug repurposed for increasing lifespan in aging individuals shows promising results in mice study

A drug developed by Amgen, initially intended for cancer treatment, has shown potential for increasing health span and lifespan in aging individuals. Although the drug failed in treating pancreatic cancer, it was modified to target IGF receptors in the brain for research on aging. The study conducted on female mice demonstrated a 10% increase in lifespan and improved overall health. There was a decrease in inflammatory markers and cardiovascular protection. However, there is still a need to determine the drug's effectiveness on male mice. This drug could be a potential treatment option for age-related issues in the future, but further research is required before it can be commercialized.

Gender Differences in Inflammatory Response to Growth Hormone Treatment

There is a difference in the inflammatory response to growth hormone treatment between males and females. While preclinical studies have shown that the treatment is beneficial for females, the same cannot be said for males. There is evidence suggesting that higher levels of IGF in men may lead to better functionality, but it is not statistically significant. Therefore, it is hard to conclude that giving growth hormone is bad for men. The inflammation caused by low IGF levels is still not fully understood, especially in relation to sex hormones. Further studies are needed, including experimenting with younger mice to explore the protective effects of sex hormones and investigating alternative treatments like microRNA. Ultimately, fasting remains the most obvious way to manipulate IGF levels.

Exploring the potential benefits of a cyclic approach to IGF levels and autophagy through fasting and intermittent fasting.

There is a potential benefit to adopting a cyclic approach to IGF levels and autophagy. Peter Attia discusses how fasting has a significant impact on his IGF levels, causing them to decrease during the fast and slowly rise afterwards. He wonders if this cyclic approach to IGF is healthier compared to consistently being calorically restricted. Nir Barzilai highlights the importance of IGF decrease for longevity but also mentions that intermittent fasting, rather than caloric restriction, may be more effective in achieving low IGF levels. Both researchers emphasize the need to study the timeline and effects of autophagy in humans. Overall, understanding the relationship between fasting, IGF levels, and autophagy could potentially lead to new insights on improving health and longevity.

Time Restricted Feeding and Metformin: Uncertain Impact on Human Health and Aging

Time restricted feeding may not have the same level of impact in humans as it does in mice. While mice can go 16 hours without eating, which is akin to a human not eating for 3 days, it is uncertain if humans experience the same level of deprivation. However, there doesn't seem to be a downside to time restricted feeding for humans either. The conversation also highlights the use of metformin, a drug commonly used for diabetes, and its potential effects on aging and weight loss. Preliminary studies suggest positive effects of metformin in humans, but more research is needed to fully understand its benefits. Overall, there is still much to learn about the effects of time restricted feeding and metformin on human health and aging.

The Potential Effects of Metformin on Weight and Aging

Metformin, a commonly prescribed medication for managing type 2 diabetes, may have additional effects on weight and aging. While weight loss is not the primary purpose of metformin, some patients have reported significant weight loss after taking the medication. This weight loss seems to be associated with changes in metabolism and gene expression, particularly in relation to fatty acid and pyruvate metabolism. Furthermore, the conversation suggests that metformin may have anti-aging effects, as it appears to influence genes associated with DNA repair and aging. However, more research is needed to understand the full extent of metformin's effects on weight and aging.

Importance of Clinical Studies and Objective Data in Evaluating Interventions and Treatments

Conducting clinical studies is crucial for truly understanding the effectiveness of certain interventions or treatments. The discussion highlights the limitations of relying solely on anecdotal evidence or assumptions. It is emphasized that clinical studies provide the necessary evidence to support or debunk claims about therapies or products. The conversation also touches upon the complexity of different substances, such as nicotinamide riboside (NR) and nicotinamide mononucleotide (NMM), and the uncertainty about their stability and effectiveness. The importance of objective data collection through tools like Fitbit for personal health monitoring is mentioned, but it is acknowledged that personal experiences should be cautiously interpreted without robust clinical evidence.

The Unresolved Effects of NAD on the Body and Potential Areas for Development

The effects of NAD on the body, particularly regarding sleep patterns and cellular absorption, are still not well understood. While there is some promising evidence in animal studies, it is difficult to determine the exact impact on humans without comprehensive clinical research. Additionally, the popular method of intravenous administration of NAD may not be as effective as previously thought. A potential development in the field is the creation of a drug precursor that can be taken orally or intravenously outside of the liver, which could provide more efficient delivery to cells. Ultimately, more research is needed to fully support the use and benefits of NAD.

Potential Benefits of Metformin in Non-Diabetic Individuals: An Ongoing Research

There is ongoing research on the potential benefits of metformin in non-diabetic individuals. However, it is important to understand that this study has not been completed yet, and there is no clinical evidence to prove its safety and effectiveness in this context. Additionally, it is crucial to be cautious about potential biases in the study's recruitment process, as individuals who volunteered for the study may already be engaging in other healthy behaviors, like exercise. Furthermore, it is essential to recognize that while there is hope and promise for the prevention of age-related diseases through advancements in aging research, there are still blind spots that need to be identified and addressed. Overall, the conversation emphasizes the importance of evidence-based research and the need for further investigation in this field.

Aging, Pillars, and Treatment Perspectives

Peter Attia and Nir Barzilai share common philosophies and points of view regarding aging. They discuss the interconnected nature of the pillars of aging, such as autophagy and metabolism, and how improving one pillar can positively impact others. While their data primarily comes from animal studies, they believe that aging is universal and that treatments like rapamycin can delay aging in various animals. They also acknowledge the potential differences between genders, but based on previous data on metformin, they assume no significant gender effects. Despite Peter feeling unwell, he eagerly pursued the discussion, emphasizing the importance of their conversation. They even plan to have dinner together and organize a seminar on not just caloric restriction. Their engagement in meaningful dialogue and their shared optimism for finding effective age-related treatments is the main takeaway.

Nir Barzilai, M.D.: How to tame aging | The Peter Attia Drive #35