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#268 ‒ Genetics: testing, therapy, editing, association with disease risk, autism, and more | Wendy Chung, M.D., Ph.D.

The Peter Attia Drive

Release Date: 08/28/2023

#364 – AMA #75: Diets: how to evaluate and implement any diet including keto, carnivore, vegan, Mediterranean, and more show art #364 – AMA #75: Diets: how to evaluate and implement any diet including keto, carnivore, vegan, Mediterranean, and more

The Peter Attia Drive

In this “Ask Me Anything” (AMA) episode, Peter explores how to determine the right diet for yourself rather than searching for a universal “best” diet. He begins by laying out five non-negotiable criteria that any sustainable eating pattern must meet—energy balance, metabolic health, adequate protein, micronutrient sufficiency, and long-term adherence—before introducing a practical rubric for evaluating different diets. Using this framework, Peter walks through the ketogenic, carnivore, vegan, and Mediterranean diets, highlighting their strengths, ideal candidates for each, and...

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#363 ‒ A new frontier in neurosurgery: restoring brain function with brain-computer interfaces, advancing glioblastoma care, and new hope for devastating brain diseases | Edward Chang, M.D. show art #363 ‒ A new frontier in neurosurgery: restoring brain function with brain-computer interfaces, advancing glioblastoma care, and new hope for devastating brain diseases | Edward Chang, M.D.

The Peter Attia Drive

Edward Chang is a neurosurgeon, scientist, and a pioneering leader in functional neurosurgery and brain-computer interface technology, whose work spans the operating room, the research lab, and the engineering bench to restore speech and movement for patients who have lost these capabilities. In this episode, Edward explains the evolution of modern neurosurgery and its dramatic reduction in collateral damage, the experience of awake brain surgery, real-time mapping to protect critical functions, and the split-second decisions surgeons make. He also discusses breakthroughs in brain-computer...

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Lower back pain: causes, treatment, and prevention of lower back injuries and pain | Stuart McGill, Ph.D. (#287 rebroadcast) show art Lower back pain: causes, treatment, and prevention of lower back injuries and pain | Stuart McGill, Ph.D. (#287 rebroadcast)

The Peter Attia Drive

Stuart McGill is a distinguished professor emeritus at the University of Waterloo and the chief scientific officer at Backfitpro where he specializes in evaluating complex cases of lower back pain from across the globe. In this episode, Stuart engages in a deep exploration of lower back pain, starting with the anatomy of the lower back, the workings of the spine, the pathophysiology of back pain, and areas of vulnerability. He challenges the concept of nonspecific back pain, emphasizing the importance of finding a causal relationship between injury and pain. Stuart highlights compelling...

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#362 ‒ Understanding anxiety: defining, assessing, and treating health anxiety, OCD, and the spectrum of anxiety disorders | Josh Spitalnick, Ph.D., A.B.P.P. show art #362 ‒ Understanding anxiety: defining, assessing, and treating health anxiety, OCD, and the spectrum of anxiety disorders | Josh Spitalnick, Ph.D., A.B.P.P.

The Peter Attia Drive

Josh Spitalnick is a clinical and research psychologist with expertise in treating a variety of anxiety conditions with cognitive-behavioral therapy (CBT) and other evidence-based approaches. In this episode, Josh unpacks the four layers of anxiety—psychological, emotional, cognitive, and behavioral—highlighting why avoidance is the key feature that transforms ordinary worry into disorder. He explains why he continues to treat OCD and PTSD as anxiety conditions despite their DSM-5 reclassification, and he draws important distinctions between worries versus worrying and thoughts versus...

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#361 - AMA #74: Sugar and sugar substitutes: weight control, metabolic effects, and health trade-offs show art #361 - AMA #74: Sugar and sugar substitutes: weight control, metabolic effects, and health trade-offs

The Peter Attia Drive

In this “Ask Me Anything” (AMA) episode, Peter explains how to evaluate sugar and its substitutes in the context of health. Peter explores the role of sweeteners in three common use-cases – beverages, protein supplements, and sweet treats – and breaks down how our evolutionary craving for sweetness now clashes with today’s food environment. He examines whether sugar is uniquely fattening, the hormonal effects of sugar consumption, and the significance of timing in sugar intake. The episode compares natural versus refined sugars, sugar in beverages versus in solid foods, and the...

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#360 ‒ How to change your habits: why they form and how to build or break them | Charles Duhigg, M.B.A show art #360 ‒ How to change your habits: why they form and how to build or break them | Charles Duhigg, M.B.A

The Peter Attia Drive

Charles Duhigg is a Pulitzer Prize-winning journalist and best-selling author known for distilling complex neuroscience and psychology into practical strategies for behavior change, performance, and decision-making. In this episode, Charles explores the neuroscience behind habit formation, including how cue-routine-reward loops drive nearly half of our daily actions and why positive reinforcement is far more effective than punishment. He explains how institutions like the military and Alcoholics Anonymous engineer environments to change behavior at scale, as well as discussing the limits of...

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#359 ‒ How metabolic and immune system dysfunction drive the aging process, the role of NAD, promising interventions, aging clocks, and more | Eric Verdin, M.D. show art #359 ‒ How metabolic and immune system dysfunction drive the aging process, the role of NAD, promising interventions, aging clocks, and more | Eric Verdin, M.D.

The Peter Attia Drive

Eric Verdin is a physician-scientist and the CEO of the Buck Institute for Research on Aging whose career has centered on understanding how epigenetics, metabolism, and the immune system influence the aging process. In this episode, Eric traces his scientific journey from studying viruses and histone deacetylases (HDACs) to leading aging research at the Buck Institute, offering insights into how aging impairs immune and nervous system function—including thymic shrinkage, chronic inflammation, and reduced vaccine response—and how these changes impact lifespan. He explores the metabolic...

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#358 ‒ Peter’s takeaways on navigating HRT, rejuvenating the face, understanding the biology of aging, optimizing fertility, and learning to live well from the dying | Quarterly Podcast Summary #6 show art #358 ‒ Peter’s takeaways on navigating HRT, rejuvenating the face, understanding the biology of aging, optimizing fertility, and learning to live well from the dying | Quarterly Podcast Summary #6

The Peter Attia Drive

In this quarterly podcast summary (QPS) episode, Peter summarizes his biggest takeaways from the last three months of guest interviews on the podcast. Peter shares key insights from his discussions with Paul Turek and Paula Amato on male and female fertility; Rachel Rubin on menopause and hormone replacement therapy; Brian Kennedy on the biology of aging; Tanuj Nakra and Suzan Obagi on facial aging and skin rejuvenation; and BJ Miller and Bridget Sumser on lessons we can learn from the dying about how to live. Peter highlights the most important insights from each episode and any behavioral...

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#357 ‒ A new era of longevity science: models of aging, human trials of rapamycin, biological clocks, promising compounds, and lifestyle interventions | Brian Kennedy, Ph.D. show art #357 ‒ A new era of longevity science: models of aging, human trials of rapamycin, biological clocks, promising compounds, and lifestyle interventions | Brian Kennedy, Ph.D.

The Peter Attia Drive

Brian Kennedy is a renowned biologist, leader in aging research, and director of the Center for Healthy Longevity at the National University of Singapore. In this episode, Brian shares insights from ongoing human aging studies, including clinical trials of rapamycin and how dosing strategies, timing, and exercise may influence outcomes. He presents two key models of aging—one as a linear accumulation of biological decline and the other as an exponential rise in mortality risk—and explains why traditional models of aging fall short. He also explains why most current aging biomarkers lack...

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#356 - AMA #73: Preserving brain health, optimizing exercise programming, improving body composition, and more show art #356 - AMA #73: Preserving brain health, optimizing exercise programming, improving body composition, and more

The Peter Attia Drive

In this “Ask Me Anything” (AMA) episode, Peter addresses frequently requested topics, including brain health, exercise programming, and body composition. He explores the factors that influence dementia risk—including metabolic health, fitness, sleep, hearing, cholesterol levels, and more. He explains how to implement zone 2 training and VO₂ max intervals for cardiovascular fitness and also covers how to combine cardio modalities, how to stay in zone 2, and special considerations for women. Peter highlights the benefits of light movement after meals and offers strength training tips...

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Wendy Chung is a board-certified clinical and molecular geneticist with more than 25 years of experience in human genetic disease research. In this episode, Wendy delves deep into the world of genetics by first exploring the historical landscape of genetics prior to decoding the human genome, contrasting it with what we know today thanks to whole genome and exome sequencing. She provides an overview of genetic testing by differentiating between various genetic tests such as direct-to-consumer, clinical, whole genome sequencing, and more. Additionally, Wendy unravels the genetic underpinnings of conditions such as PKU, breast cancer, obesity, autism, and cardiovascular disease. Finally, Wendy goes in depth on the current state and exciting potential of gene therapy while also contemplating the economic implications and ethical nature of gene editing.

We discuss:

  • Wendy’s interest in genetics and work as a physician-scientist [2:45];
  • The genetics of phenylketonuria (PKU), a rare inherited disorder [5:15];
  • The evolution of genetic research: from DNA structure to whole genome sequencing [18:30];
  • Insights and surprises that came out of the Human Genome Project [28:30];
  • Overview of various types of genetic tests: direct-to-consumer, clinical, whole genome sequencing, and more [34:00];
  • Whole genome sequencing [39:30];
  • Germline mutations and the implications for older parents [45:15];
  • Whole exome sequencing and the importance of read depth [50:30];
  • Genetic testing for breast cancer [54:00];
  • What information does direct-to-consumer testing provide (from companies like 23andMe and Ancestry.com)? [1:01:30];
  • The GUARDIAN study and newborn genetic screening [1:06:30];
  • Treating genetic disease with gene therapy [1:18:00];
  • How gene therapy works, and the tragic story of Jesse Gelsinger [1:22:00];
  • Use cases for gene therapy, gene addition vs. gene editing, CRISPR, and more [1:28:00];
  • Two distinct gene editing strategies for addressing Tay-Sachs and fragile X syndrome [1:37:00];
  • Exploring obesity as a polygenic disease: heritability, epigenetics, and more [1:41:15];
  • The genetics of autism [1:48:45];
  • The genetics of cardiovascular disease [2:01:45];
  • The financial costs and economic considerations of gene therapy [2:06:15];
  • The ethics of gene editing [2:12:00];
  • The future of clinical genetics [2:21:00]; and
  • More.

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