#80 - Celebrity AMA #1： Fasting, rapamycin, performance vs. longevity, and more
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Summary
In this bonus episode, Olympians Apollo Ono and Sasha Cohen join me to talk about fasting and the role of nutrition during periods of study. We cover: What is fasting? Why is it important in terms of maintaining optimal health and performance How does fasting affect fertility Is there a gender difference between women and men when it comes to fasting And more!
Transcript
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Hey everyone, welcome to the Peter Atiyah Drive. I'm your host, Peter Atiyah.
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The drive is a result of my hunger for optimizing performance, health, longevity, critical thinking,
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along with a few other obsessions along the way. I've spent the last several years working with
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some of the most successful top performing individuals in the world. And this podcast
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is my attempt to synthesize what I've learned along the way to help you live a higher quality,
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more fulfilling life. If you enjoy this podcast, you can find more information on today's episode
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Welcome to a special bonus ask me anything episode and what we are likely to call celebrity AMA number
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one. In this and future celebrity AMA bonuses, instead of being asked questions by my head
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research analyst, Bob Kaplan, I'll be asked questions by guests, either future guests,
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special guests, or just other guests on the podcast. So for celebrity AMA one, I'm joined
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by Olympians, Apollo Ono and Sasha Cohen. In this episode, we talk about fasting. We talk
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about the role of nutrition during periods of study. And this is prompted by something that
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Apollo is about to embark on. We talk about exercise, the ultimate gorge or feast meal.
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And we talk about watches, which really I think was the question I struggled with the most.
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From there, Sasha takes over and she asks me about things that excite me the most in longevity. We
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talk about mTOR and rapamycin, how to measure results when you're doing a lot of interventions,
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blood tests and supplements, along with a few other things.
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As a reminder, AMAs are for subscribers only. If you're not a subscriber, you'll only be able to
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hear a preview of the AMA here. If you are a subscriber and hearing this, it means you have
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yet to download our members only podcast feed. With this members only feed, you'll be able to
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subscribe to the drive in your podcast player to get every episode of the drive without the
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subscriber call out plus full episodes of the AMA podcast directly, along with other exclusive
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content. You can learn more about it at peteratiamd.com forward slash members to become a
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subscriber, to have access to the members only podcast feed, as well as other benefits, such
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as detailed show notes and member only discount codes and the products I believe in. You can visit
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peteratiamd.com forward slash subscribe. We'll continue to pull these questions from the AMA
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forum, and we encourage all subscribers to participate, ask questions as we hope to get to all of your
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questions in time through future AMAs. So without further delay, I hope you enjoy Celebrity AMA number
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one. I'm Apollo Ono, eight-time Olympic medalist. Spent about 15 years of my life previously pursuing
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the sport of short track speed skating, and I have the pleasure of doing a AMA with Peter Attia,
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my good friend, and I've got some interesting questions here, and hopefully you haven't answered
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all of them before in the past. I'd try to do as much due diligence as I could. Would love to
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expand upon some of these further, so thanks for having me on, Peter, to interview you.
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Yeah, let's jump right in. So my first question is centered around women and fasting, and to give
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some context, my girlfriend, she has a very difficult time doing water-only fasts. Gets dizzy,
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feels like she needs some sort of sugar, some kind of, just anything, any type of caloric intake,
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and where I can do seven-plus days, kind of no problem most of the time. So what is the difference
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here, and is there a separate protocol that you've seen for maybe perhaps clients who are female?
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I have definitely noticed over the past few years that even when it comes to time-restricted
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feeding, so not even getting to the point of a fast, but just saying not eating for 18 hours a day,
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that there appears to be a gender difference. I can sort of concoct a bunch of evolutionary
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answers that may or may not be true. Certainly one of the ones I'll come back to if we have a
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moment is to talk about the impact of fasting on fertility in women. So my point being is I
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definitely appreciate what you're saying, and we see it clinically with our patients. Now that said,
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I also have seen many female patients who can fast independent of body habitus, because obviously
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Bianca is tiny, and maybe that plays a role, but I don't think that that's it, because I think
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there might be something else going on. So I think, I don't know the answer, but what I would say is
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it might just mean that for some people they need more time to work up to a fast, which means longer
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stretches of time-restricted feeding. And then what we would typically do is progress patients
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through something as follows. So once a person can pretty consistently go 18 hours with a six-hour
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feeding window, you then move to one meal per day. Can she do one meal per day?
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Okay. So then the next thing I typically try is a 36-hour fast, where you'll do like dinner Monday,
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lunch, breakfast, Wednesday. So you go a night, and then a full day, and then into the next day.
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Yeah. She can do the 48-hour fast. Anything past, I would say, 72, really difficult for her.
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She just is not able to physically, basically can't leave the house.
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No cramps, but definitely lightheadedness, severe lack of energy, and just doesn't have
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the cognitive ability to do anything that would require semi-deep thought.
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Yeah. Again, it's hard to know. I mean, does she check her glucose and ketone levels all the
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Sometimes that provides a bit of an insight. You and I have talked about this a bunch, but
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I find going into ketosis the week before makes that transition a lot easier.
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And I've sometimes done the exact opposite and gone right into a fast out of a bender.
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And that's, I mean, you'll pay the fiddler all day long.
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The other thing that I think is important for everybody to understand is, one, I'm glad
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to hear that when she feels that way, she stops. Because I do think it's important for people
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to not hammer through fasts no matter what. You can, quote unquote, fail at a fast 99 times
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and come back on the 100th and be successful. And in my mind, they're all successful. So I think
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it's really important that people get it through their mind that, hey, if this isn't feeling
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right or going right, I stop and I eat again. The second thing is a lot of people don't realize
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how much food contains water. So when you're not eating, you have to make up that water that
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you're not getting from food in addition to what you think you normally would need to
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drink. So if you're a person who normally gets by sort of drinking, call it four liters
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of water a day, say a gallon of water, you're going to need more than that for two reasons.
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The first is when you're fasting, your body is typically excreting sodium at a higher
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rate. So that's creating what's called a diuresis.
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So you have to compensate for that. And then you also have to compensate for the fact that
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you're not getting the water in the food. So that might be the other thing to think about.
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And the easiest way, I mean, there's some technical ways that one can sort of measure
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the volume balance. But honestly, just looking at urine output is a great way to do it. I mean,
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when I'm fasting, one of the things I'm thinking about is how often am I going to the bathroom?
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If I don't get up to pee about every 90 minutes, I'm not drinking enough.
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The other thing, by the way, is she a caffeine drinker normally?
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Okay. Because that's the other thing that you always want to think about in people is sometimes when
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they stop caffeine as well, the one-two punch of no food, no caffeine can be really devastating.
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And in those patients, I generally think it makes sense to probably allow them to continue
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to drink black coffee or high caffeine tea or whatever to sort of pick and choose your battle.
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So my other question is, you have kids. So what are your thoughts on adolescent fasting? And is there
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a place for it routinely? I.e., do you think that in 20 years, it'll be a regular part 50 years of
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a curriculum or a dietary program? So I'm talking mid-teen to late-teen.
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Boy, that's an interesting question. And it really depends, I suspect, on the health of the child.
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So there are probably certain situations where it could make sense. Unfortunately, today we're in
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kind of an epidemic of obesity, type 2 diabetes, non-alcoholic fatty liver disease amongst kids
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and adolescents. And certainly in kids with metabolic conditions, under the right supervision,
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I think one could make the case that some form of fasting, whether it be time restriction feeding
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or even hypocaloric periods of time, for example, several days at a time with an energy input that's
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below requirement could have enormous medical benefit. But at the same time, one has to be
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very careful about threading this needle because they're still basically supposed to be in anabolic
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mode. A 14-, 15-, 16-year-old adolescent is still growing. And so a lot of times doctors who take care
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of kids that age that have obesity have a different goal, which is not weight loss per se,
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but actually weight stability. So let them grow into this weight. Now that's a bit of a sort of
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hokey concept because as an athlete, you'll appreciate that weight is not really the issue.
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The issue is fat mass versus muscle mass. And in the end, what we're talking about is potentially
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a treatment for excessive fat mass. The other thing, of course, that has to be really considered
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is I do believe, and I don't have great evidence to suggest this, this is really based on
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discussions with endocrinologists, my own personal experience in interacting with patients that have
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had eating disorders. But I think there is a critical window during which deprivation of food
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can be potentially harmful. And I think that's why I've certainly seen a subset of people who have
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had disordered eating or eating disorders during adolescence, and it has sort of imprinted their
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endocrine system in a way that's come back to haunt them as an adult. So kind of a long-winded
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answer, which is to say, I think we don't know the safety of that yet. My view is that
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unless you're an adult, really, this isn't something that should be considered as a regular
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part of how you eat. But that's also acknowledging the fact that I know evolutionarily it's tolerated
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because obviously we came from our ancestors who, whether they be children or adults, would have
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gone through periods of time without food. So yeah, I don't know. I think this should be studied
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though, because it's important and I wouldn't want to just speculate from or extrapolate rather from
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That's a long list, man. That is a lot of questions I'm looking at over there, dude. You went whole
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And I apologize, everyone who's listening. Some of these are selfishly because I just really want to
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know for myself. And speaking of that, I'm going back to school this fall.
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I did know this. Yeah, yeah. So I'm doing this program at Wharton this fall.
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Okay, that's what I was asking you about because I thought you were going to be in Philly this week.
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Basically in a couple of weeks. Oh, all right. So in lieu of that, what is your preferred diet
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for consuming large amounts of information, retaining it while still being alert? Because
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the influx of information and critical thinking is going to be at an all-time high for me
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