Dr. Peter Attia: Supplements for Longevity & Their Efficacy

Navigating the NAD Pathway: A Deep Dive into Longevity Strategies with Dr. Peter Atia

In this episode of the Huberman Lab podcast, renowned neurobiologist Andrew Huberman sits down with Dr. Peter Atia, a physician known for his rigorous scientific approach to healthspan and lifespan. Together, they dissect the intricate world of NAD, a molecule crucial for cellular function and a potential target for longevity interventions.

Core Concepts and Philosophies

Dr. Atia and Dr. Huberman outline a structured framework for understanding approaches to longevity, emphasizing that these strategies are not mutually exclusive but complementary. They categorize these approaches into four distinct areas: 1. **The Essential Behaviors:** These are the foundational pillars of health, including a balanced diet, regular exercise (both aerobic and resistance training), adequate sleep, and stress management. Dr. Atia argues that these behaviors are non-negotiable and should form the bedrock of any longevity strategy. 2. **Calorie and Glucose Management:** This category focuses on interventions targeting the mTOR pathway, a key regulator of cellular growth and aging. Dr. Atia highlights the importance of caloric restriction and the use of drugs like rapamycin for slowing down cellular growth and potentially extending lifespan. 3. **Geroprotective Interventions:** This category explores molecules that target specific hallmarks of aging, rather than specific diseases. Rapamycin, with its ability to suppress senescent cells and promote DNA repair, stands out as a prime example. The NAD pathway falls under this category, with its potential to enhance DNA repair and mitochondrial function. 4. **The Kitchen Sink Approach:** This rare category involves a more comprehensive and aggressive strategy, often involving multiple interventions. Dr. Atia acknowledges the existence of individuals like Brian Johnson who follow this approach but emphasizes that it requires significant effort and resources.

Practical Strategies and Advice

The podcast delves into specific strategies and advice for optimizing healthspan and lifespan, with a particular focus on the NAD pathway. Key takeaways include:

• **Understand the Difference Between NR and NMN:** Dr. Atia explains that NR (nicotinamide riboside) can cross cell membranes directly, making it potentially more effective than NMN (nicotinamide mononucleotide) for increasing intracellular NAD levels. However, the cost of NMN may be a factor for some individuals.
• **Consider the ITP (Intervention Testing Program):** Dr. Atia highlights the ITP as a gold standard for evaluating lifespan interventions in mice. He emphasizes that the ITP has not found evidence of lifespan extension with NR, suggesting that NAD supplementation may not be a reliable longevity strategy.
• **Prioritize Exercise and Sleep:** While Dr. Atia acknowledges potential benefits of NAD supplementation for healthspan (e.g., reducing inflammation, improving glucose disposal), he strongly emphasizes that exercise, sleep, and nutrition are far more impactful for both longevity and overall well-being. He recommends prioritizing these fundamental behaviors over relying on supplements.
• **Time Your Workouts Strategically:** Dr. Atia shares his observation that working out earlier in the day (before 9:00 a.m.) may lead to increased energy throughout the day, potentially related to circadian rhythms and body temperature fluctuations. He encourages listeners to experiment with workout timing to see what works best for them.

Supporting Evidence

The podcast draws upon a wealth of scientific research, including animal studies, clinical trials, and the ITP data. Dr. Atia emphasizes the importance of rigorously evaluating evidence and avoiding unsubstantiated claims. He highlights the following points:

• **Caloric restriction and rapamycin have been consistently shown to extend lifespan in multiple model organisms.** This robust evidence base is lacking for NAD supplementation.
• **Resveratrol, once thought to be a potent certuin activator, has not been shown to extend lifespan in controlled studies.** The ITP found no effect of resveratrol on lifespan in mice.
• **While some studies suggest potential benefits of NR and NMN for healthspan (e.g., reducing inflammation, improving glucose disposal), the evidence is not conclusive and further research is needed.**

Personal Application

Dr. Atia openly discusses his own supplement regimen, emphasizing that it reflects his current understanding of the scientific evidence and his personal preferences. He takes rapamycin for its geroprotective potential and several disease-specific medications (e.g., pcsk9 inhibitor, sglt2 inhibitor). He also takes NR and NMN for potential healthspan benefits but acknowledges that his conviction regarding their efficacy is less strong than for rapamycin. Dr. Huberman shares his personal experience with NAD supplementation, stating that he takes NMN and NR with a focus on potential anti-inflammatory benefits. However, he emphasizes that he does not attribute these supplements to any lifespan extension and primarily relies on exercise, sleep, and nutrition for longevity.

Recommendations for Tools and Techniques

Dr. Atia and Dr. Huberman recommend several tools and techniques for implementing their advice, providing actionable suggestions for the audience:

• **Use a CGM (Continuous Glucose Monitor):** Dr. Huberman advocates for using a CGM to understand how different foods impact blood glucose levels, helping to optimize dietary choices for both short and long-term health.
• **Control Sleeping Environment Temperature:** Dr. Huberman recommends using a smart mattress cover with cooling and heating capabilities to optimize sleep quality by regulating body temperature.
• **Explore a Foundational Nutrition Supplement:** Dr. Huberman recommends AG1, a comprehensive nutritional supplement, as a way to ensure foundational nutritional needs are met and to supplement a healthy diet.
• **Embrace Lifestyle Interventions:** Both Dr. Atia and Dr. Huberman strongly recommend prioritizing exercise, sleep, nutrition, and stress management as the most impactful strategies for healthspan and lifespan.

This in-depth exploration of the NAD pathway provides valuable insights into the complex world of longevity strategies. While the evidence for NAD supplementation as a lifespan extender is not yet conclusive, Dr. Atia and Dr. Huberman's discussion highlights the importance of a well-rounded approach, with a strong focus on fundamental behaviors, including exercise, sleep, and nutrition.