View the Show Notes Page for This Episode

Become a Member to Receive Exclusive Content

Sign Up to Receive Peter’s Weekly Newsletter

In this “Ask Me Anything” (AMA) episode, Peter tackles a diverse set of listener-submitted questions, covering a wide range of health and performance topics. He dives into assessing cardiovascular health, discussing key biomarkers and risk factors, and breaks down various fasting approaches, including time-restricted eating and prolonged fasting. The conversation also explores the impact of alcohol on health and disease risk, fundamental principles of nutrition, and optimal protein intake. Additionally, he examines the pros and cons of ketogenic and low-carb diets, strategies for building effective exercise routines, and the role of wearables in tracking health metrics. The episode concludes with insights on emotional health, making this a well-rounded discussion packed with practical takeaways for anyone looking to optimize their well-being.

If you’re not a subscriber and are listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or our website at the AMA #68 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.

We discuss:

• Episode format: overview of common health topics based on listener questions [1:30];
• How to accurately assess your cardiovascular health [3:00];
• The impact of fasting, time-restricted eating, and dietary restriction on metabolic health [9:00];
• Alcohol: health risks of consumption, limitations of research, and how to weigh the risks against social and personal enjoyment [13:45];
• Principles of a well-balanced diet: macronutrients, micronutrients, protein, energy balance, and more [23:45];
• The benefits and drawbacks of ketogenic diets: impact on satiety, metabolic health, athletic performance, lipid levels, and more [29:15];
• Protein: best sources for muscle growth, total intake, PDCAAS scoring system, and getting adequate amounts on plant-based diets [36:15];
• Creating an effective fitness routine that fits into a busy schedule [41:45];
• The role of rest and recovery in a workout routine [46:00];
• How to track fitness progress beyond just weight on a scale [48:30];
• The best low-impact exercises for individuals with joint issues [52:00];
• Wearables: insight vs. compliance, and how to use them effectively [54:45];
• How to evaluate the risks and benefits of medical interventions: procedural risks, complication rates, and asking informed questions [59:00];
• Sleep: impact on metabolic and cognitive health, and tips for improving sleep quality [1:03:45];
• How to identify and address emotional health challenges [1:08:30]; and
• More.

Connect With Peter on Twitter, Instagram, Facebook and YouTube

View the Show Notes Page for This Episode

Become a Member to Receive Exclusive Content

Sign Up to Receive Peter’s Weekly Newsletter

Mike Israetel is a sports physiologist, competitive bodybuilder, and co-founder of Renaissance Periodization, where he coaches athletes and professionals in diet and weight training. In this episode, Mike shares his journey from powerlifting to academia, breaking down the core principles of resistance training, including exercise selection, volume, intensity, and frequency. He debunks common misconceptions about strength training, explains how to structure an effective program for beginners and advanced lifters, and provides candid insights into his experience with anabolic steroids, discussing their effects on muscle growth, performance, and health risks. This conversation offers a deep dive into the science of building muscle, the realities of bodybuilding at the highest levels, and explores the potential of AI-driven breakthroughs to advance human performance and longevity.

We discuss:

• Mike’s academic journey, and early experiences in powerlifting, personal training, and sports physiology [3:30];
• Mike’s transition from powerlifting to bodybuilding, and his scientific and artistic approach to sculpting muscle and optimizing aesthetics [9:15];
• The value of strength training, time efficiency, and how it differs from endurance training [14:45];
• Neurological fatigue in strength training: balancing recovery and pushing the limits [26:15];
• The relationship between training intensity and volume, why muscle growth is not linear, and how different approaches affect results [35:00];
• Sustainable and effective approaches to maximizing muscle growth: training close to failure while minimizing fatigue [40:00];
• An efficient and effective resistance training program for beginners with limited time [49:00];
• Advice for finding a good trainer [1:06:30];
• Troubleshooting training plateaus: optimizing exercise selection, intensity, and recovery for muscle growth [1:13:30];
• The impact of genetics, age, and lifestyle on muscle growth [1:27:45];
• The importance of nutrition, protein intake, and consistency in both training and diet for muscle growth [1:31:00];
• The use of anabolic steroids to boost muscle growth: doses, drug combinations, and side effects [1:35:45];
• Long-term impact of steroid use: muscle retention, genetics and individual variability, and impact after discontinuation [1:52:15];
• Trade-offs of long-term usage of supraphysiologic doses of testosterone: health, performance, and Mike’s future plans [2:00:45];
• The potential for AI-driven medical breakthroughs to reverse aging and disease [2:07:30];
• The role of AI in accelerating drug development, advancing human longevity, and overcoming biological limitations [2:19:45];
• The philosophical implications of simulated reality, the impact of robotics on human labor and economics, and the challenge of predicting the future [2:25:15];
• Would having kids change Mike’s philosophy around anabolic steroid use? [2:32:15];
• The role of GLP-1 agonists in bodybuilding and general weight management, and the moral and philosophical debates surrounding their use [2:35:45]; and
• More.

Connect With Peter on Twitter, Instagram, Facebook and YouTube

View the Show Notes Page for This Episode

Become a Member to Receive Exclusive Content

Sign Up to Receive Peter’s Weekly Newsletter

Tom Dayspring is a world-renowned expert in clinical lipidology and a previous guest on The Drive. In this episode, Tom explores the foundations of atherosclerosis and why atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death worldwide for both men and women. He examines how the disease develops from a pathological perspective and discusses key risk factors, including often-overlooked contributors such as insulin resistance and chronic kidney disease. He breaks down the complexities of cholesterol and lipoproteins—including LDL, VLDL, IDL, and HDL—with an in-depth discussion on the critical role of apolipoprotein B (apoB) in the development of atherosclerosis. Additionally, he covers the importance of testing various biomarkers, the impact of nutrition on lipid levels, and the vital role of cholesterol in brain health, including how cholesterol is synthesized and managed in the brain, how it differs from cholesterol regulation in the rest of the body, and how pharmacological interventions can influence brain cholesterol metabolism.

We discuss:

• Defining atherosclerotic cardiovascular disease (ASCVD): development, risks, and physiological impact [2:45];
• The pathogenesis of ASCVD: the silent development over decades, and the importance of early detection for prevention of adverse outcomes [10:45];
• Risk factors versus risk markers for ASCVD, and how insulin resistance and chronic kidney disease contribute to atherosclerosis [17:30];
• How hyperinsulinemia elevates cardiovascular risk [24:00];
• How apoB-containing lipoproteins contribute to atherosclerosis, and why measuring apoB is a superior indicator of cardiovascular risk compared to LDL cholesterol [29:45];
• The challenges of detecting early-stage atherosclerosis before calcification appears [46:15];
• Lp(a): structure, genetic basis, and significant risks associated with elevated Lp(a) [55:30];
• How aging and lifestyle factors contribute to rising apoB and LDL cholesterol levels, and the lifestyle changes that can lower it [59:45];
• How elevated triglycerides, driven by insulin resistance, increase apoB particle concentration and promote atherosclerosis [1:08:00];
• How LDL particle size, remnant lipoproteins, Lp(a), and non-HDL cholesterol contribute to cardiovascular risk beyond apoB levels [1:21:45];
• The limitations of using HDL cholesterol as a marker for heart health [1:29:00];
• The critical role of cholesterol in brain function and how the brain manages its cholesterol supply [1:36:30];
• The impact of ApoE genotype on brain health and Alzheimer's disease risk [1:46:00];
• How the brain manages cholesterol through specialized pathways, and biomarkers to track cholesterol health of the brain [1:50:30];
• How statins might affect brain cholesterol synthesis and cognitive function, and alternative lipid-lowering strategies for high-risk individuals [1:57:30];
• Exciting advancements in therapeutics, diagnostics, and biomarkers coming in the next few years [2:09:30];
• Recent consensus statements on apoB and Lp(a) from the National Lipid Association (NLA) [2:12:30]; and
• More.

Connect With Peter on Twitter, Instagram, Facebook and YouTube