The Peter Attia Drive

<p><a href= "https://peterattiamd.com/lisamosconi/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=260119-pod-lisamosconi&utm_content=260126-pod-lisamosconi-podfeed"> View the Show Notes Page for This Episode</a></p> <p><a href= "https://peterattiamd.com/subscribe/?utm_source=podcast-feed&lisamosconi%20=referral&utm_campaign=260126-pod-lisamosconi&utm_content=260126-pod-lisamosconi-podfeed"> Become a Member to Receive Exclusive Content</a></p> <p><a href= "https://peterattiamd.com/newsletter/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=260126-pod-lisamosconi&utm_content=260126-pod-lisamosconi-podfeed"> Sign Up to Receive Peter's Weekly Newsletter</a></p> <p>Lisa Mosconi is a world-renowned neuroscientist and the director of the Women's Brain Initiative at Weill Cornell Medicine, where she studies how sex differences and hormonal transitions influence brain aging and Alzheimer's disease risk. In this episode, Lisa explores why Alzheimer's disease disproportionately affects women and why longer lifespan alone does not explain their nearly twofold risk compared to men. She explains why Alzheimer's disease may be best understood as a midlife disease for women, beginning decades before symptoms appear, and how menopause represents a fundamental brain event that reshapes brain energy use, structure, and immune signaling. The conversation also examines what advanced brain imaging reveals about preclinical Alzheimer's disease, estrogen receptors in the brain, and why genetic risks such as APOE4 appear to affect women differently from men. Finally, Lisa discusses the nuanced evidence around menopause hormone therapy, the legacy of the WHI, her new CARE Initiative to cut women's Alzheimer's risk in half by 2050, and practical, evidence-based strategies to support brain health through midlife—including lifestyle, sleep, metabolism, mood, and emerging therapies such as GLP-1 agonists and SERMs (selective estrogen receptor modulators).</p> <p><strong>We discuss:</strong></p> <ul type="disc"> <li>How Lisa's personal family history and scientific background led her to focus on the intersection of women's health, brain aging, and Alzheimer's disease (AD) [2:45];</li> <li>The long preclinical phase of AD and the emotional burden carried by patients before dementia becomes severe [7:15];</li> <li>How AD compares to other common forms of dementia: prevalence, pathology, symptoms, diagnostic challenges, and more [10:45];</li> <li>Why AD disproportionately affects women: how AD is not simply a disease of old age or longevity but a midlife disease in which women develop pathology earlier [16:15];</li> <li>Menopause as a leading explanation for women's increased Alzheimer's risk, and how advanced braining imaging can detect early changes in the brain [26:15];</li> <li>How a new method for imaging estrogen receptors in the brain is changing how we think about the menopause transition [35:45];</li> <li>What estrogen receptor imaging can and cannot tell us about hormone therapy's potential impact on brain health [48:45];</li> <li>Lisa's studies on the relationship between levels of systemic estrogen and density of estrogen receptors in the brain [58:00];</li> <li>Why blood estrogen levels poorly reflect brain estrogen signaling, and how tightly regulated brain hormone dynamics complicate our understanding of menstrual-cycle and lifestyle effects [1:02:15];</li> <li>The CARE Initiative: Lisa's research program looking to slash AD rates in women [1:07:45];</li> <li>The dramatic difference in AD risk between men and women associated with APOE4 [1:10:45];</li> <li>What the evidence suggests about menopausal hormone therapy (MHT) and AD risk, and why timing, formulation, and uterine status appear to matter [1:12:00];</li> <li>How the CARE initiative plans to study MHT and AD risk, within the practical constraints of a three-year research window [1:17:30];</li> <li>How to think about starting hormone therapy during perimenopause: balancing symptom relief, hormonal variability, and individualized care [1:21:00];</li> <li>Investigating selective estrogen receptor modulators (SERMs) as a targeted approach to brain health during and after menopause [1:25:00];</li> <li>Why estrogen became wrongly associated with cancer risk and what the evidence actually shows [1:29:30];</li> <li>Why better biomarkers are central to advancing women's Alzheimer's research [1:38:30];</li> <li>Modifiable risk factors for dementia, the limitations of risk models, and questionable conclusions drawn from observational data [1:44:15];</li> <li>GLP-1 agonists and brain health: exploring potential neuroprotective effects of GLP-1 agonists beyond metabolic benefits [1:49:00];</li> <li>The importance of lifestyle factors in reducing risk of dementia: practical strategies for women to support brain health [1:53:45];</li> <li>Why long-term, consistent lifestyle habits are essential for building cognitive resilience and protecting brain health over decades [2:01:15]; and</li> <li>More.</li> </ul> <p>Connect With Peter on <a href= "https://twitter.com/PeterAttiaMD">Twitter</a>, <a href= "https://www.instagram.com/peterattiamd/">Instagram</a>, <a href="https://www.facebook.com/peterattiamd/">Facebook</a> and <a href="https://www.youtube.com/channel/UC8kGsMa0LygSX9nkBcBH1Sg">YouTube</a></p>

<p><a href= "https://peterattiamd.com/laynenorton4/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=260119-pod-laynenorton4&utm_content=260119-pod-laynenorton4-podfeed"> View the Show Notes Page for This Episode</a></p> <p><a href= "https://peterattiamd.com/subscribe/?utm_source=podcast-feed&laynenorton4%20=referral&utm_campaign=260119-pod-laynenorton4&utm_content=260119-pod-laynenorton4-podfeed"> Become a Member to Receive Exclusive Content</a></p> <p><a href= "https://peterattiamd.com/newsletter/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=260119-pod-laynenorton4&utm_content=260119-pod-laynenorton4-podfeed"> Sign Up to Receive Peter's Weekly Newsletter</a></p> <p>Layne Norton is a nutrition scientist and accomplished power athlete,who returns to The Drive for a conversation that departs from the show's usual format. In this episode, Layne presents the evidence-based case that seed oils are not uniquely harmful under isocaloric conditions, while Peter steelmans the strongest versions of the opposing argument that seed oils are inherently harmful. They examine how scientific bias and evidence are evaluated, revisit the historical randomized controlled trials that shaped the seed oil controversy, and explore the mechanistic biology underlying LDL oxidation and atherosclerosis. Along the way, Layne unpacks the chemistry and processing of modern seed oils, assesses evolutionary and ancestral nutrition arguments, clarifies the relationship between seed oils, ultra-processed foods, and contemporary dietary patterns, and situates these questions within the larger context of lifestyle factors that drive cardiometabolic health. Layne concludes by offering practical considerations around dietary fats, cooking oils, and real-world food choices.</p> <p><strong>We discuss:</strong></p> <ul type="disc"> <li>The idea behind this episode, biases, and evidence-based thinking [5:15];</li> <li>The four core arguments behind claims that seed oils are harmful [12:30];</li> <li>The Minnesota Coronary Experiment (MCE) [14:30];</li> <li>The differences among saturated, monounsaturated, polyunsaturated, and trans fats, and why those differences matter for cardiovascular disease [18:30];</li> <li>Missing trans fat data as a confounder in the Minnesota Coronary Experiment, other limitations of that study, and the challenge detecting meaningful differences in hard outcomes through nutrition research [24:00];</li> <li>The Sydney Diet Heart Study (SDHS): an attempt to address the "duration problem" by enrolling a much higher-risk population [28:30];</li> <li>Debating whether evidence from randomized trials supports the idea that seed oils are uniquely harmful once major confounders are removed [34:00];</li> <li>The Rose Corn Oil trial: an often-cited study used to argue against polyunsaturated fats [36:30];</li> <li>Three studies where replacing saturated fat with polyunsaturated fat produced different results than earlier trials [41:30];</li> <li>Layne's explanation for why the evidence is pointing towards cardiovascular risk reduction when substituting polyunsaturated fat for saturated fat [47:30];</li> <li>What Mendelian randomization says about the causal role of LDL cholesterol in ASCVD [56:45];</li> <li>The compounding effects of life-long exposure to high LDL cholesterol [1:06:45];</li> <li>Does the linoleic acid (omega-6) content of seed oils cause inflammation? [1:13:45];</li> <li>Does the linoleic acid (omega-6) content of seed oils increase oxidized LDL? [1:19:30];</li> <li>Layne's analogy to explain why lower LDL particle number outweighs higher per-particle oxidation risk when comparing polyunsaturated fats to saturated fats [1:26:15];</li> <li>The role of oxidized LDL in CVD: exploring differences in a diet high in polyunsaturated fat (seed oils) versus high in saturated fat [1:28:00];</li> <li>Examining whether industrial processing and solvent extraction of seed oils—especially residual hexane—could plausibly cause long-term harm [1:34:00];</li> <li>The evolutionary and "ancestral diet" argument against seed oils [1:40:45];</li> <li>Weighing concerns about industrial processing of seed oils against the totality of metabolic and cardiovascular evidence [1:47:30];</li> <li>Practical considerations around dietary fats, cooking oils, and real-world food choices [1:50:00];</li> <li>Comparing the health impact of seed oils with that of caloric intake and activity levels, and how to prioritize interventions [2:00:15];</li> <li>More.</li> </ul> <p>Connect With Peter on <a href= "https://twitter.com/PeterAttiaMD">Twitter</a>, <a href= "https://www.instagram.com/peterattiamd/">Instagram</a>, <a href="https://www.facebook.com/peterattiamd/">Facebook</a> and <a href="https://www.youtube.com/channel/UC8kGsMa0LygSX9nkBcBH1Sg">YouTube</a></p>

<p><a href= "https://peterattiamd.com/ama79/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=260112-pod-ama79&utm_content=260112-pod-ama79-podfeed"> View the Show Notes Page for This Episode</a></p> <p><a href= "https://peterattiamd.com/subscribe/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=260112-pod-ama79&utm_content=260112-pod-ama79-podfeed"> Become a Member to Receive Exclusive Content</a></p> <p><a href= "https://peterattiamd.com/newsletter/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=260112-pod-ama79&utm_content=260112-pod-ama79-podfeed"> Sign Up to Receive Peter's Weekly Newsletter</a></p> <p>In this "Ask Me Anything" (AMA) episode, Peter brings together his most up-to-date thinking on cardiorespiratory fitness into a single, practical guide designed to help listeners structure training for maximal impact on healthspan, lifespan, and long-term independence. He explains why cardiorespiratory fitness is one of the strongest modifiable predictors of longevity, clarifies what zone 2 training actually represents and how it differs from higher-intensity work, and addresses persistent confusion around exercise volume, intensity, and time constraints. The discussion covers how to measure and track progress in zone 2, VO₂ max targets and age-adjusted goals, planning for the marginal decade, and how to balance zone 2 with higher-intensity training across different weekly volumes. Peter also outlines how cardio training should be tailored for beginners, experienced trainees, and older adults, with special considerations for women and guidance on avoiding the most common cardio-training mistakes.</p> <p>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 <a href= "https://peterattiamd.com/members/private-podcast-feed/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=260112-pod-ama79&utm_content=260112-pod-ama79-podfeed">private RSS feed </a>or our website at the <a href= "http://peterattiamd.com/ama79/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=260112-pod-ama79&utm_content=260112-pod-ama79-podfeed">AMA #79 show notes page</a>. If you are not a subscriber, you can learn more about the subscriber benefits <a href= "https://peterattiamd.com/subscribe/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=260112-pod-ama79&utm_content=260112-pod-ama78-podfeed">here</a>.</p> <p><strong>We discuss:</strong></p> <ul type="disc"> <li>Rational for discussing cardiorespiratory fitness, zone 2, and VO₂ max despite having covered the topic extensively [2:30];</li> <li>Why cardiorespiratory fitness and VO₂ max are powerful and modifiable predictors of all-cause mortality compared with other health metrics [7:30];</li> <li>How age-related declines in VO₂ max constrain healthspan and everyday physical function [12:30];</li> <li>The cardiorespiratory fitness triangle: how different training intensities contribute to building the aerobic base, the aerobic peak, and overall aerobic capacity [14:15];</li> <li>The cellular mechanics of cardiorespiratory fitness: mitochondria, lactate, muscle fiber recruitment, and intensity thresholds [18:45];</li> <li>The debate over whether zone 2 training has unique benefits or whether higher-intensity exercise alone is sufficient [27:15];</li> <li>Balancing intensity and sustainability as training volume increases, and the important role of zone 2 training [32:15];</li> <li>How to identify your zone 2 training intensity [34:45];</li> <li>How to measure and track improvements in zone 2 fitness [40:00];</li> <li>How to accurately measure VO₂ max: lab testing, field tests, and the limits of wearables [45:15];</li> <li>How to set meaningful VO₂ max targets based on age, sex, long-term decline, and desired physical capabilities later in life [51:15];</li> <li>How to structure and execute a zone 2 workout [59:45];</li> <li>How strictly should zone 2 be maintained during a workout? [1:04:00];</li> <li>How to design a VO₂ max training session: interval length, intensity, recovery, and progression strategies [1:07:00];</li> <li>Why heart rate is not a reliable metric for titrating VO₂ max interval intensity [1:12:00];</li> <li>Practical ways to monitor VO₂ max improvements [1:13:30];</li> <li>How to balance zone 2 and VO₂ max training [1:15:30];</li> <li>How to structure training for someone limited to 150 minutes per week of total exercise [1:19:00];</li> <li>How to allocate 150 minutes per week of dedicated cardiorespiratory training between zone 2 and VO₂ max work [1:23:00];</li> <li>How to structure training for someone with substantial available time who wants to maximize cardiorespiratory fitness [1:24:30];</li> <li>Why spreading aerobic training across the week beats compressing volume into one session [1:26:15];</li> <li>How beginners and metabolically unhealthy individuals should start cardiorespiratory training safely [1:28:00];</li> <li>How "training age" determines the intensity and workload needed to continue improving cardiorespiratory fitness [1:31:15];</li> <li>Why zone 2 training still matters for women (including postmenopausal women) [1:32:45];</li> <li>How cardiorespiratory training should adapt with aging [1:35:45];</li> <li>The most common mistakes people make when training cardiorespiratory fitness and how to avoid them [1:37:45];</li> <li>How to break through a VO₂ max plateau [1:40:45];</li> <li>The main takeaways about cardiorespiratory fitness and longevity [1:41:30];</li> <li>Peter's carve out: oral hygiene and Peter's two-toothbrush system [1:43:00]; and</li> <li>More.</li> </ul> <p>Connect With Peter on <a href= "https://twitter.com/PeterAttiaMD">Twitter</a>, <a href= "https://www.instagram.com/peterattiamd/">Instagram</a>, <a href="https://www.facebook.com/peterattiamd/">Facebook</a> and <a href="https://www.youtube.com/channel/UC8kGsMa0LygSX9nkBcBH1Sg">YouTube</a></p>

<p><a href= "https://peterattiamd.com/carolehooven/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=251201-pod-carolehooven&utm_content=251201-pod-antoniobianco-podfeed"> View the Show Notes Page for This Episode</a></p> <p><a href= "https://peterattiamd.com/subscribe/?utm_source=podcast-feed&carolehooven%20=referral&utm_campaign=251201-pod-carolehooven&utm_content=251201-pod-antoniobianco-podfeed"> Become a Member to Receive Exclusive Content</a></p> <p><a href= "https://peterattiamd.com/newsletter/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=251201-pod-carolehooven&utm_content=251201-pod-carolehooven-podfeed"> Sign Up to Receive Peter's Weekly Newsletter</a></p> <p>Carole Hooven is a human evolutionary biologist whose research centers on testosterone, sex differences, and behavior. In this episode, she explores how prenatal testosterone orchestrates male development in the body and brain, how early hormonal surges shape lifelong behavioral tendencies, and what rare natural experiments—such as 5-alpha-reductase deficiency—reveal about the biology of sex differentiation. She discusses distinct male and female aggression styles through an evolutionary lens, how modern environments interact with ancient competitive drives, and the implications of attempting to suppress them. The conversation also covers testosterone across the lifespan, the role of hormone therapy in both men and women, and Carole's own experience after surgical menopause, culminating in a broader discussion of masculinity, cultural narratives, and the consequences of denying biological sex differences.</p> <p><strong>We discuss:</strong></p> <ul type="disc"> <li>How Carole became interested in exploring the biological and evolutionary roots of sex differences and the role of testosterone [2:30];</li> <li>How testosterone and other hormones influence sex differences in aggression and behavior across species [9:45];</li> <li>How chromosomes, the SRY gene, and early hormones direct embryonic sexual differentiation [12:15];</li> <li>A stark contrast of male social bonding compared to females, and evolutionary parallels in chimpanzees [19:30];</li> <li>How hormones like DHT shape sexual differentiation, and how 5⍺-reductase deficiency reveals the distinct roles of these hormones [22:45];</li> <li>How sex chromosomes and prenatal testosterone shape early brain development and explain sex differences in childhood behavior [31:30];</li> <li>How gamete differences shape reproductive strategies, energetic costs, and sex-specific behavior [42:30];</li> <li>How evolutionary biology shapes sex differences in play, aggression, and conflict resolution (and how modern environments and cultural messaging can disrupt those patterns) [49:00];</li> <li>Why males commit disproportionately more violent crime, and how cultural and environmental forces shape aggression [1:01:00];</li> <li>Why females evolved different behavioral strategies: nurturing, risk aversion, and the cultural norms that override biology [1:04:00];</li> <li>Whether male aggression is still necessary in modern society, why the underlying biological drives persist, and how modern society redirects these drives [1:06:30];</li> <li>How testosterone levels naturally shift to support fatherhood and caregiving [1:13:30];</li> <li>How testosterone shapes male mating strategies, and why long-term pair-bonding persists even when reproduction is no longer at stake [1:18:30];</li> <li>The distinct roles of estrogen in male development, mood, libido, and muscle [1:25:00];</li> <li>How evolution, health, lifestyle, and androgen receptor biology shape modern testosterone replacement therapy (TRT) [1:34:15];</li> <li>Carole's experience with hormone replacement therapy (HRT), and the risks associated with TRT in younger men [1:45:15];</li> <li>How Carole rebuilt after controversy: leaving academia and recommitting to scientific honesty [1:51:30,];</li> <li>Carole's next book: examining masculinity, cultural narratives, and the cost of denying biological sex differences [1:57:30]; and</li> <li>More.</li> </ul> <p>Connect With Peter on <a href= "https://twitter.com/PeterAttiaMD">Twitter</a>, <a href= "https://www.instagram.com/peterattiamd/">Instagram</a>, <a href="https://www.facebook.com/peterattiamd/">Facebook</a> and <a href="https://www.youtube.com/channel/UC8kGsMa0LygSX9nkBcBH1Sg">YouTube</a></p>

<p><a href= "https://peterattiamd.com/antoniobianco/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=251117-pod-antoniobianco&utm_content=251117-pod-antoniobianco-podfeed"> View the Show Notes Page for This Episode</a></p> <p><a href= "https://peterattiamd.com/subscribe/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=251117-pod-antoniobianco&utm_content=251117-pod-antoniobianco-podfeed"> Become a Member to Receive Exclusive Content</a></p> <p><a href= "https://peterattiamd.com/newsletter/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=251117-pod-antoniobianco&utm_content=251117-pod-antoniobianco-podfeed"> Sign Up to Receive Peter's Weekly Newsletter</a></p> <p>Antonio Bianco is a world-renowned physician-scientist and expert in thyroid physiology and metabolism. In this episode, Antonio explores the complex biology of thyroid hormone production, conversion, and regulation—highlighting how deiodinase enzymes modulate hormone activity at the tissue level and why that matters for interpreting lab results. He discusses the shortcomings of relying solely on TSH as a marker of thyroid function, the ongoing debate around combination therapy with T3 and T4 versus standard T4 treatment, and how genetics, tissue sensitivity, and individual variability influence thyroid hormone metabolism. The conversation also examines how hypothyroidism affects energy, mood, cognition, and longevity; why some patients remain symptomatic despite "normal" labs; and how future research could reshape treatment paradigms.</p> <p><strong>We discuss:</strong></p> <ul type="disc"> <li>How the thyroid produces, stores, and activates hormones like T4 and T3 to finely regulate thyroid activity [2:45];</li> <li>How fasting alters thyroid hormones to conserve energy [12:45];</li> <li>Action of the deiodinases: how D1, D2, and D3 enzymes control the activation and inactivation of thyroid hormones [19:15];</li> <li>The normal function of thyroid hormone and the roles of the hypothalamus, pituitary gland, and deiodinases in maintaining hormonal balance [23:30];</li> <li>Why understanding thyroid physiology is essential for proper diagnosis and treatment of hypothyroidism [33:45];</li> <li>Testing for thyroid hormones: understanding free vs. total levels, the limitations of current T3 assays, best practices, and more [36:00];</li> <li>Genetic and sex-based variability in thyroid hormone regulation and their limited clinical significance [43:45];</li> <li>Hyperthyroidism: causes, symptoms, diagnosis, and treatment options [46:00];</li> <li>Hypothyroidism: diagnosis and autoimmune causes of hypothyroidism [56:30];</li> <li>More on hypothyroidism: diagnostic biomarkers, antibody patterns, and non-autoimmune presentations [1:05:00];</li> <li>Thyroid hormone replacement therapy [1:15:15];</li> <li>More on thyroid replacement strategies: exploring the evidence gaps, mortality signals, effects on lipids, and more [1:28:00];</li> <li>Hypothyroidism basics: causes, antibody implications (including pregnancy), and how to make the diagnosis before choosing therapy [1:35:15];</li> <li>Thyroid medication: compounded controlled-release T3, brand name versus generic, and what Antonio prescribes to newly diagnosed hypothyroid patients [1:42:45];</li> <li>Redefining treatment success: why normalizing TSH isn't always enough for patients with hypothyroidism [1:54:45];</li> <li>Case studies: analysis of two unusual cases of thyroid disease [1:57:00];</li> <li>Dangers of supplementing with high levels of iodine, and female-specific risk of thyroid disease [2:05:45];</li> <li>Case study of a patient who presents with elevated TSH but no symptoms [2:09:30];</li> <li>How future research could reshape treatment, and Antonio's new book called "Rethinking Hypothyroidism" [2:13:15]; and</li> <li>More.</li> </ul> <p>Connect With Peter on <a href= "https://twitter.com/PeterAttiaMD">Twitter</a>, <a href= "https://www.instagram.com/peterattiamd/">Instagram</a>, <a href="https://www.facebook.com/peterattiamd/">Facebook</a> and <a href="https://www.youtube.com/channel/UC8kGsMa0LygSX9nkBcBH1Sg">YouTube</a></p>

<p><a href= "https://peterattiamd.com/ama77/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=251110-pod-ama76&utm_content=251110-pod-ama77-podfeed"> View the Show Notes Page for This Episode</a></p> <p><a href= "https://peterattiamd.com/subscribe/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=251110-pod-ama77&utm_content=251110-pod-ama77-podfeed"> Become a Member to Receive Exclusive Content</a></p> <p><a href= "https://peterattiamd.com/newsletter/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=251110-pod-ama77&utm_content=251110-pod-ama77-podfeed"> Sign Up to Receive Peter's Weekly Newsletter</a></p> <p>In this "Ask Me Anything" (AMA) episode, Peter breaks down the science of dietary fiber, moving beyond the blanket advice to "eat more fiber" to uncover what it actually does in the body and where its benefits are truly supported by evidence. He explains how different types of fiber—soluble, insoluble, viscous, and fermentable—affect digestion, satiety, weight management, and glycemic control, and compares their impact to other, more potent metabolic tools. Peter also examines how certain fibers influence lipid metabolism and cardiovascular risk, evaluates the strength of evidence for fiber's role in colorectal cancer prevention, and highlights why some individuals may not tolerate specific fibers well. The discussion concludes with practical guidance on moving past generic fiber targets toward a more strategic and personalized approach that maximizes the true benefits of fiber.</p> <p>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 <a href= "https://peterattiamd.com/members/private-podcast-feed/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=251110-pod-ama76&utm_content=251110-pod-ama77-podfeed">private RSS feed </a>or our website at the <a href= "http://peterattiamd.com/ama77/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=251110-pod-ama77&utm_content=251110-pod-ama77-podfeed">AMA #77 show notes page</a>. If you are not a subscriber, you can learn more about the subscriber benefits <a href= "https://peterattiamd.com/subscribe/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=251110-pod-ama77&utm_content=251119-pod-ama77-podfeed">here</a>.</p> <p><strong>We discuss:</strong></p> <ul type="disc"> <li>Why it's time to re-examine the evidence behind dietary fiber recommendations [2:00];</li> <li>Why it's hard to isolate fiber's true effects on health: the limits of nutritional epidemiology [5:45];</li> <li>Defining dietary fiber: what it is, how it's digested, and why different types have different effects [8:15];</li> <li>Understanding fiber properties: how solubility, viscosity, and fermentability shape its effects in the body [11:15];</li> <li>Resistant starches explained: types, food sources, and how cooking and cooling influence their benefits [16:30];</li> <li>A framework for evaluating each of the major health claims linked to fiber [19:15];</li> <li>How fiber can support weight loss: mechanisms, realistic expectations, and its complementary role to broader dietary strategies [20:30];</li> <li>How fiber modestly improves glycemic control by reducing glucose spikes and insulin demand [26:15];</li> <li>How fiber modestly lowers LDL cholesterol and supports cardiovascular health [34:30];</li> <li>How fiber compares to other available tools and strategies for managing lipids, blood sugar, and weight [42:00];</li> <li>Fiber's role in colon cancer prevention: mechanisms, evidence, and limitations [45:30];</li> <li>Is fiber necessary for colon cancer prevention in otherwise healthy individuals? [53:30];</li> <li>Why some people have adverse reactions to certain types of fiber, and how to manage them [56:00];</li> <li>A general strategy for dietary fiber: combine multiple fiber types through whole foods and supplements [58:45];</li> <li>Why total fiber intake is more important than the ratio of soluble-to-insoluble fiber [1:02:45];</li> <li>The optimal timing and context for consuming fiber to maximize blood sugar control and metabolic benefits [1:05:00];</li> <li>How food processing affects the functional properties of fiber, the differences between supplement forms and natural sources, and why whole foods generally remain the best option [1:06:45];</li> <li>Fiber's potential to interfere with medication absorption [1:09:30];</li> <li>How to safely increase fiber intake: ramp up gradually and stay hydrated [1:12:00];</li> <li>Final takeaway on fiber: modest benefits, strong rationale, low downside [1:13:00];</li> <li>Peter's carve-out: lessons and inspiration from the Acquired podcast [1:14:30]; and</li> <li>More.</li> </ul> <p>Connect With Peter on <a href= "https://twitter.com/PeterAttiaMD">Twitter</a>, <a href= "https://www.instagram.com/peterattiamd/">Instagram</a>, <a href="https://www.facebook.com/peterattiamd/">Facebook</a> and <a href="https://www.youtube.com/channel/UC8kGsMa0LygSX9nkBcBH1Sg">YouTube</a></p>