All Summaries for The Peter Attia Drive

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Expert insight on health, performance, longevity, critical thinking, and pursuing excellence. Dr. Peter Attia (Stanford/Hopkins/NIH-trained MD) talks with leaders in their fields.

#268 ‒ Genetics: testing, therapy, editing, association with disease risk, autism, and more | Wendy Chung, M.D., Ph.D.
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter 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. Connect With Peter on Twitter, Instagram, Facebook and YouTube
Mon, August 28, 2023
#267 ‒ The latest in cancer therapeutics, diagnostics, and early detection | Keith Flaherty, M.D.
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter Keith Flaherty is the director of clinical research at the Massachusetts General Hospital Cancer Center and a previous guest on The Drive. In this episode, Keith first delves into the statistics on cancer's prevalence as we age, underscoring the significance of finding effective treatments and early detection methodologies. He touches on the history of cancer therapeutics and illuminates the notable enhancements in cancer therapy within the last decade that are setting the stage for a promising future. He goes into detail on the potential of immunotherapy and therapies that can combat cancer’s evasive tactics while explaining some of the existing challenges around specificity, cost, and scalability. Additionally, Keith highlights the significant leap in early detection methodologies, namely liquid biopsies, which have the potential not only to determine if a cancer is present in an early stage, but also identify the possible tissue of origin. We discuss: Keith’s interest and expertise in cancer [3:15]; Cancer deaths by decade of life, and how cancer compares to other top causes of death [7:00]; The relationship between hormones and cancer [12:00]; The link between obesity and cancer [18:45]; Current state of treatments for metastatic cancer and reasons for the lack of progress over the decades [22:30]; The interplay between the immune system and cancer cells [32:00]; Different ways cancer can suppress the immune response, and how immunotherapy can combat cancer’s evasive tactics [39:30]; Elimination of a substantial portion of cancers through immune cell engineering faces challenges of specificity, cost, and scalability [52:15]; Why TIL therapy isn’t always effective, and the necessity for multimodal therapy to address various aspects of the cancer microenvironment [1:01:00]; Potential developments in cancer therapy over the next five years: T-cell activation, metabolic interventions, targeting tumor microenvironments, and more [1:06:30]; The challenge of treating metastatic cancer underscores the importance of early detection to improve survivability [1:19:15]; Liquid biopsies for early detection of cancer and determining the possible tissue of origin [1:24:45]; Commercially available cancer screening tests [1:33:45]; How to address the disparity in cancer care, and the exciting pace of progress for cancer detection and treatment [1:40:15]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
Mon, August 21, 2023
#266 - AMA #50: Genetics: how they impact disease risk, what you can do about it, testing, and more
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 delves into the realm of genetics, unraveling its connection to disease and emphasizing the value of understanding one's genetic risks. He elucidates essential background knowledge on genetics before delving into the myriad reasons why individuals might consider genetic testing. Peter differentiates scenarios where genetic testing provides genuine insights from those where it may not be as useful. From there, Peter explores a comprehensive comparison of commercial direct-to-consumer genetic tests, providing insights on interpreting results and identifying the standout options for gaining insights into personal health. 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 #50 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here. We discuss: Defining the term “genetics” and why it’s important [2:15]; What is DNA, and how does it impact our biology and traits? [5:45]; How are genetics passed down from parent to child? [8:45]; How much do genes vary across individuals? [13:00]; Which traits are determined by genetics versus experience or environmental factors? [17:00]; Reasons for genetic testing [22:30]; What exactly is being measured by a genetic test? [29:15]; Testing for monogenic disorders [35:15]; Understanding polygenic risk [39:30]; Is genetic testing more important for someone who doesn’t know their family history? [40:45]; What does it mean to be positive for a particular variant? [43:00]; What does it mean to be negative for a particular variant? [45:45]; How does someone get genetic testing through their healthcare provider, and how are these tests performed? [48:15]; The financial cost of various genetic tests [54:30]; Could having a risk allele for a disease result in an increase in one’s insurance premium? [57:15]; Other risks associated with genetic testing [59:00]; How do commercial, direct-to-consumer genetic tests compare to the information one might receive from clinical genetic testing? [1:01:45]; Are certain direct-to-consumer tests better than others? [1:03:45]; How long until whole genome sequencing becomes genuinely useful? [1:16:00]; How useful are personalized dietary recommendations based on genetics? [1:18:15]; Final thoughts and advice regarding genetic testing [1:20:00]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
Mon, August 14, 2023
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