Supplements for Longevity & Their Efficacy | Dr. Peter Attia
Dr. Peter Attia, a physician trained at Stanford and Johns Hopkins, shares his expertise on longevity and healthspan. He dives into the NAD pathway and the supplementation debate surrounding NAD, NMN, and NR. Attia evaluates their efficacy and safety while discussing lifestyle factors like sleep, nutrition, and exercise essential for longevity. The conversation also touches on whether biological age tests are accurate indicators of aging and the complex interplay of modern lifestyle habits in preventing disease.
Top snips
NAD pathway — What is it and why the hype?
25:02 – 27:06
NAD is a ubiquitous molecule used mostly as an electron shuttle (NAD/NADH) and sometimes as a substrate for DNA repair via sirtuins. Levels decline with age in many tissues, especially skin.
So the logic: low NAD → less DNA repair → aging. But that chain has several big leaps of faith.
Don't tell me what you think. Show me what's in your portfolio.
— Peter Attia
NR vs NMN vs IV NAD — delivery matters (and costs!)
1:07:18 – 1:12:19
Three common approaches: IV NAD, oral NR, oral NMN. NR crosses cell membranes easily; NMN has a phosphate and may require cleavage. IV gives acute blood rises but is costly ($300–$1,000/infusion) and uncomfortable.
Peter: bioavailability differences exist, but it’s unclear how much NAD actually gets into key tissues like muscle or brain.
The data on NR/NMN for lifespan: mostly negative
1:14:12 – 1:15:35
The Interventions Testing Program (ITP) gave megadoses of NR to mice — result: no lifespan or healthspan benefit. Human trials (fatty liver, glucose disposal) show small or clinically insignificant effects.
Bottom line: raising blood NAD ≠ proven longevity benefit in animals or humans.
One possible real benefit: fewer non‑melanoma skin cancers
1:26:56 – 1:30:02
A human study found ~60–80% reduction in basal and squamous cell carcinomas with NAD precursors (NR/NMN), but no effect on melanoma. Skin shows the largest age-related NAD decline, so this signal is biologically plausible — but needs replication before broad recommendation.
Rapamycin: strongest geroprotective evidence
18:08 – 20:22
Rapamycin and caloric restriction are the only interventions to extend life across many model organisms. Rapamycin shows uniform life extension in mice; human data suggest immune modulation (better vaccine response with intermittent dosing).
Peter takes 8 mg once weekly with breaks, based on the preclinical signal.
Practical hierarchy: behaviors first
2:25:30 – 2:26:34
Both hosts emphasize this: sleep, nutrition, movement, and mental health are far larger determinants of lifespan/healthspan than current NAD supplements. Think of behavior as the Titanic's heading; supplements are the menu choice on board.
Do the foundations before chasing unproven pills.