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The Peter Attia Drive

#370 - AMA #76: Peter evaluates longevity drugs, aspirin for CVD, and strategies to improve muscle mass — promising, proven, fuzzy, noise, or nonsense?

27 Oct 2025

Transcription

Chapter 1: What is the proven, promising, fuzzy, noise, nonsense scale?

10.595 - 30.561 Peter Attia

Hey everyone, welcome to a sneak peek, Ask Me Anything, or AMA episode of The Drive Podcast. I'm your host, Peter Attia. At the end of this short episode, I'll explain how you can access the AMA episodes in full, along with a ton of other membership benefits we've created. Or you can learn more now by going to peterattiamd.com forward slash subscribe.

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30.982 - 55.767 Peter Attia

So without further delay, here's today's sneak peek of the Ask Me Anything episode. Welcome to Ask Me Anything AMA episode number 76. In today's AMA, we revisit the proving, promising, fuzzy, noise, nonsense scale and apply it to a variety of commonly inquired about and hot button topics.

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56.287 - 76.594 Peter Attia

We start with a quick reset on what each bucket means and define them, of course, and then we walk through every topic where we're going to land on. So the goal of this episode is that if you're coming to this topic without any previous background or you just want the TLDR, this is the place for you. We group the topics by the intended outcome, and there are three categories today.

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76.894 - 90.231 Peter Attia

Drugs for Giro protection, where we cover GLP-1 agonists, SGLT2 inhibitors, methylene blue, and telomere lengthening supplements. Talk about low-dose aspirin for CVD prevention.

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Chapter 2: What are the benefits of GLP-1 receptor agonists beyond weight loss?

90.211 - 119.02 Peter Attia

And then we look at interventions to improve muscle mass, talking specifically about protein, but also phallostatin gene therapy. If you're a subscriber and want to watch the full video of this podcast, you can find it on the show notes page. And if you're not a subscriber, you can watch the sneak peek of this video on our YouTube page. So without further delay, I hope you enjoy AMA 76.

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119.506 - 129.241 Unknown

Peter, Artia, doctor, podcaster, author, speaker, bad chess player. How are you doing today?

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Chapter 3: What potential cognitive benefits do GLP-1 drugs offer?

129.461 - 135.089 Peter Attia

Hey, hey, hey, hey, hey, hey, hey. You could say shepherd in there. You don't have to, you don't have to take cheap shots.

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136.151 - 147.837 Unknown

Shepherd of diabetic sheep, race car driver. Anything else missing? Oh, that's good. That's good. I didn't want to forget the diabetic sheep out there. That's true.

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Chapter 4: How do SGLT2 inhibitors contribute to geroprotection?

147.998 - 150.145 Unknown

That's true. How's the day going today?

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150.165 - 159.22 Peter Attia

Started out good, then took a little dip with the follow-up chess match, but There's a recurring theme here that you, I know you just love picking this scab.

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159.661 - 166.137 Unknown

Well, I just, sometimes you think about feats, like Tom Brady. Right. Like what he went through.

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Chapter 5: What evidence supports the anti-aging effects of methylene blue?

166.157 - 182.938 Unknown

Greatest of all time. Right. Yeah. People who come back from injuries. Tamar Hamlin, like almost died, came back and played. I mean, like you getting second in a four person in-house chess tournament with two children has to be up there, right?

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183.699 - 189.246 Peter Attia

Listen, we all started playing at the same time.

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189.326 - 199.058 Unknown

Pogacar just won the tour again, went through two in a row, grueling, not as mentally tough as what you went through though a month ago.

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199.358 - 211.694 Peter Attia

I would argue what I go through on the daily, trying to just make sure I don't get beat by an eight-year-old in chess, is at least on par mentally with some of the feats you're talking about.

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Chapter 6: Why do telomere-lengthening supplements lack scientific credibility?

212.274 - 218.202 Unknown

We need to have Tom on the podcast, and you should ask him about it. Which one was harder, all those Super Bowls?

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218.482 - 231.791 Peter Attia

Is it harder to be down 28-3, having thrown a pick six in the Super Bowl, or... succumbing to an eight-year-old's gambit, which is tougher.

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232.232 - 247.181 Unknown

To be fair, there is a real chance the eight-year-old might have talked more trash than what was going on in the Super Bowl, which says something. Yep. All right. So today's AMA, not about chess, going to be a little different.

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247.682 - 267.839 Unknown

So what we're going to do is cover a variety of topics, looking at it through a certain lens, which is we are going to take concepts and things that we've talked about before, some new things that we haven't talked about before that we get asked about a lot, And instead of going super deep in them, we're going to kind of summarize them into how you think about them.

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268.219 - 276.35 Unknown

And we're going to do it into five different buckets. And those buckets are proven, promising, fuzzy, noise, nonsense.

Chapter 7: What are the risks and benefits of low-dose aspirin for cardiovascular disease?

276.37 - 297.318 Unknown

People who have listened for a bit will remember this. We did this in episode 300 of the podcast, which was back in May 2024. So it's been a little bit, but people really liked it because it allowed us to cover a And it allowed us to kind of look at them in an apples to apples comparison with what we know about them and how people should be thinking about it.

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297.498 - 309.176 Unknown

So in today's episode, we are going to look at some geroprotective drugs like GLP-1s, things like Ozempic, SGLT2 inhibitors, both of which we talked about before.

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Chapter 8: How can protein intake improve muscle mass and what is follistatin gene therapy?

309.256 - 329.387 Unknown

We're going to look at methylene blue and telomere lengthening supplements. Those are kind of newer. We're going to look at what we know about low dose aspirin and cardiovascular disease prevention. And then we're going to look at interventions that can help improve muscle mass, things like protein, phallostatin gene therapy, etc. Hopefully a good variety of things for people.

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329.688 - 341.888 Unknown

Hopefully kind of a way to go through it where people can kind of look, get clear, clean takeaways. With that said, anything you want to add before we get rolling?

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342.323 - 364.407 Peter Attia

No, but maybe I will just remind people or for folks who are new to the program, what these categories mean. So you mentioned five and we're starting from the most promising or the closest to quote unquote truth, which we're calling proven. Although I put proven in quotes because technically nothing in biology is proven, right?

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364.427 - 385.178 Peter Attia

It's not like mathematics where you prove something and write QED at the end and never have to think about it again. So proven would be as close to well-established claim as you're going to find. The implication for us, of course, is you've got lots of high quality consistent data. The category beneath that would be promising. This is a category where the claims look good.

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385.218 - 404.036 Peter Attia

There are data to support it, but maybe we're still waiting on replication or maybe most of the data are moving in one direction, but not all of it or something like that. Category beneath that we call fuzzy. And this means there are some data around the claim, but they are really inconsistent and incomplete.

404.477 - 427.54 Peter Attia

So overall, you would say the data quality here is not that great, but there's probably a signal. Beneath that, we have noise. So here we have something where there are just frankly no real meaningful results. So noise is something that it's not that I'm saying you shouldn't pay attention to it, but you clearly don't want to be distracted by it.

427.68 - 453.917 Peter Attia

And it's best to wait and see if noise declares itself by going up to fuzzy or with the presence of some data as it works its way up the chain or whether data actually emerge that put it in the final category, which is actual nonsense. So again, nonsense means we actually have data and the data refute the claim being made So as far as we can tell, this is as close to disproven as you'll be.

454.098 - 464.923 Peter Attia

So again, those are the five categories. Just kind of keep that in mind as we apply our judgments to these things. And keep in mind as well that these are fluid. Things can move up and down these chains in the presence of new information.

465.443 - 484.515 Unknown

Yeah, and I think I always like to anchor people to this. And so we've talked about it before, but I do think it's helpful, which is sometimes I think in today's day and age where people are very confident in their opinions and usually kind of stick to them, you see it a lot in nutrition where it's like you just get in a camp and you stay with it.

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