Nir Barzilai, M.D.: How to tame aging

**Peter Attia** (0:04)
Hey, everyone, welcome to The Peter Attia Drive. I'm your host, Peter Attia.
The Drive is a result of my hunger for optimizing performance, health, longevity, critical thinking, along with a few other obsessions along the way. I've spent the last several years working with some of the most successful top-performing individuals in the world. And this podcast is my attempt to synthesize what I've learned along the way to help you live a higher quality, more fulfilling life. If you enjoy this podcast, you can find more information on today's episode and other topics at peterattiamd.com.
Hey everybody, welcome to this week's episode of The Drive, and happy new year to everyone. We took a week off, as you probably noticed, so hopefully everybody's ready to jump back into this fun stuff.
My guest this week is Nir Barzilai, and if you're at all into the space of longevity, he'll be no stranger to you. Nir is the founding director of the Institute for Aging Research, the Nathan Shock Center of Excellence and Basic Biology at Albert Einstein. He's completed two fellowships, one in metabolism at Yale, the other in endocrinology and molecular biology at Cornell. He directs the Longevity Genes Project, and in my estimate, Nir is probably the most knowledgeable person ever on the genetics of longevity, and we talk a ton about that during this episode. He also is leading the effort to test Metformin in a prospective clinical trial for non-diabetics with respect to aging, and this is referred to as the TAME trial. We get into that obviously in detail here, and also we'll use a lot of the data for that in the show notes. This is, in many ways, I think Nir is probably one of the most insightful people when it comes to understanding the clinical benefits of Metformin, and we talk about that a ton. We also talk about insulin resistance. I can't resist the urge, no pun intended, I guess, to get into sort of a detailed discussion on what IR is with sort of people who are really deep in this space. We talk a lot about IGF and growth hormone, and I gotta tell you, this is a topic that you've probably heard me waffle on a little bit, because I'm still really kind of on the fence about this relationship of IGF, GH. I think the centenarian data point in one direction. I think the epidemiology outside of centenarians point in a different direction, and of course, none of this really speaks to the question I get asked constantly, which is, do you think administration of growth hormone is beneficial from a lifespan or health span perspective? Or do you think it's harmful? And truthfully, I've always leaned towards the harmful side, but we get into this in detail, and Nir offers some great insights. Certainly for me, I was really helped by this process.
We do go back and talk about the centenarians, and because I'm in the midst, as some of you know, of writing this book, I'm knee deep on all that literature. And so it was really great to kind of clarify a few things that I think even if you're not steeped in this stuff, you'll find very interesting. And of course, we talk about all of my other favorite topics like autophagy, caloric restriction. We even get into a little bit of the stuff around NAD and nicotinamide riboside and things like that. So overall, I think this is a bit of a technical episode, but not that technical. We've certainly done more technical stuff. The show notes will be valuable as always, especially for a show of this nature. So with nothing else to add, please welcome to the show Nir Barzilai.
Hey Nir, how are you?

**Nir Barzilai** (3:34)
I'm terrific. How are you?

**Peter Attia** (3:35)
I'm good. I can't believe, not only did you make it down here on time, but you made it down here ahead of me at my own place.

**Nir Barzilai** (3:42)
Nice to stay young.

**Peter Attia** (3:45)
Yeah, this is, I don't know, these days, this weather is so unpleasant, but yeah, you beat me here. I was a bit embarrassed.

**Nir Barzilai** (3:52)
It's unpleasant for you because you're in California most of the time.

**Peter Attia** (3:55)
Yeah, yeah, I think that's part of it. But you're from Israel, so this has to be unpleasant for you too.

**Nir Barzilai** (4:00)
Israel was too warm for me. I'm okay.

**Peter Attia** (4:03)
Got it. Well, speaking of which, so you were born in Israel.
You spent how long there? Did you serve military time there?

**Nir Barzilai** (4:10)
Yes, I served military time. I was a nurse and a medical student. I went to the Technion Medical School.