logo
episode-header-image
Aug 4
2h 11m

#359 ‒ How metabolic and immune system d...

Peter Attia, MD
About this episode

View the Show Notes Page for This Episode

Become a Member to Receive Exclusive Content

Sign Up to Receive Peter's Weekly Newsletter

Eric Verdin is a physician-scientist and the CEO of the Buck Institute for Research on Aging whose career has centered on understanding how epigenetics, metabolism, and the immune system influence the aging process. In this episode, Eric traces his scientific journey from studying viruses and histone deacetylases (HDACs) to leading aging research at the Buck Institute, offering insights into how aging impairs immune and nervous system function—including thymic shrinkage, chronic inflammation, and reduced vaccine response—and how these changes impact lifespan. He explores the metabolic underpinnings of aging, such as oxidative stress and insulin and IGF-1 signaling, and he discusses practical tools like zone 2 cardio, ketogenic diets, and GLP-1 drugs. The conversation also covers declining NAD levels with age, the roles of NAD-consuming enzymes such as sirtuins and CD38, and what current NAD-boosting strategies (like NMN, NR, and IV NAD) can and can't accomplish. Eric weighs in on promising longevity interventions including rapamycin, growth hormone for thymic regeneration, and anti-inflammatory therapies, while also examining the promise and limitations of current biological age tests and the potential of combining epigenetic, proteomic, and organ-specific metrics with wearables to guide personalized longevity care.

We discuss:

  • Eric's scientific journey from virology to the field of geroscience [2:45];
  • How dysfunction in the immune system and central nervous system can drive aging throughout the body [5:00];
  • The role of metabolism and oxidative stress in aging, and why antioxidant strategies have failed to deliver clear benefits [8:45];
  • Other aspects of metabolism linked to aging: mitochondrial efficiency, fuel utilization, and glucose-modulating drugs [16:30];
  • How inefficient glucose metabolism drives insulin, IGF-1 signaling, and accelerates aging [21:45];
  • The metabolic effects of GLP-1 agonists, and the need to move beyond crude metrics like BMI in favor of more precise assessments of metabolic health [27:00];
  • The case for immune health as a "fifth horseman" [36:00];
  • How the innate and adaptive immune systems work together to build immune memory [39:45];
  • Why vaccines lose effectiveness with age: shrinking of the thymus gland and diminished T-cell diversity [44:15];
  • Exploring growth hormone, thymic regeneration, and the role of exercise in slowing immune aging [48:45];
  • The challenges of identifying reliable biomarkers for immune function, and the potential of rapamycin analogs to enhance vaccine response in older adults [57:45];
  • How rapamycin's effects on the immune system vary dramatically by dosage and frequency [1:03:30];
  • The limitations of mouse models in aging research and the need for cautious interpretation of rapamycin's benefits in humans [1:08:15];
  • NAD, sirtuins, and aging: scientific promise amid commercial hype [1:15:45];
  • How CD38 drives age-related NAD decline, influences immune function, and may impact longevity [1:23:45];
  • How NMN and NR supplementation interact with CD38 and NAD metabolism, and potential risks like homocysteine elevation and one-carbon cycle depletion [1:31:00];
  • Intravenous NAD: limited evidence and serious risks [1:37:00];
  • Interleukin-11 (IL-11) as a new target in immune aging, the dual role of chronic inflammation in aging, and the need for better biomarkers to guide interventions [1:43:00];
  • Biological aging clocks: types of clocks, promise, major limitations, and future outlook [1:48:30];
  • The potential of proteomics-based aging clocks for detecting organ-specific decline and frailty [2:00:45]; and
  • More.

Connect With Peter on TwitterInstagramFacebook and YouTube

Up next
Nov 17
#373 – Thyroid function and hypothyroidism: why current diagnosis and treatment fall short for many, and how new approaches are transforming care | Antonio Bianco, M.D., Ph.D.
<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/ ... Show More
2h 20m
Nov 10
#372 - AMA #77: Dietary fiber and health outcomes: real benefits, overhyped claims, and practical applications
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 breaks down the science of dietary fiber, moving beyond the blanket advice to "eat more fiber" to unc ... Show More
24m 14s
Nov 3
#371 – Women's sexual health: desire, arousal, and orgasms, navigating perimenopause, and enhancing satisfaction | Sally Greenwald, M.D., M.P.H.
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter's Weekly Newsletter Sally Greenwald is an OB-GYN who specializes in women's sexual health from a hormonal and physiologic perspective, with expertise spanning desire, a ... Show More
1h 52m
Recommended Episodes
Sep 2024
The Surprising Link Between Space Travel and Aging with Dr. David Furman
<p>On this episode of Longevity by Design, Ashley Reaver, MS, RD, CSSD, and Dr. Gil Blander, delve into the intricate world of the immune system and its impact on aging with Dr. David Furman, Associate Professor at the Buck Institute for Research on Aging. David discusses his gro ... Show More
1h 8m
Sep 2024
Longevity Scientist Shares Top Strategies for Improving Your Health Span w/ Matt Kaeberlein, PhD
<p>Today's show is brought to you by MYOXCIENCE Nutrition. In this episode Matt Kaeberlein, PhD, CEO of Optispan, discusses the significance of enhancing health span through interventions like rapamycin and highlights the role of senescent cells in chronic inflammation and age-re ... Show More
1h 29m
Jun 2019
#046 Dr. Elissa Epel on Telomeres and the Role of Stress Biology in Cellular Aging
<p><strong>Elissa Epel</strong></p> <p>Elissa Epel, PhD, is a Professor in the Department of Psychiatry at the University of California, San Francisco where she serves as the director of the Aging, Metabolism, and Emotions Center.</p> <p>Her research centers on the mechanisms of ... Show More
1h 13m
Oct 2024
Unlocking the Secrets of Longevity with Dr. David Sinclair
<p>In this episode of Longevity by Design, our host Dr. Gil Blander speaks with Dr. David Sinclair, a professor of genetics at Harvard Medical School, about the science behind aging and how we can extend both lifespan and healthspan. Dr. Sinclair shares his groundbreaking researc ... Show More
46m 23s
May 2025
Aging
Aging is an essential topic for the MCAT, and in this episode, we’ll explore it from multiple angles. We start with the biological aspects of aging, including key processes like telomere shortening, cell senescence, and mitochondrial dysfunction—each providing insight into how an ... Show More
30m 51s
Jul 2024
Supplements for Longevity & Their Efficacy | Dr. Peter Attia
In this episode, my guest is Dr. Peter Attia, M.D., a Stanford and Johns Hopkins School of Medicine-trained physician expert in improving human healthspan and lifespan. Dr. Attia is also the host of The Drive podcast and author of the best-selling book Outlive.  We discuss the NA ... Show More
2h 30m
Mar 2025
The Science, Evolution, and Future of Lifespan and Healthspan with Dr. Michael Ringel
<p>On this episode of Longevity by Design, Dr. Gil Blander speaks with Dr. Michael Ringel, COO of Life Biosciences, about the science of aging and longevity. Michael discusses how evolution influences lifespan and why aging occurs. He explains the trade-off between resource alloc ... Show More
1h 12m
Jul 2025
Powering cellular energy and healthy ageing: behind the hype of NAD, NMN and NR supplements
Have you heard any of the buzz about NAD supplements? NAD is a molecule found in nearly every cell and sits at the heart of energy production and DNA repair. Our levels of NAD though can decline with age which has led to the idea that this could be one cause of many age-related d ... Show More
12m 42s
Sep 25
#282 - Longevity biomarkers for healthy aging and well-being | Dr. Matt Kaeberlein & Mike Haney
Longevity is a hot health topic, but what factors move the needle on not only how long you live but how long you experience relatively good health? Some lab and other tests can help assess how healthy you’re aging and provide context for what lifestyle and other changes to make. ... Show More
1h 50m