Peter Attia is a medical doctor, perhaps best known for his podcast, and appearances on popular podcasts like Tim Ferriss & Joe Rogan. He currently focuses on the science behind living a longer, healthier life. Each patient he works with has different risk factors, and thus each treatment plan is different. In the same manner, what Peter chooses to do for his own health, isn’t necessarily optimal for you.

In this post I’m going to delve into what Peter does for himself, based on podcasts, blogs and videos, to see what we can learn.

Supplements

Peter doesn’t believe in a one-size-fits-all approach to supplementation. Thus Peter discusses the supplements he takes with hesitation, in case people copy it, thinking what works for him will work for them.

That being said, it’s still possible to gain insight from what Peter does, given his detailed explanations around what he does, doesn’t and why.

As part of research for this section, I’ve looked back at the different times Peter has discussed supplements. Start in 2011 and working to the present. It’s also encouraging to see how much Peter’s supplementation has changed over time – we’re all in the same boat with regards to research and understanding changing over time, and the need to constantly update our beliefs.

To save time, I’ve linked some of the main supplements he has discussed, so you can jump to those sections:

  • Omega-3 Fish Oil (the main supplement, besides BCAAs, that Peter has discussed taking consistently since 2011)
  • Magnesium
  • Vitamin D (levels you want to target)
  • Lithium (why an ultra low dose may be of interest)
  • Aspirin (and new scepticism on its usage for flights and CV risk)
  • Berberine (what Peter likes it for)
  • BCAAs – Branch Chain Amino Acids (which brands he trusts)

Prescription medications:

So lets begin (after the table of contents)…

2011

In 2011, Peter listed his supplements as:

Supplement? How much and when? Why? If reason given
Magnesium 400 mg per day Adequate magnesium levels help preserve Potassium, which is necessary for cellular function, and prevents cramping
Potassium 200 mg per day 200mg is relatively minor, but he supplemented for the sake of avoiding muscle cramps
Fish Oil 2 teaspoons (10 mL) every evening with dinner, providing 1600mg EPA and 1,000mg DHA He aimed to get his omega-3 to omega-6 ratio closer to 1:1, first by limiting sources of omega-6, and secondly by supplementing omega-3s.

At this point his supplementation was fairly minimalistic.

2012, January

Then in a video from 2012, Peter discusses taking:

Supplement? How much and when? Why? If reason given
Multivitamin Daily – no specifics on brand or composition He actually says he thinks he probably shouldn’t be taking it, as it might be doing more harm than good. And says he will look into it more
Fish Oil 1 tablespoon/day of Carlson’s fish oil Peter increased on his 2011 dosage, because recent a test showed him low in omega-3s
BCAAs (3 Amino Acids) 2-4grams with water, whilst in the weight room (resistance training) Important for preserving muscle density and tissue integrity, under periods of great stress
Glutamine (Amino Acid) Post hard workouts (bike, weights or swimming) “Some evidence” glutamine helps your muscles rebuild after a difficult bout of training

Omega-3 Fish Oil

Whilst Peter’s supplements have varied widely between 2011 and 2019, one thing has stayed constant, which is the supplementation of omega-3 fish oil.

There seems to be a common understanding among experts that modern diets provide insufficient levels of omega-3 fatty acids. When I’ve looked at other thought leaders supplement habits; Joe Rogan (link) & Dr Rhonda Patrick’s (link), they also choose to take omega-3 fatty acids daily.

Peter mentions trusting two brands; Nordic Naturals and Carlson. On AMA #11 @ 17 mins he says he takes around 2 grams daily of EPA/DHA. With Carlson’s Fish Oil he prefers the non-encapsulated version.

If you find capsules more convenient (as I do), Carlson also do an encapsulated version; Elite Omega-3 Gems.

2015 – Tim Ferriss Podcast

The next mention I can find of Peter’s supplementation is his March 2015 podcast with Tim Ferriss (source and transcript). He was taking:

Supplement? How much and when? Why? If reason given
Vitamin D Dose & timing not mentioned Took in order to target a certain blood level
Baby Asprin 1x baby aspirin Was taking to mitigate cardiovascular event risk
Methylfolate (B-9) Approximately 2x per week Peter has a MTHFR mutation which reduces folic acid processing efficiency, but taking the methylated form of of folic acid (folate), circumvents this absorption issue
B-12 Takes low dose, approximately 2x per week To get B-12 to desired blood levels
Fish Oil Dose & timing not mentioned Same reasons as previously mentioned
Berberine Dose & timing not mentioned 1) It activates AMP-Kinase, which suppresses hepatic glucose output, which maintains lower levels of insulin and therefore lower levels of IGF-1. The latter Peter says he values.
2) It inhibits PCSK9, which for over expressers of PCSK9 (he estimates ~10% of population) this can drop their LDL particle count.
Probiotic Taken periodically throughout the week Not mentioned on this podcast

Compared to 2012, Peter has dropped the multivitamin, and honed in on potential deficiencies he might have, such as B-vitamins and vitamin D. He also looks to be experimenting with probiotics, berberine and baby aspirin.

2016 – Tools of Titans Chapter

In Tim Ferriss’ 2016 book; Tools of Titans, each chapter is a list of tips from a different person. In the Peter Attia chapter, Peter shares a few nuggets on supplements.

Firstly, he discusses supplements he does not take:

  • Multivitamin – Peter notes he is not an advocate of multivitamins (see more below).
  • Vitamins A and E – Peter isn’t convinced he needs more than he absorbs through whole foods.
  • Vitamin K – Peter believes that if you’re eating leafy green vegetables (big “if” for some people), you’ll be getting enough vitamin K. For vitamin K2, it may be a different story for some people, depending on their diet.
  • Vitamin C – He posits that most people get enough in their diet. And whilst mega-doses may be interesting, in particular for combating viral illnesses, vitamin C isn’t bioavailable enough in oral form. These megadoses would require intravenous administration.

Then Peter touches on some of the supplements he is a proponent of:

Magnesium

Peter is a big proponent of magnesium supplementation. Magnesium is needed by every cell in the human body, and plays a crucial role in core functions such as energy production. In Tools of Titans he takes 600 to 800 mg per day, alternating between magnesium sulfate and magnesium oxide. He was also taking calcium carbonate 2 times per week.

Source: Twitter

Later, in 2018 (see tweet source above), Peter is taking a specific form of magnesium sulphate called Slow-Mag. Slow-Mag also has an enteric coating, which reduces the ability of the stomach acids to break down the outer capsule, meaning the capsule makes its way to the intestines before disintegrating and the contents being dispersed. This can help avoid stomach discomfort. Also, instead of just containing magnesium sulphite, Slow-Mag also contains calcium.

2018 – AMA #2

Then in Peter’s August 2018 AMA #2, he is taking the below supplements and now some prescription drugs (he may have been taking these prescription drugs for much longer, but this is the first time I see mention of them):

Supplement? How much and when? Why? If reason given
Vitamin D Nightly, at bedtime Not mentioned on this podcast
Methylfolate Every morning Not mentioned on this podcast
Methyl B12 Every morning Not mentioned on this podcast
Lithium Nightly, at bedtime Not mentioned on this podcast
Fish Oil Nightly, at bedtime Presumably, same reason as prior
Selenium Every morning Not mentioned on this podcast
Baby Aspirin Every morning Not mentioned on this podcast
N-acetylcysteine (NAC) Twice daily Not mentioned on this podcast
Curcumin Every morning Not mentioned on this podcast
Magnesium Oxide 400mg nightly, at bedtime Not mentioned on this podcast
Slo-Mag (Slow Release Magnesium 2 tablets, every morning Not mentioned on this podcast

Prescription Drugs

Prescription Drug How much and when? Why? If reason given
Metformin 1g – 2x daily Not mentioned on this podcast.
Atorvastatin (Lipitor) 10 mg – Monday / Wednesday / Friday – Evenings Not mentioned on this podcast. But Atorvastatin is a statin, intended to lower lipid levels and reduce cardiovascular disease risk.
Ezetimibe (Zetia) 10 mg – Tuesday / Thursday / Saturday – Mornings Not mentioned on this podcast. But Ezetimibe is a drug to treat high cholesterol, and is generally taken alongside a statin.

Vitamin D

Just like with other vitamins, Peter doesn’t suggest indiscriminate usage. On his interview on Joe Rogan, he cites an optimal range of Vitamin as between 40-60ng/ml. To target optimal ranges, it requires at least 2 blood tests. One prior, to understand where you are currently, and then one after a period of time supplementing, to understand the effect of the supplementation.

It can be particularly valuable to check vitamin D levels during winter, if your sunlight exposure is limited.

Lithium

First, a bit of background on lithium:

  • Lithium is not essential for human life – at least not based on current understanding. There’s a big list of essential micronutrients that humans need to survive, and lithium is not one of them.
  • That said, lithium is found abundantly in small quantities, in rocks and soil around the world, even making it into our drinking water. So humans are very used to getting it in small amounts.
  • There’s a significant amount of research that associates higher levels of lithium in the drinking water, with lower levels of suicide1, and even reduced incidences of crimes and arrests due to drug addictions2. It appears to have mood improving and stabilizing effects3
  • It’s used clinically in high doses to help treat conditions such as bipolar, schizophenia and major depressive disorder.

Peter has experimented with Lithium in 2 different ways:

  1. In AMA #3 he refers to an experiment, where he consulted with Psychiatrist Paul Conti, who specialises in lithium monotherapy for bipolar patients, and then started taking 600mg/day, which is about 1/2 of what a bipolar patient would take. This is a very high dose, and *should not* be done outside of the care of a specialist physician. Peter didn’t tell anyone about taking lithium, and waited to see if anyone noticed a change in his mood. After about 4 months his wife noticed his mood had improved, and he was being “less of an asshole”. Later, Peter decided to discontinue his mega-dose of lithium, experiencing some side effects such as nausea.
  2. As of AMA#3 (Oct 2018) he takes low dose lithium (10-20mg/daily). Noting he’s unclear if it has an effect, given that he has added things like meditation, which also make a big difference to his mood.

Peter hasn’t explicitly mentioned which Lithium supplement he takes, but given he favors Jarrow and Pure Encapsulations, and Jarrow don’t make a Lithium supplement, there’s a chance it’s something like Pure Encapsulations – Lithium orotate. It contains 5mg of lithium orotate, and 200mg of N-acetyl-l-cysteine (NAC), which is a precursor to glutathione, the major antioxidant in the brain, and is added to this formula, they say, for enhanced protection of brain cell membranes.

2018 – AMA #3

Then on Peter’s AMA #3 (October 2018) he updates a few details:

Aspirin

Peter’s stance on aspirin has changed as the data has changed. Prior to this podcast, he saw aspirin as valuable in 2 situations:

  1. If a patients AspirinWorks Test result was high, and they had one of the following; elevated LP-PLA2, or elevated Lp(a) (spoken out loud as “LP little a”), or if they had significant family history of heart disease. A combination of those two factors would make them a candidate from taking a daily baby aspirin.
  2. If you’re on a long flight, and you want to minimize your risk of getting a blood clot – especially if you have another risk factor such as Lp(a), which would increase your risk of blood clots.

So then in regards to (1) – Peter cites a recent study of twelve thousand people, that was randomized, double blinded, placebo controlled, with one group taking aspirin, and the other not. The results didn’t show any real benefit of taking aspirin – and thus Peter is now more hesitant to use aspirin as the benefits appear less clear.

In-flight Blood Clot Risk Reduction

With regards to (2), one of Peter’s researchers did a deep dive into the literature on using aspiring on flights to reduce thrombosis risk (blood clots). The research actually didn’t show benefits to taking aspirin on flights (in blinded trials). Which just leaves tools such low molecular weight heparin, which is an injectable, and thus a lot of hassle, or an over the counter supplement called Flite Tabs.

Peter elaborates more on Flite Tabs in his Kevin Rose interview [10m 53s], and explains how they contain FDA regarded “GRAS” substances (Generally Regarded As Safe) that are really good at thinning the blood under flight circumstances:

  • Reduced oxygen concentration in the air
  • Dehydration (almost inevitable on long flights)
  • Physical seat confinement

When I was looking to buy FliteTabs they were out of stock on Amazon. Some searching around led me to Life Extension’s VenoFlow which is very similar to Flite Tabs. Both contain the same 2 ingredients; Pycnogenol, a pine bark extract, and nattokinase, a soy natto extract. Flite Tabs bottles are 4 servings of 300mg (2 caps), whereas Venoflow is 30 servings of 200mg (1 cap) per bottle.

Berberine

Berberine is a plant derived supplement that Peter mentioned taking in the 2015 Tim Ferriss podcast. However in his next update (2016) he was no longer taking it. He occasionally uses it with patients, noting in AMA #3 [1:20:27] that Berberine has 2 key properties:

  1. It’s a weak activator of AMP Kinase, which is the “secret sauce” of metformin. Peter suggests that if you’re going after AMP Kinase activation, you’re best served through the use of metformin. In part at least, because metformin’s production is regulated as a pharamaceutical drug, and thus all the things you’d expect, like quality control, are scruitinized much more heavily. Whereas Berberine is sold as a supplement, and supplements are subject to comparatively little regulation.
  2. It’s a weak inhibitor of the enzyme PCSK9. Berberine acts to inhibit the PCSK9 enzyme, which then results in a reduction of total cholesterol and low-density lipoprotein cholesterol4. Thus in the small subset of the population that over-express PCSK9, Berberine can be effective. However Peter notes that when LDL-P is high, and the normal causes such as diet have been addressed, it is only around 5% of the time about PCSK9. There are literally thousands of other possibilities as to why it could be high.

Peter notes later in the podcast [2:04:14], when they do use Berberine, they suggest Thorne’s Berberine as the brand.

Atorvastatin & Ezetimibe

Peter explains [1:53:10] that he is no longer taking either – presumably stopping at some point between AMA #2 and AMA #3.

He *was* taking them because he’s trying to live as long as he can, which means delaying the onset of atherosclerotic disease as long as possible. To achieve that, he’s taking an “all hands on deck approach” consisting of:

  1. Reducing the burden of lipoproteins (where statins can be used)
  2. Reducing inflammation
  3. Improving endothelial health
  4. Increasing insulin sensitivity

At the time Peter took them, these drugs helped Peter get his lipid scores below the 20th percentile in terms of risk. He’s now off those meds and trying a different approach, but intends to continue vacillating in and out of lipid lowering medications if needed.

Rapamycin

Kevin Rose (left) and Peter Attia (Right)

Peter announces on podcast with Kevin Rose that he had started taking rapamycin at the end of 2018 (see approx. 52m 15s of the podcast). As recently as August 2020, Peter mentions on this podcast that he’s still taking rapamycin.

Specifically mentions taking ~6 milligrams once per week. Each quarter he says he does 8 weeks on rapamycin, 5 weeks off. He mentions in AMA 11 that he does not take rapamycin whilst fasting.

In terms of unwanted side-effects, Peter notes that it gives him occasional aphthous ulcers. He also notes that his finger nails grow slower whilst taking it. However, in day to day life, he doesn’t notice any difference whilst on it.

Sirolimus is the USAN-assigned generic name for the natural product rapamycin

About Rapamycin

Rapamycin is a prescription drug that is FDA approved for use as an immunosuppresor. When taken daily, it stops the bodies of transplant patients from rejecting their new organ.

The use of rapamycin for healthspan/lifespan benefits is off-label, and does not have FDA backing (yet).

The reason for the interest in rapamycin for healthspan/lifespan benefits derives primarily from success in labs, where it has been able to extend the lifespan in animal models (fruit flies, worms and mice).

Despite this potential, there haven’t been any studies of its lifespan/healthspan benefits in humans yet. There are likely many reasons for this, but one of the main ones is:

  • The FDA do not recognise ageing as a disease. This means that you can’t get a drug approved by them to help improve lifespan/healthspan. Instead you have to pick a very specific disease, such as a type of cancer, and get it approved for that. Thus, if you can’t get your drug FDA approved, then it’s hard for US companies to justify the high costs of the clinical trials needed to test if there are healthspan/lifespan benefits to rapamycin.

That said, in recent years, there has been substantial interest in the use of rapamycin to tackle ageing. Thus it’s likely studies in humans will take place in the coming years.

Should You Take Rapamycin? Probably not (yet)

As far as I understand, if someone was interested in taking rapamycin, they would first want to make sure they have everything dialed in with their current lifestyle, specifically; sleep, diet, exercise and stress. They would want to have significant numbers of blood markers tested over time, to ensure that their lifestyle was putting them in the optimal ranges. Those steps are by far the low hanging fruit of longevity.

Once that was all dialled in, they would then want to seek supervision of a doctor who is familiar with rapamycin usage for the purpose of improved healthspan/lifespan. On the podcast Peter mentions there is a doctor in New York (Alan Green) who provides off-label rapamycin treatment. Even under supervision, you’d still be stepping out onto the fringes of modern scientific understanding, and would in some ways be a guinea pig for scientific research.

Related to this, I was fortunate enough to catch a presentation by David Sabatini earlier in 2019. David is someone Peter talks about a lot, because David and his lab are at the forefront of research around mTOR, including first discovering mTOR complex 1 and 2. Anyway, after the presentation I asked David about his thoughts on taking mTOR, and he said he doesn’t personally take it. For now he simply eats a low carbohydrate diet and practices intermittent fasting. He thinks in the future there will better molecules than mTOR that capture the upsides, with less of the downside. I found that interesting, given he knows the subject area better than 99.9 (with lots more 9s proceeding) of the population. But, as Peter said, different people have different risk tolerances. And one things for sure, ageing is coming for us, whether we choose to try and delay it, or not.

David Sabatini – an MIT professor whose lab are at the forefront of research into mTOR

Branch Chain Amino Acids (BCAAs)

In the discussion with Kevin around rapamycin, they meander onto the subject of branch chain amino acids. Peter explains that the bodybuilding community was wise to the idea that if you wanted to grow your muscles you want lots of these branch chain amino acids. Unfortunately, he says, most of the industry is a sham, and many of the products literally contain crushed bird feathers. There’s only two companies that he’s aware of that make a legitimate branch chain amino acid. Noting not to say that these are the *only* two, but these are the only two he can vouch for.

1) A company in Japan called Ajinomoto, the original creator a true pharma grade amino acid. They sell their BCAAs to other companies, who then put the Ajinomoto mark (branded as “Ajipure”) on their packaging.

Example from Gold Nutrition BCAAs showing the Ajinomoto / Ajipure labelling

2) The other is a company in Canada called Biosteel

If a patient comes to him and says, I want to be on Amino acids, Peter is putting them on Biosteel, because he thinks it’s the best option out there. And if they can’t stand the taste, because it’s a bit too sweet, then he says, lets look for something else, that at least has the Ajinomoto stamp on it – so that we know it’s coming in with the right stuff.

Supplement Companies Peter Uses

In AMA #3 [2:02:30]Peter was asked the question, “which brand of supplements have you found effective”. He notes that the supplement world is “kind of a shit show” because it’s so unregulated. He goes on to say that supplement companies he relies upon are:

  • Pure Encapsulations
  • Jarrow

For Omega-3s:

  • Carlson (as mentioned above)
  • Nordic Naturals

Noting there are a couple other companies he will use, depending on the product. For example with Berberine, they use the Thorne brand.

Diet

Previous Ketogenic Diet

Before we touch on how Peter eats now, it’s worth noting he hasn’t always eaten this way. For example, for 3 years, between 2011 and 2014 Peter ate a 100% ketogenic diet. This was back before ketogenic diets really hit the mainstream, as visualized on Google Trends:

Peter was practicing the diet when it was relatively unknown, and thus he wrote a few interesting articles to help raise awareness on the subject:

He explains that whilst he no longer eats keto, it’s not because he lost confidence in its efficacy, noting:

“I was leaner, and more mentally and physically fit during this three year period [ketogenic diet] than during any other period of time as an adult, and my biomarkers were as good as they had ever been.”

For more information on Peter’s transition away from keto, see:

Current Diet

Firstly, lets just clarify what Peter’s diet is not…

  • As mentioned above, it’s not ketogenic
  • It’s not vegetarian, vegan or pescatarian
  • It’s not dairy or gluten free

Peter’s current diet can simplified into 3 “rules”:

  1. Time Restricted Feeding
  2. Avoid Sugars, High Fructose Corn Syrup & Junk Food
  3. No Restriction on Healthy Starches and Vegetables

1) Time Restricted Feeding

At the low end, Peter fasts between 14 – 16 hours each day, and at the high end, he fasts between 20 – 22 hours. Essentially meaning he fasts for most of the day, and eats all his calories in a tight window between between the afternoon and evening. From what he describes, this means some days he will be eating one (big) meal per day (often referred to by the acronym OMAD).

A Cell paper illustration shows the benefits to pre-diabetic patients who adopted a smaller eating window. With blood markers trending in a desirable direction. Notably Peter adopts a late eating window, rather than the early one discussed in this paper.

2) Avoid Sugars, HFCS & Junk Food

Peter makes sure to avoid foods containing sucrose (sugar) and high fructose corn syrup (HFCS). These are often in non-obvious places such as sauces and dressings, for food that would otherwise be healthy.

He also works to avoid obvious junk foods such as potato chips, cookies, pastries etc.

Everything in moderation, including moderation. Peter understands the need to enjoy life, as well as optimize it. These pics of gelato and pizza are from his trip to Italy – via IG (1) & (2)

3) No Restriction on Healthy Starches & Vegetables

Peter doesn’t place restrictions on healthy starches such as rice and potatoes. Likewise, no restrictions on vegetables.

Peter prepping for an evening grill, before and after- via IG (1) & (2)

 

Left – Peter about to enjoy a bowl of Venison stew and vegetables (via IG) Right – Peter about to enjoy a large bowl of salad w/ fruit (via IG)

 

Peter doesn’t do strict keto normally, but when he does, these are the sorts of things he buys – image via IG

What does one of Peter’s meals look like?

If Peter’s eating once a day, which he does from time to time, he eats about 3,000 calories in 1 meal. It’s usually a combination of:

  • A huge salad – Such as lettuce, tomatoes, cucumbers, carrots, mushroom Extra Virgin Olive Oil (EVOO), freshly squeezed lemon, salt, and pepper
  • Protein – He rotates through salmon, pork, steak or game meat
  • Carbohydrates – A serving of rice, potatoes or sweet potato

The above meal is an example taken from a podcast with Kevin Rose. Of course, he isn’t always eating 1 meal per day, but he does generally aim to delay eating until at least lunch time / early afternoon.

…So that’s essentially “it” for Peter’s day-to-day diet. Or at least I’ve covered as much as I currently understand. It may also be of interest to peek at this post I wrote on Peter’s nutrition framework. Which provides a nice mental model for the way he thinks about diet.

Fasting

Peter currently water fasts for 3 consecutive days each month. Research by Valter Longo and others show fasting benefits include:

  • Decrease in visceral fat (the “bad” fat located around the organs, as opposed to subcutaneous fat, that’s visible under the skin)
  • Increase in cellular cleanup (autophagy) around day 3
  • Lowered IGF-1
  • Decreased blood glucose and insulin

Up until the end of 2019 Peter was doing a 7 day fast once every 3 months. His process comprised of:

  • 7 days of a ketogenic diet prior to the water-only fast
  • 7 days of water only fasting
  • 7 further days of keto after the fast

However, for 2020 he does a 3 day fast once per month, without the strict keto diet either side. He made the switch for 2 key reasons:

  • 7-day fasts are intrusive on life.
  • During the 7-day fast, it was typically day 2 where he saw a big shift in his glucose/ketone levels. With glucose normalising, and ketone production ramping up. Therefore he anticipates 3-day fasts will capture some of this important metabolic change.

So far Peter has found the 3-day fasts:

  • Significantly easier than 7-days + he never feels as though he’s “dragging” like he does at points on 7-day fasts
  • Allow for a higher exercise tolerance, due to less glycogen depletion. Meaning he won’t have to dial back the volume/intensity of his workouts each quarter

During the fasting period it’s water only. – and for Peter this means plenty of his favourite carbonated water drink – Topo Chico:

Peter with Topo Chico (via IG)

Supplements whilst fasting?

In AMA 11 Peter discussed his approach to supplements whilst fasting. He continues taking:

  • Magnesium – he takes magnesium oxide and Magnesium L-threonate when not fasting. When fasting, he switches out the magnesium oxide for a slow absorbing form of magnesium (Slow-Mag), then continues to take Magnesium L-Threonate.
  • Methylated B vitamin complex – Peter takes these all the time, fasting or not fasting.

He stops taking:

  • EPA/DHA – he takes about 2g daily of EPA/DHA normally, but whilst fasting he stops. Skipping the ~20 calories or so it would contain.
  • Rapamycin – He stops taking rapamycin whilst fasting because he is already getting natural mTOR inhibition via the fast.
  • Metformin – He doesn’t take metformin anymore, however when he was taking it, he would stop whilst fasting.
  • Sodium – on his 7 day fasts he would supplement 2 grams of sodium via bouillon. However, for 3-day fasts he doesn’t add sodium and feels good. But suggests that others may benefit from sodium whilst fasting, especially if they don’t fast regularly.

Fasting Mimicking Diets?

For those interested in emulating something like Peter Attia’s 3 or 7 day water only fasts, but aren’t quite as extreme, the ProLon fasting mimicking diet may be of interest. One of Peter’s clients, Kevin Rose, discussed having premature cardiovascular disease risk in the family, and using multiple cycles of ProLon (spread out, not back to back) as suggested by Peter – to help normalize some of his blood biomarkers. For more information on ProLon, see my review.

Peter has also discussed using a modified version of the ProLon diet with his clients. However he hasn’t (that I’m aware) shared the specific details. As noted in his tweet below, two of the key components are calorie restriction and low protein. The ProLon diet goes one step further with low protein, by being 100% plant based. That’s not all hippy dippy stuff – by removing animal products you change the amino acid profile, in particular keeping methionine low. Methionine is particularly abundant in animal proteins, and plays a key role in growth pathway signalling56.

Exercise

Peter is a former time-trial cyclist and endurance swimmer. For example, he’s one of small group to have swum the Catalina Channel in both directions (separate swims). That’s in the range of a 10-hour swim, if you’re really giving it some. The LA Times did a write-up here. Peter stopped training athletically 4 years ago (at ~43 years of age), and now just exercises for health and wellbeing.

Specifically Peter’s training focuses on 4 key areas:

  1. Stability – training this daily
  2. Strength – 3-days/week
  3. Aerobic Efficiency – 3 hours a week, split between 3-4 sessions
  4. Anaerobic Performance – 2x per week

Stability

Good stability is key to healthy movement, athletic performance and reducing injury risk. It comes primarily from our core (lumbopelvic region) and connects our upper and lower body together. Allowing them to co-ordinate and transfer load efficiently. Peter has an upcoming video series which will cover more details around exercises he uses for improving stability. In the interim, if you’re interested, you can check out content on YouTube around stability exercises.

Peter training using bands (via IG)

Strength

Whilst Peter’s weight-lifting is likely varied, he has written previously about his obsession with heavy squats and deadlifts. Noting that he trains deadlifts with a hex bar rather than straight bar – to reduce risk of injury.

Two of his favourite squat/deadlift sets are:

  1. A thorough warmup of 7-10 sets ascending in weight, with a main set of 5 sets of 5 reps (5×5), followed by 4 sets of 10 reps (4×10), following by 3 sets of 20 reps(3×20).
  2. Ascending sets of 5 reps until failure (i.e. keep increasing the weight until you can’t get 5 reps), then dropping down to a “test” weight (Peter gives an example of using 315lbs on deadlift and 275lbs on squat) and going to failure. Then, drop to a second, lighter “test” weight (Peter gives an example of using 275lbs on deadlift and 225lbs on squat) and go to failure once more. He notes that failure occurs when form breaks, not when you fall under the bar. The goal is increase the reps of those test sets each week.

Peter is quick to point out that this should NOT be followed if you don’t know how to squat and deadlift perfectly. For an education, he recommends Mark Rippetoe’s book Starting Strength.

Peter training an isometric deadlift (via IG)

Aerobic Efficiency & Anaerobic Performance

Training for aerobic efficiency involves exercising at a medium pace, such that your bodies energy needs can be provided by the oxygen you’re breathing. When you exercise so fast that your body doesn’t have enough oxygen to keep up (and thus switches to its other 2 methods of energy production), that’s anaerobic exercise.

For these types of exercise, Peter often uses his Wahoo Kickr (+ Trainer Road) or Peloton Bike.

Besides training on bikes, Peter also does Tabata or a boot-camp type workout.

On a bike you’ll tap into both aerobic and anaerobic capacity by cycling over a distance (aerobic), with interspersed sprints (anaerobic).

Left – Peter praising the Wahoo Kickr (via IG) | Right – Peter training aerobic capacity on the bike (via IG)

Final Words

I’m sure you’ll agree, Peter is a wealth of knowledge, and it’s fantastic that he makes ways (primarily through podcasts) to share this information with the world.

This seems like a good opportunity to mention Peter’s subscription service – with which I have zero affiliation, if that wasn’t clear already (am just enthusiastic about it).

For a small monthly, or annual fee, it gives you access to a whole host of benefits that aren’t available otherwise. Including the new “Qualys” series, which are short (<10 minute) highlights from the back catalog of podcasts.

This is a great way to support Peter’s continued time spent on the podcast, as well as make sure you’re getting all the latest and greatest info.

Post Change Log

For those curious, see this post for a log of the key changes to this article, starting from July 24, 2020.

See Post Sources Below:

  1. Lithium levels in drinking water and risk of suicide – Hirochika et al. – 2018
  2. Lithium in drinking water and the incidences of crimes, suicides, and arrests related to drug addictions – Schrauzer et al. 1990
  3. Effects of nutritional lithium supplementation on mood. A placebo-controlled study with former drug users – Schrauzer et al. – 1994
  4. The Effects of Berberine on Blood Lipids: A Systemic Review and Meta-Analysis of Randomized Controlled Trials – Dong et al. (2013)
  5. Methionine restriction and lifespan control – Lee et al (2016)
  6. Short-term methionine deprivation improves metabolic health via sexually dimorphic, mTORC1-independent mechanisms – Yu et al (2018)
John Alexander

Posted by John Alexander

Note: Not a Medical Doctor or PhD. I'm a researcher and writer, with a focus on the subjects of health and longevity. My intent is to write about scientific research in an accessible, understandable way. If you believe something I've stated needs a reference, and I haven't done so, please let me know in the comments. Follow on: Twitter

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PiF
PiF
18 days ago

Wow, the amount of info and research in these posts is just amazing. And from all the gurus I follow, too. Keep up the great work, because I just found my new favorite health website. Thank you for your hard work!

I would just add, from my memory, that, while fasting, Peter takes 2 Slow-Mags in the morning and two in the evening and 2 Magnesium L-threonate in the evening. But I guess this depends on each person.

Last edited 18 days ago by PiF
bruce walker
bruce walker
19 days ago

Thank you so much. GREAT summary! A key question for me is how much protein does he take now (%?) to support his muscle gain goals and his longevity goals….or does he use this monthly fasting to inhibit mTOR? Thank you.

dipidoo
dipidoo
1 month ago

what about arginine supplementation for GH hack

Moritz
Moritz
1 month ago

Great summary, thanks a lot! One question though that still confuses me: Does Peter still take his supplements during the fasting / restricted feeding periods or does “water only” literally mean nothing but water, not even vitamins or minerals?

treewx
treewx
2 months ago

Awesome summary, FYI as I understand. Peter now does 3 day fasts, once a month. Claims it’s more practical.

Last edited 2 months ago by treewx
Emilia
Emilia
2 months ago

Excellent content! Thank you!

Julie
Julie
2 months ago

Excellent summary of my favorite health guru – thanks!!

Dania
Dania
2 months ago

Thank you for the great summary

David
David
3 months ago

Thank you for this valuable content !!
From Paris, France.

DEBORAH D WELCH
DEBORAH D WELCH
Reply to  David
2 months ago

Thank you John. Would you update this please. Peter now uses a three day fasting protocol each month Thanks for your great work

Steve
Steve
3 months ago

Amazing. Thank you.

Ryley
Ryley
4 months ago

Thanks for putting all of this info together, I really appreciate it!! I use it all of them time.

Guangxiao Zhang
Guangxiao Zhang
5 months ago

Thank you so much for taking the time putting these information together from all sources! It’s really helpful.

Norbi
Norbi
6 months ago

Very comprehensive article, thanks for doing it!

Stephanie Peden
Stephanie Peden
8 months ago

After watching many of his videos on YouTube about fasting and other topics I still could not find a specific answer of his current diet now that he is not in ketosis, so thank you so much for all the specifics and the amount of detail and effort put into this article!

Baruch
Baruch
8 months ago

Fantastic and comprehensive review, well done.

R Berman
R Berman
10 months ago

WOW!! This is amazing and so well done!!!!!

Ivan
Ivan
10 months ago

I just wanted to tell you how excellent work you are doing. Excellent page, superb articles.Bravo!!