In this special episode of The Drive, Peter introduces a brand-new roundtable format. Joined by three renowned experts in longevity science—Steven Austad, Richard Miller, and Matt Kaeberlein—the group explores the rapidly evolving field of geroscience. Together, they dive deep into topics like the relationship between healthspan and lifespan, evaluating interventions like rapamycin and senolytics, the role of epigenetic changes in aging, and whether GLP-1 receptor agonists hold geroprotective potential. They also tackle major challenges in funding and public acceptance of longevity research including how geroprotective interventions might be tested in humans. Packed with nuanced debate, humor, and groundbreaking insights, this episode is a must-listen for anyone fascinated by the science of aging. View show notes here: https://bit.ly/4jpjjj8 Become a member to receive exclusive content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ We discuss: 0:00:00 - Intro 0:01:07 - The recent rise in public interest in longevity, misconceptions, and the link between healthspan and lifespan 0:10:54 - Redefining healthspan, the US healthcare paradox, and separating longevity science from commercial hype 0:20:48 - The need to redirect medical research from disease-specific models to aging-focused approaches 0:30:19 - Proactive healthcare: rethinking health, disease, and the role of aging 0:35:36 - Biologic age versus chronologic age, and the limitations and potential of epigenetic clocks 0:51:42 - The utility and drawbacks of the “hallmarks of aging” as a framework for research and funding 0:59:22 - The role of epigenetic changes in aging and the challenges of proving causality 1:07:08 - The translational challenges of moving aging research from preclinical studies to human applications 1:22:23 - Distinguishing between a biomarker of aging and aging rate indicators 1:26:32 - The difficulties of translating longevity research in mice to humans, and the difficulties of testing interventions in humans 1:42:45 - Exercise, aging, and healthspan: does exercise slow aging? 1:48:26 - Are GLP-1 receptor agonists geroprotective beyond caloric restriction effects? 1:54:15- The role of senescent cells in aging, challenges with reproducibility in studies, and differing views on the value of current research approaches 2:09:46 - How funding challenges and leadership in NIH and other institutes impact the advancement of aging-related research 2:12:11 - Metformin: geroprotective potential, mechanisms, and unanswered questions 2:21:45 - Canagliflozin and rapamycin as geroprotective molecules: mechanisms, dosing strategies, and longevity potential 2:35:22 - Resveratrol and NAD precursors—a lack of evidence for anti-aging effects 2:43:17 - The potential of parabiosis and plasmapheresis to slow aging, the challenges in translating mouse studies to humans, and possible design for human studies -------- About: The Peter Attia Drive is a deep-dive podcast focusing on maximizing longevity, and all that goes into that from physical to cognitive to emotional health. With over 90 million episodes downloaded, it features topics including exercise, nutritional biochemistry, cardiovascular disease, Alzheimer’s disease, cancer, mental health, and much more. Peter Attia is the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to patients with the goal of lengthening their lifespan and simultaneously improving their healthspan. Learn more: https://peterattiamd.com Connect with Peter on: Facebook: http://bit.ly/PeterAttiaMDFB Twitter: http://bit.ly/PeterAttiaMDTW Instagram: http://bit.ly/PeterAttiaMDIG Subscribe to The Drive: Apple Podcast: http://bit.ly/TheDriveApplePodcasts Overcast: http://bit.ly/TheDriveOvercast Spotify: http://bit.ly/TheDriveSpotify Google Podcasts: http://bit.ly/TheDriveGoogle Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice. No doctor-patient relationship is formed. The use of this information and the materials linked to this podcast is at the user's own risk. The content on this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they have, and they should seek the assistance of their healthcare professionals for any such conditions. I take conflicts of interest very seriously. For all of my disclosures and the companies I invest in or advise, please visit my website where I keep an up-to-date and active list of such companies. For a full list of our registered and unregistered trademarks, trade names, and service marks, please review our Terms of Use: https://peterattiamd.com/terms-of-use/