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cover of episode Journal Club With Dr. Peter Attia | Metformin for Longevity & the Power of Belief Effects

Journal Club With Dr. Peter Attia | Metformin for Longevity & the Power of Belief Effects

2023/9/11
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Huberman Lab

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A
Andrew Huberman
是一位专注于神经科学、学习和健康的斯坦福大学教授和播客主持人。
P
Peter Attia
Topics
Andrew Huberman: 本节讨论了两篇重要的科学论文。第一篇探讨了二甲双胍对长寿的潜在影响,研究结果显示,服用二甲双胍的2型糖尿病患者的死亡率降低了15%。然而,另一项研究对该结果提出了质疑,认为二甲双胍的益处可能被高估了。第二篇论文研究了安慰剂效应,发现安慰剂效应存在剂量反应关系,即个体对药物剂量的信念会影响药物的实际效果。 Peter Attia: 第一篇论文评估了服用二甲双胍的2型糖尿病患者的生存优势。Bannister 2014年的研究曾显示二甲双胍具有保护作用,但Keys等人的研究对该结果提出了质疑。Keys研究使用了更大的样本量,并进行了更严格的分析,结果显示服用二甲双胍的2型糖尿病患者的死亡风险并未降低。该研究存在一些局限性,例如药物使用情况存在差异,难以完全消除混杂因素的影响。此外,该研究使用了信息性删失法,这可能会低估二甲双胍的益处。尽管如此,该研究的结果表明,在该人群中,二甲双胍并未能抵消2型糖尿病带来的死亡风险增加。目前尚不清楚二甲双胍是否具有延缓衰老的益处,需要进行随机对照试验才能得出确切结论。 第二篇论文研究了尼古丁的信念效应。研究发现,个体对尼古丁剂量的信念会影响大脑对尼古丁的反应方式。即使所有参与者都接受了相同剂量的尼古丁,但如果他们被告知接受的剂量不同,他们的生理反应也会与被告知的剂量相符。这表明,信念效应不仅会改变个体的主观体验,还会改变大脑对药物的实际反应。

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Chapters
This chapter delves into a study on metformin's role in longevity, analyzing its effects on type 2 diabetics compared to non-diabetics. The discussion covers the drug's mechanism, limitations of the study design, and interpretations of the findings.
  • Metformin inhibits complex I of the mitochondria, impacting glucose metabolism.
  • Studies show mixed results on metformin's effect on mortality in type 2 diabetics.
  • Informative censoring in studies can bias results.
  • The drug's mechanism and potential benefits beyond glucose regulation are still debated.

Shownotes Transcript

In this journal club episode, my guest is Stanford and Johns Hopkins-trained physician, Dr. Peter Attia, M.D.), who is also the host of The Drive) podcast and the author of the bestselling book "Outlive: The Science & Art of Longevity."

We each present a scientific paper and discuss the findings' strengths, weaknesses and actionable takeaways.

First, we discuss an article that addresses whether taking the drug metformin can enhance longevity. Then, we discuss an article on belief effects (similar to placebo effects), showing how the effects of a drug on the brain and cognition depend on one's belief about the dose of the drug taken, not the actual dose.

Our conversation also highlights how to read, interpret and critique scientific studies. This episode ought to be of interest to those curious about health and longevity, medicine and psychology and for anyone seeking to better understand how to read and digest scientific findings.

For show notes, including referenced articles and additional resources, please visit hubermanlab.com).

Use Ask Huberman Lab), our new AI-powered platform, for a summary, clips, and insights from this episode.

Thank you to our sponsors

AG1 (Athletic Greens): https://athleticgreens.com/huberman)

LMNT: https://drinklmnt.com/huberman)

Waking Up: https://wakingup.com/huberman)

Momentous: https://www.livemomentous.com/huberman)

Timestamps

(00:00:00) Dr. Peter Attia, Journal Club

(00:03:43) Sponsors: LMNT & Waking Up

(00:06:11) Dreams

(00:12:36) Article #1), Metformin, Mitochondria, Blood Glucose

(00:19:47) Type 2 Diabetes & Causes, Insulin Resistance

(00:25:30) Type 2 Diabetes Medications, Metformin, Geroprotection, Bannister Study)

(00:36:37) Sponsor: AG1

(00:37:15) TAME Trial; Demographics, Twin Cohort

(00:44:27) Metformin & Mortality Rate

(00:51:28) Kaplan-Meier Mortality Curve, Error Bars & Significance, Statistical Power

(01:02:23) Hazard Ratios, Censoring

(01:09:00) Metformin Advantage?, Variables, Interventions Testing Program

(01:16:02) Berberine, Acarbose, SGLT2 Inhibitors

(01:23:48) Blood Glucose & Energy Balance; Caloric Restriction, Aging Biomarkers

(01:32:22) Tool: Reading Journal Articles, 4 Questions, Supplemental Information

(01:38:10) Article #2), Belief Effects vs. Placebo Effect

(01:45:22) Nicotine Effects

(01:51:07) Nicotine Doses & Belief Effects, fMRI Scan

(02:00:07) Biological Effects, Dose-Dependent Response & Belief Effects

(02:05:14) Biology & Beliefs, Significance, Dopamine Response, Non-Smokers

(02:10:57) Dose-Dependence & Beliefs, Side Effects, Nocebo Effect

(02:19:06) Zero-Cost Support, YouTube Feedback, Spotify & Apple Reviews, Sponsors, Momentous, Neural Network Newsletter, Social Media

Title Card Photo Credit: Mike Blabac)

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