312 - A masterclass in lactate: metabolic fuel, implications for diseases, and therapeutic potential

View show notes here: https://bit.ly/4dp0xVd Become a member to receive exclusive content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ George A. Brooks is a renowned professor of integrative biology at UC Berkeley. Known for his groundbreaking "lactate shuttle" theory proposed in the 1980s, George revolutionized our understanding of lactate as a crucial fuel source rather than just a byproduct of exercise. In this episode, George clarifies common misconceptions between lactate and lactic acid, delves into historical perspectives, and explains how lactate serves as a fuel for the brain and muscles. He explores the metabolic differences in exceptional athletes and how training impacts lactate flux and utilization. Furthermore, George reveals the significance of lactate in type 2 diabetes, cancer, and brain injuries, highlighting its therapeutic potential. This in-depth conversation discusses everything from the fundamentals of metabolism to the latest research on lactate's role in gene expression and therapeutic applications. We discuss: 0:00:00 - Intro 0:00:12 - Our historical understanding of lactate and muscle metabolism: early misconceptions and key discoveries 0:15:02 - Fundamentals of metabolism: how glucose is metabolized to produce ATP and fuel our bodies 0:23:49 - The critical role of lactate in energy production within muscles 0:31:30 - Lactate as a preferred fuel during high-energy demands: impact on fat oxidation, implications for type 2 diabetes, and more 0:45:55 - How the infusion of lactate could aid recovery from traumatic brain injuries (TBI) 0:53:51 - The effects of exercise-induced lactate 0:56:35 - Metabolic differences between highly-trained athletes and insulin-resistant individuals 1:04:21 - How training enhances lactate utilization and facilitates lactate shuttling between fast-twitch and slow-twitch muscle fibers 1:12:44 - The growing recognition of lactate and monocarboxylate transporters (MCT) 1:16:21 - The intricate pathways of lactate metabolism: isotope tracer studies, how exceptional athletes are able to utilize more lactate, and more 1:33:40 - The role of lactate in cancer 1:41:24 - The role of lactate in the pathophysiology of various diseases, and how exercise could mitigate lactate's carcinogenic effects and support brain health 1:50:15 - George’s current research interests involving lactate 2:06:41 - Questions that remain about lactate: role in gene expression, therapeutic potential, difference between endogenous and exogenous lactate, and more -------- 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/