October 27, 2025

#370 - AMA #76: Peter evaluates longevity drugs, aspirin for CVD, and strategies to improve muscle mass — proven, promising, fuzzy, noise, or nonsense?

17 minutes

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In this "Ask Me Anything" (AMA) episode, Peter revisits the "proven, promising, fuzzy, noise, nonsense" scale and applies it to a variety of popular topics. He begins with a refresher on what each category represents before classifying a range of interventions based on the strength of their supporting evidence. The conversation spans three main areas: drugs for geroprotection (including GLP-1 receptor agonists, SGLT2 inhibitors, methylene blue, and telomere-lengthening supplements), the use of low-dose aspirin for cardiovascular disease prevention, and strategies to improve muscle mass through optimal protein intake and follistatin gene therapy. This episode provides a clear, evidence-based overview for listeners seeking to understand where these popular health and longevity interventions stand on the spectrum of scientific credibility.

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We discuss:

A scale for evaluating scientific claims: proven, promising, fuzzy, noise, or nonsense [1:30];
Strong convictions, loosely held: the mindset that separates great scientists from the rest [7:30];
GLP-1 receptor agonists: are there benefits beyond improving metabolic health and promoting weight loss? [12:45];
GLP-1 drugs and the brain: exploring the potential cognitive benefits [18:45];
GLP-1 drugs and lifespan: examining the evidence for potential geroprotective effects [23:00];
Rapamycin and geroprotection: why it remains in the "promising" category [25:45];
SGLT2 inhibitors and their potential geroprotective effect [27:30];
Methylene blue: examining the evidence of an anti-aging effect [34:45];
Methylene blue's potential neuroprotective effects: limited and inconsistent evidence in humans, and the challenges of dosing and safety [41:15];
Telomeres: what they are, how they relate to aging, and why telomere-lengthening supplements lack credible scientific evidence [43:45];
Does the idea of targeting telomere length to extend lifespan have scientific merit? [50:15];
Low-dose aspirin for cardiovascular disease prevention: weighing its clot-prevention benefits against bleeding risks across different populations [55:00];
Rethinking the protein RDA: why most people need twice the recommended amount for muscle health [1:00:45];
Debunking the protein–cancer myth: why higher protein intake doesn't promote tumor growth [1:06:15];
The biology of follistatin and myostatin, and why follistatin gene therapy has become an emerging topic of interest for muscle growth [1:13:15];
Follistatin gene therapy for muscle growth: state of the evidence in animals and humans, and the technical challenges and regulatory barriers [1:17:00];
Why injectable follistatin is theoretically possible but impractical for real-world use [1:23:15]; and
More.

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By Peter Attia, MD

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