How Metabolic and Immune System Dysfunction Drive the Aging Process, NAD, Aging Clocks & More (Video)
In this 3 August 2025 videi, host Dr. Peter Attia talks with Eric Verdin, a physician-scientist & the CEO of the Buck Institute for Research on Aging. In this episode, Eric traces his scientific journey from studying viruses to leading aging research at the Buck Institute, offering insights into how aging impairs immune & nervous system function—including thymic shrinkage, chronic inflammation, & reduced vaccine response—& how these changes impact lifespan. He explores the metabolic underpinnings of aging, such as oxidative stress & insulin & IGF-1 signaling, & he discusses practical tools like zone 2 cardio, ketogenic diets, & GLP-1 drugs.
The conversation also covers declining NAD levels with age, the roles of NAD-consuming enzymes such as sirtuins & CD38, & what current NAD-boosting strategies can & can’t accomplish. Eric weighs in on promising longevity interventions including rapamycin, growth hormone for thymic regeneration, & anti-inflammatory therapies, the promise & limitations of current biological age tests, & the potential of combining epigenetic, proteomic, & organ-specific metrics with wearables to guide personalized longevity care.
https://youtu.be/818-8vS5JpA
0:00:00-Introductiom
0:01:20-Eric’s journey from virology to geroscience
0:04:16-How dysfunction in the immune system & central nervous system can drive aging
0:08:28-Role of metabolism & oxidative stress in aging
0:17:32-Other aspects of metabolism linked to aging: mitochondrial efficiency, fuel utilization, & glucose-modulating drugs
0:23:42-How inefficient glucose metabolism drives insulin, IGF-1 signaling, & accelerates aging
0:29:45-Metabolic effects of GLP-1 agonists
0:40:48-Immune health as a “fifth horseman”
0:45:11-How the innate & adaptive immune systems work together to build immune memory
0:50:26-Why vaccines lose effectiveness with age
0:55:48-Exploring growth hormone, thymic regeneration, & the role of exercise in slowing immune aging
1:06:09-Challenges of identifying reliable biomarkers for immune function, & the potential of rapamycin analogs to enhance vaccine response
1:13:08-How rapamycin’s effects on the immune system vary dramatically by dosage & frequency
1:18:50-Limitations of mouse models & the need for cautious interpretation of rapamycin’s benefits in humans
1:27:50-NAD, sirtuins, & aging: scientific promise amid commercial hype
1:37:10-How CD38 drives age-related NAD decline, influences immune function, & may impact longevity
1:45:41-How NMN & NR supplementation interact with CD38 & NAD metabolism
1:52:24-Intravenous NAD: limited evidence & serious risks
1:59:50-Interleukin-11 (IL-11) as a new target in immune aging, the dual role of chronic inflammation in aging, & the need for better biomarkers to guide interventions
2:06:26-Biological aging clocks
2:20:48-Potential of proteomics-based aging clocks for detecting organ-specific decline
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