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In this special episode of The Drive, Peter addresses the recent headlines linking acetaminophen (Tylenol) use during pregnancy to autism in exposed children. Recognizing the confusion these claims have sparked among patients, listeners, and the broader public, Peter uses this episode to provide a framework for thinking critically about complex conditions and the research related to them. He highlights the dramatic rise in autism diagnoses over recent decades, noting that multifactorial conditions rarely have a single cause, and emphasizes the importance of resisting oversimplified explanations. Peter also stresses that humans are not naturally wired for scientific thinking, making disciplined frameworks like the Bradford Hill criteria essential for evaluating causality in epidemiology. Ultimately, he uses this framework to explore the evidence surrounding acetaminophen use during pregnancy and its potential link to autism.

We discuss:

• Laying the groundwork for this discussion, the rise in autism rates, and the value in using frameworks [1:00];
• The FDA pregnancy drug categories, where Tylenol falls within that framework, and a structured method for evaluating scientific evidence and causality [6:00];
• What exactly are the claims being made about acetaminophen and autism? [13:45];
• The increase in autism rates and why so many things are being linked to autism: the multiple comparisons problem [15:00];
• Evaluating the review paper that triggered the recent concern over acetaminophen and autism [21:45];
• Breaking down the largest studies on prenatal Tylenol exposure and autism: is there a causal link? [35:00];
• Why observational studies can’t prove causality, the role of confounding variables, and the importance of frameworks like the Bradford Hill criteria [43:30];
• Applying the Bradford Hill criteria: testing the case for Tylenol and autism [45:45];
• Putting it all together to answer the question: Does acetaminophen use during pregnancy increase the risk of autism? [56:15];
• If autism risk is overwhelmingly genetic, what explains the dramatic rise in autism diagnoses? [59:15];
• Other risk factors for autism: parental age, maternal health, environment, and where Tylenol fits in [1:09:15];
• Medication use during pregnancy: balancing risks, benefits, and FDA categories [1:15:15];
• Considerations for taking Tylenol during pregnancy [1:19:30];
• Final thoughts: critical thinking, balanced risk assessment, and the importance of context when evaluating medications like Tylenol during pregnancy [1:22:30]; and
• More.

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Joe Liemandt is a software entrepreneur turned education reformer who left Stanford in 1989 to found Trilogy, a highly profitable private software company, before pivoting to transforming K-12 learning. In this episode, Joe shares how he transitioned from leading a global software enterprise to becoming principal of Alpha School, where his focus is building a mastery-based, individualized education model that leverages AI as the missing infrastructure for large-scale change. He details the shortcomings of traditional K-12 education, explains how Alpha replaces conventional seat time with focused academics, and outlines the role of AI tutors and human coaches in helping students accelerate through material. Joe also discusses early results, the data-driven systems that track progress, and his ambitious plan to reach a billion children in the next 20 years by combining cutting-edge technology with proven learning science.

We discuss:

• Joe’s early interest in AI and the story of how he quit school to build Trilogy [4:45];
• Joe’s first encounter with Alpha School and how it sparked his journey into education innovation [8:15];
• America’s declining K-12 performance and the hidden power of mastering fundamentals [13:00];
• How traditional time-based grade progression undermines later learning, and how mastery-focused instruction can transform student achievement [20:30];
• Motivation as the key to high-level learning: how Alpha School fosters motivation with its “Timeback” model and leverages AI to accelerate learning [28:45];
• Core principles of learning: how high standards, mastery-based instruction, and supportive struggle foster both academic excellence and personal growth [35:45];
• Breaking down self-imposed limitations with foundational skills, defined time requirements, and a mastery model [41:15];
• Using short-term extrinsic rewards to help students overcome limiting beliefs and ignite lasting intrinsic motivation [46:45];
• $100 for 100: a simple but powerful incentive system that helps students fill academic gaps and master fundamentals [53:45];
• How AI is the pivotal technology that can finally allow proven learning science to scale and unlock unprecedented student potential [57:45];
• The emergence of generative AI that catalyzed Joe’s billion-dollar investment in education [1:09:45];
• The path and obstacles to integrating Alpha’s AI-powered model into mainstream education [1:12:00];
• Reimagining schooling from the ground up across five key dimensions [1:22:30];
• The potential of this educational approach to reduce inequality in academic success [1:30:00];
• Why the biggest challenge to scaling Alpha’s AI-driven education is cultural adoption and systemic redesign [1:34:00];
• Peter’s daughter’s experience at Alpha School [1:38:30];
• Alpha School’s expansion plans and need for people and resources for maximum impact [1:42:30]; and
• More.

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In this special episode of The Drive, Peter hosts a strength and conditioning roundtable with three experts in the field—Gabrielle Lyon, Jeff Cavaliere, and Mike Boyle. Together they explore why maintaining muscle mass, strength, and power is essential for healthspan and longevity, and examine how resistance training supports metabolic resilience and injury prevention across the lifespan. The conversation covers practical strategies for getting started and staying consistent, the importance of a protein-centered diet tailored to age and activity level, and approaches to resistance training for peri- and post-menopausal women—including tendon care and optimal programming. They debate single-leg training versus heavy bilateral lifts, share knee-friendly lower-body options, and highlight exercises that belong in the “graveyard” due to poor risk-reward ratios. Finally, the group discusses youth sports specialization, emphasizing the long-term value of variety for developing lifelong athletes.

We discuss:

• Personal career journeys and philosophies of each guest that shaped their approaches to strength, conditioning, and lifelong health [3:30];
• Why so few people engage in resistance training despite its proven health benefits [8:30];
• Mike’s low-stress, high-consistency method for training beginners to resistance training [18:45];
• How resistance training enhances metabolic health and body composition even in lean, highly active endurance athletes [25:30];
• The dominant role of nutrition in shaping physique and achieving low body fat, the synergistic effect of resistance training, and the unrealistic expectations about muscle growth and fat loss [28:30];
• Why Jeff advocates for five meals a day, and why meal timing matters less than overall protein intake and caloric consistency [38:00];
• Optimizing protein for every stage of life: quality, quantity, and guidelines for diverse diets and body types [44:15];
• The advantages of unilateral lower-body training over heavy bilateral lifts: impact on strength, athleticism, recovery, and functional movement [51:45];
• Rethinking heavy squats and deadlifts: risk-reward, aging bodies, and the case for reverse lunges and other single-leg alternatives [1:01:15];
• Adapting with age: Gabrielle on injuries, hip dysplasia, and the shift to smarter training [1:10:15];
• Exercises that belong in the “iron graveyard”: unnecessarily risky exercises and their safer alternatives [1:19:15];
• The downside of early sports specialization in children and the long-term benefits of encouraging kids to play multiple sports [1:25:00];
• Advice for preventing an Achilles injury: calf strength, ankle mobility, and listening to pain signals [1:33:15];
• Shoulder pain: how to keep training the upper body when shoulder pain limits pressing movements [1:40:45];
• Effective strength training strategies for women before, during, and after the menopausal transition [1:43:15];
• Best practices for strength training and athletic development in children, and the pitfalls of early sports specialization [1:50:30];
• How to foster healthy habits and an interest in fitness beyond playing sports [2:00:00];
• Something each guest has changed their mind about in the last five years [2:04:00]; and
• More.

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