Watch the full episode and view show notes here: https://bit.ly/3O29ZUB
Become a member to receive exclusive content: https://peterattiamd.com/subscribe/
Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/

In this special episode filmed live in front of readers of Outlive, Peter answers questions revolving around his concept of the centenarian decathlon. He starts by defining the “marginal decade” and how that shapes his training for the events and activities that make up his personal centenarian decathlon. Peter explains how he coaches patients through the challenges of customizing their own list and building out a training plan, including how to set fitness goals early in life in preparation for the marginal decade. From there, he dives into training within the four pillars (zone 2, VO2 max, stability, and strength), including the minimum effective dose, how to split your time, his personal protocols, and other considerations. Additionally, he touches on bone mineral density, female-specific considerations, working through injuries, and the profound impact training can have on the overall quality of life.

We discuss:
0:00:00 - Intro
0:02:10 - The best interventions for longevity
0:03:45 - The marginal decade and the centenarian decathlon
0:07:14 - Peter’s personal list of events for his “centenarian decathlon” and how he helps patients create their own list
0:15:00 - Determining your fitness goals early in life in preparation for the marginal decade, metrics to track, and more
0:25:27 - How does playing sports like tennis, basketball, or golf fit into training for the centenarian decathlon?
0:29:15 - Training within the four pillars: minimum effect dose, how to split your time, and other considerations
0:35:57 - Advice for the older person and why it’s never too late to start
0:39:08 - Bone mineral density and other female-specific concerns and considerations
0:42:24 - Training advice for those with minimal access to a gym or equipment
0:44:14 - Injuries: prevention and working through existing conditions
0:48:07 - Cardiorespiratory training: how to split time between zone 2 and VO2 max training, and different modalities for a true zone 2 workout
0:54:33 - VO2 max training: modalities, Peter’s protocol, and how to monitor progress
1:04:28 - The profound impact training can have on the overall quality of life

--------
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 60 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/

261 ‒ Training for The Centenarian Decathlon: zone 2, VO2 max, stability, and strength

Watch the full episode and view show notes here: https://bit.ly/3qzGLR2 
Become a member to receive exclusive content: https://bit.ly/3NobpH0
Sign up to receive Peter's email newsletter: https://bit.ly/3LasWQX

------

Iñigo San-Millán is an internationally renowned applied physiologist and a previous guest on The Drive. His research and clinical work focuses on exercise-related metabolism, metabolic health, diabetes, cancer metabolism, nutrition, sports performance, and critical care. In this episode, Iñigo describes how his work with Tour de France winner Tadej Pogačar has provided insights into the amazing potential of elite athletes from a performance and metabolic perspective. He speaks specifically about lactate levels, fat oxidation, how carbohydrates in food can affect our lactate and how equal lactate outputs between an athlete and a metabolically unhealthy individual can mean different things. Next, he discusses how Zone 2 training boosts mitochondrial function and impacts longevity. He explains the different metrics for assessing one’s Zone 2 threshold and describes the optimal dose, frequency, duration, and type of exercise for Zone 2. Additionally, he offers his thoughts on how to incorporate high intensity training (Zone 5) to optimize health, as well as the potential of metformin and NAD to boost mitochondrial health. Finally, he discusses insights he’s gathered from studying the mitochondria of long COVID patients in the ICU.

We discuss:
0:00:00 - Intro
0:00:10 - The amazing potential of cyclist Tadej Pogačar
0:06:54 - Metrics for assessing athletic performance in cyclists and how that impacts race strategy
0:17:20 - The impact of performance-enhancing drugs and the potential for transparency into athletes’ data during competition
0:26:06 - Tadej Pogačar’s race strategy and mindset at the Tour de France
0:29:58 - Defining Zone 2, fat oxidation, and how they are measured
0:40:04 - Using fat and carbohydrate utilization to calculate the mitochondrial function and metabolic flexibility
0:44:30 - Lactate levels and fat oxidation as it relates to Zone 2 exercise
0:59:54 - How moderately active individuals should train to improve metabolic function and maximize mitochondrial performance
1:06:27 - Bioenergetics of the cell and what is different in elite athletes
1:19:19 - How the level of carbohydrate in the diet and ketogenic diets affects fuel utilization and power output during exercise
1:27:27 - Glutamine as a source for making glycogen—insights from studying the altered metabolism of ICU patients
1:34:27 - How exercise mobilizes glucose transporters—an important factor in diabetic patients
1:39:00 - Metrics for finding Zone 2 threshold—lactate, heart rate, and more
1:58:27 - Optimal Zone 2 training: dose, frequency, duration, and type of exercise
2:10:22 - How to incorporate high intensity training (Zone 5) to increase VO2 max and optimize fitness
2:23:25 - Compounding benefits of Zone 2 exercise and how we can improve metabolic health into old age
2:27:57 - The effects of metformin, NAD, and supplements on mitochondrial function
2:37:45 - The role of lactate and exercise in cancer
2:44:42 - How assessing metabolic parameters in long COVID patients provides insights into this disease
2:52:57 - The advantages of using cellular surrogates of metabolism instead of VO2 max for prescribing exercise
3:02:30 - Metabolomics reveals how cellular metabolism is altered in sedentary individuals
3:08:49 - Cellular changes in the metabolism of people with diabetes and metabolic syndrome

--------
About:

The Peter Attia Drive is a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking…and a few other things. With over 40 million episodes downloaded, it features topics including fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more.

Peter is a physician focusing on the applied science of longevity. His practice deals extensively with nutritional interventions, exercise physiology, sleep physiology, emotional and mental health, and pharmacology to increase lifespan (delay the onset of chronic disease), while simultaneously improving healthspan (quality of life).

Learn more: https://bit.ly/3815AyX

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

Peter Attia MD Transcript on Youtube

261 ‒ Training for The Centenarian Decathlon: zone 2, VO2 max, stability, and strength

201 - Deep dive back into Zone 2 Training | Iñigo San-Millán, Ph.D. & Peter Attia, M.D.