#261 ‒ Training for The Centenarian Decathlon： zone 2, VO2 max, stability, and strength ｜ Peter Attia, M.D.
Episode Stats
Length
1 hour and 5 minutes
Words per Minute
193.06764
Summary
In this episode, we release the live AMA that we recorded celebrating the release of Outlive, celebrating the centenarian decathlon. In this episode we focus the entire conversation around the Centenarian Decathlon and how people can know if they are on track to achieve their goal of reaching their 100th birthday.
Transcript
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Hey, everyone. Welcome to the drive podcast. I'm your host, Peter Atiyah. This podcast,
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my website, and my weekly newsletter all focus on the goal of translating the science of longevity
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into something accessible for everyone. Our goal is to provide the best content in health and
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wellness, full stop. And we've assembled a great team of analysts to make this happen.
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If you enjoy this podcast, we've created a membership program that brings you far more
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in-depth content. If you want to take your knowledge of the space to the next level at
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the end of this episode, I'll explain what those benefits are. Or if you want to learn more now,
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head over to peteratiyahmd.com forward slash subscribe. Now, without further delay,
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here's today's episode. Welcome to a special episode of the drive for this week's episode.
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We're going to release the live AMA that we recorded celebrating the release of Outlive,
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which was recorded in April. We received a good bit of feedback from those who were invited and
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able to attend this episode live. So we decided to make it more widely available. Our AMAs, of course,
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are typically reserved only for our subscribers. So if you're not a subscriber, this might give you
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a bit of an idea what our AMAs are like. Although this is not the typical format. Usually our AMAs go a
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little bit deeper into content than this one. But nevertheless, hopefully this gives you a sense
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of what we're up to. In this episode, we really focus the entire conversation around the centenarian
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decathlon. We speak about the events in my centenarian decathlon and how I decided on them
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and how I work with patients to create their own list. We then talk about how people can know if
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they're on track for their centenarian decathlon across a variety of ages and the various fitness tests
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that can help determine that. We focus the rest of the discussion around training for the
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centenarian decathlon, including what that training should look like, whether you're older, younger,
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new to exercise, or a veteran. And we talk about some questions that came up around zone two and
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VO2 max training. So without further delay, I hope you enjoy this special episode of The Drive.
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Never done a live event, never done a live AMA. Everything has been recorded. So how do you feel?
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You feel like there's more pressure on this because there is, you can't screw up. Everything you say
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That's good. We'll see how it goes. So what we're doing tonight, today, depending on where you're at,
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is kind of an AMA that's all focused on one thing, which is the centenarian decathlon.
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And so what we did is for everyone who pre-ordered, they could sign up for the event.
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They submitted a bunch of questions. We went through, I mean, there was thousands of questions.
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So right off the bat, we'll apologize to anybody who we can't answer the question, but we tried to
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group them together, kind of organize them a bit, really to try and get through as much as we can.
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So if anyone has heard our AMAs before, they'll probably know. Sometimes we can go into a little
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bit of detail and sometimes one question can take a while, but the goal for this one is more of that
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rapid fire. Let's see how many we can get out and it should be good. So anything you want to add or
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say before we get rolling? No, but feel free to interrupt me if I'm being too long-winded.
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All right. We'll just point at the watch and say, we got to speed it up. So I think what would be
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helpful is because we did get a lot of questions around, Hey, what's the best thing you can do
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for longevity? Like if there's only one thing, you know, you have five tactics in the toolkit,
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but if there's one thing people should focus on, what would that be? And maybe it'd be worth
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just kind of giving a little piece on that, just as we set the stage on why we decided to focus on
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the centenarian decathlon and kind of why you think that's so important for people's longevity journey.
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Yeah. I mean, look, it's an impossible question to answer because if you've got a person who's
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sleeping four hours a night, if you don't fix that, nothing else will matter. If you have a person
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who's malnourished, you know, you sort of have to address these issues, but generally speaking,
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if everything in your life is a six or seven out of 10, taking your exercise to a 10 out of 10
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is going to have a greater impact on both the length and quality of your life than any of the
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other domains that I can think of, perhaps with the exception of emotional health. That's one that
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can be such a binary thing. If you take a person who, you know, for example, like me, where that
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house is not in order, you know, until that's addressed, all the exercise in the world wouldn't
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fix that either. So it's a tough question. I get asked that question all the time. I wish
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I had a slick answer for it, but that's really the best I can say.
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Yeah. If anyone's read the book and has a really quick 30 second answer, they want to email to us
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that Peter can steal, feel free to do that because we'll take it. So I think it'd be helpful. Maybe
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let's just quickly define centenary decathlon marginal decade, two terms that we use quite a bit.
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Obviously people will have read the book, but I think it's still good to just get a quick
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definition of that because it will set the stone for everything we're going to cover.
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Yeah. Marginal decade is the last decade of your life. So everyone will have a marginal
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decade. Most people certainly don't know the day they enter it. Sometimes you know when you're in
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it, especially if you're nearing the end of it, a person probably has a sense of that appreciation,
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but it is an important model because I think that the marginal decade for most people is
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really a period of poor life quality. Physical health has usually declined significantly.
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cognitive health potentially has declined as well. As I have sort of observed many people in their
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marginal decades, including people I've been close to, I noticed that there can be a great
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sense of withdrawal because of these things, right? You're not participating in life. So the idea here
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is quite simple, which is if you plan to have a remarkable marginal decade, by definition, it means
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that all the decades that came before it also had to be pretty remarkable. And the analogy I use
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in the book is that of an archer, probably because that's what I am. But if you really want to be
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proficient at 50 yards with a bow and arrow, practice at a hundred and you'll be amazed at how
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simple 50 becomes and 60 and 70 and 80. It's a very nonlinear relationship in terms of accuracy with a
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bow and arrow. The centenarian decathlon becomes the scaffolding upon which I actually think of
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this. So this, again, came from an idea or an observation, I suppose, I had in my own life, which was
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from age 13 to about 42, I was constantly involved in something very specific that I was training for. So I
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never exercised. I trained. I trained for boxing. I trained for cycling. I trained for swimming. I had
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competitions. I had meets. And everything I did vis-a-vis exercise was in service of a goal.
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And that made it very easy. There was real specificity to what I did. And then when I sort
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of hung up my bike, I realized, oh my God, like, I don't know what I'm doing. I mean, I'm still
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exercising, but it didn't feel like it had a purpose. And I sort of realized that's actually how
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most people exercise. And when compared to the alternative, which is not exercising, that's okay.
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But I realized as I thought more about this marginal decade, I needed to be very specific
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in my training to make sure I didn't arrive there and sort of leave it to chance. Would
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I be strong enough, healthy enough, have enough balance, all of those things. And so what I
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realized is I had to, you know, to borrow the phrase from Annie Duke, I had to backcast from
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that marginal decade around a set of very specific events. And that set of events we would call the
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centenarian decathlon. And everybody's going to pick different events. These can be activities of
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daily living. These could be very specific recreational activities. I think it's a good
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idea to have both in there. And the more specifically you train for those, the more directed your training
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And I think what would be helpful right now is, I know you have that list right next to you,
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is maybe just reading through your list. And again, as you kind of stated, your list doesn't
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mean it has to be everyone else's list. But a lot of times, I think when there's newer concepts or
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people are trying to figure out how this works, it's helpful to hear an example. So do you kind
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of want to just burn through your list and let people know how you're thinking about this in your
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I will say this. It's organized in a way that's a bit confusing because in my mind, I'm constantly
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thinking, okay, mobility and strength matter. Aerobic capacity matters. So sort of aerobic
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efficiency matters. Peak aerobic performance matters. I'm in the back of my mind thinking,
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I have to make sure I can do all of those things well. And then some of my centenarian decathlon
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Olympics are like exercises or metrics or feats and others are activities. So I'll try to add a bit
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Real quick, you kind of mentioned your four pillars of exercise, but people are also known
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by different things, which is zone two maybe or VO2 max. So do you just kind of want to
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Yeah. So when I talk about aerobic efficiency, that's zone two. When I talk about peak aerobic
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output, that's VO2 max. Strength, stability, in with stability is mobility, balance, things like
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that. Okay. So in no particular order, pick up a 30-pound child from a squatted position or
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from a crib. Those are two very difficult positions. So that requires strength, stability,
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mobility. Get up off the floor with one point of support. That's stability and strength.
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Place a 30-pound suitcase overhead. Strength, also mobility. Dead hang for 30 seconds. Strength
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and stability. Farmer walk for one minute with 25% of body weight in each hand. So again, it's
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something that today I could do for a day. That's really pushing the bounds of what I would
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want to be able to do in my 80s, for example. Strength and anaerobic. Pull or push a weighted
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sled 100 feet with, and I've put in here kind of a metric of resistance. Again, what is that
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really all about? This is kind of one of those things. If you're in a dangerous situation,
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a spouse has fallen, you have to pull somebody out of the way or something like that. Walk up
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and down stairs with feet pointed perfectly forward. So if your feet are pointed perfectly forward
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as you're walking up and down flights of stairs, it means you still have the ankle mobility to do
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that. So you can get an angle between your foot and your tibia, your shin, into an acute angle as
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opposed to having to turn your feet outward. Single leg stand with eyes open for 30 seconds,
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with eyes closed for 15 seconds. Single leg get up without support. So like getting up off a seat,
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for example, hex bar deadlift my body weight for five reps. Again, pretty aggressive, not now.
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A dumbbell lunge in perfect form with 15% of my body weight in each hand for 10 reps. Cover three
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miles in one hour by foot. So again, that's 20 minute mile is pretty slow. But if you think about
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being able to do that in the last decade of your life, carry 20 pounds up four flights of stairs,
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produce a VO2 max above 30 milliliters per minute per kilogram. And if you can do that,
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that basically buys you a whole bunch of activities. That means you could walk
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up a 6% grade at three miles an hour for a period of time, not necessarily for an hour,
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but perhaps for 20, 15 minutes. Tread water for 10 minutes. Not that I have a plan to,
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but again, you think about what's implied. Like that's a very functionally aerobic thing to do.
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Scale a ledge at shoulder height or pull myself out of a pool onto a deck 12 inches above the water
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surface. Single leg glute bridge, 15 reps without loading my lumbar spine and do a plank in perfect
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form with scapula retracted, no hip sag for one minute. So I have several of these lists. There
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are things that I would add to this that are, you know, or I have on a different list that get more
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into recreational activities. I do want to be able to pull a 50 pound bow back, a compound bow that's
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50 pounds and a compound bow of course lets off as you get further, but you still have to be able to
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pull 50 pounds at the outset. So. I think it's helpful for people because if you think about
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the list you made, the very specific things, but you kind of hinted at there's a reason behind
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everything. The dumbbell being able to lift it is grandkids, great grandkids. You want to be able to
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play with them. Being able to get off the ground is you want to be able to live by yourself or with a
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spouse and be able to like fully move, not worry about falling. And so if anyone's having trouble
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kind of thinking about how they do it, it's sometimes helpful to just take a step back and
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be like, you know, do you want to live in a city area where you can walk to get groceries and bring
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them back and then you can get specific from there too. So for anyone who's kind of thinking, okay,
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what specifically should they think about for that? Always feel free to take a step back and then get
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detailed going forward. Now you mentioned earlier kind of emotional health. There wasn't anything on
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there on your list as it relates to that. And we did get a few questions on that. And also, you know,
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you kind of talked about how physical and cognitive as you get older is always going to decline,
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but emotional health on the other end, that's only piece of health span that can actually go up.
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And so is it purposeful you don't have that on your centenarian decathlon list?
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Yeah. The centenarian decathlon is focusing purely on that physical piece that is invariably going to
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decline. So it doesn't really get into the cognitive or as you said, the emotional part,
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which, you know, if we're really doing that right, it should be getting better as we age.
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When you talk to your patients about this, because I know you work with every patient,
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you want them to be able to create this list and kind of anchor back to it. Because like you said,
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you're not training for a marathon, you're not training for a triathlon, you're really training
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for this. What advice, what encouragement do you give them as they're starting to kind of think
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through, okay, how do I create this list? How do I start to build this process in my mind?
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We've gone through several iterations on this. Initially, we asked patients to do what I did,
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which is just sit down and come up with the list. That didn't produce as much fruit, perhaps because
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people weren't putting as much thought into it as I was. You know, it just wasn't something they were
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spending all of their time thinking about. So what we do now is we give them a list
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of about 50 items. About half of them are activities of daily living. About half of them
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are sort of feats of fitness or strength. And we say, pick 10. And we've gone through multiple
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iterations of this. We used to say, pick as many as you want. That turned out to be. So now it's like,
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pick 10. So you have to really think about this. You have to prioritize. What are the 10 most
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important things to you on this list? And then we ask the question, okay, to do those things,
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do you know what is required? Do you know what's required to pick up a 30 pound child off the ground?
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What type of stability is required? What type of strength is required? And how much will that
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require you to be able to do today based on the extrapolation of how much those,
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each of those parameters declines? And one of the questions we got come through a ton was,
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those are the things you want to do at a hundred. To be clear, I don't expect to live to a hundred.
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You know, if you look at my wall chart, it says 88. So call it in my eighties was probably,
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you know, where I hope to be. In your marginal. In my marginal decade. Yeah.
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So how are you thinking about, okay, so if in your marginal decade, you want to be able to do that,
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you know, there's people who are listening, who are going to be in their twenties, thirties,
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forties, fifties, sixties, seventies, eighties, the people who are on the younger spectrum of that,
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we're kind of wondering, you can do all those right now, easy all day, every day. So how do you
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think about how much you should be able to do in your thirties or forties or fifties? Kind of,
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how do you talk to patients about how they kind of like back cast and figure out, okay, my goal
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at 40 should be X to be Y at 80. We have a pretty good sense of how major parameters like
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strength and VO two max decline with age. And so even though I can do everything on that list
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blindfolded, it's going to take a lot of work to make sure that my VO two max is 30 to 32 mils per
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minute per kilogram in 30 to 40 years, especially if it's closer to 40 years. And truthfully, like
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right now, my VO two max is not what I'd like it to be. It's probably in the mid fifties,
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which is again, fine for somebody my age, but I really would like a bigger margin of error and
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maybe want it to be mid to high fifties as opposed to low to mid fifties. So if you're 30, if you're
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20 years younger than me, the bar is even higher. So paradoxically, the youngest people aren't
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necessarily in the best shape here on a relative basis. They might be in absolute terms,
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but they have longer to maintain that. And therefore they have to be starting from a higher
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place. You mentioned VO two max there. Do you maybe want to talk about a few metrics or
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tests people could do so they can understand where they're at currently from a cardio perspective and
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let's say a strength perspective? VO two max is, I don't know that it's necessarily the single best
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metric of cardiorespiratory fitness, but it's certainly the one that's been studied the most. And
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it's obviously the one that for which we have the most data. It's also one that you can go out and
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get done on your own. It's a hundred dollar test, maybe $150 test. You can go and find any,
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in most cities, they would be able to do this for you. There are also free versions. You can estimate
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it. You could run a Cooper's test or various versions of these tests, which we've talked
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about elsewhere. And you can just look that up to, if you want to run, know how to do that protocol.
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So you don't need to even spend a dollar to estimate your VO two max, if you're willing to go down
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to a track and run a mile or something. So the question then becomes, what are some other metrics
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that go with it? Well, I mean, certainly strength metrics matter. We've talked about some of those
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things. A great metric for both upper body strength and grip strength and a bit of stamina
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to boot is a farmer carry. And so, you know, for men, we'd like to say a guy in his forties
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should be able to carry his body weight for a minute. So half his body weight in each hand.
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Do you maybe want to explain what a farmer carry is for people who aren't familiar?
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Yeah. It's literally just carrying and walking. So if a person weighs 180 pounds,
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can they put 90 pounds in each hand and walk for a minute? For a woman who's 40,
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we would want to see that at about 75% of her weight. So just do the math and adjust accordingly.
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I've talked about the dead hang. That's another great one for grip strength. Again, we have sort
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of metrics that we would look at. We would say a man in his forties, we'd want to see two minutes
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of dead hang for a woman a minute and a half. And then of course that gets discounted by roughly 10
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to 15 seconds per decade as you go from 40 to 50, et cetera. There are other great examples of
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strength, a wall sit, for example. Can you do a wall sit for two minutes? So you're sitting with
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your back against the wall, your thighs are parallel to the ground, you're not using your hands. And
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basically this is a one way to test leg strength. There are better ways to do it. We typically do this
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in a more free form where we have people do an air squat where they're hovering, but not using their
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back for support. So now it's a little more stressful because you're not just using your
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legs, but you have to stabilize. Whereas on the wall sit, you get all the stabilization for free
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because you're pushing back into the wall. So there are no shortage of ways to do this kind of
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thing and probably beyond the scope of our discussion now to go through all the different ways.
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Zone two, of course, is another really important thing to do. So there's the technical way it's
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defined based on lactate production. But again, the simplest way for most people is the RPE way,
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right? Zone two is that threshold where you go from being able to speak while you're exercising,
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but being uncomfortable to not being able to speak. And where most people cross that threshold is where
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you will now start to net accumulate lactate with your activity. And so figuring out and
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demonstrating that you can generate more and more work at that level, whether it be wattage or speed
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or whatever your metric you're using, that becomes also just an enormous way to track your progress.
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And do you, not to put you on the spot or make it awkward, but I think with RPE and zone two,
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sometimes people don't know what that level is of like, if I'm talking like this, is that okay?
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Should it be like, I can only get one word out every five seconds? Do you kind of...
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No, for me, I mean, it feels like if I'm on my bike doing a zone two and my wife comes in or one
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of my kids comes in to talk to me, I'm like, I can talk. I'm like, hey, yeah. Okay. Yep. I got it.
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Yep. I'll pick them up. You know, do I want to sit there and talk? No, but I can. If I could talk like
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this, I'm in zone one. If you and I went for a walk, we're in zone one. In fact, you've rucked
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with me. Most of rucking is below zone two, except when you're going up the hills.
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Then you're not talking. Then you're out of zone two. So there's very little of a ruck that's
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actually in zone two. The closest I can get to zone two is doing that shuffle run. I can do sort
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of a light shuffle. But if I'm walking, it's hard, but it's not hard enough. And if I'm walking flat,
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it's too easy. If I'm walking up a hill, it's too hard. And another important piece
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is muscle mass. And I know you typically will kind of look at muscle mass based on metrics from a DEXA
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scan. And then there's also, you know, certain percentiles that you want to see patients in.
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So maybe talk a little bit about that because that way anyone who's listening to this and is curious,
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okay, how do I stack up from a muscle perspective? Do I need to increase? Am I okay? They can go out
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and get one of these done relatively cheap. They're relatively easy to find. And there's a
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few core metrics. So maybe just talk about that for a second.
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Yeah. I think everybody should have a DEXA scan. You just have to know this data. You have to know
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your bone mineral density. I think you have to know how much visceral fat you have. And I think
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you have to know how much muscle mass you have. Obviously you're also getting body fat, which is
00:22:06.560
important, but it's not as important as those other three. A DEXA scan will either automatically
00:22:11.860
calculate for you, or at least give you the data to calculate for yourself, something called the ALMI
00:22:16.600
and the FFMI. So the ALMI stands for Appendicular Lean Mass Index. And again, sometimes it's just spit
00:22:23.920
out in the report. But if it's not, you would simply go to the report where it shows you lean mass for
00:22:30.940
left leg, right leg, left arm, right arm. And you add those three up, make sure they're in kilograms.
00:22:37.200
So if they're in pounds, you have to convert them to kilograms, divide by 2.204, and then divide that
00:22:42.420
by your height in meters squared. And if that's given in inches or feet, you have to make the
00:22:46.320
conversion. So, and then you'll get a number, right? It could be eight, nine, 10, if you're a male,
00:22:51.640
five, six, seven, eight, if you're a female. And then there are nomograms that will tell you for your
00:22:57.040
age and for your sex, what percentile you are in. And we want all of our patients to be at or above
00:23:03.260
the 75th percentile for ALMI. And again, it's associative data, but it's very strong associative
00:23:09.660
data, which is look, muscle mass is a great integrator of exercise and strength. So hemoglobin
00:23:18.220
A1C is a metric that is effectively an integral function for glucose. So you get this number,
00:23:25.580
6.5, and it tells you directionally over the last three months, your average blood glucose has been
00:23:31.600
140 milligrams per deciliter. So the hemoglobin A1C integrated the area under the curve and spit
00:23:37.080
out that number. And similarly, that's effectively what VO2 max muscle mass and strength are doing.
00:23:44.000
They are integrators of the work that it takes to have a high VO2 max, to have high muscle mass,
00:23:50.420
to have high strength. And the work that goes into that is the secret sauce. In other words,
00:23:55.880
it's not so much the muscle mass, I think that is the most important thing. It's what you had to do
00:24:01.580
to get said muscle mass and what that muscle mass will then do vis-a-vis metabolic function.
00:24:07.600
And of course, the implication with respect to the functional side of things. So muscle mass and
00:24:12.280
strength are not equivalent. And when put head-to-head, strength beats muscle mass as a predictor of
00:24:19.300
lifespan. But all of these things are important metrics to be tracking. So I think then the rest of
00:24:25.860
the conversation will kind of focus on the actual training piece of it, right? So that was the bulk
00:24:30.940
of questions that we received, which is how much should I be training? How much in the different
00:24:37.040
pillars? How do you best train zone two? How often? How many times a week? VO2 max. So I think we'll kind
00:24:43.620
of now start getting into those pieces. But I think what would be helpful is we also received a lot of
00:24:49.480
questions from people who are like, hey, I play basketball four times a week. Hey, I play tennis.
00:24:54.160
I play golf. Hey, I do marathons. I maybe just go to the gym and I lift. Is that okay? Or how
00:25:02.780
important is it to actually be really specific to train for this and to hit all of those pillars?
00:25:09.920
Well, again, I think it depends on your objective. So everything has to be compared to the alternative.
00:25:15.660
So if a person says, look, I'm playing tennis twice a week, I'm playing basketball twice a week,
00:25:20.160
and I'm lifting weights once a week. Am I doing great? The answer is, yeah, you are doing great
00:25:26.100
relative to most people. But I don't think that that's a recipe for success if you want to be in
00:25:34.580
the best shape possible in your last decade. And the reason being is sports like any sport, whether it
00:25:41.900
be basketball, tennis, swimming, any particular sport has so much repetitive stress in it that
00:25:50.580
you're going to develop movement issues. You're going to have asymmetries in joints and muscles,
00:25:56.260
and you want to kind of balance those things out as much as possible. So again, if you want to be
00:26:01.500
able to play golf every week and you're going to walk five miles, that's great. But you have to
00:26:07.160
acknowledge every time you're swinging that club, it's asymmetric. So you have to think about what
00:26:11.460
am I doing to counteract that? Same with tennis, same with basketball. And so again, it just depends
00:26:17.440
on how much time a person is willing to put into this. I don't want to suggest that everybody needs
00:26:21.980
to do this because I acknowledge it's really difficult. If it wasn't difficult, everybody
00:26:25.500
would be doing it already. By definition, this is really a complicated idea. And maybe I just have
00:26:32.800
the privilege of two things, right? One, I got to experience my marginal decade in my 20s, right?
00:26:39.300
I had that back injury when I was 28 that left me unable to walk for three months. And in so much
00:26:46.580
pain, I didn't know my name for a year. And during that period of time, I would have given my life to
00:26:53.480
have had everything back. So when I got it back, it's just, it's seared into my brain what it feels like
00:27:00.540
to be so immobile, so debilitated, and in so much pain. And I think that's just the greatest gift I
00:27:07.440
ever received was to have that time machine to basically go and experience the last decade of
00:27:13.200
my life and then get zapped back to being 28 with a totally different mindset of, yeah, I never want
00:27:19.880
that to happen again. And at least I'll do everything in my power to make sure it doesn't.
00:27:23.560
So long answer to a short question, but the reality of it is you really do need to be training very
00:27:29.020
specifically. And that means a lot of really silly looking, unsexy things that I do every day,
00:27:36.000
sometimes as little as 10 minutes a day, sometimes as much as an hour a day, just on the stability
00:27:40.420
stuff, just on the movement piece. But I wouldn't trade it for anything because the way my body feels,
00:27:45.640
I'm thanked for it. So now let's talk about, so if someone's listening, they're like, okay,
00:27:50.520
I want to train for this and I'm willing to put in the work to the four pillars. So the strength,
00:27:55.340
stability, zone two VO2 max, just to keep it simple, what's the minimum effective dose where
00:28:02.200
it's, okay, how much per week does someone need to commit to be able to hit those four things?
00:28:08.960
And then we can get into each of them in a little more detail, but just from a minimum effective
00:28:14.340
dose, if they have kids, busy job, families don't have a ton of time, what should they strive to set
00:28:21.320
out for? Well, it depends where you're starting, right? So the minimum effective dose, if you're
00:28:25.120
doing nothing is not that much, you're going to get huge benefits when you go from nothing to
00:28:31.720
probably three hours a week, that would be an enormous improvement. So I don't know if that's
00:28:38.960
the right way to think about it. Well, let's, maybe let's just start there. So let's say someone
00:28:42.460
starts at nothing. So you're saying, okay, start at three hours a week. How are you breaking that out?
00:28:48.120
Well, if you only had three hours a week to commit to this, you know, I think you'd have to
00:28:53.620
put probably an hour of that into steady state aerobic training zone two. I think you'd have to put
00:29:01.440
an hour of that into strength training. I think you'd probably want to put 20 minutes of that or 30
00:29:07.080
minutes of that across one or two sessions into high intensity aerobic training. So not hit intervals
00:29:15.200
by the way, but you know, sort of the longer intervals that are VO2 max appropriate. And
00:29:20.720
then the remainder of that time, call it another, you know, 30 or 40 minutes spread out at 10 minutes
00:29:26.600
a day into some of the stability training. And again, I think it's important to understand
00:29:31.280
if you say, look, I'm only willing to devote 60 minutes a week to this stability stuff, which seems
00:29:37.200
so boring. Should I just blast it out in one, one hour session? The answer is no, you're better
00:29:42.740
off doing 10 minutes a day, six days a week. There's really something to the neurologic pattern
00:29:47.800
that comes from practicing your IAP, practicing your breathing, your saccapular cars, your cat-cow
00:29:54.560
exercises. Doing that for 10 minutes every day is better off than just trying to do it all in one
00:29:59.780
shot. So anyway, that's probably how I would structure a three-hour program.
00:30:03.620
And for the, on the stability side, you kind of mentioned a few exercises there. And actually
00:30:09.420
what you and Beth did is we recorded those videos of you in the gym. And so those are available
00:30:14.720
peteratiamd.com slash outlive slash videos. And so anyone who wants to learn more about,
00:30:22.100
okay, what are those stability exercises that I could do 10 minutes a day, real short, real simple
00:30:27.260
videos, you can go check them out. So we won't spend time double clicking on those because as you've
00:30:32.900
stated before, it's, you really have to see it to understand it as opposed to just hearing about
00:30:36.980
it. And so let's say then someone is like, okay, I'll start with three hours a week. How often do
00:30:45.240
you ratchet that up? Does that get increased every week? Does it get increased every month? Is it when
00:30:50.620
certain milestones are hit? Well, it depends what the limiting factor is. So usually when a person
00:30:56.200
starts at three hours per week, it's because that's the only time they're willing to put into it.
00:31:00.280
And conversely, if a person's never lifted a finger and they say, oh my God, like I'm willing
00:31:06.000
to do whatever it takes. And they only started three hours a week because you don't want to injure
00:31:10.600
them. Then you're in that situation where how much can you ratchet it up? And I'd probably ratchet a
00:31:14.840
person up every six weeks in a scenario like that. But I think the far more typical scenario is,
00:31:21.160
okay, I'm willing to do three hours. I do three hours a week. Usually a person sort of starts to
00:31:27.400
habituate to that stress. And one of the important principles of training is a principle that most
00:31:32.900
people have heard of called progressive overload. So in one way or another, the training, the load,
00:31:39.340
the ask needs to get more complicated, needs to get more difficult. So if you're talking about
00:31:44.280
strength training, that could mean heavier weight. That could mean more reps, more sets, less rest
00:31:51.080
between other things that make it more complicated, such as using BFR. So we're always looking for ways
00:31:57.500
to make this more demanding. For example, in my stage now, I'm not adding time anymore.
00:32:03.020
I am at the limits of how much I'm willing to spend on this. My kids are young. Every minute I'm doing
00:32:09.220
that, I'm not spending time with them or I'm not working or, you know, I'm just falling behind in
00:32:14.120
some other area of my life. So, you know, I'm already spending about as much time as I'm willing to
00:32:18.220
spend in the gym. And it's probably on the strength side, six hours a week. So I have to find other
00:32:23.100
ways to add that demand. The other thing I would be doing is thinking about where the deficits are.
00:32:29.840
So let's say you have that person that's at three hours per week. Maybe their ALMI is already at the
00:32:35.380
70th percentile and they're actually reasonably strong, but their aerobic training is an atrocity.
00:32:40.760
So then I'm going to disproportionately add to that as opposed to just equally build all of them.
00:32:47.280
But conversely, you know, we have a patient in our practice upon entering the practice. I mean,
00:32:51.940
this guy's VO2 max was probably above 60 and he is 60, but he's been a lifelong runner,
00:32:57.040
but he never touched a weight in his life. So he has, you know, very little muscle mass.
00:33:01.420
And this is a guy who we're actually saying, look, we're probably going to need you to run a little
00:33:05.520
bit less. And your running is amazing. And you're very fortunate that you haven't been injured doing
00:33:10.420
it. We want you to keep running as long as you can, but we also have to address some of these
00:33:14.740
other issues. Cause you do have some of the really common issues of runners, some of the very common
00:33:19.960
imbalances and things like that. So in his case, it was like, can we subtract a little bit of running
00:33:25.180
time and start to get you doing strength training? So people almost need to take just an inventory of
00:33:31.320
what they're doing and where their strengths are. And that's where it's good to know. Where is your VO2
00:33:36.280
max? How does your DEXA scan look? Can you farm or carry what percent of your weight? And if it's high
00:33:42.160
and that piece is good, it's like, okay, keep training that, but then fill in those deficits.
00:33:47.540
You know, so we kind of hinted that the three hours per week really is for the people who are
00:33:51.540
time limited. What about different ages? Because we did get a lot of questions of, you know, I'm older.
00:33:58.860
Is it too late for me to start training for this? And if the answer is no, how should I think about
00:34:06.320
that? Because I'm not as young. I can't quite bounce back. I'm not as strong as when I'm younger.
00:34:11.440
They might be coming into this with not as much strength. And so when you have a patient like
00:34:17.240
that, do you think about how they should tackle this differently? Are they on kind of a different
00:34:24.240
program than if someone was 30? Kind of, how do you think about that from an age perspective?
00:34:28.880
Everybody's different and age is definitely one of the factors that, you know, calls for
00:34:32.820
sort of nuance around programming. I'll say this, and I think I've talked about this on a previous
00:34:37.580
podcast. I don't recall which one. There was a study that was done in Australia. I think we
00:34:42.680
talked about on one of our podcasts, actually, where an investigator took a group of women with
00:34:47.360
osteopenia or osteoporosis. So these women had very low bone density. They'd never exercised in
00:34:52.620
their life. They were, if I'm not mistaken, no one was younger than in their mid sixties. They were
00:34:57.600
probably, you know, in their seventies. And these women were put on a pumping iron regimen. I mean,
00:35:04.280
literally like old school in a gym, picking up weights, walking around. This wasn't like some
00:35:10.300
fancy posh Pilates class. This was pickup weights. And I think by the end of this study, one of the
00:35:17.880
women may even got to the point where she was deadlifting her body weight. Imagine that 120
00:35:22.160
pound woman picking up 120 pounds off the ground. While that was a great example, because it was
00:35:27.900
documented in a clinical trial. There are so many stories of these things that you just see that
00:35:32.680
I just have to believe that people are far more resilient than they can imagine. And, you know,
00:35:38.200
I write about one example of this in the case of Barry. Barry is someone who gets mentioned in,
00:35:43.440
I think it's in the stability chapter, actually. Here's a guy who traded his health for wealth,
00:35:49.000
which is a pretty standard refrain, and then retired and had all the money in the world and
00:35:53.800
realized, wait a minute, like I can't do anything. My body hurts so much. And if you look at Barry today,
00:36:00.040
I mean, the guy's functioning better than he was 20 years ago. So I think it really just comes down
00:36:05.960
to being consistent and having a real sense of purpose around this stuff. And obviously you have
00:36:10.420
to be smart about it. I mean, you can injure yourself in the process of these things. So
00:36:14.400
having someone who knows how to kind of guide that and using common sense is essential. But I would
00:36:19.580
never want anybody to come away from this thinking I'm too old to do anything about it. I think as long
00:36:24.520
as you're breathing, you have a chance to do something about it. On that front, you kind of
00:36:29.220
mentioned osteopenia, osteoporosis. We did get a lot of other questions too, outside of age, which is,
00:36:35.520
is there anything female specific that they should be thinking about as it relates to centenary
00:36:40.020
decathlon? And I know DEXA scan, in addition to the muscle, it can also give bone mineral density,
00:36:45.140
which is very important as we age. So maybe do you want to talk a second about BMD and then also
00:36:51.760
why that's something that maybe female specifically should be paying attention to thinking about,
00:36:56.800
and then ultimately how that leads to how they should be training.
00:37:01.160
Bone mineral density is very important for both sexes, but women are at a greater risk. And the
00:37:08.100
reason for that is the way bones work, and I'm oversimplifying a little bit, but bones effectively
00:37:13.700
have strain gauges in them and they respond to tensile stress. So when a muscle,
00:37:21.760
is contracting, the muscle via the tendon is attached to the bone, and as the muscle contracts,
00:37:29.080
the bone is compressing. So imagine a strain gauge inside the bone that senses that. That's a
00:37:36.160
mechanical signal. That gets converted into a chemical signal, so mechanical to chemical via estrogen.
00:37:43.900
Estrogen is the hormone that does the signal transduction, and that tells osteoblasts and
00:37:51.360
osteoclasts, which are the bone-building, bone-reabsorbing cells to make the bone stronger, not weaker. So in other
00:37:58.220
words, the use it or lose it philosophy is at play here, and estrogen is the key link. Now, men and women
00:38:06.460
have estrogen, and it's very important for both sexes. The difference is women lose estrogen precipitously
00:38:14.000
in midlife, and therefore women are more at risk for osteopenia and osteoporosis.
00:38:20.860
Now, for men and women alike, it's very difficult to add bone density after you reach the critical
00:38:28.000
period of maturation, typically in the early 20s. So unfortunately, most of our audience is past that
00:38:35.460
point. I'm not sitting here having a discussion with teenagers, but of course, if I am, the answer is
00:38:40.640
load-bearing, load-bearing, load-bearing. Reach your genetic potential while you have a chance.
00:38:46.280
But for those of us who are past that point, the key is how much can you slow the rate of decline?
00:38:51.600
And nothing is more important for that than load-bearing activity. And in fact, it needs to be
00:38:56.840
heavy load-bearing activity. Walking does not count as load-bearing activity. Running, certainly better
00:39:02.260
than swimming or cycling where you're not bearing load, but none of those compare to strength training.
00:39:07.180
So strength training is really the most important piece of maintaining bone mineral density. And it
00:39:15.040
must be supported from an endocrine perspective with the appropriate amount of estrogen and
00:39:19.740
potentially testosterone, and certainly with the correct nutrition and supplementation, such as
00:39:24.580
vitamin D and the right amount of protein and things like that. One of the other questions we
00:39:28.840
received is people were saying, hey, like, what if you can't afford a trainer, maybe don't have a gym to
00:39:35.960
go to? How much of this can you do kind of without fancy equipment, maybe with body weight? How do
00:39:43.200
you think about that in terms of as people are wanting to train for this? You can definitely do
00:39:48.340
quite a bit of stuff with body weight, but I would also encourage people to say, like, if I don't have
00:39:52.400
a lot of room, can I at least get some dumbbells and kettlebells? And, you know, they do make these
00:39:56.720
dumbbells. They're not cheap, but they're efficient and they're cheaper than buying all the sets where,
00:40:02.380
as you know, one dumbbell has multiple links in it. So it could be 70 pounds, 60 pounds, 50 pounds,
00:40:09.200
et cetera, depending on where you click it. So I feel like if you're going to think about, okay,
00:40:13.340
what's the most efficient way to do this? I would say you do want to splurge on a few pieces of
00:40:19.440
equipment and certainly heavy enough dumbbells that you can get into carrying would be important.
00:40:26.240
I think resistance bands are also really important. I've had a couple periods in my life where I
00:40:31.940
haven't had access to a gym for, you know, three or four weeks. And during those periods of time,
00:40:37.160
traveling with heavy resistance bands was essential. And if I could have added to that,
00:40:41.860
having some dumbbells makes a big difference. So it's definitely easier if you have access to a gym
00:40:47.260
or you can go to a gym, like a TRX is probably another really great piece of device for people
00:40:52.520
who don't know what that is. That's kind of this strap device that you either hang around
00:40:57.180
a rack or something, or you can even put it behind a door. You just make sure the door is
00:41:01.680
that you're on the right side of the door. So the door can't open and you can do a lot of exercises
00:41:06.380
with that as well. What about injury? So you kind of mentioned there earlier being conscious of if
00:41:14.020
you're starting out just to not get injured, how should people think about this? If they're either
00:41:18.660
coming into it with previous injuries, if they're worried about injury, especially kind of in the
00:41:24.980
older population is, you know, is that where the stability work can be much more effective? Is it
00:41:30.780
if you haven't lifted much weight, start lower and work on positioning and how the movement works or
00:41:37.560
how should people think about the injury piece? You know, this is something where I think you just
00:41:41.280
have to be careful. And I don't think it would be reasonable for me to represent that I can offer an
00:41:45.320
answer that would cover that in a broad way. For example, we did a podcast with Alton Barron
00:41:50.740
looking at injuries of the shoulder, neck, elbow, hand. Was that like a six-hour podcast?
00:41:58.520
It was like definitely one of our three longest podcasts up with maybe Tom Dayspring and Matt
00:42:03.220
Walker. And that didn't even really get into the rehabilitation. That just talked about like what's
00:42:08.840
at the root of it. You know, I've certainly done a number of videos with Kyler Brown where we've gone
00:42:13.120
over some of my rehab post-shoulder surgery. So I think the truth of it is you're just,
00:42:18.560
unfortunately, I hate to say this, it sounds like, but you've got to be able to align with people
00:42:22.880
who understand how to not paint by numbers in their approach to rehabilitation. So maybe one
00:42:29.540
way to help screen for that is basically when you meet a practitioner, just spending some time
00:42:35.060
talking to them about their philosophy around your particular injury. For example, before I had my
00:42:39.620
shoulder surgery, I wanted to understand all the details of early versus late mobilization,
00:42:45.260
the trade-off between range of motion and stability. These are trade-offs when you're
00:42:49.480
repairing a joint as flexible as the shoulder. You can make it really stable again if you're
00:42:53.560
willing to give up all range of motion and vice versa. I hate to say it, but I think you just have to
00:42:57.560
become a more involved consumer of your care in that regard. But unfortunately, I just can't offer
00:43:06.120
But for the most part, even if someone's dealing with an injury, you would highly encourage them to
00:43:11.540
not let them just give up on working out because of that injury.
00:43:16.200
No. I mean, if anything, that should be motivation to get better. I mean, injuries,
00:43:19.780
it depends where you are in your life cycle. But for most people who I think are listening to us
00:43:24.440
right now, if you have a nagging injury and you take the approach of, I'm just going to sort of
00:43:30.840
ignore it and it's not necessarily getting better, you're on a very slippery slope. I know someone very
00:43:37.140
well who's had a shoulder injury for the last six months and it's not getting better. It's clearly
00:43:42.240
not getting better, but more importantly, she's beginning to atrophy around it. She's becoming
00:43:47.120
so weak and her pain is so significant around it that she's altered all of her movement patterns
00:43:53.680
in response to this. You know, she's younger than I am. So I sort of had a heart to heart with her
00:43:58.100
recently and said, what do you think the natural history of this is? Like, do you just think this is
00:44:02.840
magically going to get better when you're 70? No chance. You need to do X, Y, and Z right now.
00:44:09.620
And yeah, that means you're going to have to invest like at least three hours a week in doing
00:44:13.980
this kind of rehab to see if you can get this better without surgery. And maybe it will require
00:44:19.100
surgery. I don't think it will actually in this particular case, but it's the alternative is worse.
00:44:24.860
Let's touch on VO2 max again. So a lot of people reached out and said, how should I train for VO2 max?
00:44:31.120
So if you take away the only three hours a week to do everything, if it's someone saying, okay,
00:44:36.880
my muscle mass is good, but my VO2 max sucks, what program should I get on?
00:44:42.480
So the first thing to remember is you've got to be spending, if you're really committed to
00:44:46.480
developing your cardiorespiratory fitness, you know, I think I talked about this on one of the
00:44:51.040
podcasts, maybe it was on Tim's podcast. You're trying to maximize the area of a triangle.
00:44:55.960
So the triangle has a base and the triangle has a peak. And the goal is how big an area can I get?
00:45:03.720
Not how wide, not how tall. You don't want one that's this wide and this tall, and you don't
00:45:08.640
want one that's this tall and this wide. You want the max. The base is your zone two. The peak is your
00:45:15.420
VO2 max. From a training perspective, the rule of thumb that is applicable for people like us,
00:45:21.960
i.e. normal people, and the best athletes in the world is roughly 80-20. 80% of your volume is down
00:45:30.400
here, 20% of your volume up here. In fact, some of the really, really elites are probably closer to 90-10.
00:45:37.660
So you're saying no matter if you're just an ordinary athlete or you're the best of the best,
00:45:45.120
Tadi Pogacar, who's the greatest cyclist on this planet, two-time winner of the Tour de France,
00:45:50.840
absolutely mopping up the field of cyclists like they're children. That guy's doing 80-90% of his
00:45:58.460
training at zone two. And I know that for a red fact because we know who his coach is.
00:46:03.100
So then let's maybe talk about that pyramid. So maybe let's just step back and say-
00:46:06.200
I didn't answer your question, by the way, about VO2 max, which we can come to.
00:46:08.720
Yeah. So maybe I was just going to say, maybe let's just cover the whole pyramid. So what's the
00:46:12.260
training of the whole pyramid? If you know it's kind of 80%, 20%, let's break out what that looks like.
00:46:16.620
So I just start with how much time am I willing to put into this? Now, I got to be honest with you.
00:46:19.840
I wish I could be putting 10 hours a week into cardio. I mean, historically, I've put in 14 to
00:46:25.480
20 hours a week into cardio up until 10 years ago. So I really miss those days. I miss being insanely
00:46:32.800
fit. I miss that terribly. And I miss the joy of that much training. It's simply not possible today
00:46:39.360
for all of the obligations that I have. And I've done the math 10 ways to Sunday. I'd have to give up
00:46:45.280
something I'm not willing to give up. I've had to give up archery or give up driving or give up
00:46:50.600
my kids or something like that. I'm just, I'm not willing to give any of these things up. So
00:46:53.580
I basically start with what's the most amount of time I can put into dedicated cardio. And for me,
00:46:58.660
it's like four to five hours a week, not including rucking. I sort of keep that in its own bucket.
00:47:02.640
So then it's a very simple calculation. 80% of that time is zone two and 20% of that time is VO2 max.
00:47:11.000
And how are you breaking out? Let's just start with zone two. How many?
00:47:15.080
I divide it into four workouts a week, Tuesday, Thursday, Saturday, Sunday.
00:47:19.340
And do you always recommend doing it over? Like, let's say you could do four hours in one day.
00:47:26.720
Is there the same benefit of doing all your zone two in one day versus spreading it out?
00:47:31.840
You know, I've talked about this with Inigo. His view is if you can get at least 30 to 45 minutes,
00:47:36.720
you should spread them out. Again, if you're only able to commit an hour to it, it might be
00:47:40.940
one hour once or 30 minutes twice, but I'm sort of doing 45 minutes to 60 minutes each time is what I do.
00:47:48.140
Are you doing zone two VO2 max on the same day?
00:47:52.160
One of those days. So Tuesday, Thursday is just zone two, and then two long sessions of
00:48:00.100
stability training. Call it an hour of zone two, an hour of stability. Actually, why don't I just
00:48:05.220
walk you through the whole week? That'll be easier. So Monday is just strength training. So that's about
00:48:10.120
90 minutes to two hours when you include the stability training that I do as well. So movement prep,
00:48:15.100
stability training, strength training, and that's all lower body. That's Monday.
00:48:18.080
Tuesday is zone two followed by dedicated hour of stability. Wednesday is upper body strength and
00:48:27.280
stability. Again, 90 minutes to two hours. Thursday is a repeat of Tuesday. Friday is a repeat of
00:48:34.600
Monday. Saturday is zone two in the morning, upper body strength repeat of Wednesday in the afternoon.
00:48:49.560
And will you ever do VO2 max before you do zone two?
00:48:53.440
I generally don't just because I like to have a lot of reps before I go for broke. So even when I was like a
00:49:02.700
cyclist and doing two VO2 max workouts a week, they were always preceded by the metric we would use on a
00:49:10.740
bike was kilojoules. So it was how many kilojoules of work would you do before you would do the super
00:49:15.780
hard sets? And it had to be at least a thousand kilojoules, which would translate to at least a
00:49:22.420
For zone two, I know you said you kind of like to break it up. If someone is like, hey, you know,
00:49:27.920
I can do four days a week of zone two, but I can only do 15 minutes a day. Would you say-
00:49:33.620
Then I'd compress it. I would say do two thirties.
00:49:35.920
So in your zone two sessions, you like to do at least 30.
00:49:40.960
When you're in those zone twos, are you like when you hit the bike and the clock starts?
00:49:46.000
I do it all mine on a bike, sometimes on a treadmill. But what I do is the computer is
00:49:50.700
programming to the Wahoo kicker, which is the device I'm sitting on. So it's taking 10 minutes
00:49:56.020
Maybe just walk through what modalities can people do zone two on? Treadmill, bike?
00:50:01.400
Anything that is steady state. So swimming is a great way to do it because you can really swim
00:50:06.120
in a pool at a steady state. Running is a great way to do it because you can pretty much run at
00:50:10.480
a steady state. Cycling outdoors is generally hard unless you have specific, like Fiesta Island was
00:50:17.860
a great place to train. I used to train at Fiesta Island because for people who don't know where that
00:50:21.800
is in San Diego, it's where all the time trial bike races were. And it's just a seven kilometer loop
00:50:27.480
that you can ride on without lights or any, like there's no traffic or anything that gets in your
00:50:32.220
way. But for the most part, I wouldn't be able to do zone two outside here in Austin. It's too hilly
00:50:37.440
and there's too much traffic. It's fits and starts. I can do my VO2 max here because I go to a hill
00:50:43.760
and that's my favorite way to do VO2 max is on a hill that's about a mile long and just do very hard
00:50:50.780
up the hill and then easy down the hill. A treadmill is another great way to do it. Just kind of a
00:50:55.320
walking incline typically. Rowing machine, if you're really a good rower, you have to be efficient
00:51:01.740
enough. Most people are not efficient enough and they don't have the strength. They don't have the
00:51:06.460
stability to row really well for 45 minutes. Stair climber is another really good one. Depends.
00:51:12.980
Again, if you're starting out, brisk walking is probably good enough too. We don't have to get
00:51:17.700
into all the reasons or the benefits of zone two because we have so many podcasts with Inigo,
00:51:23.080
San Milan people can listen to, but you kind of hinted at another thing there, which is
00:51:27.480
when you start your zone two workouts, you'll ramp up. But also a lot of times we get questions where,
00:51:33.340
you know, Hey, I did a 90 minute workout and I was in zone two for 45 minutes of it. Am I good?
00:51:41.080
I think what you mean in that question is, you know, like I went out for a three hour bike ride today.
00:51:45.980
When I got back, my computer told me I was in, I did 44 minutes of zone two. So two issues there. One is
00:51:51.420
that's just a zone two based on heart rate. That's generally the worst approximation of zone two.
00:51:56.160
So zone two really is more based on lactate. If we're going to be purely accurate or at a minimum
00:52:00.740
RPE. But even if you posit that that 45 minutes of zone two from your heart rate is roughly accurate,
00:52:08.560
it's not the same physiologically because usually you're passing in and out of zone two in that
00:52:12.900
situation. And so you're not getting kind of that constant steady state churn, which you're looking
00:52:18.700
for. What we're really kind of looking for is the harnessing of mitochondrial efficiency.
00:52:23.440
And to do that, you have to be able to push oxidative phosphorylation right to its limit
00:52:28.600
before you trip into glycolysis. And you're just at the limit of that glycolysis being the dominant
00:52:36.380
energy source. Whereas if you're on that ride, you're going into and out of glycolysis constantly.
00:52:42.120
So it's not that you're so much in zone two for 45 minutes as that you passed through zone two
00:52:46.520
for a sum total of 45 minutes, which again, there's still value in that, but not for what
00:52:51.740
we're talking about. And what about VO2 max? What modalities can you do VO2 max training on?
00:52:57.880
You know, here, I think it's probably easier in a way, right? Because it's pretty much anything
00:53:01.680
that gets your heart rate up and gets you very tired. So, you know, look, it could be an air bike.
00:53:07.660
It could be a regular bike. It could be a stationary bike, stair climber, treadmill, running outside.
00:53:13.540
You know, the sky's almost the limit. Something like burpees is probably pretty tough once you
00:53:18.560
get into something that intense, like jumping, because the sweet spot for VO2 max is kind of
00:53:24.800
three to eight minute intervals. So you don't want to be doing things that are so intense that you
00:53:30.120
can't do them for at least three minutes. And so that's why I'd kind of hold off on that stuff.
00:53:34.720
I mean, when I was young and I was really fit, I did a lot of it with jumping, but I can't jump
00:53:40.560
for three minutes anymore. Like I'm not that fit anymore. So I have to rely on easier things.
00:53:45.280
What's your current VO2 max workout? So you mentioned kind of three to eight minutes on,
00:53:50.160
Typically I do four on four off is sort of where I spend most of my time. Sometimes three on three
00:53:55.740
off on a rowing machine. I got into that quite a bit last summer, but these days, and sometimes by
00:54:01.520
the way, I just am in a bit of a rush and I'll just do one minute on two minute off at a much higher
00:54:09.600
intensity on the stair climber. So I have one of those like industrial grade strength climbers.
00:54:15.020
And sometimes I'll just go sprint for a minute up the stairs and then takes me two minutes to get
00:54:20.560
my heart rate back down to about a hundred and then repeat that for 20 to 30 minutes. So that's
00:54:27.060
kind of like my poor man's cheating VO2 max workout. But what I really like to do is four minute repeats,
00:54:35.220
And on the four minutes on, are you going a hundred percent for the full? Like how should
00:54:40.240
someone think about you have to play with this? This is years and years of practice to know what
00:54:45.360
that feels like. So again, I'm doing this on a bike. So I'm looking at wattage and my watts are
00:54:49.980
so low now I'm embarrassed. So I'm not going to tell you what the watts are because there's so much
00:54:53.280
lower than they used to be. But I know I have a sense of what I need to average my wattage over
00:54:59.180
those four minutes. So I might go out at 105% of that wattage and it feels pretty easy for the
00:55:08.420
first minute. If it doesn't, I've gone too hard. By three minutes, I'm very uncomfortable. In that
00:55:15.720
last minute, i.e. at four minutes, I don't have much left. You know, if you go out all out in that
00:55:21.720
first minute, you're not going to get to four minutes. You're just going to crash and you're
00:55:24.940
sort of not in that zone. There's no question I positive split the thing, meaning I do more work
00:55:30.200
in the first half than the second, but I don't want it to be more than about 10%. How much of this
00:55:34.320
can it improve for people, right? So if people are saying, okay, I'm willing to put in the work
00:55:38.840
for zone two, I'm willing to put in the work to increase my VO2 max. Is this something if it's been
00:55:44.840
two weeks, a month, two months, and they're not seeing maybe huge increases, like they should get
00:55:51.280
discouraged? I mean, I don't think you're going to get in your VO2 max tested every three months,
00:55:56.020
you know? So it's, how should people think about just monitoring progress in order to see if
00:56:00.960
improvements are happening just to keep people motivated? Well, again, it depends on what
00:56:05.160
modality you're using, but yeah, I don't think you need to test your VO2 max more than once a year.
00:56:09.840
What you're looking for is you pick a modality and I'll give you an answer.
00:56:16.020
Okay. So again, most stationary bikes have a power meter. If you're riding outdoors,
00:56:21.380
you'd probably want to have a power meter. I do think it's the great equalizer. So speed can be
00:56:25.240
misleading because of wind and stuff like that. So you'll know how much wattage you can do. So when
00:56:30.840
you start out, you might only be able to put out 150 watts for the four minutes. But if in six months
00:56:38.820
you're putting out 175 watts for those four minutes, assuming that your weight has an increased
00:56:45.280
significantly, your VO2 max has gone up. Again, the other thing to keep in mind with VO2 max is
00:56:50.520
weight plays an important role in it because it is VO2 max in liters per minute divided by your weight
00:56:57.400
in kilograms. So if the name of the game for you is how do I maximize my VO2 max in total absolute
00:57:05.080
terms, you can really game the system. My VO2 max when I was cycling was high because I was very light
00:57:11.460
and I was disproportionately light in my upper body and your upper body is contributing nothing to
00:57:17.720
the VO2 max for most tests because it's basically tested on a bike or on a treadmill. So you get
00:57:25.380
punished for any upper body mass and you're only rewarded for lower body mass. So the lighter your
00:57:31.180
upper body is, the better you are. It can also be good motivation to people who, let's say on the
00:57:37.880
two-by-two nutrition framework, if you maybe are overnourished and you do lose weight while you're
00:57:43.180
starting to get the cardio, you can see a good jump in your VO2 max if you're losing excess weight.
00:57:48.820
Yeah, it just comes down to how long you're willing to put into this. The literature on this suggests
00:57:52.120
you can only improve your VO2 max by 50%, but the literature is typically looking at eight-week
00:57:57.860
studies. So what we're interested in is a lifetime of training. And in a lifetime of training,
00:58:03.540
you can increase your VO2 max by 50%. So there is a strong genetic component to it. You know,
00:58:08.360
when you see these people who have freakishly high VO2 maxes in the eighties, there's unquestionably
00:58:13.760
a strong genetic component to that, but they're also training like crazy.
00:58:17.580
Well, and you kind of hinted, right? Which is the goal for people who are wanting to start training for
00:58:23.040
the centenarian decathlon for them is thinking about it based on their lifetime horizon. It's not
00:58:29.360
something that's going to play out as I can train for this for six months. Like, it's not like I'm
00:58:34.180
going to train for a marathon after I train for the marathon, I'm going to go back to doing what I
00:58:37.860
was doing. It's, you really do want to create a program that you can keep up with for years and
00:58:43.700
decades. And also you keep that timeline perspective of, okay, I don't need to increase in a sane amount
00:58:50.860
because what I want to do is not get injured, be able to do something that I can do, find enjoyment
00:58:56.480
out of it and find value. Well, that kind of took us that time. This was a little bit of a shorter AMA
00:59:04.020
for us. We also just kind of speed around those questions, but hopefully people found some value out of
00:59:10.380
it and just kind of to build off what they learned. But any last piece of advice that you would want to give
00:59:16.300
people as they think about centenary decathlon, as I think about their longevity journey, again, kind of
00:59:21.900
assuming people read the book, you know, what advice would you give them? Advice, maybe not, but
00:59:27.820
certainly incentive would be the following. We talk so much about the benefits of exercise in terms of
00:59:33.860
how much it reduces the risk of chronic disease, how much it reduces all cause mortality. You've probably
00:59:39.460
heard me say this before, but it's worth repeating. If I knew that all this training I was doing,
00:59:44.560
everything I'm doing, if I knew that it was going to shorten my life by a year, I would still do it
00:59:49.900
purely for the improvement in quality of life between now and the end of my life. The fact that
00:59:57.600
it's not shortening my life by a year, the fact that it's probably adding five to seven years to my
01:00:02.560
life and improving the quality of my life means day in and day out. I just think it's about the most
01:00:12.320
important thing that I can do vis-a-vis my physical health. There's other elements of health that we
01:00:17.940
didn't get to. That would be sort of my parting thought. And of course, my parting comment would
01:00:22.300
be a thanks to everyone who's listening to this. Because by definition, if you're listening to this,
01:00:26.780
you were an early purchaser of Outlive. So I really want to thank you for that. It means a lot to me.
01:00:33.760
I think I mentioned this once before on our podcast, but it's probably worth repeating.
01:00:38.380
I never thought that a book would mean as much as it has in terms of how personal it feels and how
01:00:46.640
attached to the thing that I feel as it's out there. And there's no other piece of content I've
01:00:52.700
ever created. There's no blog post I ever felt this attached to or newsletter or podcast. There's
01:00:59.160
just nothing. And this feels oddly personal. And therefore, whenever I go somewhere and I run into
01:01:05.540
someone and they send me a message about it and they say, hey, I got your book. I read it. I really
01:01:09.080
liked it. It means more to me than I thought I would. I'm sorry that I can't be thanking each and
01:01:13.220
every one of you in person for purchasing the book as early as you did. Hopefully, this is the next
01:01:17.960
best thing. And so thank you very much. And I should say, too, the one thing I forgot to mention
01:01:22.960
earlier is for anyone who has a physical copy of the book, if you haven't popped the jacket cover
01:01:28.300
off yet and seen the actual cover, there is something on the actual cover to itself that
01:01:33.960
was a special design. And again, shout out to... No one's mentioned that yet.
01:01:38.060
Not a lot. We got in a few, but again, Rodrigo Corral and that whole crew, just awesome. Not
01:01:45.000
only on the jacket cover, but the physical... What's that called? The board? What are they
01:01:50.180
called? The hard cover of the thing? There's a name for that and I forgot. I just call it the book.
01:01:54.500
The book. It's a different question, but it's a little Easter egg out there for people, but
01:01:57.500
awesome. All right, Peter. Thank you very much. Thank you very much.
01:02:01.480
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