The Peter Attia Drive - #294 ‒ Peak athletic performance： How to measure it and how to train for it from the coach of the most elite athletes on earth

00:00:00.000 Hey, everyone. Welcome to the Drive podcast. I'm your host, Peter Atiyah. This podcast,

00:00:16.540 my website, and my weekly newsletter all focus on the goal of translating the science of longevity

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00:00:53.200 of a subscription. If you want to learn more about the benefits of our premium membership,

00:00:58.020 head over to peteratiyahmd.com forward slash subscribe. My guest this week is Olav Alexander

00:01:06.980 Bu. Olav is an endurance coach, exercise scientist, engineer, and physiologist. He is the head of

00:01:14.380 performance for Norway triathlon and is best known for coaching two of the world's greatest triathletes,

00:01:20.840 Christian Blumenfeldt and Gustav Eden. And he coaches the Norwegian Olympic sailing team and

00:01:27.920 consults for multiple world tour cycling and elite track and field teams. In this episode, we were only

00:01:34.140 able to cover a fraction of what I was hoping to cover as we ended up going so deep on VO2 max and

00:01:41.660 performance. Safe to say this will be the first of several interviews that I do with Olav. In this

00:01:48.100 interview, we look at the relationship between VO2 max and ATP production, efficiency, energy,

00:01:54.520 and power. We speak about the quality of low intensity training as it relates to VO2 max,

00:02:00.560 how weight impacts VO2 max, absolute versus relative VO2 max values, and why we maybe ought to pay a little

00:02:08.700 more attention to the absolute numbers than just the relative as I have typically done, the different

00:02:13.520 ways to test for VO2 max, and the different ways to train to improve your VO2 max, and of course,

00:02:19.320 Olav's work with his athletes. We also have a pretty deep discussion around the role of lactate testing

00:02:25.960 and its role in performance. So a couple things I want to say just to put this into context. Of course,

00:02:31.720 if you're listening to this podcast, you have heard me go on and on about the importance of VO2 max. And so

00:02:37.100 to really have the masterclass in VO2 max here alone is worth the price of admission. But there

00:02:43.660 are so many other nuances we get into here around different terms that people have heard and sometimes

00:02:49.600 confused. So what's the difference between lactate threshold one, lactate threshold two, LT1, LT2,

00:02:54.900 and zone two? How are these actually measured? And even if you think, well, gosh, I really have no interest

00:03:01.860 in doing the kind of deep testing that Olav does, or even the stuff that Peter does on himself. You're still going

00:03:07.420 to learn a lot about the physiology of this stuff here. One final thing I'll say. During the course of this

00:03:12.760 discussion, I learned about something called the VO2 master, which is a portable VO2 max unit that Olav uses

00:03:20.980 extensively with his athletes. Now, I've certainly heard of these types of devices in the past, though not

00:03:27.040 specifically the VO2 master. So it's always with a bit of skepticism that I assume that these

00:03:31.740 things can't be that accurate. But during the course of the podcast, and then after the podcast,

00:03:37.000 Olav and I got talking about it, and my curiosity was piqued so much that I actually got one of these

00:03:41.600 devices. Needless to say, I have been blown away by this device. I consider it the single best

00:03:49.020 investment I've made in tracking, and the accuracy is staggering. It's really remarkable that I can put

00:03:56.900 this thing on and go outside and do a workout on my bike or do a workout on my Stairmaster. Basically,

00:04:02.560 I can test my VO2 max on my own. And again, this is just one of the many nuggets that came out of

00:04:08.140 this podcast. I'm not suggesting you have to go out and buy a VO2 master, though if you're like me,

00:04:13.000 I would highly recommend it. So anyway, without further delay,

00:04:15.680 please enjoy my conversation with Olav Alexander-Boo.

00:04:24.020 Olav, thank you so much for making time to sit down with me today. I'm really excited about this

00:04:30.040 episode, and I'm going to try to contain my own enthusiasm such that the people listening to this

00:04:36.960 will understand what we're talking about because the topic we're going to go into today is really

00:04:42.440 one that fascinates me to no end. But more than that, you are someone who brings a level of

00:04:48.160 expertise that is so high that it really allows me to engage at a level of curiosity that I rarely

00:04:55.820 get to engage in. And I don't think I've taken more notes coming into a podcast than I have for this

00:05:02.680 one. I fully expect we will not get through half of what I've written down in terms of topics that I

00:05:09.580 want to explore. But nevertheless, I'm going to apologize in advance to you and to everybody else

00:05:15.520 for just how enthusiastically I want to address the subject matter of human performance. Perhaps

00:05:23.180 before we get into that, though, maybe you could just tell folks, let's assume people don't know

00:05:28.560 anything about you and who you are, Olav. Just tell them who you are, what you do, and the types of

00:05:33.240 athletes that you work with? To try to make a liner story, I actually grew up on a farm on the west

00:05:40.540 coast of Norway. I had to participate in a lot of work at the farm when I was a kid against my will

00:05:48.480 because I saw my neighbors and others were playing and I would very much like to do that as well. But I

00:05:54.800 think for sure in my now today and already a long time ago, I already started to really appreciate all the

00:06:03.900 hardship, more or less. Fast forward, I already developed a very keen interest for technology already as a

00:06:11.720 kid, and I was extremely curious. I liked to really pick things apart and understand how things were put

00:06:17.240 together, fascinated about everything from the universe and rockets and so on. And of course, living at the farm,

00:06:23.860 you also get the possibility to pick apart a lot of machineries and other things and see how this is

00:06:28.920 working. And so being with animals, I have a very strong connection with animals. I also started to

00:06:35.000 develop as I started to grow a little older, I started to get very interested in more things that

00:06:39.700 were more extreme. I had an attraction towards things that were extreme. So extreme sports typically

00:06:44.100 were a thing that resonates a lot with me. There are probably no extreme sports I haven't

00:06:49.840 participated in, call it on a okay level. Yeah, and then I took my degree in electrotechnics,

00:06:57.640 went on to engineering, found out that I was not cut for the eight to four working style. For me,

00:07:04.020 it was more about entrepreneurship. I like to build things, innovate new things, solve things that

00:07:09.420 nobody has solved before. Those again, a little bit extreme things that basically are abstract,

00:07:14.800 really, really fascinates me. So in 2011, there was an event happening in my life. This was after I

00:07:21.860 actually started my second company, we were into the mountains, we had to use helicopter to get into

00:07:26.480 the mountains. There was a big, or basically half my family died on this trip into the mountains.

00:07:36.020 And again, it made a shift in my life. And I decided to, for various reasons, I got even more

00:07:44.600 into sports. So I was then asked to start to combine the field of exercise physiology and technology,

00:07:51.300 or my strength in technology and see whether we could start to take more of, let's say more research,

00:07:56.980 a lot of research that typically happens in laboratory settings, or even in microbiology,

00:08:01.220 where you're taking out components and looking at how does it react. But we very rarely are able to

00:08:06.540 transform that back into humans in a way that makes us the same difference. So how could we now

00:08:12.480 study people, use technology to study people, especially elites, for example, in the setting

00:08:19.280 where they normally exercise and even use that to continue to drive performance. And then,

00:08:25.180 of course, today, two of my personal, at least three of my personal athletes,

00:08:29.140 Christian Blumenfeld, Gustav Yedin, Ken Janina, they hold all the records that are in triathlon,

00:08:36.120 short course, long course, Olympic medal, world championship medal, short course,

00:08:41.680 the Ironman world, world championship 70.3 and full distance from Kona and St. George last year.

00:08:48.300 And yeah, it's been an incredible journey because I, one thing is, of course, what I have contributed to

00:08:53.400 with them, but I really like a collaborative way of working. So I learn always from them as well,

00:08:58.220 because I'm very curious about how they feel, what they see, how they perceive different things,

00:09:02.840 because there's a lot of things we can measure with data and there's a lot of things we can't

00:09:06.220 measure with data still. So you need also to that context as well. And mainly today, we are actually

00:09:12.260 building a company where we are scaling these companies using AI, so numerical models, large

00:09:17.420 language models into a company called enthalpy, like physics, of course. So enthalpy and thermodynamics

00:09:23.160 are some fundamental laws, humans can't escape no matter how we think we are. And then on the other

00:09:28.920 side, I work also as a coach for coaches mainly. So I'm more coaching coaches at Olympic level,

00:09:34.900 world tour level, racing at the highest levels. So yeah, that's a long introduction on me.

00:09:43.820 Well, let's start with some fundamentals, because we're going to spend a lot of time today talking

00:09:48.340 about extreme performance and peak performance around the types of sports in which you're coaching

00:09:56.140 athletes. So the triathlete is kind of a remarkable athlete in several levels. The first being that he

00:10:03.500 or she must be very good in three disciplines that are related, but quite distinct, different body types.

00:10:11.740 If you look at the world's best swimmers, the world's best cyclists, and the world's best runners,

00:10:15.500 they actually have quite different physiology depending on the distances they race, and certainly

00:10:20.300 different methods of training. And the triathlete therefore has to be really respected because they

00:10:25.900 have to be almost world-class in each of those things to be world-class in their sport. And their

00:10:32.240 physiology as a result of that is remarkable. And there are so many things that we're going to talk

00:10:37.000 about today, including temperature management, energy expenditure, energy consumption, all these

00:10:41.380 things. That said, I want to make sure that the listener is able to follow where we go. And we're

00:10:47.540 going to get into some really serious weeds, right? We're going to talk about MCT transporters for

00:10:52.880 shuttling lactate out of cells and all of those things, because that's where I want to go. But I want

00:10:59.020 to make sure people understand the fundamentals, the very basics. So humor me as we go through kind of

00:11:05.980 the 101 of ATP production and utilization. So you and I are sitting here right now having a

00:11:13.740 discussion. And of course, our body is converting all the while chemical energy into electrical energy,

00:11:22.880 back into chemical energy, and it requires the substrates of oxygen and hydrocarbons to do that.

00:11:31.060 Can you explain, you know, in a little bit of detail, exactly what that process looks like for

00:11:36.260 us right now, as we're sitting here under obviously a very low physiologic demand?

00:11:42.220 On a very deep level, or do you want more like a high level?

00:11:45.280 Let's start high level.

00:11:46.760 Okay. I think one of the things, Roche, there's a really beautiful map, call it a map,

00:11:54.140 made by Roche. I think it's called Roche. They are a medical supplier.

00:11:57.940 In the Swiss pharmaceutical company, R-O-C-H-E. Yeah, exactly.

00:12:03.140 They made a really beautiful map, which is still not exhausted. We are continuously learning new

00:12:10.860 things that we can add to this map. And this map is called, there are two maps they basically

00:12:16.440 distinguish between, and there's one that they call the metabolic pathways, another one they call

00:12:20.300 the signaling pathways. And on the metabolic pathways, we have, of course, many ways that we

00:12:26.740 can convert energy from mainly, of course, its proteins, its fats, its carbohydrates that we

00:12:34.760 are converting basically from a substrate or from the food that we ingest and we store in our body

00:12:39.200 to then basically ATP, which is the main fuel source that the muscles, different muscles in the body

00:12:45.900 are using or different functions in our body is using in order to survive. And of course, to convert

00:12:51.500 those substrates also into ATP, also there's oxygen required, but there are many, many different

00:12:56.680 pathways. And the problem a little bit with this as well is that even though this is a field which

00:13:04.160 we have studied quite a lot, we are still learning more and we don't fully understand it still either.

00:13:13.060 And that's why very often actually to bring it up maybe to where I think is more useful very often

00:13:18.480 to work on this is that if you dig too much into some of these different things that you lose track,

00:13:24.080 you start to lose track exactly of how do you increase performance of somebody as well.

00:13:30.560 To use another example, today we have, for example, smartwatches and other things as well that are

00:13:35.680 trying to say something about a sleep. It's derived or inferred basically from movement from your wrist,

00:13:41.480 for example, and it's based on HRV. But the problem is also when you're looking at, okay, what is

00:13:46.220 performance? So if we say the calamity, so again, back to thermodynamics or fundamental laws,

00:13:51.220 on the one side, humans need to move. That's what we do. So we're sitting here now in the chairs,

00:13:55.960 we're moving around, we're gesticulating with my hands and these kinds of things,

00:13:58.780 we are nodding with our heads. And all this requires energy in order to do that. And that's

00:14:03.820 movement. You can track this movement. You could even have quantified it in centimeters or meters or

00:14:08.980 whatever over a day for each of our components or globally when we are running, for example,

00:14:14.020 the distance we cover. But in order to do so, we need an energy source. We need energy from

00:14:19.700 somewhere. And of course, the currency for the muscles or for anything in our body is basically

00:14:23.940 ATP. But in order to create ATPs, then basically we need a different substrate to be broken down.

00:14:29.980 And in order for combustion to take place, we need oxygen. This is the most people probably remember

00:14:34.720 the fire triangle where basically you need oxygen, you need temperature, and then we need something to

00:14:39.720 combust. And of course, oxygen is probably the most practical way today, of course, to measure exactly

00:14:45.860 how much energy are we using at any given time. And then, of course, we can always start to break

00:14:53.440 this down and try to understand how much ATPs this release or what is the energy yield from that amount

00:14:59.540 of oxygen. But this is also highly different also in humans. Some humans will be more efficient.

00:15:04.340 Typically, elites are very efficient at this, while normal population would probably be less

00:15:10.000 efficient at this to create energy. So typically then to round that up, I would say that the way

00:15:16.340 that I very often work today is to not lose track. On one side, of course, I have a large team around

00:15:22.600 with people that are extremely good at this. One of the researchers that I work with, he was just

00:15:29.200 actually now recognized as the number one researcher in the cycling world this year. And they are

00:15:35.640 digging a lot into everything from enzymatic activities to how energy is being released and so

00:15:40.740 on. How can we do this better? But one thing that I found very much more useful is actually that we

00:15:46.160 need sometimes just to black boxes. And we have to remember what is important there. We know movement

00:15:51.460 is the most important part to humanity. So being able to move. If we can sit at work, we can sit there

00:15:56.820 in the podcast. But then basically afterwards, this, we still have an energy surplus that allows

00:16:01.840 us to come home and move around with our kids and play and be kind to our wives and help them out at

00:16:07.740 home and so on. That's a situation we all feel good with. That's what we all want. So then the question

00:16:12.580 is, how do we do that? So how can we track different parameters to understand how we can get there?

00:16:17.340 And this is where I think very often that looking at more of, let's say, humans as an engine,

00:16:22.680 as a machine, there's a fuel and an energy input. So you look at oxygen consumption, for example,

00:16:27.580 because this you can do with the cars. And then you look at, okay, you have power. So most people

00:16:31.780 will probably have a power meter, but if they are cycling and a little bit more, if you don't have,

00:16:36.080 it really is not that important because anyway, the output from this process will be distance per

00:16:41.080 time. And one thing that we see also between, let's say, less trained people, or to put another way,

00:16:47.640 people are putting in less volume into their training is also that very often in order to do

00:16:53.340 a certain amount of work, or let's say moving a certain distance has a higher oxygen cost or

00:16:59.480 basically a higher calorie cost for them to move that distance as well. So I think on the one side,

00:17:05.140 I'm very fascinated about breaking down things into the, let's say, the smaller details. But the

00:17:09.840 problem is that we have a limit to how much time we have available and how do we then make sure that

00:17:14.140 we get the best or how can we then make sure that the things that we do, the interventions we plan,

00:17:20.720 the changes we make to our lives, how can we then quantify what it has an effect? One, of course,

00:17:27.560 is the ultimate measurement of this is ultimately distance per time. But in order to understand what

00:17:32.780 mechanisms are actually happening here now, we can measure, of course, if you have a power meter or

00:17:37.040 power meter technology, we can start, is it biomechanically driven? So are you improving your

00:17:41.020 biomechanics? Or we can look between power, so work basically, and calometry, is it the biochemical

00:17:47.020 part that is improving? And we can even then decide just to say, okay, we black box it. We don't

00:17:53.060 necessarily need to understand it because we can see whether things are improving or not improving.

00:17:57.260 If it does improve, continue to do more of it. If it doesn't improve, then we basically say, okay,

00:18:02.480 fine, we can dig more deeper into it. And that's where, of course, we have specialists and others around

00:18:07.700 us that basically are trying to understand exactly what is happening on a deeper level.

00:18:12.200 Let's use some real examples on that. And I want to just synthesize what you said a little bit,

00:18:16.380 because it's very interesting. One of the first things you said is, look, the metric that matters

00:18:20.520 is velocity. You described it as distance per unit time, but of course, that's velocity. So if you're a

00:18:25.980 runner, if you're a cyclist, if you're a swimmer, if you're a triathlete, the winner and loser is

00:18:30.480 determined by velocity, not power output, not any other metric. Obviously, there's a very strong

00:18:35.740 correlation between power normalized to weight and velocity, but it is not one-to-one. I'll use an

00:18:41.640 example, especially in a triathlon or a time trial where aerodynamics matters significantly. You can

00:18:48.840 have people that put out more power, but they create more drag. And obviously that's very true

00:18:53.600 in swimming as well. In running, obviously there's running efficiency that can speak to energy

00:18:58.780 expenditure versus velocity. So velocity is king. I like the way you kind of broke it down into two

00:19:04.980 drivers. You can have, how efficient are you at using the energy source to make the ATP? What is

00:19:14.280 your loss ratio there? So presumably majority of that energy is lost in the form of heat.

00:19:20.660 We typically, I remember, used to use like a one to five ratio. So you could sort of

00:19:24.720 take the number of kilojoules, divide by five. That was approximately going to be your energy

00:19:30.240 expenditure. But let's come back to that because that's obviously very crude. But then you said,

00:19:34.320 no, no, no, look, you also have to be equally focused on your mechanical efficiency. That gets

00:19:38.600 to what I just talked about. First of all, is that a reasonable synthesis of what you just said?

00:19:43.620 Yeah. And you can split that also into, because here it helps to, when you look at mechanical part,

00:19:47.880 it's also when you look between power and velocity, then you can of course say that one component is

00:19:53.240 of course the biomechanical part, but another part of it is also the work economy or where you basically

00:19:58.020 look at equipment, for example. So aerodynamics and other things as well. So there are two components,

00:20:02.180 but purely if you look at the human locomotion, then basically it's exactly like you break it down.

00:20:07.200 I'm going to share with you one really funny example before we come back to this. So 10 years

00:20:11.120 ago, back when I used to ride a bike and the only thing I would do was time trial. That was my favorite

00:20:15.520 event to do. I had two partners that I trained with who were both much better than me, collegiate

00:20:20.660 cyclists. And we used to do this workout every Saturday, which was an 80 kilometer ride on a time

00:20:28.480 trial circuit, closed off. It's flat. Each loop was maybe seven or eight kilometers, but here was the

00:20:34.440 thing we used to do. We used to not allow ourselves to go over 200 Watts. So we had a power meter and

00:20:41.780 the SRM will tell you exactly what your wattage and your average wattage is. So you had to keep that

00:20:46.800 average watt at 200, not 201, not 199. And each week we would see if we could get faster and faster

00:20:54.540 while keeping the wattage at 200. And as you know, 200 Watts is not a lot of Watts, of course.

00:21:00.900 So it was not hard to hold that for the 80 kilometers, but over the span of a year, I think

00:21:07.700 if I remember correctly, we were able to increase our velocity from maybe, I want to say like 20 and a

00:21:16.160 half miles per hour to maybe 22 miles per hour, which is a very significant improvement in efficiency.

00:21:23.420 And I'm curious, how much of that do you think we did by getting better in our CDA, our coefficient

00:21:31.120 of drag times frontal surface area, didn't require new equipment. And then how much of that do you think

00:21:36.600 we did metabolically? In other words, that we metabolically got better at turning energy into

00:21:44.580 power.

00:21:46.460 So first of all, of course, when you have a power meter, you don't know how much the metabolic

00:21:50.360 efficiency. We missed the VO2 data. We have no idea what oxygen consumption did in that year.

00:21:55.960 That's right.

00:21:56.360 Exactly. So that part is not a part of the equation, but if you look at a work economy,

00:22:01.820 then I think there are a couple of things that mainly, of course, since a power meter on a bike,

00:22:06.760 like the SRM only measures, let's say the net mechanical power. So it basically only measures

00:22:12.520 the component of power that actually goes in the direction that you are actually moving the crank

00:22:18.940 arm. And of course, already there are two components. We don't have to focus on that here,

00:22:23.460 but that's where the difference between net mechanical power and gross mechanical power comes

00:22:26.920 in, of course. I don't know, maybe we touch even further on this because there are also several ways

00:22:31.300 to produce 200 watts as well, because you can also have a very large intracyclic power also true.

00:22:36.380 Sorry, I should make this point. The goal was to keep average power and normalize power the same.

00:22:41.760 So no bursts of power. Yep.

00:22:43.700 Yeah. But even there, actually what most people don't realize is that when basically your power

00:22:47.960 meter shows 200 watts and you keep it super steady around 200 watts as well, you'll actually have

00:22:54.000 inside one second or one revolution, for example, you already there have a variation of power.

00:23:00.520 Let's say it's 200 watts. You will have a peak power production, I would say probably for you

00:23:05.080 because of your focus and how determined you were there. Probably you were sitting on the nicer side

00:23:09.340 of it, but I wouldn't be surprised for some people riding 200 watts to be pushing 1,200 watts,

00:23:15.920 for example, peak throughout every single revolution. Wow.

00:23:19.360 Yeah. Wow.

00:23:20.400 This is something we already quantify by the power meters. But since we don't have to focus on that

00:23:24.640 part here, because you're measuring the locomotive part of the power component, then I would say there

00:23:29.800 is a couple of things that is very interesting. One is, of course, that you say that you are already

00:23:33.520 riding at the power output, which is very comfortable. And I think that is important

00:23:38.060 in many senses when you really want to work on your work economy for it, because here we

00:23:42.400 are mainly, we have already excluded the biomechanical part of it, because since you are not looking

00:23:47.060 at the difference between gross mechanical power and net mechanical power, then we are already

00:23:51.180 said that, OK, we don't care even about the biomechanical part. We are only looking now basically

00:23:55.340 on, let's say, what is transferred into forward propulsion or velocity.

00:23:59.820 But when you're riding 2,000, what I think is really important and undervalued is that

00:24:04.900 the harder we go, more of our oxygen and blood will basically be prioritized towards, one,

00:24:12.100 driving the muscles forward. Secondly, also, even more for cooling. You hit it pretty spot on

00:24:17.860 when you say there's a 20% efficiency, 80% heat, 20%. That's what we see pretty much for elites,

00:24:23.700 not for people. As you said, we'll come back to that probably.

00:24:26.080 So then basically, when you are focused on this, I think that there are no better setting

00:24:31.760 when you ride at a little bit lower power. It allows you to be very mindful and cognitive

00:24:37.800 present to your movement and how you are in the bike there and everything there. And this

00:24:43.240 is some things that I see very often is a difference between also the specialists and the triathletes

00:24:47.880 as well, because the triathletes are much more inclined to solve tasks brute force than

00:24:53.860 the specialists. The specialists are, because they simply have more time on lower intensity,

00:24:59.860 medium intensity, and high intensities, or let's say especially lower intensities,

00:25:04.060 they tend very often exactly to build a better feeling for how they are moving through the

00:25:10.900 landscape more efficiently by doing exactly like you say. You look at the 200 watts and it becomes so

00:25:16.360 measurable because you can start to evaluate what is happening with your velocity as a function of

00:25:22.240 that. You just see that, okay, I'm creeping down with my head a little bit and you start to feel

00:25:26.200 these nuances. Because to maybe end it a little bit here is that when you go to a wind tunnel,

00:25:32.260 one of the problems with going to a wind tunnel is that you go in there and you do something that is

00:25:36.340 like a spot. It's a spot picture exactly of the position that you're holding for the moment.

00:25:41.500 I don't know how many hours is spent in the wind tunnel, but for various purposes, but obviously

00:25:45.480 a part of that has been looking at aerodynamics of an athlete. The problem is that the moment you take

00:25:49.860 the athlete off the bike and you put him on the chair and you ask him to go back into the position

00:25:53.400 there, if he doesn't have an outline in front of him that tells him exactly the position to be in,

00:25:58.620 that can already start to offset any other margins that you're looking to gain from, for example,

00:26:03.560 clothing and other things. So in order now to re-evaluate clothing on an athlete and not on a

00:26:08.060 dummy or a doll, but basically on a live athlete, the problem with that is exactly if you go off the

00:26:13.760 bike, come back on again, you won't have the same position unless you have an outline that you see

00:26:17.940 that you're fitting yourself into. And the problem with that is exactly that you haven't gotten the

00:26:22.720 time to rehearse your position and actually start to feel and get aware about your whole body position

00:26:28.120 in exactly that position there, which is completely the contrary to when you're riding 200 watts.

00:26:33.820 You're riding at a power output that allows you exactly to have that cognitive access to evaluate

00:26:38.880 yourself, feel yourself, be aware of the surroundings and everything there. And you are basically

00:26:43.820 programming that into your, basically your backbone for that. This is the position there. So when you

00:26:48.640 go out, let's say in a race, you have trained that position so deep into your body that you can almost

00:26:56.460 do it blind. I think you're spot on here, Olive, now that we discussed it. I actually think that that

00:27:01.980 whatever it is, 5% improvement came almost entirely through frontal surface area. And as you said,

00:27:09.700 it's so relaxed. I mean, we're talking as we're doing this ride. It's not a hard ride, which meant

00:27:15.960 all of your cognitive reserve goes into wiggling your way into how narrow can I get my shoulders?

00:27:23.960 What's the best position of my knees on the top tube? All of that kind of stuff. So that's very

00:27:29.340 interesting. And it's also interesting that you point out that it's a luxury that the one sport athlete

00:27:35.760 has, because at the time that was the only thing, I mean, I swam, but most of my energy was on the

00:27:40.820 bike. And yes, I think a triathlete would have a harder time maybe justifying that. Do you think

00:27:46.800 a triathlete would benefit, however, from doing some of that kind of training that seems sort of like

00:27:51.640 junk mileage because it's so low in intensity?

00:27:55.620 So this is where I would differ because it becomes junk mileage when you're not mindful

00:28:00.060 about that. So of course, this is also where, for example, I know that a lot of

00:28:03.700 people talk about when you do a quality or high quality or quality workout is a high intensity

00:28:08.640 workout. But basically how I basically see it instead is that low intensity, medium intensity

00:28:13.400 and high intensity should all be high quality. All of them should be mindful workouts because you can

00:28:18.480 use them for different purposes. Exactly when you're doing the lower intensity, it allows you

00:28:22.920 exactly to have that cognitive reserve to basically use your senses to give you better biofeedback

00:28:30.340 and learn better what you can improve, which you don't will have the cognitive reserve to do

00:28:35.160 when you do the higher intensity workouts, because then you are exactly focusing more on surviving

00:28:40.220 instead. So yes, absolutely. This, I think, becomes most evident in swimming. In cycling, we actually do

00:28:48.160 see that the triathletes, because the movement pattern and other things, there are very, very few

00:28:54.140 degrees of freedom when you're sitting on a bike. So in cycling, we see that, for example, the best

00:29:00.320 triathletes in the world are on par, close to or on par with actually the best cyclists in the world.

00:29:06.920 In running, this, of course, starts to become a little bit bigger difference between them, simply

00:29:11.480 because now you start to allow for a little bit more degrees of freedom. And swimming is, of course,

00:29:15.860 the worst. This is where you have so many degrees of freedom and so poor feedback values. You need to have a

00:29:21.620 very good spatial awareness of your body and what you're doing there in order to allow you to have

00:29:28.180 or to utilize your oxygen for maximum propulsion. To give you an example, we were in the flume at

00:29:35.080 Tenerife tea tree. This is not like a counter current pool where there's a jet sitting in front of you and

00:29:40.960 pumping some water today. This is a full-fledged wind tunnel. Basically, water is circulated full

00:29:46.580 cross-sectional area around in a huge circle. And there is basically a three times, three meters

00:29:52.720 wide, one and a half meter deep, five meter, five, six meter long cross-sectional area of water just

00:29:59.400 passing over or past you like you were in an endless ocean, swimming in an ocean. Water quality

00:30:05.120 is perfect. There's no turbulence, no nutter, just pure water running past.

00:30:09.720 But sorry, the athlete is able to swim in place. So it's not like, you know, an endless pool where

00:30:15.100 you're being blasted with a five mile per hour current two feet from your face. You're out far

00:30:21.120 enough in the pool that it just feels like you're in the ocean and you're not moving, but you're using

00:30:26.700 a natural stroke. It looks very similar to a wind tunnel. It has the honeycomb structure on both on

00:30:33.620 the front and the back here. And then basically there are some huge fans pumped sitting in another

00:30:38.180 part of there. So it's not sitting where you are swimming, but basically sitting on a return section

00:30:42.640 instead there. So basically what happens here is that you're laying in this tank and the water is

00:30:47.420 just passing. So you can just set the speed here in the same way as you do with an endless pool or

00:30:50.720 counter current pool. So you set the speed to, for example, 1.5 meter per second, and you just jump

00:30:56.380 in and you're just swimming there. And you want, whether you go left or whether you go right or forward

00:31:00.740 or back, the current is exactly the same here. There is no turbulence anymore. So the interesting thing

00:31:06.500 now is that we built, we took a gold standard metabolic cart and then basically we made hoses and

00:31:11.560 everything in an apparatus that allows them to use this while they are swimming.

00:31:15.740 So meaning you are able to measure the ventilatory rate of oxygen consumption, carbon dioxide

00:31:20.740 production.

00:31:21.720 Everything. So the input, basically you're measuring the fuel consumption of the car and you're looking

00:31:25.520 at what are the certain...

00:31:26.460 And the exhaust. Yeah.

00:31:27.960 Yes, exactly. Yeah. Not the only exhaust, but the exhaust is measured, but also the back wheels

00:31:32.700 basically of your car. So then basically when they are in the flume there, we know that Christian

00:31:37.560 and Gustav, for example, have a equally high or higher view to max than the elite swimmers in the

00:31:42.800 world. And now I'm not talking about where you're comparing running with swimming. We are taking them

00:31:47.440 and measured it in swimming. And the same thing I've done also on elite swimmers. And basically where

00:31:51.880 we say Christian and Gustav has a higher view to max. So a bigger engine than the best swimmers in the

00:31:58.720 world. The people that are winning gold in the Olympics.

00:32:01.260 Yep. So in other words, when you push the speed high enough to the point where they reach the

00:32:07.680 maximum amount of oxygen that they're going to be able to consume, which is equivalent to,

00:32:13.180 or linearly equivalent to, the maximum energy expenditure. And we always know that the bigger

00:32:18.660 that number, the bigger the engine. They do more. They are able to consume more oxygen and put more

00:32:25.020 calories to work than the world's best swimmers. But of course, you're about to tell us they're not as fast.

00:32:30.080 Exactly. And the difference is so big, you don't even want to know it. So for example, we had the

00:32:36.600 bronze medalist from the Olympics swimming in the flume there. He is 195, 195 tall. He weighs more

00:32:44.100 than I think, let's say around 90 kilograms or more. Massive guy, a lot of muscles. He goes into the

00:32:50.640 flume, swims at the same velocity as Christian is doing, and is using almost a liter less of oxygen.

00:32:58.540 At that point, that was close to 25% less oxygen. And what we also do know, the more muscles you have

00:33:05.160 in the body, the more oxygen you can also consume. Because you have almost no muscles, obviously there

00:33:09.800 won't be a lot of oxygen consumption because it's the muscles mainly that are using oxygen during

00:33:14.360 basically exercising. So now when you have an athlete that is this massive, obviously you would

00:33:18.980 assume that, okay, he is using also a lot of oxygen because there's a lot of muscles involved.

00:33:22.800 But because he is so efficient, he actually swam at the same velocity with almost 25% less oxygen

00:33:30.620 consumption than the best triathletes in the world is doing. And that is a little bit mind-boggling,

00:33:37.580 but it just tells how important also efficiency or movement efficiency is into this whole equation as

00:33:44.500 well. I would argue that is only mind-boggling to someone who has not swum. But as a former swimmer

00:33:52.380 myself, this doesn't surprise me one bit, not one iota. Because I came to swimming late in life. I'm

00:34:01.620 an adult onset swimmer. So I didn't swim until I was 31 years old. This is almost 20 years ago.

00:34:07.480 And it never ceased to amaze me. Even when I was at my absolute fittest on the bike,

00:34:15.100 when my VO2 max was more than five liters, how people with seemingly such a lack of fitness

00:34:22.200 could destroy me in a swimming pool. These people were technically so superior that I could consume

00:34:29.700 five liters of oxygen. They would consume three, no comparison.

00:34:33.460 And that's where exactly being mindful, using that cognitive reserve, not to do junk miles,

00:34:39.780 but doing really mindful miles in the pool, on the bike, exactly like you did. It's so important,

00:34:46.540 but very undervalued. And it could have been used so much better.

00:34:51.720 Super interesting. Well, let's start talking about some of these things. We've already alluded to VO2

00:34:55.700 and VO2 max, and you've already made a very bold claim, which in the pool is easier to accept,

00:35:02.740 but let's extend it now. And let's talk about what it means on the bike and on the run, because

00:35:07.700 people who listen to this podcast have heard me say over and over again, that VO2 max is the greatest

00:35:13.960 predictor of lifespan. This is kind of a remarkable statement, and I'll repeat it because it is so

00:35:19.940 profound. Whether you smoke or don't smoke, whether you have diabetes or don't have diabetes, whether

00:35:26.800 you have end-stage kidney disease or don't, heart disease not, hypertension or not, all of those

00:35:32.400 things play an important role in predicting the length of your life, but not as much as having a very

00:35:38.800 high VO2 max. This rises above every other biomarker we have to predict the length of life. And the reason I

00:35:48.680 argue that that's probably the case is that VO2 max is an exceptional integrator of work that is done.

00:35:58.280 So for the few times I have patients that will tolerate the mathematical equation, I would say, loosely

00:36:04.060 speaking, VO2 max equals the integral from T1 to T2 of work as a function of time DT. And we know that that

00:36:13.420 work is very valuable for your health, right? We can quantify why it is that exercise helps you live

00:36:20.420 longer. Why is it good for the brain? Why is it good for the heart? Why is it good for the immune

00:36:25.400 system? And therefore VO2 max becomes a very reproducible way to document that work. And it can't

00:36:33.740 be changed quickly. So it's not a cheap biomarker like vitamin D where you can just take a bunch of

00:36:40.440 vitamin D supplements and immediately change your vitamin D level. So with all of that said,

00:36:46.520 when we get into the minutiae of exceptional human performance, VO2 max is not the best predictor.

00:36:54.140 So let's put swimming aside because it's so obvious there, but why would it not be the best predictor of

00:37:02.000 performance in something like cycling, for example, or running where the aerodynamic contribution

00:37:10.040 in the case of cycling is easier to mitigate still nowhere near as bad as swimming and where the

00:37:16.480 efficiency maybe isn't as important. So where do we see VO2 max not become the most important driver

00:37:24.120 of endurance performance? So first of all, I would not agree more with you on that VO2 max is

00:37:32.840 probably or still today the holy grail for understanding basically longevity or let's say

00:37:41.540 the best marker or metric we have in order to quantify it. Because to just elaborate a little

00:37:47.320 bit further on that, you can also say that, well, VO2 max is a measure of something. So we are measuring

00:37:51.900 something in the end there. And to be a little bit crude, you could say that, okay, fine. Some people

00:37:58.680 could say, well, having a good heart is a good predictor of longevity, for example. But I'm pretty

00:38:04.460 sure we can find people that are in the bed and they are really sick that still have a really good

00:38:10.640 heart. You understand that, well, there has to be more nuances to this than just the heart itself.

00:38:15.600 You can have people that has a great heart, everything looks good, lungs perfect, everything like this,

00:38:20.780 but they have neurological diseases, for example. All of these will limit you from reaching a high

00:38:29.160 VO2 max, which is again, so integral. It basically just encompasses all this kind of thing because you

00:38:34.560 can't reach a high VO2 max if any of these functions here are not good. I couldn't agree more with you.

00:38:42.040 VO2 max is the absolute best predictor of mostly everything just because that it encompasses all these

00:38:49.320 things. Then on to why doesn't VO2 max become a very good predictor of performance in cycling? I would

00:38:55.980 argue it does, but then we are also starting to reach some more limitations as well. You want to

00:39:01.700 have as a high VO2 max as possible, even as a cyclist. The only problem is that we are now facing some

00:39:08.880 other problems as well when you are an elite athlete, and that is something we call maximum sustainable

00:39:13.320 energy expenditure. So obviously, to turn around more calories per time, that obviously means also

00:39:20.560 that over time, you will use more calories as well. And this, in order now to support growth,

00:39:25.540 you obviously have to input more calories also. Because you're burning more, you need to bring

00:39:29.840 more in. Otherwise, you are starting to run into deficit, and you, worst case, end up with problems.

00:39:35.620 So feeding that, let's say, calorie consumption becomes crucial.

00:39:38.700 Further, the problem is that VO2 max is closely related. So if we wanted to have a surrogate

00:39:45.340 metric for VO2 max, we typically do make an athlete run all out for, let's say, a couple of minutes,

00:39:51.860 one to five minutes, let's say three minutes to make it simple. Or we can have cyclists do a three

00:39:57.200 minute or four, five minutes, but something short. Not too short, but absolutely not too long.

00:40:01.940 Yeah, like four minutes is a pretty good spot.

00:40:04.620 Exactly. Yes, exactly. This is, again, a very good proxy to understand, or as a surrogate,

00:40:10.060 to understand, of course, what is your VO2 max as well. But then what we have to understand as well,

00:40:15.220 that this is not necessarily what you need in Tour de France. You don't need to be the best four-minute

00:40:20.040 athlete. This is more important for a track cyclist. A track cyclist that has the working time for four

00:40:24.820 hours, for four minutes, then VO2 max becomes maybe the best predictor of performance again. So it's a

00:40:30.360 little bit depending on context. But because we already said now there's another limitation here

00:40:34.860 as well, and that is the maximum sustainable energy expenditure. How much energy can you expend on

00:40:40.300 different, let's say, intensities in order to increase, let's say, the speciality of what you're

00:40:45.340 going to be good at? So if you are going to be best in the world riding 160 kilometers and then

00:40:51.120 sprinting towards the finish line over a couple of hundred meters, you can even not argue that it's a

00:40:56.340 sprint even. But let's say you are really going fast the last kilometers. The problem with this

00:41:01.860 is that if you spend most of that energy that you have available now to increase your VO2 max,

00:41:07.660 you're spending obviously less time on specializing what you're really going to be good at. And you

00:41:12.800 won't find a track cyclist that you can put into Tour de France and think that he will win Tour de

00:41:17.340 France. And you won't find a Tour de France rider that you can put on a track and become the one

00:41:21.320 kilometer winner there. Obviously, because they are specializing on two different durations. So

00:41:26.940 simply because we have a limitation for how much energy that we can turn around per day, per week,

00:41:33.860 and so on, sustainably, because that's the key here, sustainably, it basically means also that we

00:41:39.180 have to focus more on that exactly specificity that we're looking to excel in. And then, yes,

00:41:45.140 VO2 max will still be the best predictor, but not necessarily having the highest number.

00:41:50.360 That is the nuance to it.

00:41:53.420 Yeah. And let's stay with cycling and even keep it simple and just talk about not include the track,

00:42:00.820 which is far closer to an anaerobic effort. It's sort of on the anaerobic side of a peak aerobic

00:42:07.820 effort. But even if you think about, let's go back to the distance of the 112 mile time trial

00:42:14.920 that a triathlete is doing in an Ironman. So for the most part, I mean,

00:42:19.920 there's no sprinting in there. He's not sprinting at the very end. In fact, he's probably trying to

00:42:25.720 keep that relatively constant in effort to prepare himself or herself to do the marathon run that's

00:42:32.380 following. Even in that system, let's go back and talk about two athletes. If there are two athletes

00:42:38.040 that have the same VO2 max, does power at VO2 max give you another layer of insight? Let's just say

00:42:47.220 Christian and Gustav each have a VO2 max of 80 milliliters per minute per kilogram. But one of

00:42:55.740 them is doing that at 450 watts and one of them is doing it at 425 watts. Does that give you a new

00:43:05.420 piece of information or is it still limited because that's really only speaking to a four minute,

00:43:10.560 five minute effort? Yes and no. That is of course where you can black box, of course, a little bit.

00:43:16.900 Now we just talked purely about VO2 max, my focus on that. But of course, there will be a fairly good

00:43:21.480 correlation also between oxygen consumption, let's say, at VO2 max because you could argue that

00:43:28.020 there's really no power at VO2 max as long as you are above what we call VO2 steady state. So you have

00:43:34.780 a couple of different steady state scenarios. You have typically one that a lot of people knows about

00:43:39.260 which is the maximum like the steady state. But then of course, above there again, you have something

00:43:43.480 called VO2 steady state. And at the moment you start to exceed over VO2 steady state, then basically it's

00:43:48.920 just a matter of duration before you will basically elicit VO2 max. But obviously, the closer you stay

00:43:54.580 to your VO2 steady state, the lower the power you will basically outputting. If you put out a too high

00:43:59.920 power, obviously you won't be able to reach VO2 max because you will not be able to contract your muscles

00:44:04.240 efficiently anymore and you won't be able to bring your ventilation or oxygen consumption up to a max.

00:44:09.620 But there's a sweet spot there, more or less, where basically any power that sits between, let's say,

00:44:14.740 VO2 steady state and a higher power number will elicit VO2 max. It's just the amount of duration that is needed

00:44:22.000 in order to get there. So of course, this adds uncertainty because you need to know this. You need to know this.

00:44:28.020 I think it's important just so the listener understands that you can't necessarily just go out and people start

00:44:32.860 talking about power at VO2 max and their VO2 max because then suddenly people will get confused because you have to know

00:44:38.740 also then what was the duration of it as well. How did you get there? And yeah, yeah, exactly.

00:44:45.080 Yep. Yep. Yeah. Yeah. Maybe let's take a quick aside because you and I are speaking about this with

00:44:49.340 such a degree of familiarity. I want to make sure the listener understands how you're measuring VO2 max

00:44:55.160 in the lab. This is a test that I believe every human being, athlete and non-athlete should have done

00:45:01.260 because everybody needs to know their number and everybody needs to know where they stack up against

00:45:07.060 people, their age and their sex. Because again, it is one of the most important, if not the most

00:45:13.200 important modifiable metric we have to speak to both the length and quality of life. So if I came

00:45:20.080 into your lab tomorrow to have my VO2 max measured, tell me what we would do. So the good thing now,

00:45:27.400 of course, is that also VO2 max is being, or let's say metabolic measurements are being democratized as

00:45:32.540 well. For example, we work very closely with a Canadian company called VO2 master that allows you

00:45:37.920 basically to put now a mask. So it's like the old age, basically, when you have these big computer

00:45:42.500 towers and everything. Today, we have iPhones and Androids that basically have computational power

00:45:47.640 that exceeds millions of times, even what the Apollo 11 expedition had.

00:45:52.100 Yeah. So the same thing is, of course, happening also to metabolic analyzers as well,

00:45:57.440 from basically being these huge towers that were basically exclusive to labs to basically where

00:46:01.600 it's now being democratized. And you basically have like this super portable analyzer just sitting on

00:46:06.120 your face, meshing your oxygen uptake. But to bring it to the lab setting, what happens there is that

00:46:11.820 you come into the laboratory setting. I don't work so much with relative values, but a lot of people

00:46:16.900 will do. So obviously, we've got to measure your weight. So we get your weight there.

00:46:20.560 You mentioned Christian, or let's say an elite athlete, you said 80 milliliters per minute per

00:46:25.760 kilogram. So we have normalized this to kilogram. That's why we need to measure your weight.

00:46:30.440 So what we do is that depending on what kind of modality that's important to you,

00:46:33.800 so let's say that it's running, for example, what you'll do is that you get on a treadmill.

00:46:38.520 And basically, there's a couple of different ways to do this. Whereas the method is pretty much the

00:46:44.820 same, but it can be a little bit of a different gear. Some people will use something that we call

00:46:49.440 mixing chamber system, and some people will use what we call the breath systems. But it would

00:46:54.200 basically involve basically you having either a mouthpiece in your mouth, where there sits a

00:46:59.140 turbine with a sample line from it. Basically, when you're exhaling in this mask there, or through

00:47:04.540 this mouthpiece, we are measuring the flow or how much air you are breathing in and out per time.

00:47:12.940 If it's a turbine, then basically we correlate it to how many RPMs this turbine is spinning. So now we know

00:47:17.700 whether you are breathing, for example, 50 liters or 100 liters, 150 liters per minute.

00:47:22.920 But then, of course, now we only measure your ventilation. We don't know anything about your

00:47:26.680 oxygen consumption yet. We only know something about your ventilation. So then what we also have

00:47:31.300 to do is we need a sample line that sticks in there as well, that basically collects now the

00:47:35.840 concentration of oxygen and carbon dioxide as well. So what we then do is that because we know that

00:47:43.400 the ambient oxygen condition and ambient CO2 conditions is basically, let's say, 20.9% oxygen

00:47:50.420 and then 0.05% CO2 more or less, roughly speaking. While you are now running and you're breathing,

00:47:59.040 you are obviously breathing in a certain amount of oxygen into your lungs, and then you're consuming

00:48:03.360 some of the air into your lungs, which contains basically 20.9% oxygen. When that comes into your lungs,

00:48:10.500 parts of that oxygen, far from all of it, actually only closer to 25% of the oxygen, you are actually

00:48:16.740 taking up in your lungs, and it's being now transported through your body, and you're exhaling

00:48:21.220 actually 75%, roughly speaking, 75% oxygen. You actually exhale out again now. Since we are

00:48:27.360 measuring now the oxygen concentration with this device, we can measure, we know now the delta

00:48:31.740 concentration that sits between what is the oxygen concentration when it goes in, how much is oxygen

00:48:36.560 concentration that goes out. Since we also measure the volume of air, we know we can now extrapolate

00:48:42.140 that and say, okay, this is the amount of oxygen you're actually extracting from there, and this

00:48:46.260 is how we know your oxygen consumption. So why is oxygen consumption important? Well, this comes back

00:48:52.120 to basically calamity. Calimetry actually is very often people think then immediately of nutrition and

00:48:58.400 foods and these kind of things, but it's actually just a unit. It's actually just a unit,

00:49:03.460 a scientific unit, actually, for knowing how much energy is needed to heat water from 14 to 15

00:49:09.840 degrees, for example, a certain amount of that, and then how much calories is needed. So we could

00:49:13.680 even use gasoline for this. But it basically comes back to the fire triangle. You need something to

00:49:18.860 combust, you need oxygen, and you need temperature. And basically, when we know, when you combust,

00:49:23.620 there's a field, now I'm getting really nerdy here, but there's a field, so there's a field in

00:49:27.380 biochemistry, which is called, or actually not only biochem, yeah, well, biochemistry,

00:49:31.540 about chemistry in general, which is called stoichiometry. So in stoichiometry, there we can

00:49:36.940 basically look at, so when we have, like you mentioned initially in the call as well, you talk

00:49:41.340 about hydrocarbons, for example, but let's say carbohydrate, carbon, hydrogen, and oxygen, and then

00:49:46.240 we know how many atoms there are of each of these in that molecule there. And then basically, when we

00:49:51.340 want to convert this into ATPs, for example, then we are breaking this down. So for example, if you look

00:49:56.300 at the glycolysis, we are taking, for example, glucose, which is C6H12O6, and we are breaking

00:50:01.980 that down into two pyruvids, or basically C3H5O3. But we've got two of them now. But in this process

00:50:10.240 of releasing ATPs there, at the same time, what happens is also we are releasing hydrogen ions.

00:50:15.220 And this is actually, when you feel a burning sensation in your muscles, this is actually,

00:50:18.860 it's not the lactate, it's actually this that you are feeling in your muscles. Lactate is actually

00:50:22.340 a superfuel. If the muscles get access to both lactate and glucose, it will actually use

00:50:27.780 lactate as a preferred source before even glucose. But then basically, because C3H5O3 basically lacks

00:50:35.820 one hydrogen molecule now, as long as you have an excess of this, then basically you are able to

00:50:40.040 bind back that hydrogen molecule in there, and you get C3H6O3, which is lactate molecule. We've got

00:50:46.220 two of them. So you split one glucose molecules effectively now down to two lactate molecules.

00:50:52.360 When you're looking now at the energy yield here, basically we know that when you burn,

00:50:56.560 when you convert from glucose to lactate, for example, there is a certain amount of

00:51:00.420 energy or joules that is released in this process. We can even say, okay, let's forget about even ATPs and

00:51:06.000 make it even a little bit simpler. What is the potential joules that sits in a glucose molecule?

00:51:11.260 And then when we split this glucose molecule, how many joules are we releasing in this process?

00:51:15.940 And basically, because it says C3, or basically C6H12O6, we know there are six oxygen molecules there.

00:51:23.520 And now we can actually calculate, or we can know actually from your oxygen consumption,

00:51:28.380 because that's O2 molecules going in, and then there comes out CO2 molecules,

00:51:32.500 or both O2 molecules, but also CO2 molecules. But what we can know now is that we can know exactly,

00:51:38.080 because we can use stoichiometry, and we can basically calculate how much joules has been

00:51:42.680 released in this process. And that ties back to VO2 max. The more oxygen you are capable of turning

00:51:47.860 around per time, the more calories, or let's say the more fats, proteins, carbohydrates, you are able

00:51:54.120 to break down and release energy that you can use for the propulsion in the process. And that's why

00:52:00.460 VO2 measurements is a holy grail metric. We can always talk about direct calimetry, but that's so,

00:52:06.480 let's say, call it intrusive into a process, and so little practical to do.

00:52:11.560 So indirect calimetry measured with VO2 max, or VO2 and VO2 max, is a superior method to understand

00:52:19.200 how much energy are you able to release in this process. And also then, just to come back a little

00:52:24.640 bit to your field as well, medicine. If you have a low VO2 max, it basically means also at the moment

00:52:30.680 you start to have stress in your lives, you have infections in your lives, anything like this,

00:52:34.480 you are utilizing a much higher percentage of that ability. Because to get healthy as well,

00:52:41.960 you need energy to get healthy as well, to do whatever, transporting blood around in your body

00:52:46.800 or whatever. So an athlete that has a huge VO2 max that becomes sick, there's a fractional change,

00:52:53.700 basically, or relatively small change of their capacity or reserve that is utilized now in this

00:53:00.080 process. So at the moment they release basically their training, or they reduce the training volume,

00:53:04.680 they get a huge excess of energy or ability to recover now. And if you're quick enough to do it,

00:53:11.740 you won't almost increase in infection at all, because the body gets so much energy excess to help

00:53:18.860 aid in the recovery process now, compared to a person which has a solo VO2 max that even walking up the

00:53:25.440 stairs. I think that's such a great point. And I don't think people fully appreciate what a

00:53:30.360 physiologic stress significant illness is. So I won't bore people with all of the details,

00:53:36.040 but if you go and do the chemistry on what it takes to raise the body's temperature from 98 Fahrenheit

00:53:41.820 to 103 Fahrenheit, that is an enormous energy cost. When we look at cardiac patients, when we look at

00:53:49.800 any patients in the ICU, and you look at the change in cardiac output that might be required to support

00:53:57.440 a systemic inflammatory response syndrome, it is profound. So I think this is absolutely spot on,

00:54:03.840 and it really comes down to just having more reserve. I want to ask you several questions. Let

00:54:08.700 me try to take them in order. First, you mentioned that you prefer to look at VO2 max in absolute terms.

00:54:15.440 So how much does Christian and Gustav weigh? Those guys probably weigh 75 kilos.

00:54:21.200 So the funny thing is that leading into the Olympics, one of the things we actually looked

00:54:24.500 even at is basically what happens, because we have tried to reduce the weight very conservatively by

00:54:29.920 global standards, even in sports, to reduce the weight, because we had already ingrained in our

00:54:35.880 heads from basically a past and other people saying that, well, you need to bring up your relative

00:54:40.060 VO2 max. And that is done very simply by reducing the weight. The interesting thing was we found

00:54:45.420 after we had done this a couple of times, and a little bit by accident, because we do so much

00:54:49.500 measurements, is that we saw actually that, well, the relative VO2 max didn't come up, and the absolute

00:54:54.520 VO2 max came down even more than the weight came down. So let's just make sure people understand exactly

00:55:00.220 what you said. It's very important. And we should use some numbers so people understand. So I'm making

00:55:05.080 this up, but if they weigh 80 kilograms, their maximal oxygen consumption is six liters, you take six

00:55:10.940 liters or 6,000 milliliters divided by 80, and you're going to get a big number. And you're saying,

00:55:16.420 well, gosh, I mean, the tried and true method here is we have to lower that body weight. Why don't we

00:55:21.820 take that body weight from 80 kilos to 75 kilos? And now 6,000 divided by 75 is a much bigger number.

00:55:29.020 All things equal, we're much better. The problem is it's not all things equal, because that 6,000

00:55:34.040 milliliters of oxygen might have come down to 5,500 milliliters per oxygen. And now that ratio

00:55:40.820 has actually gone down. Exactly. So both absolute have gone down and also relative have actually gone

00:55:46.500 down. It's a little bit, I think, shocking, because most people, we of course have a lot of theories of

00:55:54.820 why. One, why this is happening, but also why do people still cling to the idea of reducing? So you

00:56:03.000 come up to a certain level. Let's say that you had hundreds of athletes through your program,

00:56:07.540 suddenly comes this really good, like this guy that just responds, a girl that just responds to

00:56:11.920 your training. He goes to junior level, starts to win, senior level, starts to win, starts to go to

00:56:16.940 the championships and whatever. But now you're starting to really have to fight for the sports.

00:56:22.280 Okay, what do you do? Okay, my training program is perfect. That's something that's very easy to

00:56:27.940 sometimes think, or you're afraid of making changes to the program, because you don't necessarily

00:56:31.840 understand exactly why you got there. But we have got ingrained with that, okay, fine, let's reduce

00:56:36.620 the weight now, because that will be the next step now, because we are not able to make you

00:56:40.060 more powerful. So let's start now to reduce your weight. There are two things happening now.

00:56:44.880 One thing is, of course, the things we have observed, the view to max starts to come down,

00:56:48.440 absolute and relative value starts to come down.

00:56:51.180 Does that happen because you're unable to control where you're taking the weight off? So

00:56:56.620 for example, are you losing disproportionately lower body muscle mass, which is, I think,

00:57:03.840 disproportionately contributing to VO2 max relative to upper body?

00:57:07.980 No, unfortunately, it is more complicated than that, because it is without even losing muscle mass.

00:57:13.960 So it is related then to basal energy expenditure. If your total body mass is coming down,

00:57:19.800 your basal energy expenditure is coming down, that is probably altering fundamental metabolic

00:57:26.280 pathways at rest that must be translating to what's happening under stress.

00:57:31.220 Most probably, yes. This is, of course, something I haven't had enough time to dive into,

00:57:36.220 because on the one side, I'm looking more to drive performance. There are some findings that

00:57:40.340 we really want to understand better, but we have to say, okay, that's going to happen in the next life

00:57:45.660 or next period or whatever.

00:57:46.920 I mean, an interesting experiment to do here, sorry to interrupt, would be

00:57:50.480 to actually use doubly labeled water under the weight reduced setting compared to the previous

00:57:58.360 setting. Obviously, you could do indirect calorimetry during rest. You wouldn't be able

00:58:02.900 to get total energy expenditure, which is what you want, and see if that drop proportionately

00:58:08.860 corresponds to the drop you saw in VO2 max absolute.

00:58:12.980 Yeah. So this is also something, because you can think of it, and maybe this is just a

00:58:16.020 temporary phase. So maybe this is a temporary phase before you stabilize the weight, and then

00:58:19.960 at some point, it will start to come up again as well, but it doesn't either. So that's a little

00:58:24.260 bit of the thing here. Also, we can venture a little bit into double labeled water because we spent

00:58:28.240 a fortune on doing several double labeled water or blocks. And this, it's a nice method, but it also

00:58:35.480 has several pitfalls. So actually, what we have started to do much more of lately is exactly

00:58:41.460 doing resting metabolic rates. So again, having the portable metabolic analyzer

00:58:45.600 like the VO2 master, it allows us basically, we do measurements before dinner, we do it after

00:58:50.220 dinner just to look at the foods, for example. We do after training to see basically what happens

00:58:55.620 there. And we even see that it even sometimes dips below normal resting levels, for example,

00:59:01.660 even. We can only theorize on why that is happening. But the thing is that there's a couple of

00:59:06.380 mechanisms that we just need to control, and we need to become even better at it.

00:59:10.520 But back to a little bit to VO2 max and ESA. So why do I work on absolute values versus relative

00:59:15.340 values? One of the things that we do see is that, first of all, Christian and Gustav now,

00:59:20.120 they weigh 73, 74 for Gustav and 80 kilograms for Christian. And he's 175 tall. You would almost

00:59:30.420 say that, hey. He's stocky, right? 175 centimeters at 80 kilos. He looks like a muscular guy. He's not

00:59:36.620 a beanpole. Exactly. But you'll also see that he has a little bit of extra fat on his body compared

00:59:41.760 to what you would expect to have from an independent. But we can't look at it that way because I'm not

00:59:46.460 looking to build aesthetic machines. No, no, no. It's performance. Philosophy matters.

00:59:51.020 Exactly. Exactly. When you make things relative, because if you look at a power number,

00:59:55.580 so you can have two guys, for example, that has, let's say, five watts per kilogram. They are

01:00:00.280 producing five watts per kilogram over a certain distance. But one of the guys is just moving much

01:00:05.920 faster, everything equal. So aerodynamics would be equal, everything like that. But the problem is

01:00:10.340 only that the raw power from a bigger guy that has five watts per kilogram is much higher power,

01:00:16.580 which basically then with aerodynamics are the same. He will move much faster for this. And this goes

01:00:21.600 the same also with VO2 max as well. If you look at relative values, okay, there's nice,

01:00:25.460 to have an idea of what kind of level people are at. But if you just want to look now purely at

01:00:30.600 propulsion, then basically you have to look at it in absolute terms instead. Because most of the

01:00:34.780 racing that is being done today is not very hilly. There are very few sports that are very hilly.

01:00:40.080 And of course, if it starts to become very hilly, then of course, then you can start to say,

01:00:43.240 okay, fine. Now relative values will maybe give you a better predictor of the performance

01:00:48.040 necessarily than absolute values would give. Yeah. So that's the main reason.

01:00:51.680 That's very interesting. So again, a couple of things. One is, yeah, in cycling, especially in

01:00:56.700 the Tour de France, I've heard it stated. And the data for this are a bit confounded because

01:01:04.440 they were based on the two decades of cycling when EPO was widely used. Every single top cyclist was

01:01:13.000 using EPO. But that said, I think that still normalizes it and makes it clear. And basically,

01:01:18.400 you could look at predictions of who would win the Tour absent a strategic blunder or an accident.

01:01:25.500 And it was all predicated by functional threshold power in watts per kilo.

01:01:31.020 So if you could know how many watts a cyclist could hold for 60 minutes divided by their weight,

01:01:39.200 and you line those up in descending order, all things equal, that was going to be your

01:01:44.760 championship finish. And of course, it's never exactly equal because as I said,

01:01:48.780 you can make a strategic blunder, there can be an accident, lots of things can happen.

01:01:52.720 But I suppose that that doesn't surprise you given the vertical nature of the Tour de France. It is

01:01:58.120 mostly one in vertical distance, not horizontal distance.

01:02:02.460 Exactly. Just to add to that also, I think one problem there is a little bit when you talk about

01:02:07.060 60-minute power. So you take 60-minute power and you divide it by kilograms to make it relative.

01:02:11.740 I think that then you are starting to get a fairly robust metric for it. The problem very often is

01:02:16.340 that people use much shorter durations. Right. They use 8-minute power, 10-minute power,

01:02:21.100 and it's a very different bet. Yep. Yeah.

01:02:23.360 And then the problem, if you now extrapolate that, then you still call that functional threshold

01:02:27.020 power, for example, and you divide it by your weight. What you don't know when you're looking at it

01:02:31.840 this way is how much of energy comes from oxidative phosphorylation and how much comes from the

01:02:36.500 glycolysis, for example. And the shorter the duration is, and you're extrapolating that up to

01:02:40.840 a larger value. The more dangerous it is metabolically. Yeah. Let's actually make sure people

01:02:45.120 understand why. If you're doing this analysis based on five minutes, to your point, what if during that

01:02:51.440 five minutes, 80% of the energy was glycolytic, which is producing a lot of lactate? And we've just

01:02:57.520 described, and we're going to come back to lactate. Lactate's great. It's the hydrogen that comes

01:03:01.740 with it that's going to paralyze you. And so your 80% of that energy source, you will not be able to

01:03:07.880 do that for 90 minutes or 60 minutes. But if you push the test out to 60 minutes, you can't fake it,

01:03:13.780 basically. You will not be able to do an 80% glycolytic effort for 60 minutes.

01:03:19.200 Exactly. There, it becomes a really good predictor. But that's what I also like when people talk about,

01:03:23.620 okay, my 60-minute power, this is my 60-minute power. That's extremely precise way of describing

01:03:29.700 your capabilities. Because then at least you have a single point, or you have two points. You have a

01:03:34.200 power, and you have a duration that you're capable of holding in. And that gives you already a fairly

01:03:38.580 good idea of the level of the athlete. Of course, if you start to have two data points now, so of

01:03:43.160 course, now maybe they are, you asked him also, what's your five-minute power?

01:03:46.040 What's your 30-minute? Yeah, yeah, yeah.

01:03:47.740 Yeah, yeah, or five-minute power, for example. Because then you're already starting to get a slope as well.

01:03:52.000 So you can start to even understand a little bit what kind of characteristics that is behind

01:03:55.620 this athlete. So typically, a sprinter will have a higher ratio between the five-minute and 60-minute

01:04:00.420 power, while a TT specialist will typically have a lower ratio between the five-minute power and 60-minute

01:04:04.720 power. Obviously, back a little bit to the maximum sustainable energy expenditure and VO2 max, why

01:04:09.320 it's not necessarily a good predictor always of performance when you look at these long or these

01:04:13.580 endurance events, simply because specificity becomes so important there as well. But this is again,

01:04:20.020 yes, I agree. When you talk about 60-minute power, and you divide it by kilogram, and you're using

01:04:24.760 that to compare it across athletes in Tour de France, then it starts to become at least a pretty

01:04:29.620 good metric to understand, or at least if I'm going to bet my money, it's a safer bet where you

01:04:35.340 would go with the money looking at a higher number. Yeah.

01:04:38.560 Yeah. When you go back to, again, because the data are most available when you actually go now and

01:04:43.140 talk to cyclists like Lance Armstrong and Jan Ulrich and these guys, and they'll tell you. I mean,

01:04:47.920 again, I think today cyclists are very guarded of those data. But back in the heyday of oxygenated

01:04:54.740 performance enhancing drugs, these guys were able to put out six and a half watts per kilo for 60

01:05:01.540 minutes. I think today people believe that they're only able only they're able to do five and a half

01:05:08.460 watts per kilo for 60 minutes. So that's giving you a relative sense of the difference on and off these

01:05:14.940 agents. I want to come back to another thing you said twice. Now you've alluded to less technical,

01:05:21.540 more portable, indirect calorimetry devices than what I'm used to in the lab if I'm doing a VO2 max

01:05:30.280 test. Now I was under the impression, and I'd love to be corrected here, that these portable devices

01:05:37.120 are probably decent for measuring VO2, i.e. the consumption of oxygen, but their accuracy is

01:05:45.520 sorely lacking for measuring VCO2, the production of carbon dioxide. And therefore, it might be a good

01:05:53.360 tool for estimating VO2 max, but it's not a great tool for estimating total energy expenditure,

01:06:00.680 which is calculated by using VO2 and VCO2, and nor is it a great tool for measuring fat oxidation,

01:06:09.300 because there you must be able to look at a very accurate ratio of VCO2 and VO2. So are there devices

01:06:17.880 out there that we could be buying, that we could be testing ourselves on every month at home, that would

01:06:25.000 meet the criteria of being accurate enough in those domains?

01:06:29.240 Yes. So I think the accuracy of the devices are starting to become fairly good. We do very often back-to-back

01:06:36.240 testing between the devices. So of course, in a laboratory setting, we are using mixing chamber

01:06:40.040 system, which is, of course, is validated against many different methods.

01:06:43.960 Which system do you use in your lab?

01:06:46.140 So I am actually sticking still to an old system.

01:06:49.200 Parvo?

01:06:50.040 No, actually, no, not the Parvo. I'm actually using a Jager Oxycon Pro with a mixing chamber system.

01:06:55.520 But I also really like the AEI Moxus as well, simply because it has some superior technologies

01:07:03.820 in it compared to most of the other devices on the market. Most of the devices on the market,

01:07:08.920 we're not going to go into this, most of them are using galvanic fuel cells to measure oxygen and

01:07:14.300 then use infrared sensors to measure the CO2. But one of the things that, for example, the AEI

01:07:19.460 Moxus is doing is that it actually measures it using a zirconia cell instead. And zirconia cell is

01:07:24.540 actually one of the most sensitive cells that we have. For example, if you want to look at the

01:07:28.200 photosynthesis, for example, you can't use a galvanic fuel cell because it's not sensitive enough.

01:07:32.680 While a zirconia cell is sensitive enough. But nevertheless, the same technology now sits

01:07:38.560 in the portable devices. So it's still using, also the portable devices now are using galvanic

01:07:43.540 fuel cells. We, of course, I mentioned the view to master. One of the benefits we have had is that

01:07:49.040 we enter into a partnership with them to advance the technology. Several years back, I did a screening

01:07:55.120 on the market of all kinds of different metabolic or portable metabolic devices. What I am in need of

01:08:00.940 is that I need to find a compromise. It doesn't help me necessarily to find a device that is a

01:08:05.240 little bit more accurate than the view to master, for example, if the athlete doesn't want to use

01:08:08.960 it because it has a rucksack and it has a lot of procedures, it is a horrible user interface and all

01:08:14.340 this kind of thing. Then basically, I bought a super nice device. I'm able to get the athletes to

01:08:18.260 measure it one or twice a time, but that's not where the strength of data comes. The strength of

01:08:22.940 data comes exactly from what you say. You need to measure regularly all the time there,

01:08:26.960 and it has to be done in a way that the athlete doesn't feel it as intrusive or invasive into

01:08:31.740 their lives. Tell me a little bit about the VO2 master because I'm aware of some of the other

01:08:35.740 portable devices, but not this one. Obviously, the hallmark of this is you're going to be plugging

01:08:41.320 the nose. You've got a mask that creates a perfect seal and therefore very clearly at a minimum can

01:08:48.640 measure the airflow rate in and out, correct? Yeah. The thing is actually you don't need to plug your

01:08:54.760 nose. It actually uses a Hans Rudolf mask. Most labs you'll very often see at least are using

01:08:59.780 these blue masks, more or less. The cool thing is that what they did is that they actually designed

01:09:04.720 a device that sits, actually mounts on this Hans Rudolf mask that is around in the labs.

01:09:10.740 Then basically, what it does is the same as you do with a metabolic card that sits in the laboratories.

01:09:15.540 It has galvanic fuel cells because this is made by maybe there are five manufacturers of galvanic

01:09:20.360 fuel cells in the world. Basically, everybody purchases from more or less these five different

01:09:25.380 manufacturers. It's the same galvanic fuel cells that sits in the VO2 master. Then basically,

01:09:29.980 the main differences between this device is that they have removed the turbine and they're using

01:09:33.920 the same way of measuring flow that you do in Formula One and aerospace. They use differential

01:09:38.900 pressure instead to quantify the flow of what you're doing. Basically, this is a device that just sits

01:09:43.940 here. It's a headgear. There's no wires. There's no nothing. It basically connects to your phone,

01:09:47.880 watch, whatever that you have. Then basically, this is how you now collect your oxygen consumption.

01:09:52.580 I could go out for a bike ride. If I'm going to go and do VO2 max intervals and hill repeats,

01:09:57.940 my favorite workout is the four to five minute hill repeat. I could be wearing this thing and that's it.

01:10:05.420 I come home and it's going to say, if I did 10 sets, it's going to tell me peak oxygen consumption

01:10:11.500 per each set. You can even connect it to your garment computer and you go into your garment account and you

01:10:17.000 can see it there, all the views. You can see your breathing frequency, tidal volume. You can see

01:10:22.040 your fraction of expired O2, your VO2, all the values basically combined there in the same together

01:10:28.540 with your power, with your velocity, with your position, everything there, like in one place.

01:10:33.600 You don't need to look at one separate report for your VO2 numbers and then basically looking at

01:10:38.040 your garment numbers. They are overlaid.

01:10:39.740 So it's going to show me heart rate versus power versus VO2 at every moment in time.

01:10:46.260 Exactly.

01:10:46.800 And how accurately is it measuring VO2 relative to what you can do in the lab? And how about VCO2?

01:10:52.820 So VCO2 is, of course, that's a place where we have been very fortunate because we are a little

01:10:57.640 bit ahead of the curve there. So we have had their device that has CO2 now for this must be soon

01:11:03.780 two years, I think.

01:11:05.340 The VO2 master also does VCO2?

01:11:07.600 Yeah, in the prototype, this is probably going to be released to the market sometimes during

01:11:12.660 next year. Then basically the whole market will have access to it. So we also have the

01:11:17.080 CO2 capabilities as well. But yes, basically you can go out and how it compares with basically

01:11:23.220 a metabolic card. I think here there are two things to keep in mind. One is, of course,

01:11:27.600 that measure of VO2 is a measure of VO2. So obviously they should on one side be the same.

01:11:31.980 But one thing also, we know that between different devices, so the Oxycontro, for example,

01:11:36.640 we have the option to basically use it as a breath-to-breath device, or we can use it as

01:11:40.640 a mixing chamber device. If it uses a breath-to-breath device, then basically you're breathing

01:11:44.620 straight through the turbine. That's it. So there's minimal resistance.

01:11:48.740 Then, of course, on the other side, we can use the mixing chamber system. And then you

01:11:51.520 have a 2.7 meter long hose. If you want to know, I can come back why it's 2.7 meters

01:11:56.040 later on. But anyway, it's connected to a mixing chamber. And then basically what happens

01:12:00.060 here is the breathing resistance now goes up a little bit. And as we know also, breathing is

01:12:04.300 not free either. Your lungs, in order to breathe, they also need energy. They need

01:12:08.620 ATPs to contract or basically breathe. Simple as that. And basically, the more resistance

01:12:14.560 there is to the breathing, the higher the oxygen consumption obviously will be. So you will

01:12:18.840 actually see now for the exact same device, the exact same sensor, but just depending on

01:12:23.100 the method they're using, that there will be differences between the two machines. Simple

01:12:26.800 as that. Further, when you go out and you actually do biking, one thing that is important

01:12:31.440 to keep in mind there is that you are creating a very high headwind, most likely when you

01:12:35.880 are going fast. Of course, you can go in a hill or these kind of things and you bring

01:12:39.120 down the velocity to very low velocities, but you put out big power there. But what we

01:12:44.140 have to remember is that any system that is based on measuring flow, and you now have an

01:12:48.880 interference from basically flow reaching or hitting the turbine, hitting the VO2 master

01:12:54.540 or any metabolic device there, will most likely also start to influence a little bit

01:12:59.500 the numbers there. Because we have to remember also that we are not really measuring the flow,

01:13:04.560 and we are not really measuring total oxygen consumption. We are inferring it based on methods

01:13:10.860 that are basically saying that when we see that the turbine is rotating at this many RPMs per

01:13:16.720 minute, for example, then basically we know that that correlates to a certain thing. So there

01:13:22.840 will always be a little bit of uncertainty. And that's why, for example, when you're in a lab setting

01:13:26.260 where basically you have no headwind, you have very controlled conditions and all these kind of

01:13:29.500 things, the ability to get a higher accuracy will always be higher than it is out in the field.

01:13:35.060 But then we know that what you do in the laboratory is still quite far from what you do out in the

01:13:40.800 field because you're already starting to limit the way that you're moving, the cooling. Yes,

01:13:45.320 maybe you have a fan of this, but cooling will be different. There are a lot of things that already

01:13:48.920 are different there. So the question is always, do you want accuracy of what really you are looking at,

01:13:55.540 or do you are just looking at oxygen consumption and then you create an artificial setting,

01:14:00.920 which is not necessarily representable for what you're doing? So it is a little bit of a give

01:14:05.060 and take where basically, yes, you give a little bit in one place, you lose maybe a little bit of,

01:14:09.300 let's say, absolute accuracy from the device because you're introducing some more unknown variables

01:14:13.920 there. But at the same time, you're looking at it now in real life conditions where you want to see,

01:14:19.740 okay, what is it looking like here? And you get that accuracy in there,

01:14:23.460 but on a compromise of absolutely as a measurement.

01:14:27.040 And how much of a difference are you seeing in one of your athletes between what you're doing

01:14:32.220 gold standard on an ergometer in a lab versus if you put the mask on them and you make them go and

01:14:40.100 do four minute hill repeats where the velocity is not that high, but they're probably still going

01:14:44.540 18 to 20 miles an hour up a hill, pushing a massive gear to hit that VO2 max.

01:14:50.420 How much of a difference are you seeing in the VO2 and the VCO2?

01:14:55.640 Between the two devices. So between the lab and the portable, the VO2 master.

01:15:00.060 Typically when we do back-to-back testing there between the two devices, we would see

01:15:04.780 normally for Christian and Gustav, let's say difference of maybe 50 milliliters between the

01:15:12.120 two devices. That's it?

01:15:13.800 Yeah.

01:15:14.140 That's nothing.

01:15:15.760 Yeah, exactly.

01:15:16.300 I thought you were going to say 500 milliliters.

01:15:19.040 No, then we could just throw the device out the window. Then it has no value anymore.

01:15:23.300 No, no, that wouldn't be acceptable.

01:15:25.020 Okay, okay, okay. But 50 milliliters of oxygen, you guys are putting out probably,

01:15:30.220 you guys have an absolute of probably six liters.

01:15:32.720 Seven.

01:15:33.280 Seven liters. Oh my God. So understandably, it makes a difference at their level,

01:15:38.600 but for someone at my level and for most of the people listening here,

01:15:41.540 a 50 milliliter difference is nothing. It's less than nothing. This is so exciting to me because

01:15:48.120 I was under the impression that these devices were still so far away that they were not even worth

01:15:54.540 entertaining the use of.

01:15:56.480 No. One thing that, of course, you also start, which is a little bit interesting there,

01:16:00.980 obviously because we use mixing chamber system, that's where we come from. You'll ask the question

01:16:05.820 if you think it's interesting to your listeners, whether they want to understand why there are mixing

01:16:09.140 chamber systems and so on. But to spare them for that for now, basically what we do know is that

01:16:15.160 when you have a mixing chamber system, just because you have a little bit of the higher resistance in

01:16:20.120 a system like that, typically we see also a more stable breathing pattern just because they're

01:16:25.700 actually being reminded more about exactly how they're breathing because they feel a little bit

01:16:30.320 more of the resistance. What you do see is as a system gets less resistance, you naturally also

01:16:37.040 start to see a little bit of more variation going up and down and these kind of things.

01:16:41.540 Because even though, if you look at a power meter, people that are not used to ride with a power

01:16:46.220 meter, they're only used to use heart rate and you give them suddenly a power meter. The first time

01:16:50.200 they get a power meter, they don't understand anything because power goes all over the place

01:16:53.900 there because they are not used to focus on a power and it becomes almost like they're chasing a

01:16:58.320 number that they don't have. They don't have the coordination or the skills to basically keep it

01:17:03.220 or relax around that very stable power and how to basically read it. Breathing is even worse.

01:17:10.140 Breathing is even worse than power because now you're even one order further away from performance.

01:17:16.440 So velocity obviously is first principle, first order. That's where exactly the performance

01:17:20.920 happened. Power, you're one step further away. And this is of course a system that is very responsive

01:17:25.980 as well to what you do. You won't necessarily see if you suddenly get a spike, let's say you're riding

01:17:31.640 200 watts. If you went to 210 watts for a second and back down to 190 to 200 watts, your speed wouldn't

01:17:37.460 change at all. Your velocity would be the same more or less. But still you have the volatility there.

01:17:41.360 So if you now are using velocity as the gauge for whether a system is correct or not, you will always

01:17:45.820 say, hey, this cannot be correct. I went to 210 watts, it should be immediately giving me this. But again,

01:17:51.080 the sensitivity to velocity, how the velocity is measured, is not good enough necessarily to capture

01:17:56.280 the small changes that are happening intra-cyclic in the power production there, in between there.

01:18:01.400 It's being smoothed out because of inertia, measurement, weaknesses, and so on. This gets

01:18:07.120 even worse when you get to velocity because what we know is the body, exactly because of when we get

01:18:12.340 to ventilation. Yeah, ventilation, yeah. Good clarification because exactly we are meshing on

01:18:16.900 the exhaust even here. And between basically where we are doing work and basically when we are breathing

01:18:22.100 in and we are exhaling out again, there are so many compensating regulatory mechanisms in the body

01:18:26.980 that are compensating for the lack in one place and here back and forth all the time, more or less,

01:18:31.740 to make sure that we deliver energy as efficiently as possible to sustain that propulsion that we are

01:18:36.900 doing. And now when you are measuring VO2 here, you can have quite a bit of fluctuation in this and

01:18:42.820 there are, let's say, kinetics involved here. To give an example, if you are running at, let's say,

01:18:49.020 you're running 15 kilometers power and you have a certain oxygen consumption now at 15. So I'm just

01:18:53.760 making up a number. Let's say that you are, or to use power, you're riding at a constant power to

01:18:58.660 make a simple constant power of 300 watts. And you're consuming now four and a half liters of

01:19:05.260 oxygen. So you can still output those 300 watts there. But if you hold your breath now, what happens?

01:19:10.500 VO2 comes down, ventilation comes down, or tidal volume and breathing frequency comes down.

01:19:14.900 But you start to feel that something builds up in your body. You're still able to output

01:19:19.140 those 300 watts there. At the moment you start, at some point, you either are forced now to stop,

01:19:23.880 or you have to start breathing and you're forced to start breathing again.

01:19:27.120 And at the moment you start breathing again now, you have a huge depth in your body. And what will

01:19:30.820 happen is that basically you get a huge spike in ventilation, huge spike in VO2. But what you also

01:19:36.400 see is that when you break this down, is that obviously the big spike comes from both that you're

01:19:40.960 driving a much larger tide volume. Breathing frequency goes up a lot, but also your fraction

01:19:45.400 of expired O2. So the delta between how much of the oxygen you are consuming now, you are going

01:19:50.100 much deeper than the 25% we said initially. But then basically, because there are, things are not

01:19:56.020 reacting extremely quickly on the exhaust part here, you'll see basically that here is almost like a

01:20:01.260 regulator, like a PAD regulator that are trying to bring this back to that stable settings there.

01:20:06.520 And it happens, okay, yes, your breathing comes down again, but still maybe you have a high VO2 and

01:20:11.480 then suddenly VO2 undershoots a little bit because fraction of expired O2 comes up a little bit higher,

01:20:15.840 but then says, oh, this is not enough. This is too little oxygen, so I need to increase the extraction

01:20:19.820 a little bit again before it comes back again. And this just tells to basically that yes, 300 watts

01:20:24.900 there, but you can still have a lot of variations there. Just by the fact that you're sitting on the bike

01:20:29.500 and you're sipping that bottle there, you're holding your breath when you're sipping that bottle there,

01:20:32.940 that will already influence your breathing and your VO2 for the next half minute on there.

01:20:38.080 If you are swallowing, just the fact that if you start to have a lot of spit, for example,

01:20:41.980 in your mouth and you're swallowing there, you are building a miniature debt there now that you

01:20:46.000 have to pay for again afterwards there. What one has to be careful about there,

01:20:50.940 I don't like standardized and say, you can't drink, you can't swallow, you can't do it,

01:20:54.620 you have to be a machine because that's not who we are. We have to learn to look past the noise of

01:20:59.640 the data by collecting a lot of data and knowing exactly that we are not machines. Well, you could

01:21:05.100 maybe say that we are machines as well, but there are so many things happening in between here that

01:21:10.160 you can't necessarily, exactly like you also say, you can't want one ratio.

01:21:13.420 Well, we're much more complicated machines.

01:21:15.500 Yes.

01:21:15.920 You've alluded to F1 twice now, that happens to be my favorite sport. And as much as we can look at

01:21:21.780 those cars and say, they are the most remarkably engineered things with wheels that have ever been

01:21:30.420 produced. Everything from the engines that they build, these hybrid internal combustion engines

01:21:38.000 through the chassis and the aerodynamics. Again, most people are shocked to learn that the aerodynamics of

01:21:44.280 that car are such that it can drive upside down at a hundred KPH. All of those things are remarkable.

01:21:49.780 I still think we're far more complex. I mean, hands down, because every element of that car

01:21:55.360 can be modeled. There is an equation that explains every piece of it. Whereas there is no equation to

01:22:02.740 explain what you just described. And by the way, there's an element of chaos in that system.

01:22:08.520 One thing that I'll suggest listeners try if they have power meters, it's just a great example of what

01:22:14.120 you said. So if you have a heart rate monitor and a power meter, next time you're on your bike,

01:22:18.540 make a deliberate effort to change your ventilatory rate. Vent a lot and vent a little and watch what

01:22:26.920 the heart rate does, even as you hold the power constant. And of course, this is because that CO2 is

01:22:33.300 very soluble and CO2 is tracked by the brain very closely as a proxy for pH. And the body is very

01:22:44.020 particular about keeping the pH at 7.4. As you slow down your ventilation rate and hold your breath

01:22:50.740 and your carbon dioxide levels rise and your pH falls, you will see that heart rate start to spike

01:22:58.020 with no additional input in power output. And of course the reverse is true. It's just a great example

01:23:03.800 of what you said, but it's one where you can sort of be the guinea pig and watch it. I still to this day

01:23:08.900 get a kick out of playing that game to see how much I can move my heart rate just by interfering

01:23:14.240 with my ventilatory rate. But I can say that I think that that's also why some people become

01:23:20.860 better also and others not. Because I think that one thing that we very often tend to lose as we get

01:23:26.740 older or we go through, for example, different training is that we lose that ability to play.

01:23:32.220 And exactly going out and playing is one of the best ways to learn actually what influences and

01:23:38.380 increase our awareness of that. Because one of the things is that I've learned also with elites is

01:23:43.660 that elites are not necessarily perfectly calibrated either. They need to actually be calibrated because

01:23:49.940 you have some athletes that typically, if you ask them to go out and do call it a threshold workout,

01:23:54.420 or let's say a workout that has, let's say intervals, a combined duration of intervals that are

01:23:59.220 between 60 to 80 minutes and that should be fairly close to all out, or let's say to bring it to

01:24:03.820 exhaustion on the last interval. You'll see that some athletes, elite athletes, they are ending up

01:24:09.720 going out too hard and they end up dropping the power towards the end. Some athletes, they go out a

01:24:15.320 little bit too light and they have to go really hard towards the end to bring it up there. But both

01:24:20.500 scenarios, if you were able to keep it at a very calibrated or accurate level there, you would see that

01:24:26.640 the total amount of kilojoules you were able to accumulate on those 80 minutes or 60 or 80 minutes

01:24:31.560 or whatever the length there would be, would be higher than if you ended up going progressive or

01:24:36.040 worst case, you end up ending up going regressive because you go too hard in the beginning and

01:24:40.620 forced to come down towards the end there. What standard do you use, by the way? So let's use

01:24:44.960 that as a quick example. So again, I said I'll use myself because I'm trying to get as much free

01:24:49.440 coaching as I can here. So if I love doing my VO2 max sets on a bike, on a hill, I have a fixed

01:24:56.200 distance that I ride. So it really depends on the wind. So if I have a headwind, it'll take about

01:25:00.820 five minutes. And if I have a tailwind, it could take 345. That's how much the wind can play a role

01:25:06.840 on this hill. But basically it's not an all out effort because you want to be able to do it multiple

01:25:13.080 times. But it's a very hard effort followed by about a one-to-one ratio of recovery. And that's

01:25:20.100 the workout. After a warmup, it's over and over and over and over again. It's like an hour of doing

01:25:25.320 that. Now, I typically, and I think this is because I've become softer in my old age, I typically ascend

01:25:35.300 in power. So I will typically start out at a very conservative power where at the very end,

01:25:43.100 I am not dead. But by the end, by the last one, I might be doing 10% more power than on the first

01:25:52.760 set. And I'm absolutely at my limit. How would you recommend I change that? You want that to be

01:26:00.220 within 5% the whole way through? Or how would you recommend that? If again, the goal is maximizing

01:26:07.480 that workout to maximize VO2 max and to increase the engine size? Maybe we should add one more

01:26:13.180 dimension to this now, because I think that very often we confuse, for example, also when we talk

01:26:17.980 about FTP, just FTP, and we black box a metric as FTP instead of saying 60 minute power or 20 minute

01:26:24.360 power, whatever. What's really accurate with the 20, when you say 20 minute power, 60 minute power,

01:26:28.500 you basically know that, okay, you can hold that power for that duration. That's the maximum,

01:26:32.260 for example, before you basically end up dropping too much and you just call it David. Very often

01:26:37.080 when we talk about VO2 max, it's very often confused with aerobic capacity, while in reality, it's not.

01:26:42.100 It's aerobic power. You're measuring how much oxygen for undefined time. Yes, we have normalized it as

01:26:48.540 milliliters per minute, but you can have a big range between athletes that has the same VO2 max. Some can do

01:26:53.320 that for several minutes. Some can only do that for, let's say, one minute, for example.

01:26:57.100 And this is where the important is, because we're looking for to provide signal, signaling and or

01:27:02.120 stimulus to the body. If you go out and you do one five minute interval, more or less,

01:27:07.460 then basically, okay, fine. That's the stimulus that you're providing yourself there. So this is

01:27:11.340 about how, okay, you've got a certain amount of time available to go out and do that VO2 max session

01:27:16.380 today, for example. Let's say there's 90 minutes. Then basically, of course, now this is one dimensional

01:27:21.320 because we're not talking only about a single workout as well. I think the most undervalued

01:27:27.160 thing, which is not very sexy to talk about, and also the most undervalued thing is that basically

01:27:32.180 it's consistency. Consistency in the training over time. And that means that you need to leave a little

01:27:38.140 bit in reserve there. And we haven't even touched on the topic of psychology yet either, because we are

01:27:42.860 very much not talking about the things in physiology that we are good at measuring and these kinds of

01:27:46.780 things, but there are also plenty of things that we are not able to measure. And even the things that

01:27:51.020 we like to say that we, oh, we are so good in stoichiometry or are so good in understanding

01:27:55.000 metabolic pathways or signaling pathways, there are still things added to this where we basically

01:27:59.340 understand that no, we don't. And then we haven't even dived into the topic of microbiome. It's a world,

01:28:05.560 undiscovered world that we are basically taking on now. So one of the things that is that when you're

01:28:10.800 doing this exercise, but a good thing with VO2 is that, of course, that we're measuring a quantity.

01:28:14.980 We're measuring a volume of something. It's much in the same way when we talk about power versus

01:28:18.860 work. So you talk about work, for example, to make this a little bit more practical. So when you say,

01:28:23.580 okay, I want to basically do my VO2 max workouts and go a little bit progressive, I would normally

01:28:27.640 say that's a good thing to do. Because also what happens is there is a priming effect also happening

01:28:32.800 in the body as well. So if you go out like where you think that you maybe would be able to sustain

01:28:36.960 throughout the workout, you might figure out that you still are able to go a little bit higher.

01:28:40.900 At some point, it's the opposite. One thing that we have done multiple times over the last half

01:28:46.140 decade is that very often people think that, okay, when I've done a VO2 max effort, then basically

01:28:50.800 I'm done. I won't be able to repeat that. I need two days of rest or maybe a week of rest or whatever

01:28:55.580 before I can do that. That's not true either. We know that, for example, if you do a VO2 max effort,

01:29:01.300 and then basically you give an adequate time of rest in between, you are able to go even harder on the

01:29:06.020 next one now, even though that was completely to exhaustion on the first one.

01:29:11.700 Say more about that. So put some time and numbers to it so I can understand what you're saying. So

01:29:16.400 you could take one of your athletes and what duration of an interval would you have them push to?

01:29:22.760 So for example, here, let's say that we are using an old-fashioned way of quantifying VO2 max. You

01:29:27.420 say that you do a graded exercise test. So you increase the power by 5%, for example, every minute that

01:29:33.480 goes there until you basically come to exhaustion. Let's say that now that it finishes around 500

01:29:39.420 watts and around seven liters of oxygen. For the listener, those are world-class numbers that are

01:29:45.400 obscene. You're not running into people on the street that can do that, but carry on.

01:29:49.320 Yeah. And here already, I haven't told what's happening before there as well, because if I only

01:29:54.160 took them fresh during this, then the power number would be different. So again, this comes back a

01:29:58.080 little bit to talking about power at VO2 max, where this is already manipulated depending on what

01:30:03.180 you've done before this as well. So now basically they do this. So let's say that they last for six

01:30:08.440 minutes and then finish the last one on, let's say, 500 watts, 500, last minute on 500 watts. Maybe

01:30:13.340 they go a couple of seconds longer into the next one. And this is also important. So when you do a

01:30:18.140 graded exercise test, if you come to the next step now and you feel that, oh, this is too hard,

01:30:22.600 push as long as you can, because every second counter, because it's more work, it's more work,

01:30:27.900 it's more oxygen consumed. They're a strong stimulus, more or less. I wouldn't advise doing this very

01:30:32.820 often, but we can come back to that a little bit later because I'm not a big fan of doing very

01:30:36.620 often two exhaustion workouts that you should put them in very sparingly into your program.

01:30:41.540 And that ties back to consistency. But anyways, now given in between, let's say if we give 10 minutes

01:30:47.540 of rest in between and a little bit more rest in between there, then basically if you do now a new

01:30:51.860 VO2 max, the same athlete, we bring now to more than seven liters or 7.1, or maybe even a little bit

01:30:59.520 higher and power output is also now, for example, comes up now maybe one more minute at one higher

01:31:05.660 power output. So now we are already at maybe 525 watts for one minute as well.

01:31:11.380 You're saying that that's happening because they've been primed by the first set to be able

01:31:15.680 to do that with only 10 minutes of rest?

01:31:18.660 If it goes too long rest in between there, then basically you start to lose the effects.

01:31:23.000 If the duration or the rest in between there, then you are not able to draw the effect of that

01:31:27.060 anymore. That can be, I think you could probably extend it up to 15 or maybe 20 minutes. But when

01:31:32.620 you get past 20 minutes, I'm not so sure whether that would hold true anymore. So it needs to be

01:31:37.720 short. And this can also come back to because we know also that oxygen, when we think about

01:31:41.920 hemoglobin as well, the affinity for oxygen and CO2 to the hemoglobin is also affected by the

01:31:48.040 temperature of the blood or the body and the hemoglobin as well. So this is also improving

01:31:53.060 actually with a higher temperature than it is at a cola. So when you get 20 minutes, obviously

01:31:58.140 temperature of your body will also come further down, come longer down than it is at 10 minutes.

01:32:03.260 10 minutes, it will also come down, but maybe not as much. But the most interesting thing that

01:32:07.220 happens also now is that our R value is heavily skewed towards oxygen consumption and less carbon

01:32:15.260 dioxide production. Even when you do this, you would even say that this doesn't qualify for a

01:32:20.240 VO2 max set. So the VO2 numbers now are equally high or higher, but the carbon dioxide production

01:32:25.280 is actually now just maybe a little bit higher than one in RR value. And normally we would say that

01:32:31.140 if you just went by the papers or the old school books, you would say that, okay, in order for

01:32:35.560 to qualify a VO2 max set, you should, for example, one of the criteria is often they say that you need

01:32:40.360 to exceed an RR value of 1.1, for example, for it to be valid. Of course, what are you going to say?

01:32:46.120 The VO2 max value was higher. Are we not going to disqualify it? It was a higher oxygen

01:32:49.500 consumption than it was in the previous one. It's also equally more now. Let's explain this to

01:32:53.980 people. You and I already alluded to this very briefly, but we didn't make a big point of it. So

01:32:58.280 the RER is calculated instantaneously at any moment in time as the ratio of VCO2 to VO2. So

01:33:05.620 let's go back to, you're going to put one of your athletes on the bike and he starts riding really

01:33:11.480 slowly. In that moment, he's at a hundred watts. So he's not even breaking a sweat. What is his RER at

01:33:17.300 that moment? The thing is that this is actually a little bit funny because here it's very easy when

01:33:21.580 we look at the values, when you look at RER, we typically look at the ratio of concentration and

01:33:25.920 we already exclude a little bit of volume of oxygen and volume of CO2 that is there. And of course,

01:33:30.960 there is a requirement for a certain amount of energy to be turned around per time. That's why,

01:33:35.580 for example, if you look at lactate as a surrogate, again, if you go back all the way to stoichiometry and

01:33:41.080 we'd said, we already said C6, H12, O6, glucose broken down to lactate and this kind of thing,

01:33:46.300 we already know here how much CO2 that is being produced in this process there of certain ratios.

01:33:51.980 But since we also know the ratio between glucose and lactate as well, we can use that also surrogate

01:33:58.180 to have more or less the same confirmations as well, or the same indications as well. The

01:34:02.760 difference is only that VCO2 is a volumetric measurement, while lactate is a concentration metric

01:34:07.060 and concentration metrics are influenced by many other factors as well. So that's why lactate can

01:34:12.140 be a little bit more unpredictable, and it's not as a good indicator as VCO2 is. But coming back to

01:34:18.700 that, basically at 100, typically there, you won't see necessarily a very good ratio between VO2 and

01:34:23.720 VCO2. So RER value there can actually be quite high, because two things that are playing into account

01:34:28.380 there. Your resting metabolic rate already plays a much bigger factor or a relatively larger percent

01:34:34.020 of the total oxygen consumption and a carbon dioxide production now, as opposed to when you

01:34:39.580 start to go to a higher number. So the higher the number are, the smaller the percentage of the

01:34:44.320 resting. Because when we measure VO2 and VCO2, we measure actually the gross oxygen and gross CO2

01:34:50.800 production. We're not measuring only oxygen as a function of exercise, but actually of both exercise.

01:34:56.480 Yes, and basal resting. Okay, so now this, of course, is going to be heavily influenced by their diet and

01:35:01.400 the carbohydrate content of their diet. But I'm assuming your athletes are on a pretty high

01:35:05.360 carbohydrate diet. Oh, yeah. Yeah. So that means that their resting RER is probably 0.85 to 0.9.

01:35:14.680 Or higher. Okay. So that means that they get a nadir in their RER when energy expenditure gets high

01:35:24.420 enough that it starts to dwarf basal energy expenditure. And you're really achieving maximal

01:35:31.140 fat oxidation, which is probably occurring at, I don't know, about, at a wattage that probably

01:35:41.240 corresponds to 75 or 80% of their best one-hour power. I'm guessing that in and about that wattage,

01:35:49.000 they are at maximum fat oxidation and they probably are at minimum RER.

01:35:54.560 Actually, it's even higher for endurance athletes or especially triathletes or long course triathletes,

01:35:59.560 because this comes back also a little bit to, now we are getting a little bit deeper into it,

01:36:03.340 but this also comes back to why it's not necessarily VU2MAX a good predictor of performance,

01:36:07.760 especially the longer the events becomes. So for example, to let people in on a little bit of our,

01:36:13.100 let's call it a... Secret sauce.

01:36:14.840 Yeah. Not secret sauce, but secret. And that is that actually for Christian and Gustav to win the

01:36:20.320 world championships, so last year, basically we had a consequence of the specialization we did.

01:36:26.920 VU2MAX came down significantly. From them, basically racing in the Olympics,

01:36:32.440 clocking in, so using relative values, which is maybe a little bit more easier to relate to,

01:36:37.720 both Christian and Gustav would typically test in around, let's say, close to 90 milliliters per

01:36:42.460 minute per kilogram. But at Ironman, in order to set new records in Ironman, we had to bring it down

01:36:51.620 to actually below 80 milliliters per minute per kilogram.

01:36:56.880 And you did this purely because of energy demand and energy consumption?

01:37:02.260 Purely because you can't sustain, because think of it more like a curve.

01:37:06.240 You had to detune the engine, basically. You had to bring the fuel flow rate and oxygen flow rate in

01:37:12.980 the engine down to do Le Mans versus do a Formula One race.

01:37:17.940 Exactly. Because you can't now prioritize keeping doing those five-minute power surges

01:37:23.160 or microintervals anymore, because it's too far away from basically what you need in an Ironman.

01:37:28.700 And you need to build more, let's say, towards the higher energy demands or, let's say, higher

01:37:32.960 power outputs in an Ironman, the lower ones or the sustainable ones and so on, and maybe even

01:37:37.160 building a little bit longer as well. You basically don't have the time anymore. Basically,

01:37:41.420 that's not right. You have the time, but you actually are not able to consume enough energy

01:37:46.840 over weeks and months to sustain a program that allows you to both increase your V2MX at the same

01:37:53.880 time as you're building up that long-duration power output. Let's say the four-hour power as well

01:37:59.580 at the same time. I think what would be interesting for folks to understand is, so there's something

01:38:04.260 called the WIC equation, which tells us the relationship between energy consumed

01:38:11.180 and oxygen consumed and CO2 produced. I used to know it off by heart, but I think it's basically

01:38:16.740 energy expenditure is 3.75 times VO2 in liters per minute, plus 1.25 times VCO2 in liters per minute.

01:38:26.980 Does that sound right?

01:38:28.100 Actually, I would make it even simpler, because basically, we know that from one milliliter

01:38:32.080 of oxygen, basically, there's 20 joules. There are 20 joules of energy being there. And then we know

01:38:37.040 already, as you said, you already said that, well, the efficiency of the body is approximately 20%

01:38:42.200 propulsive and 80% are thermal. So you can actually do this far simpler in that sense that

01:38:47.060 you can just look at, okay, how many milliliters of oxygen you're consuming and multiply it actually

01:38:51.520 just by 20, roughly speaking.

01:38:53.600 At six liters per minute of VO2. And I guess the reason you can make that simplification is by the

01:39:01.500 time you're at six liters of VO2, you can assume what VCO2 is. You don't have to measure it.

01:39:07.380 The approximate, let me just do the math. So that's about, that's 30 calories per minute

01:39:15.060 of energy consumption. 1,800 calories per hour of energy consumption at six liters per minute.

01:39:26.260 And at that point, you now exceed the capacity of the human digestive system.

01:39:32.160 There is no means by which a human in any form can ingest 1,800 calories in an hour and actually

01:39:41.860 get those calories out of the gastrointestinal system, into the circulatory system, into the

01:39:48.360 muscles. So really at this level, it becomes an energetic problem as much as a problem of stroke

01:39:56.440 volume, heart rate, and capillary efficiencies. You can even say that you don't even care about

01:40:03.360 heart rate or stroke volume or cardiac output anyway, because that's what you even started with,

01:40:07.580 which also resonates so well with me. VO2 encompasses exactly that stroke volume because

01:40:13.300 cardiac output is just a function of VO2 in the end anyway, because what you really need,

01:40:19.660 the cardiac output is just to supply you with oxygen. Really it's the oxygen, which is the key

01:40:24.860 metric here. So again, yes, the energetic demand becomes so crazy that you just have to start to

01:40:30.760 prioritize and you just say that, okay, how important is it for you to be able to do like super high

01:40:35.660 five-minute watt surges in Ironman? Not important at all. Yeah, never. Exactly. So you can't spend time

01:40:41.340 on training it. If you could feed more energy, so if you somehow would be able to even feed more energy,

01:40:46.620 yes, then you can definitely uphold more of that. And that's, of course, what we did there. We looked

01:40:51.880 exactly at how can we stay in this perfect balance there, living at the edge where we can keep the

01:40:56.980 VO2 max as high as possible, or let's say the whole curve as high as possible, because that in the end

01:41:02.120 will give us a better ability to race than necessarily our competitors setting records.

01:41:08.420 Now, given these huge energetic differences, let's just make sure people understand the

01:41:13.220 distances we're talking about. At the Olympics in Paris next July or August, it's an Olympic

01:41:18.880 distance triathlon, so we won't need to go into the distances, but let's just tell people a world-class

01:41:24.100 athlete is doing that in what, an hour and 40 minutes or maybe even less at this point? Where are they?

01:41:29.480 140, 145 is basically where you need to be. And that's basically 51.5 kilometers,

01:41:35.460 1500 meters swimming, 40 kilometers biking, and then basically 10 kilometers running.

01:41:39.900 Conversely, if you look at Ironman distance at the other end of the spectrum,

01:41:43.720 we're 2.4 miles in the water, 112 on the bike, full marathon run. The world-class

01:41:50.200 guys are doing that in what, seven and a half hours, 740-ish?

01:41:55.780 Yeah, seven and a half. Christian went 721, one of the fastest.

01:42:00.400 Again, it's simply unfathomable to anybody who's done any of those things that they're going that

01:42:05.780 fast. But the energy demand, if you're trying to do something all out for an hour and 40,

01:42:13.360 that is a much easier fueling strategy than if you have to go at a sub-maximal effort for seven and a

01:42:20.860 half hours. So is it surprising to you that you can have one athlete who can be exceptional and

01:42:29.260 world-class at both? Because I have to be honest with you, it's a little counterintuitive to me

01:42:34.180 based on this discussion that you could be the best in the world at both of those.

01:42:38.980 Is there another sport where we would see such disparity? Like we wouldn't expect that the best

01:42:44.080 400-meter runner is also going to be the best 10K runner. And we wouldn't expect that the best 5K

01:42:51.200 runner would be the best marathoner.

01:42:53.360 This is where I think that we have hugely benefited from using science because it allowed us to break

01:42:59.740 down the arm and distance and understand where basically we could gain much more time than what

01:43:04.900 had been done before. Because what we have to think is that the training, let's say the method for

01:43:09.760 training, we can come back to it because you mentioned the five-minute intervals and how you

01:43:14.120 were executing this to basically do your view to max session. We can come back to that because

01:43:17.680 if you're thinking of it, we are organic creatures. So we respond to stress by normally getting stronger,

01:43:23.920 given that we are providing the conditions to allow it to grow stronger. So now basically when you are out

01:43:30.080 and you are doing your five-minute efforts, you have a finite amount of time that you can do this

01:43:35.660 exercise. So let's say you had 90 minutes. You can twist this around instead and say that in the same

01:43:40.040 way that you go out and you play a little bit with your breathing to see what you can do with your

01:43:44.200 heart rate at a certain power. Now you can just say that, okay, fine. I'm actually now looking to

01:43:48.560 provide the maximum amount of stimulus to increase my view to max. We already said that, for example,

01:43:54.520 five-minute power or three-minute power is a good proxy or surrogate to understand how high your view to max

01:43:59.980 is. Now think of it this way instead, that when you go out, you're looking actually to

01:44:04.340 accumulate the maximum amount of work that you can do at a certain output. That is actually a better

01:44:11.080 way of looking at how can I actually here provide the best possible stimulus for me now to grow my

01:44:17.460 engine, to grow my view to max. Sorry, just to be clear, you're saying you might go out and say for

01:44:22.940 an hour, what's the most number of kilojoules that I can expend as opposed to what's the highest VO2 max

01:44:32.240 I could sustain for that period of time? Are you basically saying we should just use kilojoules

01:44:35.920 or we could just use kilojoules as the metric?

01:44:39.140 Yeah, because you can think of it this way, that the further away we are from, because in the end,

01:44:43.240 you can say that, okay, velocity is the ultimate measurement of form. And the further away we move

01:44:47.660 from this, the more gray it becomes because there are more mechanisms compensating and that has an

01:44:52.620 influence on what is happening there. So we can think of it this way, that, okay, the reason why we want

01:44:56.980 to grow an engine is because we want to become faster on the one side. But then when you go out,

01:45:02.300 you are not measuring VO2 max. You're not measuring milliliters per minute or how much oxygen you're

01:45:07.200 consuming when you're doing your exercise now. But we know that the higher intensity you go,

01:45:13.100 the more oxygen you will consume per time. So then we are saying that now we are providing a stimulus

01:45:18.340 to the body to say that we need more oxygen. You need to respond to this and basically facilitate

01:45:23.340 this moving forward. Because this guy, he might be crazy enough to go out and do this session again

01:45:28.420 next week or something like this. So again, the theory of supercompensation, that's why normally

01:45:32.980 we would say that, okay, the reason why we get stronger is because we exercise or we provide a

01:45:36.820 controlled stress to the body that the body is able to respond to and grow from. So now when you're

01:45:42.860 out and exercising and you're doing this hill repeats there, now you can instead think of it this

01:45:47.200 way. Okay, so when I did my five minutes, my five minute efforts, let's say you accumulated,

01:45:51.800 how many repeats would you do during an hour? Or let's say how many repeats would you do during

01:45:55.600 the session? Six to 10. Six to 10. So then basically when you do six to 10, that means

01:46:00.400 basically then you are accumulating between 30 to 50 minutes of, let's say, that high intensity.

01:46:05.100 Of work, yes, that's right. Of work there. So of course you do more work, but you do that specific

01:46:09.460 work there with the idea of that this will give you a bigger engine. But ultimately, actually what

01:46:14.140 you're really looking for is to become faster. That's what you're really looking for. And that can be done

01:46:18.640 like we also mentioned initially as well. And in one sense, you can say you don't really care

01:46:22.220 either. If your VO2 max comes down, but you just come faster, okay, well, efficiency have increased,

01:46:26.600 but okay, that's most likely not going to be the race. The outcome of it, it will probably be a mix

01:46:30.480 between a lot of things there. But now you can think of it this way. And that is that when you go

01:46:35.340 out and you do, so let's say that you ride now at 400 watts and you accumulate 30 minutes at 400

01:46:41.680 watts. So let's say something like that.

01:46:43.420 Those days are over, by the way. That used to be the case. I wish I could still do 400 watts for

01:46:51.800 five minutes, but anyway.

01:46:53.700 Let's say 300 watts. It doesn't matter. It doesn't matter. 300 watts and this is close to exhaustion.

01:46:58.860 Close to exhaustion. You have a little bit of reserve so you can repeat this. Like you say,

01:47:02.000 you have enough even in reserve that you even are able to progress throughout the session a little

01:47:05.540 bit of this. So let's say that now you're accumulating in average at 310 watts, you accumulate 30

01:47:11.800 minutes, 30 minutes of work around there. Because if you go to 50 minutes, a normal consequence of

01:47:17.380 this would normally be that either now you have gotten fitter or you just had a lot more in reserve

01:47:22.180 when you do the 30 minutes and you really didn't bring yourself close to exhaustion at all. So then

01:47:26.040 the stimulus and then the stress on the body is also much less. Worst case, if you were capable of

01:47:31.840 doing now 50 minutes, accumulating 50 minutes at 300 watts or 310 watts, for example, two weeks ago,

01:47:39.200 if you now do it only for 30 minutes, that's already detraining of the ability to stay at

01:47:45.500 300 watts if you do too many of these sessions now moving forward. Unless you only use this one as a

01:47:50.680 way to just provide some adaptation or make yourself ready for something bigger to come forward.

01:47:56.640 But now you can look at it another way. So let's say again, 300 watts, 30 minutes, that's approximately

01:48:00.860 where you're sitting or 310 watts, 30 minutes, that's approximately where you're sitting, then you're

01:48:04.700 close to exhaustion. The time you have got available for this training that you had there now, maybe that

01:48:09.600 was 60 minutes or less. How long are these sessions lasting typically from basically when you start

01:48:14.260 until you stop the session in total? Not that much longer because the warm-up and the cool-down

01:48:19.100 is 20 minutes in total. So most of the set, I could be door-to-door from my house in 75 to 90 minutes

01:48:26.540 easily. Okay, but brilliant. So basically here we're talking about 75 to 90 minutes in total of a

01:48:32.060 training time available. It's very different. So just to be clear, when I used to train,

01:48:37.080 I exercise now, I don't train. When I used to train, my coach on the really big days would sometimes

01:48:43.660 want me to not begin the VO2 max set until I had done 2,000 kilojoules. So I would go out and do

01:48:53.620 a relatively easy, like a 200 watt, 2,000 kilojoule ride, and then finish with a very big main set

01:49:05.900 of hill repeats, short hill repeats. So six minute hill repeats. And so that was an enormous total

01:49:12.800 amount of energy expenditure, but most of it was actually at zone one to zone two, pure aerobic

01:49:21.260 efficiency, and then finishing with the VO2 max. Again, I don't remember what the rationale was

01:49:27.620 for where the, get those 2,000 kilojoules of work in before you go there. But those were much longer

01:49:33.580 days, obviously. Again, today, because I'm not training, for me personally, velocity doesn't

01:49:39.340 matter anymore, nor does power. Frankly, I'm only training for the conditioning of it. I'm basically

01:49:46.520 asking the question, how long can I keep my VO2 max high? One of the things I think about is,

01:49:54.880 at what age will my VO2 max in relative terms, mils per kilogram per minute, be smaller than my age

01:50:03.820 in numbers? It's an interesting question. Where do we make that crossover?

01:50:08.160 I think this is also something that we will probably have a completely new picture of also over the next

01:50:13.300 five to 10 years as well, just because a lot of measurement equipment that we have available

01:50:17.720 becomes more democratized. One thing I can also say is that from all the data, I collect so much

01:50:22.600 data on my athletes as well. And also many of the coaches I work with, they collect so much data on

01:50:27.240 the athletes. But the problem is that we even see that we can use the data to even make the athletes

01:50:31.840 faster. So we even haven't gone as fast as it is possible to do yet. But the time that is available

01:50:37.220 to basically analyze all these metrics and bring it back into our sound program is so time consuming

01:50:43.700 to do that you sometimes just have to skip this and you have to focus on the more important part

01:50:47.940 of it. So one of the things that we are doing is we have a company called Enthalpy and where we

01:50:53.020 basically are building AI, but of course, LLMs or natural language processing systems and numerical

01:50:58.840 models where we basically allow us to start to utilize even more of this data in order to provide even

01:51:05.460 more deeper individualization for athletes. But even when you go out and basically exercising and

01:51:10.560 you're looking at it, because we can break this even further down, because again, your ability to

01:51:14.820 put out 300 watts, for example, is also a function of force and circumferential velocity, or let's say

01:51:20.700 torque and cadence. Because it's very easy sometimes when you go out and you're thinking that, okay, now I'm

01:51:25.600 going to go max. What you feel is the torque. You don't feel the power in the same way. You feel really the

01:51:30.860 torque. But if you aim for something that really feels like super heavy, that's a big

01:51:35.340 torque, but it doesn't necessarily yield a very high power output at all. And power is basically

01:51:40.200 what drives the energy demand for the body. It's not the torque. Of course, it's not entirely. It's

01:51:44.620 a mix of a little bit of the two. But do you subscribe to the idea, again, using this example,

01:51:49.140 where if you shift more towards higher torque, lower velocity, you're putting more of the stress

01:51:54.900 on the musculature of the legs. If you switch more towards a higher velocity by velocity, I mean crank

01:52:00.280 velocity, lower torque, you're switching more of the demand in the direction of the cardiovascular

01:52:05.880 system. I mean, remember, people used to talk about this all the time between Lance and Jan,

01:52:10.320 right? One was pushing 95 to 100 RPM. The other was pushing 65 to 70 RPM. They're putting out the same

01:52:16.480 power, but two different strategies. Do you think about that distinction for the cyclist?

01:52:21.620 Well, yes, I do. And this is also something that's very easy to measure. So for example, if you're out and

01:52:26.500 you put on a view to master and you go for a certain power output and you drop, for example,

01:52:30.440 that cadence, so you bring up the torque. Yeah, you can basically make VO2 the metric

01:52:34.760 that helps you decide, and that should correspond most to fatigue. Well, actually, the interesting

01:52:39.940 thing is that what you're seeing now is that you might actually bring down the VO2 as a function of

01:52:45.080 that you're increasing the torque. So you get a little bit better ratio there. But what can happen

01:52:49.600 actually as a functional is that you also see that CO2 comes up a little bit more. So you actually

01:52:53.800 are shifting a little bit to substrate. That's right. Yes, exactly. And of course,

01:52:57.700 the mechanism behind this is probably also like, it's fairly easy to rationalize. And simply because

01:53:03.720 when you are starting to use a higher torque, you are activating a larger cross-sectional area of your

01:53:07.980 muscles. So you're also recruiting more type 2 fibers versus only type 1 fibers as well.

01:53:13.780 So you're becoming much more glycogen dependent as you make that recruitment.

01:53:18.520 It's not entirely black-white like that, but in general, yes. But also here,

01:53:23.100 you can say that because then we're thinking, okay, but we have heard about the expression slow

01:53:27.060 twitch and fast twitch fibers. And should more of that be activated when you start to pedal

01:53:30.980 faster? Well, yes, but you're not even approaching the limit of basically a slow twitch

01:53:36.300 fiber or type 1 fiber contractile velocity when you're at 90 or 100 or 110. It's more a pure

01:53:44.540 limitation of coordination or being able to coordinate your pedaling motion in order to have a better

01:53:50.480 balance between your gross power and your net power. And this is basically where people sometimes

01:53:56.960 they forget this, that what happens, you start to go at a higher cadence. If you now actually measure

01:54:02.280 your gross power and your net power, you start to see that, yes, the net power is the same, but the

01:54:07.920 gross power actually starts to go up when you're starting to bring up your cadence as well, which tells

01:54:13.480 why the VO2 now also starts to go up. The VO2 or the oxygen consumption doesn't care about your

01:54:19.240 propulsive power. It cares about how much power is required now. It's counting both the usable and

01:54:26.780 wasted energy. Exactly. So this is one thing that you see is if you go with a little bit lower cadence,

01:54:32.860 typically what happens is that you have a bed that is easier to coordinate your pedaling motion versus,

01:54:38.360 for example, when you start to go with a higher cadence. Let's say you do a graded exercise test.

01:54:43.160 If you aim for a low torque, the problem is there as the ergometer basically now starts to force you

01:54:48.260 to go to higher power, higher power, higher power, higher power, and you go with a low cadence. This

01:54:53.820 will basically start to increase the motor unit activations. You're recruiting more and more of

01:54:59.480 muscle fibers, and you won't be able to get up to an equally high power output simply because the

01:55:05.540 limitation that comes in now is that you have no more motor units, you have no more muscles to

01:55:10.040 recruit anymore, and you are forced to stop. The only way now to compensate for this is that you

01:55:15.500 have to bring up your cadence instead as a function because if there's no more muscles to recruit there,

01:55:21.200 well, then only thing you can do is start to work faster instead or bring you up the cadence faster.

01:55:26.080 So to bring it back again to your question a little bit about, okay, so you're looking to

01:55:30.200 conditioning or creating the ability to put out a big power there. Again, we know that there's a

01:55:36.200 very good correlation between power and VO2. Obviously, more work, more oxygen consumption,

01:55:41.160 simple as that. You can almost say it's a linear relationship. So if you increase your power by 10%,

01:55:46.180 you will no more increase your oxygen consumption by 10% as well. For those people that are really into

01:55:51.580 the pudding here, of course, they understand that this is not entirely the case. This is a curve

01:55:55.460 linear relationship, but for the simplicity, we keep it this way for now. And just to complete that,

01:56:00.400 you will not increase velocity by 10% in that situation because of the relationship,

01:56:06.340 the square relationship between velocity and drag. So just so folks understand,

01:56:10.020 while those two things are moving up in a curvilinear relationship, the velocity relationship

01:56:14.480 is actually a squared or a power relationship. And therefore, it gets harder and harder when you're

01:56:20.400 talking about athletes at the level that you're coaching to eke out an additional kilometer per

01:56:25.860 hour. When they're already going 48 kilometers per hour, it becomes seismic to try to add 5% to that.

01:56:35.920 Yeah, exactly. So then back to your question. Here, you can think of it this way. Since we know that

01:56:41.460 there is a fairly good correlation between or not a fairly good, it's an extreme good correlation between

01:56:47.020 power and oxygen consumption. Now you can think of it this way. Okay, so how can I then increase my

01:56:52.360 oxygen consumption? Because now we're not talking about milliliters per minute. Now we are talking

01:56:56.620 about milliliters accumulated. So in the same way we talk about power and the relationship between

01:57:02.240 power and work, we could talk about also the difference between milliliters per minute and

01:57:06.720 milliliters per, let's say, session, for example. So then we can think of it this way. Okay, so how do I

01:57:12.120 provide a stronger stimulus, let's say, to the cardiovascular system, respiratory system, to everything,

01:57:17.020 so to basically I get a higher view to max? Well, I would then say that you have already a power

01:57:22.400 meter. So you already have something that we know have an extremely close relationship with oxygen.

01:57:28.020 So how can we now increase the total oxygen consumption during that session there?

01:57:32.700 Then basically, I would probably argue that saying doing five minutes on, five minutes off,

01:57:37.500 for example, will not necessarily yield the maximum work that you can do at that. Because we're not

01:57:43.300 looking at total work during the session, because obviously that would be better if you brought

01:57:46.780 down the intensity in total. But now you're looking for the specific, you want to increase

01:57:51.180 the maximum oxygen output. So we're now looking at something that sits in this range there,

01:57:54.880 there's high intensity. So I would rather here look at it more like go out and play a little bit and

01:57:59.880 look a little bit, okay, what kind of intervals do I have to do here to pack as much as possible

01:58:05.260 kilojoules of work here? At that power outputs during that session that you got available.

01:58:11.820 And I'm pretty sure if you do this over a month, and you go back into the lab and you test your view

01:58:16.560 to max, you'll already see now that you have a higher view to max than what you did have before.

01:58:22.420 And just to give a sense of what some of those games could look like, again, I used to experiment with

01:58:27.300 every type of interval from 30 seconds on to 30 seconds off up to eight minutes on eight minutes

01:58:34.900 off. The only thing that was constant was the one to one work to rest ratio. But as I just alluded

01:58:41.380 to, right, the work to rest could be as little as 30 seconds, one minute, two minutes. Even less.

01:58:46.280 Yeah. Even less, yeah.

01:58:47.580 And so what is your intuition? Because again, the classic thinking, classic cycling physiology

01:58:54.180 is maximizing VO2 max and maximizing PVO2 max, powered VO2 max, critical power, for example,

01:59:03.540 is going to be attained at three to eight minute intervals. Now, it doesn't mean you don't improve

01:59:09.280 the engine size when you're doing intervals less than three minutes or more than eight minutes,

01:59:13.460 but you're most efficient in your training time at those intervals. Are you arguing? That's not

01:59:19.680 necessarily true. There could be gains outside of that if you're using maximum kilojoules per unit

01:59:27.100 time as your metric. Yeah. Accumulated inside a session. Think of it this way. We are looking

01:59:32.320 for a stimulus. So to again, make it or to be a little bit blunt, rude, you can think of it if you

01:59:37.600 do one minute. No, if you do five minute interval, and that's the only thing you do, the stimulus that

01:59:42.400 you are providing now at, let's say, PVO2 max or power at VO2 max, for example, or let's say you

01:59:48.260 had an oxygen mask and you could measure now your oxygen up, you will see that the total accumulated

01:59:52.500 oxygen that you have been using now during that session is very, very little. So the reason for

01:59:57.360 why you do intervals and you don't try to do, for example, if you try to do it even as intervals,

02:00:02.000 you even try to just combine those 30 minutes into one power output at all, you won't be able to put

02:00:07.480 out the same amount of power. If you just did it in one go, 30 minutes there, probably then you

02:00:12.540 would be forced to do maybe to bring it down to 280, 270. If it was 300, for example, what's when

02:00:18.480 you did it as five minute intervals, maybe even more down. Now we can think of it this way in the

02:00:23.580 same way. We can just bring it down. So why five minutes? Why did you land on five minutes? Could

02:00:27.420 it also be four, for example? Could it be three? Could it be two? Because what we're really looking at

02:00:31.900 here is the maximum. But we want to make sure we don't make the interval too small that we're

02:00:37.240 cheating and using pure glycolytic power, which obviously has its benefits, but won't necessarily

02:00:44.460 increase, presumably at some level, mitochondrial function and mitochondrial throughput. I mean,

02:00:50.780 because we're so focused on VO2 max here, we want to make sure we're increasing an energy system that

02:00:56.260 is flexible enough to oxidize both glucose and fatty acid through the mitochondria and therefore

02:01:04.160 with oxygen. So at some level, don't those interval durations get so short that we can be misled by

02:01:11.040 what we're seeing, assuming we don't have the oxygen mask. So if we have the oxygen mask, of course,

02:01:16.080 we'll notice that. But if we're only relying on power, that correlation between power and VO2,

02:01:22.920 that linear curve starts to separate in lower durations, doesn't it?

02:01:28.180 One thing to bring in here, so disclaimer, which is very important to think, I think that there's no

02:01:33.040 single workout that is the golden workout. We need different kinds of stimulus. When you do different

02:01:38.980 kind of intervals at VO2 max, they will elicit different functions in your body or different

02:01:44.820 benefits in your body. For example, if you do micro intervals, micro intervals, one of the things

02:01:49.800 that might be there is that you won't necessarily bring your core temperature as high up as you would

02:01:55.180 do if you do a long workout, for example. And we know that also, for example, one thing that's very

02:01:59.720 beneficial to our body is to have more plasma. More plasma is good for us. And we also know that

02:02:05.440 that also has an influence on VO2 max as well, for example. So bringing up the core temperature,

02:02:11.060 let's say also like working on fatigue or being able to focus on relaxing when you get more fatigue in

02:02:16.860 your body as you're doing longer intervals. There are many benefits of doing longer intervals as

02:02:21.200 well. But now we are purely looking at one thing here. So we just said, okay, fine, let's see how

02:02:25.580 can we bring the VO2 max the highest. We disregard everything else. We don't talk about necessarily

02:02:30.620 about endurance, fatigue resistance, all these kinds of things that we just neglect that for now.

02:02:36.380 So now you can think of it this way. What is it that causes us to bring up the oxygen? Why does it

02:02:43.180 come up? Here, I think it is useful to think of also what is the measurement method that we're using

02:02:48.580 as well, very often to quantify this. We have to remember that this oxygen apparatus, when we are

02:02:54.000 measuring oxygen consumption, we are not measuring what's happening inside the muscle. We are measuring

02:02:57.840 what comes out in the exhaust here. And then we are quantifying VO2 max as a function of that.

02:03:03.880 If we go into, so for example, if you do mitochondrial respirations, if you take the mitochondria,

02:03:08.560 you do a biopsy, you take out now the mitochondria, and you put it into chambers,

02:03:13.840 specific chambers there to measure now the mitochondrial respiration, we are not talking

02:03:18.260 about 90 milliliters per minute per kilogram anymore. Even for not well-trained athletes,

02:03:24.120 you're already at 200 milliliters per minute per kilogram. We know that for elites, you are more

02:03:28.660 than 300 to 500 milliliters per minute per kilogram if you go into what the mitochondria is capable

02:03:34.240 of using of oxygen there. Just to make sure we understand that, Olav, what you're saying is

02:03:40.140 we are never limited at the level of the mitochondria. I would say statistically speaking,

02:03:46.900 so if you're not talking about... I mean, not talking about people with mitochondrial disease,

02:03:50.100 but if you're talking about you and me and your athletes and most of the people listening to this,

02:03:55.360 when we ask the question, where is the rate limiting step in oxygen consumption or more to the

02:04:02.520 point oxygen utilization, it is not at the mitochondria. It's not that we are unable to

02:04:08.880 put more oxygen through the system at the final point where it is needed for combustion.

02:04:14.980 By the way, I've always thought it's at the level of stroke volume, that it's actually at

02:04:21.200 getting the plasma to the muscle. Is that what you believe? Getting the oxygen, getting the hemoglobin

02:04:27.960 transported to the cells is the most important thing, more or less. It's more of a central limitation

02:04:32.800 than a peripheral limitation we're talking about there. Because the peripheries, if you look at it,

02:04:37.200 for example, from a mitochondrial perspective, the ratio between what it can use is so extreme

02:04:42.600 compared to what we are able to pump around or take up in our lungs and pump around to the body

02:04:48.120 compared to what we can use. Without touching into that, that actually goes also from when we look

02:04:53.800 at it. For example, you mentioned that my athletes are using a lot of carbohydrates for fueling and so

02:04:59.780 on. We also know that basically the 60 to 90 grams per hour, that's not a limitation either. It's

02:05:06.600 much, much, much higher than that. How do we quantify this? We use isotope traces. So we add

02:05:12.680 isotope traces to the carbohydrate and then basically we similar concept as double label water. But here we

02:05:17.500 add it actually to the carbon instead to look at the carbohydrate uptake. So we know that that's also

02:05:21.920 much higher. This is a lot of research that we have done with Morton, specifically on Christian

02:05:26.920 and Gustav. And we know that, again, if you do muscle biopsies, then we see basically that the

02:05:31.420 carbohydrate is so much higher than what we are able to supply to our system. So again...

02:05:37.200 Sorry, meaning you're limited in what the gastrointestinal tract can tolerate,

02:05:41.760 not at the substrate utilization in the mitochondria.

02:05:46.300 Exactly. Now I'm going to be very crude there. Put it this way. What brings us to VO2 max? It's not

02:05:53.360 because we're thinking that we want to have a high VO2 max. Oh, now I want to. You can start to

02:05:57.180 breathe. Increase your ventilation now as high as you want. Yes, you will increase your oxygen...

02:06:01.880 Right, but you'll never get to your maximum level without sufficient work. You need work.

02:06:05.900 Exactly. Not even close to it. You will bring it up because you're breathing more and you're

02:06:09.720 working more when you're doing that. But then coming back to microintervals and whether this is

02:06:14.580 glycolytic or not, I think that if you go into the muscles and you measure in the muscles, you'll see

02:06:19.400 that basically what happens there is that basically the muscles are trying to use all, absolutely all,

02:06:25.800 basically energy systems immediately, instantly. But because we have a lot of buffer mechanisms in

02:06:32.360 our body, if the burst is short enough, then basically it won't show up as something here because

02:06:38.460 you are basically just feeding it to our body. And then basically you have a long taper or let's say

02:06:42.760 you will never get the spike in VO2, but you can see that you have an elevated VO2 consumption

02:06:47.720 over a little bit longer time. If you just measure during the interval, it won't show up on the

02:06:52.820 exhaust because you take off the mask before it basically shows up there. But if you keep the

02:06:56.760 mask on now and you keep it on there for, let's say, a couple of minutes after, you will see that

02:07:00.640 now that basically you have an elevated oxygen consumption compared to before you did that

02:07:04.700 interval there. So basically we can say that when you do a burst, it will use most likely all

02:07:10.620 energy systems instantaneously, all of them as much as possible. If you say that, okay, now it's

02:07:16.380 first we use stored ATPs and then we shift to PCR and then it becomes glycolytic. And then basically

02:07:21.420 we go off to beta oxidation. I think the more correct way to view this, basically the reason

02:07:25.740 why you can have a high power output, short and high power output is because you are able to supply

02:07:30.360 from all the energy systems instantaneously, but then you're depleting the different energies.

02:07:35.400 Yeah. And then all of a sudden the phospholated creatine comes down immediately and then the

02:07:39.460 glycolytic and then, yeah, yeah, yeah. That makes sense.

02:07:42.640 Yeah. So now basically coming back then to microintervals versus longer intervals,

02:07:46.520 as long as you start to accumulate enough work during that session, because we also talk about

02:07:52.060 VO2 and VCO2. VCO2 is really useful for, you get an instantaneous picture of, of course,

02:07:57.920 what kind of substrates are you using? And whether you are at an RIR value of, let's say,

02:08:02.160 0.8 or even, let's say, below 0.8, for example, but let's say that you are 0.8 or you're 0.9 or

02:08:08.040 you're 1 in RIR value. Basically, it doesn't make that much of a difference in your energy yield. So

02:08:14.080 one milliliter of oxygen, if you use 20 joules of energy, 20 joules as a number to basically

02:08:20.640 understand your energy demand there, you won't go very wrong whether you had been using. So if you put

02:08:25.940 this into the formula and you start to look, okay, how much big of a difference it is there,

02:08:29.960 is not a massive difference. Yes, there is a difference, but it's not massive. So if you

02:08:33.880 want to be accurate, obviously you want to do this. But if you want to understand more of a

02:08:37.460 fueling strategy perspective, then of course you need CO2 to better understand, okay, where are you?

02:08:42.060 How are you using fuels at different times? But here also, we have to remember now that when we

02:08:45.860 go into a lab and we test there as well, this is a completely different picture than what it would

02:08:50.500 be if you brought somebody into the lab at the moment they went over the finish line in a race,

02:08:54.240 because now you would basically see that the velocity that they hold there at the end or the power they

02:08:58.020 hold at the end there, even though maybe it's much lower, it's still very close to their VO2 max,

02:09:04.200 because basically they are not able. So the VO2 max, anything have come down, yeah. So there's a

02:09:08.800 missing time component into this very often when we look at research papers, when we talk about this,

02:09:13.540 because we talk about it very often as a spot picture of something that happened in a fresh state,

02:09:18.240 rested state or whatever, yeah, ideal state. Then coming back to the question and to round that up,

02:09:23.460 I think exactly that when you do microintervals and so on, we talk about glycolitting and so on,

02:09:28.920 basically you can use here also your heart rate as a gauge. If you start to see that when you do

02:09:33.180 microintervals and you're packing in, let's say that you did 310 watts and you were able to accumulate

02:09:38.240 30 minutes of that during that session there. If you now do microintervals, so let's say you're able

02:09:43.680 now to bring it to 330 watts, for example, and you do 30 minutes of that, maybe you're able to do 330

02:09:49.320 watts average and you even accumulated now, for example, 35 minutes of that. What you'll see

02:09:55.340 there, because now it starts to become quite a lot of them there, is that most likely you'll see that

02:09:59.520 you also have a very high heart rate and maybe equally high heart rate as you did when you did

02:10:03.980 the five minute intervals, unless you look at accumulated heart rate there. Because you can

02:10:08.620 here also use heart rates as an indicator of how much time you have accumulated close to VO2 max.

02:10:14.660 Because we know that one of the conditions that has to be met also for you to reach VO2 max

02:10:19.100 is that you also are thinking then you need to pump as a maximum amount of oxygen around in your

02:10:23.480 body in order to do that. And we do know that that is a combination of a very, very high heart

02:10:28.980 rate, close to maximum heart rate and stroke volume as well. So it's just occurred to me that I've got

02:10:36.320 eight pages of notes here of things I want to talk about with you. And we are halfway through the

02:10:42.460 first page. So clearly this is part one of many podcasts we're going to have to do together.

02:10:48.640 Hopefully the next one will be in person. There are, however, a few things I want to discuss

02:10:53.320 before we part today. We have yet to do kind of a more thorough discussion around lactate. And if I

02:11:00.280 can only discuss one more thing with you for maybe another 15 to 30 minutes before we go, I'd like to do

02:11:07.520 a little bit of a deep dive into lactate. Now for some background, since I kind of abandoned any

02:11:14.320 athletic goals and the only thing I train for now is my health, right? It's for my longevity. It's for

02:11:22.060 something I call the centenarian decathlon. So being as fit and strong as I can be in my eighties and

02:11:28.520 nineties without necessarily worrying about what I'm doing today in terms of trying to maximize my

02:11:35.040 performance today, I'm trying to maximize my performance tomorrow. A very important part of my

02:11:39.600 training because my training volume is now so much lower than it used to be when I lived on a bike

02:11:46.420 or lived in the water. I'm trying to be maximally efficient, which is always risky because sometimes

02:11:52.440 you just have to put the miles in. But what I do spend is about three hours a week in zone two. And

02:11:59.900 again, there's so many different ways to describe zones. So I'm not doing this in terms of heart rate.

02:12:03.960 I'm really defining this in terms of mitochondria. So zone two is my highest power output where my

02:12:11.060 lactate stays below two millimole. So this is very sustainable from an RPE perspective. It's RPE six

02:12:21.220 to seven. I can talk, but I'm not comfortable talking, but I can talk. It's definitely below my

02:12:28.180 one hour functional threshold power, but it's more challenging than that 200 Watts riding around in

02:12:35.340 circles, having fun, trying to just purely focus on position. And I do use my lactate. I do check my

02:12:44.060 lactate constantly to make sure that I'm really hitting that spot. Now, what's the rationale for

02:12:51.080 that? Well, the rationale for that is that two millimole is about the tipping point about which you can be in a

02:12:57.580 steady state of producing lactate, clearing lactate. And once lactate starts to get into the three and

02:13:02.960 four millimole range, you wouldn't have indefinite access to that energy system. You're going to start

02:13:08.820 accumulating so much hydrogen that at some point your physics of performance are going to be compromised.

02:13:15.240 So let's now talk about this in terms of world-class athletes. So if you had a continuous lactate

02:13:21.120 sensor on an Ironman in his seven hours and 30 minutes, give me a sense of what his lactate tracing

02:13:29.140 looks like. So this is where I differentiate between volumetric measurements and concentration

02:13:36.560 metrics. Lactate is a concentration metrics. We don't measure the volume of lactate. And the plasma

02:13:42.140 volume is decreasing as the athlete is running. So you would expect the lactate concentration to go

02:13:49.180 up slightly even if the production of lactate is constant. Yeah. Also further here is that we have

02:13:57.720 made some discoveries over the last years as well, which is when we start to do Ironman training,

02:14:05.040 for example, which also are very different from a lot of the understanding that currently is there.

02:14:13.880 There are some things there that are changing and we will definitely touch on this in, let's say,

02:14:19.880 an upcoming podcast. But to give you the trace now, first of all, I think that two millimoles,

02:14:26.100 when you have little time to train during a week. For me, if, for example, you came to me and say,

02:14:31.420 hey, Olaf, I need some training advice. For me, longevity, that's the most important for you or

02:14:36.580 wellness. But we can always say that, well, in the end, it's about whether you have a high view to max

02:14:41.200 really doesn't matter if you're not capable of moving very efficiently around just because you're

02:14:45.620 wasting energy. So we can say that universally, maybe more universally, it's about being able to

02:14:51.080 move more per time. Like we said in the beginning, even moving your head is movement. It's just better

02:14:56.540 if we break it down to a global movement of the body or we break it down to basically, let's say,

02:15:00.940 local movements of parts of our body. But movement is actually the most important thing in the end

02:15:07.240 here for all of us. If you came to me, I would very much look at, okay, most important thing would

02:15:12.860 be to bring joy of exercising and sense of achievement into your training moving forward,

02:15:17.960 because that's what's going to get you out in the day. That's what's going to get you out of the bed.

02:15:21.280 If you look forward to exercising, because you find it enjoyable, you'll do more of it. That's the

02:15:26.280 easier way to get you out. And even where you would start to prioritize it over other things you

02:15:30.320 are doing, instead of pushing it always in front of you. And then finally, you get out and exercise

02:15:34.220 because you know you should do exercising exactly to meet your expectations. So that would be the

02:15:40.780 most important thing. But if we look away from that, the differences between riding also at one

02:15:46.100 millimoles versus two millimoles, as long as one millimole is more sustainable for you, let's say

02:15:51.800 over months and years, because it brings more joy to you, it allows you to maybe be more present or

02:15:56.520 let's say almost use it as a mindfulness session. If that becomes more sustainable, you can think about

02:16:01.960 what you accumulate. Because we very often, again, this is a problem very often with research and

02:16:05.720 many things, is that we give a spot picture of something. We look at something in one session

02:16:09.580 over a couple of sessions, instead of actually looking at over a lifespan or over a long, long

02:16:14.520 period. And then this is where I think exactly that we very often, we undervalue the joy of exercising

02:16:21.600 because we go out with an expectation that, okay, I have to go hard, I have to go all out and this

02:16:26.780 kind of thing, which is very demanding and taxing on the body, especially if you're not prepared for this.

02:16:31.960 I'll interject there that I can completely relate to that. And I've accepted that as a part of the

02:16:40.260 transition in my life. So there was a day, there were many days, there were many years where I had

02:16:46.480 a belief system that said every single day, without exception, you must burn the pack of matches fully

02:16:54.620 at least once. So it didn't matter what the workout was. There was still an all out effort of

02:17:01.840 about three to five minutes somewhere in the day that would probably when I measured it, I wouldn't

02:17:08.440 always measure it, but it would take lactate into the 16 to 18 millimole range, like incredible pain.

02:17:16.360 And truthfully, I can't do that anymore, because I don't have the mental fortitude for that much

02:17:25.520 suffering anymore. I love to exercise, there's never a day that I don't want to. But I also don't have to look

02:17:32.800 forward to that degree of suffering anymore. And I think that that's okay. That's the difference between being

02:17:38.580 50 and being 30. And I also don't think I need to suffer that much, certainly on a daily basis, maybe once in a

02:17:47.520 while. But that said, I still really enjoy quantifying my training. And I know that there are many people

02:17:56.780 who don't. For example, most of my patients are absolutely not measuring their lactate levels during

02:18:04.320 their cardio training. If 2% or 5% are, that would probably be accurate. And for most people, it's what you

02:18:12.600 say. It's, what do I need to do to make you enjoy this? And use your rate of perceived exertion as the

02:18:21.060 guide tool. But look, I still have a little bit of a data person in me. And I like using this metric

02:18:29.340 to maximize the efficiency. And it's a great way for me to track my progress. Am I able to get watts

02:18:35.620 higher and higher and higher, while keeping heart rate and lactate more or less the same? And so I'm just

02:18:42.360 guessing that at your level, this must be a relatively important metric, right? I mean,

02:18:48.080 in terms of, first of all, maybe just define for folks what a lactate threshold is. We haven't even

02:18:53.080 talked about it. It's not something I particularly care about anymore. But talk about what a lactate

02:18:58.180 threshold is, how it's measured. Do you guys even still do lactate performance curves?

02:19:02.800 Yeah, more as a function of other metrics that I collect. Lactate for me, again, is a concentration

02:19:08.600 metric is a marker of something. And for me, it's a marker more of substrate utilization. Not an

02:19:13.900 extremely accurate one, but it's a good one. So I would say that lactate for me is a way that allows

02:19:19.780 me to collect, this is a redundant metric to other metrics as well, to basically be more precise in the

02:19:26.240 way that I would prescribe or change even the training on a session. So I would say that there are

02:19:31.380 plenty of good surrogates or proxies that you can use instead to do the exact same thing without

02:19:38.360 lactate. But if you're looking more, let's say, for example, you want to know better now,

02:19:42.720 for example, your subsidization or have an idea of that, I would say even argue that you can't

02:19:47.740 necessarily only do one measurement. You have to do a little bit of couple of, let's say,

02:19:51.140 little bit change in intensities, not much, but a small range there with a couple of measurements

02:19:55.820 to get an idea because your, let's say, call it your lactate or your maximum lactate steady state

02:20:01.440 concentration, for example, in a session can also vary based on, for example, dehydration.

02:20:06.560 So for example, if you go out, you have one lactate concentration today, this might already change

02:20:11.380 in two days time, for example. That's one. I mean, I'll tell you how we used to do it,

02:20:16.780 and it was probably much cruder than what you would do, but we would do repeated intervals

02:20:23.220 at descending pace. So ascending effort, descending pace. So if it was in the pool,

02:20:28.260 we would swim 100s or 200s. That changed the pace. So you'd go out pretty easy for the first one,

02:20:35.160 check the lactate, fully recover, repeat it, fully recover, repeat it, and you're getting faster and

02:20:40.740 faster and faster. So then you make a graph. The x-axis is the speed. We would note heart rate as

02:20:46.520 well, but we would really focus on speed. And then the y-axis was the lactate concentration,

02:20:51.200 and it becomes a power curve. And again, this is very crude, so I can imagine that now the methods

02:20:57.900 are much better, but you can eyeball them as sort of two separate linear curves, and their intersection

02:21:03.600 becomes the inflection point at which you go from kind of sustainable to unsustainable lactate

02:21:09.420 production, or non-linear parabolic lactate production. And we would sort of say, look,

02:21:14.760 let's just assume that that intersection occurred at 3.5 millimole concentration of lactate. And we

02:21:22.000 would note what the pace was there. We would say to that athlete, you have to be mindful of exceeding

02:21:28.480 that pace. Now, this speaks to everything you just said. I mean, that pace is going to change depending

02:21:34.440 on your hydration, depending on your energy reserves, depending on your fatigue. So of course,

02:21:40.100 it's crude, but directionally, that's what we thought about as you have to be very careful every

02:21:46.180 time you exceed that pace in a race, because you're now tapping into a very finite reserve.

02:21:52.120 Is that kind of how you still do it, albeit probably with much more accuracy?

02:21:56.700 What I really like with what you say is, one, you talk about the infliction point,

02:22:00.700 because this is very misunderstood. Some people still today go by fixed blood lactate accumulation

02:22:06.240 values or concentration values. So they stick, for example, to four millimoles or something like

02:22:11.020 this. And okay, if you're going to publish a paper and you want it to be able to compare with other

02:22:16.120 papers that are out there, that's fine. But already here, the problem with that is that four millimoles

02:22:21.440 can be accumulated in a whole range of different ways. You can go just above your second infliction

02:22:27.180 point, or just above maximum like this day, and then you creep up towards four millimoles,

02:22:31.460 meaning that now you have to have a smaller power output in order to get there. Or you can go with a

02:22:36.040 very high power output, and it will take a short time for you to reach that four millimoles there.

02:22:40.240 So how do you now go backwards and say that, okay, well, four millimoles should correlate to this

02:22:44.100 power. It's highly dependent on the protocol that you're doing there already. The way that you

02:22:49.280 described that you basically said it is something I would say that this is fine, because the two most

02:22:54.140 important things, if you want to use it as a way to control your intensity, so you want to,

02:22:58.300 let's say, a different way of controlling intensity, as opposed to, for example, heart rate or other

02:23:02.640 things. And we know, of course, again, heart rate, again, also influenced by hydration,

02:23:06.100 and other stressors and other things as well. So when you are using lactate now, one, I like the

02:23:11.880 way that you describe it. You talk about the infliction points perfectly, and make it as simple

02:23:15.460 as you said as well. Depending on how long your protocol is now, you can draw three lines. You're

02:23:19.720 looking at basically drawing one line that goes through the flat section of your profile more,

02:23:23.440 or let's say, of the lactate. Then you get one that goes more on, let's say, on the liner increase

02:23:27.300 for every step you increase in pace. Then basically, you also see there's an increase in lactate. But at some

02:23:31.900 point, you see there's a complete departure between increase in pace and lactate, and it goes

02:23:36.260 very hard up.

02:23:37.540 Yeah, almost vertical. Yeah.

02:23:38.940 Yeah. So this is where you could say that also then talking back to, for example, metabolism,

02:23:43.480 you could say that the first infliction point is not too far off where normally where you would see

02:23:47.300 your fat max is. And the second one is typically where you would see your maximum lactate steady state

02:23:51.560 is more or less.

02:23:52.420 And some people, I think, in the nomenclature call that LT1, LT2?

02:23:57.260 Yes. We use that very much. I like to be specific in this sense, because when you talk about LT

02:24:02.180 and LT2, then you already have distinguished it away from, for example, MLSS.

02:24:07.880 A fixed one. Yeah.

02:24:08.980 Yeah.

02:24:09.240 Yeah. Because if you talk about MLSS, this actually normally requires you to do a very specific profile.

02:24:14.840 So you would do, for example, longer interval. So you could, for example, do 30-minute or 20-minute

02:24:20.660 rolling effort, for example, and you're looking at lactate as a function of, let's say,

02:24:25.240 every five minutes to see whether the lactate value is stable or whether it starts to increase.

02:24:30.020 So maximum lactate steady state is basically what it says in the names is the highest lactate

02:24:36.560 value that you're able to sustain steady state. If you go now a little bit higher in effort or in

02:24:43.480 intensity, or let's say you are accumulating a little bit more fatigue, then basically you already

02:24:47.880 start to see that now lactate is not stable anymore. For the same power output down, it

02:24:51.920 will actually start to see that lactate starts to accumulate up, going upwards. So it's not steady

02:24:56.320 state anymore.

02:24:57.580 And what capacity or duration is built into that assumption of LT2? Because again, LT2 cannot

02:25:04.760 be sustained indefinitely. So there's some point at which it ceases to be a true steady state.

02:25:10.660 What does that look like in an athlete?

02:25:12.040 So this, again, depends a little bit because at maximum lactate steady state, depending on how

02:25:17.620 powerful the athlete is, and here is also a misconception, a lot of people think that maximum

02:25:22.060 lactate steady state is the equivalent of RR value of one. This is not correct.

02:25:26.620 Not at all. Yep.

02:25:27.340 So one thing you very often see is that for, actually, this is something that we discovered

02:25:31.900 with our athletes through different when we went Ironman and when we went Olympic racing,

02:25:37.320 so short, long, and other athletes as well. And that is that what you'll see is that the maximum

02:25:41.620 molecular steady state typically occurs at the lower RR value, depending on the distance you're

02:25:46.460 doing. So the longer the distance you do, you'll actually find that that sits at the lower RR value.

02:25:51.200 It is logical. If you look at it from a physics perspective, or let's say you were talking about

02:25:55.680 stationary action principle, for example, or thermodynamics, then basically how do you supply

02:26:01.060 the bodies with the most sustainable energy, the simplest possible way? Yeah, it comes back to that.

02:26:05.860 At an Olympic distance, are they able to hold LT2 for the whole race? Whereas at the Ironman,

02:26:13.460 are they well below LT2 and closer to LT1?

02:26:17.520 The problem with very powerful athletes is that already, because now this is the problem where

02:26:22.720 lactate comes in, because lactate only looks at concentration, it doesn't look at volume.

02:26:26.820 So the problem is that the LT1 will already occur. So very high utilization of VO2 max for an

02:26:34.080 Ironman athlete. How high? Just give us a sense.

02:26:37.240 Well, I have to sit down now because now it's more than a year ago since we did Ironman.

02:26:42.200 Roughly speaking, I would say that it sits in at around close to 80% of VO2 max.

02:26:48.120 That's right. So if the VO2 max is six liters per minute, at 80% of that at 4.8 liters per minute,

02:26:57.600 they're at about LT1.

02:26:58.980 Yeah. And that you already do know that that's not sustainable because you're already now turning

02:27:03.500 around so much carbs per hour that this doesn't work anymore. So you have to-

02:27:07.400 Well, but hang on, hang on. It depends a little bit on the RER, right? Because you're now at maximum

02:27:11.340 fat oxidation.

02:27:12.640 Yes.

02:27:12.860 And so what are your athletes? Now, your athletes have one thing working for them and one thing

02:27:18.260 working against them. The thing that they have working for them is they have the healthiest

02:27:22.340 mitochondria on the planet. But the thing they have working against them is they're on a very

02:27:27.120 high carbohydrate diet. And I'm saying for and against them in terms of fuel utilization.

02:27:31.700 So they actually have the capacity for insane fat oxidation, but their system is tuned towards

02:27:41.160 a faster fuel, not a more energy dense fuel. So let me guess, would they hit 0.8 grams per minute

02:27:50.240 of fat ox? Are they getting that high? Put it this way, we have had blocks where we just have been

02:27:56.320 looking at how high we can get them in fat ox and it's extremely high, but I have to go back.

02:28:00.560 You're probably getting close to one gram per minute then.

02:28:03.760 No, even higher.

02:28:04.940 Okay. And that's on a high carb diet.

02:28:07.200 Yeah.

02:28:07.900 It's absurd to me that we are out of time here. And if it weren't for the fact that I had a hundred

02:28:11.960 patient calls today that I can't just cancel, we would just continue to do this.

02:28:16.340 So we have officially covered two thirds of one page out of eight pages. We have not yet talked

02:28:23.020 about what I want to discuss around muscle biopsies. We have not talked about getting into

02:28:28.680 anaerobic threshold, a term that I don't pay any attention to, but I think we should talk

02:28:32.140 about. We haven't talked about the use of temperature probes and understanding the effect

02:28:37.700 of cooling during both competition and training. We haven't talked about heart rate, heart rate

02:28:42.180 variability, training desire, performance, and recovery. We have not talked about some questions

02:28:47.380 I have about the use of PEDs and why they don't seem as prevalent in triathlon as they do

02:28:53.380 in other endurance sports. I could go on and on. That's just finishing what's on the first

02:28:56.760 page. I wanted to really get into MCT density. I wanted to talk about too many things for me to

02:29:02.200 even rattle off now. So you said you're going to be in the U S at some point. I hope we could do

02:29:06.980 round two of this in person. Would be fantastic. All right. Yeah. This has been really cool for me

02:29:12.720 as well. I want to say also one final thing here. We, of course, we talk very much about terminology

02:29:17.440 and how we see things and so on. One thing that is important for me to be very clear on is that

02:29:22.720 terminology is one thing, but we have to remember also that people might use these terminologies

02:29:27.580 also differently as well. And as long as a coach and an athlete, for example, have an understanding

02:29:33.100 of something and that works for them, don't get discouraged or don't start quarreling over

02:29:38.280 definitions and these kinds of things. Because the most important thing is exactly that you have a

02:29:42.020 language and it does work for you. And that's most important. People like us come and hammer them

02:29:46.420 with a lot of terminologies and a lot of definitions. They obviously have gotten something

02:29:51.320 right. And it's important to have respect for that. And it's also a lot of things that we don't

02:29:54.860 know. There's a reason why we are continuing to do all this research as well, because we are so

02:29:59.920 curious. We want to understand more and we understand that there's so much still to discover

02:30:04.480 as well about everything we even covered now during this call. Well, thank you, Olaf. That was really

02:30:10.320 wonderful. I very much look forward to round two. The same. Thank you so much.

02:30:14.580 Thank you for listening to this week's episode of The Drive. It's extremely important to me to

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02:33:37.560 You

The Peter Attia Drive - March 18, 2024

#294 ‒ Peak athletic performance： How to measure it and how to train for it from the coach of the most elite athletes on earth ｜ Olav Aleksander Bu

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