217 ‒ Exercise, VO2 max, and longevity | Mike Joyner, M.D.

[@PeterAttiaMD]

In this episode, we discuss: 0:00:00 - Intro 0:00:08 - Mike’s training as an anesthesiologist and interest in exercise physiology 0:05:25 - How exercise increases longevity 0:08:54 - The impressive data on the benefits of exercise 0:14:33 - The Centenarian Olympics and other ways to mitigate age-related decline in strength and stability 0:19:06 - The violent dropoff in strength and activity with age and how exercise preserves fitness in old age 0:22:39 - Benefits of exercise on mortality and fracture risk, and the interplay of nutrition and exercise 0:28:08 - How exercise benefits the autonomic nervous system and why this plays an important role in our health 0:30:40 - VO2 max, heart rate recovery, heart rate variability, and other metrics of fitness positively impacted by exercise 0:35:31 - Reduction in all-cause mortality with increased fitness levels and VO2 max 0:44:04 - Does the relationship between exercise and longevity follow a J-curve? 0:51:33 - Mitigating age-related decline in fitness by elevating your VO2 max at a young age 1:01:51 - Breaking down the variables that drive VO2 max 1:08:43 - Learning from elite athletes: Training regimens, aerobic efficiency, and other impressive metrics 1:19:02 - Health benefits of light exercise for the average person 1:21:55 - Simple training metrics to track, and Mike’s current exercise regimen 1:31:24 - How to boost your VO2 max, and the importance of form and tempo with interval training 1:39:49 - Training advice for the average person 1:42:33 - Why professional athletes have longer careers than they’ve had in the past 1:45:45 - Use of performance-enhancing drugs in professional sports 1:54:24 - Can the miracle of exercise be put in a pill? 1:57:58 - Mike’s current research and questions he’s most interested in answering 2:00:44 - Use of convalescent plasma to treat COVID-19 2:07:58 - Parting thoughts on the current state of fitness and exercise in society

[@brokengames9020]

01:48:00 cycling is not state wide is private clubs.

[@williamchase5698]

did I hear rucksack? as a veteran.... rucking is great zone 2-3 type training.....I've gotten back into it at 49yr old.

[@ApaX1981]

I used to tend to have low iron levels. For that reason I started activly make sure I get plenty of iron. The thing I noticed: much more difficult to get the heat rate up. My legs would just blow-up. 6 month later, legs are much more capable to sustain the load....only now it is easier to get the hearrate up. I always understood the hearrate was request driven. What is causing the decline of max heart rate? Could it simply not be a decline in reqeust?

[@brokengames9020]

You said you could "easily" get to 200, 205 bpm while you were under 20... Then above 20 you had problems getting to/over 180 bpm... Can you remember heart rate recovery rate? e.g. how much time you stayed at 200 bpm and how much it took to recover under 99 bpm? e.g. how much time you stayed at 180 bpm and how much it took to recover under 99 bpm? and these days e.g. how much time you stayed at 170 bpm and how much it took to recover under 99 bpm?

[@SmoknJ]

Love your content, but the audio levels on this video aren't great. The podcast of this episode seems to be fine though.

[@ginamiller9206]

I am 75 and in fairly bad shape physically but I am not giving up. I am learning so much from Peter and all his guests and I have given Peter’s book Outlive to my daughters and their husbands. They have a chance to do better.

[@robertcunningham9626]

The journey of a thousand miles begins with a single step.

[@tgere79]

Hooray for you! It's never too late to get started. Find a good personal coach to guide you on your physical training path. Good luck on your venture!

[@Simlatio]

The good news is you can start your fitness journey even at your advanced age and have massive improvements in your quality of life. You can still be 70% of who you could have been if you were into fitness your whole life, and that 70% is still fit enough to remain fully independent well into your 90s.

[@Your_Favorite_Onion]

Carnivore diet is best for health

[@marcoj25]

The body has amazing ability to repair!

[@upupandaway5646]

As a 63 male i still lift 5 days a week .strech and walk 1 hour every night hiking bike swim .been working out since 16 NEVER STOP NEVER GIVE UP

[@sandyfisbeck9488]

Im 67 and do either yoga, pilates, or swim justabout evry day.Thats on top of working full time.I feel better than I ever have❤❤

[@bgrimlan]

I get so discouraged every time I hear Dr Peter Attia mentions what I should be able to do in order to escape a short life. I am 49 years old with cerebral palsy (I walk, but have poor balance so I fall a lot). Everything is getting harder for me, but I am fighting by losing some extra pounds (22 lb in 10 weeks so far) and exercising. But...the things he lists (be able to get off of the ground with just 1 hand, do 3 miles in a hour, carry your body weight for 2 mins, etc) I am nowhere near achieving nor do I think I will ever be able to. But..I am fighting.

[@ill_eye]

Hei, don't get discouraged. The effort counts in these things. We all have limitations. It's not that you have to be able to DO those things, but that you work towards them adjusted to your inherent ability. Keep on keeping on!

[@mirceabranda]

What you did with the extra pounds and the fact that you do your best every day it is inspiring. Keep doing it and more and more positive results will come. Read books about mindset and try to understand while doing exercise what is happening it our brain. I can highly recommend Habbits of a happy brain, Mindset, Grit and all Gabor Mate's books to understand what our early early years did to us. I wish you all the best. Hugs!

[@non9886]

man, i read some notes of one scientist or doctor which studied elder people quite long and extensively. there are a lot of interesting facts in it and few very interesting and surprising statistics and so. there are two things for you. what you did in previous life doesn!t matter so much as what you do in you older age. even if you are not able to do what average person in your age, it means nothing. just try to stay in best shape you can. other thing, even more important. they stated that physical activity is more important than condition! although it is quite connected, it is not the same. if someone has better dispositions and was more active as younger, he could stay in better shape than average. but when he stops or does too little, his health and life span can deteriorate faster than of people with worse condition which are more active in that critical older age...

[@toomanymarys7355]

That's for people with ordinary muscular control. You'll do better with more weight training, especially machine exercises. Look up cerebral palsy weight lifting.

[@SammeerSRaawat]

Hi CR1988, I like your spirit! Keep it up! It will be difficult for me to understand your problem, but I empathise with you. Listen to your body, try some yoga asanas for balance (usually standing on 1 feet). I wish you find peace, strength and wisdom to find right direction and goal.

[@Chille0]

Mike Joyner is the definition of a class act and what everyone should aspire to be imp. I interacted with him briefly professionally and he treated me amazingly even as a grunt. Even from the start of this interview, so humble and yet extremely clear and obviously vastly knowledgeable. Love that guy!! XD

[@davewyman]

For decades, from observation of older cyclists, I've believed I’d be fairly vigorous until I reached about 75 and then glide into a physical decline. That’s how old I’ll be next January. So I was shocked when the discussion turned to the claim that there’s a cliff almost everyone physically falls off of at that age. Thank goodness I hung around to listen to how fit Norwegian cross country skier‘s can be into their 80s. I have been a serious cyclist since 1975. I started to cycle seriously because I wanted to cardiovascularly strong for mountaineering. I’m no longer a mountaineer. I am still a cyclist. Waking heart rate: 39 bpm. I can briefly hit 180 with a very hard effort. My weight is low. On a casual ride, I keep up with cyclists decades younger than me. I can hang at higher speeds for a few minutes. I like riding up steep roads. Cyclists I don’t know who I ride with for the first time will sometimes ask me how old I am. When I tell the, they usually say they hope they will be where I am when they’re my age. I advise them to just keep riding. I’ll see what happens to me in five months. I think I will find some Norwegian in me. In the meantime, after watching this awesome video, I realize I really do have to start working with some weights.

[@g99se9]

That’s great! My brother is a longtime cyclist as well. Me, I’m a walker/hiker/resistance training guy. I’ve heard that cyclists have a bone density deficiency due to lack of skeletal stress in the act of riding. Something to look into perhaps.

[@ccamire]

Do swift 4x/wk classes in the winter, you will keep your vo2 max at high levels

[@1pittmanj]

Dave I am very curious what your workouts were on the bike and what the carryover was to your mountaineering?

[@Markhypnosis1]

@@1pittmanj He's talking about building his cardiovascular fitness with cycling for mountaineering. That's the carryover.

[@ryankeels4661]

I'm a strong believer that the physical decline that many experience is due to allowing the slip by not staying active. The people that are still participating in sports at that age are in shocking shape relative to the general population at the same age.

[@samiraba1]

Second time I’m listing to this podcast, thank you Peter and Mike for such fascinating and informative discussions. Shoutout to my dad who planted the seed of exercise in me at a young age in a part of world that this is not part of the culture, certainly not for girls. I’ve been active all my my and still going strong at 45!

[@janetderouin9533]

Peter, you have been smiling lately. I like to see you at peace with the world. When you smile and seem more relaxed I have a better day. Thanks for your podcasts.

[@juliehelliker8629]

I’m 63 I fell down 8 stairs half asleep going to pee in the middle of the night , the stairs and the bathroom door right beside each other , I got a big bruise on my lateral upper thigh , no other injuries and couple of scrapes , I got up cautiously , back to bed and woke up next morning , and mopped my floors kitchen and dining area where I landed , I’ve been teaching group fitness all my adult life everything from step classes , cardio box , muscle conditioning classes , Zumba and aqua fit , I walk daily an hour sometimes two now that I retired last year, worked in healthcare as a care giver , very active daily job, raised my children ran the house , worked shifts, now a very active involved grandmother keeping up with toddler grand baby, just a testimony to my active life and balanced food intake, I plan on aging backwards lol continuing to be super active as I go!!! Hearing and keeping up with this current science through you and others in this community just justifies my life style and where it is going to take me!! 🙌🙌🙌💪💪💪thank you Peter!

[@perrysimpson6261]

my word, this is an insanely valuable interview. life changing and life giving content - thank you, Peter and Mike.

[@untonsured]

Joyner is very clear and a good communicator.

[@briansndbrg]

My mother and Mother-in-law are both 95 and have no idea who Peter Attia is. They also have no knowledge of anything to do with exercise physiology. What they have in common is "Walking". They have both been walking for years.

[@forajc]

I agree there seem to be anecdotally a lot of women in the 90's in good shape and never did any of this training. Would they be even healthier if the engaged in these prescribed activities? The general population studies that these Dr's cite seem to indicate such. Not sure what to make of all this information. How much and to what intensity should one do resistance training and cardio? Still somewhat confusing.

[@Noneofyourbusiness-rq9jq]

women do less high intense physical activity over there life . you drive your car fast for a long time and it doesn't last long take your time keep it ticking over and it will last longer.

[@homefrontt]

Don’t we all

[@metalrunner4398]

Tell them to at least get some sleep.

[@caseydh73]

My great grandmother just passed away this last year at the age of 106. Her health was just about as perfect as it could be her whole life. She grew up ranching and then walked everyday in her later life. Even at 106 she could walk, sit and stand on her own, lift her arms above her head, ect.

[@The80shilling]

At age 60, I finally got my VO2 max to increase. I have been swimming my whole life, and as I got older, I started to swim 3 times a week, anywhere from 1500 meters, to 6,000 meters, depending on my mood, available time and energy levels. For 3 years, I couldn't get my VO2 max above 41. 8 months ago, I started doing 1500 meters only, but THEN, after my 1500 meter swim, I started adding 750 meters of flat out sprints at the end. I split the sprints into 50s and 100s, and made sure I got 3 minutes rest between sets. I saw almost immediate results. After 6 weeks, my VO2 max hit 42, and now I'm at 45 as of this week. I also have added Mountain Biking 2 to 3 times a week. My resting heart rate hits high 30's (37, 38, 39) while I sleep, and I'm at 48 bpm as my average resting heart rate while awake. While swim sprinting, I hit around 165 bpm peak, and while Mountain Biking, I hit around 185 bpm peak. For the first time in my life, I feel like I have my exercise routine at a place where it is sustainable without burning me out, which was a problem previously due to the large distances I was swimming. Less overall distance, but with HIT sprints seems to be the magic solution for me.

[@pierrex3226]

I've done a few triathlons and was able to be a half decent swimmer. Doing pyramids in the pool I always found pretty terrifying, drowning and all that. Now road cycling on the other hand, especially on a turbo trainer (WITH A FAN ON YOU), you can really do interval training without worrying about drowning, injury, form, and so on. MTB will likely make you a good sprinter (anaerobic driven stuff) but you don't really get to do 8 to 10min intervals at vo2max on a MTB. And those tend to raise your vo2max the most, it seems.

[@whydoyouneedmyname6508]

@@pierrex3226 what, you can't train at vo2max for 8-10 mins lol

[@pierrex3226]

@@whydoyouneedmyname6508 indeed, I meant FTP, not vo2max...

[@VishalRaoOnYouTube]

What age did you start training regularly? I'm 43 and I'm motivated by Peter's discussion on relative hazard ratios to start Zone 2 and Zone 5 cardio.

[@tommyrq180]

Those increases in VO2 Max fall well within the error range of whatever test you are doing. And the main point is power or speed at VO2 Max and/or time at VO2 Max. That can increase whereas the number is much harder (or impossible) to nudge. ALL of it is hard as hell to measure. Just my two cents.

[@jonathanrobinson2628]

I love these discussions Peter. As someone who cycles 10-15hrs a week (typically), and does a reasonably physical job, it's nice to understand the physiology of what effect it's having on my body as I age

[@onlyfoolriding8223]

Don't know about you guys, but measuring HRV and HR has given me IMMENSE insight into my recovery. It is fascinating to watch HRV drop and then gradually rise as I absorb training and recover.

[@brokengames9020]

Is there any help... or you guys support Polar corporation that is abusing user data? User can't directly download their private, personal data without sending it via vulnerable world wide web network and store it where user have no oversight over their data? Since they can do whatever they want with the data and can easily lie they are not doing x or y with the data. Remember Polar had program that was Pro trainer... where there was no internet connection required to analyze personal data. Now this is not longer an option due their abuse corporate policy. So the watch we use have possibility to measure HRV. But it is artificially blocked by software developer, because they want us to extort out of money to add logarithm and features to the watch. They will not answer to support mails. We have been discriminated because we do not use their latest model despite hardware clearly support the features they have on never models. This kind of extortion should be illegal. Polar corporation doesn't care about your health. They will extort you any day they can. Will anyone do anything to stop this exploitation?

[@chrisbarnes10]

I'm 71 years young. Still power walk 4 miles everyday. I also go to the gym 3 days a week. I'm attempting to do the Asian squat.

[@abejaamarilla4961]

I do it naturally the squat, Im 60. Probably because I did it when I was a child in a little town to go to poop! My husband can not do it..

[@mmmyeahh]

I love listening to intelligent conversation, great discussion!

[@hillcevan]

Referencing 48:00 I'm sure many would love to see a complete episode on AFIB - New diagnosis, methods of treatment - surgery vs lifestyle, causation, etc. Newly diagnosed and now understanding how common it is (and surprisingly even among younger individuals). Tying into this conversation - what are the long term implications of arrhythmic medications / beta blockers on VO2 max values and cardiac output over time

[@SpiKrishPri]

I have arrhythmias due to too many overreaching runs, but it does not affect my potential. Maybe my heart is working better with those extra bip 😉

[@elizabethm.9556]

I grew up in an "active" family which saved my life. I was diagnosed with Crohns disease 5 decades ago, when i was 10 years old. By the time i was 18, i was 5 of 10 operations in and 7 years of almost continuous steroids. By the time I received my undergrad degree, my bones were light and i had other serious health issues from treatments. With help of surgeon, i decided to "fix" much of the unintended consequences of Crohns treatment, through exercise. I went off to law school with a firm plan. By the time i graduated i was planning on my first marathon, which was not cancelled when i had emergency surgery to resect my small bowel (100% obstructed). Two weeks post-op i was back training. When i survived septic shock the head of the ICU said "you must have 9 lives because there is no way you should be alive". I said "I train for these incidents, 40 miles a week with or without a central line". Fast forward to Covid and we got through as a family (i live in Trudeau's velvet Totalitarian state) with outdoor activity. My youngest nephew was 3 and my dad 82 and we (12 of us) skied (Lake Louise) every Saturday from November of 2020 until April of 2022. We got my dad an electric bike and from May of 2020 until October of 2021, we had family rides in Banff every Saturday and hikes on Sunday's. My dad is 84. He works out in a gym 3-4 times a week. Rides his bike in the summer and just got his "super senior" $19 season pass for Lake Louise winter of 2022/23. I have had 10 abdominal operations, i have a belly full of scar tissue, and do 6 days in the gym and just got my "adult, NOT $19 season pass. Attia & Joyner should be leaders of a task force whose goal is to create k-12 curriculum for 60-90 minutes of daily physical activity, for all public schools.

[@abejaamarilla4961]

We wish you the best, interesting way to live! I need more consistency, thanks for your sharing experiences!

[@Chille0]

Agree completely. Well done and ya it would be nice to see any kind of action in the US to promote healthy living and activity but sadly its more like the opposite here

[@kirbymegorden8820]

16:00, 52:00 “Decreasing Inevitably of decline” 29:30 max heart rate, vagal nerve, 38:00 linking Vo2 max and all-cause mortality, monotonic relationship more is better 57:00 metabolic “significance” 1:20:00 phys act vs fitness 44:30 MET hours / week 1:02:27 variables behind cardiac output and vO2 max, importance of Q for longevity / performance 44:50 MET

[@chriswalker7972]

Excellent information. Information for all levels of fitness. I have recently started to concentrate in my vo2 levels so look forward to the benefits into my golden years.

[@JeffJohnston-o3e]

Hey Peter, I'm 60 and I bought your book this spring (audio and hard copy) and I'm all in. I've always been in good shape and interested in fitness, wellness and health span. I've done a Galleri test (clean), extensive blood work - LDL 212, HDL 62, LPa - 7, Testosterone 975, Ca score 12. 6'0", 190 (played HS football at 188). I had a VO2 Max recently - 43.8. The ExPhys guy said my max HR was 166 (resting HR 46-48) but my Aerobic Threshold was lower than he expected based on my results. He said my Zone 2 should be around 115 (which seems low)! Love to hear anyone's thoughts.

[@ManjiMachine]

Can you talk about how to recognize aerobic training fatigue and how to manage that? Signs of when to back off or when to ramp it up

[@ManjiMachine]

Thanks for that. Very simple concept

[@ManjiMachine]

@markmetternich1435im assuming intensity applies in the same way? How can increase watt output lets say on a bicycle while maintaining in zone 2 were as that increase would normally put me into a higher zone

[@raiderkeno]

Peter you damn near saved my life buddy! I’m sleeping, I’m operating at an optimal level. Everybody loves me. This happened in short order too… amazing!

[@rliao]

One of your best episodes yet. Excellent discussion of the J-curve phenomenon. Thank you!

[@emilybarry9410]

This was a FANTASTIC conversation, which I sent to both of my parents in an effort to encourage them to get active. 🙏 Peter and Mike!

[@williamerdman4888]

I watch most of your interviews, Peter as a subscriber. THis one was particularly interesting to me... keep them coming!

[@scottymackay1801]

There's just one thing that I feel Peter always misses when talking about older people and exercise. They simply don't want to. As they get into their final years, they lose interest in exertion. Their appetite naturally decreases too. Their bodies are preparing for death, yet Peter thinks they all want to deadlift. My grandmother lived till 103 and was in perfect health in terms of her organs, but died from falling and breaking a hip. She had a relatively active job, but had basically done nothing but go on short walks for the last 55 years. In her last 5 years she didn't want to go out for walks any longer. She was capable, but had lost the interest and motivation for it. Peter is thinking like a guy in his 40s wanting to extend his life. It's not the same feeling when you're 90.

[@victoriajones7463]

Amazing insight. I think depression sets in, somehow chemically, sometimes earlier. But what I see happens is just what you said. One becomes listless & uninterested in life. I think this is also a social phenomenon be in some cultures (Blue Zones) the elderly are revered, not seen as a burden and uninterested in LIFE.

[@scottymackay1801]

@@victoriajones7463 Yes, there could be a difference there. But my grandmother had no shortage of kids, grandkids, great grandkids etc all wanting to visit. She could only handle a few minutes before kind of 'switching off' or saying it's nap time or her TV time lol. They get into a very selfish routine. As I said, they're preparing and prepared to go. Peter is thinking he'll still want to squat. I doubt it. There are exceptions though, I'm sure.

[@brettweidner7184]

Maybe point is it’s not about what you wanna do. I don’t wanna go to work but I do. I don’t always wanna work out at my age but I do. You just do. Who gives a shit if you want to or not. Weak mindset.

[@BenOgorek]

I think I want to keep exercising, but yourself in 40 years is a stranger to you now

[@CulbsDC]

Purpose is the best motivator and driver. And self-esteem. 😉

[@MindfulSimpleSolutions]

“Religious experience” that is for sure!! Great episode will listen to it again! Thank you!🙏❤️

[@damir2052]

First, teaching faculty as well as student the science of physical health and education. Like this talk in this podcast. Make it relatable, and then go out there and implement it.

[@r3sid3ntttv9]

Thank you Dr Attia for making content. I found some clips from you and have been falling deep into the rabbits hole. I have learned so much and appreciate all that you share.

[@sabrinnahe.8500]

Another fabulous ride. Maybe I can now have some holiday pie. Thanks Kaleigh for keeping us fit through the holidays❤❤

[@treyjones5240]

Quality researchers and scientists who also have athletic ability like this individual are a pleasure to listen to.

[@keithmitchell1374]

On my 4th listen and still picking up subtle points. At around 1:26-1:27 Dr Joyner is talking about his easy days. He pairs workout with documentary or movie carrot. This technique works very well!

[@pierrex3226]

It's called rewards bundling. Freakonomics made a podcast on it years ago. Works very well especially for all sorts of people, elite athletes or not

[@apizer]

Great interview. Only thing I would have liked is a deeper analysis of Mike Joyner's own workout regimen. He seems to have almost no Zone 2 in it, except maybe his short warm-up on his hard days. He described his easy days as "active rest," which sounds like zone 1. Would have liked if Peter had asked him about the lack of Zone 2, since it's such a fundamental part of Peter's workout recommendations.

[@willnitschke]

People are getting way too hung up on these zone fads. Peter is especially culpable. I did almost exclusively zone 5 a few years ago as that was the hot fad at the time. My functional fitness levels were rubbish. I noticed I'd be out of breath walking up a steep hill! Now I'm much more relaxed about things and do lots of walking, some high intensity and some medium intensity, and at 55 I'm the fittest I've ever been.

[@forajc]

I got the same thing from Dr Mike that he did not seem to prioritize zone 2 like Peter does. Dr Mike mentioned several high level athletes who seemed to use almost exclusive interval training.

[@willnitschke]

@@forajc Absolutely, but how many people are high level athletes? And probably their sports requires sprint type energy bursts. If you were a marathon runner it'd be pretty dumb to prioritize zone 5. I think the original idea was that if you focued on zone 5, zone 5 was so amazing, you didn't have to spend a lot of time doing cardio work. Like 20 minutes a few times a week and you'd end up super fit. BS on all that. I tried it and it didn't work in practice.

[@wadehodges5740]

I think you could read into Mikes easy day some zone 2 training.......

[@bennetwolper8234]

I wish Peter asserted his Z2 and VO2 program. I would have liked to hear Dr. Mike respond. I’ve been sort of following it and I was left somewhat hanging and disappointed. It seems a number of times Peter introduced it and floated the topic but then dropped it when Dr. Mike didn’t pick it up. Too bad Peter didn’t pursue it.

[@bobmciver6437]

Wow!Lots to digest here.As a 69 year old who loves sprinting, walking,hiking and weights/bodyweight circuit training, lately my instinct has been prodding me to increase the number of plexes (eg. currently 12 rounds of 100m sprints with supporting exercises)...So,I am understanding that I could increase the rounds (given proper effort) and benefit VO2 max?That prospect is exciting!Hope I am interpreting this correctly...both mind and body balk at the idea of any sustained distance running, swimming or cycling...all out 400m is my idea of a marathon, lol...

[@bobmciver6437]

@NipNinnies Since the comment,I have increased the number of rounds but decreased the plex of exercises so I am sprinting every 5 minutes...so Zone 5 back down to Zone 2.So far,getting faster recovery...which is a pleasant bonus.I have a female crossfit client 61 and we are experimenting with this approach.

[@julesgarcia5854]

Ahhh! Your smooth voice and your choice of 🎶 music makes your yoga sessions so enjoyable. ❤

[@victoriaelliott-gt7yl]

Great work out pushed myself to get back on it! Thank you Sydney! My goal is to keep going and turning up for work outs! X

[@Bungifun]

Diet is a big confounder for exercise. The driver/conductor could be confounded due to snacking or whatever. Exercise/activity leaves less room for eating which may make you focus on proper meals outside of the feeding window making you feel more full outside the time spend on activity. It would still be a change in diet die to activity though so it can be attributed to exercise, at least in a natural setting

[@christinestump6377]

More is better... except when it's not. Over exerting when HRV/HRR is low can be deleterious from many directions - fatigue, muscle building, injury to name a few. I have a suspicion this is more common in women than men and is also understudied. Timing of exertion is important, escalation rate of exertion, and a potentially new variable: timing of exertion during recovery from whatever the current variant is.

[@RonaldKrzesniak]

Listened to in its entirety. I’m 75 and feel I’m far from falling down the cliff. I have been actively moving my entire life…

[@trismegistus3461]

1:31:24 - How to boost your VO2 max, and the importance of form and tempo with interval training

[@mimosa9638]

In this clip you do look more calm and relaxed, Peter. May be because you just listen without having to speak much when your brain was running at double speed. To be a good listener is the best way to know others but much more about ourselves. Meditation is just that-stay silent, listen with the mind and Voila we are enlightened…just whatever bit. 😊

[@KetzalSterling]

Hey Peter. You really need to get Dr. Stephen Seiler on your show. He's probably the best exercise scientist to discuss training distribution etc

[@rodredoun1922]

This talk is packed with great information. I am 55 yo. I learned to alternate esy day hard day when it comes to training. Stability, strength, stamina...etc

[@pierrex3226]

What's the paper mentioned at 38:30? Published in jam? :D curious to read it

[@chefgoldblum1450]

I am also curious about this

[@jeanrichards-carter2522]

This is exactly what I needed to learn . I was unsure what I should add into my routine that I may have been missing. Thank you

[@riverlevity]

What effect does the air quality where you train have? Has there been any studies done regarding this? (City air vs Rural air)

[@tommyrq180]

Very important. Many studies on this. You’ll find them. Important for many reasons. Just as an example, some people have asthmatic reactions (EIB) to ozone which is generally a city pollutant. Smoke from fires as we’re seeing right now is also very bad for the lungs and the more vigorously you exercise in it, the worse it could affect your health. FWIW, my “pain cave” for cycling training has temperature and humidity regulation AND a very efficient HEPA air filter. I want the air to be in the mid-60s, low humidity, and clean. Significantly enhances my ability to work hard and achieve gains compared to people sweating, breathing pollen or other pollutants, etc.

[@kevinmorrison1516]

The link between VO2 max and longevity is interesting . But I think the precursor to higher VO2 max is joint integrity , for a large majority of people this is the limiting factor , I could run/swim/bike or otherwise if my joints would not fail or be a limiting factor. So if you are lucky enough to have a very robust mechanical system while at the same time motivated to do increasing amounts of cardio I think its the perfect combination .

[@eugeniebreida]

Indeed. My lower body (knees) - and elbow - joints deterioration have me listening to much of this as a bystander.

[@wildernesstraining1957]

I’m 65 two new hips 3 & 4 years ago. Stem cell transplant January 2021 wiped me out physically. Back to good robust health. Boxing, resistance work, jogging up to 5k. I’d be ruined without the new hips, and stem cells of course…

[@paulhorvat6]

and don’t forget about sauna as aid for people with joint issues

[@toomanymarys7355]

1) make sure anterior and posterior chains are balanced. Most people are anterior dominant which causes things like runners knee. 2) Collagen peptides and hyaluronic acid actually work! 3) Far red and near infrared really works too!

[@sueyorio424]

​@@toomanymarys7355 I agree with your comment❤ not many know about red infrared Heating pads that heals you on a different level! Thank you for mentioning... It really works. And it is not hot. It's not cold! It just works!

[@k1mfor]

What's the study mentioned in 54:45? I can't make out the name of the doctor he says.

[@angelar3625]

thank you so much for youre time and priceless information .🙏🙏

[@ThePhotofit]

This is so very illuminating! Thanks very much for conducting the interview and posting

[@HubertAlacoque]

I found this interview very informative indeed. I am 67 and swim 2000 meters 6 days a week. I feel all the benefits discussed, and I am learning more and more about these metrics such as mets, VO2 max etc... With all that, I am intrigued with the low level hyperbaric chambers used for sports injury recovery therapies and what not... Have these low level hyperbaric treatments or applications ever been used, studied or tested for any effect they may have on affecting VO2 max and any other performance and health enhancement strategies????

[@andreasneeb7448]

Hi Peter, if you are testing individuals with an already high VO2max, this could be a group in terms of all-cause mortality, as this group has survived has survived risks of training. For example, there are a lot of accidents when you do a lot of outdoor cycling. So more training is better, but maybe the risk of training injuries cause a J-curve. You could test the effect by comparing a type of indoor training with low risk with an outdoor training training with high risk.

[@mikevaldez7684]

Fascinating, at 1:07:33 they speak about their peak heart rate being 150 & 170 ( on a good day) respectively -- I'm 62 & just started running this year & I've already gotten my h.r. up to almost 173

[@JamesBMiller411]

It's a crap shoot. As a highly competitive triathlete in my late 30's I would see up to 204 and today at 60 I'd say I can go as high as 180.

[@mikevaldez7684]

@@JamesBMiller411 interesting. Cycling in my teens in the Hollywood Hills I remember getting mine above 210; I'd guess mine now is probably 175, maybe higher. But it's all about stroke volume & how efficiently you can reabsorb the lactate within the cell vs in the blood & your power output

[@tommyrq180]

Max HR tells you virtually nothing. It is merely a widely variable genetic quantity. I’m 65 and max HR is 180-just saw it again doing VO2 Max intervals yesterday. But it means nothing. What matters is my power output (cycling) and endurance (duration of power) and recovery from VO2 efforts. A guy with a max HR of 130 could potentially kick my butt if he put out more power at the same level of intensity.

[@johnkorth4048]

Age 64 181 max I think my heart is on the smaller size

[@bwryuun]

I have mild CP too. Wore leg braces as a kid. Jump rope? Forget it! Very poor at sports. Loosing weight too. You got me beat! But I’ve lost weight on NUTRISYSTEM twice… trying too

[@skol8421]

Damn, There are not many people that can say this, but I was intrigued from min 1 to the end. Dr. Joyner is the absolute bomb. Peter, keep this kind of content coming.

[@rigaleb]

Peter - a discussion about orthopedics and neurosurgery would be of great interest. You are talking about exercise in many podcasts, but there is a certain point after which people cannot exercise, because of chronic low back and neck pain. What are the future developments for those, cause people keep fusing those spines like crazy and replacing those discs with devices that no one really knows how are gonna work after 10 years and how are people gonna be able to exercise, even zone 2 training.. Curious about your approach and the experts you know on this subject which affects probably a lot of your viewers.

[@lisanewcombe168]

My VO2 is avg 40-50. I have always been fit with regular exercise and eat a paleo/low carb diet with minimal processed food. I’m only 44. Why is it so low? I recently started adding in zone 2 to see if it helps…

[@carolinepotter3809]

Thank you! So much content! 🙏

[@SpeedBoosted911]

Great!! Just finished to watch Zone2 with Inigo and was waiting for more videos, here it is 🤩🤩👍Thank you Peter

[@stevepace-first8617]

I have watched a few Attia videos, have yet to come across any mention of Tempo runs. As I understand it he does zone 2, zone 5 and strength work. Is there any place for tempo runs?

[@jefremonte]

I like “active rest” (1:27:35) cause I do the same. I do weightlifting and I’d go jogging on the treadmill or road-running to lose up my muscles…

[@joshuadelacruz6617]

This is awesome. Thanks guys.

[@QUENTINHARDAGE]

I have VO2 max of 37 and HRV in 40’s indicating more rest and recovery needed. Age 74

[@-Stop-it]

I want to live long enough that I have the time to watch a 2:00 hour video about living longer. It is somewhat a catch 22. - You will live to be 95, but you’ll spend 10 years watching longevity videos.

[@gradysimpson3137]

What should your speed be on a treadmill working V02 max for a 60 yr old male in good shape?

[@Michael-4]

Mike Joyner is brilliant. If I could say one thing. If he could not talk when Peter is talking. You can do that in normal conversation but doesn't work on Podcasts.

[@sandiegojoey1]

Listening now and looking at your existing video categories I see you don’t have a sorts performance folder, just thought you might want to cluster this one with Inigo, BioLayne and others you’ve interviewed about strength and endurance

[@yozimerio]

I've one of those guys that has gone on/off the bike many times. Invariably at the start of each "on" period, it takes around 2 weeks of training for HR to start coming down from 120 to 100 in less than one minute after stopping pedaling (one hour ride). As training progresses to more than 2 hours rides, HR goes down to 90 bpm consistently in less than one minute. It seems to be my natural recovery barrier. Nothing compared to Miguel Indurain's 60 bpm after one minute. Nevertheless, I'm happy. It's kind of scary to be sitting down after exercise and feeling your heart beating at 120 bpm for 10 minutes or longer.

[@erwinrogers9470]

Excellent interview 👏

[@periososa]

This centenarian Olympic is utter non sense. I’m 66 and I only care about being in shape at 66 so I can do all those things Dr. Attia is planning to do at 90 I can do them today. I enjoy biking, swimming, yoga, Pickleball, hiking….and to do all those things wanting or not you have to be healthy. I love the advise in this podcast and I try to take the best care in all areas to be able to wake up tomorrow morning and enjoy whatever my body allows me to do. If to do it at 90 is the goal then riding my e-mountain bike would be out of the equation because of the risk of falling and that would make me a very sad 66 y/o do I prefer to prudently take the risk and have the fun today!!

[@hamletgomes6818]

My grandfather lived till 102. Man had nothing wrong with him other than hearing loss. Man followed his routine to the core. Got at least eight hours of sleep. Walked hour in the morning hour in the evening. He would switch between fish and meat as far as his protein goes. He took a quick nap in the afternoon . Ate 5 times day. Never ate too much. Was drinking plenty of water. He would have one shot of whiskey with like lot of water every day before dinner…😂.. .. He would say that was his medicine. He did not need any help walking even until his last day.

[@tommyrq180]

Good for him. He had good genetics. All we can conclude from this is that it worked FOR HIM. Likelihood of working for others? Low. N=1 tells us virtually nothing. There are always examples of people who smoked packs a day until they died at over 100. These two are getting at what we can learn for broader populations but human variability always confounds prescriptions.

[@HkFinn83]

@@tommyrq180100% Anybody who has lived to be a centenarian has done so mainly because of genetics and good luck. Perhaps in the future we can change this

[@cjtuccio]

@PeterAttiaMD.... At 1:23:00 he says 180 minutes a day. Is that realistic or did he mean 3 hrs a week?

[@unchartedexe]

CORRECT Great podcast. 😁

[@BrianS-ny9yd]

You could make a drinking game based on "correct."

[@ChrisDorpat]

Wow that was really good! 🙏🏼🙏🏼🙏🏼

[@chuckfrizzell8668]

Greetings - I’m 63 years of age, male, 137 pounds. I have been a cyclist for more than 30 years. I recently participated in a Bruce Protocol running / incline treadmill stress test in a cardiac lab administered by two nurses in Colorado Springs, CO. The test was terminated at 13:30 stage 5 at 150 beats per minute. The nurse told me I had reached 14.5 Mets. Can this result be translated to VO2 max? I understand that had a been a trained runner I would have scored higher but aerobic capacity is what it is. Can I use some type of scale to pinpoint my heart rate training zones using this Echo stress test? My doctor was searching for an explanation to arrhythmia (found it was caused by too much omega 3 fatty acid supplements). Any information much appreciated.

[@apizer]

How much omega 3s were you taking?

[@chuckfrizzell8668]

Hi Adam. Thanks for asking. I was taking 1000mg per day. About 2 days after I stopped the arrhythmia stopped and has not returned. Kinda weird ???

[@apizer]

@@chuckfrizzell8668 Interesting. Thanks for sharing that. I have a cardiologist's appointment scheduled to try to figure out some heart beat irregularity. I take a similar amount of Omega 3s. Will stop taking for a bit to see if it has any impact on me.

[@chuckfrizzell8668]

The omega 3 were recommended by my doc initially. I’m really thin 69” tall 137 pounds and she was trying to stimulate my appetite and body fat %. However the arrhythmia became a serious issue at my age (63) and scary cardiac family history. So no more omega 3. Good luck to you.

[@eugeniebreida]

@@chuckfrizzell8668 Do you think that the omega-3 issue was particularly to yourself? As I take more omega-3 per day a double or triple. I’m quite low BMI as well. Are there studies on omega-3s and arrythmia? In any event, she doesn’t know much about nutrition. If you want to gain wet don’t take oils like that, carbohydrate so are the way to go to gain weight.

[@charitymartin]

Remix Madness! 9 years younger Amy never took a break! Looking forward to the rest of May!

[@davidnorman5488]

Is there a direct correlation between Nitric Oxide increase and VO2 Max increase? If so, what kind of protocols exist to do it. IF not, please explain the difference.

[@GotDamBoi]

whenever I don't feel like running I'll watch something like this and I still don't want to run. but I do. living is pretty neat

[@fhowland]

I’m 39 and my max HR is still 185. Been riding and racing since my teens.

[@brokengames9020]

Can you recall what was your max HR at 29, 19? How much time it takes you from max bpm to 99 bpm?

[@tommyrq180]

Meaningless. Max HR is hereditary and varies widely. I’m 65 and my max HR is 180. Means nothing. I’ve been an endurance athlete my whole life and still race bikes but my max HR, although it has declined as it does naturally in virtually all humans, has always been much higher than the norm. Again, meaningless in terms of performance. Someone my age with a max HR of 130 could also possibly kick my butt in a race. Max Testa often said: “Some have heart like diesel, some like Ferrari.” What matters is your power or speed or endurance at various heart rates, which is trainable and matters much more.

[@kailashyogi4314]

Greetings! What’s your take on something like a SlackBow or SlackBlock training? 🔥🙏🏽🔥

[@iljaivantsov1771]

Thank you 🙏

[@garrett7101]

Please help.. I’m a 49 year old male and my vo2max according to my Apple Watch is 19. It was 32 until a) I went on Clonidine for blood pressure and b) I listened to people who said lift and get your steps no heavy cardio needed. I lifted and I walked 10k steps per day and went to 19 vo2max. I recently realized how important vo2max and have increased to 23 in just 3 weeks or so, but I know 23 is terrible. What should I do? Do people coach you on how to increase vo2max? I never could figure out why I got winded so easy since I walk a lot. Bc of the blood pressure medicine it’s very hard for me to get my heart rate up. I have been losing weight and my BP is getting better and I want to get off Clonidine asap. Please help with any ideas or things I can do! Thanks!

[@stevenqirkle]

Awesome interview!

[@jasoncornick-h9z]

You may outrun a bad diet until you get arthritis from that bad diet then what do you do?

[@fhowland]

I’d like to hear Peter do a podcast about cycling induced E.D.

[@crazylagggs]

I'm confused as a lot of elite cyclists still spend a lot of hours doing recovery pace riding day in day out, not zone 2 (based on their power data on Strava).

[@XX-is7ps]

I think it’s worth bearing in mind those are athletes seeking to optimise performance, not health as per the focus of this discusssion

[@StatzGee]

But I think you could say low v2 IS recovery training, especially when volume is kept in check

[@XX-is7ps]

Absolutely. 8hours in “zone1” is going to provide more stress (and stimulus) than 5minutes in zone2. We definitely get too caught up in the science of training zones and forget that they only relate to lactate rather than all the other physiological al processes - and even then they’re gradations not hard boundaries

[@lainierenfro6069]

Holy biscuits!! What a way to get going today…. I was almost screaming at the end😅

[@dblissmn]

At around 27 and a half minutes, a comment about the conditioning of Tour de France cyclists. One thing it omits is that nutrition on the bike in the pro tour has roughly doubled just in the past five years in terms of caloric value -- everything from the usual energy bars and drinks down to sugary gels that are basically pure empty carbs but formulated so as not to cause an upset stomach. Not coincidentally, power outputs of the top cyclists are now equalling those at the peak of the EPO doping era in 1998 and 1999.

[@quantumdecoherence1289]

With all due respect to Dr. Joyner, if he's doing 300+ watts for an hour, I would maybe start by questioning the calibration of his Peloton. That is on another planet given his age.

[@bennguyen1313]

Anyone know the jama studies mentioned at the 19m and 38m30s marks on the monotonic benefit of exercise (vo2max) on all cause-mortality, and its sharp decline in ones 70s. Regarding how a good vo2max (ex. 30s for someone aged 80) is a good predictor of longevity, how does it compare to grip-strength, or muscle-mass? Any thoughts on those Blood-Flow-Restriction weight-training devices (GoBstrong , KAATSU etc)? Also, if v02max declines 5-10 percent per decade is due to a lower peak heart rate (roughly approximated by 220 - age), is there any danger in trying to get your heart rate to its maximum (zone-5)? BTW, regarding jump-rope training for 'foot reactivity' , any thoughts on those blackboard-training foot exercises for balance? And if the vagus nerve is responsible for heart-rate recovery, hrv, suppressing arrhythmia.. do vagus-nerve stimulation exercises have any merit? Kinda reminds me trampolines.. where Azra Raza recommends them for the lymphatic system!

[@bennguyen1313]

Also, Kaleen Lavin was on the recent STEM talk podcast, talking about the importance of exercise for the brain! BTW, why is the podcast from the rss feed only 1h58m while the YT is 2h12min long?

[@SirGalaEd]

My question is this, how do I understand what my hazard ratio might be if I was a serious high school athlete, continued training on and of at various intensity (martial arts, resistance training, some cardio) over the next 50 years but maybe had periods of a year or something where i virtuallystopped training then started up again. I have never had a BMI over like 30 ( yes i know BMI has its problems but it gives readers and idea of my relative weight in my life). What benefits did I gain in high school, I may have held on to with aging? And can I reignite any of those benefits with current exercise?

[@miroslavnovak3711]

Good talk. At around 1:30h, if he was talking he can hold 320w on bike for 1h, I think thats BS, he should get his trainer calibrate.

[@csmrfx]

@1:24:27 exercise regimen

[@erikknudsen4034]

I'm 47, VO2 max of 71 ml/kg/min. I own a cycling coaching business, and I ride about 11 hours per week. I do it because I love it, and never really considered the longevity aspects.

[@VishalRaoOnYouTube]

39:52 This discussion of hazard ratios is pretty staggering!

[@angelbaybee3700]

You 2 docs may be the ones who can answer my question...fingers crossed. I 62 female at 53 had double mastectomy. Since surgery, I have NEVER been able to breath fully unless I consciously force meself. It is as though I FORGET to breath. Surgeon did great job...little scar tissue. I wonder if while under anesthesia if I got scared and somehow held my breath... Have you had any patents experience something similar. I can breath deeply but ONLY if I focus on it! At any given time of day I feel as though I could fall asleep even while standing up! I live in Oakland Ca. Any doc recs also would be most welcome! Excellent discussion thx!

[@marky5493]

diaphragm nerve damage maybe??

[@erwinrogers9470]

Love it 🔥