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The Peter Attia Drive
#201 - Deep dive back into Zone 2 | Iñigo San-Millán, Ph.D. (Pt. 2)
Mar 28, 2022
02:45:31
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Quick takeaways
- Understanding lactate levels and fat oxidation in elite athletes can provide insights into their amazing potential from a performance and metabolic perspective.
- Zone 2 training boosts mitochondrial function, impacting longevity and overall health.
- Accurate assessment of lactate profiles and fat oxidation capacities is essential for optimizing training zones and improving metabolic flexibility.
- Understanding the relationship between lactate production, fat oxidation, and glucose metabolism is crucial for optimizing training strategies and overall health.
- Balancing both Zone 2 training and high-intensity interval sessions stimulates both the glycolytic and aerobic energy systems, leading to improved metabolic health and efficiency.
- Disturbances in mitochondrial function observed in long COVID patients resemble those seen in individuals with type 2 diabetes, highlighting the need for targeted interventions.
Deep dives
Importance of Translating the Science of Longevity
This podcast episode focuses on translating the science of longevity into accessible content for everyone. The host and guest discuss various topics related to health and well-being, with a particular emphasis on metabolism, nutrition, sports performance, and critical care. The conversation explores the importance of understanding lactate levels, fat oxidation, and the relationship between exercise intensity and mitochondrial function. The episode also delves into the significance of zone two training and its effects on longevity and overall health. Additionally, the guest shares insights from their study on the impact of long COVID on mitochondrial health and its resemblance to type 2 diabetes.
Exploring the Work of Tadej Pogačar
The episode highlights the work of Inigo San Millan with professional cyclist Tadej Pogačar, the two-time Tour de France winner. They discuss Pogačar's impressive performance and his physiological characteristics that set him apart. The conversation focuses on factors such as lactate clearance, fat oxidation, and the ability to sustain high power output for extended periods. The episode also touches on the strategic approach to training and race performance, including the use of physiological data and metabolic analysis. Pogačar's exceptional abilities and physiology provide valuable insights into the world of professional cycling and training methodologies.
Understanding Zone Two Training and Fat Oxidation
The podcast examines the concept of zone two training, which is the exercise intensity that primarily stimulates fat oxidation and mitochondrial function. The conversation delves into the correlation between lactate levels, carbohydrate utilization, and fat oxidation. The host and guest discuss how different individuals and athletes exhibit variations in their lactate profiles and fat oxidation capacities. They also touch on the importance of accurately identifying maximum fat oxidation and adjusting training zones accordingly. The episode highlights the benefits of zone two training and its potential impact on improving metabolic flexibility, fuel partitioning, and overall endurance.
Evaluating Lactate Levels and Fuel Utilization
The podcast episode emphasizes the relationship between blood lactate levels and fuel utilization during exercise. The guest explains how measurements of lactate and substrate oxidation provide insights into an individual's metabolic efficiency and performance potential. The conversation explores the differences in lactate profiles between elite athletes, moderately active individuals, and those with metabolic syndrome. The discussion also delves into the intricate connection between lactate production, fat oxidation, and glucose metabolism in the mitochondria. The guest highlights the significance of understanding these metabolic processes to optimize training strategies and overall health.
Duration and Frequency:
To achieve the benefits of this type of training, it is recommended to train for 1 to 1.5 hours, four to five times a week. This frequency allows for consistent stimulation and adaptation of the body's energy systems.
Balancing Energy Systems:
In addition to Zone 2 training, incorporating some high-intensity intervals is beneficial to stimulate the glycolytic energy system. For example, at the end of a Zone 2 workout, a high-intensity interval of 5 minutes can be added to target anaerobic performance.
Adapting to Fitness Level:
For beginners or those out of fitness, starting with 20 minutes or so and gradually building up to 1 hour can be effective. Increasing the duration over time helps improve mitochondrial function.
Targeting Energy Systems:
The focus should be on Zone 2 training for most workouts, with occasional high-intensity interval sessions to stimulate the glycolytic system. By balancing both energy systems, the body can benefit from improved metabolic health and efficiency.
Mitocondrial Health and Aging
Sedentary individuals who are not clinically symptomatic already show significant disruptions in mitochondrial metabolism compared to physically active individuals. This includes downregulation of glucose and fat oxidation, as well as decreased capacity in the transporters and electron transport chain of the mitochondria. In sedentary individuals, there is a significant dysregulation in the mitochondrial pyruvate carrier, leading to impaired pyruvate transport into the mitochondria and increased lactate production. This disruption in mitochondrial function may be a prelude to the development of insulin resistance and metabolic disorders in the future.
Exercise as a Tool for Longevity
Exercise remains the most potent intervention for improving longevity. Although acute exercise may not appear to be gero-protective on its own, chronic exercise exerts undeniable benefits on various physiological and cellular levels. The cellular adaptations to exercise, particularly at the mitochondrial level, are more important indicators of longevity and metabolic health than VO2 max or other cardiorespiratory markers. The compounding effects of exercise, performed consistently over time, lead to significant improvements in cellular metabolism and overall fitness, defying traditional notions that age-related decline is inevitable.
Long COVID and Mitochondrial Dysfunction
Individuals recovering from long COVID, even those previously healthy, experience significant disturbances in mitochondrial function similar to individuals with type 2 diabetes. These disturbances include impaired fat oxidation, increased lactate production, and decreased metabolic flexibility. The disruption in mitochondrial metabolism may explain the symptoms observed in long COVID patients, such as exercise intolerance. Further research is needed to understand the precise mechanisms and develop targeted interventions to restore mitochondrial health in long COVID patients.
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Episode Description:
Iñigo San-Millán is an internationally renowned applied physiologist and a previous guest on The Drive. His research and clinical work focuses on exercise-related metabolism, metabolic health, diabetes, cancer metabolism, nutrition, sports performance, and critical care. In this episode, Iñigo describes how his work with Tour de France winner Tadej Pogačar has provided insights into the amazing potential of elite athletes from a performance and metabolic perspective. He speaks specifically about lactate levels, fat oxidation, how carbohydrates in food can affect our lactate and how equal lactate outputs between an athlete and a metabolically unhealthy individual can mean different things. Next, he discusses how Zone 2 training boosts mitochondrial function and impacts longevity. He explains the different metrics for assessing one’s Zone 2 threshold and describes the optimal dose, frequency, duration, and type of exercise for Zone 2. Additionally, he offers his thoughts on how to incorporate high intensity training (Zone 5) to optimize health, as well as the potential of metformin and NAD to boost mitochondrial health. Finally, he discusses insights he’s gathered from studying the mitochondria of long COVID patients in the ICU.
We discuss:
- The amazing potential of cyclist Tadej Pogačar [3:00];
- Metrics for assessing athletic performance in cyclists and how that impacts race strategy [8:30];
- The impact of performance-enhancing drugs and the potential for transparency into athletes’ data during competition [17:00];
- Tadej Pogačar’s race strategy and mindset at the Tour de France [24:00];
- Defining Zone 2, fat oxidation, and how they are measured [26:45];
- Using fat and carbohydrate utilization to calculate mitochondrial function and metabolic flexibility [35:45];
- Lactate levels and fat oxidation as it relates to Zone 2 exercise [40:00];
- How moderately active individuals should train to improve metabolic function and maximize mitochondrial performance [51:45];
- Bioenergetics of the cell and what is different in elite athletes [57:30];
- How the level of carbohydrate in the diet affects fuel utilization and power output during exercise [1:08:30];
- Glutamine as a source for making glycogen—insights from studying the altered metabolism of ICU patients [1:15:00];
- How exercise mobilizes glucose transporters—an important factor in diabetic patients [1:21:00];
- Metrics for finding Zone 2 threshold—lactate, heart rate, and more [1:25:00];
- Optimal Zone 2 training: dose, frequency, duration, and type of exercise [1:41:15];
- How to incorporate high intensity training (Zone 5) to increase VO2 max and optimize fitness [1:51:15];
- Compounding benefits of Zone 2 exercise and how we can improve metabolic health into old age [2:01:45];
- The effects of metformin, NAD, and supplements on mitochondrial function [2:05:15];
- The role of lactate and exercise in cancer [2:13:30];
- How assessing metabolic parameters in long COVID patients provides insights into this disease [2:19:00];
- The advantages of using cellular surrogates of metabolism instead of VO2 max for prescribing exercise [2:25:45];
- Metabolomics reveals how cellular metabolism is altered in sedentary individuals [2:33:45];
- Cellular changes in the metabolism of people with diabetes and metabolic syndrome [2:39:15]; and
- More.
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