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Mitochondria are the powerhouse of the cell....yes, but what does that mean? What can we do, as Wise Athletes, to have enough healthy mitochondria in our muscles and everywhere else powering our bodily functions for optimal brain power, energy levels, we well as muscle power and endurance?

These questions and more are addressed by Dr. Mark Tarnopolsky, neurologist, mitochondrial researcher, lifelong elite athlete. Mark is the real deal who knows both sides of the story....the science and the practice of building muscle and VO2Max for performance today and a long stay on the planet as a strong athlete.

All right, let's talk to Dr Tarnopolsky about the single best way to stay healthy and strong as we get older....exercise.

BIO: Mark Tarnopolsky, MD, PhD, FRCP(C)

• Professor of Pediatrics and Medicine, CEO and CSO, Exerkine Corporation,
• Director of Neuromuscular and Neurometabolic Clinic,
• McMaster University Medical Center

Bullet points -- Muscle & Mitochondria

• "We all are suffering from the mitochondrial disease called aging"
• "An ounce of prevention is worth a ton of cure"...Muscle loss prevention is ideal but it’s never too late to restart exercising; benefits accrue to everyone who starts exercising at any age.
• Aerobic training is very good, but we also need weight training.  Exercise provides a modest 4-year lifespan extension but a 10-year healthspan extension as it lengthens the time in life we can be mobile and take care of ourselves.
• Do at least 30 minutes of exercise everyday
• VO2Max is a function of and delivery of oxygen (heart stroke volume and heart rate) and extraction of oxygen (capillarization of blood vessels into muscle and mitochondrial volume to use oxygen)
• Vo2max: 
• At rest:  3.5 milliliters of oxygen per kg of body weight per minute
• Min. to live without assistance:  12 ml/kg/min
• Mark's VO2Max at his athletic peak: 88.2 ml/kg/min
• VO2Max falls from 25/30 yo but older athletes have higher vo2max than sedentary young people
•  But VO2Max isn’t enough for longevity.  We need 3x/week of endurance training for VO2Max and 2-3x week of resistance training to build and maintain muscle mass.
• Longevity metrics:  VO2Max, leg strength, waist-to-hip circumference
• Elite athletes need 2x the protein of sedentary people
• Don’t train with futility:  Get enough high quality protein (aim for 1.2g/kg), don’t be deficient in Vit D (take a supplement), get sufficient calcium in diet.  Milk and egg whites are the best quality proteins.  Collagen is low quality protein (used as the no-protein control in experiments)
• Running or cycling at 65% of VO2Max (approx. lactate threshold; top of zone 2) 3-5x per week for 30-60 minutes a day will increase mitochondria.
• Interval training will increase the pace and HR possible at a zone 2 (“all day pace” of work) by increasing the lactate threshold.  Once lactate starts to accumulate, it is only a matter of time before exhaustion sets in.
• Weight training in untrained older people does build mitochondria, and there is a spill over into VO2Max development
• Weight training for endurance athletes is about building muscle mass for strength and healthspan
• Fast vs. Slow twitch:
• Slow are the endurance fibers that are full of mitochondria, can go all day without fatigue, can burn every fuel we have with oxygen, but are smaller (to allow better oxygen delivery) and slower to turn fuel into energy.  These fibers and their mitochondria come from a demand (consistent exercise) for long, moderate effort of work.
• Fast are the stronger fibers that have some mitochondria but not as much, burn glucose with or with oxygen, are bigger and stronger but tire easily.  These are the fibers we build lifting weights that usually does not stimulate mitochondrial biogenesis

Why do we lose muscle? What can we do to stop it?

1. Lack of use is the big one
2. Loss of enervation…the nerve that connects the muscle fiber to the brain dies, and now the muscle cannot get any signal to move, so the muscle is lost. On average people lose 30% of the muscle nerves.  This seems to occur more frequently in people who do not exercise.  Nerve talks to muscle; muscle talks to nerve.
3. Mitochondrial damage from oxidative stress.  Antioxidants made by the body and in our diets can help.  As we lose mitochondria, the remaining mitochondria make more reactive oxygen species which cause oxidative damage.  And old mitochondria have accumulated more damage and make more ROS.   Exercise stimulates mitophagy…the clearing out of old mitochondria.  But the ROS is also a signal to make the cells stronger and more resilient, so some ROS is good while too much can cause extra damage.
4. Taking antioxidants after moderate exercise is probably not helpful and might impede adaptation but antioxidants after very hard, perhaps excessive exercise can be helpful to minimize the damage
5. Other things Mark takes:  a multi-vitamin, Alpha Lipoic Acid (ALA), coQ10 because he exercises hard 7 days a week.
6. Deficiencies are never good:  get iron/ferritin levels checked, b12 is often low, check thyroid…low thyroid is bad for mitochondria, vit d, lipids,
7. Anabolic resistance…older people have a lower level of muscle protein synthesis for a given level of stimulation (exercise or amino acids).  Largely related to poorly functioning transporters that bring the amino acids into the muscle cell to use to make more muscle.  Probably from oxidative stress, AGEs damaged proteins,
8. 0.8 g/kg is not enough for trained athletes training very hard…cannot fully recover. When training 1.5-2 hours a day, athletes need almost double the protein (1.6-1.7g/kg per day).High quality protein is best at these minimum intakes.
9. Older adults should aim for 1.2g/kg/day vs the RDA of 0.8-1.0 unless training heavily and then aim for 50% more than younger athletes training the same amount
10. “humanized milk” = 60% casein & 40% whey
11. Autophagy is increased by exercise, which is safer for older athletes than fasting or caloric restriction.
12. To adapt to training you need to match calorie intake with calorie expenditure AND get enough protein.  Eat a variety of colors (phytonutrients are important).  Eat “close to nature”.   Avoid simple sugars and highly processed foods.  Antioxidants in food are always good.
13. Chronic inflammation is a cause for reduced muscle mass and slower muscle building.  Exercise lowers chronic inflammation. A healthy gut comes from a healthy diet.  Avoid the highly processed food (i.e. peanut butter) with emulsifiers.
14. Mitochondria are not just in the muscle…but exercise is good for mitochondria everywhere in the body.  Exercise is the key to healthy aging as well as health today.  Cataracts, hearing loss,
15. Supplements: 
16. fish oil (best in fish) good for muscle and mitochondrial preservation during disuse, ALA and Vit E and creatine combined lowered oxygen-related stress, creative alone is useful for improved sleep and muscle strength and brain health
17. TRIM7 -- Obesity supplement also is good for mitochondrial health:  Coq10 ALA, Vit E, beet root extract, Green tea extract, green coffee bean extract and mint extract called Forskolin.  Browning of white fat….helps people to lose weight without losing muscle.
18. Urolithin A – poor evidence of efficacy.
19. NAD+ boosters….may not be good and some evidence of problems from niacin and niacatinamide.
20. MUSCLE5 – creative, humanized milk, vit D, calcium.

Related info and episodes:

• Episode 128-mitochondrial-power-up-w-methylene-blue-scott-sherr-md/
• Episode 127-how-to-get-great-bones-dr-keith-mccormick/

More Tarnolpolsky info:

• Mark's Supplement Company: Stay Above Nutrition: https://stayabovenutrition.ca
• Exerkine (Revolutionizing Medical Nutrition): https://www.exerkine.com/

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