Maximize your VO2 max and fitness levels to live longer and healthier | Peter Attia and Mike Joyner

so let's talk about this V2 Max test CU we're going to talk about what it means and and you know how predictive it might be of an individual's uh mortality so let's just start by um explaining to people what you do when a person comes into the lab right so what you do is you get them on a bike or a treadmill you put some EKG electrodes on them and they either run on the treadmill or ride a bike and they have a nose clip on if you're going to measure directly and and either a face mask or a mouthpiece that they breathe and that allows us to measure how much oxygen they breathe in or air they breathe in how much air they breathe out we know that the air has 21% oxygen coming in if we measure the amount of oxygen in the expired air we can make an estimate of how much oxygen has been consumed and so what happens is when people start to exercise they go from using about 3 and 1 12 MLS per kg per minute so think about you know or or or maybe 250 MLS or 300 MLS so like 10 or 12 ounces of oxygen per minute right and an unfit you know person in their 30s or 40s can typically increase that about 8 or tenfold to say in in in to to say 30 or 35 yeah to 30 and that would be that would be 30 or 35 or about 3 l a minute right and training most people can increase things at least 10 or 20% and if you have some ability and or you train very hard some people can almost double it and so what happens is that once your V2 Max goes up again just like physical activity it's a measure of of physical fitness and it's also linked to all cause mortality so people the fitter you are the the lower your chance of dying in the next year two years five years years 10 years and it's it for many years they thought that thing sort of plateaued at what they call about 10 or 12 Mets a met mean your resting metabolic rate so you had to be able to get 10 10 Mets and 10 Mets is being able to run one mile in about 10 minutes roughly for the average person and and now people have shown a group in at in Henry Ford in Detroit have shown that that continues to rise even up to 15 16 Mets so people that are quite fit continue to to to gain uh you know benefit in terms of all cause mortality I mentioned the the cross country skiers earlier and while they didn't do V2 Max test in those people the people who had completed the most races and done the races the fastest so people who had both been active for the longest period of time and probably were the fittest also had lower lower all CA mortality than people who had not not compared to sedentary peers but compared to people who'd done a few races a little bit slower so yeah Peak Fitness Matters yeah when we look at that that there so there's a paper in jamama that I think is by far the most compelling description of this phenomenon a couple things are noteworthy about it and I've talked about this in a previous AMA because it's it's really one of the I would consider one of the 10 most influential papers that I um have read in terms of changing how I think about uh you know Health span and lifespan um as you said the relationship is monotonic and it does not Plateau so corre it's that's that's an important thing to to appreciate which is this is a more is better phenomenon and very few things in physiology are more is better yeah usually physiology behaves in U's and upside down U's or maybe J's and things like that or or or whatever exactly sigmoid curves but this is not the case here this study that we're talking about put people into the bottom 25th percentile you know 25th to 50th percentile 50th to 75th and then the last group it basically divided into you know 75th to 97 a half and then they had that little sliver of people that they called Elite that were at the top two and a half percentile and all cause mortality just went lower and lower and lower and lower correct and if you looked at the hazard ratio the other way because we often think about Hazard ratios in Risk reduction but if you look about it in Risk increase when you compared the people in the top two and a half percent uh of V2 Max to the bottom 25% the hazard ratio moving in that direction was 5.04 my memory Serv me correctly that means there's a fivefold increase in all caused mortality between the fittest 25% and the least 25% and even when you took something less extreme I believe if you looked at the least fit 25% to the third quartile so the 50th to the 75th percentile the hazard ratio was still about just just below three I think it was 2.75 is which was kind of right on par with the increase in mortality that you would see from having endstage renal disease which is by the way greater than the hazard ratio associated with smoking yeah no no being unfit is an incredible risk factor you know and people like Frank Booth have argued that that it should be you know for lack of a better word the risk factor and Jill Barnes one of my fellows at the time she's now at the University of Wisconsin a faculty member she and I wrote wrote a um wrote a editorial for male clinic proceedings maybe 5 10 years ago where we said look if people had you know 12 13 14 met Peak Exercise capacity other than doing cancer screening you could probably just ignore everything else you know I mean mean and that's a little bit I don't think anybody's ready to go there the sorts of people who do health screening that sort of thing but if you screen people for physical fitness and again just did the routine kind of cancer screening and you could even argue that you could probably cut back on the routine cancer screening for most things except for skin cancers because fit people tend to be outside a bit more you can make that argument yeah you make it with a straight face and the data is there to support it and I would belt in suspenders it and say but look I'd still do the cancer screening I'd still agressive lipid management and things but but you're absolutely right I mean there's really no intervention that we have that's going to rival it well and and I think I think you mentioned lipids uh Peter and I think there's a couple things you got to remember one especially for people who pick it up late in life you know exercise is not a vaccine and and one of the the most incredible studies ever done again we're talking about these sort of one in in of one experiment of nature sorts of things is there was a man named Clarence dear he won the Boston Marathon seven times was born I think in 1888 or 1890 also won a medal in the 24 Olympics got a bronze medal in the marathon and he really is almost like Master athlete number one so he kept training his whole life ended up dying I think of stomach cancer at about age 70 so he didn't live to be a gazan but remember he was born in in in 1888 or 1890 anyways uh Paul Dudley white a famous cardiologist we know him from something called The Wolf Parkinson White syndrome a weird kind of funny heart good he did an autopsy on dear and he'd run really till very late in life and he had some plaque or you know fatty builds up and calcium buildup in his coronary arteries but his coronary arteries were huge were just massive and subsequent to that uh a man named Bill hasad at Stanford in the middle 90s studied a bunch of alter people who done ultramarathons and they did the same thing except this time they put catheters in and and injected drugs to make blood vessels expand and they showed the blood vessels were bigger and they expanded more so so again while you can still have some blockages uh even if you exercise and there are people with horrible lipids who do in fact get heart disease in spite of exercise so it's not a complete U you know complete vaccine but uh its overall protective effect is is quite large uh both in terms of what it does to people's lipids but the fact that the blood vessels get so much bigger and the Linings of the blood vessels are are are [Music] healthier

Channel: Peter Attia MD

Views: 54,191

Keywords: Peter Attia MD, Dr. Peter Attia, Early Medical, The Drive Podcast, The Drive, Longevity, Zone 2, vo2 max, cardiovascular health

Id: b5FirUwmI3g

Length: 8min 42sec (522 seconds)

Published: Thu Mar 07 2024