Dr. Peter Attia
speaker
5,258 appearances
36 recordings
6 series
first heard Jan 2024
last heard Jun 2025
Dr. Peter Attia’s voice in public audio — every appearance, attributed to the second.
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And it has a whole bunch of lines that come across that show various activities. You know, if you want to be able to run a six-minute mile, you have to have a VO2 that's very high. If you want to be able to run an eight-minute mile, a 10-minute mile. If you want to be able to climb a flight of stairs without getting out of breath.
Like it shows all of these different things and you see what the required VO2 is. I think, in fact, we might even have these graphs in here. Yeah, right there. So we put your dot on the graph and we say, if you stay where you are, meaning right at that green curve, you're in for a great life. Why? Because even when you're in your 80s, you're still going to be able to do all of those things.
Yeah. So he did both a Zone 2 and a VO2 max test. So Jack got on the treadmill. And there's a protocol for how you warm somebody up. You really want them to be able to get to a maximum effort. You don't just put them on a treadmill and crank it up. You take your time getting them up there. And he had an amazing result. So his VO2 max was 4.1 liters per minute.
And he achieved that at a heart rate of 204 beats per minute, which is higher than what was predicted for his age. If you normalize it by his weight, he was at 56.5 milliliters per kilogram per minute. So when you look at his age, because he's in his 20s, he was at about the 97th percentile for his age, meaning his VO2 max was higher than 97% of people his age.
And so out of the gate, that just tells us from a longevity standpoint, our goal is to keep him there as long as possible. I mean, we're so ambitious with our patients and clients that we actually want them to be, as an aspiration, to be two decades younger at the top 2%. So if you're 50, you wanna be VO2 max north of 53.
And then the other thing we do is we check on something called heart rate recovery. So in 60 seconds post VO2 max, how long does it take? How many beats does their heart rate come down in one minute? This is also a very powerful predictor of mortality because it's a huge indication of what's called parasympathetic sympathetic balance. So it's basically a question of,
How much is their autonomic nervous system in favor of sort of a stress response versus a recovery response? And so the gold standard here, we want to see people that can recover at least 30 beats in the first minute. He did pretty well. He recovered 28 beats. You know, if you're really, really fit, you're going to be 40, 50 beats of recovery within the first one minute. It's incredible. Wow.
Then we tested his lactate levels and we ran him for what we called zone two testing, right? So zone two is his aerobic base. This is where he should be spending 80% of his training, 80% of his cardio training time should be in this energy system. So it's Hard enough that it's not just pure recovery, but not so hard that it's pushing energy systems that are higher.
This is a pace he should be able to hold for an hour. And he should certainly feel like he's working, but not feel it too much. Technically, it's also a place where he's got maximum fat oxidation. So we do this also in the same measure on a treadmill. This is a bit more of a complicated test because you're titrating between how he feels and what his blood lactate levels are.
Maybe not to get too complicated in the weeds on that, but we're simultaneously looking at the ratio of how much carbon dioxide he produces to how much oxygen he consumes. Mm-hmm. That tells us how much fat he is using in his own body. And we look at that number and he maxed out at 0.77 grams per minute, which is very good. One gram per minute of fat oxidation is exceptional.
So 0.7677 is pretty darn good. His lactate hit about 2 millimole, and he achieved this running at 7.3 miles per hour. So again, there's a lot to unpack in there, but that gives us a pretty good sense of his level of fitness. And for a guy in his 20s, that's really good fitness.
Yes, yeah. But even this test is about – we normally would separate these two tests on two separate days. Okay. So people who come to 10 Squared are not from Austin. They're from all over the place. So they come in for two days of testing, and you've got to sort of figure out a way to take a person who's not necessarily that fit and allow them to do these tests.
So it's kind of broken up over to a couple days so they can mix it with the strength testing and all the other stuff.
So the truth of the matter is, looking at his stuff here, I would say I think you've got the endurance thing really covered. In his case... There were other issues that were uncovered during his intake that were of more concern. And this is a matter of like now what we think of as portfolio management, right?
So when your VO2 max is in the top 2%, when you're fat oxidizing 0.7, you know, almost 0.8 grams per minute, and he's got a heart rate of 165 to 170 when he's in zone two. I mean, this guy's cardio is dialed in.
All right. Well, first off, Jack, thanks for being an awesome guinea pig yesterday. You hit it out of the park as far as your cardio training. So tell me a little bit, like, what are you doing for cardio? How often are you running?
Interesting. I know that the team talked to you about your left foot. Yes. And did they show you the pictures on the treadmill?
I think it's very likely that the ankle sprain has changed your gait such that you probably are going to develop an injury over time with your running if your pattern is not corrected. So you're overcompensating on the left. And I assume you noticed the difference in the height of your shoulders and your head and everything while you were running.
So even though the engine is working insanely well, this test only measures the performance of your engine. Your chassis, which is a subjective assessment to use the car analogy, shows that the chassis is a bit weak.
That's right. And again, the good news about running is each step is very light. But if you're running 20K, that's a lot of steps. So even something that's a light impact but done thousands of times will produce a problem. Okay. So let's shift from how well the engine is, which is exceptional at both ends, by the way. To be clear, your peak engine output, which is VO2 max, was awesome.
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