Effect of Thalassemia Trait (B) on VO2max
The Thalessemia trait is quite prevalent in both the Mediterranean and in parts of Asia and of course in the US there are many individuals who carry the trait because of their ethnic background. While largely asymptomatic, it stands to logic that the presence of a thalassemia trait could potentially lower VO2max in affected individuals. Is there any scientific literature on what is the effect of Thalassemia Trait on VO2max? Are fit individuals who exercise regularly (Zone 2, Zone 5) expected to have lower VO2max as a result of the trait and presumably reduced oxygen carrying capacity of their red blood cells? Are there known (adjusted) VO2max ranges for such individuals and any recommendations on how to exercise effectively and safely in the presence of the trait?
Endurance Training and Carb Intake
Hi Peter, long time listener and I love the show. It's clear that you believe endurance sport is generally a good thing, but I'd like to pick your brain as it relates to fuelling for racing. As a former triathlete who has recently been getting "back in the groove" for longer distance racing, one of the things I have been thinking about in terms of trade-offs is practising race-day nutrition. For competitive Ironman racing, 90-110g_carb/hr is approximately the fuel one can train to sustain. In my mind, race day is a small abberation in the calendar and I could be happy with very poor diet for one or two days out of the year. However, in order to ensure I can handle this fuel on race day I have been aiming for a similar consumption for midweek Z3+ efforts, and also for the sunday long ride. When fuelling these efforts, it effectively puts me in the region of 50-60 oz of maple syrup per week!! From this lens and as a former endurance athlete yourself, do you foresee potential for a deleterious effect on longevity? And do you believe the tradeoff in terms of exceptional cardiovascular fitness is worth it? I imagine that: 1) A fair amount of the carbs go to satisfying immediate energy needs. It is not clear to me whether that wholly negates any negative impacts (whether on insulin response or elsewhere). 2) A negative impact on metabolic flexibility would be, at least partially, offset by the volume of Z2 training that is inherent to the sport.
Other health enhancing/improving benefits of Cialis (Tadalafil) or other PDE5 inhibitors
What are your thoughts on a low dose of Cialis for claimed benefits beyond ED? Benefits I've heard or read are increased androgen receptor density, reduced aromatase expression, improved blood flow for workouts, slightly lowering blood pressure, and cardioprotective properties. Do you see this as a potentially helpful medication for men with symptoms of low testosterone or as an adjunct for men on TRT?
High intensity exercise causing coronary calcification
Could Peter comment on this study which sounds very counter intuitive and has great implications ? News-Medical.Net: Intense exercise encourages coronary artery calcification. https://www.news-medical.net/news/20230105/Intense-exercise-encourages-coronary-artery-calcification.aspx
Fasting regulates circadian rhythms?
How does extended fasting, not eating for at least one day, affect circadian rhythms? Would also be interesting with another podcast hosting Prof. Satchin Panda since he seems to have published some interesting studies recently on how fasting affects circadian rhythms: https://pubmed.ncbi.nlm.nih.gov/36198291/ and https://www.cell.com/cell-metabolism/fulltext/S1550-4131(22)00543-5?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS1550413122005435%3Fshowall%3Dtrue