mitochondria function in 62yr old and VO2 max
Hi Peter , wonderful show thank you . I am a 62yr old woman,of above average fitness i think for my age . I am still actively working (on a yacht as a superyacht chef ) which entails standing for long periods of time and lifting heavy things . When I am not on board I up my exercise regime - weight lifting and cardio . I heard on Dr Gabriel Lyons podcast that mitochondria function slows down as we age and older people should consider taking Mitopure or urolithin A to help them be more consistent and get results from their workouts . What is your opinion on this and which brand would you recommend . I am also working on my VO2 max - my watch (apple) gives me a reading of 31.6 which is HIGH . I have you new book - which is fabulous as i love all these things but would you say that the only real way to measure your VO2 max is by having it done professionally at a clinic ? I live in Mallorca Spain when Im not on the yacht . Heres to the Centenian Decathalon !
AI tools for nutrition / food recognition
What is the state of the art for doing image analysis for nutrition studies? I was just listening to Episode #324, which included information on the Nutrition for Precision Health study. As a participant in the study, I used several of their tools for journaling food (though not the glasses that are mentioned). I have also used the free food recognition available through the Zoe app, and that is MUCH better at recognizing foods, at least in home-cooked rather than packaged meals. I haven't tried to quantify the amount of each food, as they focus more on plant diversity than on calorie or macro counts, but it seems to me that recognizing which foods are present accurately is the harder problem. Zoe was recently updated, and I'm just wondering if you have found anything better than its newest version.
Lp(a) in women
What should we make of recent research showing that Lp(a) fluctuates in women in ways it doesn't in men? Given the importance of it, should women test this more than once? When? Does it affect treatment at all? https://www.healio.com/news/cardiology/20251217/womens-hormones-modulate-lpa-but-data-on-management-conflicting
Lp(a) in otherwise healthy individuals
Is a statin a good option for an individual whose has genetically high lp(a) (~120) but has no other problematic lab test results and is relatively healthy, and already has a decent workout routine (incorporating cardio & strength). Where is the research at for other treatments for high lp(a) and is it always necessarily problematic?
Stability, Mobility and Flexibility
Exercise is the backbone of Peter’s strategy for longevity but most of the podcasts to date have focused on strength training, zone 2 or VO2 Max. While I am in full agreement that these three are the most important pillars for extending health span they need to bee built on a foundation of a body that is injury free and moves well. To this end I feel like a deep dive into stability, mobility and flexibility would be be really interesting. Defining all three, weighting there importance in one’s exercise regime and how they contribute to injury prevention as well as any practical take aways for long term injury prevention.
Joint integrity
Hi, i’ve often heard that people can be born with either ‘good’ or ‘bad’ joints - the ‘bad’ ones meaning that they get injured more easily (they are more fragile) or will wear out quicker and need a replacement (like knees or hips), and that the cartilage in a joint only has a limited life and if it gets worn out you need to go for a replacement surgery…. While i’d always thought that building muscle and range of motion around any joint is the best way to ‘bulletproof’ it, is there anything else that we should be doing to prevent a joint from getting worn out and needing a replacement surgery? John
Gadolinium risk over time and exposure
I have been dx with the BRCA2 mutation and have many big decisions to make. On the prevention side of things (vs. surgical) I would have to undergo 2 MRI’s a year (pancreas and breast) for the rest of my life? I am weary of the risk of gadolinium build up especially in my brain. What are your thoughts? Thanks, Kara
Differences in heart rate measurement
What is the difference between the Apple Watch heart rate and the Polar OH1 heart rate? I have put my VO2 levels (results from a treadmill test) into both systems but the calorie count varies quite a bit. I use a chest strap with the Polar system. Which is the most accurate?
Longevity and T1D
Hi Dr Attia, first of all, I love the content you share with us, your work is so meaningful, so congrats for being so kind in spreading knowledge and thank you. Secondly, my daughter has T1D and I’d love to hear a podcast on longevity in T1D. Maybe that’s too specific for the general public, so it could be around autoimmune diseases or another correlated subject. When we first found out she had T1D, the first thing that crossed my mind was: will she have a lower life expectancy because of T1D? And also a lower health span? I believe she can get her maximum potential on both but it takes a lot of effort (and because she is only 8 most of this work is still within parental care). Anyway, not sure if this message will ever reach you but I would love this topic to be explored! You have touched on T1D several times during other podcasts but would be wonderful to have a dedicated one. I wish you and your family a fantastic 2026, and hope your work get spread more and more! Bruna
the role of sports in training load
Loved Loved Loved the AMA on cardio training!! I was absolutely the guy who misunderstood what you were saying and saw Zone 2 as a magical training target. What I took away is the following. We have 3 stages of loading. Stage 1 rest and zone 1, very little training benefit. Stage 2 is zone 2 and let's say 2a for full zone 2, minimal lactate production. 2B lactate consumed in the muscle. 2C lactate consumed in the body. In zone 2, too hard is better than not hard enough. Stage 3 excess lactate buildup. Even during a stage 3 or zone 3/4/5 workout, the mitochondria is working full speed. The muscles are learning to burn all lactate they can, so I still get the training benefit of zone 2 at the higher rates of exertion, I just can't maintain those higher rates for too long. Assuming this is right... the question. How do I think about Sporting activities compared to "pure" training? I have access to a lot of sporting opportunities. One hour on the Elliptical is 9 METS or 64 TRIMP score. In two hours of volleyball, I do 10 METs and 169 TRIMP. 90 minutes of pickleball is a VERY easy to talk myself into and gets 10.5 METs and 154 TRIMP. I have a 2 hour commute and a late career but trying full time job. It is much easier for me to spend an hour or two playing with friends than grinding in the gym. Assuming I am getting my weight training in, can I look at the aerobic work as an area under the curve problem? Where I want to maximize the heart rate over time, as I don't have the time to burn myself out? I average about 100 minutes of some kind of exercise per day. THANKS!!
Rapamycin and Healthspan.com
I know there is a long waiting list to become one of your patients and you are taking rapamycin off-label. Healthspan.com is a site that offers the med as well as lab evals, etc Is this site good? Vetted by your team? If not are there any sites or practices in SF that follow your principles? It’s ok if it’s concierge. Thanks.
Menopausal status with pharmacologically suppressed menstruation
Is it possible to determine menopause / perimenopause status with a suppressed menstrual cycle? Is it worth trying to track hormones in urine or blood in order to figure this out? Presumably it would take a lot of data points in order to get a complete picture, and would therefore be relatively expensive.
Why equal on-off intervals for HIIT?
Is there any scientific basis for using equal active and recovery intervals for HIIT, e.g., 4x4, other than simplicity (I could not find anything in the scientific literature)? If I know my maximal heart rate accurately from using a Polar strap, is it OK to start the next active period when my heart rate has dropped to something like 60% of maximal heart rate? If so, for a given total time available for HIIT, I can get more volume in the active periods than strictly following 4x4.
GLP-1 impact on HRV and maintenance dose
Do you have any updates on the impact of GLP-1 receptor agonist medications on resting heart rate and HRV? What kind of strategies are you seeing for health maintenance after reaching a target body composition / target metabolic health biomarkers while taking a GLP-1? Would you integrate HRV monitoring into developing a maintenance strategy?