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    The Peter Attia Drive

    Training for The Centenarian Decathlon: zone 2, VO2 max, stability, and strength | Peter Attia, M.D.

    Mon Jul 10 2023
    Centenarian DecathlonFitness TrainingZone Two TrainingVO2 Max TrainingProgressive OverloadBone Mineral DensityRehabilitationInjury PreventionCardiovascular TrainingMeasuring PerformanceLong-Term CommitmentExercise and Health

    Description

    This episode is a live AMA celebrating the release of Outlive. The conversation focuses on the centenarian decathlon and how to create a list of events for it. They discuss fitness tests, training approaches, zone two and VO2 max training, prioritizing activities and fitness goals, progressive overload, injury prevention, maintaining bone mineral density, rehabilitation, cardiovascular training, measuring performance, and long-term commitment.

    Insights

    Centenarian Decathlon

    The centenarian decathlon is a list of specific events that can be activities of daily living or recreational activities. It includes strength, stability, mobility, aerobic capacity, and balance exercises.

    Zone Two Training

    Zone two training is important for tracking progress and net accumulating lactate. It helps harness mitochondrial efficiency and push oxidative phosphorylation to its limit before transitioning into glycolysis.

    VO2 Max Training

    VO2 max training can be done on various modalities such as air bike, regular bike, stationary bike, stair climber, treadmill running, and rowing. The sweet spot for VO2 max intervals is three to eight minutes of high intensity.

    Progressive Overload

    Progressive overload is an important principle in training where the load needs to become more difficult over time. Strength training can involve heavier weights, more reps, more sets, less rest, or using BFR.

    Maintaining Bone Mineral Density

    Strength training is crucial for maintaining bone mineral density. Walking, running, swimming, and cycling are not as effective as strength training for maintaining bone density.

    Rehabilitation and Injury Prevention

    Investing at least three hours a week in rehab can help avoid surgery for those with significant pain. Identifying deficits and focusing on them disproportionately can be effective in injury prevention.

    Cardiovascular Training

    Training for VO2 max requires spending a significant amount of time on cardi respiratory fitness. The training volume for developing cardi respiratory fitness is roughly 80% zone two and 20% VO2 max.

    Measuring Performance

    Power meters are important for measuring performance on stationary bikes and outdoor cycling. Wattage is a more accurate measure of effort than speed due to factors like wind.

    Long-Term Commitment

    Improving VO2 max requires long-term commitment and consistent training. Longevity-focused training should be approached with a lifetime perspective and enjoyment in mind.

    Exercise and Health

    Exercise has numerous benefits for quality of life and overall health, even if it were to shorten lifespan slightly (which it doesn't).

    Chapters

    1. Introduction
    2. Creating the Centenarian Decathlon
    3. Prioritizing Activities and Fitness Goals
    4. Zone Two Training and VO2 Max
    5. Training for Optimal Shape in Your Last Decade
    6. Progressive Overload and Injury Prevention
    7. Maintaining Bone Mineral Density
    8. Rehabilitation and Cardiovascular Training
    9. Zone Two and VO2 Max Training
    10. Measuring Performance and Long-Term Commitment
    Summary
    Transcript

    Introduction

    00:11 - 07:03

    • This episode is a live AMA celebrating the release of Outlive
    • The conversation focuses on the centenarian decathlon and how to create a list of events for it
    • They discuss fitness tests to determine if someone is on track for their centenarian decathlon
    • Training for the centenarian decathlon is discussed, including different approaches based on age and experience
    • Questions about zone two and VO2 max training are addressed

    Creating the Centenarian Decathlon

    06:34 - 13:18

    • The speaker trained for specific goals in their life, such as boxing, cycling, and swimming competitions.
    • They realized that most people exercise without a specific purpose.
    • To prepare for the marginal decade (age 80-90), the speaker created a centenarian decathlon with specific events.
    • The events can be activities of daily living or recreational activities.
    • The speaker listed various events including strength, stability, mobility, aerobic capacity, and balance exercises.
    • Examples of events include picking up a child from a squatted position or crib, getting up off the floor with one point of support, and placing a suitcase overhead.
    • Other events include dead hanging for 30 seconds, farmer walking with weight, and pulling or pushing a weighted sled.
    • The speaker also mentioned walking up and down stairs with feet pointed forward, single leg stands with eyes open and closed, hex bar deadlifts, dumbbell lunges in perfect form, covering three miles in one hour by foot, carrying weight up stairs, achieving VO2 max above 30 milliliters per minute per kilogram, treading water for ten minutes, scaling a ledge at shoulder height or pulling oneself out of a pool onto a deck twelve inches above the water surface, performing single leg glue bridges without loading the lumbar spine, doing planks in perfect form with scapular retracted and no hip sag for one minute, and being able to pull back a fifty-pound compound bow.

    Prioritizing Activities and Fitness Goals

    12:55 - 19:18

    • The centenary decathlon focuses on the physical piece of health span that is inevitably going to decline.
    • Emotional health is not included in the centenary decathlon list.
    • Patients are encouraged to create their own list of 10 most important activities or fitness goals.
    • Understanding the requirements for each activity helps prioritize and plan for them.
    • The goal is to be able to do those activities at a certain age, even if living to 100 is not expected.
    • Younger individuals have higher expectations and need to start from a higher place in terms of fitness.
    • VO2 Max is a commonly studied metric for cardiovascular fitness, which can be tested through various methods including a $100-$150 test or free estimations like Cooper's test.
    • Strength metrics such as farmer carry, dead hang, and wall set are also important indicators of overall fitness and can be measured against specific benchmarks based on age and gender.

    Zone Two Training and VO2 Max

    18:51 - 25:29

    • Wall set and air squat are great examples of testing leg strength
    • Zone two is important for tracking progress and net accumulating lactate
    • Zone two is when you can speak while exercising but it's uncomfortable
    • Rucking is mostly below zone two, except when going uphill
    • Muscle mass can be measured using a DEXA scan and should be at or above the 75th percentile for ALMI
    • Hemoglobin A1c, VO2 max, muscle mass, and strength are integrators of exercise and metabolic function
    • Strength beats muscle mass as a predictor of lifespan
    • Training frequency and specificity depend on individual objectives
    • Playing sports and lifting weights regularly is generally considered good

    Training for Optimal Shape in Your Last Decade

    25:10 - 31:43

    • Playing sports like tennis, basketball, and swimming can lead to movement issues and asymmetries in the body.
    • To counteract the repetitive stress of sports, it's important to focus on specific training for stability and movement.
    • Training specifically for optimal shape in your last decade requires dedication and commitment.
    • The minimum effective dose for training includes three hours per week.
    • For those starting from nothing, three hours per week will yield significant benefits.
    • The breakdown of the three hours should include one hour of steady-state aerobic training (zone two), one hour of strength training, 20-30 minutes of high-intensity aerobic training (VO2 max appropriate), and 30-40 minutes of stability training spread out over multiple sessions.
    • Practicing stability exercises for 10 minutes a day is more beneficial than doing it all in one session.
    • Videos demonstrating stability exercises are available at peterotiamd.com/outlive/video.
    • Increasing the training load depends on individual factors such as willingness and ability to handle more stress.
    • Progressive overload is an important principle in training, where the load needs to become more difficult over time.

    Progressive Overload and Injury Prevention

    31:21 - 37:44

    • Progressive overload is an important principle in training, where the load needs to get more complicated and difficult.
    • Strength training can involve heavier weights, more reps, more sets, less rest, or using BFR.
    • Finding ways to add demand without adding more time in the gym is crucial.
    • Identifying deficits and focusing on them disproportionately can be effective.
    • Age calls for nuance in programming, but people are often more resilient than they think.
    • Consistency and purpose are key to improving health and function at any age.
    • Bone mineral density (BMD) is important for both sexes, but women are at a greater risk.
    • Bones have strain gauges that respond to tensile stress from muscle contractions.
    • Women should pay attention to BMD as they age due to hormonal changes.

    Maintaining Bone Mineral Density

    37:24 - 44:05

    • Estrogen is the hormone that signals osteoblasts and osteoclasts to make the bone stronger.
    • Women are more at risk for osteopenia and osteoporosis due to the precipitous loss of estrogen in midlife.
    • Strength training is crucial for maintaining bone mineral density.
    • Walking, running, swimming, and cycling are not as effective as strength training for maintaining bone density.
    • Having access to a gym or equipment like dumbbells, kettlebells, and resistance bands can enhance the effectiveness of strength training.
    • Injury prevention should be a priority when starting a strength training program.
    • Finding practitioners who understand individualized rehabilitation approaches is important for injury recovery.
    • Nagging injuries should not be an excuse to give up on working out; they should motivate individuals to get better.

    Rehabilitation and Cardiovascular Training

    43:48 - 50:12

    • A person with significant pain has altered movement patterns and needs to invest at least three hours a week in rehab to avoid surgery.
    • Training for VO2 Max requires spending a significant amount of time on cardi respiratory fitness.
    • The training volume for developing cardi respiratory fitness is roughly 80% zone two and 20% VO2 max.
    • Even elite athletes like Tadi Ogatcher do 80-90% of their training at zone two.
    • The maximum amount of time the speaker can dedicate to cardio is four to five hours per week, divided into zone two and VO2 max sessions.
    • Zone two workouts are done on Tuesday, Thursday, Saturday, and Sunday, each lasting around 45-60 minutes.
    • VO2 max workouts are done on Sunday after the zone two session.
    • Strength training and stability exercises are also included in the weekly routine.

    Zone Two and VO2 Max Training

    49:56 - 56:37

    • Modalities for zone two training include swimming, running, cycling (on a flat course), treadmill running, rowing (if efficient and strong enough), stair climber, and brisk walking.
    • Zone two training is beneficial for harnessing mitochondrial efficiency and pushing oxidative phosphorylation to its limit before transitioning into glycolysis.
    • VO2 Max training can be done on various modalities such as air bike, regular bike, stationary bike, stair climber, treadmill running, and rowing.
    • The sweet spot for VO2 Max intervals is three to eight minutes of high intensity.
    • A four-minute on/four-minute off interval workout is effective for VO2 Max training.
    • Monitoring progress in VO2 Max improvement can be done by using a power meter on stationary bikes or outdoor rides.

    Measuring Performance and Long-Term Commitment

    56:16 - 1:02:38

    • Power meters are important for measuring performance on stationary bikes and outdoor cycling.
    • Wattage is a more accurate measure of effort than speed due to factors like wind.
    • VO2 max, a measure of aerobic fitness, can be improved over time with training.
    • Weight plays a role in VO2 max calculations, with lower body mass being more beneficial.
    • Losing excess weight can lead to an increase in VO2 max.
    • Improving VO2 max requires long-term commitment and consistent training.
    • There is a genetic component to high VO2 max levels, but training also plays a significant role.
    • Longevity-focused training should be approached with a lifetime perspective and enjoyment in mind.
    • Exercise has numerous benefits for quality of life and overall health, even if it were to shorten lifespan slightly (which it doesn't).
    • The author expresses gratitude for readers of his book and the personal connection he feels towards it.
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