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    #276 ‒ Special episode: Peter answers questions on longevity, supplements, protein, fasting, apoB, statins, and more

    Managing dietary conditions requires more than just changing eating habits; factors such as activity levels, sleep quality, cortisol levels, and muscle mass are also crucial for maintaining a healthy lifestyle.

    enOctober 23, 2023

    About this Episode

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    In this special episode of The Drive, Peter discusses a variety of topics, breaking away from the typical deep-dive format to explore a wide range of common questions submitted by listeners. Peter tackles subjects like the viability of living to 120 and beyond, addressing some of the optimistic theories regarding achievement of this remarkable feat. Peter then shares his drug and supplement regimen while emphasizing how individualized these protocols need to be. The conversation also touches on lowering apoB, the long-term use of statins, the myth of good vs. bad cholesterol, the complexities of nutrition research, the quest for the ideal diet, and Peter's strategies for hitting daily protein goals. Peter finishes with a discussion about his favorite health-tracking wearables, the role of CGM in non-diabetics, and more.

    We discuss:

    • Overview of topics and previous episodes of a similar format [2:45];
    • The viability of living to 120 and beyond: some optimistic theories [4:45];
    • The potential of mTOR inhibition as a mid-life intervention, and longevity potential for the next generation [13:30];
    • A framework for thinking about geroprotective drugs and supplements in the context of a lack of aging biomarkers [17:00];
    • Supplements Peter takes and how his regimen has changed in the last year [26:15];
    • Pharmacologic strategies to lower ASCVD risk, the limitations of statins, nutritional interventions, and more [36:15];
    • Misnomers about cholesterol [48:00];
    • Why nutritional research is so challenging, some general principles of nutrition, and why Peter stopped doing prolonged fasts [50:45];
    • Optimizing protein intake [59:45];
    • Wearables for sleep and exercise, continuous glucose monitors (CGM), and a continuous blood pressure monitor on the horizon [1:04:45]; and
    • More.

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    🔑 Key Takeaways

    • Reversing the aging process and living to 120 or 150 years old may not be possible as aging is a complex process we currently lack the tools to effectively address.
    • Prioritizing preventive measures and embracing technological breakthroughs can enhance health and increase lifespan, but focusing on living robustly and compressing morbidity is crucial for maintaining a high quality of life.
    • As we age, we have the ability to maintain our physical and mental fitness through activities like carrying weights and swimming, and advancements in scientific research offer hope for extending our healthy lifespan. It's important to consider both the opportunities and challenges in future health and well-being.
    • Biomarkers and diagnostics play a crucial role in determining the effectiveness of various interventions, allowing individuals to adjust their approaches accordingly. However, measuring the effectiveness of geroprotective interventions remains challenging due to the lack of measurable biomarkers.
    • Before making decisions about interventions, such as taking supplements, it is important to evaluate the level of risk involved and the potential reward or benefit. Consider factors like certainty, safety, efficacy, and the position on the risk-reward matrix.
    • Peter Attia believes in the potential benefits of supplements but acknowledges the lack of quality research. He emphasizes personalization based on biomarkers and genetics, and remains open to adjusting his regimen based on new evidence.
    • It is crucial to research reputable brands for supplements, consider pharmacology for managing medical conditions, and consult professionals for personalized advice on supplements, medications, and lifestyle choices.
    • Dietary changes can help lower LDL cholesterol, but medication may be necessary for those at genetic risk or aiming for optimal levels, considering potential side effects.
    • It is important to be aware of the potential side effects of statins and explore alternative options, such as Rosuvastatin or Livalo, for cholesterol management in young individuals who cannot afford more expensive alternatives.
    • It is crucial to use accurate nomenclature when discussing cholesterol and to recognize the limitations of nutrition research in providing a complete understanding of long-term health.
    • Long-term health outcomes cannot be fully understood through controlled experiments in hospitals. Real-world studies, focusing on energy balance and diverse populations, are crucial for studying human nutrition and identifying sustainable dietary approaches.
    • Managing dietary conditions requires more than just changing eating habits; factors such as activity levels, sleep quality, cortisol levels, and muscle mass are also crucial for maintaining a healthy lifestyle.
    • Consuming adequate protein and tracking sleep quality can help optimize training intensity and overall readiness for exercise.
    • CGMs provide valuable information about average blood glucose levels and variability, helping diabetics and healthcare professionals tailor treatment plans. Continuous blood pressure monitors, like the Actia device, offer promising results.
    • Innovative wearable devices have the potential to revolutionize healthcare by eliminating cumbersome blood pressure cuffs and providing accurate insights into metabolic processes during exercise, enhancing training and overall health monitoring.

    📝 Podcast Summary

    The unrealistic notion of biohacking our way to extreme longevity.

    The idea of "biohacking" our way to extreme longevity, such as living to 120 or 150 years old, may not be realistic. While there are many claims and speculations about reversing aging processes, the evidence simply isn't there. Aging is a complex biological process with various underlying factors that we currently don't have the tools to address effectively. Slowing down the rate of aging is possible, but there is limited proof of being able to reverse it in a meaningful way. To believe that someone in their 50s, for example, will still be alive in 70 years, we would have to assume that aging will be completely halted or reversed within the next decade. Currently, the scientific reality differs greatly from the exaggerated portrayals often seen in the media and social platforms.

    Balancing prevention and technological advancements for a healthier and longer life.

    Taking proactive steps to prevent and delay diseases can significantly improve our health, but it may not necessarily extend our lifespan by decades. By focusing on primary and secondary prevention, such as managing risk factors like high cholesterol and hypertension early in life, we can reduce the chances of developing diseases like ASCVD. However, prolonging life to extreme ages like 120 or 150 years may require significant technological breakthroughs. Instead, the emphasis should be on living robustly and compressing the period of morbidity in the later years. The goal is to add a decade or two to our lifespan while prioritizing a high quality of life, especially during the marginal decade.

    Taking Control of Our Health as We Age

    We have the potential to take control of our health as we age. Even though our abilities may decline with time, there are still actions we can take to maintain a level of physical and mental fitness. It is important to focus on activities that keep us in good shape, such as carrying weights, swimming, and staying active. Additionally, advancements in scientific research offer hope for extending the healthy lifespan. The inhibition of mTOR through pharmacological means shows promise in improving lifespan and health span, even when applied later in life. However, it is crucial to acknowledge that while the future holds potential for positive breakthroughs, there is also the possibility of negative events occurring. Therefore, it is essential to consider both the opportunities and challenges that lie ahead, especially when it comes to the health and well-being of future generations.

    The Importance of Biomarkers and Diagnostics in Monitoring Interventions

    Having biomarkers and diagnostics is crucial in determining the effectiveness of interventions, whether it be nutrition, exercise, sleep, or medication. Biomarkers offer feedback and enable individuals to adjust their approach accordingly. For example, weight, waist circumference, insulin levels, and glucose levels can serve as biomarkers for monitoring nutrition. In the case of medication, such as Lisinopril for lowering blood pressure, measuring blood pressure serves as a biomarker to determine if the drug is working optimally. However, when it comes to geroprotective interventions that target the underlying mechanisms of aging, measuring its effectiveness becomes challenging due to the lack of measurable biomarkers. This highlights the importance of investing in the development of diagnostics and biomarkers to advance research and understanding in the field of geroprotection. Without such tools, progress in determining what works in humans becomes significantly hindered.

    Assessing Risk and Reward in Decision Making

    When making decisions about interventions, such as taking supplements, it is important to consider the risk-reward matrix. This matrix involves assessing the level of risk involved and the potential reward or benefit. Peter Attia provides examples of extreme risk, like playing dangerous games, with no real reward. When it comes to supplements, he advises considering the certainty, safety, and efficacy based on human and animal data. Additionally, he suggests analyzing where on the risk-reward matrix a particular intervention falls. For example, taking a supplement with questionable ingredients may pose high risk with little reward. Ultimately, it is crucial to evaluate the risk and reward carefully before making any decisions about interventions.

    Peter Attia's Approach to Supplementing for Health and Well-being

    Peter Attia takes several supplements to support his overall health and well-being. He believes that the risk associated with these supplements is low and that they provide potential benefits. However, he acknowledges that the research on many of these supplements, such as vitamin D and magnesium, is lacking in quality and needs further investigation. Attia also stresses the importance of personalizing supplementation based on biomarkers and genetic variants. He adjusts his dosage of certain supplements, like methylfolate and B12, to maintain optimal levels of homocysteine. Additionally, he discusses the potential benefits and risks of baby aspirin use for cardiovascular protection, emphasizing the need for cautious consideration. Overall, Attia remains open to reevaluating his supplement regimen based on new data and evidence.

    Approach supplements and drugs with caution, individualize based on medical history, and consult healthcare professionals for guidance.

    Supplements and drugs should be approached with caution and individualized based on one's medical history. Not everyone should take the same supplements or medications as others. Regarding supplements, it is important to research and choose reputable brands that have been rigorously tested and validated. As for drugs, pharmacology is often the most effective way to manage certain conditions, such as ASCVD. Exercise, while beneficial in other ways, does not significantly impact lipoprotein risk factors. When it comes to nutrition, reducing carbohydrate intake can help lower triglycerides, thereby reducing the burden on ApoB. Overall, it's important to consult with healthcare professionals and consider personal health goals when determining the appropriate supplements, medications, and lifestyle choices.

    Managing lipid levels and reducing ASCVD risk with diet and medication

    The key to managing lipid levels and reducing the risk of ASCVD is a combination of dietary changes and pharmacology. Cutting saturated fat from the diet can upregulate LDL receptors in the liver, leading to a decrease in LDL cholesterol levels. However, for individuals with a genetic predisposition to ASCVD or those aiming for optimal APOB levels, dietary modifications alone may not be sufficient. In such cases, pharmacological interventions can be highly effective. Drugs like PCSK nine inhibitors, Bempedoic acid, and ezetimibe can significantly lower APOB levels when used in combination. It is important to note that these drugs have advanced significantly in recent years, providing alternative options to high-dose statins. However, it is essential to consider the potential side effects and weigh them against the benefits when deciding on long-term medication use.

    Side effects and alternative options for statin medication

    There are well-documented side effects of statins, including muscle aches, liver function test elevations, and insulin resistance. These side effects may be small but should not be ignored. For young individuals who cannot afford expensive alternatives like Bempedoic acid or PCSK 9 inhibitors, statins may be the alternative option. It is important to find the right statin with the fewest side effects, such as Rosuvastatin or Livalo, although it may require trying a couple of options. The availability and affordability of PCSK 9 inhibitors are likely to improve over time, with the development of drugs like antisense oligonucleotide showing promising results. However, approval for primary prevention may take longer, and insurance coverage for such drugs may be limited. Overall, it is important to consider the individual's needs and available options when choosing a medication for cholesterol management.

    Understanding the misconception about good and bad cholesterol and the complexities of nutrition research

    There is a misconception about good and bad cholesterol. LDL and HDL are not measurements, but carrier molecules. LDL carries cholesterol to the artery wall, leading to atherosclerosis, while HDL does not. It is important to be accurate in nomenclature and say "LDL cholesterol" or "HDL cholesterol" rather than just "LDL" or "HDL." Saying there is good and bad cholesterol is highly inaccurate and reflects a lack of understanding. Moving on to nutrition research, it is incredibly challenging and flawed due to the complexity of studying human organisms and the complexity of the intervention, which is eating. Controlled experiments in humans can provide insight into precise mechanisms but cannot give a clear understanding of long-term health.

    The Need for Real-World Study in Understanding Long-Term Health Outcomes

    Understanding long-term health outcomes requires studying patients outside of controlled environments like hospitals, where they have the freedom to eat what they want. The Minnesota coronary study, conducted on elderly patients in a nursing home, illustrated the importance of this approach. Despite being at high risk for cardiovascular disease, the patients did not show the expected results due to the strictly controlled diets provided to them. This highlights the reliance on epidemiology in studying human nutrition, as experiments and randomization are not always feasible. Additionally, it is crucial to focus on energy balance for metabolic health rather than fixating on specific diet types. Creating a caloric deficit, whether through carbohydrate restriction or other means, is key for patients with insulin resistance. Ultimately, finding a sustainable and manageable dietary approach is more important than pursuing short-term "perfect" diets. When considering populations with longer lifespans, it is important to understand that a variety of factors contribute to their longevity, and it may not solely be attributed to diet. Other elements such as activity level, sleep, stress, social connections, and environmental factors play a significant role. Therefore, it is challenging to identify a one-size-fits-all perfect diet, as diverse populations with different diets have demonstrated longevity.

    Maintaining Energy Balance and Prioritizing Metabolic Health in Managing Dietary Conditions.

    Managing dietary conditions is possible for humans as long as energy balance is maintained and metabolic health is prioritized. Changing eating habits alone will not guarantee a healthy lifestyle. Factors such as activity levels, quality of sleep, and cortisol levels also play a crucial role. While longer fasts were previously practiced during travels, logistical reasons have led to a discontinuation of this practice. The lack of a clear understanding of the benefits and potential negative effects further contributes to the hesitation. Regarding protein intake, it depends on factors such as age and muscle mass. Those in a caloric deficit may temporarily reduce protein intake, while those with low muscle mass should prioritize higher protein consumption. Overall, the importance of maintaining muscle mass throughout life, especially in later years, cannot be emphasized enough.

    Importance of Protein Intake and Monitoring Sleep Quality

    Peter Attia emphasizes the importance of consuming an adequate amount of protein, aiming for somewhere between 150 and 180 grams per day. He utilizes high-quality protein sources like venison jerky sticks, which provide approximately 10 grams of protein per stick. Attia also mentions that he may incorporate a high-quality whey protein shake if needed. He spreads his protein intake throughout the day with typically four servings. Another takeaway is that Attia recommends tracking and monitoring sleep quality and recovery using a device called Morpheus, which measures heart rate, respiratory rate, and heart rate variability. This data can help individuals make informed decisions about training intensity and overall readiness for exercise. Attia believes this tool could be beneficial for patients who may not be as knowledgeable about their own exertion levels or lactate levels.

    The Value of Continuous Glucose Monitors (CGMs) and Potential for Continuous Blood Pressure Monitors

    Continuous glucose monitors (CGMs) are a valuable tool for both diabetics and nondiabetics. They provide important information about average blood glucose levels, which is strongly linked to all-cause mortality. CGMs also measure standard deviation, indicating the variability in glucose levels. While spikes in blood glucose are less important when average levels and variability are within a healthy range, they can be a concern for individuals using insulin. Another key point is that CGMs can help healthcare professionals tailor treatment plans for patients, especially those in the "middle" who may not fit into clear diagnostic categories. Additionally, the discussion touches on the potential for continuous blood pressure monitors, with the Actia device showing promising results and already available in Europe.

    The Potential of Wearable Devices in Healthcare

    There are innovative wearable devices in development that can revolutionize healthcare. Peter Attia expresses his hope for a specific device to be approved in the US, which would eliminate the need for cumbersome and low-compliance ambulatory blood pressure cuffs. However, the approval process is dependent on the FDA, and there may be challenges in getting it approved. Additionally, Attia mentions his excitement for continuous lactate monitoring during exercise, as it would provide accurate insights into metabolic processes. These wearables have the potential to enhance training and improve overall health monitoring. Overall, this conversation highlights the importance of advancements in wearable technology and the potential they hold for transforming healthcare.

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    View the Show Notes Page for This Episode

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    • The discrepancy between outward success and inner fulfillment, and the importance of a healthy “generative drive” for genuine well-being [13:00];
    • A deeper dive into generative drive: impact on human behavior, resilience, purpose, and more [23:15];
    • Evaluating one’s inner self: introspection, self-awareness, challenging societal norms, and returning to the basics of physical and emotional well-being [29:00];
    • Self-auditing tools: introspection, curiosity, and exploring underlying reasons for unwanted behaviors [41:45];
    • Breaking free from destructive cycles by understanding the continuum of self-care and addictive behaviors and remaining curious [50:15];
    • Critical self talk: the malleability of one’s inner dialogue and the potential for transformative change with perseverance and self-compassion [1:00:15];
    • Slowing the anger response and gaining insights into the underlying triggers to achieve lasting change and self-understanding [1:13:45];
    • Foster gratitude and humility by achieving balance between the three drives—assertion, pleasure, and generative [1:20:45];
    • The conflict between intellectual understanding and emotional feelings, problematic comparison frameworks, and the importance of living in the present with intentionality [1:24:15];
    • How making peace with our mortality can foster a sense of hope, purpose and well-being [1:34:45];
    • Advice for finding a compatible therapist [1:43:45];
    • The key components of therapeutic progress [1:57:00];
    • The caricatures of four common patient phenotypes, and how to get through to them [2:05:30];
    • How Paul manages his own well-being and the emotional challenges that come with his line of work [2:15:15]; and
    • More.

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    #297 - AMA #58: Iron: its role in health, testing methods, and strategies for preventing and managing iron deficiency

    #297 - AMA #58: Iron: its role in health, testing methods, and strategies for preventing and managing iron deficiency

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    In this “Ask Me Anything” (AMA) episode, Peter delves into the crucial yet often overlooked topic of iron and iron deficiency. He explores why iron is indispensable for the body, explains the repercussions of iron deficiency, and sheds light on the prevalence of this issue and who is most susceptible. Peter outlines strategies for increasing iron levels, covering dietary iron, supplementation, and infusion options, while also discussing the suitability of each approach for different individuals. Shifting gears, Peter tackles rapid-fire questions on creatine and sodium, as well as inquiries related to his book.

    If you’re not a subscriber and are listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or our website at the AMA #58 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.

    We discuss:

    • Overview of today’s topics and the importance of understanding iron levels in the body [1:45];
    • The importance and ubiquity of iron in the body, and the role of the protein called ferritin [4:30];
    • The processes of iron absorption, utilization, and transportation [9:30];
    • Options for testing iron levels and how to interpret the results [13:45];
    • What does it mean to be iron deficient, and how is it different from anemia? [17:15];
    • Symptoms of iron deficiency and/or anemia [22:15];
    • How prevalent is iron deficiency, and who is most susceptible? [24:30];
    • The importance of consuming an adequate amount of iron daily to prevent deficiency [30:30];
    • The best way to improve iron levels for someone who is deficient [34:45];
    • Iron supplementation: various formulations and potential side effects [37:45];
    • Intravenous iron infusion as an alternative to oral supplements -- plus restless legs syndrome and other topics [42:00];
    • Iron supplementation: who should and should not consider it [44:00];
    • Peter’s approach to creatine and his pre- and post-workout supplements [50:15];
    • Navigating sodium intake: effect on blood pressure, who should use precaution, and other considerations [54:45];
    • Peter’s thoughts about the potential of writing another book [57:15]; and
    • More.

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    #296 ‒ Foot health: preventing and treating common injuries, enhancing strength and mobility, picking footwear, and more | Courtney Conley, D.C.

    #296 ‒ Foot health: preventing and treating common injuries, enhancing strength and mobility, picking footwear, and more | Courtney Conley, D.C.

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    Courtney Conley is an internationally renowned foot and gait specialist. In this episode, Courtney delves into the intricate world of foot anatomy and functionality. She explores the complexities of the foot, discussing its anatomy, common injuries, and the importance of understanding its structure in preventing issues. She covers a range of foot ailments, factors contributing to them, treatment options, and prevention strategies. She delves into the significance of loading, balance, range of motion, and posture, emphasizing the crucial role of strength in preventing both injuries and falls. Additionally, she sheds light on the interconnectedness of the kinetic chain, from the leg muscles down to the foot, and how issues within this chain can cascade downstream, leading to various injuries and pathologies. Additionally, she provides a comprehensive overview of footwear, discussing suitable options for both adults and children to promote foot health and mitigate potential problems.

    In addition to this interview, Courtney also recorded a series of videos to better explain a number of the concepts discussed such as diagnostic tests that are used to determine mobility and strength and the exercises one should perform to improve the outcomes based on the diagnostics. The interview will be available to everyone while the videos from the gym will only be available to paid subscribers (found at the end of the show notes page).

    We discuss:

    • Why Courtney chose to specialize in the foot [3:30];
    • The vital role of foot strength, function, and health in human movement and well-being [6:15];
    • Anatomy of the rear foot and midfoot [10:15];
    • The development of flat feet, the impact of footwear, and the benefits of going barefoot [19:45];
    • Anatomy of the forefoot, common injuries, and why most injuries occur in the forefoot [23:15];
    • Foot musculature and its role in maintaining foot stability and preventing deformities like bunions and hammer toes [30:15];
    • The intrinsic musculature of the foot, plantar fasciitis, footwear, and more [39:00];
    • Plantar fasciitis: diagnosis, causes, and treatment [51:30];
    • Posterior leg muscles: strength assessment methods, role in ACL injuries, and more [59:15];
    • Lateral and medial muscles: ankle stability, arch support, big toe stabilization, and exercises to strengthen and prevent injuries [1:04:15];
    • Importance of strength of lower leg muscles for gait and preventing shin splints, stress injuries, and more [1:08:15];
    • Tendinopathies and other common pathologies related to the anterior and lateral compartments of the foot [1:13:00];
    • The importance of midfoot integrity, ankle dorsiflexion, and a discussion of gait alterations [1:19:45];
    • Proximal stability and its implications for posture and movement patterns [1:27:00];
    • The age-related decline in foot sensation and strength [1:32:45];
    • Common toe injuries, treatment, and how to prevent further progression of the injury [1:36:30];
    • Preventing falls and managing arthritis with proactive foot care and exercises [1:46:45];
    • Footwear: advice for picking shoes that promote foot health [1:54:45];
    • Footwear for runners [2:05:30];
    • The importance of prioritizing footwear that promotes natural foot movement and strength while considering individual comfort and foot health needs [2:09:30]; and
    • More.

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    #295 ‒ Roadway death and injury: why everyone should care and what you can do to reduce risk | Mark Rosekind, Ph.D.

    #295 ‒ Roadway death and injury: why everyone should care and what you can do to reduce risk | Mark Rosekind, Ph.D.

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    Mark Rosekind is an expert on road safety and a policy leader with more than 30 years of experience enacting strategic, practical, and effective data-based solutions that enhance driver and pedestrian safety and health in complex environments. In this episode, Mark delves into the persistent issue of accidental deaths resulting from roadway accidents, a concern for those focused on longevity given its consistent risk throughout life. From exploring statistics on car crashes to identifying the demographics most at risk and the key locations of incidents, he uncovers various risk factors including distractions like smartphone usage, the influence of alcohol and cannabis, the dangers of sleep deprivation, and speeding. Mark also provides practical advice for both drivers and pedestrians to enhance safety, while delving into the potential and challenges of emerging technologies such as autonomous vehicles. Additionally, Mark provides valuable resources for listeners, particularly parents navigating the road safety landscape with teenage drivers.

    We discuss:

    • Mark’s background and education, and the profound impact of transportation accidents on human lives [4:15];
    • From sleep science to safety leadership: Mark’s journey in transportation innovation [14:15];
    • Stats on transportation accidents and fatalities [18:00];
    • Historical trends in road fatalities and the key contributors—impairment, distraction, and more [28:00];
    • The demographics of drivers involved in crashes, and the life-saving potential of better driver education programs [34:30];
    • The most critical areas where drivers need to be hyper-aware to protect themselves [41:00];
    • The role of the National Transportation Safety Board (NTSB) in accident investigations, and the importance of data sources like event data recorders (EDRs) in accident reconstruction and investigations [47:00];
    • The dangers of phone use while driving [53:45];
    • How drunk driving was addressed through advocacy and legal changes [1:01:30];
    • The need to address distracted driving and the psychological impact of distracted driving accidents on both victims and perpetrators[1:07:15];
    • Navigating the roads and lowering your risk of accidents: weather, human error, and defensive driving [1:15:45];
    • The impact of impaired driving: alcohol, cannabis, prescription drugs, and more [1:26:15];
    • Mitigating the effects of vehicle speed [1:38:15];
    • The promise and challenges of autonomous vehicles for road safety [1:44:15];
    • Automatic emergency braking (AEB): the effectiveness and challenges of implementing AEB as a standard feature in new vehicles [1:53:00];
    • Sleep deprivation: the impact of poor sleep, drowsiness, and disrupted circadian rhythm on driving [1:58:15];
    • Protecting pedestrians: strategies for reducing the risk of fatal accidents with pedestrians on foot or bicycle [2:02:30];
    • Empowering safe driving: essential resources and tips for parents and teenage drivers [2:14:00];
    • Promoting a culture of proactive safety: parting thoughts from Mark [2:19:15]; and
    • More.

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    #294 ‒ Peak athletic performance: How to measure it and how to train for it from the coach of the most elite athletes on earth | Olav Aleksander Bu

    #294 ‒ Peak athletic performance: How to measure it and how to train for it from the coach of the most elite athletes on earth | Olav Aleksander Bu

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    Olav Aleksander Bu is an internationally renowned sports scientist acclaimed for his coaching prowess with elite athletes spanning a diverse range of sports disciplines. In this episode, Olav delves deep into the intricacies of VO2 max and its profound impact on performance. They explore the relationship between VO2 max and ATP production, energy efficiency, and power, as well as the impact of low-intensity training on VO2 max. The conversation extends to Olav’s experiences pushing the boundaries with high-performance athletes and the data driven interventions he uses to improve performance. They also dissect the role of lactate threshold, discuss other important metrics to track, and explore the exciting possibility of utilizing a portable VO2 testing device as a practical alternative to traditional lab-based assessments.

    We discuss:

    • Olav’s background, expertise in exercise physiology, coaching experience, and interest in the extremes of human capability [4:15];
    • The processes of energy conversion within the human body and its implications for performance [9:30];
    • Improving movement efficiency, and the importance of mindfulness in training to optimize performance [20:00];
    • The relationship between VO2 max, power output, and endurance performance in different sporting contexts [34:45];
    • How VO2 max is measured in the lab, and why it’s a crucial predictor of both lifespan and quality of life [44:45];
    • Absolute vs relative VO2 max, the significance of functional threshold power in cycling, and the importance of longer duration tests for accurate assessments [54:00];
    • Portable VO2 testing devices as a practical alternative to lab-based tests [1:05:15];
    • The complexities of measuring ventilation and its impact on performance metrics like VO2 max and heart rate [1:15:45];
    • Training interventions to increase VO2 max, and factors that impact performance outcomes [1:23:30];
    • The respiratory exchange ratio (RER) and endurance sports, and how factors such as diet composition and exercise intensity influence RER values and performance [1:32:45];
    • Science-guided training for versatile athletes: maximizing VO2 max, power, torque, and cadence in cycling, and the importance of incorporating diverse stimuli to enhance performance [1:41:00];
    • Physiological limitations on VO2 max [2:02:15];
    • The different energy systems used during work, and other things to monitor like VCO2 and heart rate [2:06:00];
    • Lactate threshold and other metrics to guide your training [2:10:30];
    • Analysis of a lactate power curve: exploring lactate dynamics in endurance training and performance [2:23:15]; and
    • More.

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