How does VO2 max correlate with longevity? | The Peter Attia Drive Podcast
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- čas přidán 16. 05. 2022
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The Peter Attia Drive is a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking…and a few other things. With over 40 million episodes downloaded, it features topics including fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more.
Peter is a physician focusing on the applied science of longevity. His practice deals extensively with nutritional interventions, exercise physiology, sleep physiology, emotional and mental health, and pharmacology to increase lifespan (delay the onset of chronic disease), while simultaneously improving healthspan (quality of life).
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I contend the high group is more likely to win the centenarian olympics than are the elite group. Way too many people celebrate their own extremism when it comes to exercise. Especially as you age, its not how hard you train, its how well you recover.
Elite vo2max may also require so much training targeting that quality that it'll impact your ability to build others (time, energy, motivation, etc).
If you study the centenarians in the blue zones, they don't appear to do extreme exercise. Moderate exercise every day.
Look at the Riders of the Cycling Grand Tours. Crazy fitness, crazy VO2Max … for now… wait until they’re in their 60’s or 70’s. Many will go from current lean and mean to pudgy or overweight and how will that affect longevity?
Agree. All the macho BS is fine in your 20s when you go beyond 40, self care includes the discipline of holding yourself back.
I agree, we need more studying about how to recovery more effectively
Normal relaxed walk speed even says a lot in regards to balance and fitness health and perhaps mortality depending on some other important factors.
Thank you
I live on the Nicoya coast of Costa rica, where the elevation is 5600 ft. It's a Blue zone, Old people walk up and down all day long. If you want to live longer look to the 5 blue zones! I moved out of the U.S. eight years ago and haven't been back! Moving out of the U.S. alone will increase longevity!
I wonder if there is any studies where VO2max is studied on muscular population? Relative VO2max (ml/kg/min) is a bit like BMI where muscular people tend to get penalized even when it may not have correlation on their health.
Is a high VO2 max merely a marker for a combination of many factors, all of which contribute to health? Weight is built in to the calculation for VO2 max, therefore it could be that high VO2 max is a marker for low body fat. We know also that exercise reduces blood pressure, helps with glucose sensitivity, reduces stress etc...
Yes I’m sure that exercise has benefit but my concern is that how much can we actually hack our way to longevity versus not. I guess I’m just not sure that we can force longevity to happen through exercise. There probably are a whole host of factors at play including genetics and certain dietary practices. I Keep wondering if gut health is really critical and if I should get a stool transplant.
@@timmothyburke for gut health from what I can gather it's extremely important for longevity, and very difficult to measure. We know at the population level diets that help, but not so much for individual interventions.
It would be nice to understand what diets work. This stuff is so complex, very challenging.
I hear Mediterranean and the Okinawa diets are good
David... you're correct in that VO2 max is a numerical representation of many contributing factors. In a simplistic way they're saying that the higher your VO2 max the more likely you are to fit certain health and longevity stereotypes. The elite athlete is outside getting sunlight, working their lymphatic system, stressing their body, drinking more fluids, enhancing their bone density, etc vs. the coach potato that hit virtually none of those check boxes.
Great content, do you have a book which we could read and learn more ?
Metal bands singing "Too fast to die" were right after all.
It might be more interesting to add in BMI (but with relationship to height and girth at waist) vs VO2 Max and longevity instead of looking only at VO2Max. It is not always easy to measure VO2Max. I am using Polar H10 HR strap and the Apple Watch but not so sure about accuracy. Polar claims it sis pretty accurate based on comparison to actual laboratory results. The devices both show my VO2Max @ 46+ and I'm 58 years old. Covid - Delta knocked it down to 35'ish and took me 4 months of hard work to bring it back. But will I live to see 90? IMO, genetics such as telemere lengths, environment, stress, diet and other factors play a bigger part than VO2Max. My father in law and my step father are both in their early 90's and healthy and their fathers both passed away in the mid 90's and none of them really did much exercising except being active on a daily basis. But they all ate in moderation and are (were) all fairly thin. One actually smoked and drank most of his life... go figure... 😄
Sounds like you're talking about height to waist ratio.
BMI should have been long deprecated by now although some old school doctors are still using poor data.
@@uelude Yes, BMI does not take into account muscularity.
Yes VO2max is measured per kilo so a couch potato could improve their score simply by losing weight. It would be more interesting to have an absolute number so you can see how much of the effect is due to fitness and how much is due to being over-fat. I don't know about Polar but on the Garmin the VO2max numbers can be easily gamed and since I train 80% zone 2 my VO2max is much lower than in reality
@@uelude My legs are short in comparison to my torso and my wife is the opposite. At times I have been quite slim but still shown as over-fat on the height to waist ratio. Also talking to my body builder son - he said that weight lifters can have a larger waist due to muscle and not fat
@@MichaelJanos1024 to my understanding, VO2max has a large genetic component as well as exercising / fitness and body weight. And as well, according to many coaches, best way to train to increase VO2Max is via a Polarized training program of 80/20.
What could be the downside of running long distances in lower end of zone 5?
Man has a Senna Helmet. Much respect!
Peter how do you reconcile the VO2max data suggesting it is probably the best overall measure available to date for predicting morbidity & mortality and hence longevity in general, with your recommendations to focus on Zone 2 training for maximum effect on longevity. Focusing on Zone 2 probably isn't going to generate the greatest gains in VO2max. Your presentation seems to argue in favor of maybe spending more time in higher intensity zones to Optimize VO2max. Of course, depending on your starting fitness level, even zone 2 training could generate significant improvements in VO2max. What do you think?
Excellent comment/question
Side note. Higher aerobic base may allow u to do high intensity training as better at flushing tissues with oxygenated blood. Aerobic training seems to be recovdry runs so recover between workouts as well.
@@nikitaw1982 yes, I understand your point and agree that both forms of training are beneficial and shouldn't be neglected depending on what your training goals are. My question essentially comes down to 'given the time constraints for training and prioritizing Longevity as the primary aim, which gives the greatest adaptive reward? - training focused on staying in Zone 2 or, training focused on maximizing VO2MAX - which I have to believe would incorporate more frequent forays into higher intensity Zones in addition to Zone 2. My guess is that it would be wise not to neglect high intensity training and it would be equally wise to periodically measure your VO2max against norms for your age and gender.
@@drdavid62 Yes, let's say we keep 80% Zone 2 and the rest Upper Zones
@@betosvr1626 Totally agree. Also, although VO2max seems to rule the roost when it comes to predictors of morbidity and mortality, I'm not certain just how strong the correlation is. I'm Looking for some studies that might answer that question. By comparison, Bone density as measured by DEXA scan is the unquestioned gold standard for predicting fracture risk in men and women. And yet, the actual correlation between bone density and fracture incidence is roughly 30%. Not a very strong argument for it being the gold standard. But it's the best quantifiable measure currently available. So, in a similar fashion I'm wondering how strong the VO2max correlation is with long life!?? That answer might determine how heavily I weight upper zones in my workouts.
My question is, do fitter people live longer because they are healthier to begin with (i.e., better genes, healthier lifestyle, etc.) and these things won't change if a low person started training tomorrow or can a person train from low to high and get the same benefits (even though his/her genes have not changed). I guess it is the difference between cross-sectional and longitudinal analysis.
You can't get away from genetics, but on the whole of it the things you can change (diet & exercise) will contribute to your health and naturally reduce your ACM.
There's one study that looked at 143 pairs of twins and measured the genetic age, which essentially showed this.
"Combined healthy lifestyle score and risk of epigenetic aging: a discordant monozygotic twin study" - Hexiang Peng, Wenjing Gao
In my late 40s, I find high intensity exercise, cycling and swimming, more likely leads to minor injuries, either muscle strains or sore joints. I’m not a weekend warrior; I’ve been training for decades. And these injuries take longer and longer to recover. I can’t imagine maintaining this intensity in later decades.
Not sure I'm interpreting your point correctly but I think Dr Attia would advocate boosting VO2max with high volumes of Zone 2 training which would not be considered "high intensity". I agree that training with lots of "VO2max" volume (what Dr Attia would probably call Zone 5) has a much greater injury risk but he's not claiming this is the best way to improve VO2max.
Also the vo2 max data is based of age. So being elite as a 50yr does not require the same level as being im an elite 20yr old.
If I remember correctly one of his videos says to improve VO2 max with 4 minutes as hard as you can maintain and 4 minutes rest. This intensity is tough for lungs, heart etc but should not be intense enough to cause injury. In addition, if you cross train, bike, swim etc less chance of injury.
Yoga and stretching will help recovery along side lifting weights and cardio
One thing I think gets missed in the discussion about VO2max, longevity, and HIIT is this. If your cardiorespiratory fitness is low, just get up and start walking. Do what you can sustain and build that over time. If you're below average, try to get to average by jogging or cycling or whatever a bit more. Think about trying some high intensity intervals.
The fitter you are, the more likely it is that you will need HIIT to progress. I'm not saying people should avoid HIIT unless they're very unfit. I'm saying that I think that for people with low or below average fitness, the most important thing is to start exercising and gradually build the volume out.
The smoking part is vague. How much smoking? What type of smoking? Chemically-laced cigarettes? Cigars? Inhale or not inhale the smoke?
Love the charts and stats; its hard to argue with them, and they really drive the point home more than just words alone.
Not everyone has access to expensive VO2Max lab tests. Are there any low tech home tests we can do to estimate where we are on the curve? Perhaps, number of burpees or 1-mile speed or any other combination of things? Something I can do on my own, measure and keep track. Many thanks in advance for any answers.
A close approximation is the VO2Max calcilated on Garmin watches. Still a $175-$200USD purchase to get a model with the VO2Max measurement and tracking. Alternatively, I believe there are distance/time/weight/gender based self tests(run some number of KM for time). This is of course free and up to you.
1.5 mile run for best time. Then use that with online charts to get an estimation of your VO2 max and percentile.
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-Such a tease
Were 122,000 people actually given a VO2max test or did they do a fitness test i.e. Cooper 12 minutes fitness run and then the time results correlated with VO2max? If it were the later, remember that VO2max is not a predictor of performance. Lactate threshold is a far better predictor than VO2max. See David Costill's analysis of American distance runner from 1974.
What about all the long living people in Okinawa or the Mediterranean or other Blue zones? Are you saying they all have very high V02 maxes? Because Id Wager they don’t, probably only average to poor.
what type of fitness though? "heart" cardio fitness, or strong muscles?
Cardio is the main driver for VO2 max test
At 6:09, wouldn't it be an ~180% increase for ESRD?
Correlation does not equal causality. To be rigorous, you need to address that issue directly.
Effort to get a good vo2max makes other changes?
Completely agree watts.
@@nikitaw1982 Perhaps, but not my point. I was being a little picky on the "science" part of this -- in science, correlation is not causality. Because two things appear together in a statistically significant way does not prove a direct causal link between them (i.e. one is required to cause the other).
To be fair, this podcast was a clip of something larger, so perhaps that was addressed, I don't know.
Agree, but it does beg for further study. What about other contributing factors: BMI, diet, socioeconomic status, etc. for this group of people.
Let me save you time: higher VO2 max increases life span.
It doesn't though.
@@scottk1525😊❤
so it isn't quite clear to me is it so that all things equal then the differences are what was presented here. if not I would imagine that VOmax might be just proxy for many other things. Many who belongs to the lowest "performing" group are probably having a lot other issues increasing mortality. or?
It is an interesting study in general but there is a caveat here that this study may not be much accurate because the evaluation method used to quantify the CRF on the ETT ( i read this article on pubmed) is a poor method and gives room for error , i mean they didn’t used direct spirometry to measure the oxygen consumption, which uses the a device attached to your mouth, and is the gold standard for VO2 max determination , instead they used an estimate based on the max heart rate measures on treadmill and their ages, which is an indirect method because uses a table obtained on a test made previously by other individuals and cataloged on a table to be used whenever some researcher wants to easily and quickly get the VO2, but gives a poor accuracy that don’t takes into account individual differences or ethnic. The left ventricular size of the heart dictates the heart rate to a certain oxygen demand, but it vary from person to person, as for gender and body composition. It creates a possible paradox in which a certain individual have an excellent condition and have his CRF undermined as along with the increase in physical endurance comes a reduction in heart rate due to an increased left ventricular size( a common adaptation to endurance training also called eccentric hypertrophy)for a specific exercise intensity, which provides a greater ejection volume, but when compared to another individual which would be on the same condition of test intensity would have a lower heart rate but actually their VO2 are the same.
The same situation may occur inversely, as an individual with a low condition and a lower ventricular volume have his metabolic equivalent overestimated and so his CRF.
I guess the result is biased and the study flawed.
Peter really hope you can help me.have been a window cleaner up and down ladders for last 43 years.now for the last ten years have really struggled with pain getting up from low chairs and down into them and getting up and down off the floor is just the same.apart from that they are generally not to bad though hills are not good either.really need your help and guidance Peter.hope you are well Peter.kindest regards tim
Upvote
Have you seen a chiropractor? Sounds like your movement/lack of stretching has finally caught up with you. Sounds like a supremely tight Psoas for 1. BUT its never too late to get started and start moving right. Proper movement, proper body. Good luck sir, only you can take charge, take the steps, and change you! No shortcuts, no secrets. Only humility and ownership of the state of your body.
@@paulpilecki4037 hi yes have seen loads over the years.cartridge nearly gone which x rays show.have had prosaic worked on several times with me also doing a variety of stretches all the time plus yoga.am worried that I may make them worse.dont want to end up more disabled than I already am
Upright Health is a great CZcams channel for this
czcams.com/users/Uprighthealth
You say that Tour de France cyclists have incredibly high VO2 maxes, and I suspect you would say that ultra marathon runners also do. So how come you don’t see many ex Tour de France cyclists and ultra marathon runners living into their 90’s?
Or for that matter, any longer than other people?
low (
Wonder how recovering from Covid affect VO2.
In the vaccinated or unvaccinated? How many bodys stuffed by vax compared to those stuffed by covid in under 60 and previously healthy
I assume that graph is for people who already are ill with something? You say it starts at 52 and it shows the next 10 years to 62. According to this, 10% of the "average" died in that time. I have watched many many people go from 52 to 62 during my 40 years of life and of course this is just my N=1 anecdotal observation, but nowhere near 10% (fortunately) have died! If I think of all my family and all my friends parents, my past teachers, other people who were involved in my life, doctors, neighbours, colleagues at work. It's a rather large sample that comes together and the death figure is certainly well below 5%.
But people with low VO2Max probably practices other unhealthy lifestyle habits also.
Peter,
The Audio volume during the intros is way too high compared to the balance of the podcast. Please address this in the future.
For many of us, this distraction throws us off so that we miss out on the beginning of the talk when we are coping with the volume perturbations.
Thank you for you consideration of my concern with audio levels.
Peace and love,
ct
So, I’m 60, row 50k a week and have a Vo2 max of 49.07. A lot of that will be down to genetic luck but if you keep moving, they can’t nail the lid down.
Did you test your Vo2max running or rowing?
V02 Max of 61 here
The Importance of Fitness and Mortality
* Introduction:
* Discussion on the relationship between fitness levels and mortality rates
* Comparison of fitness impact on mortality with other health factors such as smoking, coronary artery disease, type 2 diabetes, hypertension, and end-stage renal disease
* Key Points:
* The study analyzed 122,000 patients with varying fitness levels and tracked their mortality rates
* Fitness levels were categorized as low, below average, above average, high, and elite
* There is a clear, monotonic relationship between fitness and mortality
* The biggest gap in mortality rates is between the bottom 25% (low fitness) and everyone else
* Moving from low to below average fitness results in a 50% reduction in mortality over a decade for people starting in their 50s
* Going from low to above average fitness results in a 60-70% reduction in mortality
* The smallest improvement in mortality rates is going from high to elite fitness, but it is still statistically significant
* Comparison with other health factors:
* Smoking: 41% increase in mortality
* Coronary artery disease: 29% increase in mortality
* Type 2 diabetes: 40% increase in mortality
* Hypertension: 21% increase in mortality
* End-stage renal disease: 280% increase in mortality
* Improving fitness from low to above average has a similar impact on mortality as end-stage renal disease
Benchmarking Fitness Levels with VO2 Max Test
* Introduction:
* The importance of the VO2 max test in determining fitness levels and setting goals for improvement
* The test is used to help patients benchmark their fitness as they work towards better health and longevity
* Key Points:
* Most patients are encouraged to undergo a VO2 max test to establish a baseline for their fitness levels
* Improving fitness from the bottom 25% to the 50th-75th percentile is an achievable goal that can significantly impact mortality rates
Genes play a HUGE advantage. Or disadvantage.
i wonder what greg lemonds would be today, 50, 40??
May not be vo2 max ,,obviously contribution ,,,but higher vo2 probably suggest s. Healthier lifestyle ,,which could be no smoking ,drinking ,good diet
Dumb question: what is vo2 max?
Vo2 max is a measurement for how efficient your body can consume oxygen and circulate oxygenated blood throughout the body. Higher is better
@@nilespj007 how is it measured? Thank you for the definition
My genetic makeup is terrible.. 44 years old at 5'11" 187, when I'm completely out of shape, my vo2max is about 29... after running into shape for many months, it tops out about 37.. no matter what I do I'll never be above average vo2max.. ever since I was a kid in junior high I wasn't good at aerobic exercise
📍Culverhouse School of Business
I would wager the vast majority of people in the elite group would clinically have an enlarged heart. Food for thought
Yah!! The 104 year old woman that drank "hooch" every morning and smoked stoggies every day didn't worry about her vo2's?? She just worried about some delicious cornbread with butter on it.
C'mon? Longevity is first determined by what?? ¡¡GENETICS!! There are no clinical trials favoring any world diet fad. As a not famous saying "this too shall pass away.
Common sense, cardiovascular care, and being happy or well adjusted equals better quality of life...
How is this not the same fallacy people make when they claim that increasing grip strength will improve longevity? In other words, couldn't it just be the case that only very healthy people are able to achieve elite VO2 max, and that's why there's such a strong correlation? Do we have any interventional data that shows increasing VO2 max has significant benefit above and beyond that of zone 2 or other less intense exercise?
I'm not opposed to intense training. But it just doesn't seem feasible that one needs to puke on a peleton 3x per week in order to reap the longevity benefits of exercise.
Exercising to hack longevity via direct VO2 Max improvements doesn't seem intuitive. Centenarians aren't always running about or jogging or cycling at a "moderate" intensity as we see them, but rather engaged in an overall healthy lifestyle and move very often at a slow pace and engage all of their muscles. Not sure if any studies have actually tested the aerobic VO2 Max of different centenarian populations / people??
This doesn’t really help me at all, not really sure what you’re suggesting other than stay healthy lol
Helpful information, but damn, could you present it in a more boring, droll fashion???
VO2 max test allows for centurian Olympics! 🏆💪🏾🏃🏾♂️
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I am top 90 percentile of high Vo2 max, I can run pretty well but my blood pressure and kidneys are not in the best shape. 🥲