Name: Peter Attia on The Best Exercises for Longevity
Uploaded: 2021-11-17T18:41:15.000Z
Description: Watch the stand-up comedy video 'Peter Attia on The Best Exercises for Longevity' from PowerfulJRE on Comedy Buff. Published 2021-11-17. Transcript available.

Watch the stand-up comedy video 'Peter Attia on The Best Exercises for Longevity' from PowerfulJRE on Comedy Buff. Published 2021-11-17. Transcript available.

- The Joe Rogan experience.
- I think exercise is the single most important
longevity drug we have, bar none.
Like if you said like, I wanna go deep down
the rabbit hole of living longer, what do I need to do?
It's like a super well-crafted exercise program
that is geared towards strength, muscle mass,
and cardiorespiratory fitness.
- So it's all of the above, it's not just one.
- Right, I mean the hazard ratios for each of these
are pretty interesting.
This has become like, each year I try to bring
one new focus into our practice, and the past 12 months
the focus has been entirely around taking exercise
to a new level in terms of our understanding
of how to fine tune it.
And the data are unbelievable, right?
So if you, everybody knows that if you smoke
or have diabetes, your risk of death goes up a lot.
But your risk of death from having
high cardiorespiratory fitness goes down
by much more than your risk of death goes up
from smoking or diabetes.
So smoking and diabetes will double
or triple your risk of death,
depending on the timeframe you're looking at.
Having very high cardiorespiratory fitness,
so having a VO2 max that is elite,
we would define that as the top 2.5% of the population,
compared to below average, is a five-fold reduction
in all-cause mortality.
- Wow. - Death from any kind.
- Whoa.
- I mean, we don't have drugs that have a 5X reduction
in mortality.
- That's incredible, and that's just elite
cardiovascular health.
- Right, and then when you layer in strength and muscle mass,
we actually now have pretty good data as to the fact that strength
is more important than muscle mass.
We just use, muscle mass is a good proxy for strength,
but if you just focus on strength, that's the metric that matters.
It's about a three-fold reduction in all-cause mortality
when you compare high strength to low strength.
And the tests are, you know, we're talking,
it's not like how much you can squat and deadlift.
It's like grip strength, dead hang,
how long can you do, like, an air squat?
You know, like, what's your quad strength?
How quickly can you do five reps up and down from a chair?
I mean, it's relatively simple stuff,
but when you stratify people by those metrics
and you compare the highest to the lowest performers,
there's just no comparison.
- Is there a point of diminishing returns, though,
where you just get really, really strong,
but it's not helping you any more than being fairly strong?
- On the strength data, we don't see it
because the data have only been parsed out as high to low.
On the cardiorespiratory,
there is a point of diminishing return.
So remember I said elite is the top 2.5%,
and then you, so it's, we break them into five categories,
but they're not equal in bucket size.
You get most of the benefit, honestly,
by going from not fit at all to average fit.
That gives you three of the five X.
Now that said, you know, I hold myself and my patients
to a way higher standard,
which is we have a chart that shows all the data
by age, by gender, and by VO2 max.
And I would say, you know, if you're a 52-year-old male,
I'm asking you to have the VO2 max
of an elite 42-year-old male.
So I want you to be a decade younger elite.
And then we do the same thing with strength metrics.
And when you prescribe that, like, say, if you take a 52-year-old male
that doesn't have a history of cardiovascular activity,
you know, maybe they, you know, lightly work out the gym or something like that.
What, what particular exercises do you think are the best to achieve that
result?
So we'd start with a base of zone two.
So this zone two is that lactate thing I was talking about.
So your zone two is defined as the highest level of aerobic output that you can
generate
while keeping lactate below two millimole.
So I think a bike is the easiest way to do this because the--
Stationary or?
Stationary, just because it's, you can keep it steady state.
You know, when you're on the road, it's all, you're all over the place.
But, um, so if you're on like a, you know, a stationary bike and, um, so you,
and also wattage
is such an easy metric for people to understand.
So how many watts are you putting out, right?
So, um, the first thing we would do is say, you probably need to be doing at
least three
hours a week of that zone two, which is building an aerobic base.
So four 45 minute sessions at zone two, constantly driving it up.
And honestly, one session of VO2 max training per week.
And the best protocol for that is the four by four protocol.
So that's four minutes at the highest output you can sustain.
So here you could do it on an air bike or something, right?
So you could do what's the highest wattage you can hold for four minutes and
then four
minute recovery and do five of those sets once a week.
Hmm.
So when you're doing that, do you think that the best is like an airdyne that
works the
arms and the legs?
Or do you think just a regular bike that just works the legs?
Like what is?
For zone two, I mean, it really just matters that you're consistent, but, um, I
think most
people find you can do a higher output when you're on an air bike in terms of
absolute
wattage because you are leveraging upper and lower body.
It really doesn't matter that much.
I mean, you can do this on a treadmill.
You can do this on a stair climber.
You can do this on any kind of cardiovascular activity, but you need 45 minutes,
four times
a week.
That would, that seems to be the minimum effective dose on zone two.
Now, if someone's super deconditioned, it can probably be three 30 minute
sessions
to start and they'll see benefit.
Hmm.
Interesting.
And then as far as a strength program, like, do you recommend specific
exercises?
Is it like squat deadlift?
Well, it depends on, this is where it gets very dependent on the person.
So we have a test that we put our patients through that's, um, 10 exercises.
Um, and they're all basically normalized to your body weight and gender.
So like a dead hang.
So how long can you hang from a bar dead?
So for males, should you be able to hold?
We hold males to the standard of two minutes and females to a minute and a half
at the age
of 40.
So then it gets discounted by decade.
Watch the entire episode for free only on Spotify.