Feel Better, Live More with Dr Rangan Chatterjee - BITESIZE | The 4 Pillars of Movement for a Long and Healthy Life | Dr Peter Attia #496

Episode Date: November 22, 2024

For many of us, finding the time to exercise regularly can be a challenge - particularly as we lead increasingly busy lives. But today’s guest really wants us all to recognise the critical importance of movement for our long term wellbeing - something that’s very relevant today given how much movement has been engineered out of our lives. Feel Better Live More Bitesize is my weekly podcast for your mind, body, and heart. Each week I’ll be featuring inspirational stories and practical tips from some of my former guests. Today’s clip is from episode 389 of the podcast with medical doctor and longevity expert Dr Peter Attia. Whilst decline in our physicality is inevitable as we get older, In this clip, Peter shares that there is plenty we can do right now that will slow the rate of decline and ensure we are as fit and healthy as possible in our later years. Thanks to our sponsor https://www.drinkag1.com/livemore Support the podcast and enjoy Ad-Free episodes. Try FREE for 7 days on Apple Podcasts https://apple.co/feelbetterlivemore. For other podcast platforms go to https://fblm.supercast.com. Show notes and the full podcast are available at drchatterjee.com/389 DISCLAIMER: The content in the podcast and on this webpage is not intended to constitute or be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or other qualified health care provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have heard on the podcast or on my website.

Today's Bite Size episode is brought to you by AG1, a science-driven daily health drink with over 70 essential nutrients to support your overall health. It includes vitamin C and zinc, which helps support a healthy immune system, something that is really important at this time of year. It also contains prebiotics and digestive enzymes that help support your gut health. It's really tasty and has been in my own life for over five years. Until the end of January, AG1 are giving a limited time offer. Usually they offer my listeners a one-year supply of vitamin D and K2 and five free travel packs with their first order. But until the end of January, they are doubling the five free travel packs to

10. And these packs are perfect for keeping in your backpack, office, or car. If you want to take advantage of this limited time offer, all you have to do is go to drinkag1.com forward slash live more. Welcome to Feel Better Live More Bite Size, your weekly dose of positivity and optimism to get you ready for the weekend. Today's clip is from episode 389 of the podcast with medical doctor and longevity expert, Dr. Peter Atiyah. Whilst decline in our physicality is inevitable as we get older, in this clip, Peter shares that there is plenty we can do right now that will slow the rate of decline and ensure that we are as fit and healthy as possible in our later years. If you're listening to this and you're a person who doesn't like exercising, that's fine. But

just understand that there's a huge responsibility that comes with living in the modern world to yourself. Our ancestors didn't deliberately exercise. If they saw that there were things like gyms and treadmills, they wouldn't fathom what we were doing. But all of this is a construct we've had to create to compensate for the fact that the modern world has taken the need for all movement out of our lives. So we have to go above and beyond. So I fully buy the beauty of the modern world we live in. It's not perfect, but it's better than the world a hundred years ago, 200 years ago, and 300 years ago. But it comes at a cost. Like everything. And we have to be very mindful of that cost. I think that exercise and nutrition are probably the two greatest examples of where we pay that price. So in some ways, the human

superpower from an energetic standpoint is the capacity for energy storage. We are very efficient at energy storage. That served us incredibly well until relatively recently. When energy became so abundant, energy, of course, in the form of food, that superpower became a detriment. And now most people, became a detriment. And now most people, certainly in the developed world, are overnourished and we're on the wrong side of the energetic curve. Does that mean that we should all aspire to be hunter gatherers again, where we don't know where our next meal is going to come from? No, it just means we have to understand that with this great privilege came a responsibility. Yeah, and also, I mean, I love that line of thinking because it also means, I think,

yes, we need to take responsibility as much as we can within our means, within our, what's possible in our environment. But I often say to patients, if your great-grandparents were here today in this food environment, you know, we'd probably find 78% of them would also be overweight and obese. It's not a moral failing. No, not at all. It was your superpower in a different environment. Now, it's your Achilles heel. You have these four pillars of exercise or movement when it comes to

being that generalist who's able to do the things that they want to do in their marginal decades. So you have strength, you have zone two cardio, you have VO2 max, and you have stability. you have zone two cardio, you have VO2 max, and you have stability. And I really want to make sure we make this as practical as possible for people, right? But I wonder if it's worth just giving the broad overview of these four pillars and what percentage of time perhaps we should be allocating. I have strong feelings about that. We should allocate to each one? Yeah. So you've got it right. Those are the four pillars. I will say that we have the most data, the most clarity around two of them, strength and VO2 max. We have to be great

generalists. So we have to have high peak cardiorespiratory fitness, wide aerobic base, high levels of strength, great amount of stability, all of these things. And the data for strength and VO2 max are undeniable. So when the epidemiology says having a very high VO2 max leads to a longer life, I mean, it's crystal clear. So the higher it is, the fitter you are. This is your peak aerobic capacity. High VO2 max is associated with a lower all-cause mortality to a greater extent than any other health metric, including not smoking, not having high blood pressure, not having coronary artery disease, not having end-stage renal disease, none of those compare to the harm that they bring more than being unfit

does. So the association, the hazard ratio for being in the top 2% of VO2 max compared to the bottom 25% is a hazard ratio of over five. I mean, it's just, it's a staggering value. It's almost as staggering when you consider having high strength. High strength to low strength is almost as potent. It's a hazard ratio of over three. And for people who don't know hazard ratio, Peter explained it in depth in our first conversation. Yeah, yeah.

So, okay. so let's talk about these things. Why is strength so important? Strength and muscle mass are positively associated with lifespan and healthspan for men and women equally. And there's a big step up once you're at the 75th percentile. So in other words, the top 25% compared to the bottom 25% for muscle mass is a pretty significant difference in terms of risk of all-cause mortality. Why is stability so important? Stability basically is the capacity to transmit force from the body to the outside world and vice versa, stably and without injury, would be the easiest way to explain that.

So every time you're taking a step, you're transmitting a force to the ground. That's what propels you forward, but a force is being transmitted in the equal and opposite direction back to you. So what prevents your knee and hip and back from hurting? It's stability. What allows you to do that efficiently is stability. So typically when an elderly person falls, it's due to a lack of strength and stability. Stability is, for example, what allows the foot to maintain balance. Stand in front of a mirror and stand on one leg

and watch your foot. Watch what it needs to do. You'll notice that that foot is twitching like crazy to try to preserve balance. And we think of that as balance, but balance is kind of like the readout state for stability. Yeah. Most people probably have heard

of different types of muscle fibers, fast twitch muscle fibers and slow twitch muscle fibers. Well, the fast twitch muscle fibers, the type two muscle fibers, are the muscle fibers that give us power. So you can have strength in both of these fibers, but the explosive power comes in the type two muscle fiber. Well, that is the hallmark of aging

is the atrophy of that type two muscle fiber. So hold on, Peter, just, so when we hear about fast twitch, some of us will go to, yeah, if I want to be a hundred meter sprinter, that's what I need. What's the relevance of that to when I'm 80 years old? Because when you're 80 years old, if you lose your footing slightly and you, let's just say you're stepping off a curb and you lose your footing, you need to be able to react with enormous force. And so much of the injury we see in people as they age is the direct result of the

atrophy of that powerful, fast to fatigue muscle fiber. Now, if you train it, you can maintain it. Now, you'll never maintain, no 80 year old is gonna walk around with the volume of fast twitch muscle fibers that a fit 30 year old has. That's not going to happen. But a well-trained 80 year old can still have the fast twitch muscle fibers of a 60 year old.

And that's what we wanna have. We want to know that we still maintain some power in those muscle fibers. And that's why, for example, lifting heavy weights is essential for everyone at every age, be it man or woman. So strength training is imperative for people as they age. And not only does it have an enormous impact on bone mineral density, but it has this enormous impact on these type two muscle fibers. I just want to clarify,

when you're lifting weights, does it need to be done with speed in order to really help that fast twitch fiber or does simply lifting a heavy weight slowly also count as a stimulus for that particular it still does it doesn't have to be lifted quickly so it really comes down to the weight so you have to lift a heavy enough weight that the type 2 muscle fiber gets recruited and if the weight isn't heavy enough, the muscle will simply recruit the slow twitch fibers

to do the work. Yeah. What is zone two cardio for people who've never heard that term before, right? And I think there will be quite a few. This is the tell for when you're in zone two, or what we call rate of perceived exertion. When you're in zone two, you can speak,

but it's uncomfortable and you don't want to, but you can still speak in full sentences. If you can do, if you can speak in full sentences easily, you're in zone one and you're not achieving that training effect. So in other words, it's not hard enough. So if you and I went for a walk right now, we would not be in zone two. Because we'd be in zone one. We'd be in zone one. Flat ground, having a walk, we'd be in zone one. That's right. Let's just assume for a moment, we did something where we're both kind of comparably fit and we couldn't speak to each other. Or if we did, it was one word here and there, we would be in zone three, four, or five. Yeah. And there's

benefit in doing that, but not for this type or five. Yeah. And that would, there's benefit in doing that, but not for this type of conditioning. Yeah. You have to thread the needle to that sweet spot. And that's what you're basically doing is enhancing your mitochondrial efficiency. The beautiful thing about zone two is it's quite easy. It doesn't, you know, yes, you know,

you're a bit out of breath as you say, you can hold a conversation, but you don't want to. A lot of people get put off exercise. I think it's too hard. And I find one of the great things about Zones 2 is I really enjoy it because I think, listen to a podcast, listen to an album I haven't listened to for ages or whatever it might be. And the recovery time is negligible. So actually I feel it enhances my life and it enhances my cognition. And I know it's doing something for longevity. So I'm not sure how appreciated that is.

So for people who are scared of exercise and don't want that uncomfortable feeling of real high exertion, zone two can become one of your very best friends very quickly. And it's important even if you're the best in the world. So if you look at the Kipchoge's of the world, they're still spending 80% of their training time in zone two.

Yeah. And you asked earlier, can you think about a way of what percentage of your time should you spend in each of these zones? I mean, that's really what it comes down to. Exactly. It's about 80-20. So it's about 80% of your cardio time should be spent in zone two. 20% of your cardio time should be spent at a much higher intensity. But if you start to push that down, you're going to risk overtraining, burnout, and injury. Yeah. So if you say, I'm going to do 50% of my time will be high

intensity and 50% of my time will be low intensity or zone two, A, you're not going to achieve as good a result, but more importantly, I think you're going to run the risk of that injury and overtraining. If we just zoom out for a moment and think about a lot of the centenarians that we see being interviewed. And of course, that's not a scientific study. This is just observations of humans in blue zones or wherever it might be. What strikes me as very interesting is that very few of them were trying to work on their longevity, from what I can tell, right? It doesn't mean we shouldn't be. It also is pretty obvious that most of those people are living in environments whereby

a lot of the things that you write about were being automatically covered. Let's say, I don't know, a farmer in Sardinia still herding goats in his 80s, right? Well, he's kind of going up hills a lot, walking, VO2 max, probably lifting things around. I think it's always good to zoom out and go, okay, these guys weren't measuring every metric. I feel, and I wonder what you feel about this, is that because of the way many of us now live, we kind of need these frameworks to help us achieve what these guys are doing naturally. Yeah. Or would you see it differently? No, I see it exactly that way.

Do you remember in like the original Spider-Man story, you've got Peter Parker when his uncle Ben gets shot. Yeah. got Peter Parker when his uncle Ben gets shot. And right before that, his uncle says to him something, which is, Peter, with great power comes great responsibility. And I kind of always have that in the back of my mind when I think about modernity. There's a huge responsibility that comes with living in the modern world. And even though your ancestors five generations back wouldn't exercise, they didn't need to because of what they were doing. Just to finish off then, Peter, final words. If someone is asking you, listen, I'm inspired by what you do. There's so much info out there. I don't know where to start. What do you say to them?

there's so much info out there. I don't know where to start. What do you say to them? Boy, that's tough. I guess I would say just sort of pick one thing. I mean, presumably the person asking this question has enough awareness to know where they are most deficient, whether it be, hey, I'm really overnourished. I'm under-muscled, I'm sleeping four hours a night. I would say, pick the one thing that you're confident you could chalk up to a win and just do that for the next 12 weeks and really fix that pattern. Again, if it's your sleep, really fix your sleep. We haven't talked about that today, but you know, again, there's lots to do there. If it's nutrition, just really get that because it's just as much about the confidence that comes from sort of addressing that pattern and making incremental

changes that stick as opposed to trying to make massive changes that are harder to stick. You know, for a person who's never exercised, I think it's actually quite intimidating and initially unpleasant to exercise. And you can tell them until you're blue in the face that once you get over kind of the initial challenge of this, it's actually going to feel quite good. You're actually going to appreciate the fact that it's not just beneficial for you in the long run, which it is, but even in the short run. But they do have to take a bit of a leap of faith sometimes to do that. You know, one of the things that we try to remind folks,

try not to have two back-to-back misses. Yeah. I think that a lot of people get into a negative spiral when they punish themselves for that bad day and they feel ashamed that they've missed their workout, something when they punish themselves for that bad day and they feel ashamed that they've missed their workout, something that they set themselves to do. And sort of that shame becomes the more dominant emotion as they are getting ready to have that next workout and it becomes easier to miss that next workout. And instead, what I think you want to try is say,

look, you have that bad meal that you said you weren't going to have you Miss that workout you do something that is kind of off your path um Just give yourself a total pass with no judgment and just say yeah, it's really hard Like if this was easy, you would have done it Last year or the year before or the year before but just get it right the next one Just make sure the next meal is right. Make sure the next workout happens. And I even find this as important myself.

I mean, and I tend to, you know, people would look at me and assume I'm sort of a beacon of willpower, but it's not always true. And I still have to be very nonjudgmental and sort of remind myself when I slip that it's okay and let's just run it to slip tomorrow. Hope you enjoyed that bite-sized clip.

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