Is Dr. Peter Attia incorrect about the relevance of VO2Max?

Dr. Peter Attia, a top health podcaster, says VO₂Max is the #1 predictor of longevity. It measures your max oxygen uptake and represents aerobic capacity, mitochondrial function, and heart health.

Some of his key points:

Use an 80/20 balance between Zone 2 and Zone 5 intensity

Train Zone 2 4 to 6 hours a week (optimally)

Train Zone 5 1-2x week, 60 minutes max

For optimal VO2Max training, you need to train your cardiovascular system approximately 5 hours a week.

And that’s my - and probably your - primary problem.

Most of us don’t have 5 hours a week to dedicate for “just” cardio.

We still need to:

Strength train

Focus on joint health (stability, mobility, flexibility)

And -

Have a life.

It’s not that I disagree with Dr. Attia per se…

I just disagree with his strategy .

Several reasons:

First, if you have lower back, knee, or hip pain, stiffness, or tightness, one of the best ways to MAKE IT WORSE is to engage in high repetition cardio.

Why?

It engrains those negative compensatory movement patterns and muscle imbalances further into your CNS (Central Nervous System) making them much harder to get rid of , and keeping you in pain longer.

And pain shuts down the normal functioning of your joints and muscles.

The more you train into and through pain, the faster you’re facing a catastrophic injury or joint replacement.

Second, you require MUSCLE to move.

It’s a documented fact that men lose 10% of their muscle - predominantly fast-twitch muscle fibers - the ones for running faster, jumping higher, and lifting more…

At a rate of 10% per decade if not directly trained.

These are the ones that consume the most energy.

And they are the fibers responsible for keeping your metabolism elevated - your ability to burn calories at rest.

Training your VO2Max trains your slow twitch (endurance) fibers.

And too much endurance training actually turns your fast twitch fibers into slow twitch fibers.

And that’s exactly the opposite of what we’re trying to do .

Third, an overabundance of cardio (relative to the individual) elevates circulating cortisol levels which lowers :

It diminishes testosterone, increasing fatigue and muscle loss, especially in men over 40.

The number of fast-twitch muscle fibers you have… which are the ones you shed quickest but Power require critically over 30

Leads to fatigue… something many men already battle , so we don’t need more of that !

Might damage mitochondria if not done right … which might sound trivial until you realize that mitochondria damage → mitochondria death → YOUR death!

So, it’s not that I take issue with Dr. Attia’s interpretation of the research…

I just have a different view with his solution(s).

They are quite unrealistic for most of us over-40 types.

Unless you have all the time in the world, then you can totally do it .

What should you do as an alternative?

1- Focus on maintaining your joints

It’s a well known fact that the reason people end up in nursing homes ( besides Alzheimer’s and dementia) is that they lose mobility .

Why’s that?

We’ll explain that next.

But first, get rid of your joint limitations to the best of your ability.

If you’re chasing that [INSERT YOUR PET LIFT HERE] but you’re constantly beaten up, sore, and in pain as a result …

You might want to rethink that.

You’re not going to win any gold medals or corporate sponsorships at your age .

(Said the pot to the kettle. For real, I’ve had to have this conversation with myself several times over the last 15 years .)

2- Focus on increasing strength

Work on improving your fast-twitch muscle fibers .

Then grow them.

Use the kettlebell Grinds - Press, Front Squat, etc., and keep your reps between 1 and 6.

You can also use the kettlebell ballistics and keep your reps around 10 to 12.

Doing so revs up your metabolism and is another way to avoid or reverse Type 2 Diabetes onset .

And as a result, you’ll increase your chances of living longer .

3- Focus on POWER TRAINING

Why?

Power training builds fast-twitch fibers and reaction time, often diminished after 40.

Kettlebells are perfect for this.

4- Focus on VO2MAX TRAINING

Now, fortunately, as you get more skilled with #3 - Power Training…

You can “slide into” this type of training, depending on how you set it up .

“Yeah, but how well does it work compared to Zone 2 training that Dr. Attia recommends?”

Yes, several meta analyses* demonstrated HIIT - which, when you come right down to it - is a form of power training -

Was more effective to MICT - Moderate Intensity Continuous Training - for improving VO2Max in older populations.

But you can still add in 1-2 Zone 2 sessions a week if you have the time.

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