Summary of 201 - Deep dive back into Zone 2 Training | Iñigo San-Millán, Ph.D. & Peter Attia, M.D.

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00:00:00 - 01:00:00

In this video, Iñigo San-Millán, Ph.D. and Peter Attia, M.D. discuss zone 2 training and its importance in cycling. Zone 2 training includes training at a power output that is lower than FTP, but still high enough to be sustainable for a long period of time. By knowing a rider's capabilities and their limits, coaches can plan strategies accordingly for the next day's race.

00:00:00 Iñigo San-Millán, Ph.D. and Peter Attia, M.D. discuss Zone 2 training, Teddy Pogachar, and the potential for professional cyclists. San-Millán notes that Pogachar had excellent physiological potential and that this potential was apparent from the start of their working relationship.
00:05:00 The video discusses how Iñigo San-Millán, Ph.D., and Peter Attia, M.D., use deep dive training protocols to help professional athletes and cyclists achieve their training goals. The protocols include training picks software to identify training peaks, and measuring metabolites to identify changes in training intensity and recovery. The video also discusses how this information can be used to predict performance in the season.
00:10:00 In this video, Iñigo San-Millán, Ph.D. and Peter Attia, M.D. discuss Zone 2 training and its importance in cycling. Zone 2 training includes training at a power output that is lower than FTP, but still high enough to be sustainable for a long period of time. By knowing a rider's capabilities and their limits, coaches can plan strategies accordingly for the next day's race.
00:15:00 The video discusses Zone 2 training, which is a form of training that is designed to help athletes who are at a high level of performance. Zone 2 training is designed to help athletes maintain their level of performance even when they are not at their best. The video also discusses the predictors of readiness to perform, which includes data that is confidential.
00:20:00 The video discusses Zone 2 training, which is a type of training that is designed to improve power output. It discusses the difficulties of releasing data, as well as the potential for cycling to become more engaging for viewers.
00:25:00 In this video, Iñigo San-Millán, Ph.D., and Peter Attia, M.D., discuss the Van Tu stage of the Tour de France and how Tala Van Garderen's strategy played out. San-Millán says that Van Garderen's strategy was "no panic, plenty of time." Van Garderen finished the stage in second place and Attia says that Van Garderen's strategy "probably" won him the stage.
00:30:00 Zone 2 training is a type of exercise intensity that is best for stimulating mitochondrial function and fat oxidation.
00:35:00 The video discusses the correlation between exercise intensity and fat oxidation. It explains that one can estimate fat oxidation based on oxygen consumption (VO2 and VCO2) and carbon dioxide production (VCO2 and CO2). The video also describes the shape of the fat oxidation curve and differentiates Pogacar from average humans.
00:40:00 The video discusses the differences between metabolisms in Zone 1 (fast oxidation) and Zone 2 (slow oxidation). It explains that elite athletes have a high fat oxidation capacity, while for recreational athletes and people with type 2 diabetes, glucose is the main energy source. The video shows how to calculate fat oxidation using the metabolic map.
00:45:00 The first graph in this video shows the relationship between lactate levels and workload in different groups of athletes, with athletes with metabolic syndrome tending to have resting lactate levels above two millimole. The second graph shows the same relationship between lactate levels and workload, but with watts per kilogram as the independent variable.
00:50:00 In the 201 video, Iñigo San-Millán, Ph.D. and Peter Attia, M.D. discuss how an individual's fitness level affects their ability to burn fat. The fittest individuals reach their maximum fat oxidation point much earlier than when they reach their lactate threshold. This information can help clinicians better tune their patients' exercise protocols.
00:55:00 In this video, Iñigo San-Millán, Ph.D. and Peter Attia, M.D. discuss the differences between the blood lactate levels of elite athletes and recreational athletes. They note that the blood lactate levels of elite athletes might not correspond with the fat max, but that the blood lactate levels of recreational athletes might correspond more closely. This level of nuance is important because it helps to ensure that athletes are using the correct intensity level to achieve their goals.

01:00:00 - 02:00:00

Iñigo San-Millán, Ph.D. and Peter Attia, M.D. discuss Zone 2 training, which is a type of training that is meant to help athletes achieve their maximum fat oxidation. They discuss how ketosis can affect fat oxidation and how the metabolic card can be inaccurate when measuring oxygen uptake in athletes. They also discuss how carbohydrate and fat intake vary among athletes and how adjusting the metabolic card can help provide more accurate information about an athlete's metabolic state.

01:00:00 This YouTube video is a deep dive into Zone 2 training, which is the training zone that corresponds to moderately active individuals. Zone 2 training is designed to help moderately fit individuals improve their metabolic function and mitochondrial performance.
01:05:00 The video discusses how the three transporters that allow substrates to enter and leave the mitochondria are important for efficient energy production. The first transporter, the fatty acids, are truncated and enter the Krebs cycle. The second, glucose, byproducts, is reduced to pyruvate which enters the cell through its own carrier and is then oxidized to acetyl-coa. This acetyl-coa is then transported to the mitochondria and entered through the mitochonria transporter, MCT-1. Lactate is then oxidized back to pyruvate and enters the Krebs cycle. This process is necessary for the continued function of glycolysis.
01:10:00 Zone 2 training is designed to help athletes produce less lactate, and to improve performance by increasing the efficiency of energy production. Zone 2 training can be enhanced with epigenetic interventions, such as training specifically to stimulate the mitochondrial energy system.
01:15:00 Iñigo San-Millán, Ph.D. and Peter Attia, M.D. discuss how different levels of metabolic acidosis (high levels of hydrogen ions in the blood) affect muscle function and performance. They also discuss how carbohydrate intake affects lactate production and how a ketogenic diet can improve muscle fitness.
01:20:00 Iñigo San-Millán, Ph.D. and Peter Attia, M.D. discuss Zone 2 training, which is a type of training that is meant to help athletes achieve their maximum fat oxidation. They discuss how ketosis can affect fat oxidation and how the metabolic card can be inaccurate when measuring oxygen uptake in athletes. They also discuss how carbohydrate and fat intake vary among athletes and how adjusting the metabolic card can help provide more accurate information about an athlete's metabolic state.
01:25:00 The author discusses how the oxidation rate, which reflects how well the mitochondria can oxidize fat, can be altered in people who are not elite athletes or who have depleted glycogen stores. They present research which suggests that glutamine plays an important role in energy production, and suggest that when mitochondria are unable to use glucose for energy, they may turn to glutamine for fuel.
01:30:00 The video discusses the importance of exercise for icu patients, which can help improve their outcomes. Glutamine is a key player in this process, as it is released when the muscles break down protein. Hyperglycemia and insulin resistance are both likely caused by the liver's ability to maintain glycogen levels.
01:35:00 The presenter discusses how insulin resistance and pre-type 2 diabetes can affect the way in which glucose is absorbed into the cells. They explain that the two mechanisms by which glucose is absorbed - muscle contraction and insulin independent glucose uptake - are both active at the same time, leading to hypoglycemia. The presenter goes on to discuss how exercise can prevent or manage glucose levels in type 1 and type 2 diabetes.
01:40:00 The presenter discusses Zone 2 training, which is a training intensity zone that is above the maximal fat oxidation level of 1.5 watts per kilo. The presenter recommends using metabolic tests to determine a person's Zone 2 training zone and then using relative perceived exertion (rpe) or watts to determine the intensity and frequency of the training.
01:45:00 Iñigo San-Millán, Ph.D. and Peter Attia, M.D. discuss Zone 2 training, which is a type of training that is designed to help people who are struggling to maintain a conversation while working out. They explain that a person's zone 2 is usually at about 78-81% of their maximum heart rate, and that there are different ranges that people can start at depending on their level of training. They also mention that heart rate variability (the range of heart rates that a person experiences) can offer a lot of information about their state of fatigue. Finally, they mention a self-experiment that they've done where they've had to endure a lot of unpleasantness in order to gather data.
01:50:00 The video discusses how beta blockers can affect heart rate and how this can be used to improve Zone 2 training. Iñigo San-Millán, Ph.D. and Peter Attia, M.D. discuss how this works and how it is related to energy levels and fatigue. They also discuss how intermittent fasting can help to improve fuel availability for the heart.
01:55:00 The speaker discusses how high intensity training is not always sufficient, and how a training program should be designed for an individual based on their preferences and limitations.

02:00:00 - 03:00:00

This video discusses the importance of Zone 2 training, which is a type of endurance training that is shorter in duration and uses higher intensity levels. The presenter recommends that individuals try to do this type of training between three to four days a week, and that those who are new to an exercise program might not need as much frequency.

02:00:00 The video discusses the importance of Zone 2 training, which is a type of endurance training that is shorter in duration and uses higher intensity levels. The presenter recommends that individuals try to do this type of training between three to four days a week, and that those who are new to an exercise program might not need as much frequency.
02:05:00 Zone 2 training is important, but it should be done more frequently than once a week. Additionally, it is important to stimulate other energy systems besides the glycolytic system.
02:10:00 The author discusses the pros and cons of high intensity training, and suggests a four-by-four protocol for achieving the most effective results.
02:15:00 Iñigo San-Millán, Ph.D. and Peter Attia, M.D. discuss how people can improve their Zone 2 training by doing a warm-up and cool down, spending an hour doing Zone 2, or doing Zone 2 three or four times a week. The last point is key, as if people stimulate a regular base of Zone 2 training, they will see benefits in terms of energy systems, cortisol levels, and anemia.
02:20:00 In this video, Iñigo San-Millán, Ph.D. and Peter Attia, M.D. discuss the idea that you don't need a lot of data when you're doing Zone 2 training. They also discuss how they maintain their metabolic health and athletic performance into their 60s and 70s despite changing their lifestyle and diet in their 40s.
02:25:00 Dr. Iñigo San-Millán, Ph.D. and Dr. Peter Attia, M.D. discuss the benefits and drawbacks of metformin and how it can be used to improve mitochondrial function. They also mention that more research is needed on the long-term effects of the drug.
02:30:00 In this video, Iñigo San-Millán, Ph.D. and Peter Attia, M.D. discuss how lactate levels can be an artifact of Zone 2 training and how taking metformin or other supplements that boost NAD could be beneficial to the mitochondria. They also mention that there is no evidence that taking too much NAD will increase longevity.
02:35:00 The study found that increasing NAD levels in tumors increased their glycolytic rate, which favored their growth.
02:40:00 This video discusses how exercise can help to prevent cancer growth, but it can also increase the amount of lactate in the body. The researchers are trying to find out why this is happening and whether or not exercise can counteract the increase in lactate.
02:45:00 This video, which is a deep dive into Zone 2 training, discusses how healthy people can become susceptible to a phenotype resembling type 2 diabetes when they complete the training. The authors suggest that this could be due to mitochondrial dysfunction. They discuss how this could lead to multiple diseases, and suggest that biopsies be taken in order to better understand the mechanism.
02:50:00 The video discusses how a virus called alphaherpesviruses can hijack mitochondria and interfere with the fission and fusion processes, which can lead to myocarditis. The authors discuss a study that looked at how predictable the relationship between zone two as defined by maximum fat oxidation and vo2 max is. They speculate that this virus may be more prevalent in females and that more research is needed to determine the demographics of those infected.
02:55:00 The video discusses how different levels of exercise intensity and carbohydrate oxidation correspond to different metabolic states. The research found that elite athletes have a much higher carbohydrate oxidation rate than sedentary individuals, and that this corresponded with a different metabolic state.

03:00:00 - 03:15:00

In this video, Iñigo San-Millán, Ph.D. and Peter Attia, M.D. discuss the role of mitochondrial dysfunction in the development of diabetes and metabolic syndrome. They suggest that the model for studying diabetes should not be the healthy, sedentary individual, and discuss the potential benefits of metformin for mitochondrial function and performance.