<p class="p1"><span class="s1"><a href="https://peterattiamd.com/subscribe/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=220221-pod-ama32&utm_content=220221-pod-ama32-podfeed"> Become a Member to Listen to the Full Episode</a></span></p> <p class="p1"><span class="s1"><a href="https://peterattiamd.com/ama32/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=220221-pod-ama32&utm_content=220221-pod-ama32-podfeed"> View the Show Notes Page for This Episode</a></span></p> <p class="p2"><strong>Episode Description:</strong></p> <p class="p2">In this "Ask Me Anything" (AMA) episode, Peter shares his current workout regimen and how he incorporates blood flow restriction (BFR). He walks through the mechanics and fundamentals of some of his favorite lifts including squats, deadlifts, and hip thrusters and stresses the relative importance of each in the context of longevity. He touches on the relative importance of muscle size vs. muscle strength and discusses the impact of fasting on muscle mass and the potential tradeoffs during aging. Peter then dives into the topic of testosterone replacement therapy (TRT) for both men and women, starting with a clinical discussion around how he actually replaces testosterone in patients. He explains the targets of this therapy as well as the risks and benefits, and he gives his interpretation of current data on the association between TRT and heart disease.</p> <p class="p2">If you're not a subscriber and listening on a podcast player, you'll only be able to hear a preview of the AMA. If you're a subscriber, you can now listen to this full episode on your <a href="https://peterattiamd.com/members/private-podcast-feed/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=220221-pod-ama32&utm_content=220221-pod-ama32-podfeed"><span class="s2">private RSS feed</span></a> or on our website at the <a href="http://peterattiamd.com/ama32/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=220221-pod-ama32&utm_content=220221-pod-ama32-podfeed"><span class="s2">AMA#32 show notes page</span></a>. If you are not a subscriber, you can learn more about the subscriber benefits <a href="https://peterattiamd.com/subscribe/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=220221-pod-ama32&utm_content=220221-pod-ama32-podfeed"><span class="s2">here</span></a>.</p> <p class="p2"><strong>We discuss:</strong></p> <ul class="ul1"> <li class="li2">Peter's current exercise routine [2:25];</li> <li class="li2">How Peter incorporates blood flow restriction (BFR) into his workouts [5:45];</li> <li class="li2">Relative importance of muscle size vs. muscle strength [16:45];</li> <li class="li2">Comparing squats to deadlifts and why both are important [22:00];</li> <li class="li2">Squatting technique and fundamentals [31:15];</li> <li class="li2">Important cues to look for while lifting weights [38:30];</li> <li class="li2">Proper mechanics of a deadlift [42:00];</li> <li class="li2">Hip thrusters as an alternative to the squat or deadlift [44:00];</li> <li class="li2">Split-leg work for simulating activities of daily living [47:00];</li> <li class="li2">The impact of fasting/calorie restriction on muscle mass and the potential tradeoffs to consider [49:45];</li> <li class="li2">Testosterone replacement therapy: considerations when contemplating TRT and Peter's approach with patents [54:30];</li> <li class="li2">Data on the association between TRT and heart disease [1:04:15];</li> <li class="li2">TRT for women—risks and benefits [1:06:45];</li> <li class="li2">Impact of fasting on testosterone levels [1:13:45]; and</li> <li class="li2">More.</li> </ul> <p class="p1"><span class="s1"><a href="https://peterattiamd.com/newsletter/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=220221-pod-ama32&utm_content=220221-pod-ama32-podfeed"> Sign Up to Receive Peter's Weekly Newsletter</a></span></p> <p class="p1"><span class="s4">Connect With Peter on <a href="https://twitter.com/PeterAttiaMD"><span class="s1">Twitter</span></a>, <a href="https://www.instagram.com/peterattiamd/"><span class="s1">Instagram</span></a>, <a href="https://www.facebook.com/peterattiamd/"><span class="s1">Facebook</span></a> & <a href="https://www.youtube.com/channel/UC8kGsMa0LygSX9nkBcBH1Sg"><span class="s1">YouTube</span></a></span></p>
Actionable Insights
1. Structured Weekly Exercise Plan
Implement a consistent weekly exercise routine with cardio on Tuesday, Thursday, Saturday, Sunday (Zone 2 for 45 mins, with Saturday optionally including a 30-min Zone 5 workout or longer anaerobic ride), and lifting on Monday, Wednesday, Friday, Sunday (using an upper body/lower body split, e.g., lower body Monday/Friday, upper body Wednesday/Sunday).
2. Prioritize Cardio Before Lifting
Always perform cardio before lifting, as doing the reverse has been demonstrated to erode strength training gains.
3. Never Compromise Scheduled Lifts
Prioritize completing all four scheduled lifting sessions each week, even if it means moving days around or doubling up on a different day, to ensure consistency in strength training.
4. Invest in Quality BFR Cuffs
For effective blood flow restriction (BFR) training, invest in high-quality cuffs (e.g., ‘smart cuff’) that measure occlusive pressure, as they provide a significant improvement over basic bands and are considered worth the cost.
5. Daily BFR at Workout End
Incorporate blood flow restriction (BFR) training at the end of every lifting workout, typically for one to two exercises per muscle group, such as a leg press set after a leg session or bicep/tricep sets after an upper body session.
6. Standard BFR Rep Protocol
When performing BFR, follow the standard protocol: 30 reps, rest 30 seconds, 15 reps, rest 30 seconds, 15 reps, rest 30 seconds, 15 reps.
7. Calculate BFR Training Weight
To determine the appropriate weight for BFR, use 30-40% of your one-rep max (1RM); calculate this by taking your best 10-rep weight, dividing it by 0.75 (to estimate 1RM), and then multiplying the result by 0.3 to 0.4.
8. Optimal BFR Occlusive Pressure
When using BFR cuffs with an inflation device, ensure they measure occlusive pressure and aim to operate at approximately 30% of the arterial occlusive pressure for effective training.
9. Identify Proper BFR Sensation
When BFR is applied correctly, the sensation should be one of lactic acidosis throughout the entire limb, as opposed to localized pain from the band’s constriction, indicating a true occlusive effect.
10. Consistent Weekday Morning Lifts
On weekdays, schedule lifting sessions consistently around 7:15-7:30 AM, after morning routines and once children are out the door, to maintain adherence.
11. Build Dead Hang Strength Progressively
For dead hangs, aim for 2-2:30 minutes most days without going to failure, as this approach helps build strength progressively rather than always pushing to max effort.
12. Integrate Finger Pull-ups
Incorporate finger pull-ups into your routine, starting with four fingers and progressing to three fingers (e.g., three sets of four four-finger pull-ups, followed by four sets of two three-finger pull-ups), to significantly enhance grip strength.
13. BFR as Workout Finisher
Use blood flow restriction (BFR) as a finisher or near the end of a workout, rather than before heavy, neurologically demanding exercises, to ensure you are fresh for primary lifts.
14. End Workouts with Dead Hangs
Consider incorporating dead hangs as the very last exercise in a workout to build grip strength and finish the session.
15. Consult Healthcare Professionals
Always seek the assistance of healthcare professionals for medical advice, diagnosis, or treatment, as the podcast content is for general informational purposes only and not a substitute for professional medical guidance.
16. Access Exclusive Member Content
Become a member at peteratiamd.com/subscribe to gain access to complete AMA episodes, comprehensive show notes, private podcast feeds (’the qualies’), and discount codes for products, providing more in-depth and exclusive content.
17. Download Member Podcast Feed
If you are already a member, download the member-only podcast feed from peteratiamd.com/members to access full AMA episodes and avoid listening to sneak peeks.
Follow Peter Attia on Twitter, Instagram, and Facebook (@peteratiamd) and leave reviews on podcast platforms to engage with the content and support the show.
19. Review Conflict of Interest Disclosures
Review the conflict of interest disclosures and a list of companies invested in or advised by Peter Attia at peteratiamd.com/about for transparency.
20. Avoid DIY Doppler for BFR
Do not attempt to use a Doppler device to measure occlusive pressure for BFR with basic bands, as it is cumbersome and impractical; instead, invest in cuffs that can accurately measure and adjust pressure.
21. Watch Podcast Videos for Visual Aids
Watch the full video version of the podcast (if available to subscribers) or the sneak peek on YouTube, especially when figures are discussed, to enhance understanding.