← The Peter Attia Drive

#261 ‒ Training for The Centenarian Decathlon: zone 2, VO2 max, stability, and strength | Peter Attia, M.D.

Jul 10, 2023 1h 4m 37 insights
<p><a href="https://peterattiamd.com/training-for-the-centenarian-decathlon/?utm_source=podcast-feed&amp;utm_medium=referral&amp;utm_campaign=230710-pod-trainingforthecentenariandecathlon&amp;utm_content=230710-pod-trainingforthecentenariandecathlon-podfeed"> View the Show Notes Page for This Episode</a></p> <p><a href="https://peterattiamd.com/subscribe/?utm_source=podcast-feed&amp;utm_medium=referral&amp;utm_campaign=230710-pod-trainingforthecentenariandecathlon&amp;utm_content=230710-pod-trainingforthecentenariandecathlon-podfeed"> Become a Member to Receive Exclusive Content</a></p> <p><a href="https://peterattiamd.com/newsletter/?utm_source=podcast-feed&amp;utm_medium=referral&amp;utm_campaign=230710-pod-trainingforthecentenariandecathlon&amp;utm_content=230710-pod-trainingforthecentenariandecathlon-podfeed"> Sign Up to Receive Peter's Weekly Newsletter</a></p> <p>In this special episode filmed live in front of readers of Outlive, Peter answers questions revolving around his concept of the centenarian decathlon. He starts by defining the "marginal decade" and how that shapes his training for the events and activities that make up his personal centenarian decathlon. Peter explains how he coaches patients through the challenges of customizing their own list and building out a training plan, including how to set fitness goals early in life in preparation for the marginal decade. From there, he dives into training within the four pillars (zone 2, VO2 max, stability, and strength), including the minimum effective dose, how to split your time, his personal protocols, and other considerations. Additionally, he touches on bone mineral density, female-specific considerations, working through injuries, and the profound impact training can have on the overall quality of life.</p> <p><strong>We discuss:</strong></p> <ul type="disc"> <li>The best interventions for longevity [2:15];</li> <li>The marginal decade and the centenarian decathlon [4:45];</li> <li>Peter's personal list of events for his "centenarian decathlon" and how he helps patients create their own list [8:00];</li> <li>Determining your fitness goals early in life in preparation for the marginal decade, metrics to track, and more [15:00];</li> <li>How does playing sports like tennis, basketball, or golf fit into training for the centenarian decathlon? [24:15];</li> <li>Training within the four pillars: minimum effect dose, how to split your time, and other considerations [27:45];</li> <li>Advice for the older person and why it's never too late to start [33:45];</li> <li>Bone mineral density and other female-specific concerns and considerations [36:15];</li> <li>Training advice for those with minimal access to a gym or equipment [39:30];</li> <li>Injuries: prevention and working through existing conditions [41:00];</li> <li>Cardiorespiratory training: how to split time between zone 2 and VO2 max training, and different modalities for a true zone 2 workout [44:15];</li> <li>VO2 max training: modalities, Peter's protocol, and how to monitor progress [54:45];</li> <li>The profound impact training can have on the overall quality of life [58:15]; and</li> <li>More.</li> </ul> <p>Connect With Peter on <a href="https://twitter.com/PeterAttiaMD">Twitter</a>, <a href="https://www.instagram.com/peterattiamd/">Instagram</a>, <a href="https://www.facebook.com/peterattiamd/">Facebook</a> and <a href="https://www.youtube.com/channel/UC8kGsMa0LygSX9nkBcBH1Sg">YouTube</a></p>
Actionable Insights

1. Prioritize Quality of Life

Engage in consistent exercise primarily for the significant improvement it brings to your quality of life, even if it didn’t extend lifespan, as the daily benefits are profoundly impactful.

2. Adopt a Lifetime Training Horizon

Approach training for the centenarian decathlon with a lifetime perspective, creating a sustainable program that you can maintain for decades, focusing on consistent progress, injury prevention, and enjoyment rather than short-term, intense bursts.

3. Plan for Remarkable Marginal Decade

Backcast from your desired ‘marginal decade’ (the last decade of your life) by setting specific goals to ensure all preceding decades are also remarkable, enabling a high quality of life throughout.

4. Create Your Centenarian Decathlon

Design a personalized ‘centenarian decathlon’ by backcasting from your marginal decade, selecting 10 specific events that combine activities of daily living and recreational activities, and then training specifically for those chosen events to direct your fitness goals.

5. Define ‘Why’ for Decathlon

When creating your centenarian decathlon list, start by considering your desired quality of life (e.g., playing with grandkids, living independently, walking to get groceries) to help you define specific, meaningful events to train for.

6. Prioritize 10 Decathlon Events

When creating your centenarian decathlon, select and prioritize the 10 most important activities of daily living or feats of fitness/strength from a broader list to ensure focused training.

7. Integrate All Four Exercise Pillars

Structure your weekly exercise by integrating all four pillars—lower body strength, upper body strength, Zone 2 cardio, VO2 max training, and dedicated stability work—across multiple days to ensure comprehensive physical development.

8. Minimum Effective Dose Exercise

For a minimum of three hours of exercise per week, allocate one hour to Zone 2 aerobic training, one hour to strength training, 20-30 minutes (1-2 sessions) to VO2 max appropriate high-intensity aerobic training, and 30-40 minutes (spread as 10 minutes daily) to stability training.

9. Apply 80/20 Rule for Cardio

Structure your cardiorespiratory training with an 80/20 split, dedicating approximately 80% of your volume to Zone 2 (base) and 20% to VO2 max (peak) workouts, a principle applicable to all fitness levels for maximizing overall aerobic capacity.

10. Address Fitness Deficits

Identify your specific fitness deficits (e.g., low ALMI, poor aerobic training) through metrics like DEXA scans and VO2 max tests, then disproportionately allocate training time to improve those weaker areas rather than equally distributing effort across all pillars.

11. Apply Progressive Overload

Continuously increase the demand of your training every six weeks by applying progressive overload, which can involve heavier weights, more reps, more sets, less rest, or advanced techniques like BFR, to prevent habituation and ensure continued improvement.

12. Never Too Old to Train

Regardless of age, understand that you are resilient and can significantly improve your physical health through consistent and purposeful training, as long as you are breathing.

13. Young People Need Higher Baseline

If you are younger, aim for a higher baseline of fitness in areas like strength and VO2 max, as you have a longer period to maintain these parameters, requiring a greater margin of error.

14. Address Nagging Injuries Proactively

Do not ignore nagging injuries; instead, view them as motivation to engage in dedicated rehabilitation, potentially investing at least three hours a week in specific rehab exercises, as delaying treatment can lead to worse outcomes.

15. Balance Sport-Specific Training

While sports are beneficial, supplement them with specific training to counteract repetitive stress and asymmetries in joints and muscles, ensuring balanced fitness for long-term health rather than relying solely on sport-specific activities.

16. Get a DEXA Scan

Obtain a DEXA scan to measure your bone mineral density, visceral fat, and muscle mass, as these are crucial data points for understanding your overall health and fitness.

17. Target 75th Percentile for ALMI

Calculate your Appendicular Lean Mass Index (ALMI) from your DEXA scan data and aim to be at or above the 75th percentile for your age and sex, as it’s a strong indicator of muscle mass and strength.

18. Measure Your VO2 Max

Assess your cardiorespiratory fitness by getting a VO2 max test, which is widely available and affordable, or estimate it for free using tests like the Cooper’s test, to understand your current fitness level.

19. Identify Your Zone 2 Threshold

Determine your Zone 2 heart rate or effort level by finding the threshold where you can still speak but feel uncomfortable, just before you can no longer speak, as this indicates where your body starts to accumulate lactate.

20. Prioritize Strength for Lifespan

Focus on developing strength over just increasing muscle mass, as strength is a more significant predictor of lifespan when compared head-to-head.

21. Prioritize Heavy Strength Training

Engage in heavy load-bearing strength training, which is crucial for maintaining bone mineral density and slowing its decline, especially for women at higher risk, and support this with adequate estrogen, testosterone, vitamin D, and protein.

22. Incorporate Daily Stability Training

Dedicate time daily (10 minutes to an hour) to specific, unsexy stability and movement exercises to counteract imbalances and maintain overall physical function for long-term health.

23. Distribute Stability Training Daily

Instead of one long session, perform stability training (e.g., IAP, breathing, saccapular cars, cat cow) for 10 minutes daily, six days a week, to maximize neurological patterning benefits.

24. Minimum 30-Minute Zone 2 Sessions

Aim for Zone 2 cardio sessions of at least 30 minutes to achieve optimal physiological benefits, rather than shorter, more frequent sessions.

25. Maintain Steady State Zone 2

For effective Zone 2 training, aim for a continuous, steady state where you are consistently at the limit of oxidative phosphorylation without constantly dipping into and out of glycolysis, to maximize mitochondrial efficiency.

26. Precede VO2 Max with Base Work

Perform VO2 max workouts after a significant amount of base work (e.g., at least 1000 kilojoules or calories of work on a bike) to ensure adequate preparation before high-intensity efforts.

27. Optimize VO2 Max Interval Duration

For VO2 max training, focus on intervals lasting between three to eight minutes, ensuring the intensity allows you to sustain the effort for at least three minutes per interval.

28. Use 1:1 Work-Rest for VO2 Max

Implement VO2 max intervals with a 1:1 work-to-rest ratio (e.g., four minutes on, four minutes off, or three minutes on, three minutes off) to maximize training effectiveness.

29. Pace VO2 Max Intervals Strategically

Pace your VO2 max intervals by starting at a sustainable intensity (e.g., 105% of target wattage) that feels easy initially, ensuring you can maintain effort for the full duration and avoid crashing, with no more than a 10% positive split.

30. Commit to Lifetime VO2 Max

Understand that while short-term studies show limited VO2 max improvement, a lifetime commitment to training can lead to a substantial 50% increase in your VO2 max.

31. Track VO2 Max with Power Meter

Monitor your VO2 max progress annually, but track more frequent improvements by using a power meter on a bike to measure wattage output during intervals, noting increases over time (e.g., 150 to 175 watts in six months) as an indicator of improved fitness.

32. Improve VO2 Max by Losing Weight

If you are overnourished, losing excess body weight while engaging in cardio training can lead to a significant and motivating improvement in your VO2 max score.

33. Consider Body Weight for VO2 Max

Recognize that body weight significantly impacts your VO2 max score (liters/min/kg), so managing your weight, particularly reducing non-contributing upper body mass, can help optimize your relative VO2 max.

34. Test Farmer Carry Strength

Measure your upper body and grip strength by performing a farmer carry: a 40-year-old man should aim to carry his body weight (half in each hand) for one minute, while a 40-year-old woman should aim for 75% of her body weight.

35. Test Dead Hang Grip Strength

Evaluate your grip strength by performing a dead hang: a 40-year-old man should aim for two minutes, and a 40-year-old woman for one and a half minutes, with a 10-15 second reduction per decade thereafter.

36. Test Leg Strength with Wall Sit

Test your leg strength by performing a wall sit, aiming to hold the position for two minutes with your back against a wall and thighs parallel to the ground, without using your hands for support.

37. Invest in Home Exercise Equipment

Supplement bodyweight exercises by investing in efficient home exercise equipment like adjustable dumbbells, kettlebells, heavy resistance bands, and a TRX system to enable comprehensive strength training without a gym.