206 - Exercising for longevity: strength, stability, zone 2, zone 5, and more | Peter Attia, M.D.

KEYPOINTS

• 01

  Training for longevity is different from training for performance.

  Attia says performance goals such as a sub-2:40 Chicago Marathon, a sub-10-hour Ironman or a deadlift of 3.5 times body weight demand energy systems that aren't co-linear with longevity and can be 'orthogonal' to it. Longevity training rests on stability and strength, a large base of low-end aerobic work in zone 2 and brief bursts of zone 5. 'Life is zone one, zone two and zone five,' he says.

• 02

  Work backward from age 100 with a 'Centenarian Decathlon.'

  Instead of planning year by year from 25, Attia projects his kids' ages forward and estimates he'd have great-grandchildren aged about 1 to 8 when he turns 100. He listed 18 things he wants to do with them. Examples: drop into a squat and pick up a 30-lb child (approximated by a goblet squat), lift 30 lb overhead like a carry-on bag, and climb three flights of stairs carrying 10 lb of groceries in each hand. Because of age-related decline, each must be done at a much higher level at 80, 60 and today.

• 03

  Today's centenarians mostly got there through genes, not habits.

  Attia makes what he calls an extreme claim: almost every current centenarian made it because of exceptional genes. On average they didn't live better than their peers, and many smoked. He doubts many could do his 18 events. People hoping to 'hack' their way to 100 will have to be far more deliberate.

• 04

  Muscle and strength decline compounds, so being average at 50 isn't enough.

  Estimates of muscle loss range from about 0.3% to 1–2% a year after 50, or roughly 35–40% between ages 20 and 80. Strength losses may be greater, around 2–3% a year and up to 4% in some studies. 'If you have the aspiration of kicking ass when you're 85, you can't afford to be average when you're 50.'

• 05

  Strength predicts mortality independently of muscle size.

  Attia reviews a study of men and women averaging about 54 years old, followed for five to six years. In men, each 0.2-unit drop in quad strength normalized to CT muscle area, or each 0.34-unit drop normalized to DEXA, was linked to about 26% and 39% higher all-cause mortality. Grip strength normalized to arm lean mass showed about a 23% increase. Results in women were significant but with wider confidence intervals.

• 06

  Stability is usually the first thing to fail.

  Dynamic neuromuscular stabilization (DNS) is based on 13–14 innate movements that babies master by about 18 months, which then deteriorate, especially once children start sitting in school. Attia's advice to a 25-year-old: build static stability, then dynamic stability, and integrate both into strength work. The core includes the diaphragm, obliques, transversalis fascia and pelvic floor. He admits he has always squatted and deadlifted without fully engaging his pelvic floor and now sees the damage it caused.

• 07

  Zone 2 should be steady, measured and frequent.

  Attia does zone 2 four times a week for about 45 minutes, checking lactate every session. He knows his zone 2 wattage and expected heart rate. If heart rate runs high, he may be ill or dehydrated, so he lowers the power. He likes erg mode on a bike, which holds about 200 W regardless of cadence, so he can listen to audiobooks. A treadmill at a known incline works too. He prefers rowing for zone 5, not zone 2. Interactions with Iñigo San-Millán convinced him that zone 2 had been a glaring gap in his training.

• 08

  VO2 max is the size of your aerobic engine, and 'all-out' is limited to about 10 seconds.

  A.V. Hill first described VO2 max in the 1920s. Attia once measured about 5.1–5.2 L/min, around 70 mL/kg/min at his heavier weight. A huge rower might hit 7 L/min while using less oxygen per kilogram. A riding partner who tested at 55–60 mL/kg/min always beat him, showing that VO2 max alone doesn't predict speed. Citing Alex Hutchinson's Endure, Attia says a true all-out effort lasts only about 10 seconds; even Usain Bolt slows in the second half of a 200 m.