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The Peter Attia Drive #85 – Iñigo San Millán, Ph.D.: Mitochondria, exercise, and metabolic health

If you get inspired by geeking out on the latest science this is an awesome podcast for a long run outside. Highly recommended for anyone seeking to understand and improve their endurance.

Dr. Iñigo San Millán, Assistant Professor at the University of Colorado School of Medicine (and ex-Real Madrid youth team player and professional cyclist) talks to healthspan & longevity doctor Peter Attia about the crucial role of mitochondrial function in everything from metabolic health to elite exercise performance.

If you’ve read Training for the Uphill Athlete by Steve House, Scott Johnston & Kílian Jornet you’ll recognize the prescription of zone 2 training to promote mitochondrial efficiency and quantity.

Dr San Millán compares the mitochondria of elite athletes with those of regular people and with individuals suffering from metabolic disorders such as type 2 diabetes. It’s not just size and quantity – elite athletes have bigger and more plentiful mitochondria – it’s how they super efficiently process fat, glycogen and lactate that sets them apart from the others. And San Millán talks about the combination of genetics and training that causes this. The discussion goes deep on the science and is absolutely fascinating. In short train to optimize your mitochondria.

Besides optimizing for athletic performance we learn that zone 2 training is a prescription for treating many metabolic issues.

Dr Attia has experimented extensively with the keto diet and it’s interesting to hear both their observations of keto vs. “normal” vs. high carb diets in elite and amateur athletes and how it impacts performance and why that might be.

One piece that I found very interesting was Dr San Millán’s recollection of his retirement from professional cycling and subsequent 65lb weight gain. Going from fueling and metabolic adaptation appropriate for a pro cyclist to a desk job was difficult to say the least. Makes me think that coaches ought to prepare de-training plans for elite athletes retiring or college athletes transitioning to life in the workplace. I suspect that with appropriate diet and training guidance to wind down the engine to a sustainable amateur/weekend warrior level a lot of weight gain and self-esteem issues might well be avoided.

There’s a lot to understand and process in this podcast. I plan on listening again. Show notes are available on Dr Attia’s website.

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