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Summary of Description:
Dr. Iñigo San Millán, Assistant Professor at the University of Colorado School of Medicine, speaks about the importance of mitochondrial function in metabolic health and elite exercise performance in a podcast conversation with physician Peter Attia. The podcast covers topics including the various energy systems and fuels used during exercise, the six zones of exercise training, and the power of zone 2 training as a diagnostic tool and treatment for mitochondrial and metabolic dysfunction. It also discusses the relationship between exercise and insulin sensitivity, metformin’s impact on mitochondrial function, lactate production, and how it affects the benefits of exercise, among other topics.
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Understanding Mitochondrial Function and Exercise Performance with Dr. Iñigo San Millán
Dr. Iñigo San Millán, Assistant Professor at the University of Colorado School of Medicine, joins Peter Attia in this episode to discuss the vital role of mitochondrial function in metabolic health and exercise performance. Dr. San Millán provides a masterclass on the different energy system pathways, fuel sources, six zones of exercise training, and the parameters he uses to measure metabolic health. He also highlights the power of zone 2 training as a diagnostic tool and treatment for mitochondrial and metabolic dysfunction.
Background and Overview
Dr. San Millán discusses his background in sports, decision to focus on education, and how an athlete’s needs motivated his research. He explains that mitochondrial function is essential to metabolic health and how individuals with mitochondrial dysfunction are at higher risk for chronic metabolic diseases.
Energy Systems and Fuel Sources
Dr. San Millán explains the three energy systems and the different fuel sources used during exercise, including carbohydrates, fat, and lactate. He also debunks the myth of lactate being a waste product and highlights its importance as a fuel source.
The Six Zones of Exercise Training
Dr. San Millán qualifies energy systems into six training zones to help individuals improve their metabolic health and exercise performance. He details what individuals should do in each of the zones, including zone 2, which he calls the “transition zone.”
Zone 2 Training and Mitochondrial Function
Dr. San Millán highlights the importance of zone 2 training as a powerful diagnostic tool for mitochondrial and metabolic dysfunction. He explains how blood lactate levels and the zone-2 threshold can assess one’s mitochondrial function and offers advice on how to dose zone 2 training.
The Relationship Between Exercise and Insulin Sensitivity
Dr. San Millán explains the relationship between exercise and insulin sensitivity and what we can learn from studying patients with type 1 diabetes. He also discusses Metformin’s impact on mitochondrial function and lactate production and how it affects the benefits of exercise.
The Warburg Effect and Lactate in Carcinogenesis
Dr. San Millán proposes an explanation of the Warburg Effect and the role of lactate in carcinogenesis.
Doping in Cycling and Altitude Training
Dr. San Millán discusses doping in cycling and the trend towards altitude training. He highlights the importance of proper dosing and balancing exercise with nutrition to maximize health and longevity.
Conclusion
This episode with Dr. San Millán provides valuable insights into the crucial role of mitochondrial function in metabolic health and exercise performance. From the different energy system pathways to the six zones of exercise training, individuals can learn how to optimize their metabolic health and longevity.
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Source Description
Original release date: 12/23/2019
In this episode, Dr. Iñigo San Millán, Assistant Professor at the University of Colorado School of Medicine, explains the crucial role of mitochondrial function in everything from metabolic health to elite exercise performance. Iñigo provides a masterclass into the many different energy system pathways, the various fuel sources (including the misunderstood lactate), the six zones of exercise training, and the parameters he uses to measure metabolic health. Additionally, he highlights the power of zone 2 training in its ability to act as a powerful diagnostic tool, and perhaps more importantly as a treatment for mitochondrial and metabolic dysfunction.
We discuss:
-Iñigo’s background in sports and decision to focus on education [7:15];
-Explaining the various energy systems and fuels used during exercise [14:45];
-Iñigo qualifies energy systems into six training zones [23:00];
-Lactate is an important fuel source [33:00];
-Zone 2 training—physiologic characteristics, fuel sources, lactate, and the transition into zone 3 [40:30];
-Using blood lactate levels (and zone-2 threshold) to assess mitochondrial function [47:00];
-Accessing mitochondrial function by looking at one’s ability to utilize fat as fuel (with an RQ test) [55:00];
-Athletes vs. metabolically ill patients—mitochondria, fat oxidation, muscle glycogen capacity, “fat droplets”, and more [1:00:00];
-Physiologic characteristics of zone 3, zone 4, and the lactate threshold [1:20:00];
-Fueling exercise—dietary implications on glycolytic function [1:30:30];
-Relationship between exercise and insulin sensitivity (and what we can learn from studying patients with type 1 diabetes) [1:46:30];
-Metformin’s impact on mitochondrial function, lactate production, and how this affects the benefits of exercise [2:04:15];
-Raising awareness for risk of “double diabetes” [2:15:00];
-How to dose zone 2 training, and balancing exercise with nutrition [2:18:00];
-Proposed explanation of the Warburg Effect: Role of lactate in carcinogenesis [2:27:00];
-Doping in cycling, and the trend towards altitude training [2:39:15] and;
-More.
Show notes page: https://peterattiamd.com/inigosanmillan/
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About:
The Peter Attia Drive is a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking…and a few other things. With over 30 million episodes downloaded, it features topics including fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more.
Peter is a physician focusing on the applied science of longevity. His practice deals extensively with nutritional interventions, exercise physiology, sleep physiology, emotional and mental health, and pharmacology to increase lifespan (delay the onset of chronic disease), while simultaneously improving healthspan (quality of life).
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