Transcript of Most Replayed Moment: The 7-Day Training Blueprint To Live Longer! Peter Attia

When you think about all those things you want to accomplish, if we were then to codify them into a bunch of exercises or areas of your health that you had to now be thinking about, that I needed to be thinking about, what are the most important things? So I'm a 32-year-old. What are the most important parts of my health that I should be thinking about if I want to achieve all the things that I said to you in my final decade?

No one in the final decade of their life ever said, I wish I had less strength, and I I wish I had less endurance. You cannot be too strong and you cannot be too fit. The only time that one would throttle back on the pursuit of those is, A, if doing so is coming at the expense of something else, either with respect to your health or your life. Two, if the pursuit of that at such an extreme level produces risk of injury. In other words, could I be stronger than I am today? Yes. I'll give you an example. We know that in resistance training, the sweet spot for pure strength is 1-5 reps. When your goal is to maximize strength, you need to be pushing 1, 2, 3, 4, 5 reps. Once you start thinking about hypertrophy, muscle size, we're starting to think about 7, 8, 9, 10, 11, 12 reps. Once we start thinking about muscular endurance, we start thinking about north of 15. Those are the general patterns of resistance training.

If I want to build my muscles because I'm going for esthetic goals, then I need to be aiming above 5 reps. It needs to be 10 or 12. But if I'm just purely thinking about strength, bigger weights but lower reps.

That's exactly right.

Then if I want muscular endurance, which is- Got to be even higher reps. Lower weight.

Again, we could go into much more detail around that. But just to finish the point here, why do I not do much training at one to five reps? In fact, These days, I don't do any training at 1: 00 to 5: 00 reps anymore. Why? Because to train at 1: 00 to 5: 00 reps comes at a risk, especially for heavy compound movements. I'm okay getting a little bit less of a strength benefit while still, of course, getting stronger, but training at a higher rep load. I'm targeting 8: 00 to 12: 00 reps With one to two reps in reserve is basically how I'm doing my resistance training. That means every set I'm doing, I would expect to get to within about one rep of failure somewhere. Today, when I lifted, I don't think I did less than seven. I didn't do more than twelve. The weight was always titrated so that I was either almost failing, or one rep away from failing somewhere in there. I was adjusting the weight constantly on every exercise to get there. With the exception of one exercise. I did push-ups was one of the things I did. Pushups are more in the muscle endurance.

Obviously, I'm doing more reps when I was doing push-ups. But pretty much everything else was in that range. Again, I'm not fully maximizing strength anymore because the cost of it might be a little bit high in terms of injury risk. Similarly, I'm not strength training 24/7 because I need to make time to do my endurance training and other types of training.

How often do you train resistance training?

I resistance train three times a week.

How often do you train generally?

I train every day.

Every day? Yeah. Why?

Because, again, the intensity of my training is not that high, at least three days a week. The three resistance days are pretty hard because I'm really only doing each body part once a week. When I'm doing it, I'll spend that 90 minutes really hammering those body parts. Three of those days are just zone two. Three of my four cardio days are zone two days where I'm on a bike and I am riding at a level of intensity that actually allows me to still talk. Not talk like I am now, but talking in a strained way. For me, that's about a heart rate of 140 beats per minute. That's just not taking a huge toll on me. Those are almost like recovery days for me. Then one day a week, I do a really, really hard VO₂ max day, and that's a really hard day. That burns a lot of matches. That's tomorrow. Not looking forward to it all.

Do you do cardio on your resistance training days as well? No, I don't.

It's four days of cardio, three days of resistance. Now, that's going to change in the summer when I'm going to add three days of swimming, and I will end up doing some swims on some resistance days.

Before you do your resistance workout, you don't go on the stepper for 20 minutes or cycle for 20 minutes or something? I don't. Is there a particular reason why?

It wouldn't really serve a purpose. I know a lot of people do that. I know a lot of people will say, Hey, I'm going to do a little bit of a warmup on this treadmill or the step master before I lift. But I actually have a pretty strong point of view on how we should warm up to lift. I don't think walking on the treadmill or running on the treadmill or being on the stair master on the bike is a great prep for the lift. I think it's better to warm up for a lift doing movements that prepare you to lift. For example, if it's a leg day, so Monday is leg day, so what am I going to do? I'm going to start by doing a bunch of core stabilizing stuff. I'm going to do a whole bunch of this dynamic neuromuscular stabilization stuff. You get into basically these baby positions, and you really learn to activate your core as you move around in a six-month position and stuff like that. I then do a whole bunch of, like you know what a 9090 is or a shin box exercise is, where you're on the ground in a position where you're really...

You can start out doing it isometrically, but ultimately going through a slow, eccentric and concentric phase of movement that's activating glutes. I go through basically a whole DNS sequence. Then I get into a dynamic movement prep. Then I get into a bunch of bouncing, a bunch of footwork, and then I start with really light weights. I'll go to a leg extension machine and do very, very light leg extensions, very, very light leg curves, come back and do more jumping and moving and lunging and go back and forth. I'll spend 20 minutes doing a warmup, but the warmup is geared for me to lift. Whereas if I had just sat on a bike and pedaled around, that doesn't actually replicate any of the movements I'm going to do when I start loading myself.

I've got particularly concerned about injury now that I'm 32, because when I was 30, 20, I could do almost anything. It seemed to nothing break. But I had a couple of injuries when doing shoulder presses and things like that. And one of my friends had a similar injury recently, which took him out for three or four months, where he did a shoulder press, pulled something in his back or something, his neck, and then he couldn't turn his head anymore. In terms of injury, if I wanted to get injured, am I right in thinking that the thing that leads to injury is basically just walking straight in and trying to lift something heavy? Or is there things further upstream that cause injury in the gym?

No, that's That's one way to increase your risk of injury for sure. But yes, there are other ways that it can happen, and I think about it a lot. One of the injuries I think a lot about are calf injuries, Achilles injuries, tendon injuries. This is, I I think one of the things that becomes a real problem for people as they age, you often hear about people my age tearing an Achilles. It's a devastating injury. Now, again, it's not devastating in that you won't recover from it, but boy, it's going to take you out of commission for six months. A lot of these injuries happen because the individual still has strength, but they've lost some of the pliability in the tendon because they've lost some of the jumping. That's why I always start these workouts with low level of jumping. I'll progress to higher levels of jumping. But jumping is actually a very important part of training. It's one of the things that we take for granted. But boy, when your ability to jump is gone. Jumping, by the way, can mean just initiating a jump, but it can also mean jumping off something and stopping yourself.

Those are really important skills. Something like jumping rope is really important. Your feet are just moving like that. They're acting as shock absorbers. Caps and Achilles have to constantly change in length. That accommodation is a really important part of resilience. I think that should be an important part of everybody's warmup at a minimum, if not part of their workout.

One thing I'd love you to do is to persuade people listening that muscle mass matters for longevity. And also, if you can within that, that leg day matters because we all avoid leg day, including me. And sometimes I need to be told again why it matters for me to add it.

Well, I think, look, muscle mass is probably the second most highly correlated finding, or third most, to longevity after strength and cardiorespiratory fitness, VO2 max. Why is that? First of all, I think that muscle mass is both directly a proxy for strength. In general, the more muscle you have, the stronger you are. We all know exceptions to that. We know wirery little people who are insanely strong, and I have patients like that. They're just naturally thin people. But when we put them through the testing protocols, they're remarkable in terms of their strength. I tend to not worry about the fact that they're slight and build when I see that they're strong across the board. There is another benefit of muscle mass, which is it's the place where you dispose of glucose. From a metabolic perspective, the more muscle mass you have, the more glucose buffering capacity you have.

Why does that matter as I age?

Because one of the hallmarks of aging is a reduction in the capacity to metabolize and buffer glucose. As glucose levels become less and less regulated, all sorts of bad things happen. Bad things happen to microvessels in the body. If you think of the most extreme example of this is type 2 diabetes. Once a person has type 2 diabetes, what are they at risk for? They're at the risk of reduced vision and ultimately, blindness, amputations of their digits, impotence. The penis has tons of tiny blood vessels in it. The more that glycosylated proteins accumulate there, the less they get blood flow and obviously damage to the small blood vessels of the brain as well. All of these things are hugely problematic when glucose is dysregulated. Again, the most important thing that you can do to regulate glucose, in addition to the obvious, which is eating in energy balance, not eating too much, is making sure you have large insulin sensitive muscles, which means large muscles in the context of an individual who's sleeping well and exercising, and you're going to basically have a great place to put all of that glucose when you consume it.

Is that going to stave off me getting belly fat because my glucose is going to be stored in the muscles as opposed to somewhere else?

Again, it all depends on the total energy balance, but yes, it's clearly going to make a difference. One of the surest ways to reduce your capacity to store fat is to add more muscle. Okay.

I I did the grip strength test. I've done it twice now.

Meaning you did one of the grip meters or you did a hanging test?

One of the grip meters. I actually did it at Brian Johnson's house, but I also did it with Andy Galpin. People tell me it's an indicator of longevity, but I've never really understood why. Is it just testing my strength?

Yeah. Grip strength of all the strength metrics, it's one of the most highly correlated with longevity. We actually prefer to do it like a 10 squared where your colleagues tested yesterday. We prefer to do it on a dead hang. So we make them hang from a bar, and we just time how long they can hang. So that's a really good metric of your grip strength because it's also normalized to your weight.

Okay.

So we want to see that people can hang for at least two minutes on a bar. The question is, why is that so highly correlated with longevity? It's what you said. It's strength. The reason for it is it's really hard to be strong anywhere in the upper body if your grip is weak. If you think about being able to push, especially being able to pull, all of the real metrics of upper body strength require a strong grip. If you have a strong grip, you have a strong hand, you have a strong forearm, you have a strong scapula that is connected to your rib cage, it goes up the whole chain. That's another reason why we like the dead hang as a way to test it, because the dead hang is testing everything. It's testing your actual grip It's testing your scapular stabilization, the stability of your shoulder. It's basically testing that entire chain. Then I also think there's a practical side of this. It's very underappreciated what frailty does to an aging individual and what sarcopenia, loss of muscle mass, does to an aging person. And what it is about falling that is so devastating to an older person.

And the stronger your grip, the easier you're able to navigate a lot of those things, right?

It just seems unthinkable that falling is something I should be thinking about at 32 in the future. It seems ridiculous. It seems ridiculous, yeah.

And yet it is devastating. So once you reach the age of 65, which that ain't that far. You know 65-year-olds all day long. That's not a very old person. Once you reach the age of 65, your mortality from a fall that results in a broken hip or femur is It's 15 to 30%. Just think it is such a staggering number. You're over 65, you fall, and that fall results in the break of a femur or hip. There's a 15 to 30% chance you'll be dead within a year.

What kills me.

It could be something very acute, like the fall that's significant enough to do that also bangs your head. It could be that you get a fat embolism, you get a blood clot. It could be that during the recovery process of this, You just never really get better. You never thrive again. I think a more disturbing statistic is that of all the people who survive, 50% will never again regain the level of function they had before the injury. So they will require a cane for the rest of their life or something like that. Now, there are lots of things that account for that. Andy Galpin, who you mentioned a moment ago, talks a lot about this, but a lot of it comes down to foot explosiveness, power. The reason you're not really afraid of falling, when was the last time you were walking and your foot caught something and you slipped? Like yesterday? Yeah, quite often. Yeah, exactly. Why don't you fall when that happens?

Because I can quickly readjust. Right.

That's power. Okay. You have the power in your foot to readjust when you lose your step. You step off a curb not realizing it, it doesn't matter. You readjust. Okay. Those are a very, very specific muscle fiber that is responsible for that. It's called the Type 2B muscle fiber. That is the first fiber that atrophies when you age. In fact, you're already at your peak. It's all downhill from where you are now. Thank you so much. Yes. I'm already 20 years past you, and my power is a fraction of what it was 20 years ago. Now, I fight like hell based on the exercises I do to try to keep it as high as possible. The reason that these people who are in their 70s are falling all the time is people think it's a balanced thing. It's not just a balanced thing. It's that They're undergoing the same insult you and I undergo on a daily basis. But the difference is their probability of being able to catch it either through the explosiveness of their foot or their lower leg, coupled with maybe not being able to grab onto something as quickly and adjust.

It's a power deficit problem.

What do I have to train now at 32 to ensure that, specifically the example of hitting something and quickly being able to adjust, I'm able to do that when I'm 70?

I think jumping is a great way to do this. I use certain special pieces of equipment that actually have power built into it because power is different from strength. So strength is really the ability to... It's just the ability to move a force independent of the speed at which you move it. Power is the maximum combination of force and speed.

Okay.

So on the X axis, if you were to put force, and on the Y axis, if you were to put power, the curve is an inverted U. As the force or the weight that you're moving goes up and you're trying to move it as fast as you can, you're getting more and more and more and more power. But then at some point, the weight gets so heavy that even as you continue to move it, it's going slower and slower and slower, so your power is going down. So there's a sweet spot there. So one of the things I do is there are certain specialized pieces of equipment that allow you to train in that way. I definitely rely on a lot of those. But even if you don't have access to that machine, jumping is a really important way to generate power. So if you're just doing a vertical jump, that's power.

What about balance? I was at Brian Johnson's house, and as he was cooking his breakfast or lunch, whatever, he was balancing on a half ball. You've seen one of those things? Yeah. I don't think I asked him why he was balancing on it, but I assume it was to do with balance and there's certain muscles in the leg.

There are lots of exercises that are great for balance. Anything that produces instability is great because it's, for lack of a better term, I've heard it described as problem solving for your foot. If you think about being on any unstable surface, even if you're just walking on an unstable surface, so if you were to look at a person's foot, their lower leg, actually, as they're walking on a surface that's constantly changing, so like a gravel path or something like that, you're going to see, if this were my lower leg, you would see the musculature of the lower leg constantly adjusting to it. I really enjoy things that force that type of training.

Do you do flexibility stuff?

Yeah. So I'm actually naturally a pretty lax person. So I don't do any stretching, if that's what you're asking. But all of the stability and dynamic stuff I do incorporates movement at end ranges. So I'll give you an example of why I think the notion of flexibility might be a little bit misunderstood. If you ask a person to stand up and with their legs straight, touch their toes, most people would say that's a great test of flexibility in the ham string, right? And most people can't do that. What they don't realize is everybody's hamstrings are long enough to allow them to do that. The reason they can't do it is their central nervous system will not release them to do it. Does that make sense?

Interesting. Their central nervous system won't release them to do it.

That's right. It doesn't feel safe for them to do it. Now, how do I know this? Because if you take a person under general anesthesia, you can put them into almost any position possible. If you took a person under general anesthesia, laid them on the operating room table, you could lift their leg up to here. When they're awake, you couldn't get it past here. When they wake up from surgery, will they have a torn ham string? Not at all. They won't even know their leg was moved. The difference is when they're under general anesthesia, their brain is not sending a signal to the leg that says, Don't lift. Why is the brain doing that to the individual? This is how I learned it on a personal level. About six years ago, I had tweaked my back and had just done an unnecessarily heavy set of deadlifts and just pushed it a little too far. I was nursing this It was just very, very tight QL. I was completely jammed up. I came in to do some training with a friend of mine who's one of the guys that... Actually, he is really the guy that introduced me to this thing called DNS, Dynamic Neuromuscular Stabilization.

I was stiff as a board. I couldn't get past my knees bending forward. I'd been hurting for three days. We went through a series of exercises for 40 minutes, which included me laying on my with my legs up, him leaning on top of me, so my feet are here on his chest, and doing isometric pushes while working on generating intraabdominal pressure. After maybe 40 minutes of this type of exercises, I was palms on the floor. Now, how do I go from not being able to get to my knees to palms on the floor in 40 minutes with three days of horrible back pain? The difference is when my back was hurting, my body was not going to let me go down. The body was saying, No way, your back, I'm protecting you because you are not stable. You're not going to go any further. What we went through with this exercise, in a series of exercises, was basically... I'm oversimplifying this and anthropomorphizing it, but letting my brain know it's okay, you're stable, you're stable, you're stable. The back is safe, the back is safe. Let him go. Then, I'm palms on the floor. I love testing this.

Sometimes I'll just wake up in the morning and do five minutes of breathing exercises when I'm stiff as a board and just get into a position on the floor.

Why the breathing exercises?

Because that's really how... The breathing is how I create this cylinder in my abdomen to push the floor of the cylinder down as the pelvic wall, the diaphragm as the cylinder, the top, and then the entire, the entirety of my abdomen is the wall of the cylinder. And so I go through these exercises every single day, usually on my back, actually. That's part of my warmup. And it's just a way to ground myself around creating a concentric pressure in the abdomen.

Just to get some tips from you around your strength training regime. How many exercises do you do? What does... I'm really curious. So you train three days a week doing strength and resistance stuff. Do you do shoulders and back as a pet? Yeah, exactly.

So on Monday, Monday is pure lower body. Okay. And Wednesday is arms and shoulders. And Friday is chest and back. Okay. Super simple. No rocket science. An hour? I mean, it's an hour and a half of lifting, plus maybe 20 minutes of the warm-up stuff.

So on the chest and back day, how many chest exercises are you doing? Four. Four? Okay. And then four on back? Yeah. Okay.

And I'm just supersetting them, and I'm going to do maybe five sets of each, five working sets. So there's a lot of warmup in there, too. And I'll also do some other stuff, like some MedBall slams or things like that as well.

It's been this huge rise in people doing these high Rocks and elite endurance events and such. It's really interesting that it's so popular, even things like running clubs, I know. But the fact that more people are doing marathons now than ever before, why do you think this is happening?

I don't know. I think it's a very net positive thing, though. I do think that there's more and more people that are taking up things like rucking and running and finding camaraderie in these things. The only thing I hope is that people are doing it in a manner that's sustainable and safe and allows them to do it indefinitely. So I'm always hopeful that whatever thing that people That whatever thing that people are doing, they're not injuring themselves because, again, rule number one is don't get injured. The name of the game is to play the game as long as possible.

What you just listened to was a most replayed moment from a previous episode. If you want to listen to that full episode, I've linked it down below. Check the description. Thank you.