#69

Oddly, older people tend to have elevated levels of erythropoetin. They’re modestly resistant to it for some reason.

EPO has many minor effects, but is mostly known for stimulating red blood cell production. Oxygen transport is performance limiting in athletes at higher exertion levels, does the same hold for elderly people in normal activities?

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#70

OK, so this is going to be my year for increasing my Vo2 max. I’ve just gotten a new Coros Apex 2 watch that can track Vo2Max with reasonably good accuracy. COROS APEX 2/2 Pro GPS Outdoor Watch

For those who are experienced in this area and track their VO2 Max, what is the dose/response relationship of exercise (e.g. HIIT) and increase in Vo2Max over time? What is the most a person might reasonably expect to increase his or her Vo2 Max over a year of training?

@约瑟夫_拉维尔 , @midage_runner , @Maveric78

It sounds like Richard managed to increase his by 10 to 15 mL/kg/min.

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#71

No, @LaraPo, it is not enough. Walking and “moderate” swimming is only a little better than sleeping all day. You have to do HIIT. That’s going all-out in both intensity and frequency.

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#72

I’m a retired firefighter who was a member of their stair-climbing team. Every year, we’d do the Hancock, the Aon, and the Sears Tower. Fortunately, I live in a 20-story building, so I was always training. I’m 75 now and still do 100 flights a day.

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#73

Wow - 100 flights a day, very impressive! Keep it up. Any idea what your Vo2 max is?

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#74

You make a very interesting point… Have you looked at this in-depth at all? I’m specifically wondering if something like EPO might allow me to increase my VO2 max faster than otherwise? I.e. increase my fitness levels faster than otherwise. I wonder if it might be dosed at lower or periodic dosing schedules to help increase fitness levels faster, without the downside risks that have been identified with higher or chronic dosing?

Your source mentions this:

EPO has been shown to increase performance parameters such as maximal oxygen consumption (VO2max) and time to exhaustion, which is why it’s commonly abused in endurance sports.

Does EPO have any negative health effects?

EPO has significant clinical utility and therapeutic benefit when used appropriately, but its misuse to gain a performance benefit can result in serious health consequences. WADA explains that EPO thickens the blood, which “leads to an increased risk of several deadly diseases, such as heart disease, stroke, and cerebral or pulmonary embolism.” Athletes who misuse recombinant human EPO are also at risk of serious autoimmune diseases.

How long can EPO stay in a person’s system?

It depends on many factors, including dose, frequency, route of administration, and type of ESA administered. Some newer generation ESAs are designed to remain active in the blood for weeks rather than days to make it easier for less frequent administration when used by clinically ill patients; thus, the detection window of these substances is much longer.

As is frequently the case… cost isn’t much of an issue (80 rupees to the US$):

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#75

I don’t remember the number, but the tech who gave me the test said that he must have made a mistake because only professional athletes, like players on the Bulls, have a V02 max that high. But back in those days, I was doing 200 flights a night when I didn’t have a shift, and I would often do it in full gear. Even so, there were guys on the job who could smoke me in the stairwell.

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#76

vo2max is a good topic but it is complex. Off the top of my head, here are a few points and a few questions regarding VO2 max:

  • vo2max is the highest amount of oxygen that a person can burn in a short period (a few minutes). It is the lower of: the amount of oxygen that can be captured via lungs and delivered via the blood vessels or the amount of oxygen that can be used via muscles (and heart, brain, etc). It is thought that healthy human lung capacity is not the limiter.

  • vo2max can be thought of as a function of maximum heart rate, amount of blood pumped per beat, capillarization to carry blood to / from muscles, maximum lung capacity to capture o2 and dispose of co2, blood / red blood cell volume, amount of mitochondria to use oxygen.

  • some of these attributes can change quickly but others take a long time. The items that improve quickly can also disappear quickly if not used regularly.

  • potential rate of improvement will depend upon the starting point and the max potential vo2max. The lower the current vo2max, the more improvement in fast changers is probably available: blood volume, respiratory muscles, mitochondria in existing muscle cells, etc.

  • I haven’t studied the relationship between vo2max and healthspan/ longevity but i cannot believe that maximizing vo2max is ideal unless everything else is already perfect. Some small regular amount of HIIT is important to stress the system in ways nothing else can, but a lot of HIIT requires a premium in recovery which takes away from time and freshness needed for endurance activities and enjoyment of life.

  • HIIT done to maximum is true suffering. I only do a few minutes per month of maximum HIIT. I can only bring myself to do it when racing on Zwift.

  • does Attia say maximizing vo2max is ideal for healthy longevity?

  • If so, I wonder which components of vo2max drive the effect?

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#77

HRV and mitochondria health are my focus at the moment! (Autophagy is a previous one I feel I’ve incorporated enough for now into my lifestyle - fortnightly D&Q and daily Trehalose).

For HRV I’m following breathing exercises. There is strong science behind this approach to increasing HRV. Dr Richard Brown is something of a guru in the field. He has a book and youtube posts:

The Healing Power of the Breath: Simple… by Richard P. Brown (amazon.com)

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#78

Who says that it’s not “enough” (beneficial) for a 69 year old? Can you support it with research? Do you believe may be that centenarians do HIIT every day?:grinning: It normalized my BP and keeps me in a great shape. I do not need HIIT at this age. It can be even dangerous.

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#79

Will you also do a few real VO2max tests along the way? Seems like they really are the gold standard vs watches?

I’ve been thinking of doing one via eg DexaFit (they seem to be popping up around the country)

#80

I am not in the class of your listed experts, but I would offer the following:

Train for an event like a 5k run. You peak for an event and as @约瑟夫_拉维尔 points out, " lot of HIIT requires a premium in recovery which takes away from time and freshness needed for endurance activities and enjoyment of life." You can measure your V02 max and in addition, see how well you do against peers and their training methods. Make your V02 year sustainable.

I personally find doing longer “repeats” more effective for training than briefer all out sessions. For example, mile repeats vs 200 meter repeats. There is less wear and tear and higher heart rate in my opinion. But basically trust your own experience. Being rigid with someone else’s training program can be a recipe for injury or over training.

At this point in my competitive experience (age 69) I am actually placing in the top of my age group for the first time, and still competitive with my younger self… It is quite sweet. So consider where you want to be 10 years out from now. And train for that also.

Keep us informed how it goes!

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#81

It seems that the Coros Apex 2 is accurate to about +/- 4%, or about 2 mL/kg/min in the range of 40 to 55 mL/kg/min that I’m operating in… so its good enough to give me a rough idea of how I’m doing over the coming months. But once a year or so I think I’ll do the full exercise physiology lab-based measure of Vo2Max to compare my ultimate results to what I’m seeing on the watch.

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#82

There are 80 year olds who can run the hundred-yard dash in 15 seconds and 75 year olds who can do it in 13. You can HIIT it hard like these guys or you can go for a nice, casual walk. Either way, your choice will be reflected in your overall health score, including length of years.

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#83

At 82, I do HIIT training as a by-product of my gym workouts. Some of my resistance training raises my heart rate a substantial amount for short periods. (Not going to run 'til I croak ):laughing:

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#84

I’m not one of those sports geniuses for sure. But today, for instance, when I was running on a treadmill my HR was 102. I exercise every day and it includes moderate swimming, which means 1 km non-stop. Thanks Tim for your concern :yum:

#85

American researchers at Brigham Young University analyzed data from 4,458 adults who participated in the National Health and Nutrition Examination Survey (NHANES).

Results
In the cells of the runners who ran at least 75 minutes weekly, the telomeres were 190 base pairs longer than in the cells of the study participants who were not physically active.

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#86

The contrary findings from the Finns.

Researchers at the University of Helsinki will soon publish the results of a study in which they followed 287 men from 1974 to 2003. The average age of the subjects in 1974 was 47. The researchers were able to divide the men into three groups: non-active, moderately active and highly active. The men didn’t change their pattern of activity as they aged.

The moderately active men walked, cycled, gardened, bowled and fished. The highly active men ran or cycled. The publication makes no mention of strength sports or fitness.

In 2003 the researchers took blood samples from the subjects, extracted immune cells from the blood and measured the length of the telomeres. They discovered that the group that did moderately intensive activity had longer telomeres than the other groups. So activities like walking and gardening might delay your molecular aging, but more intensive forms of exercise don’t.

Proportion of short telomeres

Low activity 12.20
Moderate activity 11.40
High activity 12.40

Note the telomeres measured came from specific cells - immune cells.

So the Brigham Young findings talk about length of telomeres, while the Finns talk about the percentage of telomeres that are short. Brigham Young has the edge on size of sample population - 4,458. The Finns have the edge on the years they followed the subjects - 1974 - 2003.

Brigham Young compared those who were active versus those who were not physically active. The Finns compared among those with low physical activity, moderate, and high physical activity.

Everything in moderation, has oft-been repeated. So I will go with the Finns.

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#87

TBH I have not looked into it in-depth. I recall from the book that Attia cited a VO2 of around 30 mL/kg/min being the point at which people tend to lose the ability to do stuff. So, it stands to reason that if elderly people can stay consistently above that number, PEDs such as EPO could be potential longevity drugs. When Attia had a recent podcast on PEDs, I thought he might address this issue, but it turned out mainly to be about steroids. I didn’t get through the whole thing.

There are negative risks obviously, such as the blood thickening issue. As you mentioned, taking less than what a doping pro athlete is an option, as well as using low grade blood thinners (like Pantethine) or even low doses of blood thinning drugs. Another option is just monitoring, by D-dimer, fibrinogen, or other clotting risk assessment tests through Marek.

Per this article, the effects don’t last long:

Here’s a review article:

These articles look worthwhile to go through in detail:

In regards to cellular protection with EPO and mTOR during programmed cell death, EPO blocks apoptotic cell death through the activation of mTOR

In mature populations that are affected by aging-related disorders, the conclusion for the use of EPO to treat clinical disease is less clear. In a small study with twenty-six Parkinson’s disease patients, recombinant EPO administration improved cardiovascular autonomic dysfunction and cognition, but did not alter motor function (216). Increased expression of the EPO receptor in temporal cortical and hippocampal astrocytes in sporadic AD patients has been observed and considered to be an early neuroprotective pathway (272). The biosimilar epoetin α (Binocrit) administered in elderly patients with myelodysplastic syndromes also have experienced improved cognitive function that may be related to resolution of anemia (273). Yet, in relation to TBI, neither the administration of EPO or maintaining hemoglobin concentration above 10 g/dL led to improvement in neurological outcome at six months (274). In a large clinical trial with close to six hundred patients that experienced brain injury, EPO did not significantly affect six-month mortality, reduce severe neurological dysfunction, or increase the occurrence of deep venous thrombosis of the lower limbs (275). In addition, administration of human choriogonadotropin alfa followed by EPO did not show improvement in neurological recovery in patients with ischemic stroke (276). Similar to prior studies with cardiovascular disease (229, 250, 277–279), additional work suggests that high concentrations of EPO may not be effective for cardiac protection. Recent studies with out-of-hospital cardiac arrest demonstrate that EPO did not confer a benefit and was associated with a higher thrombotic complication rate (280, 281).

#89

Are you saying you don’t run at all? Or that you do run but not until your legs fall off? What is the most vigorous exercise you do? If I may ask, what is your height and weight? You’re very health conscious for your age and, at 82, you’re probably cheating death already. My doctors tell me that 85 is when most people start falling off the cliff. It takes them longer to recover, or they don’t recover at all.