Is VO2 Max Enough? Why Mitochondrial Function Matters for Longevity | Inigo San Milan | Be Well Moments

0:00Welcome to Live Well Be Well, a show to help high performers improve their health and well-being.

0:10VO2 Max, because it's a big buzzword, especially in the last, I would say three to five years, it's become at the forefront of many health conversations. It's become the gold standard of fitness, the number one metric that every athlete wants to improve. But you've said that VAT Max really only scratches the surface. So why doesn't it tell us the full story? We've been knowing about VAT Max for decades and we've been using it for decades, especially with athletes. It dates back more than 100 years, at least since we have more standard ways to measure it. And it's been always linked to fitness, to performance, therefore to health.

0:52And now in the times of longevity, it's one more parameter that is plugged in longevity. And it's a great measurement. However, it doesn't tell the whole story. There's more than that. VO2 max, it's a representative of the central cardiorespiratory adaptations. right but there's more because ultimately that oxygen is utilized by the cells and is utilized by the cells in mitochondria as well as fuels and this is where the area of physiology in general has evolved from vo2 max to what happens at the cellular level and in the same manner that that we've been using, you know, with athletes VU2 max for decades, right?

1:44And now it's mainstream. We have already passed that time. We work now at the cellular level. And this is what I see the mainstream, mainly in the area of longevity, getting into. In fact, already people are talking about mitochondrial function, metabolic health, right? And this is the next level. And this is what we've been working with athletes. For performance, you need to produce ATP energy, and that's produced in mitochondria. And for health, if mitochondria don't work, that cell and that organ is not going to function very well because it doesn't produce ATP well enough. For longevity, as we age, our cells age, our mitochondria age, and our energy production overall ages as well and decreases.

2:37And that resides in mitochondria. Therefore, it's that mitochondrial function and health is the next level. Okay. So this is kind of like the next stage of where we're exploring now, I would say. I mean, longevity is a buzzword, but mitochondrial health, I think many people will have known from GCSE biology and then forgotten about it. But the way that I always think about it is a powerhouse of the cells. But how can one actually measure their mitochondrial health? Because the VA2 max is, yes, a bit easier to attain and to get to. But mitochondrial health, how do we even measure that? Well, we can do it through a muscle biopsy and get a chunk of muscle and look under the microscope or do a bunch of things to that.

3:24But I don't think it's a very convenient way to do it because you will have a chunk of like a big scar. That sounds quite painful. Yeah, I don't think you want that. But the other way, I developed a methodology years ago and I've been using it with athletes for a long time where we have two proxies for that. On one hand, with the same device that you measure VO2 max, which it's like in a colloquial form, we call them metabolic cards. They've been used, always used metabolic cards. We can look at gas exchange, right? And so when we look at gas exchange, we look indirectly through some complicated equations.

4:10we can see how much fat and carbohydrates you are burning in grams per minute. We can see that. Now, when it comes to fat, we know that fat can only be burned in mitochondria. Okay? So by looking at fat, by measuring fat oxidation, it's called fat burning, we can indirectly have a proxy for mitochondrial function. Then lactate can only be burned in mitochondria. Right. So by pricking your finger or your earlobe and getting a small sample of lactate and measuring it, we can have an idea of how well your cells are processing glucose and which under resting conditions, it happens in mitochondria.

4:58But the fact is that if you have higher blood lactate levels, it's a sign that your mitochondria are not processing that lactate or clearing it or recycling it properly. Therefore, with the two parameters, fat utilization and lactate, you can indirectly see or measure mitochondrial function. We published that study a few years ago, and now we have already published a preprint about an extension of that study where we look at muscle biopsies and in the muscle biopsies we look directly how they work and we correlate them with this methodology so it's quite robust to do it in a non-invasive way and an ambulatory manner where a lot of people can do it out there thanks so much for listening to hear the full episode there's a link in the description

5:56Thank you.