Zone 2 Training Explained: The Single Best Workout for Your Mitochondria | Dr. Inigo San Millan

42:54But she's still a massive advocate for it. But she says it's in its infancy. What's like, now I have you on, what is your view on women versus men in Zone 2 training? Is there any evidence that you can share with us or even that you've worked with athletes yourself in this sector? Well, that's a good question. And I think that things get mixed up because of the perception that everything is Zone 2. And therefore, whether you're a man or a woman, that's not it. You need to do high intensity. and this is this is when when i started with the concept zone two i was the zone four and zone five also and as i mentioned i had never heard anybody winning a race in the zone two for you need to do high intensity now everything comes to the extreme right that is only zone two and that's not true so maybe when stacy refers that you need to do less on two is because you need to do more high intensity i agree with that because that's what i recommend uh to uh to my patients whether they are men or or women or my athletes also so that's that's important thing um that you need to have and as we just talked we need to do some like one or two times a week you need to you know get those incursions into into high intensity because are necessary for that glycolytic capacity the one thing too women have a decreased glycolytic capacity and by glycolytic capacity i mean that turbo capacity and that's the high intensity they have a lower muscle mass they have a lower capacity for those fast twitch muscles to produce atp fast right and therefore there's a reason for women they can try to stimulate that more that being said when it comes to um mitochondrial function men and women are equal or should be equal right and therefore um any exercise that that increases you know mitochondrial function should be applied like zone two it sounds very similar so i guess you're saying that men and women shouldn't have this really any differently we should both be prioritizing zone two yeah actually women will struggle more with HIIT because of these because of these muscle fibers to produce the ATP and that makes so much sense because I went through a phase probably about eight years ago when HIIT was I don't know if you remember there was a huge surge in HIIT and everybody every studio was opening and everyone was doing HIIT and I felt worse than I've ever felt before like awful and also what what was coming up at that time and I'd be really interested to ask you about this with exercise and also how you train athletes and if it's different from men and women.

45:37I was also fasting before I was doing those sessions as well. So you can imagine I had like no energy in me and I was going off to do these ridiculously expensive classes for an hour and raising into zone four, zone five. And I've never felt worse in my life. Yeah, you're totally right. And this is one of the things that, yeah, I mean, heat was a hype and, you know, It was very popular 10 years ago, but very few people from 10 years ago, they're still doing it. Or not that many people, or at least people who were pursuing health benefits through HIIT. It's not sustainable and it can lead to injuries.

46:19Again, I am not saying that HIIT is bad for you, but any exercise program based on HIIT is not sustainable. There are no athletes in the world who all that training they do is hit. It doesn't exist. And believe me, I know a little bit about what athletes train, but it doesn't exist. And in fact, now, and I'm not saying if it's a tendency or not, but what we have seen historically is the 80-20, whereas the proportions of the time, or not the time, the sessions, not the time because you know that you know the sessions that you dedicate to different intensities about 80 is a lower intensity call it zone two maybe and about 20 is higher intensity this is the approach that we've been using with athletes forever and it has worked any other approach of doing 20 80 like 20 lower intensity 80 hit it doesn't tend to work it causes overtraining fatigue and i was mentioning earlier but that's kind of what we do with athletes so that the whole thing of now the 80 20 it comes from from again like like as many concepts come from what we have learned with athletes they're now becoming mainstream right but 80 20 is not about minutes or percentage of minutes because in fact if we go by the minutes it's even less if you look at the volume just observationally if you look at the volume of any athlete whether it's a a very high intensity of athlete, uh, like a swimmer, a hundred meter swimmer or a rower or a marathon runner, uh, about five to 10 % of the entire minutes per season are in high intensity, right?

48:10So, but we need to think more about sessions. So, uh, it's about 80 % of the sessions who contemplate maybe zone two and about 20 % of the sessions should contemplate high intensity. And the way we break it down is to, yes, so many times we isolate a session because they have more time to specifically do high intensity because of the demands of competition. Other sessions specifically is zone two training and they can be four or five hours, but more models don't have four or five hours or they even can do four or five hours at zone two or high intensity. so the way is about to come combining as i said but if you do four days a week zone two in combination with high intensity at least two or so at towards the end that's when you start hitting some sweet spot and then that was like uh the um um the the the distribution right it's more like 80 20 but but again like you know hit uh it's something that yeah it's just a lot of people you know did it but it is many people don't enjoy it didn't enjoy it have you had to change a lot of these athletes mindsets on this approach to more an 80 percent like lower intensity and the 20 percent high intensity like have you seen them have some resistance to that because obviously you've seen these insane changes i'd love for you to share some of these stories for for our listeners but how is the mindset approach when you're working with with athletes in this Not much, to be honest, because that's been the mentality always like that.

49:46In fact, as I mentioned earlier, if you watch what swimmers do and have done forever, and they continue breaking records, is that you go to a swimming and you see the world-class swimmers, they swim up and down, up and down. And then eventually, obviously, they do some intensities, right? But it's not the other way around. so you don't have to convince them to hey you can't do 1000 sprints a day it's bad for you do five or do 10 right well they're already they're already there right in fact what i had to convince him more is that the zone two is a much harder intensity than just cruising which was what a lot of people were doing because that 80 20 they didn't know it by 20 but in you know that's what they were doing was like more aerobic training long endurance run or ride it was too easy right and it was too easy it was close to a recovery intensity and that doesn't stimulate uh that bioenergetics of uh mitochondrial function as much so it was about convincing them that they had to go faster and if you look at well you look at if you talk to some other people that i've been working with at zone two, especially at high level athletes, is really, really, really demanding, very demanding until they get used to that.

51:14But it's not an easy training at all. For that, we have recovery days. Okay. And what do the recovery days look like? Nothing? No, I'm not active recovery. I mean, yeah, you have to do nothing. It's important to, that's what I think. I remember when I introduced also the concepts of off days, in a, you know, like a long time ago to, to the athletes I was working with, it was a crazy idea to have an off day or even a recovery week, like an active recovery. Right. But now every, everybody does an off day completely. And, uh, and at least a recovering active recovery day, which is, you know, like a light run with friends to, to, to grab a coffee, right.

51:54Or a light, uh, bike ride, you know, to grab another coffee with friends and come back, you know, So it's something that is more, to me, there's no difference between an active recovery day than just do nothing, right? Because when you do nothing, you just rest. And we do active recovery days, maybe more psychological, because to break out of the routine of training hard, because you need to train by yourself many times in individual sports. So that day where you're going to have fun and just gather with some friends, that's your recovery day for a coffee ride. for example, or a coffee run. But, um, yeah, you need, you need those too.

52:34To make sure you're performing, but also to make sure I guess your immune system and everything, you need recovery for so many different dimensions. You know, your immune system plays such a big role in, in exercise. Yeah. And this is something that, um, to me, it's, it's, it's an area of, uh, of importance because I have seen a lot of people, let's not talk about athletes now, but obviously you see that over training, but you see a lot of people there, you know, whether it's for longevity or for fitness, they are completely crushed and they don't know it. You know, people who have, as you were saying, on top of doing one routine of exercise, they're going through extreme diet, they're struggling through, and that has consequences.

53:19You can pay for those. And that has consequences in the long-term, for example, and I've seen looking at biomarkers i do a lot of biomarkers to look at how athletes are simulating training and competition but again we can use these biomarkers for people you know for longevity purposes people with different diseases and how they are simulating that dose of training is it too much or is the right one right so i see biomarkers and we see a lot of muscle damage for example in people and uh low i mean low rate inflammation chronic low grade inflammation When you have muscle damage or when you are working so hard and not enough nutrients and not enough rest, the body fights it because it's an aggression to the body.

54:06It's an insult. The body cannot recover fast enough and therefore it starts breaking down like muscle mass. And one of the ways that the body has to heal is inflammation. It's a physiological process. but that inflammation usually should be acute according to the damage when that damage is chronic that inflammation becomes chronic and that's what you start seeing also you know some biomarkers of telling you that that person has chronic low-grade inflammation which as we know from epidemiological studies uh is uh it's important uh because it's been related to multiple diseases. Yeah, I mean, inflammation is the start of every chronic disease, right?

54:52And I think like when we don't sometimes always are aware of how much pressure our immune system is under, but it's not just exercise, it's all the other things in the day. Like I know if I'm doing an intense session and then I've got an intense work day and I've not slept well, and then my nutrition is not great, I'm not going to get the outcome of that session that I want, which is really important to think about and I mean I want to make sure that we touch on metabolic flexibility because this might also be connected to this as well you were saying just earlier before this that it's quite a new term can you explain metabolic flexibility because my understanding is how you can how easily you can switch from fats to carbohydrates which I feel like women do pretty well in their menstrual cycle phases but can you talk to us a little bit about this term and get us to understand it better?

55:43Yeah. So metabolic flexibility is, it's, um, it's not a new term necessarily, but it's been, we've been knowing for maybe 20, 25 years, but yeah, now it's mainstream, like a lot of things. And, uh, but yeah, it's, it's about that, right. Uh, uh, I mean, in a simple way, uh, it's about the ability, you know, to switch back and forth between fuels, mainly fats and carbohydrates. Absolutely. And, and, and where does it happen where do you burn fuels in mitochondria right you burn the fuels because you have to produce atp and that atp happens in mitochondria and when you burn those fuels are in mitochondria and and and yes this is this is why metabolic flexibility and mitochondrial function are pretty much identical terms at least in my view right because if you have a good mitochondrial function like athletes you're going to be switching back and forth fuels very well You want to burn fat now?

56:38Okay, let's burn fat. You want to burn high amounts of glucose? Okay, let's do that. That's being metabolically flexible, right? And that's pretty much what is the same terms. Metabolic flexibility and mitochondrial function are, for these purposes of bioenergetics, are very important. and when mitochondrial dysfunction happens or mitochondrial decay happens the first thing that you start seeing is a decrease in the capacity to burn those fuels right and that's you start become inflexible and we can talk about that in more detail that's the study that we exactly what we were talking about the other day about that transporter that we have identified that that's the root or one of the roots of the issues.

57:27This is the glut flaw, right? The transporter that we were talking about in the study. Yes, yes. Yeah. So you just mentioned there, which we should definitely go to study, but you just mentioned there before that mitochondrial decay. Sounds obviously cellular death. It's terrifying, but it happens all the time. So let's like, how do people know if they're getting mitochondrial decay? well that's a good point so mitochondrial decay is like you don't know you know that's no you don't know i mean so a mitochondrial decay is going to lead down the road some to some form of dysfunction and and i think we talk about mitochondrial dysfunction quite lightly me included because we try to talk you know like uh um in in you know in uh immense terms but um mitochondrial dysfunction means that the mitochondria don't work you know or they're aberrant right i i like to call it more a mitochondrial decay right as we age for example our mitochondria are not as solid as when we were younger or as we become sedentary our mitochondria don't work as well and we become more and more inflexible metabolically inflexible and this is this is one of the things that at this point we i mentioned that the methodology that i developed looking at fat oxidation and lactate, it tells you, because when you have a mitochondrial decay that is not pathological, you see a decrease in the function of oxidation or burning fats and also lactate.

59:01And that's a signature, right? But again, it's not, you don't wake up one day like, oh, I think I have mitochondrial decay, right? No, you wake up one day and you go like, hmm, there's something funky. I don't know. I've been feeling strange for a while. I don't know. What's going on? You go to your doctor, you get blood analysis. Your blood glucose is 150 and your A1C is seven and a half or eight, right? Like, boom, you have prediabetes or you have diabetes, right? But yeah, and it's part of that mitochondrial decay. As I said earlier, if we were able to identify biomarkers 10, 15 years, because it's a decay, way, right?

59:41Then we should be able to intervene much faster and efficiently. Yeah. So talk to me about this paper that we were talking about before. Tell me about what you've just found. We're kind of rewriting it again. But tell everyone about the new discovery. Yeah. So what we saw, we wanted to see what are the metabolic responses of sedentary health individuals, right? Versus people who are moderately active. That is, they do exercise about at least 150 minutes a week, right? Which are the recommendations, right? So we wanted to see if there are differences. So what we did in the study, we looked at mitochondrial function of both groups through muscle biopsies.

1:00:31So we looked at muscle biopsies in the skeletal muscle, and we were looking at how those mitochondria were working. So we looked at a wide range of areas from like how well they burned fats and carbohydrates, how well they transported carbohydrates and how well the electron transport chain, which is the apparatus where central apparatus to mitochondria to the furnace where you produce the ATP works and how well they print, how much they produce ATP, right? So what we saw is that they have a significant reduction in mitochondrial function compared to active individuals. Morally active, not only the sedentary healthy.

1:01:17And this is what I call the inside-out hypothesis that I'm starting to develop from that. And that originated the study. When it comes to prediabetes or type 2 diabetes, we clinically and at the research level, we see this or contemplate this at a peripheral level. That is, it's everything about glucose transport uptake into the cell. It's about insulin signaling the cell, the receptor, hyperglycemia, hyperinsulinemia from the pancreas, right? everything what happens at the surface but that's the first part of the trip of glucose being burned in mitochondria right and there's the assumption that once the glucose enters the cell it's going to be burnt no no no no that's only the first part of the trip and the glucose as we know enters through the cell through these transporters that door that is called the glad force or glut force and there's there they're singled by insulin right but then once glucose enters the cell, it has to be broken down to pyruvate.

1:02:28It's another component through 10 steps. That's the second part of the trip. The third part of the trip is that pyruvate needs to enter the furnace through another door, right? We call it the NPC, we worry about the name, but it's another door. And then once pyruvate enters through another door, that's the fourth part of the trip that pyruvate has to be converted it has to enter the the krebs cycle the famous thing that we know from biology the lovely krebs like you take me back to my biochemistry days thank you for that yeah that's the fourth part of the trip and the fifth part of the trip is that then eventually uh you need to produce the atp in the electron transport chain right so it's a long trip so what we were looking is at all these different parts of the trips and what we saw is that Like everywhere you looked, except for the entrance, everything is dysregulated.

1:03:23In the sedentary individuals? In the sedentary. Wow. So you see, the first thing that's dysregulated is the entrance of pyruvate into the furnace, right? So, sorry, the entrance of glucose is normal because the number or the expression of that door at the cell surface for glucose, that glute force, they're the same. They have the same amount of expression. But then the door of pyruvate entering mitochondria is decreased by about 50%, significantly decreased. And that's the door. And the entry of pyruvate into mitochondria is about 38%, something like that, decreased. And then the capacity for the electron transport chain to produce ATP is about 35 to 38 % decrease.

1:04:19So it's a significant decrease in the production of energy, right? Just for glucose, right? And then that's where we call the inside out. These people already, they have a very strong signature of mitochondrial decay, not dysfunction. mitochondrial decay probably 10, 15, 20 years before they're going to show the surface levels that glucose cannot get in, which is what we see nowadays as a diagnosis. That's on one hand regarding glucose. Can I just ask how sedentary these individuals were that you saw in these? They just didn't do any exercise at all. Exactly. Well, maybe they walked the supermarket, right but the typical person that you we see in a lot of our today's uh societies right they get in the car go to work office go back to the car maybe go to the supermarket and walk that's yeah that's sedentary people yeah so but the the paradox of that is that health they're healthy they don't have any clinical symptoms but you know like historically in in biomedical research the control has been that group, the healthy sedentary individuals who metabolically are a disaster compared to the real control, right?

1:05:40And this is what even at the university, when I needed to clear all the permissions to get the okay to give this data, I told them that the sedentary individuals are the intervention group and the control are the more active individual. That at first was a no, no, we're not going to let you go with this study at the University of Colorado. This is a crazy idea. But actually, it's the reality. And this is why I want to be provocative on purpose for this. Because our genes are made to be active, right? This is ingrained in our brains, I mean, in our genes being active, right? We haven't evolved to become sedentary yet, right?

1:06:26Our control status, except for the last 200 years or so, has been to be active always, right? And that's how our genes are. But the perception that exercise is the intervention is new to humans and is wrong because the real intervention was to become sedentary as a result of progress. And that sedentarism is what's causing a lot of diseases, right? So I wanted to provoke with that. The real control are people who are moderately active. They have the good, well-functioning mitochondria. For people who are sedentary, they already have a decay, significant decay at the mitochondrial level, which down the road is going to take them to different diseases.

1:07:15I mean, it's so interesting that you put it like that because that's everything about our health system. We're not preventative in any way. So the fact that we're having to look at sedentary as our control group is actually a little bit frightening. I mean, it's interesting, you know, exercise is part of who we are, the DNA. But we all pay to go and pay to do exercise in gyms. I mean, I'm one of them. But it's like kind of taking us out of our normal environments. Like, obviously, that's such an obvious thing. But just hearing you say it makes it even more obvious. Which is just quite funny. And the fact that we're studying people who aren't moving their bodies, who aren't eating well, and calling them the controls.

1:08:00Yes, you're right. And that's why I don't think it's the real control, right? I think that morally active people are the control. In the same way that if we want to understand perfection, the Formula 1s are the perfect cars and those are the elite athletes, right? I think it's a paradox that we still call sedentary people healthy when they're not. And we know down the road, you know, now more and more epidemiological studies, we know that people who are sedentary, the vast majority end up having some diseases. Where do you think our health status is going to go from where we are now? What are you most interested in within this area of research?

1:08:43Because we're in an interesting time. I think that we're already in deep shit as it is already. And that, yeah, I think there's a good movement of definitely trying to be conscious about exercise, right? More people are exercising probably more than in the last 100 years or 50 years at least, right? There's a conscience, there's a science to that. there's still a lot of movements if it's hit or if it's zone two or if it's a 80 20 or whatever right i think the important thing is to get going and to be supervised that's important but what i'm more concerned now and it's about alzheimer's and the thing that frightens me is that i mentioned earlier we was trying to call it type 3 diabetes or brain diabetes or end-stage type 2 diabetes and as most of the non-communicable diseases in our society whether it's cardiovascular disease type 2 diabetes cancer it takes 20 to 25 years to develop right you don't wake up one day and oh i have a heart attack no you've been having starting to have that heart attack 20 years ago the same thing with type 2 diabetes and there's even the same thing with cancer cancer we know it's a disease that progresses over time and it takes 20 to 25 years for most cancers right that first aberrant cell that becomes uh then an irregular cell and then starts mutating some more genes and eventually becomes an adenoma and then uh that's that's eventually uh how the evolution you know cancer it takes 20 to 25 years but my worry is that um so So our generations and our parents and previous generations, right, were diagnosed with type 2 diabetes, right, or pre-type 2 diabetes or type 2 diabetes in their 50s or 60s, right?

1:10:43That was, you know, epidemiologically speaking, that was the norm. And people were diagnosed with Alzheimer's when they were in the high 70s, low 80s, something like that, right? Yeah, that was my grandmother. So, yeah. Yeah. Exactly that age. Yeah. So, but we know more from epidemiological studies, the relationship between type 2 diabetes and Alzheimer's is just getting stronger and stronger. Mayo Clinic, you've seen all this big data from medical records, right? About 80 % of their Alzheimer's patients, they had problems with either diabetes or prediabetes, right? So there's a very strong correlation.

1:11:27And as I mentioned earlier, looking at the brain of Alzheimer's, they have insulin resistance and mitochondrial dysfunction and a big problem to utilize glucose. So the thing is like we know if there's a correlation between Alzheimer's and type 2 diabetes, and that goes beyond a correlation because it seems to be very strong at this point in getting stronger and stronger. and there's a causality in reality, right? The problem is that we might be in big trouble because if it takes about 20 to 25 years for a person with type 2 diabetes to develop Alzheimer's, right? That's kind of when chronologically speaking, in the 50s, 60s, people are diagnosed with prediabetes or type 2 diabetes, 70s, 80s, they develop Alzheimer's.

1:12:20For the first time in human history or humankind, we're seeing teenagers or younger than teenagers with pre-type 2 diabetes or type 2 diabetes, full-blown type 2 diabetes when they're 15 or 20 years old, right? If the evolution is 20, 25 years, are we going to see a lot of people in the millions with Alzheimer's in their 40s or their 50s? if chronologically speaking it keeps making sense and i i hope i'm orally wrong but uh and i don't think i'm the only one thinking this although not many people are talking about and i think it's time to have a conversation but if it's true it's the end of societies as we know it because people in their 70s and 80s they already have retired there's money allocated to that they have produced when they were 40s or 50s.

1:13:17But if they get Alzheimer's in their 40s or 50s, we don't have money located for them. They're not producing and continuing to society. It's the end of everything. So that's the thing that worries me in the next decade or two, because this is coming to us quite soon. Yeah. Well, I mean, there's already children in America and in the UK, but more so in the States that are being diagnosed with it from the age of five so i mean it's it's young and it's interesting because i i listened to that my grandmother had alzheimer's and and she lived with it for years and she died very late in her 80s but she was diagnosed with it late 70s early 80s so she'd had a predominantly most of her life without having this condition think about my father who's been diagnosed with type 2 diabetes in his 50s and we've been luckily his daughter's a nutritionist so she's got that under control and we've reversed it but there's you know now I look at that situation and that's the thing it is reversible but I think the conversations that we're having in public health aren't the correct ones to help reverse it it's just to maintain it and then it just progressively gets worse and we go and metformin and you know that's that's kind of the end but children as young as five now it's completely a new whole era and there's also and some of this is genetic but gestational diabetes as well is on the rise and there's also a link we don't know for sure but there's also a lot of research connecting to autism and so all of this is connected to metabolic health and mitochondrial function but it's so interesting that there's all of these sectors and it's now affecting from in utero to children of five to you know up to my parents age and beyond yet we still can't seem to kind of all collectively come together on this as in what they're all still treated so differently like how do you think we get past that because for me a lot of it is about our food systems it's the bigger picture the food systems you say yeah yeah i i get definitely nutrition is very important but again i i insist as i mentioned where do we burn food mitochondria And that's the only place that we burn it.

1:15:37Postprandially, after a meal, under a glycemic clump, about 80 % of glucose, derived from carbohydrates, is burned in skeletal muscle. And during skeletal muscle, it's burning mitochondria. This is why we're also talking about muscle health nowadays, right? And we tend, I mean, I was the other day talking to, I've been giving a bunch of talks lately to medical students, to medical specialists from oncology to endocrinology, to internal medicine, pulmonology. None of them told me when I asked the question, what is the largest organ in the body? Everybody said the skin. You all say skeletal muscle, weren't you?

1:16:25the muscle is the largest organ in the body not only the largest but the most active metabolically speaking and as i mentioned about 80 percent of the glucose under eucalyptus clump is oxidizing skeletal muscle within mitochondria so it's the largest disposal for for for food stuff because it's very active metabolically speaking so this is why it comes the other paradox of the world-class athletes For example, the cyclists at the Truth of France, right? If you look at their diet, right, they have somewhere between 6 ,000 to 9 ,000 calories a day for 21 days. Carb-loading, yeah. Yeah, around 2 ,000 calories.

1:17:09And that's because they need to exist. It's not because, oh, I want to eat. No, no, no. If you don't have that at the Truth of France, you're dead meat, right? And they have tried it before, believe me. And it's so hard for them, isn't it? It's like the one thing where they're forcing. to get this down them yeah and eventually they adapt because they're professionals right and they have an amazing stomach uh intestinal i mean uh truck and they have an amazing uh microbiota as well because you have to right but the thing is that their average intake of simple sugars is about 2 000 calories a day so imagine someone you give to to like a big bowl of sugar worth 2 000 calories a day and you have to eat that for 21 days many people will die or end up in the hospital your only source of food 2 000 calories is cane sugar right it's crazy well that's what these guys have for 21 straight days and metabolically they're healthiest that's very few people in the planet right and that's metabolic flexibility they can switch back and forth wherever they want to right but what i mean about and this is an extreme case of course but nutrition is is completely related to mitochondrial function because that's what you burn and this is i think when when you have a a problem whether at the glut4 level or as i described at the inside out model right which is the npc in the mitochondria you're not going to be able to to burn glucose efficiently, you're going to make the problem worse, right?

1:18:48That's why nutrition works very well. Does nutrition, in my humble opinion, does nutrition reverse mitochondrial function? I don't think so. The only way where we can improve mitochondrial function is through exercise. Can nutrition reverse the severity of the problem, right? Of course, because you're not making it worse and if you have a mitochondrial dysfunction you need to decrease carbohydrates for sure because you already have a decay as we have shown right and we were talking about this study and uh but yes i think that um both need to be under control exercise and nutrition that's what i think yeah i think it's i think it's kind of a it's a it's a chicken and egg in my brain because i think people will go to the gym and exercise but then we're surrounded you know with so many ultra processed foods and not real foods and so it then kind of has a compounding effect unless you're literally spending your entire day which 90 or 95 % of the population aren't exercising they're surviving going to work stressed out all of the things of hierarchy of needs and then we just slowed ourselves with you know what's on offer because that is, you know, that's the most easy, convenient foods.

1:20:05And so I think, you know, it must have some impact on mitochondrial health, right? Your diet, that's from my understanding in kind of biology and as a nutritionist, that the food that you eat does impact on a cellular mechanism, the health of a cell. Yeah. And we're in a society, I think you're right. But yeah, I think we are in society also that, you know, these foods have a lot of conservatives, additives, colorants. And as you look at, you know, both European Union, which is much more strict than the U.S. AD, you know, they regulate a lot of these conservatives or colorants that might be carcinogens, right, in large amounts.

1:20:52but you can only have per food an x amount of level per food but you have many of these foods with the same colorant so you have a lot of that those carcinogens entering through your through your body every day and that's that's where like um we see for example colorectal cancer among uh young people uh it's uh it's increasing like has never done before and in uh 15 20 years is calculated to be the number one cause of mortality of cancers of all cancers among the people who are young now by the time they're older is going to be considered the number one cancer because colorectal cancer numbers are off the chart it's already very very prevalent among these people and why something is happening in maybe what they eat those those ultra processed foods these carcinogens, meat, or who knows, plastics, et cetera.

1:21:54And that's the thing, you know, like how many things can mutate or cause mutations, right? A lot of things from what we breathe, what we eat, our stress levels, our sleep, right, can definitely have an impact on our metabolic health for sure. And I've seen, you know, like not many people talk about sleep, although more and more, right but sleep is the pillar of everything right i think that if you don't sleep you can't exercise because you're too tired and you're eating you're going to eat in survival mode right because you don't have energy and you end up eating whatever so exercise is and you're going to be more stressed so exercise is a pill i mean sleeping is a pillar and i think we're in society where we need to sleep way more don't you think i agree no i believe that it's like when i've been as a nutritionist nutrition is one of my core pillars but sleep i think is the foundation if you don't get sleep everything in your day is a little bit harder the food choices that you make because your grenadine levels which is your hunger hormones higher you don't have the energy and motivation to want to go and exercise you're a bit crueler to yourself all of it's like compounding effects on your lifestyle decisions which we know is the like predisposing factor of health because if we have good lifestyle decisions then we have a better health outcome basically at the end of the day we're more likely to go and do our exercise so I guess like on leaving this the one thing that you would say to everyone listening to this to help improve their mitochondrial health is to get exercising six times a week five times a week if they can from what i'm hearing having a good recovery day a couple of zone twos resistance training one to two times i've hit roughly through the week that's kind of your i would say my leaving statement from this conversation to get people to connect to their mitochondrial health would you say that's right yes that's the only way we know that the only medicine that works for mitochondrial function is exercise because it's the stimulus that we have since we humans were conceived but uh yeah exercise um yeah just four or five days a week uh 200 300 minutes and uh yeah a combination of uh zone two uh three to four days a week uh one or two days a week intensity which you can combine within a session of zone two and then two days with resistance training that doesn't have to be full hour and a half there are many routines that you can do in 20 i mean in 30 40 minutes right but i think it all puts together about four or five hours maybe closer to five hours 300 minutes i think that we all should thrive for that uh and we're living in very uh stressful times and uh but at the same time you know how much time we dedicate to our instagram or our phones or you know whatsapps or so right uh people say i can't exercise i don't have time we do have time at least we can get 150 200 minutes a week you know it's not easy but we can another yeah so i think that uh it's important to focus on that and and have a log into this i i I force myself.

1:25:24I am very super busy at work and especially in the last two years. So my ability to exercise has decreased significantly, but I really, really try to push myself. And I try to do a minimum of about 200 minutes a week. And I annotate it every week, week one, week two, week three of the year. And I need to meet that hit of 200 minutes a week. I force myself. But anyway, I think we, and I'm not saying I do everything right by no means, but I think that exercise is important. It's key for metabolic health and for mental health, which is a whole different area, right? I'm not an expert, but definitely mental health and exercise are so important.

1:26:10I completely agree. I also, I now take exercise as time for me. And actually you say about the phone, it's the one time I think that we can all agree that we away from that as well which is why I mean there's many reasons why it's also good for mental health but that's just one reason of putting your phone in a locker and not being on your phone for 45 minutes that feels like the ultimate self-care in my brain and so even when I'm exhausted knowing that I have that 45 minutes away from my away from my phone it's kind of a really compassionate act as well so I think there's always these times if we can it's also carving it out for yourself which I think when you're busy and stressed is hard, but it's essential.

1:26:54It is. I agree 100%. Couldn't agree more. I'm into that. So, Niko, I've absolutely loved having you on. Thank you for coming on. I know how busy you are. And I always have one last question, which is obviously the name of the show, Live Well, Be Well. So what does Live Well, Be Well mean to you? For me, live well, be well is to be at first happy with yourself. It's important to have metabolic health, mental health, socialize, have friends, have family, and have interior peace. And yes, and be able to enjoy life and be simple, I guess. Which is super difficult to do, right? Takes time. Simplicity in the slalage is a very hard concept to get our heads around.

1:27:46But yeah. Da Vinci said, simplicity is the ultimate art of sophistication. I couldn't agree with that more. It's crazy. Absolutely. We need more simplicity in our life, for sure. I'm sure that's also quite good for mitochondrial health at the same time. And again, thank you so much. I feel like I've learned a lot about mitochondrial health and function and zone two and alzheimer's three all of it so thank you so much for coming on i'll put everything in the show notes i'd love if you could send us that paper um when it's out and we will show all of our all of our listeners um but thank you so much yeah thank you so much sarah i really appreciate your time and your invitation and uh yeah just had a great time as well thank you very much thanks nico Thank you.