The Peter Attia Drive

#356 - AMA #73: Preserving brain health, optimizing exercise programming, improving body composition, and more


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In this "Ask Me Anything" (AMA) episode, Peter addresses frequently requested topics, including brain health, exercise programming, and body composition. He explores the factors that influence dementia risk—including metabolic health, fitness, sleep, hearing, cholesterol levels, and more. He explains how to implement zone 2 training and VO₂ max intervals for cardiovascular fitness and also covers how to combine cardio modalities, how to stay in zone 2, and special considerations for women. Peter highlights the benefits of light movement after meals and offers strength training tips for those managing injuries. Additional insights include how to maintain fat loss, the truth about so-called "slow metabolisms," and how to set appropriate daily protein goals while managing the trade-off between lean mass and body fat over time.

If you're not a subscriber and are listening on a podcast player, you'll only be able to hear a preview of the AMA. If you're a subscriber, you can now listen to this full episode on your private RSS feed or our website at the AMA #73 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.

We discuss:

  • Overview of episode topics on brain health, cardiovascular training strategies, and body composition [2:15];
  • Understanding dementia risk: modifiable vs. non-modifiable contributors to cognitive decline [5:00];
  • The causality between metabolic health and dementia [9:45];
  • How diet and exercise influence brain health: energy balance and exercise as key preventative tools [13:30];
  • Why combining aerobic, resistance, and cognitively engaging activities offers the most comprehensive benefits for preventing cognitive decline [17:00];
  • Additional lifestyle factors that influence dementia risk: smoking, head trauma, alcohol, and sleep [19:45];
  • The link between hearing loss and dementia: dose-dependent risk and the case for correction [25:15];
  • How poor oral hygiene may contribute to neuroinflammation and dementia risk [27:30];
  • Supplements for brain health: which ones matter and when they're worth considering [28:45];
  • Low LDL cholesterol and brain health: debunking the myth of cognitive risk [33:45];
  • How to approach zone 2 training: the importance of staying in zone 2 and tailoring intensity based on your time and goals [38:00];
  • Lactate testing for zone 2: clinical protocols and at-home approaches [43:00];
  • Combining modalities in zone 2 training: balancing enjoyment and efficiency [47:00];
  • Zone 2 training for women: addressing the misconception that zone 2 training is unnecessary or ineffective for postmenopausal women [49:30];
  • Effective strategies for VO₂ max training: short vs. long intervals [51:45];
  • The benefits of post-meal walking for glucose management, and why spikes in glucose during exercise aren't harmful [56:45];
  • The role of stability training in supporting resistance work and healthy aging [1:00:15];
  • Adapting strength training to manage chronic back injuries and train for longevity [1:02:00];
  • The role of aerobic exercise (like zone 2) in fat loss, metabolic health, and weight maintenance [1:06:30];
  • Debunking the "fast vs. slow metabolism" myth: why energy balance and protein matter most for fat loss [1:09:45];
  • Lean mass vs. body fat: why both matter for health and longevity [1:12:15];
  • How protein intake impacts muscle mass and why pairing it with resistance training is significantly more effective [1:15:15]; and
  • More.

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The Peter Attia DriveBy Peter Attia, MD

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