#1 Reason You’re Still Storing Fat & Exhausted (No Matter How Healthy You Eat) | Alan Couzens

1. 0:00 – 3:27

   Why fat-burning ability matters for health and endurance performance

   1. RCDr. Rangan Chatterjee0:00

      A big part of becoming a healthy human as well as a good long-term athlete is to develop the ability to use fat in order to fuel your low intensity efforts and your day-to-day living. What does that mean for someone who's never come across that concept before?

   2. ACAlan Couzens0:20

      Yeah. I, I think, uh, a lot of the issues that, that we have from a health perspective in, in modern life are, are metabolic in nature. Um, so we as humans have this long-term evolutionary time span where we were moving a lot through our days, and we were expending a lot of energy. Um, and, and now we- we're not doing that. Um, and I... And the, the nature of exercise when, when we're in the middle of movement, it, it's a very stabilizing sort of activity for our body. So if, if we've just eaten and we go for a walk, it, it stabilizes our, our blood glucose. If we, if we sit at our desk, we don't get that sort of moderating effect. So I think a lot of the problems that we've, we've run into from a health perspective are just related to that, are related to the fact that our body's constantly under this metabolic stress. And one of the things that we can do to improve that and to give the body a lot less stress is to teach it to generate energy when we're resting from fat, so that it's not constantly having to go through these cycles of, "I've got all of this blood glucose circulating. What am I going to do with it?" So, uh, you know, a lot of the health, um, measures that I, I kind of encourage people to, to undertake are related to teaching their body to generate energy from fat. And in working with athletes, obviously that becomes even more of a factor because the glycogen that they have within their body, we w- we want to devote that to, to the training, not to walking to the mailbox and back sort of thing. So, uh, you know, I think from both perspectives, the health perspective and the fueling a lot of training perspective, having the ability to burn fat is, is really important.

   3. RCDr. Rangan Chatterjee2:25

      Yeah. Thanks, Alan. I think one of the things that is gonna be really fun to tease out today is the similarities between the populations you normally deal with, you know, endurance athletes who are coming to you for elite coaching to maybe compete in a world championship or, you know, super focused and dedicated amateurs who on their weekends and evenings want to do really incredible things with their bodies. But as I've immersed myself in your work for maybe three or four years now, it's really clear to me that the, the underpinnings of exercise physiology that you talk about absolutely also apply to the regular man or woman on the streets who just wants to be healthy. And so this idea that we want to burn fat as fuel, I guess implied within that is this idea that many people these days

2. 3:27 – 6:30

   Carb-dependent metabolism: cravings, energy swings, and weight struggles

   1. RCDr. Rangan Chatterjee3:27

      are not in good metabolic health and therefore for these low intensity activities, as you say, walking to the mailbox or sitting on your sofa watching television, they're actually tapping into burning carbs instead of burning fat. Is that correct? And if so, what is the implication of that for those individuals?

   2. ACAlan Couzens3:50

      Yeah, that's absolutely correct. Uh, i- in a, in an earlier life, I spent a lot of my time metabolically testing various levels of, of athletes, recreational athletes, people who had just sort of, you know, moved on from, from very sedentary lives, and that was exactly what we saw. At, at very low efforts, at, at resting efforts, these people are, are burning a lot of carbohydrate as sort of their default fuel, and that becomes problematic because when you burn carbohydrate, you want carbohydrate. The body starts craving carbohydrate. So you, you get into these energy swings of, you know, my glucose is dropping. Glucose is the only thing that I'm really, um, really good at burning, so I need to go to the vending machine and get some glucose right now. You know? So I think a, a lot of the, a lot of the issues of people feeling as though they don't have good control of their nutrition and good control of their weight, um, a lot of those issues aren't, aren't psychological. They're not issues of weakness. They're issues of a dysfunctional metabolism. And, and that's something that when you do change that, when you, when you do the right sort of exercise and you, you eat the right sort of nutrition to change that, all of a sudden you find it's a lot easier to do those things that you want to do, to not go to the vending machine and grab the, the nearest snack. Everything becomes a lot easier once you start to get the metabolic aspect in, uh, in check.

   3. RCDr. Rangan Chatterjee5:32

      Yeah, I think that's a great point. I'm sure many people who listen to this podcast will sometimes hear about intermittent fasting or time restricted eating or trying to reduce how much they snack, and they'll go, "Yeah, but it's, but it's really difficult. You know, I, I need a snack every two hours. I cannot go for three hours without food." And of course, there can be many reasons for that. But I think at the heart of it is just as you've said, they're not in good metabolic health. They're not usingfat as their fuel for their activities of daily living. They're tapping into carbs, so they're constantly running out of carbs and needing to fix them. Is this one of the reasons you're so keen for people to look at the zones in which they train? Perhaps we can talk about those zones and how using those zones might potentially help people get better at burning fat.

3. 6:30 – 11:09

   Reframing training zones as “movement zones” (including Zone 0)

   1. ACAlan Couzens6:30

      Yeah. I, I, I have a, a bit of a different perspective, I guess, on, on training zones. And one of the ways that I like to view training zones is more as movement zones. So if you talk with a lot of endurance coaches, uh, their, their first training zone will sort of start at a, at a good aerobic effort. And, you know, below that, if we're talking about things like walking and we're talking about things like yoga and those low-intensity activities, they, they sort of don't count, you know, in terms of training time. And for a lot of athletes, that's sort of how they see it. If, until their heart rate reaches a certain number, it doesn't count. Uh, f- from my perspective, it all counts because all, all of the low-intensity movement below what we traditionally think of as training is, is where all of the good stuff happens from a metabolic perspective. So going back to what we were talking about with, with the fat oxidation, people typically when, when they start trying to improve that aspect, they need to be exercising and moving at a very low intensity in order to, to keep it within that fat burning range. So the, the first zone for everybody is just that I'm, I'm up, I'm not on the couch anymore, and I, and I'm moving. And you know, that, that's what I call zone zero. That's your baseline zone where you've got some good metabolic things happening. Um, moving up from that to, to zone one, which is where I encourage a lot of my athletes to spend the majority of their training time, that's when we start to have some of the cardiovascular benefits. So we start to see increases in stroke volume of the heart. We start to see increases in maximal fat oxidation. We start to see a lot of the, all those positive changes that are really important for endurance athletes. So, so that's zone zero, the metabolic stuff. Zone one, we start to get into the cardiovascular stuff. And then the, the zones above that start to become much more sport specific. So for an Ironman athlete, zone two is where most Ironman athletes will be doing most of their, most of their race. For a marathoner, zone three is sort of that next step up where they'll be doing their race. And then, then moving up from that, you know, zone four, five is sort of that half marathon and, and shorter, uh, training, training zone. But, but all of those higher zones, your ability to do work in those zones is contingent on you having built that metabolic and cardiovascular base.

   2. RCDr. Rangan Chatterjee9:17

      Yeah. That's super interesting. I, I wanna go into these zones in detail. Is one way to think about these zones, Alan, to think about them as gears? You're sort of very used to talking to endurance athletes and competitive athletes, and I wanna make sure throughout this conversation that someone who's not interested in that can still glean your insights and still apply them because I think they're just as relevant, I really do. And so you're basically talking about going through the gears, aren't you? As you go up, you know, zone one, zone two, zone three, your heart rate's going up. Your intensity, your effort is going up. Is that a useful way for people to think about it, would you say?

   3. ACAlan Couzens10:02

      Yeah. Yeah. You know what? And I think, I think it's useful too to think about the fact that, that you're driving your... If we're gonna use the gears analogy, you're driving your body through your whole day, you know? So a lot of people, um, they, they sort of think of going back to, you know, having that, that threshold of if it, if it's below this level of intensity, it doesn't count. They think that exercise is only after a walk in the gym and start doing my structured workout. But every time that you're moving is some gradation of, of exercise. So I think, I think we do a real disservice to folks to think about, you know, we have to hit this magic intensity before good stuff starts to happen. And even for my pro athletes, I will program walks during their day. I'll program recovery walks, you know? And even at, at that level, these are guys with VO₂ max values of 70 and 80 mils per kilo, you know? They're very, very fit people. Even for them, there is this metabolic benefit to just going out and going for a walk.

4. 11:09 – 16:28

   Debunking ‘no pain, no gain’ with real-world results from more easy movement

   1. RCDr. Rangan Chatterjee11:09

      Yeah. I wanna talk about that because you have shared on multiple occasions on your Twitter, and now your X accounts, and on your Substack, which is just fantastic and just full of such high quality information that I think would benefit anyone. I think that you share so many case studies of athletes who have, in many ways since working with you, trained less in terms of intensity, but they've just massively increased zone zero and zone one, so very, very low intensity movement, but they've done lots and lots of it. And they're reporting that their, their 5K, you know, Saturday morning time is faster, that when they're competing in their triathlon, it's faster, even though they're not specifically training at that intensity that they need for their race. So there were two myths, I think, I... I, I was looking through a lot of your tweets today and reading all your Substack articles and really trying to... get my head around what I wanted to talk to you about. And there's two big myths you often talk about. One is this no pain, no gain idea, right? So we have this, particularly in the Western world, that it only matters when we feel it and we're out of breath at the end of it. That, that, you know, then it matters. So that's myth one. And the, and the second myth, which I think speaks to what I just said, is that you have to train at a certain intensity to improve your performance at that intensity. And I guess one of the really reassuring messages from you, which I think is very achievable for people, is to do loads and loads of zone zero and zone one training, which is frankly not that difficult.

   2. ACAlan Couzens13:01

      Yeah. It's just movement, you know? It re- it really is. It's, it's just movement, and I think a lot of, a lot of people really underestimate the benefits of just movement. And, you know, e- even, even things like walking, you know, when, when we start to increase the volume of walking in an athlete's day and we don't change anything else with their training, their performance level goes up consistently. So, you know, th- this is something that I think, uh, it, it... you really have to experience it in order to believe it. Um, you know, and, and, and a lot of folks, they, they really have to sort of, uh, you know, take that leap of faith and throw the, the heart over the bar first in order to, to get to the point that they really buy into that. But when, when you start to increase this low-volume activity through your day and you, you start to record it on your training peaks, you know, you start to say, "Th- this is actually training. This going, going for a walk for an hour is actually doing something beneficial." Um, when you start tracking that, you see improvement consistently for athletes and, you know, obviously the, the higher the level of athlete, the, uh, the, the less benefit compared to somebody who's just getting up off the couch. But for all athletes, there is benefit in increasing the amount of low intensity movement within your day.

   3. RCDr. Rangan Chatterjee14:26

      So would you say, Alan, if, if there's someone who's listening to this who loves to do a parkrun on a Saturday morning, that which is a, you know, the, the community 5K runs or walks that go on all over the world, and I know many of my listeners do like to do their local parkrun on a Saturday morning. Are you saying that if they wanted to improve their 5K time at their parkrun, and let's say they, they run a 5K on a Saturday, and maybe they run twice during the week, so maybe they run three times a week. But let's say that's all they do. Are you saying that if they could, on top of that, walk for one hour a day, that that would improve their 5K times over a period of time?

   4. ACAlan Couzens15:11

      Without question. Um, there, there's one, uh, one athlete that comes to mind who just recently went under three hours for, for the marathon, and they were doing more than half of their training as walking. So th- this is a person who, you know, is, is running seven-minute miles for, for, for the marathon in, in a competitive event, and most of their training is, was at 15 minutes per mile, was just walking. So, you know, I, I think the, the level of, of breakthrough that, that you can get just by increasing the amount of movement within your day is something that, uh, is really, really underestimated for even very high-level athletes and certainly for, you know, your, your local, local parkrunner who, uh, you know, is, is the weekend warrior who just sort of, you know, doesn't have a lot of time for, for structured training sessions within their week. If they can increase that incidental, um, portion of activity within their day, they're going to notice significant improvements, not only in their performance at the parkrun, but just in terms of their overall health as well.

5. 16:28 – 21:02

   Why walking improves running: stroke volume, heart size, and aerobic base

   1. RCDr. Rangan Chatterjee16:28

      Why is it that walking at low intensities can improve your ability to run a parkrun? Because, you know, going back to that gear system or that zone system, you were saying before that you're encouraging people to do a lot of zone zero and zone one, right? So stuff that's easy to recover from, that's not that taxing on the body, yet still has a huge benefit. Because I think the perception with most people is that if they were wanting to run a faster 5K, they need to practice running fast more and more so that they're training that speed. Now, I've been following your work for years, so I get it. But for the person who doesn't understand it, how would you describe what is going on in the body for that sort of low-intensity training to help them perform in a high-intensity event?

   2. ACAlan Couzens17:27

      Yeah. The, the biggest thing that separates very, very high-level athletes from untrained people is the size of their heart. So the, the amount of oxygen that they can deliver per beat to the working muscles for, for an elite level athlete, it's, it's about twice what it is for an untrained person. And, and we see that in things like resting heart rate. So, you know, my top pro athlete type guys have resting heart rates of about 30 beats per minute.

   3. RCDr. Rangan Chatterjee18:01

      Wow.

   4. ACAlan Couzens18:01

      Sort of low, low 30s. And you take a typical untrained person, and their resting heart rate is in the 60s, maybe 70s. You know, may- maybe, maybe more than that. So what that says is that these elite athletes are able to push out just as much oxygen to supply resting energy needsIn, in 30 beats compared to what your untrained person is gonna take tw- twice as many beats. So o- obviously there, there's a big difference in terms of the, the structure of their heart and the size of, size of their heart. Um, and the good news is that even at low intensities, our heart reaches its, its maximal filling at, at fairly low, low sort of levels of effort. Uh, you know, and certainly for, for your typical sort of deconditioned person, even walking at, you know, not even a brisk pace, even just a walk, are going to be getting very, very close to the maximal stroke volume that they can reach. And what this means is every time that the heart fills up with its maximal stroke volume, it stretches a little bit. And all of these little stretches build up over time and lead to this, this cardiac remodeling, we call it, which really is just about growing the heart and making it larger. So even, even at very, very low levels of intensity, there's a stimulus there to make the heart just that little bit larger with every beat that it takes. And over time, over years, as these beats start to accrue, we start to see improvement there and we, we start to see these people who might have started with resting heart rates in the 60s, all of a sudden they're in the 50s, and then they're in the 40s. And, and this is all coming from relatively low levels of, of, of exercise.

   5. RCDr. Rangan Chatterjee19:54

      Yeah. It, it's absolutely incredible. I think there's something about culture. I don't know if it was always like this hundreds of years ago or not, but certainly since I've been around, which is, you know, when I was born in the late '70s, I kind of feel that I have very much been surrounded by this idea of no pain, no gain, you know? Exercise or movement has to be hard. It has to feel hard. You have to feel as though you've worked afterwards. And of course, there may be certain benefits from that which we can get into later on. But I guess one of your key messages to people, pro athlete or not, is that even the low intensity movement matters. And what you said there about, you know, you get that maximum filling of your heart at those low intensities. So if you want that adaptation, which I think we all do, that's a very good adaptation in your heart. What, for example, happens if you go to medium intensity or high intensity? Does it not have the same effects on the heart when you do that?

6. 21:02 – 24:53

   The hidden risk of too much mid-to-high intensity: ‘small engine revving hard’

   1. ACAlan Couzens21:02

      Yeah. And, and you know, this is something that I think is really important from a health perspective for a lot of athletes because this is something that, that we see and what, what I've seen, you know, growing up, uh, a- as a swim coach and, and as a swimmer myself. Y- you see these, these certain types of athlete who do a lot of zone three, zone four, you know, that hard aerobic training, and, and over time, they develop the ability to train at these levels of intensity where their heart rate is very, very high for very long periods of time. You know, I- I've seen swimmers do things like, you know, they'll, they'll do a, an hour-long training set with their heart rate at 180 the whole time.

   2. RCDr. Rangan Chatterjee21:50

      Wow.

   3. ACAlan Couzens21:50

      And, and so they have this massive gap between what their muscles can do and what their heart can do. And the more you train that gap, the more you widen it. So you, you've got this very small engine that's revving very, very hard for very long periods of time. And, and from a health perspective, that's, that's not a good thing because it, it affects things like the amount of blood flow that we're able to get to the heart. You know, it has to relax in order to get, get perfusion and get a, a lot of blood in between beats. So we get this, this heart that's starved of oxygen for very long periods of time. And, you know, from a health perspective, that's just, just not a, not a good thing. So, you know, I think it's really important that we keep those things in balance. And any, any time that we spend really working on the peripheral side, on the muscles, we also spend working on the central side and making sure that our engine is growing with, with our, with our periphery.

   4. RCDr. Rangan Chatterjee22:52

      Yeah. There, there's so many things, Alan, for me that have come up there. Firstly, when you're talking about swimmers you know who can literally have a heart rate at 180 for a prolonged period of time, I mean, that is a high heart rate. Of course, in the context of racing or swimming it might make sense, but there has been this sort of idea for a while that there's a sweet spot with exercise, that you wanna be moving and exercising quite a bit, and you get benefits with your longevity and your health, but over a certain point it starts to have diminishing returns. And people would question then, you know, is marathon training good for you? You know, is running marathons good for you, or is it too much? And whenever I would see that research, I would always think, "Well, hold on a minute. Does it not depend on how you're running that marathon?" If you're not trained and you're running that marathon, and you're really, really pushing your body, and in all your training you're really, really pushing your body, well, maybe that's a huge stress on your body. And if you do that for a number of years, I can see how that could be problematic. At the same time, if you only compete once a year, if most of your training is low intensity-And, you know, your body's recovering from that, then I think, well, it, it... Saying that you both do marathons is, it's, it's not really comparable because one person is doing it in a way that they might be revving their engine continuously, so your car would wear out if you did that where... And the other person would be doing it where they're, you know, they're gently looking after their car and their engine whilst they're doing the same thing. So do you think that's one of the reasons why the research on exercise might be a little bit confusing when people say that too much might be problematic? Do you think it's because it's too much of the high-intensity stuff that causes the problems?

7. 24:53 – 29:24

   Exercise intensity and the nervous system: parasympathetic vs sympathetic training

   1. ACAlan Couzens24:53

      Yeah, I do. Uh, I, I think, uh, that there's some really good, good research on, uh, on the difference in, in the nervous system response at, at different levels of intensity. And, uh, this is something that Stephen Seiler, uh, did, did a really interesting paper on, where he looked at changes in heart rate variability after training sessions below that first threshold. So, so, you know, some of these zone zero, zone one sort of walking or very easy activity, uh, activity sessions versus what most people think of as, as exercise, those zone two through zone five, you know, uh, with, with the pain, with the, with the supposed gain, uh, s- sessions. And, and he found a significant almost sort of binary difference between what happens to the nervous system with the low intensity versus the high intensity. And the high-intensity activities are very fight or flight dominant, so the, the sympathetic nervous system really gets cranking. There's a, there's a lot of... It's, it's perceived by the body as a whole as a, as a high-stress situation, whereas the low activity, lo- low intensity activities, the parasympathetic, the rest and digest relaxation nervous system of the body actually gets activated and becomes dominant. So I think when we talk about is, is, are we doing too much, really the question is how much of the high-stress fight or flight stuff are we, are we including within our life, you know? And, and we're not just talking about exercise here, right? You know, stress is stress. So if, if you have a really stressful job, your fight or flight system is already very active during the day. And then at the end of the day, you go to the gym and you work out re- really, really hard, and you keep that fight or flight system activated and, and it's, you know, over time you, you reach the point where you've just really worn out the ability of the body to deal with stress. So I think there's a, there's a huge difference in what you're saying between someone who has this mentality of whenever I work out I have to work out ha- hard versus someone who, when they work out, they, they listen to the body and they're like, "Oh, I can't. I'm already in a high-stress situation. What kind of activity do I need to do right now to balance that out?" And if, if you take on that perspective, I think you'll find that the body actually does well with quite a lot of activity so long as it is of that, that parasympathetic rest, rest and repair, uh, kind of nature.

   2. RCDr. Rangan Chatterjee27:47

      Yeah. I, I love that, Alan, and I guess it, it really speaks to this idea that you can't really separate the inputs to your nervous system, you know, throughout your daily life. So, you know, we might think of our work life as our work life and, you know, work's busy and it's stressful and... But, hey, hey, when I finish work, now I'm in my exercise life, and in my exercise life, I like to push it hard in the gym. Actually, it sounds like a more helpful way to look at it would be, okay, work is really stressful. Let... I don't know. Let's say you're an accountant and it's coming up to the end of the tax year, right? So that for, from what I know of the accountants who I know, that's a very busy time of year. So it could be for that individual that, oh, at this part of the year, for these two months when I'm staying at the office late, I'm working harder than I want to, but that's just the nature of the job. Maybe my, in inverted commas, exercise during these two months should be lots of walking, lots of yoga, lots of low-stress movement to help me switch off my sympathetic nervous system. Whereas maybe six months away from that when they have maybe a dip in the year and work's quite light and easy to manage, maybe that's the time of year when they can be pushing things and doing the intensity and that... You know, it's a, it's a different way of looking at your training, isn't it? It's looking at your training as a way of helping your life instead of harming it.

8. 29:24 – 32:14

   Autoregulation with HRV: when to push and when to back off

   1. ACAlan Couzens29:24

      Absolutely. And, and there's been some really good research on exactly that. So if we look at things like heart rate variability, which is a really good marker of whether you're in this fight or flight state versus this, this rest and recovery state. When, when heart rate variability is already low, so, you know, maybe you've got a lot of stress going on in your life and you're just not in a, not in a good spot from a, a, uh, a kind of fight or flight nervous system perspective, you don't adapt as well to hard training. So exactly what you're talking about. If, if this person, you know, they take their heart rate variability every morning and they notice that I'm in, I'm in a really bad spot right now. You know, I've, I've just... I'm in that sort of dip where life is really hectic and I'm not recovering like I usually recover. It makes a lot of sense then to back off anything that might be, you know, zone two and above, that high-intensity stuff, because the body's just not going to respond to that during those times. And save that stuff for when you're back to a good spot with, with your nervous system and your nervous system saying, "Hey, I don't have all of this other stress that I have to deal with."I'm ready to deal with some training stress right now

   2. RCDr. Rangan Chatterjee30:44

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9. 32:14 – 35:08

   Defining metabolic health: stable daily energy fueled mostly by fat

   1. RCDr. Rangan Chatterjee32:14

      and the offer is only available while supplies last. Yeah. I want to go back to metabolic health for a moment, Alan. First of all, I'd love you to, you know, tell me or define it from your perspective, how do you see the term metabolic health?

   2. ACAlan Couzens32:38

      Yeah, I, I think a, a lot of it has to do with how you're fueling different, different intensities. So our body is really designed to be able to fuel all of our low intensity activities primarily through fat. And when, when we start to lose that ability is when we start to have some real health problems because when we start to lose that ability, we get into some of the things that we were talking about before with our blood sugar, you know, fluctuating all over the place and our body having to deal with that sort of stress. So I think, I think that's, that's step number one, develop the ability to fuel your low intensity activity and basically all of your day-to-day movement should be fueled primarily f- primarily with fat. So we, we shouldn't have these situations where through the day we're feeling our blood glucose rising and falling all over the place and feeling the need to, to hit the vending machine. That's, that's step number one, you know? And I think whether your goal is health or performance, that's the first thing that we should be doing, is trying to get to the point that we have nice stable metabolism through the day. We don't have these huge excursions that, that a lot of people are dealing with, um, in their everyday life. And, and a lot of that, again, you know, all of this is sort of tied together because a lot of this is sort of stress related too.

   3. RCDr. Rangan Chatterjee34:10

      Mm-hmm.

   4. ACAlan Couzens34:10

      You know, when, when we have that fight or flight response, our, our body releases a lot of sugar because it's like we've got this massive stress that we have to deal with, and your body doesn't know whether the stress is your boss yelling at you or you have, you have to run away from a, a lion that's, that's going to eat you sort of thing. You know, our body isn't, isn't really good. We have all of this evolutionary wiring where stress generally meant you need quick energy in order to get away from something and, you know, i- in or- in order to sort of balance that, not only do we have to do the right things from a nutrition perspective and from an exercise perspective, we also have to, to hit that other pillar that you talk about, which is stress management-

   5. RCDr. Rangan Chatterjee34:55

      Mm

   6. ACAlan Couzens34:56

      ... and relaxation and, you know, not, not falling into those patterns where we always have this lion in the background that's chasing us that, that, you know, we, we have to deal with.

10. 35:08 – 42:55

    Fat loss as ‘muscle training’: the 3-part fix (stress, easy movement, nutrition)

    1. RCDr. Rangan Chatterjee35:08

       If someone has stumbled across this conversation, Alan, and they're not an athlete, they d- they certainly don't consider themselves an athlete, but they want to get healthier and they're carrying excess fat on their body, and one of the things they want to do is to lose some of that fat, which of course is a very, very common goal these days for many people all over the world. If one of your goals is to burn fat and to lose fat off your body, is this zone zero and zone one training which then improves your body's ability to fuel its activities from fat going to be helpful?

    2. ACAlan Couzens35:57

       Yeah. I think the m- the most important thing, and something that's, that's overlooked all of the time, is that if you want to burn fat from your body, you need to be able to burn fat within your muscles. And, and so many people see a lack of, a lack of discipline, nutritional discipline, you know, where they really struggle with, with eating the right thing and sticking to, to, to diet as a mental weakness, but really it's a muscle weakness. It's you have this body that is not trained to burn fat as, as its primary energy source and is always looking for, for glucose, is always looking for, for sugar. So even though you have all this, this fat stored that you could potentially be using for energy, your muscle just doesn't know what to do with it. It, it's not trained in, in order to, to generate energy using that fat. And so you have this, this disconnect between, you know, you, you have all of this, this wonderful energy stored, uh, within your body that's just waiting to be burned, but you haven't taught your muscle how to, how to burn it.So I think, I think that's, that's such an important, important thing to realize, that it's not a, it's not a weakness. It's not a, it's not a, uh, you know, a l- a- a laziness, a lack of, uh, a lack of effort on so many people's parts. And, you know, s- so many people really struggle with sticking with, with good nutrition. It's n- it's not a mental weakness, it's a muscle weakness, and the more that you can teach your muscle to, to burn fat, the easier you're gonna find it to use what you already have on, on board and, and the quicker you're gonna find those body composition changes taking place.

    3. RCDr. Rangan Chatterjee37:50

       Yeah, that, that's a really interesting way to think about it, and I, I love that you're, you're sort of helping people understand that it- it's not necessarily you being weak in your mind, it's that you've not trained your muscle appropriately so it can utilize fat for those things. And because a lot of people who are struggling to lose weight will tell you that, "I, I went to the gym. I pushed it really hard in the gym, and I try not to snack, but I just, I get so hungry every two and a half hours that I just need to eat something." But as you say, there's a certain irony there, isn't there? There is an excess of fat literally on your body. If your body was able to fuel your life from fat and not glucose or carbs, you would be slowly, you know, bit by bit, burning off and, as you say, getting those changes in body composition. But the reason you're struggling, and A, they're often going to the gym and pushing it really hard, which I'm guessing is requiring more burning of carbs, burning of sugar, as opposed to the training of the burning of fat, right? So i- and it's really sad actually, 'cause people are trying so hard to lose weight, but are perhaps being stuck in this burning sugar cycle. So I guess, Alan, if, if someone came to you and said, "Listen, I, I think I'm not able to burn fat at low intensities. Can you please help me?" What would you ask them to do?

    4. ACAlan Couzens39:32

       Yeah. I, I think there's three, three key components. Um, and, and the first one that, that I'll, I'll hit is something that we've, we've kind of already talked about, and that is you're going to find it really hard to keep a stable metabolism if you, if you have a lot of stress in your life. So, you know, it's, it's not a, not an intuitive sort of thing to, to look to, you know, when, when you're looking to lo- lose fat. But really learning some stress management techniques and doing things-- I'm a huge fan of yoga. You know, I, I do, I do yoga pretty much every day [laughs] that, uh, that, that, that I'm around. Um, and you know, when you start doing things like that and having these mental resets during the day where you can really dial down the stress, it has a significant impact on your metabolism. So that would be the first thing that I would say to people. We, we really need to do what we can to, to have these, these anchor points during the day where you completely reset from a, from a stress perspective. And, you know, getting control of your breathing is really important. Just, I encourage people every hour, just take five deep breaths. That's all you've got to do. Every hour on the hour, set, set an alarm at, at your desk and just take five deep breaths. And simple things like that can really have a significant impact on whether your body is moving into that fight or flight mode, or whether it stays in that, in that rest and repair mode. So that, that's number one, taking care of the stress. Number two is exercise and movement. So what, what you do for exercise and, as you said, you know, how hard you push yourself is gonna have a significant impact on what you burn. So if someone is really struggling with, with weight loss, first thing I would say is just forget about anything hard. Just forget about all of the hard stuff. All of your exercise at the moment is going to be easy. So we're just gonna do things like very easy walks. You, you know, we're gonna find the nearest park with the most trees and the most beautiful nature that's just gonna keep you in that parasympathetic state, and you're gonna go for a 40-minute walk every day through the park, and that is your exercise. So e- everything is gonna be low intensity. We're not gonna spike the, the blood sugar. We're gonna keep, keep everything in that zone zero, zone one. And then the, the final thing, and you know, what most people consider as the first thing, is the nutrition. And when you do both of those things, you're gonna find that it's a lot easier then to have a diet that is more protein, lean, lean meat, vegetable, fruit, healthy focused, because you won't be having those same cravings that you were having before. So, you know, making the diet focused on real foods and relatively low carb. You know, not, not crazy, but, but relatively, relatively low carb, which tends to happen when we just, just eat good nutrition and, and real food.

11. 42:55 – 48:36

    Using CGMs (and lactate) to reveal stress and intensity effects on glucose

    1. RCDr. Rangan Chatterjee42:55

       Yeah. I love the way you put that, Alan. I've not really heard fat loss being tackled quite like that before. Um, I love the fact that you started off with stress rather than other things. You know, most people would start off with nutrition. And of course, look, there's, there's many ways to do these things right. But-I really like the way that you frame that, and it made me think of CGMs, you know, continuous glucose monitors. So I personally have found CGMs, not all the time, but now and again, to be one of the most useful tools I've seen since I qualified as a doctor to help people understand how their nutrition, their stress, their sleep, their movement affects their blood sugar. And you can't really un-know what you've learnt. Even if you just wear it once for two weeks and then take the learnings and apply them, I still think you'll get a huge amount of value. And one of the things I've learnt from using CGMs now and again is that different forms of exercise do different things to your blood sugar. If I go for a walk, even if I go on a hike on a gentle hill, my blood sugar is completely flat and stable. But if I do a Saturday morning 5K where I'm pushing it a little bit, my sugar starts to go up, and it's, it's, it's really-- I find it really exciting because I'm learning about my body and how different things I do make a difference. I then know that, oh, on high-stress days, sometimes you see your sugar going up even though your nutrition was exactly the same as the day before, or sleep deprivation makes your sugar go up. And I think I, I, I love what you said right at the start of this conversation, Alan, this idea that basically our ancestors would have been exceptionally good at fueling from fat. A, food wouldn't have been around all the time, but B, their, their lifestyles would, you know, lots of low intensity movement would have ensured that they could meet their needs every day, mostly from fat. I think that's a pretty reasonable assumption to make. And what's also really interesting when we think about that is a, a lot of these populations, these long-living populations around the world, they're not training their sprints or training fast 5Ks. They're just walking a ton, often on hilly terrain, but they're moving. So they're, they're constantly firing up zone zero and zone one, so they're getting good at using fat for fuel. And I guess because many people these days are not in good metabolic health, you know, I think the stats in America are that, you know, it's over ninety percent of people have some degree of metabolic dysfunction. The, the UK stat I found a couple of months ago suggested it was maybe sixty, sixty-five percent of the UK population have some element of metabolic dysfunction. So we're looking at populations now that are really struggling with, you know, making fuel efficiently in our bodies. And I think the primary thing that we need to help people do is, as you say, get them better at burning fat.

    2. ACAlan Couzens46:20

       Yeah, that-- you, you bring up a really good point with the, uh, with the CGMs. And I, I found, like you, I found it, it really insightful to, to wear a, a CGM for a period of time. And one of the things that, that I noticed that was, was really kind of surprising to me was that the, the patterns that I saw within my glucose had a lot more to do with what I was, what I was doing and the stress that I was under rather than what I was eating. And, you know, I think that that's one of the best uses of, of CGMs is they really tell you what sort of state your body is in, you know, and, and whether you're in that sort of fight or flight sugar burning state where your blood glucose obviously, you know, kind of goes along with that and, and, you know, your body makes available a lot of glucose to burn, or whether you're in this calm, sort of steady, uh, parasympathetic state. And when you, when you start to get control of that and you start to have more stability within your glucose profile, it becomes a lot easier then to burn fat because if, if you've got your blood sugar elevated, your-- all of your-- the fat burning of your body is, is pretty much shut off. So when you're doing your 5K at a, at a full-on effort, you're burning very, very little fat. And the same thing if you're sitting at, at, in, in your boss's office and he's yelling at you and you see that your, your glucose has spiked up because of the stress, you're burning very, very little fat. So really getting control of, of your metabolism in that sense and getting some stability there is, is absolutely key to going back to our hunter-gatherers. You know, our, our ancestors who, sure, when the lion was chasing them, they had this big glucose spike. But then for most of the day, they were sitting around the campfire and, you know, they, they were in that very, very stable parasympathetic state. So I think the more that we can get back to that sort of profile, the healthier we're going to be.

12. 48:36 – 1:03:47

    How easy is ‘easy’? Lactate testing, beginner intensity, and cultural barriers

    1. RCDr. Rangan Chatterjee48:36

       If someone, Alan, is not so good at burning fat and their body is reliant on carbs and sugar, so regular eating in order to fuel, is it going to be difficult for them to go, let's say, for that one-hour walk? You know, if they're so bad in terms of their metabolism, how do you help them rebuild that? And is it possible to rebuild in most people?

    2. ACAlan Couzens49:08

       The hardest part, honestly, is mental. Um, you know, and, and again, going back to our sort of no pain, no gain attitude, most, most people are going to struggle to exercise easy enough in order to make metabolic inroads. And, you know, this is something thatOne thing that I like to do when I'm working with sort of just, just off the couch athletes is I'll get the lactate tester out and I'll, I'll measure their lactate, you know, during a, during a very, very easy sort of, sort of walk and I'll see, you know, their, their lactate is at, is at two millimoles per liter or something, which is a, a fairly, fairly elevated sort of level. And, and I'll tell them, you know, at, at two millimoles per liter, your typical world champion triathlete is doing a really hard session at that point. You know, that's a-- that's the sort of session that they would be at the track doing, you know, 1,000-meter repeats at a, at a, a pretty good effort. And, and you're doing this walk, and the intensity that you're doing right now, is it, is at a comparable intensity to, to what the world champion would be doing for a very hard session?

    3. RCDr. Rangan Chatterjee50:25

       Wow.

    4. ACAlan Couzens50:25

       So it starts to bring in this sort of framework of i- if they want to do the sort of intensity that the world champion would be doing for 80% of their workouts, which is a, you know, around about a millimole per liter lactate, it's a very, very easy level of intensity. They have to go crazy easy, just beyond, beyond even what their mind can comprehend at that point, in order to work out at a, a similar level of intensity. So that becomes then just, okay, we, we're gonna dial this back. We're just gonna amble through, you know, over the, over the course of the next hour, we're just gonna walk through this park and we're gonna take a chat, and then at the end of it, we're gonna test your blood lactate and see where it is. And, you know, then, then maybe it's sort of a one point five at the end of, at the end of that hour of ambling through the park just, just talking. And it starts to bring in this perspective of just how easy easy has to be.

    5. RCDr. Rangan Chatterjee51:23

       And so the goal would be for that individual that they would start there. They would just, you know, have these one-hour ambles. They might sit down every fifteen minutes if they need to, but they would just keep doing that day after day, week after week, month after month, and little by little their fat burning capacity will start to improve and increase.

    6. ACAlan Couzens51:48

       Exactly. And you know, the, as I said, the hardest part is mental because our culture, our society just isn't, isn't set up to encourage that. You know, you think, oh, I, I've, I've, I've got an hour or I've got thirty minutes in which to work out during my day and the rest of my day is very busy. I have to make the absolute most of that. And when you-- when people think about making the absolute most of that, they think I have to move fast and I have to exercise hard and I have to feel as though I'm putting out this effort, when in reality that's working against these metabolic changes that we wanna make.

    7. RCDr. Rangan Chatterjee52:27

       Okay. I have a, I have a theoretical question for you, Alan. Let's say someone says to you, "I, I'm, I'm not interested in being an athlete," right? "I don't want to compete at 5Ks or in triathlons, but around my family life and around my job, I want to do what I can to stay well as I get older. And I can give you one hour a day." Right? Now, I, I recognize you might say one hour's not enough, right? But, but let-- we'll, we'll come to optimal and what you would ideally recommend in, uh, shortly in this conversation. But if they could give you one hour a day, so that's seven hours a week, what would you say would be their best bang for buck?

    8. ACAlan Couzens53:16

       The best bang for buck and the thing, the thing that I do when I'm time crunched, if, if I have a busy week of work or I'm on a training camp, uh, with athletes, you know, where I'm not getting the time that I usually get to exercise, the things that I prioritize are walking in nature and yoga. So tho- those are the two things that I think are, are my non-negotiables in terms of being a healthy human. I need to get out in nature and just walk easy every day, and I need to do some yoga. And it might just be, you know, fifteen minutes of working through various sort of yin poses and just, just to calm my nervous system at the end of the day. But tho- those are the two things that I think have the, the greatest bang for your buck. And, you know, going back to what we were talking about with, with stress, when any human is, is time crunched and they're very, very busy, they're probably spending a lot of their day in this sympathetic nervous system dominant, this fight or flight sort of mode. So there is huge benefit to just taking some time to switch, to switch out of that mode, to switch into that rest, repair, recovery mode. And from a health perspective, that's gonna give them a whole lot more than trying to make, make huge fitness gains with a really hard training session at that time. Because a- as we said, when you're dealing with all of these other stresses, you don't adapt to those hard training sessions. So, uh, so yeah, that, that, that's what I would prioritize. Anything that's gonna switch me out of this high stress mode into this parasympathetic dominant rest, relaxation. And the other thing that that's gonna do, you're gonna sleep a lot better. You're gonna, you're gonna have a much, much better recovery state for, for when you're, you're not busy, when you're not at work. You're, you're, you're gonna find that your whole energy is a, is a lot better if you're able to just, just break out of that high stress cycle.

    9. RCDr. Rangan Chatterjee55:19

       Yeah, I love that. That's, that's very helpful advice and it's quite counterintuitive. And just to be clear, not only are you on top of all the science, you have measured... this sort of stuff in people for decades now. With your athletes, you want them to test at what intensity does their lactate start to rise? So first of all, can you say what lactate is? How does it sit on top of those zones that you mentioned before or those gears? And then from there, I want to really understand, you love your athletes to test, but do you think there are benefits for Joe Public to also test their lactate as well, or do you think that's overkill?

    10. ACAlan Couzens56:08

        Yeah. So tying in with, with a lot of what, what we've talked about, um, lactate is, is fundamentally a product of sugar burning. So when, when we're in this sugar-burning, sugar-burning mode of, of glycolysis, one of the things that happens within our body is when we generate energy from that sugar, we produce this thing called pyruvate. And if, if we're very aerobically fit and we have a lot of mitochondria, this, this pyruvate can then be, uh, can be used as a fuel and can, can, can generate energy aerobically like that. Uh, when, when we don't have that, this pyruvate becomes lactate. So, so, you know, when you see elevated levels of lactate in the blood, you're basically seeing that this person is burning sugar right now, and they don't have enough aerobic fitness to use all of the lactate that's being produced, so it's starting to spill over into the blood. So that, that gives you some real important information from a metabolic perspective, you know, right, right from the get-go. High lactate, high sugar burning is, is a good way of, of thinking about it. Um, and then in terms of testing, lactate goes along with a lot of the other type of testing that we've, we've talked about. Um, so when you see elevated levels of blood glucose because you're sugar burning, you'll also typically see high levels of lactate. So it's not just that you're doing a hard 5K training effort, um, that, that righ- that results in an elevated lactate. If you're stressed out, if I, if I'm... You know, if I have a, a, uh, an argument with, with a significant other and then I go downstairs and jump on the bike and I test my lactate, it's, it's also gonna be elevated. You know?

    11. RCDr. Rangan Chatterjee58:00

        Wow.

    12. ACAlan Couzens58:00

        It won't be a, it won't be a normal resting level for me. So, uh, so I think, I think lactate is, you know, beyond kind of the elite athlete, and obviously we use it to set training zones and things like that. It is a really good marker of what's happening f- for your metabolism.

    13. RCDr. Rangan Chatterjee58:17

        Yeah. Is it fair to say that as I'm... Because there's a, there'll be a lot of people who are listening who perhaps have never come across lactate before or training zones. So going back to what we said earlier, you know, as your intensity goes up, you get different adaptations in the body and different things are being asked of your body. At the, at the lower gears, zone zero, zer- uh, zone one, you're burning fat almost exclusively, and as you get more and more intense, you're feeling it more, your heart rate goes up, you start to burn sugar more, and your lactate starts to rise as well.

    14. ACAlan Couzens58:56

        Yep, absolutely. So the, the, the sugar burning, um, starts when, when the lactate starts to... You know, if we, if we plot a curve of intensity and we start at just a walk, and then we move to a jog, and then we move to a fast run, and then we move to like a, a 5K kind of, you know, really hard effort, we'll see that the lactate curve sort of rises exponentially through, through those exercise intensities. And exactly what you're saying is happening. So when we, we move to the jog, we start to burn a little bit more sugar. But we're fit enough and there's enough mitochondria and enough aerobic fitness within the muscle to, to use most of the lactate being produced. But then over time, we... You know, as we're increasing the intensity, we start generating more sh- more sugar. We start, you know, really utilizing a lot of glycolysis to, to, to, uh, generate the energy that we need for that. And as that sugar burning increases, we produce more lactate, and eventually it's more than what our mitochondria can process, so it starts spilling out into the blood, and we see it exponentially rise as the effort goes on. You know, and, uh, one of the, one of the key, I guess, guiding training principles for all the athletes that I work with is we do want to do a whole lot of work where we're not in that sugar burning mode. So what that means from a lactate perspective is the lactate is at the lowest level that you can possibly get it to. And going back to our walk through the park example, you know, of the, the person, we really need to just amble through the park in or- order to get that lactate to the lowest possible level that we can get it to so that we know that you're burning fat and we know that you're really improving, uh, that aspect of your metabolism.

    15. RCDr. Rangan Chatterjee1:00:47

        Yeah, it's, it's really interesting, Alan, that staying in that zone, that low intensity zone where you're burning fat, has got huge performance benefits. So the athletes coming to you who want performance, they're gonna get enhanced performance from doing that. But me, through my medical lens, I'm thinking, "Yeah, but it ain't just performance," because you're gonna improve your mitochondrial function, mitochondrial efficiency, the number of mitochondria, which of course are a central part of health. So if you spend a lot of time in that fat burning zone at low intensities, you're going to improve your metabolic health. And improved metabolic health not only makes you feel good in terms of your energy and your vitality, it also reduces your risk of pretty much every single chronic disease that we have, whether that be heart attacks, strokes, dementia, all those things. A- and many forms of cancer, I should say alsoThe risk of getting them is reduced when you have excellent metabolic health. So I think this low intensity movement that our ancestors did a lot of, that you do with your athletes, that we're talking about today, have benefits for performance and for our health

    16. ACAlan Couzens1:02:10

        Absolutely. You know, and I think one of the great errors in thinking is that when you reach a certain level of performance, you, you need to trade, make the trade of, "Okay, this might not be the best thing for my health, but, but I'm, I'm a serious athlete now and I, I need to, need to sacrifice that health to some degree." But that's, that's just not the case. The things that are going to be the most beneficial for your long-term performance as an athlete are exactly the same things that are going to be the most beneficial for your long-term health as a human

    17. RCDr. Rangan Chatterjee1:02:46

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13. 1:03:47 – 1:12:24

    Building a complete longevity plan: walking + yoga baseline, then aerobic strength and selective intensity

    1. RCDr. Rangan Chatterjee1:03:47

       of working out so you can move freely and let Peloton handle the rest. Let yourself ride, lift, stretch, move, and go. Explore the new Peloton Cross Training Bike+ by clicking on the link below or by scanning the QR code on screen. Where does intensity then come in to the way you think? Because there must be a role for intensity for health and performance, but are you of the opinion that that comes in later once you've built a foundation in your life of regular amounts of low intensity movement?

    2. ACAlan Couzens1:04:32

       Absolutely, yeah. The, the, I think the, the, the way that intensity comes in is if, if you're preparing the body for a specific type of effort. So if I'm preparing to run a 5K and I wanted to do it u- under 20 minutes, um, then my muscles need to have the ability to work at this four-minute per K effort. And if I'm only ever training at seven minutes per K, then obviously I'm not using those muscle fibers in order to do that. So I, I need a certain amount of training and a certain amount of time spent where I'm recruiting those muscle fibers that I'm going to use when I do my 20-minute 5K. But if we have this really strong foundation of when I'm going through the day, you know, doing my regular activities, when I'm, I'm doing my very easy training, I'm, I'm fueling it almost exclusively through fat, then I have this glycogen that I can use just for this specific training. So by building this base of where I'm not, I'm not using sugar and I'm not using glycogen for things that it's not really designed for, I get this, this pool that I can draw on when I start to do the specific work for a, a specific event that excites me that, that I really want to prepare for. And this is really the essence of periodization. You know, you build this foundation of work capacity where you're teaching your body to use fat so that it's not wasting energy doing things that it doesn't need to be doing. So that when you move to this specific preparation, you have this, this energy reserve that you can draw from and really make the most of it

    3. RCDr. Rangan Chatterjee1:06:20

       Yeah. So your focus is basically saying, let's get the low intensity foundation in first. Find a way to get that into your life. Once you've been doing that for a period of time, then let's think about other things like intensity or, or I guess even strength. But if we were to go back to that fictional chap who said, "I don't want to be an athlete, but I want to be well, and I want good levels of longevity," and they were giving you one hour a day. You were saying walking and yoga, these very low-stress activities, which of course are gonna, you know, do multiple things. They're gonna improve your fat burning, improve your metabolic health, and they're gonna help you balance the stress from your life. What if they then said, "Okay, Alan, I've been doing that for two months. Feeling great. I'm sleeping better. I can give you two extra hours across the entire week for something else to do with fitness and movement." What would you tell them to do in those extra two hours on top of the seven hours of movement they've already got from walking and yoga?

    4. ACAlan Couzens1:07:25

       I think beyond, beyond that sort of, uh, you know, ability to, to de-stress and to mitigate some of the stresses of everyday life, one of the things that becomes problematic as we age is the, the loss of muscle mass. So, you know, if, if you don't do anything that's, um, not, not hard but, but has some, some resistance to it, then, then you lose muscle. And I think if I had that extra couple of hours, the next thing that I would add on top of that is just some very, very basic, very, um-Easy in, in the, in most people's sense of, of strength training. Uh, just sort of circuit training is something that I'm a big fan of. So, you know, relatively low loads, but just keeping them moving over the period of 30 minutes, 45 minutes, you know, moving whole, uh, whole body muscle, high muscle mass activities and, you know, under, under some level of load. So it, uh, you know, just basic movements. I do a lot of goblet squats, you know, doing things like, um, single leg, uh, Romanian deadlifts, things that involve your whole body, really work on balance, recruit enough muscle mass to, to keep, to keep that as we get, get older. You know, I think there's, there's a, a big, uh, push at the moment for more and more muscle mass and, you know, we see kinda, uh, it seems like we're in this, this phase of the, the health and wellness, uh, kind of continuum where everyone's all about getting bigger and bigger and bigger and carrying as much muscle mass as we can into, into our 60s and 70s. I don't think that's necessary. I think the aim really is to maintain the muscle mass-

    5. RCDr. Rangan Chatterjee1:09:13

       Yeah

    6. ACAlan Couzens1:09:13

       ... of a normal, young, healthy human as we get older.

    7. RCDr. Rangan Chatterjee1:09:16

       Yeah. I, I, I was gonna come to that actually, Alan, because I've also been thinking about this obsession we have these days with muscle. And, you know, I've spoken to many guests over the years who, who have said on this podcast that muscle mass is important as you get older, and it is particularly because after the age of 30, I think we can lose 3 to 5% every decade unless we do something about it. So of course it's important, but again, like we said before, you know, it's, it's, it's, it's in the detail, right? Yes, strength and muscle mass is important, but it doesn't necessarily mean that you need to be massive. For anyone who might be confused, Alan, um, in terms of how they should look at strength or muscle mass, which they've heard about before, you know, how do you make sense of it for them?

    8. ACAlan Couzens1:10:10

       Yeah, I think, uh, you, you really, you, you want muscle that you can, you can fuel aerobically. So-- And this ties in with a lot of what, a lot of what we've been talking about. Um, when, when you get people who are, are very, very well-- they have a lot of, a lot of strength, a lot of muscle mass, and they, they have a, a bias of the, these fast twitch muscle fibers, right? So we've got, we've got different types of muscle fibers within our muscle. We've got slow twitch fibers, which have a tendency to be very aerobic. You have a lot of the good stuff within them. You have a lot of mitochondria. You have the, a lot of capillaries that can deliver oxygen to them. They're, they're, they're designed to be able to fuel things aerobically. And then you have these fast twitch fibers that don't have as much of that, that good stuff. So they don't have as much mitochondria per unit. They don't have the sort of blood flow that the slow twitch fibers have. And when we start to bias our training towards those fast twitch fibers by doing traditional strength training, we, we detract from our aerobic abilities. So, you know, going along with what we said about we, we want this body that's very good at producing energy from fat and from oxygen. So we want, we want this aerobically fueled, uh, organism. And, you know, if, if we start to develop the sugar-burning side of things with these fast twitch fibers that love, love generating lactate, that love using sugar as their primary, primary energy source, we're really detracting from a lot of the health, uh, metrics that, that we're going for. So something that, that I kinda look for is if you're adding muscle mass, I want it to be aerobic muscle mass. So I want your VO₂ max to go up with the muscle mass. If I'm seeing an athlete's muscle mass go up and their VO₂ max go down, then that's telling me that that muscle is not aerobic muscle. It's not the sort of muscle that we really want.

14. 1:12:24 – 1:52:55

    VO₂ max, ‘aerobic muscle,’ aging decline, and the long-game mindset

    1. RCDr. Rangan Chatterjee1:12:24

       So okay, VO₂ max, it's a new term. Can you first of all explain what is VO₂ max? And then I'd love you to explain what are those scenarios whereby somebody would increase their muscle mass alongside their VO₂ max going down? Because it'd be interesting to know, you know, what, what, what is it people are doing that could lead to that outcome. So yeah, if you could start off there with what is VO₂ max, I think that will be helpful for people to understand.

    2. ACAlan Couzens1:12:52

       So, so VO₂ max is, is basically your whole body's oxygen uptake per unit of time. So if, if we're, if we're very aerobically fit, one of the things that we have is we have a lot of mitochondria, we have a lot of oxygen being delivered to the muscles. So per unit of time, our muscles are using all of that oxygen that's being delivered, uh, at, at a very high rate. So when we, when we see, um, you know, elite level endurance athletes, we see this, this VO₂ max number, which is basically oxygen uptake per unit of time at, at a, a super high level. So it's a consistent thing with very, very good endurance athletes to have a high VO₂ max. And beyond elite endurance athletes, it also happens to be one of the most important and, and most consistent variables that are tied to living for a very long time.

    3. RCDr. Rangan Chatterjee1:13:54

       Yeah.

    4. ACAlan Couzens1:13:55

       So if you have a very high VO₂ max for your age, your chances of dying over the next, you know, 10, 20 years is very low compared to someone who has, has a very, very low VO₂ max for their age. So, you know, it, it's, it's a very important, uh, important indicator of, of health and, and fitness as well. And-When we, when we do a lot of kind of strength work that is, is not challenging the aerobic system as most strength work, you know, most traditional strength work where you're doing sort of, you know, you'll do six to 10 reps and then you'll sit on the bench and you'll rest for three minutes, there's not, not a whole lot of oxygen demand there because the body can use what it has to generate ener- energy anaerobically, and then it has plenty of time to, to, uh, to recover. When you do that kind of activity, you get bigger muscles, but you don't get oxidative muscles. You don't get muscles with a lot of this mitochondria and-

    5. RCDr. Rangan Chatterjee1:14:59

       Hmm

    6. ACAlan Couzens1:15:00

       ... you know, capillary, uh, kind of, uh, in- innovation that, that you would get if you were doing more aerobic activities.

    7. RCDr. Rangan Chatterjee1:15:08

       That's really interesting. Okay. So I wanna make sure people don't go away from this conversation confused, right? So if someone has heard before that it's really important to put on muscle ma- You know, once you hit 30, once you get into your 40s, you must be doing something regularly to counteract the natural tendency for muscle mass to go down, and there are a variety of ways in which they can do that. They may have heard people say, you know, "Get a heavy weight, lift it five times, stop, wait two, three minutes, do it again." You know, and these things will give certain adaptations, of course, and you will grow strong, uh, you will grow bigger muscles by doing that. Do you think there's a potential downside then for people's health of training like that? Or do you think that can have value as long as we're not doing too much of it?

    8. ACAlan Couzens1:16:05

       Yeah. I, I think, I think about strength training in the way that I think about endurance training, to be honest with you. So, you know, just like when, when you're doing endurance training, you have the bulk of your work is very low intensity, and then you have this specific preparation for, you know, your 5K or whatever event you might be preparing for. Your strength training, in my opinion, should, should be similar. So the majority of the work should be relatively low intensity-

    9. RCDr. Rangan Chatterjee1:16:33

       Okay

    10. ACAlan Couzens1:16:33

        ... should be sort of circuit training, and then you might have a little bit that is devoted to some of the, these higher, uh, higher efforts. And really, what we're going for in the higher efforts is, is not so much an increase in the size of those fast twitch fibers. We're just doing enough to, to keep them around from a, from a neural perspective. So we're, we're keeping that ability to recruit these fibers and keeping the strength, uh, that, that we already have so that these fibers don't think that they're not needed anymore and start to atrophy. So I think, I think just a little bit there is really important just to, to keep your fast twitch fibers around.

    11. RCDr. Rangan Chatterjee1:17:16

        Right.

    12. ACAlan Couzens1:17:16

        But we don't need to go to that level where we need to become bodybuilder hypertrophy monsters that, you know, I, I don't think that's beneficial for health.

    13. RCDr. Rangan Chatterjee1:17:25

        Yeah. I, I love the way you think there. It's a nice way to think about your aerobic training. A lot of time, low intensity, a little bit of high intensity once you've built that aerobic base. I know you mentioned Steven Sardian before. He, he came on the podcast about 18 months ago. We had a lovely chat about all these kind of zones and why he recommends an 80/20 approach, 80% low intensity, 20%, you know, at different intensities higher. Um, and I know you share very similar perspectives o- on many levels, but I, I haven't really heard that approach applied to strength before as well, and it does make a lot of sense to me. And if I think about how I like to train my strength, it is exactly as you say. I, I, I don't particularly go and do these 30-minute sessions. I just regularly have heavy things lying around my house and my garden, and throughout the day at various times, I will just go, I'll, I'll pick up a sandbag, you know, put it on my shoulder, walk to the end of the garden, throw it up in the air, pick it up again, walk back, throw it up. I maybe do that 10 times, and then, and then I'll get on with my work. Um, or, you know, I'll pick up a kettlebell whilst I'm wa- wa- you know, on the wa- my way to cup of the cup, making a cup of tea, and I'll do 20 kettlebell swings. Put the kettle on, get the tea to brew, and then do another 20 kettlebell swings while I'm waiting, and then get my tea and I'll go back to work. So I kind of think I tend to do that. Maybe what I could improve perhaps is, you know, where's the 20% of really, really heavy stuff? Maybe I've let that slip over the past few months. Also, with respect to VO₂ max, I've had Peter Attia on a couple of times on the podcast over the past few years, and Peter of course talks a lot about VO₂ max being one of the most important predictors for our longevity. And he talks about... Well, he references a scientific paper in his book where, you know, your VO₂ max starts to gradually go down. I think it starts to fall quite sharply 40s and 50s, I think. I can't quite remember the graph. In your experience, from what you've seen, when does fitness and things like VO₂ max start to fall off? I.e. the point I'm trying to get to, Alan, is, is there an age at which you think, listen, if you haven't paid attention to your fitness, you might have got away with it in your 20s and your 30s, but there's a point in life where you simply can't get away with it anymore. You have to start doing something. Have you, have you found like an age range where you've seen that with your athletes at all?

    14. ACAlan Couzens1:20:15

        Yeah. If we look at sort of masters record performances, uh, if we look at sort of, you know, 10K or marathon performances for30-year-olds, 35-year-olds, 40-year-olds, they're, they're all still f- fairly good. And then when we start to get towards 50, they, they start to drop off. And you know, I, I can tell you from my experience, these 50-year-olds are still, still training a lot. You know, there's still, there's still 50-year-olds at the top of, uh, endurance sport who are still training just, just like, uh, you know, professional athletes do. So it's, it's not a training, uh, a training issue. It's, it's, it's an aging issue. So I, I think that's something that, uh, is not thought of enough when we see these 30-year-old health and fitness influencers who are in great shape and they are only doing their, you know, three or four hours a week or whatever they're doing. It's, it's easy for us as, you know, 50-whatever-year-old people to say, uh, "Well, that, that looks great. You know, they're, they're only training four hours a week. They're doing these high intensity sessions and their, their VO₂ max is high and, uh, you know, that I, I should, I should do that. I want that VO₂ max." But the reality is our VO₂ max is going to decline significantly with age beyond the age of 40. So if, if we want to maintain the VO₂ max of a young person when we're in our 40s, 50s, 60s, we're going to need to train more. And I think that's, uh, you know, that's a uncomfortable truth for a lot of people, but, uh, it's something that, that I l- sort of look at in terms of planning for my retirement and planning my later years in life. I plan on spending a lot of my time moving. I plan on increasing the amount of exercise that I'm doing, uh, versus right now. And you know, that's something that I think if we were to, were to sort of go into exercise with that perspective, that our objective really is sustainability and something that we can build on and not actually decrease through the years, it would change what, what we do. It would change what our exercise looks like.

    15. RCDr. Rangan Chatterjee1:22:37

        Yeah. I would say one of the things I try and do every day is do at least one hour of walking. I, like you, have realized that, hey, as I'm getting older, I need to move more, not less. And I'm very lucky because I do have a lot of autonomy over my time now in a way that I didn't have early on in my career. When opportunities come in and there's, you know, things that I could do, I'm also now thinking about it through the lens of, yes, but if I do that, if that gets in the way of my ability to move, I'm not sure it's worth the trade, right? And I would definitely, I would give you a lot of credit for that because I think your tweets over the years have really helped frame that in my brain and go, "Yeah, well, hold on a minute. It-- how do you define success?" Right? In fact, Alan, I was gonna ask you how... You know, you said you're in your 50s. I, I w- I'm too polite to ask you how old you are, right? So you're in your 50s. At this stage in your life, how do you define success?

    16. ACAlan Couzens1:23:40

        I think, I think a- as you reach, you know, the sort of age that I'm at now, you, you start to think about what you want your 60s and 70s to, to look like. And one of, one of the, the pictures I've always had in, in my head and, you know, I've spent, I've spent a bit of time in Arizona at the Grand Canyon. It's one of my favorite, favorite places to, to go, uh, you know, to, to hike around. And when I see the, the busloads of, of older people coming through, looking at the Grand Canyon through their bus windows, you know, they're people in their 70s and, and I'm sure that some of them are thinking, "I, I wish I had come here back when I was in my 30s and 40s. I would love to get down there and, you know, touch the ground and experience, experience hiking through the canyon." I, I never wanna be at that point. I never wanna be on that bus, unable to get out and walk, walk down, hike down into the canyon. So that, that's sort of my, my guiding principle, I guess. I, I always-- as long as I'm on this earth, I wanna be functional. Uh, and I think, you know, no matter how much money you have, no matter how much success you have, um, you know, fr- from a, a business perspective, if, if you're at the point where you're limited in what you can do physically, then there's something that's really important that's missing from your life. And you know, I'm trying to... Obviously, I'm not at that point yet. I'm still able to do all of these things, and I wanna keep that for as long as I possibly can.

    17. RCDr. Rangan Chatterjee1:25:25

        Yeah. It's really interesting, Alan. My, my son is currently 15 and, you know, we've been talking about what he might do for his A levels in the next two years, which are the, the sort of, you know, here in the UK at least, they, they're the exams you do in the final two years of school if you choose to stay at school beyond the age of 16. And I was having a chat with him the other day and he was talking about what some of his mates were saying, well, about what, what jobs they wanna do and, you know, one of them says, "Well, I want to be a chartered accountant. You know, I've heard they make quite a lot of money and..." And whatever. It was just interesting to hear what he was saying. And one of the things I said to him, I said, "Son, it's all interesting hearing what your mates are saying, but when you're thinking about that, what job you might want to do," A, I was saying, "Think about what you love," right? "Think about what is it you're gonna really enjoy doing. And if you don't know now, that's completely fine. We can figure that out or you can figure that out over the next five, 10, 15 years," right? "You don't have to make that decision now." But I also said to him, "Have a think about what is the cost of doing that job." And, and we went through this thought experiment about ifBeing a chartered accountant pays X thousand pounds a year, and that's what that individual wants to earn. Is it still worth it if they're working every weekend and they're working late every evening and they can't take any time off? I- is it still worth it, or might it be better to earn 10,000 pounds a year less and have your weekends free and your evenings free? And it-- what it was is, the reason I'm so passionate about this is, 'cause I know you tweet about this quite a lot, about what a, you know, how to look at the, you know, how to look at your life, you know. Um, I just wanna put the idea into him that I didn't have at that age, which is all of these choices, they have a cost. There is a consequence. If you choose a job that you, you love that, but that doesn't allow you to move. And I get loads of people are in that position, and there's nothing they can do about it. I do accept that. But I do think it's quite interesting if we were to bring up a generation thinking about, well, what kinds of jobs could I do that would pay me enough, but also give me enough time to move? Do you know what I mean?

    18. ACAlan Couzens1:27:51

        Yeah. It's, it's, you know, as a coach and, you know, a coach who's worked with a lot of ad- adult athletes who have all different types of jobs, it's, it's, uh, frustrating when there's certain cultures in certain jobs that really, really are, are built around not having control of your, of your schedule and, and almost voluntarily surrendering that. You know, it's like, if you wanna do this job, you need to, you need to be aware that we own you. We own your time, essentially. You know? And, and whether it's a, a company that you're working for is owning your time or whether you're in a startup and, you know, you just kind of realize that the business is, is everything when you're, when you're getting started, and you're not going to have your own, your own sort of, uh, you know, you're not gonna have the luxury of being able to say, "Well, I'm not, not doing this today. I'm gonna go for a, a three-hour hike instead." Um, you know, I, I think, I think a lot of that is really cultural, and you need to, you need to be careful. If you value your health, you need to be really careful on what culture you're going to take up and what, and what culture you're going to, uh, adopt as the norm because there's, there's big differences, right? I mean, I, I-- you have, on that side, some people who have very little control of their schedule, and then I've worked with others who have, have prioritized their health and fitness from the beginning and have, have carved out these niches where that's really important, and they're gonna make sure that they always have time to do what they need to do from a health and fitness perspective. And I think a lot of people, they kind of get stuck in these, these routes, you know, where you say, "Yes, I'm gonna do this. Yes, I'm moving up to this promotion." This promotion is gonna require X amount more hours per week, you know, and, and you just-- it's so easy to get really stuck in a particular path and not to be conscious of, well, you know, health and fitness was something that was really important to me back, you know, five years ago, and now all of a sudden it's just been kind of pushed out, you know? And it-

    19. RCDr. Rangan Chatterjee1:30:08

        Yeah

    20. ACAlan Couzens1:30:09

        ... it can be really insidious, and I think it's something that, as you said, it's important to, to be mindful of.

    21. RCDr. Rangan Chatterjee1:30:15

        It's really, really common, that, but it doesn't, it doesn't apply to everyone. It was really interesting. I don't know, maybe ten, fifteen years ago, one of my mates from primary school, who's a teacher, you know, he's been a teacher for a while, and he was-- I think he's the assistant head. No, the assistant... He's the head in his department, basically. Not of the school, in his department. And we-- this is back when I used to play squash with him. I think he said once that, "Oh, mate, I've been offered head of the department, but I'm not gonna take it because yeah, it's a, it's a little bit of extra money, but the amount of stress that job comes with, I don't think it's a good trade. I won't be able to do my sports at the weekend," and all the other things he enjoys doing. And it really, it really stuck in my ear when he said that because I wasn't brought up to think like that. I think like that now, but I didn't think like that back then. So there are people out there, maybe like you, maybe like my friends, who actually do see life in this kind of more holistic way and go, "Yeah, at what cost do I do the thing that everyone around me tells me I should be doing? The better job, the promotion. Well, maybe I'm okay just the..." Mate, you know, he was like, "Well, I earn enough. Like, I don't really need any more. I'd rather be able to do my fun stuff at the weekends." And, and that's exactly what you're talking about, isn't it?

    22. ACAlan Couzens1:31:42

        Yeah, exactly, you know. And, and I think, uh, I came from Australia, and I think Australia is a very sort of, uh, tradition-oriented sort of country. You know, it has these sort of working class values, and, and you know, I know that growing up, the, the path was, you know, you, as you're going through school, you identify what job you want, and then you apply to that job, and you, you get in with a company, and you sort of work your way through that company. And, and I didn't really have this exposure to there being different, different options. And it really wasn't until I moved to the US that I saw these people doing things differently, you know? Starting businesses and, uh, just, just taking these non-traditional approaches. And I think, uh, I'm really fortunate that I got exposed to that because if I, if I didn't, it just wouldn't have, it wouldn't have been a possibility. It wouldn't have been in my mindset that, you know, maybe there are, are these alternative routes that I can take-

    23. RCDr. Rangan Chatterjee1:32:45

        Yeah

    24. ACAlan Couzens1:32:46

        ... that still pay me enough-But I get, get control of my time and I get to, to make sure that I still have some agency over my health and fitness

    25. RCDr. Rangan Chatterjee1:32:56

        We were talking about VO2 max before, and you were saying even in well-trained athletes, as you get older, that VO2 max will start to decline. So I guess the follow-up question is, if we want to protect our VO2 max as we get older and, or, and potentially increase it, is there anything we can do, or do we have to accept this as inevitable decline?

    26. ACAlan Couzens1:33:26

        Yeah, I think it depends where we're coming from. You know, if, if you're, if you're, uh, Eliud Kip- Kiptumgi, who you've had on your podcast, then, uh, I, I think some, some decline in VO2 max is kind of inevitable when you're coming from that, from that level. But for most of us-

    27. RCDr. Rangan Chatterjee1:33:41

        Because you've reached your genetic potential through all your training, so it is gonna decline.

    28. ACAlan Couzens1:33:47

        Absolutely, yeah. And then, you know, for most of us though, I think my kind of, my standard or what I, what I aim to maintain through my life is I want to keep a young person's, a normal youn- normal, fit, healthy young person's VO2 max for as many years as I possibly can. And that, that's about 50 mils per kilo for a, for a, for a young male. So that's, that's the standard I have in my head of the-- I wanna do enough training to hold onto this VO2 max of 50 mils per kilo for as long as I can. And you know, in, in my 50s, that's, uh, that's a decent amount of activity. You know, I'm-- I train two hours a day basically. Um, but, but I know that in order to do that in my 60s and 70s, we're starting to get up to pretty elite levels of, of fitness for, for those guys. So, you know, I'm, I'm certainly playing the long game here and I'm, I'm pacing with that, with that in mind that I don't necessarily need to be a world champion at 50, but I, I, I wanna be of, of that sort of fitness when I get into my 70s.

    29. RCDr. Rangan Chatterjee1:34:57

        I love that. And thinking about this idea of playing the long game, one of the other themes that often comes out in your writing and your tweets is this idea that fitness is a long-term game. And again, that goes against other things in modern culture. You know, we've already mentioned no pain, no gain, right? It's gotta feel hard. But there's also this idea that we can cram stuff in. Oh, you know what? I'm just gonna sign up for that half marathon in 12 weeks and do the plan. Train hard for 12 weeks and then don't train for three months afterwards 'cause, you know, I got the medal, I did the race. And one of these key ideas that I get from, from you, Alan, is that you can't really afford to take that much time off, i.e., you are a big fan of consistency, not just for a period of weeks or months. You're a fan of consistency over years, and you sort of share a lot of the time that actually if you can stay consistent week after week, month after month, year after year, you are going to get incredible fitness adaptations. But unfortunately, most people can't maintain that consistency. Can you speak to that a little bit, please?

    30. ACAlan Couzens1:36:20

        Yeah, I think, I think it's a very, very human thing to, to not be very good at pacing over long timeframes. So, um, you know, I, I've done, done several Ironman races myself, and they all go the same, right? When, when you, when you start off, you, you do your swim, you do your bike, and people are just zipping by you for, for the first third of the race because, you know, they, they, they have this in their head that I'm going to be able to maintain this effort, effort all the way through. And 95% of them you then see later on in the day, they were in fact not able to maintain that effort all the way through. So I, I think that's, that's just a very, very human thing to, to always overestimate what we can maintain over the long term. So you know what? I think these people when they sign up for their half marathon in 12 weeks, they're not thinking that this is gonna completely burn me out and I'm gonna be wrecked and not doing anything for the next three years. I'm sure at the time it's like, "This, this is the, uh, the starting point for my fitness journey from, from here on out." But they go too hard. They, they, you know, adopt that no pain, no gain mindset, and then by the time they're-- they're done with the half marathon, they're like, "Oh, I gotta take, take a breather." You know, maybe they're-- maybe they got some injuries that they're dealing with. Maybe it's just the case of, oh, that was, that was a lot when it comes to, you know, keeping up with my schedule. So I don't think that, that people necessarily intend to be flashes in the pan, but they just-- they tend to, um, overestimate what they're gonna be able to accomplish over the long term. And you know, I think the, the good news is that we don't need to do these mammoth feats in order to, to get fitter than what we are right now. All we've gotta do is beat our long-term average and just keep continuing to beat our long-term average by the smallest of, of little bits. And when we, when we look at that and we look at it objectively and we say, "Well, how much training have you actually done over the past year?" All we've gotta do is just do a little bit above that, you know? And just, just keep doing a little bit above that year after year. Uh, it, it becomes a lot more attainable for folks.

Episode duration: 1:52:55