How to incorporate high-intensity training (Zone 5) to increase VO2 max and optimize fitness

Read Time 3 minutes

This video clip is from episode #201 – Deep dive back into Zone 2 with Iñigo San-Millán, Ph.D. (Pt. 2), originally released on March 28, 2022.

Show Notes

How to incorporate high intensity training (Zone 5) to increase VO2 max and optimize fitness [1:51:15]

  • There is a need for some high intensity too

Peter’s 4 pillars of exercise

  • 1) Stability
  • 2) Strength
  • 3) Low-end aerobic, to improve mitochondrial efficiency
  • 4) High-end aerobic, for peak aerobic/ anaerobic performance
    • Peter struggles the most with this one because when done right, it hurts the most
    • It’s also no longer relevant because he doesn’t compete in anything
    • He enjoyed this type of training when he was competing because he would see the rewards

High intensity training

  • From a lens of health, the data are unambiguous— VO2 max is highly correlated with longevity
    • There are not many variables that are more strongly correlated
    • But the levels don’t have to be that high
  • Pogačar’s VO2 max is probably 85
  • Peter notes that for someone his age to be considered elite, in the top 2.5-2.7% of the population; this carries with is a 5x reduction in risk compared to the bottom 25% of the population
    • The VO2 max required here is 52-53 mL/min/kg
    • Peter asks if this can be used as a gauge for how much high intensity training is needed? 
  • Iñigo thinks more about bioenergetics energy systems
  • Longevity is also highly related with mitochondrial function and metabolic health

There’s an aging process where we lose mitochondrial function, and there’s a sedentary component where we lose mitochondrial function”— Iñigo San-Millán

  • Iñigo wishes there was a pill you could take to increase mitochondrial function, because it would increase metabolic health and longevity
  • But the only medication we know of is exercise
  • Dose and sustainability are important
    • High intensity exercise is not sustainable
    • Very extreme diets are not sustainable
    • If you combine both, it’s even worse
  • High intensity training is important to improve glycolytic capacity
  • We lose glycolytic capacity as we age and it’s important to stimulate it
  • Peter asks, if he has 1 additional training session per week, should he do a 5th session of Zone 2 training or a VO2 max protocol?
  • For VO2 max, high intensity training, Peter prescribes patients to do a 4×4 protocol
    • 4 minutes of the highest intensity, sustained exercise followed by 4 minutes of recovery
    • Repeat this 4-6x
    • Add a warm up and cool down on either end and this will be a little over an hour
  • Iñigo recommends if you have a 5th day, do any type of high intensity session
  • What he does on almost every Zone 2 sesion is at the end, he does a very high intensity interval
  • Iñigo does 1.5 hours of Zone 2, 4-5x a week (his typical routine)
    • He tries to do a good 5 minute, high intensity interval at the end
  • Increasing mitochondrial function takes months or years
  • Increasing the glycolytic system takes much less time, weeks or months
  • If you stimulate the glycolytic system 2-3 days you’ll see progress
  • Add a high intensity interval 2-3 days a week at the end of that Zone 2 training, and you’ll target both energy systems: the oxidative mitochondrial system and the glycolytic energy system

Is zone 5 training okay to do immediately following zone 2 training?

  • Peter asks if you blunt the benefit gained from Zone 2 training if you immediately follow it with Zone 5
  • Iñigo says no, because it’s done at the end, then exercise is over
    • But don’t do it in the reverse order because this will trigger all these hormonal responses and high blood lactate
    • We know lactate inhibits lipolysis
    • So if you have a high interval in the middle or the beginning and you don’t clear lactate very well
  • Another study Iñigo has under review shows that lactate at the autocrine level decreases the activity of CPT1 and CPT2 (needed for fatty acid transport into the mitochondria for oxidation)
    • So lactate interferes with the transport of fatty acids as well
  • Peter is glad Iñigo raised this point because often patients will say, “I went out and did a two-hour ride today and it showed me that I spent 45 of those minutes, 45 of those 120 minutes were in Zone 2. So I did 45 minutes at Zone 2” 
    • This is not the same as spending 45 minutes in dedicated Zone 2 training
    • There is a lot of up and down intensity
    • The average might be Zone 2, but you’re oscillating between Zone 1, Zone 2, Zone 4, all the time
§
Iñigo San-Millán, Ph.D.

Iñigo San-Millán earned his doctorate at the University of the Basque Country School of Medicine.  He did his postdoctoral research at the Harvard Medical School Cancer Research Program.  Currently he is an Assistant professor in the School of Medicine at the University of Colorado School – Colorado Springs.  His research and clinical work focuses on: exercise metabolism, cancer metabolism, metabolic health, nutrition, sports performance, diabetes, and critical care.

Dr. San-Millán has worked for the past 25 years with many professional teams and elite athletes worldwide across multiple sports, this includes: soccer, cycling, football, basketball, track and field, rowing, triathlon, swimming, and Olympic training. He has been a consultant in exercise physiology and sports medicine to international organizations such as the US Olympic Committee.  He has pioneered the development of new methodologies for monitoring athletes at the metabolic and physiological level.  He developed the first method to indirectly measure mitochondrial function and metabolic flexibility/  He co-developed the first methodology to deploy metabolomics assessment to professional sports as well as the first method to indirectly measure skeletal muscle glycogen in a non-invasive manner using high frequency ultrasound.  Currently, he is the Director of Performance for Team UAE Emirates cycling team and the personal physiologist and coach of 2020 and 2021 Tour de France winner Tadej Pogacar. 

Although now a recreational athlete, he used to be a competitive athlete.  He played soccer for 6 years for the developmental academy of Real Madrid soccer team.  He also raced as a low-key, professional cyclist for 2 years.  [Dr. San-Millan’s Website]

Twitter: @doctorIñigo

Disclaimer: This blog is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this blog or materials linked from this blog is at the user's own risk. The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions.
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