AMA #27: The importance of muscle mass, strength, and cardiorespiratory fitness for longevity

**Peter Attia** (0:11)
Hey, everyone, welcome to a sneak peek, Ask Me Anything, or AMA episode of the Drive Podcast. I'm your host, Peter Attia. At the end of this short episode, I'll explain how you can access the AMA episodes in full, along with a ton of other membership benefits we've created. Or you can learn more now by going to peterattiamd.com forward slash subscribe. So without further delay, here's today's sneak peek of the Ask Me Anything episode.
Welcome to Ask Me Anything episode number 27 I am once again joined by Bob Kaplan. In today's episode, we discuss all things related to basically the outputs of exercise and morbidity and mortality. So specifically we go into great detail around the benefits that one gets from a high degree of cardiorespiratory fitness and the benefits that one will derive from a high amount of muscle mass and muscle strength. And conversely, what happens when you don't have those things? We also tease apart as best we can, the relative contributions of each of those things. So is it more about muscle mass? Is it more about muscle strength?
If you are optimizing to get the best health benefit in the least amount of effort, not something I recommend, where do you get the most bang for your buck? Is it strength? Is it cardiorespiratory fitness, et cetera? So anyway, this one is a really fun episode. I would encourage you to watch this one. So obviously it is available as any podcast is via audio, but this is one where I think the data being presented, and we go through a lot of this by showing the figures. It just makes a heck of a lot more sense if you can see what we're talking about. So if you're a subscriber and you want to watch the full video, which I hope you do, you can find it on the show notes page. If you're not a subscriber, you will watch a sneak peek at this video on the YouTube page, but potentially this is the episode that gets you to subscribe. So without further delay, I hope you enjoy AMA number 27
All right, Bob, we got a pretty fun AMA today here. But before we do, I don't think I realized until looking at your background that the Boston Bruins had a 30 year drought in which they did not win their division.
1940 to 1970

**Bob Kaplan** (2:30)
Oh, I'm glad I missed that drought.
Is that, 1940, was that when there was fewer teams? I mean, it'd be-

**Peter Attia** (2:36)
Oh yeah, there was only 16

**Bob Kaplan** (2:37)
Really embarrassing. That's embarrassing.

**Peter Attia** (2:39)
Well, it's not as embarrassing as the Maple Leafs who haven't won the Stanley Cup since, I think, 1967

**Bob Kaplan** (2:45)
Oh my goodness.

**Peter Attia** (2:47)
If any team deserves a Stanley Cup, it's Toronto.

**Bob Kaplan** (2:51)
I enjoyed, I think I sent you a video of a guy talking about, you know, that's bad enough, but was it a year ago or a couple of years ago? They lost to a backup goaltender, it was a Zamboni driver.

**Peter Attia** (3:03)
Yeah, right, at the ACC.

**Bob Kaplan** (3:04)
From the Toronto Maple Leafs, yeah.

**Peter Attia** (3:05)
That's a beautiful story, though.
All right, so we've got a pretty fun topic, an important topic on the docket today, which is effectively kind of scratching the exercise itch as it pertains to longevity, but at a probably a deeper level than folks are used to. So where should we start?

**Bob Kaplan** (3:24)
I think we should start with, well, aerobic fitness or cardiorespiratory fitness, because I think we've got a few things that these questions have come in. I think a bunch of questions related to this, which is studies that look at how much lean mass you have and whether that is a predictor of longevity. And then there's also studies that talk about muscle strength, not just muscle mass, and whether that predicts longevity and whether one of those is better than the other. But I think a good place to start is with cardiorespiratory fitness, so a similar question.
Does better lead to less mortality and does lower cardiorespiratory fitness lead to higher mortality, or is it at least associated?

**Peter Attia** (4:01)
Okay, so let's start by kind of explaining to folks the metrics that we're going to talk about through this. So the most common thing I think we see in the literature is either METS, metabolic equivalence, or VO2 max. And I think part of that is it's quite objective. So if anybody's had a VO2 max test, they'll understand how objective and unpleasant it is. I think we've talked about this before. So you are hooked up to an indirect calorimeter. So it's a device that provides complete occlusion around your mouth and your nose. Typically, this device also sort of plugs your nose, so you're only breathing through your mouth.