AMA #49: Heart rate recovery, strength training, rucking, kidney function, and brain health

**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 49 I'm once again joined by Nick Stenson. In today's episode, we discuss a few different topics. We start by answering some follow-up questions we've raised around some exercise content, including questions for people who are interested in starting to rock, questions around how one may think about building muscle versus maintaining it. Should you lift before or after cardio? And finally, some questions around heart rate recovery. From there, we dive into all things related to the kidney. This is something I've spoken about before and quite recently, and we've gathered a lot of questions around what blood tests are the best to measure kidney function and what levels you would want to be at. How does this decline with age? And why is it so important for anyone who cares about lifespan to have the highest possible glomerular filtration rate and make sure that the rate of decline as we age is kept to a minimum?
We end the conversation with some follow-up topics from our latest Brain AMA, including those specifically around homocysteine and alcohol.
If you're a subscriber and want to watch the full video of this podcast, you can find it on the show notes page. If you are not a subscriber, you can watch the sneak peek of the video on our YouTube page. So without further delay, I hope you enjoy AMA number 49

**Nick Stenson** (2:03)
All right, Peter, welcome to another AMA, how you doing?

**Peter Attia** (2:06)
Doing very well.

**Nick Stenson** (2:08)
I think we're just gonna get right into it because we got a lot of good stuff to talk about today and we don't really want to run out of time. And so what we did for today's AMA is we're gonna cover a few different topics. The first of which is exercise. Now, anyone who's listened is not gonna be surprised we're talking about exercise. It's a topic we've covered before. But what we did is we really pulled questions that were follow up from a lot of previous conversations that we haven't touched on before. So these will hopefully be new exercise topics and also hopefully be really actionable for people as they think about how they should exercise, what it looks like. And so that includes questions around, a lot of people are interested in how to start rucking, what weight to do, how to know when to ratchet it up, shoes to wear, kind of the more nitty gritty. And so we're going to get into that. We'll also talk about kind of when you think about building versus maintenance in terms of strength training, how you know where to break down those two, as well as questions around, should you lift before or after cardio? What one is quote unquote better? And then we also have some questions on heart rate recovery, which is something we haven't necessarily dove too deep into. So I think it'll be good to talk about that.
From there, we're gonna get to questions around the kidney. And now the kidney is something that we haven't talked about a ton on the podcast, but have a little more recently in the podcast with Ethan Weiss, talked about it in AMA 48 on blood pressure. And so we pulled some questions from there, which hopefully will be really applicable to people in terms of what do you even know about kidneys in terms of what is a good and bad metric as it relates to a blood biomarker? Because there's typical biomarkers that people track, and I know there's ones that you track with your patients and kind of looking at the difference in those and what people should be looking at to determine kidney function, as well as also talking about how kidney function declines as we age and what we know about that. So much like muscle, you always talk about because it declines, you want to start as high as possible. So getting into what do we know about the kidney as it relates to that? So even if you're 30, 40, 50, and your kidney metrics are quote unquote good, how does that look for your age with what we know about decline?
And then we'll end with a few follow-up questions that kind of arose in topics from the brain. AMA that we're gonna dive a little deeper on, provide a little more clarification on as it relates to alcohol homocysteine.