Deep dive back into Zone 2 | Iñigo San-Millán, Ph.D. (Pt. 2)

**Peter Attia** (0:11)
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Now, without further delay, here's today's episode.
My guest this week is Iñigo San Millán. Iñigo was a previous guest on the drive back in December of 2019 That episode was incredibly popular. We not only re-broadcasted it, but we reached out to many of you for follow-up questions and that of course proceeded this episode. So we talked about a lot of stuff here. We begin the conversation around Iñigo's work with Tour de France winner, two-time winner now, Tadej Pogačar, looking at the type of training that he does and getting a sense of really what the best of the best in the world are capable of. And then of course now we can use that to sort of benchmark ourselves. We speak specifically about lactate levels, fat oxidation, the relationship between watts and lactate, how carbohydrates in food can affect our lactate. And then we talk about how equal lactate outputs between an athlete and a metabolically unhealthy individual can mean different things and how to interpret that. We get into very specifics around zone two exercise, including many of the questions that people had around what metrics to use to know if you're in zone two, if you're not using a lactate meter, how to structure an ideal zone two training program with regards to duration, timing, frequency, the importance of compounding the rate of improvement that can happen with zone two training. We talk a lot about VO2 max and high intensity training, where that fits in with overall zone two training and how exercise can have such a large impact on longevity.
We speak about metformin and its potential impact on the mitochondria, as well as NAD, and claims that it can boost mitochondrial health.
We end by discussing healthy versus non-healthy mitochondria, and we speak about Iñigo's study on long COVID patients, which revealed effects on the mitochondria that were reminiscent of type two diabetes. As a brief reminder of his background, Iñigo is an assistant professor at the University of Colorado School of Medicine, where his area of research and clinical work focus on metabolism, nutrition, sports performance, overtraining, diabetes, cancer, and critical care. He's also an internationally renowned applied physiologist having worked for the past 20 years with many professional athletes and teams around the world, including, as I mentioned, the two times Tour de France winner, Tadej Pogačar. So without further delay, please enjoy my conversation with Iñigo San Millán.
Iñigo San Millán Iñigo, it is so great to be sitting down with you again. Last time, of course, we did this in person, but these days I've become too lazy to travel around and do podcasts in person. So do it by video. But that said, I really hope you can get out here to Austin so we can train together and do some cool ex-Fizz. And also I need to get out there to sort of do some of the ex-Fizz stuff we've talked about. But I almost don't know where to begin because there's so much stuff we talked about last time that we want to double click on this time. There's so much that has changed in the interval from when we spoke, gosh, probably two years ago, a little over two years ago. I thought one place we could pick it up, something we didn't really talk about last time, was your work with Tadej Pogačar. Because of course, I don't think anybody knew who he was two and a half years ago. And of course now he is, I don't know, I mean, I think it's safe to say he has the potential to potentially go down as the greatest Tour de France cyclist of all time, given how young he is, not to put that expectation out there, but to win the tour at such a young age, to not just win the yellow jersey, but the white jersey, polka dot jersey, repeatedly. He looks like something of a different species almost.
And I say that not in the way that people typically say those things of cyclists in a way that's suspicious of anything. So for the listeners who are not familiar with the Tour de France, not familiar with your work with the UAE team and your work with Tadej Pogačar, maybe give folks a little bit of an update as to what you've been doing in professional cycling over the past couple of years.