Exercise, VO2 max, and longevity | Mike Joyner, M.D.

**Peter Attia** (0:11)
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Now, without further delay, here's today's episode.
I guess this week is Mike Joyner. Now, Mike's someone I've wanted to have on this podcast for quite some time, and I even, I think I mentioned it in the podcast.
Mike's someone whose research I've been reading personally for probably over 20 years. He's a physician researcher. He is a professor and vice chair for research in the department of anesthesia and perioperative care at the Mayo Clinic. He's co-authored over 250 journal articles, and he's written numerous pieces all over the place, including in magazines that maybe some of you have read in Outside and Sports Illustrated. He also has his own website titled Human Limits, which as the name suggests, speaks to Mike's interest, which is really around the limits of human physiology. Now, his research background is in studying how the nervous system regulates vascular systems and blood flow, how age and sex disease states affect physiology and understanding basically the limits of human physiology. By studying elite athletes. In this episode, we talk mostly about exercise, and within that, we talk about how exercise helps us live longer, the importance of exercise as we age, and how exercise compares to nutrition in terms of the impact it can have in health. We talk about the impact of the autonomic nervous system, blood pressure, heart rate, heart rate variability, heart rate recovery, and maximum heart rate. From there, we talk about VO2 max, we discuss how it's measured, we talk about what leads to the decline in VO2 max as we age.
We spend some time talking about the J-curve as it pertains to over-exercising, is it possible, what are the dangers of too much exercise? We speak about how one should partition their time between training at high intensity and low intensity. And we talk about a few other things like performance enhancing drugs in sports, and if there's ever gonna be a drug that mimics the benefits of exercise. So without further delay, please enjoy my conversation with Mike Joyner.

**Mike Joyner** (2:30)
Hey!

**Peter Attia** (2:31)
It is such a pleasure to be, at least virtually, sitting here with you today. As I was kind of alluding to a moment ago, if I were to sort of look at all the people I've had on this podcast so far, and kind of ask the question, when was the first time I became familiar with their body of work?
You would be pretty far up there in terms of duration. So growing up, endurance sports were always something that meant the world to me. And once I even made that decision to go to medical school, a big part of it at least was understanding physiology better. And so it's been 25 or 30 years that I've been reading your studies.
In some ways, it's a long time coming to finally be sitting down with you and hope to meet you in person one day.

**Mike Joyner** (3:11)
Peter, thanks much. And it's great to be able to chance to visit with you today. Thank you for inviting me. And I'm glad somebody's been paying attention to what I've been doing for the last 25 or 30 years. So it's very validating. Thank you.

**Peter Attia** (3:22)
Let's talk a little bit about your background. You're a physician by training. I believe you're an anesthesiologist, correct?

**Mike Joyner** (3:28)
Correct.

**Peter Attia** (3:28)
You decided in medical school, you wanted to do anesthesia.
You've always had a lifelong interest in exercise and exercise physiology. Did you just view anesthesia as the most logical conduit to better understand human physiology?

**Mike Joyner** (3:41)
Peter, before I went to medical school, I actually volunteered to be a subject in a study on the lactate threshold or anaerobic threshold when I was 19 at the University of Arizona. And luckily there were excellent physiologists there, but a couple of younger physicians came over from the med school.
And it became clear to me when I was 19 or 20 that if I wanted to have a career as a research physiologist doing invasive studies, in other words, putting catheters in people and humans, might be wise to go to medical school. So this was always sort of my vision starting by age 20 or 21 And then what happened is I was thinking of going to cardiology or pulmonary medicine, and I was working at the Tucson VA at one time doing a surgery rotation, and I saw what they did in anesthesia, which is a lot like an exercise test. You're measuring people's breathing, you're measuring their blood pressure, their heart rate, and you're giving them drugs that affect their autonomic nervous system, and I've certainly done a lot of that. So I saw it as the flip side of the same coin.