An RCT could be much smaller. An RCT is important because we get garbage results all the time in observational studies with 100 or 200k participants.
If it’s not causal, then it doesn’t help answer the question of whether any of us should try to increase our VO2max or by how much. And it seems to me that’s the real question.
If you truly want to debate then read the thread, if you just want to flex, then have fun but don’t expect me to participate.
@Dr.Bart my view having carefully read the thread is that @mattbagg is calling out two crucial points that have been [edit: should say raised] in other ways in the thread above, but have not been addressed in a convincing way by you or anyone else
For me it seems like those points are crucial
Is it my job to convince anyone here?
I posted 3 large studies from reputable sources. I provided many reasonable arguments. 143 total posts and ZERO evidence was posted to counter any of the presented evidence.
Some people become so entrenched in their position that no amount of evidence or reasoning will be ever good enough to convince them… just like anti-vaxxers or flat-earthers.
I presented my case. If you are not convinced, then so be it.
Good luck.
@Dr.Bart You can say that you don’t have answers to @mattbagg ‘s two concerns or that you don’t want to spend time on addressing them - of course either of those paths are your right
But you don’t have to be rude to him or say that he is not raising reasonable concerns
You’re still missing the point. Comparing performance groups tells you which group as a whole is better. It doesn’t tell you where the optimum fitness level is. The thought experiment should make that clear if you’d engage with it.
You could use smaller groups. The cohort is big enough. The “Healthy” group is very large and includes some pretty unfit people.
I’m amazed you think I’m trolling. I’m just pointing out what the statistics do and do not mean. You’ve asked lots of questions, and then say you’re “done with this discussion”.That makes no sense. If you’re done with it, stop posting replies.
The flaws with the study methodology is already known, it’s about reasoning under uncertainty.
I think the point was that it would be nice to have MORE groups (i.e. 10 instead of 2 or 4) so that we could get some better granularity in the curve between “High” and “Elite” groups. At what point does the curve start to level off so we can get the most “bang for our exercise buck” (in both statistical and real-world significance) without necessarily having to be “Elite”? And it’s ok to not have all the answers yet.
Interesting discussion
I think the key is to seek patterns that suggest a personal path forward. We don’t have enough information to derive eternal truths, in my opinion. These studies are very helpful but only studies of other people…not of me. So I have to interpret accordingly.
I think that higher fitness is only possible with greater health. The work to build higher fitness probably also improves my health. So it’s all good. The question then becomes one of priority: how should I spend my limited time, money and attention?
The weak link is the one that gets you. In my past my weak link was my tendency to drive too fast and do dangerous sports. Now I think it is my insufficient ability to manage my stress (ability to relax and deactivate) and get regularly good sleep. If I exercise too much too hard and too late at night, I am weakening my weak link. My weak link also reduces my ability to recover from hard exercise. So pushing on my fitness level too directly would not be a good idea right now.
The good news is I have managed to largely solve issues related to higher apoB (statin, eze, Bempedoic acid hopefully), higher HbA1c (Akkermansia, berberine), intolerable joint pain (rapa, improved diet to improve gut health), annoying brain fog (MB), BP creeping higher (improve NO production), declining muscle power (GG, switch away from statins), declining upper body muscle mass (add weight lifting to cycling), BPH (tadalafil), and receding hair line (Minoxidil).
I’m very pleased.
I’m not surprised you’re pleased, that’s impressive. How do you improve NO production?
I agree. But also about which sources to use
My view is to look at as much data snd triangulate between different types of studies as possibles
Especially when we don’t have controlled human trial data or human MR data
Association studies in humans have massive risks of reverse causation and picking up the effect of other drivers that are correlated but not controlled for.
Animal and mechanistic studies provide other value while having other problems
The chain kept feeling like DrBart did not want to acknowledge the issues second type of data and issues of not having anything in the first group, and does not want value even an ounce of value from the third group.
MB is referring to…?
Think it is Methylene Blue
How do you know we don’t have human trial or MR data?
What about the intuitive aspect of VO2 Max aiding day-to-day activities? Its decline with age can be mitigated, or start from a higher point as it decreases.
Yes. Methylene Blue. Marvelous stuff. And super easy to use once you get the hang of it. @desertshores is the master of MB. I did a podcast with Dr Sherr of Troscriptions about MB that was very informative.
NO boosting via nitrate consumption and conversion to nitrites by oral bacteria is tricky but solvable. Use nitrite test strips (Berkley life or humann brand) to figure out an oral hygiene protocol that doesn’t kill your nitrite producing bugs. And then find a source of nitrates to consume every 12 hours. I eat celery every night and I take Berkleylife nitrate / nitrite supplements every morning.
Have you concluded that MB’s impact on NO is too little to be of concern? It’s something I’ve wondered about.
I’m saying that this conversation has not had it. I have not said that the world does not have it, that I don’t know.
Of course, there is a lot of intuitive/logic for higher VO2 max and I probably spend more energy and effort than 80% perhaps 90-95% of people on this forum on VO2 Max.
My objection is that is is also intuitive/logic and there is a massive wealth of mechanistic reasons why going out too far on the diminishing returns curve of maximizing VO Max to to extreme / elite vs just a good/great levels comes at a cost of a lot of things we know are good for long term health and longevity.
To get maximized/elite VO2 Max you will generally have to burn a lot more calories, will be driving higher IGF-1, higher mTOR, higher testosterone, higher wear and tear on joints, excessive inflammation, more oxidative stress, probably are eating more of the negative protein amino acids from a longevity perspective and probably also driving a compounded higher level of glucose in your blood vessels than someone who is training for high VO2 Max, but not going beyond that to get it to elite levels.
I agree that most of the population, perhaps >90% is under training for VO2 Max, but I do not think elite cyclists or runners are optimizing their longevity and end of life health more with their elite training regime than if they dialed it back to more of the level of eg what Peter Attia is doing today (they are of course likely close to maximizing their performance)
Said differently an Olympic runner is probably not improvising their longevity via exercise more than they would if they more matched the exercise levels of eg Michel Lustgarten or Bryan Johnson or as mentioned Peter Attia of 2020-2024 (not what he was doing when competing in sports).
A good question. In my interview with Dr Sherr, he said " * At <2mg/kg, MB causes the release of nitric oxide and the dilation of blood vessels so that more oxygen-rich blood flows to the area of increased glucose consumption." So, the key is low dose MB.
In case you are interested. Here is my recent interview with Ross Pelton on gut health and Dr Ohhira’s Probiotic and Postbiotic Metabolites. He says these postbiotic metabolites have been shown to increase endurance runner vo2max and lactate threshold. I haven’t tried it yet but I will.