Exercise for aging people: where to begin, and how to minimize risk while maximizing potential | Peter Attia, M.D.

Peter Attia

Jun 24, 2024

Episode description

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In this special episode, Peter addresses the common questions about starting or returning to an exercise routine over the age of 50. Individuals in this age group have frequently reached out with questions about whether it's too late to start exercising and often express concern over a lack of prior training, a fear of injury, or uncertainty about where to begin. Peter delves into the importance of fitness for older adults, examining all four pillars of exercise, and provides practical advice on how to start exercising safely, minimize injury risk, and maximize potential benefits. Although this conversation focuses on people in the “older” age category, it also applies to anyone of any age who is deconditioned and looking to ease into regular exercise.

We discuss:

  • Key points about starting exercise as an older adult [2:45];

  • Why it’s never too late to begin exercising and incorporating the four pillars of exercise [5:45];

  • The gradual, then sharp, decline in muscle mass and activity level that occur with age [10:00];

  • The decline of VO2 max that occurs with age [15:30];

  • Starting a training program: exercise variability, movement quality, realistic goals, and more [18:30];

  • Improving aerobic capacity: the malleability of the system, the importance of consistency, and setting long-term fitness goals [25:15];

  • Starting cardio training: base building, starting with low volume, and zone 2 training [30:45];

  • The critical role of VO2 max in longevity [36:45];

  • How to introduce VO2 max training to older or deconditioned individuals [46:15];

  • Options for performing zone 2 and VO2 max training [53:45];

  • The ability to make gains in strength and muscle mass as we age [57:00];

  • How to implement strength training for older individuals [1:01:00];

  • Advice for avoiding injury when strength training [1:07:30];

  • Risk of falls: the devastating consequences and the factors that increase fall risk [1:12:15];

  • Mitigating fall risk: the importance of foot and lower leg strength, ankle mobility, and balance [1:19:45];

  • Improving bone mineral density through

Episode description

View the Show Notes Page for This Episode

Become a Member to Receive Exclusive Content

Sign Up to Receive Peter’s Weekly Newsletter

In this special episode, Peter addresses the common questions about starting or returning to an exercise routine over the age of 50. Individuals in this age group have frequently reached out with questions about whether it's too late to start exercising and often express concern over a lack of prior training, a fear of injury, or uncertainty about where to begin. Peter delves into the importance of fitness for older adults, examining all four pillars of exercise, and provides practical advice on how to start exercising safely, minimize injury risk, and maximize potential benefits. Although this conversation focuses on people in the “older” age category, it also applies to anyone of any age who is deconditioned and looking to ease into regular exercise.

We discuss:

  • Key points about starting exercise as an older adult [2:45];

  • Why it’s never too late to begin exercising and incorporating the four pillars of exercise [5:45];

  • The gradual, then sharp, decline in muscle mass and activity level that occur with age [10:00];

  • The decline of VO2 max that occurs with age [15:30];

  • Starting a training program: exercise variability, movement quality, realistic goals, and more [18:30];

  • Improving aerobic capacity: the malleability of the system, the importance of consistency, and setting long-term fitness goals [25:15];

  • Starting cardio training: base building, starting with low volume, and zone 2 training [30:45];

  • The critical role of VO2 max in longevity [36:45];

  • How to introduce VO2 max training to older or deconditioned individuals [46:15];

  • Options for performing zone 2 and VO2 max training [53:45];

  • The ability to make gains in strength and muscle mass as we age [57:00];

  • How to implement strength training for older individuals [1:01:00];

  • Advice for avoiding injury when strength training [1:07:30];

  • Risk of falls: the devastating consequences and the factors that increase fall risk [1:12:15];

  • Mitigating fall risk: the importance of foot and lower leg strength, ankle mobility, and balance [1:19:45];

  • Improving bone mineral density through

Mindsip insights from this episode:

Start exercising now to avoid intense catch-up later

It's never too late to start exercising, but the longer you wait, the more intensely you'll have to work to catch up, similar to saving for retirement.

Cultivate enjoyment in exercise to foster long-term commitment

The most important goal when starting exercise later in life is to look back in three months and feel that your appetite to exercise has grown.

Train to boost VO2 max at any age

A study showed that people averaging 80 years old improved their VO2 max by the same percentage as 24-year-olds over a six-week training program, though they lose the gains much faster.

Improve fitness to reduce mortality risk like quitting smoking

Having a below-average VO2 max for your age carries the same 41% increased risk of all-cause mortality as being a smoker.

Reduce workout intensity to prevent injury with age

To avoid injury and stay in the game long-term, you should progressively reduce the absolute intensity and pain level of your VO2 max workouts as you get older.

Begin strength training with machines for safety and stability

For older individuals starting strength training alone, it is safest to begin with machines to build strength and stability before progressing to free weights.

Engage in heavy lifting to reverse bone loss

The 'Lift More Trial' showed that postmenopausal women with low bone mass who did heavy resistance training increased their lumbar spine bone density by almost 3% in eight months.

Strengthen toe muscles to reduce fall risk in seniors

Toe strength is a major predictor of falling in people over 65, and your great toe should be able to push down with at least 10% of your body weight.

Prevent muscle loss by addressing setbacks early

At the individual level, muscle loss with age is not a smooth decline but a series of large, discrete drops caused by minor setbacks that become permanent.

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