本期节目邀请了国际知名应用生理学家Iñigo San-Millán，他分享了对环法冠军Tadej Pogačar的代谢研究成果，揭示了精英运动员在运动表现和代谢方面的惊人潜力。他探讨了乳酸水平、脂肪氧化、碳水化合物对乳酸的影响，以及运动员和代谢不健康个体之间乳酸输出的差异。此外，还深入分析了Zone 2训练如何提升线粒体功能，以及如何通过Zone 2训练和高强度训练优化健康，并探讨了二甲双胍、NAD等物质对线粒体健康的影响。最后，还分享了对ICU中新冠肺炎长期患者线粒体的研究成果。

🚴‍♀️ **精英运动员的代谢优势：** 环法冠军Tadej Pogačar的案例表明，精英运动员拥有非凡的代谢能力，能够高效利用能量，在高强度运动中保持稳定表现。Iñigo San-Millán深入分析了Pogačar的乳酸水平、脂肪氧化、碳水化合物摄入等指标，揭示了其独特的代谢特征。例如，Pogačar在高强度骑行中，乳酸水平相对较低，脂肪氧化效率很高，这与他的训练策略和遗传因素密切相关。

💪 **Zone 2训练的益处：** Zone 2训练是指中等强度的有氧运动，可以有效提升线粒体功能，促进脂肪氧化，提高代谢灵活性。Iñigo San-Millán解释了Zone 2训练的原理，并提出了针对不同人群的训练建议，包括训练强度、频率、持续时间和类型等。此外，他还强调了Zone 2训练对提高心血管健康、降低患慢性疾病风险、延缓衰老等方面的积极作用。

🧬 **线粒体健康与疾病：** 线粒体是细胞的能量工厂，其功能与人体健康息息相关。Iñigo San-Millán探讨了线粒体健康与疾病的关系，包括二甲双胍、NAD等物质对线粒体功能的影响，以及线粒体功能障碍与癌症、糖尿病、新冠肺炎等疾病的联系。他还分享了对ICU中新冠肺炎长期患者线粒体的研究成果，揭示了新冠肺炎对患者代谢的影响，为治疗和康复提供参考。

📈 **代谢指标的应用：** Iñigo San-Millán认为，除了传统的心肺功能指标外，代谢指标可以更有效地评估个体健康状况，制定个性化的运动处方。他介绍了多种代谢指标，例如乳酸阈值、脂肪氧化率、葡萄糖利用率等，并阐述了这些指标在运动训练、疾病预防、健康管理等方面的应用价值。

🧪 **未来展望：** Iñigo San-Millán认为，代谢研究将为我们带来更多关于人体健康和疾病的深刻理解，并为个性化医疗和健康管理提供更精准的指导。他强调了代谢组学等新技术在代谢研究中的重要作用，并展望了未来代谢研究的发展方向。

💊 **补充说明：** 本期节目中，Iñigo San-Millán还探讨了酮类饮食、谷氨酰胺、葡萄糖转运蛋白等与代谢相关的议题，为听众提供了更全面的代谢知识。

🧠 **思考：** 如何利用代谢知识改善自身健康？如何通过科学的训练方法提升运动表现？

View the Show Notes Page for This Episode

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Iñigo San-Millán is an internationally renowned applied physiologist and a previous guest on The Drive. His research and clinical work focuses on exercise-related metabolism, metabolic health, diabetes, cancer metabolism, nutrition, sports performance, and critical care. In this episode, Iñigo describes how his work with Tour de France winner Tadej Pogačar has provided insights into the amazing potential of elite athletes from a performance and metabolic perspective. He speaks specifically about lactate levels, fat oxidation, how carbohydrates in food can affect our lactate and how equal lactate outputs between an athlete and a metabolically unhealthy individual can mean different things. Next, he discusses how Zone 2 training boosts mitochondrial function and impacts longevity. He explains the different metrics for assessing one’s Zone 2 threshold and describes the optimal dose, frequency, duration, and type of exercise for Zone 2. Additionally, he offers his thoughts on how to incorporate high intensity training (Zone 5) to optimize health, as well as the potential of metformin and NAD to boost mitochondrial health. Finally, he discusses insights he’s gathered from studying the mitochondria of long COVID patients in the ICU.

We discuss:

The amazing potential of cyclist Tadej Pogačar [2:00]; Metrics for assessing athletic performance in cyclists and how that impacts race strategy [7:30]; The impact of performance-enhancing drugs and the potential for transparency into athletes’ data during competition [16:15]; Tadej Pogačar’s race strategy and mindset at the Tour de France [23:15]; Defining Zone 2, fat oxidation, and how they are measured [26:00]; Using fat and carbohydrate utilization to calculate the mitochondrial function and metabolic flexibility [35:00]; Lactate levels and fat oxidation as it relates to Zone 2 exercise [39:15]; How moderately active individuals should train to improve metabolic function and maximize mitochondrial performance [51:00]; Bioenergetics of the cell and what is different in elite athletes [56:30]; How the level of carbohydrate in the diet and ketogenic diets affects fuel utilization and power output during exercise [1:07:45]; Glutamine as a source for making glycogen—insights from studying the altered metabolism of ICU patients [1:14:15]; How exercise mobilizes glucose transporters—an important factor in diabetic patients [1:20:15]; Metrics for finding Zone 2 threshold—lactate, heart rate, and more [1:24:00]; Optimal Zone 2 training: dose, frequency, duration, and type of exercise [1:40:30]; How to incorporate high intensity training (Zone 5) to increase VO2 max and optimize fitness [1:50:30]; Compounding benefits of Zone 2 exercise and how we can improve metabolic health into old age [2:01:00]; The effects of metformin, NAD, and supplements on mitochondrial function [2:04:30]; The role of lactate and exercise in cancer [2:12:45]; How assessing metabolic parameters in long COVID patients provides insights into this disease [2:18:30]; The advantages of using cellular surrogates of metabolism instead of VO2 max for prescribing exercise [2:25:00]; Metabolomics reveals how cellular metabolism is altered in sedentary individuals [2:33:00]; Cellular changes in the metabolism of people with diabetes and metabolic syndrome [2:38:30]; and More.

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