Is VO2 Max Enough? Why Mitochondrial Function Matters for Longevity | Inigo San Milan | Be Well Moments

Watch the FULL podcast here: https://youtu.be/7kfykswH6Io

This clip explores why VO2 max, despite being a long-standing marker of fitness, does not capture the full picture of our metabolic and longevity potential. We take a closer look at how oxygen is actually used at the cellular level and why mitochondrial function is emerging as the next frontier in understanding performance and healthy ageing.

The discussion moves into how mitochondrial health can be assessed in a practical, non-invasive way, including the use of gas exchange measures and lactate as proxies for cellular efficiency.

***

This episode is sponsored by:

NOWATCH: Health tracking reimaginedKnow your body, trust yourself.

15% off with code LWBW15 at nowatch.com

***

Sign up to Sarah’s Compassionate Cure newsletter:

Science Simplified, Health Humanised. Join thousands in exploring actionable insights that prioritise compassion, clarity, and real-life impact.

https://sarahmacklin.substack.com/

***

Let’s be friends!

📷 Instagram: / sarahannmacklin

📹 Subscribe: / @livewellbewellsarah

🐦 Twitter: / sarahannmacklin

📱 TikTok: / sarahannnutrition

💌 Newsletter: https://sarahmacklin.substack.com/

Episode Transcript

(00:00):
Welcome to Live Well Be Well, a show to help high performers
improve their health and well-being.
VO2 Max because it's a big buzzword, especially in the
last, I would say three to five years.
It's become at the forefront of many health conversations.

(00:20):
It's become the gold standard offitness, the number one metric
that every athlete wants to improve.
But you've said that VAT Max really only scratches the
surface. So why doesn't it tell us the
full story? We've been knowing about VA 2
Max for for decades and we've been using it for for decades
with especially with athletes. It dates back more than 100

(00:42):
years at least since we have more standard ways to measure
it. And it's been always linked to
fitness, to performance, therefore to health.
And now in the in, in the times of longevity, right?
It's, it's, it's one more parameter that is plugged in
longevity, right? And it's a great measurement.

(01:04):
However, it doesn't tell the whole story.
There's more than that VO2 Max, it's a representative of the
central cardiorespiratory adaptations, right?
But there's more because ultimately that oxygen is
utilized by the cells and it's utilized by the cells in
mitochondria as well as fuels. And this is where the area of

(01:28):
Physiology in general has evolved from VO2 Max to what
happens at the cellular level. And in the same manner that
we've been using, you know, withathletes VO2 Max for decades,
right? And now it's mainstream.
We have already passed that time.
We, we, we work now at the cellular level.

(01:51):
And this is what I see. They are mainstream mainly in
the area of longevity getting into, in fact, already people
are talking about mitochondrial function, metabolic health,
right? And this is the next level.
And this is what we've been working with athletes for
performance, you need to produceATP energy and that's produced

(02:12):
in mitochondria. And for health, if mitochondria
don't work, that hell, that celland that organ is not going to
function very well because it doesn't produce IITP well enough
for longevity. As we age, our cells age, our
mitochondria age and our energy production overall ages as well

(02:36):
and decreases and that resides in mitacondria.
Therefore is that mitacondral function and health is the next
level. OK.
So this is kind of like the nextstage of where we're exploring
now with, I would say, I mean, longevity is a buzzword, but
mitochondrial health, I think many people will have known from
GCSE biology and then forgotten about it.

(02:58):
But the way that I always think about it is a powerhouse of the
cells. But how can one actually measure
their mitochondrial health? Because the VA 2 Max is, yes, a
bit easier to attain and to get to.
But mitochondrial health, how dowe even measure that?
Well, we can do it through a muscle biopsy and get a chunk of

(03:19):
muscle and look under the microscope or do a bunch of
things to to that. And and but it's.
I don't think it's. It's a very convenient way to.
Do. Because you will have a chunk of
like a big scar and you know, but that.
Sounds quite painful. Yeah, I don't think you want
that. But the other way, I, I, I
developed a methodology years ago and I've been using it with,

(03:41):
with athletes for, for a long time, where we, we, we have two
proxies for that. On one hand, with the same
device that you measure via 2 Max, which it's, you know, like
in a colloquial form, we call them metabolic cards.
They've been used, always use metabolic cards.

(04:02):
We can look at gas exchange, right?
And so when we look at gas exchange, we look indirectly
through some complicated equations, we can see how much
fat and carbohydrates you're burning in grams per minute.
We can see that. Now when it comes to fat, we
know that fat can only be burnedin mitochondria, OK.

(04:26):
So by looking at fat, by measuring fat oxidation is
called fat burning, we can indirectly have a proxy for
mitochondrial function. Then lactate can only be burned
in mitochondria, right? So by by pricking your finger or
your earlobe and getting a smallsample of lactate and measuring

(04:47):
it, we can have an idea of how well your your cells are
processing glucose and which under resting conditions, it
happens in mitochondria. But the fact is that if you have
higher lactate blood lactate levels, it's a sign that your
mitochondria are not processing that lactate or clearing it or

(05:09):
recycling it properly. Therefore, with the two
parameters fat utilization and lactate, you can indirectly see
or or measure mitochondria function.
We published that study a few years ago and now we have, I've
already published A preprint about an extension of that study
where we look at muscle biopsiesand in the muscle biopsies we we

(05:31):
look directly how they work and we correlate them with this
methodology. So it's quite robust to do it in
a non invasive way and an ambulatory manner where a lot of
people can do it out there. Thanks so much for listening to
hear the full episode. There's a link in the
description.