Dr. Peter Attia: DEXA and VO2 Max

October 01, 2024

“Everyone should get a DEXA Scan.”
Dr. Peter Attia

Dr. Peter Attia has gained prominence over the last few years through his work in longevity science, metabolic health, and the optimization of human performance. He’s the author of #1 New York Times Bestseller Outlive. Dr. Attia focuses on using applied science of longevity to help his patients live longer and better lives.

Peter Attia covers the importance of DEXA scans and VO2 Max in his book, blog, and podcasts. In this article, we will look at Peter Attia’s work more closely, especially when it comes to using the DEXA scan and the VO2 Max to assess and improve longevity and healthspan.

Who is Peter Attia?

Peter Attia is a medical doctor and researcher known for his work in the fields of longevity, nutrition, and human optimization. He has a medical degree from Stanford University and completed his residency in general surgery at the Johns Hopkins Hospital.

Attia’s work explores evidence-based approaches to diet, exercise, and lifestyle choices to promote health and longevity. Attia focuses on the intersection of metabolic health and chronic diseases like obesity, diabetes, and cardiovascular disease.

Peter Attia’s practice, Early Medical, deals extensively with nutritional interventions, exercise physiology, sleep physiology, emotional and mental health, and pharmacology to increase lifespan (delay the onset of chronic disease), while simultaneously improving healthspan (quality of life).

Peter is also the host of The Peter Attia Drive podcast, a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking, among other things. Topics include fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more.

Attia is the author of the #1 New York Times Bestseller, Outlive: The Science and Art of Longevity. You may have seen a promotion or an email about receiving the book from Fitnescity. If not, keep an eye for those emails!

Outlive is a must-read for anyone interested in taking control of their health and longevity. At Fitnescity, we believe that it is one of the most impactful books in health and wellness.

Today, Dr. Peter Attia is known for his unique take on healthcare. Instead of just looking at disease symptoms, Dr. Attia prefers to focus on longevity - reducing the risk of chronic disease onset and making sure you’re able to experience improved quality of life. And he does so by focusing on a more comprehensive set of systems, rather than reactively relying on medication.

Dr. Peter Attia’s Thoughts on VO2 Max

What the Research Says

One thing that Dr. Peter Attia has talked about a lot, especially when touching on subjects related to longevity, is VO2 Max. He has states on multiple occasions that a person’s VO2 Max plays an important role in predicting longevity. It’s a measurement that he uses not only for longevity, but also as an indicator of overall health - even though the major focus of VO2 Max has long been to help athletes determine their cardiovascular capacity.

In one episode of his podcast, Dr. Peter Attia goes over a 2018 clinical study on VO2 Max: Attia looked closely at the research and the results that the study was able to obtain, and then broke things down to give his followers a better understanding of why VO2 Max is so important. On a side note, this is one of the reasons why Attia has gathered a massive following. Attia’s followers appreciate the fact that he does not just instruct his listeners or patients to implement a specific element in their lives, but instead, he always makes sure that the scientific evidence is made available and clear to everyone.

When covering the study, Attia showed that there’s a significant difference in longevity when comparing people with different VO2 Max ratings. The 10-year survival probability was lowest for those in the bottom group of VO2 Max levels. Elite and high VO2 Max levels had the highest survival rate. He also emphasized the fact that there’s a big jump in survival rate from low to below average - which means even some exercise could be good for increasing longevity. Dr. Attia goes beyond just explaining the important role of VO2 Max. Through his years of applied science in longevity, he’s learned the methods that best improve a person’s VO2 Max, which he shares with his followers.

In the 201st episode of this podcast, Dr. Attia speaks with Inigo San-Millan, an internationally renowned applied physiologist, and they further explore the potential of VO2 Max as a health marker and measurement. In the episode, Dr. Attia focuses on the fact that VO2 Max is an excellent marker for fitness, but also something that people can use to help optimize their fitness level.

Increasing VO2 Max: Peter’s 4 Pillars of Exercise

When it comes to increasing VO2 Max, Dr. Attia has a strategy that he calls “Peter’s 4 Pillars of Exercise.” The four pillars that Peter describes include stability, strength, low-end aerobics, and high-end aerobics.

During the episode, Dr. Attia also talks about the formula that he uses with his patients - and we can learn some valuable lessons here. Because he has been doing significant research and even competed professionally in his younger years, the advice that he gives here is also far from being merely theoretical.

The formula he shares is a form of high-intensity interval training, where the subject completes four minutes of exercise, then rests for four minutes. They then do this up to six times. He also suggests a warm-up and a cool-down.

Aerobic Capacity vs. Aerobic Efficiency

In an earlier episode, number 151, Dr. Attia talks to Ale Hutchinson about a case study. This case study followed the progress of Oskar Svensson. And what’s surprising here is that these two medical professionals actually confirm that it’s not just about getting your VO2 Max as high as possible.

A lot of athletes push on the fact that they want to get their VO2 Max high. And yes, this is something that’s been researched and proven in studies. Even Dr. Attia has talked about the fact that higher VO2 Max levels are associated with better longevity.

However, when you only focus on VO2 Max, you’re leaving other things on the table that should also be considered when it comes to fitness, performance, and health.

As Dr. Attia explains in this episode of his podcast, VO2 Max is a powerful measurement, but it’s important to also consider things like PvO2 - also known as Power at a given VO2. And this is when the two medical experts begin to talk about the differences between VO2 Max and VO2 efficiency.

Having a high VO2 Max doesn’t necessarily mean your body is using oxygen efficiently. Yes, your body is drawing in more oxygen from the air you breathe in, but efficiency is the thing that determines how well your body actually pushes all of that oxygen to the muscles that you work.

The case of Oskar Svensson is actually a perfect example of this. According to Dr. Attia, this person was able to achieve a record-high VO2 Max by the age of 18 - in fact, he broke records. When his recorded VO2 Max was 96.7 ml/min/kg, fitness experts suspected the machine was not properly calibrated. However, the accuracy of the test was later confirmed and published in an official research paper.

Yet, while Oskar became a professional cyclist by the age of 20, joining the team known as Joker, he retired from his career at 23. His VO2 Max came back down and eventually reached 77. His performance wasn’t improving, but rather deteriorating.

According to Dr. Attia and Ale Hutchinson, one of the biggest reasons for this is the fact that the focus was just placed on the fact that Oskar had a record-breaking VO2 Max. They never considered his aerobic efficiency, but only his capacity.

Why everyone should get a DEXA Scan, according to Peter Attia

Dr. Peter Attia’s work covers many aspects of longevity. While Attia places a large focus on VO2 Max, he also talks a lot about the role that DEXA scans play in getting a comprehensive overview of a person’s health.

“Everyone Should Get a DEXA Scan”

Peter Attia

In episode 227 of his podcast, Dr. Attia talks about body composition, and why DEXA is a critical measurement tool.

While DEXA scans are traditionally used to help obtain more details about a person’s bone density, they also reveal other information. As Dr. Attia mentions, this includes visceral fat, how much lean mass and fat mass a person has, bone mineral density, Appendicular Lean Mass Index (ALMI), and much more. With this type of data, you get a much better view of your health and the progress of your training program compared to simply looking at BMI.

For years, we’ve relied on BMI as a tool to determine who is at a healthy weight and who is obese. However, BMI doesn’t account for fat-free mass and fat mass. With a DEXA scan, it’s now possible to get more comprehensive data on the human body - and this data can be used to create interventions, like training programs and diet plans, that target a person’s unique needs.

Conclusion

Dr. Peter Attia, a world-renowned leader in the field of longevity, believes that VO2 Max should be considered a critical metric of cardiovascular health and fitness. He also firmly supports the use of DEXA scans to help people understand their health risks more effectively. These tools can be used together to give you a strong baseline, as well as help you track progress over time.

Find and schedule your DEXA Scan and VO2 Max through Fitnescity. Receive physician services (physician order and review of your results), detailed insights on your Fitnescity personal dashboard, and much more.