in this episode, we discuss: 0:00:12 - Our historical understanding of lactate and muscle metabolism: early misconceptions and key discoveries 0:15:02 - Fundamentals of metabolism: how glucose is metabolized to produce ATP and fuel our bodies 0:23:49 - The critical role of lactate in energy production within muscles 0:31:30 - Lactate as a preferred fuel during high-energy demands: impact on fat oxidation, implications for type 2 diabetes, and more 0:45:55 - How the infusion of lactate could aid recovery from traumatic brain injuries (TBI) 0:53:51 - The effects of exercise-induced lactate 0:56:35 - Metabolic differences between highly-trained athletes and insulin-resistant individuals 1:04:21 - How training enhances lactate utilization and facilitates lactate shuttling between fast-twitch and slow-twitch muscle fibers 1:12:44 - The growing recognition of lactate and monocarboxylate transporters (MCT) 1:16:21 - The intricate pathways of lactate metabolism: isotope tracer studies, how exceptional athletes are able to utilize more lactate, and more 1:33:40 - The role of lactate in cancer 1:41:24 - The role of lactate in the pathophysiology of various diseases, and how exercise could mitigate lactate's carcinogenic effects and support brain health 1:50:15 - George’s current research interests involving lactate 2:06:41 - Questions that remain about lactate: role in gene expression, therapeutic potential, difference between endogenous and exogenous lactate, and more
Peter … this was incredible. Also I believe it to be an enormous credit to yourself, that Dr. Brookes not only enjoyed the conversation, because you were smart enough to have it, but I believe you absolutely gave him new thoughts and avenues to go down. It’s very refreshing to see a master in his class STILL GOING STRONG! I believe he’s no more or less passionate about his craft, than you are at yours. I bet you guys could have talked for weeks. Terrific job. I’m not college educated, but like many, in recent years have studied health, fitness, and biology. I don’t even know how to categorize the different areas of the body regarding the metabolic process. BUT I STILL UNDERSTOOD almost every part of this video! Incredible stuff. Cheers
Mind-blowing discussion! Biggest wtf moment was when George said "we've been teaching glycolysis wrong for a hundred years" 🤯 *destroys year 1 medical physiology*
The energy does not come from breaking the bonds. It actually takes a little energy to break the bonds (activation energy). But you get the energy when you create new bonds with a more "aggressive" partner such as oxygen. So it is in the creation of CO2 and H2O that we get our energy when oxidizing organic materials.
I have Mitocondrial dysfunction. I can do whatever i want for 90 seconds but then I have to rest flat on my back for multiple hours until I can build up ATP again. I found if I push myself at just that point I will collapse at the 20 minute mark. Then rest for 24 hours my ability increased about 1% 2-3 times a year. After 3 years I was just maintaining that improvement. My guess was if my mitochondria sat in just the right amount of lactic acid they would be encouraged to replicate. But since lactic acid isn’t really a thing I wonder if lactate stimulating the mitochondria encouraged them to replicate. Of course this is all guessing. Trying to give my self a reason to continue exercising. After 2 decades it turns out my total muscle mass is the reason to continue exercising even though I loose 2 days when I do it. I started Rapamycin 3 years ago. It has given me the most improvement. I now only talk 12 hours to recover after 20 minutes of exercise
@vSwampFox I have been dealing with this for 2 decades, so yes I have thought about it. But it actually scares me a little bit. So I would want to do it under nurse supervision. And I have never researched it enough so I would know where to get that support.
@@ecospider5 well considering autophagy is the body’s rejuvenating mechanism for mitochondria … it could be the key to unlock your body’s ability to correct itself. Having dealt with this for 20 years as you’ve said, I’m genuinely shocked fasting/autophagy = mitochondria/regeneration … has never entered the discussion for you. Genuinely… shocked
I am not a Doctor. I find this conversation with Dr. Brooks fascinating. The body and body processes have so many ways to do the same thing. This is a great interview. Good for your Dr. Attia for getting the conversation toward quantity levels of important molecules muscle intake and exhaust for everyday athlete versus the born athlete.
haven't seen peter this academically engaged in a while. would recommend breaking out your molecular biology of human phyisiology textbooks. peter (tries) sometimes to explain the experiments and observations discussed herein, but....yeah.
@34:00 for PETER - for each glucose you burn you free up some water - 1 part glucose to 3 parts water if I remember correctly. I think this is one of the reasons. At the beginning of what may be a long term activity, it may be very helpful go get a small drink of water (and lose the weight of hydration) for what may turn out to be a long effort which may drain water. Nobody who's interviewed George (if I remember correctly) asked the question I thought someone MUST ask - what happened to the electrolyte drinks in the mid-90s up to I think mid-aughts that had lactate as a major ingredient. Did they not work? not effective at inducing a training adaptation? or cyclists & runners just weren't convinced?
Terrific comment! But why small drinking water right before? I find that if I mind my hydration well, I’ll lose 2.5-4 lbs of water weight from a 5k. Could also be this Louisiana Heat. But that’s been pretty consistent.
So has anyone thought about lactate as a way for the body to help regulate ph because if I understood correctly it is slightly alkaline taking ph from 7.38 to 7.4 this would also explain why lactate is high when people are acidotic and it could possibly be a preferred energy source in those situations
At just after 50 minutes they talk about adding lactate and the limits on it. I suspect adding exogenous lactate to the normal process could cause additional problems as your body moderates the amount closely. You could exercise harder to add it naturally and that might do what you want. Breathing exercises also help the pH level in the body based on the speed at which you remove or retain co2.
This was a very interesting episode, thank you. Anecdotally I was feel like I'm the best version of myself if I keep a bit of intensity in my training, even when I don't have much time to exercise. No need for HIIT, but a fast running mile or even just a really brisk walk, does wonders to keep my mind in a good space.
Excellent discussion. I work in ED so see sepsis, stokes and MI frequently. Changing the management protocols will take time. As a side note Prof Rinaldo Bellomo is an Intensivist at the Austin Hospital in Melbourne. He was also my supervisor. He does a lot of very interesting work in renal physiology amongst other things.
Fascinating! Really humbling how little we still know about very basic substrate metabolism and interplay between organs. Definitely agree this kind of basic science should get *way* more money (maybe less towards a slew of new synthetic compounds with terrible and unknown side effects).
It’s surprising that even the people working with lactate ignore the fact that lactate is a signalling molecule, that there is a receptor (HCAR1) expressed in the brain and it modulates neuronal activities
Did I understand correctly that the fat burning from exercise comes afterwards, in recovery? They stated that somewhere around 1:45 hrs in the interview
At about 33 minutes, he states lactate blocks fatty acid metabolism. I don't think that necessarily means fatty acid burning wouldn't take place during exercise or we would have marathoners dropping dead left and right. If you did intensive resistance training I suspect when under load this would happen. During cooldown the fatty acid would flood in as soon as the stored glycogen is mostly used and the blood glucose drops to a certain level.
Thanks and interesting! BUT? How do you explain the increase in fat oxidation 0,1 g/min to 1,2 g/min 180 min in ultrarunners low carb diet at 65% VO2max running pace. Volek 2015. Roughly 75% of total amount of kCal glycogen in the body in 180 min.
Highly trained individuals can exercise at relatively high lvls and still keep lactate reasonable. They don't reach the treshold where the body would trigger the fight/flight/sympatetic response and cut off the fat oxidation.
excellent episode. Thank you. There are test for D-lactate. 25 y ago i used enzymatic kit from Boehringer Mannheim (showing my age here) for determination of D lactate in fermented milk. I successfully traced carbon balance. Today, there is a method for D lactate, either ion chromatography or HPLC.
Fantastic discussion will have to listen a few times for my brain to catch up. Regarding testing concussions I would think a test within MMA would be a good source of subjects because Im guessing every knockout comes with a certain degree of concussion 🤷♂️. This lactate protocal could be a good post knockout as a means to address CTE maybe??
So how much lactate is coursing through my body as I sit on the sofa watching this video? I really can’t tell if you are describing metabolism in the midst of a 100m sprint, or after banging your skull, or the other 99.999% of life.
My understanding is that especially during exercise, the vast majority of the Venus blood coming from the legs would bypass the liver and go to the vena cava and not the portal vein.
What a great explanation of how training enhances lactate utilization and the positive effects of exercise-induced lactate. I am sharing this with all my sports mates!
@1:16:45 @Peter, are there any differences in training (cycling and strength) routines, nutrition and recovery between you and your friend? Keen to find out what those are or even just what your friend does for training and nutrition! Cheers
Awesome discussion, so clear and concise. Thank you You seem to be very versed in swimming if I could suggest a paper by Dr. Brent Rushall. Swimming Energy Training in the 21st Century. Would love to hear your thoughts.
I’m not college educated. I’m merely health and fitness RU-vid self reflection educated. But even I understood pretty much this entire video. Incredible stuff!
Question. Is there and studies looking at overall lactate threshold mm/DL & corresponding HR vs max HR measured in a sauna over 15-20min to determine any correlation between the two?
My understanding is that especially during exercise, the vast majority of the Venus blood coming from the legs would bypass the liver and go to the vena cava and not the portal vein. Therefore, a finger sample would not necessarily have gone through the liver, especially not 100% of the finger sample. In reference to time point 1 hour and 29 minutes.
A lot of great information in this video. But, I'm a bit confused on somepreceived lactate level goals to target for our cardio sessions while watching this video. 1. The usual recommended Zone2 cardio sessions. which after a quick search is 1.7-1.9 mmol 2. approx @00:54:00 Dr. Brooks and Dr. Attia talking about if were hungry a short time after a workout, then the workout was not intensive enough for the lactate level to reach 3-4 mmol. If we did get a good enough workout, then our appetite should be repressed for 3-4 hours. Now, many of us I am guessing do not measure blood lactate level, and maybe target the preceived things like breathing a little heavier, but not so heavy to carry on a conversation to give hint we are in Zone2. Which is actually a better indicator of a target workout zone we should strive for, the preceived breathing indicator, or whether or not we have the appetitie suppression after a workout?
Different things, zone 2 workouts should not suppress appetite, wouldn't be a zone 2 workout anymore. As I understand (understood) it zone 2 works mostly type 1 muscle fibers and increases mitochondrial efficiency. What they talk about sounds more like a VO2 max workout or at least something high in intensity which would ( I guess) build mitochondrial density, among other things. They are not talking about zone 2 training here.
What do I need to read to understand this episode and metabolism in general on a higher level? I am not an md and am interested in this from an exercise performance optimisation point of view.
Watch some RU-vid from AK lectures about glycolysis. Watch basic glycolysis, then the videos on the citric acid cycle, then some about beta oxidation, and maybe gluconeogenesis. One thing that is very important to note is that his videos, along with 99.9% of other online resources/textbooks will be presenting you the outdated hypothesis discussed in the beginning of this video: Lactate is produced as a waste product to allow glycolysis to continue when no oxygen is present. Keep this in mind and you’ll see why Dr. Brooks’ research flips this century old idea on its head. These videos might go much further in depth than you’ll need but he’s great at explaining this stuff.
Some do some dont. But you cannot "starve" cancer cells if thats your point. Its a myth. A cancer cell will ALWAYS find a way to get glucose. If not from your diet than it will break down your body proteins to draw out aminoacids from them and then it will use amioacids in gluconeogenesis to create glucose. Its dramatic.
Peter, I found several years ago if I have any glucose, fructose, Gatorade, banana, anything sweet I will develop muscle cramps within minutes. Some of these cramps can be extreme. I have torn muscles with these cramps. Verified by heavy bruising in my legs. I have not used a continuous glucose monitor so I don’t know what levels my insulin is spiking to, I do know if I take a swallow of “Utah Sea Minerals “ 4 tsp USM= 1 tsp salt, the cramp releases. My diet is 99% carnivore. The 1% difference is blueberries.
