Hello, health enthusiasts, and welcome to Rev Up Health, your go-to podcast for all things wellness. I'm Dr. Mark Hechler, and I'm Tandi Hechler. Together we're here to fuel your health journey with the best of functional medicine and holistic well-being. Each episode, we'll dive deep into topics that matter to your health, bringing you the latest insights, research, and inspiring stories. Whether you're on a quest for vibrant health or just looking for daily health tips, we've got you covered. So let's embark on this journey together and transform the way you live. So, Tandi, what's on our wellness radar for today?
We spoke about this a couple of weeks ago when we were talking about the race we did in Bhutan, and how I decided that I really wanted to focus on improving my VO2 max. So we have some great friends over at a place called BodyMetRx, and they helped us out with some testing. We're going to share the results and why we tested — we'll likely do an interview-type podcast with them later, because they have lots of great information to share.
VO2 Max and Body Composition — A Reference Point
It basically boils down to VO2 max and body composition, which is what we really found out about when we did the testing over there. The disclaimer is that there's a lot of variability in different types of testing. There are a lot of different ways and different pieces of equipment to test VO2 max and body composition, so you have to keep that in mind. It's used more as a reference than anything else — it shows you a snapshot of where you were at at the time, and then you can use that to make changes, adjustments, and improvements, or see a worsening, for that matter. So it's a way to help you gauge your own fitness and composition.
They've told us that a lot of people are reaching out to them after reading Peter Attia's book Outlive, which I don't have to cover, but it's a great book, and there's lots of great information in there about changing the way we think about practicing medicine. We'll probably do a book review of this at some point. Dr. Attia talks about knowing what your body composition is, and he recommends a DEXA scan. The testing BodyMetRx has is a seca scan, and it's preferential in my mind because it doesn't give you any radiation exposure, so you can do it more frequently because of that. And a DEXA, if I'm not mistaken, probably needs a physician's order. Yes, that's going to take a physician's order.
Obviously, you can go on Amazon and get a body composition scale — there are four-, six-, and eight-point contact scales, a lot of different points of contact for determining body composition — so it is something you can do at home to a lot of extremes, for convenience purposes. It's certainly good information. And the one thing that's great about BodyMetRx is that they keep your data, so they can see where you're at and what you're trending, all those great things. Very helpful.
Body Composition: Muscle, Fat, and Visceral Fat
Let's talk about muscle mass, fat mass, and visceral fat — that's what makes up body composition. You've got muscle mass, which is primarily skeletal muscle. There's other muscle — smooth muscle in the body too — but this is measuring skeletal muscle mass. Then there's fat mass, which is everything outside the abdominal cavity — hips, thighs, etc., the areas where you see it. And then there's visceral fat, which is what you don't see; that's inside the abdominal cavity, the fat that's around the organs, the heart, the liver, etc. That's the most dangerous — that's the fat that has the most metabolic influence for maintaining health.
Muscle mass increases as a more natural process up to around 30 years old or so, and then from 30 onward, there's a slow and steady decline. When you reach your 60s, it starts to decline a little bit faster. This is the reason there's such an emphasis on muscle health — to maintain that skeletal muscle mass going into age, because it has a natural tendency to decline. But they've also shown that you can increase your muscle mass at any age. They did studies where they took individuals in their 80s as well as individuals in their 20s, put them on an exercise program, and showed a substantial increase in muscle improvement within just a short period of time. So it's something that can be increased and built at any age. It's not, "I'm too old to start building muscle" — that's not correct. It's never too late; in fact, start today.
It's really something that's extremely imperative, and we're going to continue to talk about it on multiple podcasts, but muscle is an organ that's overlooked. It's also one of the few organs we can actually control. You can't control the brain, or the heart, etc., as much as you think, but you can make huge strides and differences in muscle. Muscle health is key to insulin resistance and glucose disposal — getting rid of glucose — so those things are very important for that. And not only are we talking about the metabolic part of that, we're also talking about strength, stability, and maintaining an upright posture, so that when you fall, you're less likely to injure yourself. When we get older, we lose our strength, and the ones who fall going up or down the stairs or off a curb, or trip over something, are going to fracture something — and your mortality risk after a fracture when you're older goes up significantly. It's a huge leading cause of death for individuals who have fractures.
Reading Your Results
I think we should get into our results — that'll help us describe a little of what we are, what we're doing, and where we all need to go. You get a great little printout of your results, and you also get it electronically, with lots of information.
It gives you your weight, your height — which is already input, and the seca scan also records your height. It gives you a fat mass percentage, skeletal muscle mass, and visceral fat. Another piece that's really good is a segmental skeletal muscle mass — it takes your torso, your right arm, left arm, right leg, and left leg, and tells you what the muscle mass is in each of those. That's kind of nice to see: if you've had an injury in the past, maybe your right hip or right leg has less muscle mass, or if you're right- or left-handed, that will show. It can be somewhat of an indicator of the areas you need to work on, if you're in an exercise environment and want to improve.
My body fat percentage, based on the group of my peers, is right there in the normal — barely. I did some other research — this is information from 2013, but from the American College of Sports Medicine — and it basically shows that for my age and body fat percentage, I'm in a very poor section, so this is definitely something I want to work on. A lot of stuff has changed, and these analyses do change based on what's currently happening in the United States — everybody's getting a little heavier, we're putting on more weight, and BMIs aren't exactly what they used to be either. With over 70% of the United States being overweight or obese, it changes these numbers.
The biggest thing I want to say, as I'm thinking about this and knowing what my fat mass percentage is — I also know what my skeletal muscle mass is, and truthfully, I'm not really in this to lose weight; I'm in this to gain muscle. That's what's important to me. But knowing that as you gain muscle, that fat percentage is also going to go down. Hormone optimization is also beneficial for better and more muscle mass, as it is with fat mass and visceral mass for that matter.
A couple of the other metrics you get in this test: it looks at your water — how hydrated you are — and they can speak more to that when we talk to them separately. The seca scan will also give you a resting metabolic rate and a total energy expenditure — basically calories per day. Mine — they have another way to test that's a little more precise, but you do get that information with this test. This is a pretty basic test that takes five or ten minutes. It's really good.
Mark, do you want to talk about yours? I'm pretty much normal for my weight. My fat mass percentage was very low — unusually low. I'd like to say elite, but I'm not an elite runner, so there's a difference there. Skeletal muscle mass is above average for me too. And our visceral fats were quite low, which is really more of an indicator of your overall diet — how healthy you are and how healthy you eat makes a huge difference. If you're running down to McDonald's or over to Dairy Queen or some of the fast-food places, that's going to change that visceral fat. We've talked a lot about how, when, and what to eat, and that certainly contributes to that visceral fat, which over time — and it takes decades for this to occur — can change, and that'll trickle down eventually to create metabolic dysfunction and lead to a lot of other problems.
The Resting Metabolic Rate Test
So the next test, the resting metabolic rate test. This is a test where you get to sit in a nice comfy lounge chair, a massage chair, and you basically breathe through a tube and plug your nose. It lasts about ten minutes — the test will let you know when it's done, and sometimes it can take a little longer for some people. What that's doing is measuring you totally at rest and relaxation. What's being measured in your breath is basically all the byproducts of respiration — what's going on physiologically within your system is essentially coming out at your mouth. It's like the exhaust on a car — that's kind of how I look at it. You can tell, is it too rich, too lean, is it burning oil, etc. Through the software, it predicts what your resting metabolic rate should be, and then they'll give you ideas.
There are things we do fill out as far as your activities — what you're doing for work and exercise — so this is a pretty great model. It tells you the resting rate and adds in your work and your activity, and then it also gives you how many calories you need to consume per day to maintain, and where you'd want to be for weight loss. I'm not always a huge fan of calorie counting — I think there are a lot of other things we can do when we're talking about nutrition — but it's good to have an idea. I do think the resting metabolic rate test is more precise, and yours was actually quite different from one test to another.
Just so you're aware, men are going to have higher resting metabolic rates than females — that's just the way it is, unfortunately, ladies. So men can sit here and burn more calories, literally, than women can. Just so you know the difference: yours was what, 1,200, 1,300? I believe it was almost about 1,300 resting, and mine was about 2,000 resting metabolic rate. That's literally sitting here doing nothing but breathing — that's what that measures. So anything activity-wise you do above that will result in more calorie burn.
The VO2 Max Test
The last test we're going to talk about today is the VO2 max, and this is one a lot of folks are talking about recently. VO2 max, for people who don't know, is how physically fit your cardiopulmonary system is. It has to do with the delivery of oxygen to the cells, so the better you're able to deliver oxygen to your cells, the more fit you are. In other words, the higher the VO2 max number, the more fit you are — your heart and lungs are able to get that oxygen where it needs to be for cellular function.
This is another thing, similar to muscle, that will steadily decline as you age, so you need to make sure that while you can, you maximize where you are, so that when the decline starts, you're starting from a higher set point. It's almost one of those things: where do you want your VO2 max to be when you're 80 or 90? Because if it's not where it needs to be for you to function — to go on those trips, put your luggage in the overhead compartments, go up the stairs, carry luggage, carry groceries, get up and down and do basic activities — then you're going to have to do more work to get it there. You have to look backwards: at 80 or 90, I want my VO2 max to be around 30-ish for me to be self-sufficient and independent, and to be there, you're going to have to start earlier — 10, 20, 30 years sooner at this VO2 max level, because it's going to go down. That's just the way it is. This is the whole idea behind training for the centenarian decathlon. It's quite important.
It's certainly something that actually can be improved at any age — you can improve your VO2 max at any age, which is a good thing about it. You just have to know there's going to be a study to call.
In this test, you get your VO2 max and your zones — where your heart rate is in each zone. You'll hear a lot about zone 2 and working out in zone 2; a component of improving your VO2 max is longer times in zone 2. There are different zones based on your heart rate, and it determines what your heart rate is and where you're at in that zone — it's pretty individualized for you. It gives you what your maximum heart rate should be, and zone 5, which is the all-out, turning-and-burning type thing that you can't sustain for very long periods of time. Zone 2, like you mentioned, is basically defined as: am I able to carry on a conversation during exercise? You're almost not comfortable, but you can still carry on a conversation. Your heart rate is the predictor of that to an extent, and of course, the better shape you're in, the lower your heart rate is going to wind up being, and you'll be able to carry on a conversation.
There are other thresholds that go along with that too, with lactate levels — those are basically breakdown products from aerobic and anaerobic changes that occur. Anaerobic exercise is what causes that lactate to get higher. Another thing you get, if you're an athlete, is a sheet that tells you where you were when you went from burning carbs to burning fat, or vice versa. That's a great thing for folks who are athletes training for marathons or half marathons — it tells you where your heart rate needs to be, and what percentage of your refueling needs to be carbs or fat, and how much you need. That lets you know that if you've got a long endurance event, you're going to have to pack 600 calories of food, or something along that line — it just depends on your levels. But that will give you indications about where you need to be with your nutrition.
Our Results
So we've been on this for a couple of weeks — and when I say "we," I mean me, because he's pretty all right. But I'll tell you, my VO2 max is 35.9, and that puts me in a good category for my age. This goes along similar to how we talk about lab values — do I want to be good for my age, or good for a 30- to 40-year-old? Do you want to be 50 or 60 good, or do you want to be 30-year-old good? Keep in mind, you want to start high, because you're going to wind up lower, so it's not easy to keep that up sometimes.
And my VO2 max was 44.6, which was in the excellent range. Yes — it better be, because I need to be in better shape for the races coming. But that kind of gives you a little indication about what VO2 maxes do.
What We're Doing to Improve
In all of this, what are some things I'm going to be doing to make progress? Right now, I'm adding in strength training regularly, more zone 2 working out, and some HIIT here and there. The other piece, from a nutrition standpoint, that I'm looking to add is more protein. The idea is to get one gram per pound of ideal body weight — that's a lot of protein, and it's best to spread it out. Studies show that the first meal of the day needs to have between 30 and 50 grams of protein; that's when your body needs that protein to perform muscle synthesis.
There are a lot of different types of protein to consume, but basically, the more complete your protein, the more complete the amino acids you intake to be able to create and produce muscle fibers. The types of protein are variable, and it's a little harder for someone who's not a meat eater, but meat in general — whether it be beef, pork, chicken, or fish — the more variety you can have, the better. And I'll add: elk is really amazing from a nutritional standpoint, so it's kind of my favorite. There are lots of plant-based proteins as well — beans, tofu, and all the different soy products.
Improving Your VO2 Max
There are several ways to increase your VO2 max — increase your zone 2. Some studies say if you can just maintain at least 80% of your exercise activities in zone 2, you're going to improve your VO2 max. But for folks who are more elite trainers, marathon runners, or Ironman-type situations, you really need to increase more of your HIIT — high-intensity interval training. You're going to spend more time in high-intensity interval training than in zone 2, for those folks.
The overall key to all the activities and exercise routines, no matter what you're doing — whether you're biking, running, or walking — resistance training is very important, endurance training is very important, but it's being consistent. Consistency wins the race. Those are the people who, time in and time out, at the end of the year, are going to have the better endurance and the better VO2 max. And it's a little easier to stay on the exercise bus if you're consistent — nobody wants to get kicked off that.
For myself, when I try high-intensity interval training, I know it's good for me, but you can also injure yourself. I've pulled many hamstrings before, not warming up properly or doing the HIIT, so I have to be very careful with that. It's all about stretching and strength to prevent injury.
Thank you for joining. We're happy that you're here, joining along in this journey. If you have questions, or if you want to see how things go, don't forget to subscribe and follow and all those good things. Have a healthy day. Bye.
Thank you for tuning in to another episode of Rev Up Health. We hope you're leaving with some valuable insights to supercharge your health journey. Don't forget to follow or subscribe to Rev Up Health wherever you listen to your podcasts, and if you enjoyed today's episode, please leave us a rating and review. Have a topic you want us to explore? Reach out to us on our social media channels — we love hearing from our wellness community. Until next time, keep thriving, and remember: your journey to health is a journey to a better you. Stay well, and we'll connect with you again soon. This is Tandi, and this is Dr. Mark, signing off from Rev Up Health. Take care.
The information provided in this podcast is for educational purposes only and is not intended as medical advice. The content is designed to support, not replace, the relationship that exists between a patient and their healthcare provider. Always consult with a qualified healthcare professional before making any changes to your healthcare regimen, including diet, exercise, or treatment plans. The views and opinions expressed in this podcast are those of the hosts and guests and do not necessarily reflect the official policy or position of Revelation Health and Wellbeing.