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Today\u2019s episode of The Drive is a rebroadcast of the conversation with I\xf1igo San Mill\xe1n, (released on December 23rd, 2019). This episode with I\xf1igo was one of the most popular discussions to date and is a prelude to an upcoming follow-up discussion in 2022.

In this episode, Dr. I\xf1igo San Mill\xe1n, Assistant Professor at the University of Colorado School of Medicine, explains the crucial role of mitochondrial function in everything from metabolic health to elite exercise performance. I\xf1igo provides a masterclass into the many different energy system pathways, the various fuel sources (including the misunderstood lactate), the six zones of exercise training, and the parameters he uses to measure metabolic health. Additionally, he highlights the power of zone 2 training as both an effective diagnostic tool and, perhaps more importantly, as a treatment for mitochondrial and metabolic dysfunction.

We discuss:

• I\xf1igo\u2019s background in sports and decision to focus on education [3:45];
  
• The various energy systems and fuels used during exercise [11:15];
  
• I\xf1igo\u2019s qualification of energy systems into six training zones [19:30];
  
• Lactate as an important fuel source [29:30];
  
• Zone 2 training\u2014physiologic characteristics, fuel sources, lactate, and the transition into zone 3 [37:00];
  
• Using blood lactate levels (and zone-2 threshold) to assess mitochondrial function [43:30];
  
• Accessing mitochondrial function by testing one\u2019s ability to utilize fat as fuel [51:30];
  
• Athletes vs. metabolically ill patients\u2014mitochondria, fat oxidation, muscle glycogen capacity, \u201cfat droplets\u201d, and more [56:30];
  
• Physiologic characteristics of zone 3, zone 4, and the lactate threshold [1:16:30];
  
• Fueling exercise\u2014dietary implications on glycolytic function [1:27:00];
  
• Relationship between exercise and insulin sensitivity (and what we can learn from studying patients with type 1 diabetes) [1:43:00];
  
• Metformin\u2019s impact on mitochondrial function, lactate production, and how this affects the benefits of exercise [2:00:45];
  
• Raising awareness of the risk of \u201cdouble diabetes\u201d [2:11:30];
  
• How to dose zone 2 training, and balancing exercise with nutrition [2:14:30];
  
• Proposed explanation of the Warburg Effect: Role of lactate in carcinogenesis [2:23:30];
  
• Doping in cycling, and the trend towards altitude training [2:35:45] and;
  
• More.

View the Show Notes Page for This Episode

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