Peter Attia· MD
in the normal glucose tolerance offspring studies before these are wage you meaning the higher the degree of hyperinsulinemia the lower their maximal vo2 yes yeah exactly it's hard to tell sort of what the link is which way it goes with net association be true across the board are you saying that it's disproportionately the case so I'm sorry so there is two sets of studies so there is one hyperinsulinemic case but these are young lean people before they've developed any signs of insulin resistance so vo2 max looks like it's already a bit of a surrogate marker for early ins and resistance in these individuals and one of the things that you see is in the normal glucose tolerance offspring that have no signs of insulin resistance if you were to measure their ATP output the ones that just have a family history of diabetes their ATP output goes up by like five percent and the ones that basically have no family history at all again normal glucose tolerance it goes up by 90% so even the earliest stages before you've seen any signs of insulin resistance you're seeing significant mitochondrial dysfunction early on