Articles on what comes before.
Clinical notes, excerpts from the book Antes and short essays on preventive nephrology, longevity, and integrative functional medicine. Content originally published on the Plenya blog, mirrored here in full.
Training to age well: the formula is Zone 2 and strength
Most people train inverted: too much medium effort, little low-intensity aerobic base, poorly directed strength. The recipe the literature supports is simple: 80% Zone 2, 20% high intensity, strength two to three times a week. It makes a difference in who you will be at 75.
The inverted pyramid of longevity — strength matters more than aerobic after 40
Most people train the body inverted — too much aerobic, too little strength. The mortality data of the last two decades say the opposite: strength and lean mass predict how long you will live with more precision than running 10 km.
Supplementation after 40: what makes a difference
I see, recurrently, patients arriving with a pharmacy bag and the right question: I spend a fortune a month, is any of this doing anything? Four substances have robust evidence after 40, and the indication of each comes out of clinical assessment, not from a fad.
Protein: the target you're not hitting
Most Brazilian adults consume 0.8 g/kg of protein per day — survival RDA, not health RDA. To preserve lean mass after 40, the literature points to 1.2 to 1.6 g/kg, distributed across three to four meals of 30 g each.
Intermittent fasting: who benefits, who is harmed
Intermittent fasting is not a universal diet. For the 45-year-old man with insulin resistance, it usually helps. For the perimenopausal woman, the strength athlete, the sarcopenic elderly, it usually makes things worse — and the difference lies in details few people look at.
Training a lot and aging wrong
I have seen many amateur athletes arrive at the office at 45 inflamed, weaker, with testosterone falling. The effort was there. The result was not. Before changing the training, you have to read the panel that says it is wrong.
The drug that cuts mortality by 80% — and no one prescribes
I learned to respect this number examining patient after patient: no medicine I prescribed protects as much as cardiorespiratory fitness. And almost no one taught me to prescribe it in medical school — I had to learn it patient by patient.
Content originally published on Plenya Blog. Each article here is a faithful version of the original, with canonical pointing to the source.
This content is educational and does not constitute medical prescription. Each case is unique — for individual evaluation and care, consult a physician.