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Olav Aleksander Bu is an internationally renowned sports scientist acclaimed for his coaching prowess with elite athletes spanning a diverse range of sports disciplines. In this episode, Olav returns to dive deeper into his groundbreaking work as an endurance coach, exercise scientist, engineer, and physiologist. The discussion explores his data-driven approach to coaching, unpacking key performance metrics like functional threshold power, VO2 max, and lactate threshold, while emphasizing the importance of consistent testing protocols. Olav shares insights on how training methodologies differ across sports, the impact of nutrition on endurance performance, and the evolving strategies for carbohydrate metabolism in fueling athletes for races. Olav concludes with a discussion on the use of artificial intelligence for optimizing training insights and performance.

We discuss:

• Olav’s unique, engineering-driven approach to endurance coaching [2:45];
• Definitions and applications of key performance metrics: FTP, power, anaerobic threshold, and lactate threshold [4:45];
• Lactate threshold: factors affecting lactate threshold, testing protocols, and how elite athletes' efficiency affects their performance and lactate profiles [14:15]
• VO2 max: definition, testing, factors affecting its accuracy, and methods for optimizing oxygen utilization in elite athletes [22:15];
• Testing VO2 max: common mistakes and key factors to consider—preparation, warm-up, timing, and more [34:00];
• VO2 max testing continued: measuring instruments, testing protocols, and advanced insights gained from elite athletes [41:45];
• The influence of supplements like beetroot concentrate and adaptogens on VO2 max and performance [49:45];
• How respiratory quotient (RQ) reflects metabolic shifts during exercise, the challenges in measuring and interpreting RQ in elite athletes, and the physiological adaptations needed for prolonged endurance events [53:30];
• Triathlon training: the challenge of maintaining elite performance across triathlon distances, metabolic efficiency, and swimming challenges [1:03:15];
• How reducing drag in swimming could revolutionize performance and the role of biofeedback tools in optimizing efficiency across various endurance sports [1:07:00];
• How endurance athletes prioritize effort regulation using RPE, heart rate, and power output, and the role of lactate in cardiac and athletic efficiency [1:20:00];
• Lactate’s role as a fuel, buffering methods to combat lactic acidosis, and the variability in athlete response to bicarbonate supplementation [1:25:45];
• The physiological mechanisms behind differences in performance between two elite athletes: lactate transport, cardiovascular efficiency, and compensatory systems [1:33:00];
• Comparing interventions like acetaminophen to enhance performance in high-heat conditions versus natural adaptations to heat [1:37:15];
• Advancements in nutrition science, changes in cyclist body composition, and the impact of fueling strategies on athletic performance and growth [1:39:30];
• Optimizing endurance performance with utilization of carbohydrates, and the potential role of ketones [1:48:00];
• Insights gained from elite performers in the 2020 and 2024 Olympics [1:58:30];
• The use of artificial intelligence to optimizing training insights and performance [2:06:30]; and
• More.

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View the Show Notes Page for This Episode

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Trenna Sutcliffe is a developmental behavioral pediatrician and the founder and medical director of the Sutcliffe Clinic in the San Francisco Bay Area, where she partners with families to provide care for children facing behavioral challenges, developmental differences, and school struggles. In this episode, Trenna shares her journey into developmental and behavioral pediatrics, including her pioneering work at Stanford and her expertise in autism, ADHD, and anxiety—the "three As." She explores the diagnostic processes, the overlap and comorbidities of these conditions, and the importance of personalized treatment plans that address both medical and environmental factors. Trenna offers valuable insights into the changing prevalence of autism, the impact of evolving diagnostic criteria, and the range of therapies and medications available to support children and their families. She also discusses the challenges in accessing care and the critical need for a holistic approach that bridges healthcare and education.

We discuss:

• Trenna’s passion for developmental-behavioral pediatrics (DBP), and the process of diagnosing anxiety, ADHD, and autism [3:15];
• Understanding anxiety and ADHD: assessing impairment and self-esteem and identifying anxiety and emotional well-being in young patients [9:45];
• The evolving diagnosis of autism: understanding the spectrum and individual needs [16:30];
• The dramatic rise in autism spectrum disorder (ASD): genetics, environment, expanded diagnostic criteria, and more [25:45];
• Exploring epigenetics and the potential multigenerational impact of environment exposures on susceptibility to certain disorders [37:15];
• The evolution of autism classifications, and the particular challenges for children with level 1 (mild) autism due to a lack of support [41:15];
• The broadening of the autism spectrum: benefits and risks of expanded diagnostic criteria and the need for future frameworks to focus on better outcomes [48:00];
• The overlap between ASD, ADHD, and anxiety [57:15];
• Understanding oppositional defiant disorder, and the importance of understanding the “why” behind a behavior when creating treatment plans [1:00:45];
• Defining developmental-behavioral pediatrics (DBP), and Trenna’s professional journey [1:07:00];
• Updated methods of ABA (applied behavioral analysis) therapy: evolution, controversies, challenges of scaling autism care, and the need for tailored interventions [1:13:45];
• Advice for parents trying to find and evaluate care for children with autism, ADHD, or anxiety [1:22:45];
• Tailored treatments for ADHD: balancing stimulant medications with behavioral training [1:28:30];
• The interplay between medication, behavioral therapy, and neuroplasticity in managing ADHD, and the potential to grow out of the need for medication [1:39:45];
• Using medication to treat anxiety and other symptoms in kids with autism without ADHD [1:44:45];
• FAQs about medicating children with ADHD: benefits, side effects, dosage, and more [1:46:30];
• The “superpowers” associated with level 1 autism [1:48:45];
• The next steps to increase support for children with ASD, anxiety, and ADHD [1:50:45]; and
• More.

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