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Program for Elite Performance PEP
The Performance Medicine Paradigm
The notion that physical fitness is associated with overall health is not new. However, in recent years, the longevity medicine community has come to regard physical performance as one of the most important predictors of both healthspan and lifespan. We know that a patient’s VO₂ max and physical strength are more strongly correlated with their longevity than blood pressure. The American Heart Association recently argued that physical fitness should be regarding as a “vital sign.”
The Performance Medicine Paradigm is simple: if we optimize our patients’ physical performance, we are optimizing their overall health. Strength, aerobic capacity, and body composition are titratable medical metrics, much the same as blood pressure, cholesterol, or blood glucose. In this model, performance isn’t separate from medicine; it is coextensive with it.
By treating performance as a prescribable and trackable variable, we extend the reach of preventative medicine. Instead of waiting for disease and debility, we proactively refine performance capacity – building resilience, promoting longevity, and improving quality of life.
THE PROBLEM WITH PERFORMANCE DECLINE
Loss of muscle mass, cardiovascular capacity, and strength is a natural consequence of aging. Muscle mass typically begins to decline around age 30, with measurable decreases in strength and endurance becoming more noticeable in each passing decade. By the time many people reach their 50s and 60s, these changes are often profound.
The genetic blueprint that guided human survival was written for a very different era. In the Stone Age, it was advantageous for the body to conserve energy by allowing muscles and aerobic capacity to fade as people aged. Survival pressures favored the young and strong. Having a lower VO₂ max reduces energy needs, and reduced muscle mass makes sense in a world where periods of food scarcity were frequent. But in today’s world, where food is abundant and lifespan has dramatically extended, these same adaptations now work against us. Declines in muscle and aerobic fitness drive frailty, reduced resilience, and higher risk of chronic disease.
Although age-related declines in performance are common, they are not inevitable. Research shows that targeted training and medical interventions can slow, halt, and even reverse much of this decline. By measuring strength, VO₂ max, and muscle mass and actively training these systems, we can preserve vitality, independence, and performance well into later life.
What Does This Program Do?
The Performance Enhancement Program (PEP) is a physician-led pathway to optimize strength, endurance, and resilience while reducing cardiovascular and metabolic risk. Using advanced testing and medical oversight, we create a clear roadmap that integrates strength training, aerobic conditioning, and targeted medical interventions. PEP goes beyond fitness – it is performance medicine.
What Do You Get?
- We measure strength, aerobic fitness, and body composition with cutting-edge tools (Tonal strength testing, PNOĒ VO₂ max and metabolic testing, SECA body composition scan).
- We risk stratify your cardiovascular and metabolic health through advanced labs, imaging and physician assessment.
- We provide expert guidance on peptides, hormone replacement therapy, nutrition, and recovery protocols to accelerate progress.
- We provide you with a Garmin watch to track biometric and performance data.
Your Garmin wearable will intergrate with TrainingPeaks for workout prescription and ongoing surveillance. - We retest every 4 months to ensure continuous improvement and recalibrate when needed.
Program Schedule
Month 1 — Baseline & Launch
- Medical intake + cardiovascular & metabolic risk assessment
- Advanced labs + SECA body composition
- PNOĒ VO₂ max & metabolic testing
- Tonal Assessment Load (AL) testing for strength, endurance, and power
- Garmin wearable issued & synced with TrainingPeaks
- Personalized optimization plan delivered (training, recovery, peptides)
Months 2–3 — Training & Monitoring
- Daily workout plans delivered via TrainingPeaks
- Continuous Garmin tracking (HRV, sleep, training load, recovery)
- Ongoing in-app communication about training progress
- Nutrition, recovery, and peptide guidance
Month 4 — Medical Check-In
- Repeat advanced labs
- Comprehensive review with your physician
- Program refinement based on lab and performance data
Month 6 — Full Re-Assessment
- Repeat SECA, Tonal, and PNOĒ testing
- Updated labs (if indicated)
- Full progress review + next-phase optimization plan
Ongoing Cycle
- Every 4 months: Labs + physician check-in
- Every 6 months: Fitness retesting (Tonal, PNOĒ, SECA)
- Daily: TrainingPeaks + Garmin monitoring and communication
- Anytime: Concierge physician appointments as needed
