Intelligent Medicine with Dr. Ronald Hoffman | The Best of High Tech Medicine and Alternative Modalities

Leyla Weighs In: The Balance of Cardio and Strength--A Path to Healthy Aging

September 18, 2026·23 min
Episode Description from the Publisher

Concurrent Training for Healthy Aging and the Overlooked B12 Risk of Metformin: Nutritionist Leyla Muedin discusses how concurrent training—combining cardio and strength work—supports healthy aging by building endurance, preserving muscle, and maintaining independence and “healthspan.” She explains that aerobic exercise improves cardiorespiratory efficiency while resistance training preserves lean tissue and functional strength, and offers practical scheduling tips: place strength sessions on two non-consecutive days, add moderate cardio around them, separate hard sessions, prioritize recovery with rest days, sleep, and adequate protein, and avoid pairing heavy lifting with hard endurance work if explosive power is important. She then summarizes evidence that clinicians often fail to check vitamin B12 levels in diabetic patients on long-term metformin, despite guidelines; metformin can impair B12 absorption, leading to deficiency, anemia, and potentially reversible neuropathy, with higher risk in the elderly, high-dose users, vegans, and PPI users. She urges proactive B12 monitoring and supplementation, such as a multivitamin with at least 100 mcg B12.

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