FoundMyFitness - #108 The Best Type of Exercise for Longevity

Starting point is 00:00:00 Hello, friends. Today we're diving into a fascinating discussion about exercise intensity. Most of us have long accepted this simple guideline that one minute of vigorous exercise equals two minutes of moderate exercise. It's intuitive, neat, convenient, but what if it's fundamentally inaccurate? That rule has shaped global physical activity guidelines for decades, yet it was largely based on calorie burn, not hard endpoints like mortality, cardiovascular events, diabetes, or cancer. Joining me to explore this important topic is endurance athlete Brady Homer, who has a master's in human performance and has collaborated with me before on the Found My Fitness Comprehensive

Starting point is 00:00:43 Training Guide. Today we're breaking down a groundbreaking new study published in nature communications that used objective, device-based data to challenge decades of conventional. exercise wisdom and guidelines. We break down the methods, the limitations, and what the data actually supports. This is a journal club style episode. In this episode, Brady and I discuss how wearable accelerometers offer a more accurate picture of physical activity than traditional self-reported methods. The surprising new finding that one minute of vigorous exercise could offer health benefits equivalent to four to nine minutes of moderate exercise, dramatically

Starting point is 00:01:27 altering our understanding of exercise efficiency. Specific outcomes showing vigorous activity is up to eight times more potent for cardiovascular health and nearly 10 times as effective in diabetes prevention. Why vigorous exercise uniquely triggers potent physiological adaptations like improved cardiovascular function, insulin sensitivity, mitochondrial health, and eating. even reduced cancer risk through targeted cellular mechanisms. We talk about the practical implications for everyday life, including the powerful health habits of vigorous, intermittent lifestyle physical activity. These are vilpas. They're quick. It's sometimes unstructured everyday lifestyle

Starting point is 00:02:07 ways that we're getting our heart rate up. But we also talk about the structured exercise snacks. This new research really could rewrite the existing exercise guidelines entirely. It challenges fitness trackers, challenges exercise apps and public health messaging to completely recalibrate the way we value and measure physical activity. Before we dive in today's episode, a quick reminder about our free evidence-based resource, how to train according to the experts. If you haven't downloaded this free guide yet, or even if you have, we just released major updates, you'll definitely want to check out.

Starting point is 00:02:43 You can find that at how to train guide.com. We've expanded our coverage on creatine supplementation with updated dosing protocols. We also have fresh insights into how it impacts brain health and cognitive function. We've also refined our recommendations on exactly how much exercise is needed to maximize longevity, and also how exercise snacks and even vilpas can contribute meaningfully to our fitness goals. So this guide really condenses the best evidence-based strategies from our leading scientists that have been on this podcast into a real single actionable toolkit. You'll find precise protocols in there for building muscle mass, building muscle strength,

Starting point is 00:03:23 targeted training methods that are proven to enhance cardio-respatory fitness. This is a really important marker for longevity. We have updated science-driven strategies to support both metabolic health, cognitive performance, and then we also have some practical exercise routines that are really crafted for people with time-constrained schedules. Again, it's entirely free and it's available right now at how-to-trained guide.com. Again, how to trainguide.com. And also, if you're intrigued a little bit more about the creatine and you want to explore it more deeply,

Starting point is 00:03:56 we also have a comprehensive collection of resources on the Found My Fitness topic pages. So found my fitness.com forward slash topics. You can go to the creatine section, which is under the C. And you can find and read all about creatine there. As always, everything we produce is made possible entirely through the support of you are listeners. Our mission here really is to deliver rigorous, unbiased, actionable science that is really accessible to everyone. You may have noticed that this podcast is free from advertising. I don't have any popular green supplement companies that are paying for this podcast. I need your

Starting point is 00:04:37 support to do this. If you value this mission and the depth of our content, please consider becoming a found my fitness premium member. Not only will you support the podcast, our YouTube channel, our topic pages that we've hit together, our great newsletters that we send out every week, literally everything we do. But you also get a premium membership with really great perks. You get access to the Alawquot. This is our members-only podcast. You get a monthly live and recorded Q&A session with me. You get a curated Science Digest where we deliver this to you twice a month, all the best science and health information. And it's really just to help support what we're doing here at Found My Fitness.

Starting point is 00:05:24 So to join and support our work directly, please go to foundmyfitness.com forward slash premium. Again, that's foundmyfitness.com forward slash premium. Thank you so much for supporting evidence-based health and fitness education. Now let's jump into today's episode. Welcome back to the podcast. Today we're going to be discussing this almost universally accepted rule that for every one minute of vigorous intensity exercise, that's equivalent to two minutes of moderate intensity exercise. And we're going to talk about whether or not that's accurate and where it came from. So today's podcast is more of a journal club type of episode where we're going to be discussing a new study that really kind of overturned that idea.

Starting point is 00:06:12 So I'm joined by endurance athlete Brady Homer, who has a master's in human performance. He's also an author of the book, V-O-2 Max Essentials, and he's a former podcast guest. He was on the podcast a few months ago on the How to Train, according to the experts podcast, where we were talking about our how to train guide, which Brady also was a collaborator on. So I'm pretty pumped to sit here and have this first episode of a journal club for Family Fitness. So, you know, hopefully we'll do more of these. So let's, what do you think? Let's get started.

Starting point is 00:06:45 For sure. Yeah. I think this will be an interesting new structure kind of for the podcast, new for, you know, some of our episodes. And I'm excited to see how it goes. Excited to talk about this study. I think it was really a eye-opening one in my mind. So, yeah, let's get into it.

Starting point is 00:06:58 Eye-opening, but not surprising, right? Totally. So, okay, well, let's, I'm going to start off by just talking about what this, you know, one to two rule is for people because it might be like not exactly understanding what I'm talking about. So essentially, You know, for decades now, we have these physical activity guidelines that's put out by the World Health Organization and, you know, other organizations that essentially state these physical

Starting point is 00:07:22 activity guidelines, which essentially are for optimal health, which is sort of vague, but for optimal health, you want to be engaging in about 150 minutes to 300 minutes of moderate intensity physical activity per week. or if you're going to be doing more vigorous intense, vigorous type of physical activity, that would be more like 75 to 150 minutes. So that's essentially you have this one to two rule, right, where it's like, okay, for every one minute of vigorous intensity, physical activity, you're going to be doing two minutes of the moderate intensity activity.

Starting point is 00:07:57 And that's kind of where this rule came from. And I don't know that it's necessarily, it's not necessarily telling you if you're trying to reduce you know, different disease risks. So cardiovascular disease or cancer, you know, fill in the blank, whatever disease. It's not really telling you that. It's just kind of like this is the guidelines, right? So let's talk about the origin of this one to two rule. It really didn't come from direct measurements of health outcomes. Essentially, it's researchers that calculated, you know, for vigorous intensity exercise, you're burning about twice as many calories as you do for moderate intensity exercise. So it's really comes down to energy expenditure, not health outcomes.

Starting point is 00:08:47 Yeah. And that was kind of like the biggest, not surprised to me because I've, you know, known about this stuff for a long time. But when you really dig into it, it's like, what's the foundation of these recommendation? It is based on the idea of the thing called metabolic equivalent or metabolic equivalent of tasks. People maybe will have heard that referred to as METs or METS.

Starting point is 00:09:06 And basically it is just, what's the caloric. expenditure of these various different activities. If, you know, you're doing a light activity, that might be somewhere between, you know, like zero to three Mets, moderate activity, three to six Mets, vigorous activity over six Mets. And it's basically saying what's your oxygen consumption or your, you know, calorie burn during these activities. And so by that logic, yes, moderate activity, you burn, you know, that might be three to six Mets. Well, if you're going harder than that, that's double the Mets, double the caloric expenditure. So you need half as much physical activity to get the same health benefit as the more moderate intensity activity.

Starting point is 00:09:41 So that kind of formed the foundation of that either 75 to 150 minutes of vigorous, 150 to 300 minutes of moderate. And it makes sense logically. But as you just said, you know, well, for what? What health outcomes are we looking at? Are we just focused on calorie burn? So yes, if it's just focused on calorie burn, yes, the two are equivalent. But health is a lot more, as you know, than just burning calories.

Starting point is 00:10:03 People are focused on different health outcomes like improving their fitness. or improving their cardiovascular health, improving their diabetes risk. So when you look at it from that perspective, it really changes the way that you think of, well, maybe it's not all just about metabolic equivalence. Maybe it's about something different, and we should be looking at the value of physical activity in different ways. Right. I think that's a really good point because I think people that are more focused on weight loss aren't necessarily the people that are looking at the physical activity guidelines, right?

Starting point is 00:10:31 Those are the people that are counting calories and they're, you know, it's a very different. they're trying to figure out how much exercise they need to do to trim down, body recomposition, whereas people that are actually looking at the physical activity health guidelines, generally in their mind have this concept of how much exercise do I need to, like, age better, right? Like that's generally what people are thinking when they're looking at these guidelines. How much exercise do I need to do to really age better? And so it's kind of unfair because, you know, these guidelines, if they aren't necessarily indicating how much exercise we need to do or what type of exercise we need to do to really age

Starting point is 00:11:10 better, then it's time to change these guidelines. And I think we're going to talk a lot about that. But I also wanted to mention, you know, you're talking about these metabolic equivalents with respect to light, moderate or vigorous, you know, intensity, physical activity. There's some examples for the guidelines that are given, which aren't necessarily what I would think of as moderate or vigorous. So for example, they say light activity is a casual stroll or maybe like you're standing, so just not sitting or maybe you're washing dishes. And then the moderate activity is like brisk walking. So you're walking more briskly or you're maybe doing a leisurely cycle or you're doing some yard work. That's considered moderate intensity physical activity. And then vigorous activity is running,

Starting point is 00:11:55 swimming, more recreational sports or if you're like, you know, playing with your kids outside, sprinting around, playing with your puppy or your dog. So those are sort of some of the guidelines, you know, in terms of how you define light, moderate, or vigorous physical activity. Yeah, and I do think that's important just for framing kind of when we start to talk about this study for framing our discussion today because when people hear vigorous, especially, you know, as you usually talk about on your podcast, it's vigorous intensity is kind of this high intensity interval training.

Starting point is 00:12:25 But when it comes to the guidelines, vigorous is a lot less vigorous. and people were probably familiar with zone two training, I would just consider like when you hear vigorous in the context of this discussion or the physical activity guidelines, that's like zone two intensity or above, basically. So it includes high intensity interval training, but it also includes things are a little less intense than one might consider high intensity interval training to be.

Starting point is 00:12:48 Right. Yeah. So typically, you know, especially in this podcast, I've talked a lot about vigorous intensity exercise and with regards to like heart rate measurements, right? Like people are wearing these wearable devices and they're measuring their heart rate, And usually it's like you're getting into the 80% max heart rate or above, you know, and like you said, you know, it's really not, that includes vigorous, yes, but like, especially when we get into this study that we're going to talk about today and looking at the physical activity guidelines in general, vigorous is a little bit less than that. So it does include more of that zone two type of training. But you are running. You are able to maybe, you know, say a few sentences while they may be breathy.

Starting point is 00:13:27 You can still state them. that's actually considered vigorous if we're actually just talking about the physical activity guidelines. Yeah, very important. And then also just, you know, I think we sort of already stated this, but just to kind of reiterate, talking about the potential flaws of the physical activity guidelines is one, potential like looking at long-term, like, health outcomes, right? Two would be like relying on self-reported data. And that's something that we're going to get into today, you know, when you're trying to ask people to, remember their physical activity and you're going to talk about this a little bit more. It's just not accurate. And then the third one would be that it's not, it's not actually able to capture some of these like, you know, you're playing with your kids or you're sprinting around with your puppy, right? These short bursts of physical activity that do matter, right? So you're not,

Starting point is 00:14:17 you're not including that as well. So why don't we get into this new study? It was published in nature communications, wearable device-based, wearable device-based health equivalents of different physical activity intensities against mortality, cardiometabolic disease, and cancer. Very good study. Maybe we can kind of start off with, you know, the, how the study was set up, like some of the methods. Yeah, sure. So this was by, it was by a group led by Stamatakis as the first kind of author on it. And importantly, they're the group behind a lot of these Vilpa studies, Rhonda, that you've talked about a lot, the vigorous, intermittent lifestyle, physical activity studies. So they authored this study and they mine data from the UK Biobank. That's just a huge, it's kind of

Starting point is 00:15:01 similar to like the N-Haines in the United States where just a cohort of a ton of individuals looked at for, you know, decades or more. They have all this health data on them, objective data, subjective data. So for this study, they focused on 73,000, more than 73,000 adults from the UK Biobank who were aged 40 to 79. So that's kind of important, I think, as well. They were, you know, middle age to older age as adults. And they tracked them over eight years. So the follow-up period in the study was eight years on average. And the important part of the study is how they measured their physical activity. It was measured using these wearable devices, these wrist-worn accelerometers. They wore it for a week at the baseline of the study. And so then they took all their physical

Starting point is 00:15:44 activity from that one week. And then, you know, that was used to establish these physical activity levels for these individuals. Kind of a limitation there, obviously, physical activity was only measured for a week using these accelerometers. But, you know, as we'll maybe discuss later, it seems like a limitation, but in a way, I almost feel like it's a strength because the strong association with these health outcomes almost assumes that this activity that they were doing during that one week may have been consistent over, you know, the next eight years or something like that. So.

Starting point is 00:16:13 Well, it's also, I mean, it's measuring everything, right? It's measuring the short burst of exercise that you would never think about. Like, if someone were to ask me how many minutes I have. exercise a week, I would only include my structured, defined workouts that I set aside to work out. I wouldn't include, you know, the three times a day I'm sprinting around my yard with my puppy or, you know, once a day that I'm playing soccer with my son, right? I don't include those, but I'm absolutely getting my heart rate up. Right. And that was, I think, the major strength of this study. So instead of self-report, which a lot of the previous studies for the guidelines did,

Starting point is 00:16:49 this one was objective data. And yes, it captured, it captured what physical activity. they were doing, what exercise they were doing, I guess. So their structured workouts, but also, as you mentioned, just everything they did throughout the day. This device was measuring every single activity in 10-second bursts throughout the day. Every 10 seconds, it measured, you know, what is the intensity that their activity is? And I don't think to the- Wait, can we pause for a minute?

Starting point is 00:17:11 When you say what the intensity their activity is and your accelerometer, right? Yeah. So people might be confused and they, again, might be going back to heart rate. Like when they hear wearable device and they're thinking, intensity, I know my brain goes right there, like heart rate. Can you kind of explain, like, how they were able to define light, moderate, and, you know, vigorous with this accelerometer data? Yeah, I'll do it the best I can without getting, like, way too complicated on how the accelerometers measure physical activity. So, yes, intensity, not based on heart rate in this study, which would be the common convention and maybe your wearables measure that using, you know, heart rate, the wearables we have today, like your, you know, Apple Watch.

Starting point is 00:17:50 So an accelerometer is literally a device that you wear on your wrist, and it is measuring the direction of movement and the physical intensity of movement. So if I move my wrist, say, slowly, that might be light intensity activity activity. If I move it more vigorously, that might be vigorous intensity. So this accelerometer device is measuring, you know, the intensity of people's movements throughout the day, the direction of that intensity because it just has this physical, an accelerometer in it, which just measures the direction and the intensity of physical activity. And so every 10 seconds throughout the day, it's measuring their intensity of physical activity. And then based on a certain threshold of how intense their movement is, that would get bucketed

Starting point is 00:18:33 into being a light intensity activity, a moderate intensity activity, or a vigorous intensity activity. So every 10 seconds, this thing is measuring, you know, what type of activity you're doing, it gets bucketed into one of those three intensities. And then summed throughout the day and then throughout the week to say you did this much vigorous, this much moderate, and this much light activity. So it's a little bit difficult because most of the devices we have these days are not accelerometer based. They're either heart rate based or they're, you know, you're actually using a GPS like most of these devices. But I think that's the best way of describing it. But the important thing there is that this is how the intensity was measured in this study, not using, say, something like

Starting point is 00:19:10 a heart rate. What I was thinking about when kind of reading the the paper and like talking about it with you is how it would categorize like let's say someone was like doing bicep curls right because your wrist is moving but you're not really walking you're not really moving distance wise so is that something that would be picked up by this device and considered and what bucket would it because like some people can be like moving fast right it would and that would be I think even regardless of the um speed at which you were moving that dumbbell that would probably be categorized as like a vigorous intensity activity because it's purposeful movement and, you know, it's, you know, the force and the torque at which you're measuring your arm. So that

Starting point is 00:19:53 would be probably categorized as a vigorous intensity activity. It doesn't necessarily matter whether you're moving physically forward or backward in space. It's just like what is the speed or the intensity at which your body is is kind of moving. Okay. So yeah, a little bit complicated, but, you know, that's the best way to describe it without considering that, yeah, I mean, considering that because, you know, a lot of times when people hear the word, vigorous intensity, you know, activity, they're not really thinking of resistance training. So maybe, like, you can give some examples, at least I know the study laid out some examples with respect to what's actually considered, you know, vigorous versus moderate versus light.

Starting point is 00:20:29 And then obviously we talked about what examples are considered that for the health guidelines, but they're pretty similar. They are similar. This study, they said, you know, light activity. They gave some examples of it. That would be just light household chores. So even maybe you're, you know, emptying the dishwasher or, or, you know, you know, sweeping or vacuuming or something like that. That would be considered like light activity based on

Starting point is 00:20:49 this study. Moderate activity would be something like actively commuting. So say you were riding your bike leisurely to work or you were commuting to work, walking from the bus to work, going up some stairs, doing maybe some more moderate household chores. And then vigorous, they gave some examples like, you know, outside playing with your kids or you're running or you're riding a bike or exercise. Exercise would be categorized in that vigorous bout or that vigorous type of activity. but really anything, you know, purposeful movement, I think is, you know, we're chatting offline. It's anything that was the purposeful movement, you're doing this for a reason of, you know, either to exercise or to get somewhere, that would kind of be considered vigorous in this study.

Starting point is 00:21:26 So again, like the guidelines, maybe a little bit less intense than what people imagine when they think of vigorous, which I think is kind of cool because when we start to discuss the benefits that vigorous activity had, it goes to show just the power that even kind of purposeful movement, even if it's not high intensity interval training, can have. Yeah. And I think it is important to point out, like, physical activity versus exercise, because people do typically when they think, when they hear even physical activity, they think, you know, structured exercise. It's a very, I think a very common, you know, thought is structured exercise is physical activity. But it's not necessarily structured exercise. It includes it, but it can also include all the things that you mentioned where you're, you know, playing with your

Starting point is 00:22:06 kids or you're playing with your dog or you're spreading up the stairs, you're walking to work or things like that. Like this is all physical activity and that's what this is all capturing. For sure. And it's kind of interesting when you think about that too because when we talk about the guidelines, I think a lot of people hear that and say 150 to 300 minutes of physical activity week. That means I need to be in the gym for 150 minutes to 300 minutes. But again, physical activity is different than exercise. Physical activity is any physical activity you're doing throughout the day. Exercise is defined, structured, a workout, like a training regimen that you, you know, go to the gym and you set aside time forward, but physical activity can be things done throughout the day, just integrated into your daily

Starting point is 00:22:45 life as well. Right, right. Okay, so health outcomes that were tracked in this study. We have, do you want to mention the health outcomes? Yeah, they pretty much tracked anything people are interested in in terms of health. So all cause mortality, death from any cause. Most people are aware of what that is cardiovascular disease mortality. So deaths from anything related to cardiovascular disease, heart attack, stroke, specifically,

Starting point is 00:23:08 major adverse cardiovascular events or mace, so that's heart attack, stroke, cardiovascular death, type 2 diabetes incidents, and then cancer incidents, and that included physical activity-related cancers as well. And one of the important points, too, about these health outcomes is that a lot of the problems with some of the previous studies were, it's this idea of the healthy user bias. So, oh, people who are more physically active, do they have lower disease risk, or do people who have less disease, do more activity. Well, they controlled for that in this study by excluding people who, if you developed any of these diseases within the first 12 months of the study, they were excluded. And additionally, anybody with a disease at baseline was excluded. So they tried their best to sort of

Starting point is 00:23:50 take care of this sick user or healthy user bias, which I think strengthens a lot of the outcomes in the study. That's a really important point. Okay. So I'm going to kind of get into some of these major findings in the study. And I think before getting into that, I just want to talk about that. When we're talking about the minutes to reduce all-cause mortality or cardiovascular-related mortality or cancer-related mortality, generally they were talking about this range between 5 to 35 percent risk reduction in, you know, reducing those mortality rates or disease incidents in the case of type-tured diabetes. You could go above that and we'll get into that when we talk about dose response. But I just want people to kind of be aware of that's kind of like the range that we're talking about here is like anywhere anywhere between 5 to 35 percent like risk reduction. Yeah, and I think the main thing too then to also mention before you get into the risk reduction was, and this was, I think, the most unique aspect of the study is they calculated something called the health equivalence ratio. So basically what they wanted to know in this study was, how many minutes of light activity or vigorous activity do you need to do to get the equivalent amount of risk reduction to a minute of vigorous intensity activity?

Starting point is 00:25:01 So it was this, they called it the health equivalence ratio in the study. they were basically looking at, you know, does this one to two, going back to the one to two rule that we talked about, does this one to two rule hold up? Do you need, if you do twice as much moderate activity does it give you the same disease reduction as a moderate, a minute of vigorous? Or is there like the skewed ratio? Is there more vigorous activity? You know, does that give you more risk reduction compared to a minute of, you know, lighter moderate activity? So when we're talking about it, you know, a lot of these studies just look at risk reduction at X level of physical activity. One of my favorite parts of this day was this health equivalence ratio thing that we're going to talk about because it really sheds some light on the impact of vigorous activity. That's great. Love it. Okay. So I think the biggest headline from this study was that vigorous intensity, physical activity was it wasn't a two to, you know, it wasn't twice as better than moderate intensity. Right.

Starting point is 00:25:56 We're talking anywhere between four times better to almost 10 times better than moderate intensity exercise, which is pretty big. So first of all, when it comes to all cause mortality, it seems as though one minute of vigorous intensity, physical activity was equivalent to about four minutes of moderate intensity activity. So basically, in terms of reducing all cause mortality, right? So this is the death from all non-accidental causes, right? And if you think about that, you know, vigorous intensity, physical activity is four times as potent in terms of, you know, you can get the bigger bang for your buck four times as potent at reducing the risk of all-cause mortality than moderate intensity, physical activity. That's pretty big.

Starting point is 00:26:42 But it actually gets even bigger when we look at cardiovascular-related mortality. And this is a really, really important point because, you know, cardiovascular disease is the number one cause of death in the United States, in many developed nations, including many European nations. So, It's something that's really, really important. And what I'm about to say will blow people's minds. I know it blew mine. And that is that vigorous intensity physical activity, for every one minute of vigorous intensity physical activity, you had to perform 7.8 minutes, almost eight minutes of moderate intensity, physical activity to get the same reduction, risk reduction in cardiovascular related mortality. I mean, that is insane. You know, so it kind of like, you know, you. You know, if you're thinking about I'm spending 75 minutes doing mod, sorry, doing intense, like more vigorous types of exercise, you're running or cycling or whatever, and you're thinking about that and go, how much time will I have to spend doing moderate intensity physical activity

Starting point is 00:27:47 to get that same benefit, health benefit on reducing my cardiovascular disease mortality risk? You'd have to, you'd have to multiply it by essentially eight. And that's huge, right? another big one is type 2 diabetes so this one isn't so surprising to me either and probably not to you as well vigorous for every one minute of vigorous intensity physical activity you had to spend about 9.4 minutes doing moderate intensity physical activity so it's almost 10 times as powerful at reducing the risk of developing type 2 diabetes and it's really not it's not that surprising because we do know that exercise intensity really does drive a lot of the metabolic adaptations and benefits that occur from exercise with respect to improving insulin sensitivity and blood glucose regulation and whatnot. But I mean, 10 times, nearly 10 times, right? That's nuts. And then the last big, I would say,

Starting point is 00:28:44 headline here with respect to comparing vigorous to moderate is cancer mortality. So for every one minute of vigorous intensity, physical activity, you had to spend about 3.4 or 3.5 minutes doing moderate intensity physical activity to get the same reduction in cancer mortality. So still underestimating, you know, if you're looking at the physical activity guidelines, underestimating the effect that vigorous intensity physical activity has on every single health outcome. You know, I mean, it's just, I feel like if people were to think about it like this, they would get so much more dopamine from their like more vigorous workouts where they would just be like, this is really doing something. You know, this is really doing something

Starting point is 00:29:28 beneficial for my overall health and for like the way age. Yeah. And I think maybe that's something we talk about later, but I just think that this could and probably should change the way like these wearable device companies program their algorithms and program their, the way they like gamify physical activity almost to enhance the, you know, the rewarding aspects of the activity that you're doing. No, yeah, definitely. Definitely. We should talk about that. and I 100% agree. But before we get there, they're going to talk a little bit more

Starting point is 00:29:59 about the insane difference between vigorous physical activity and light physical activity. I mean, it's so crazy to think about the difference between those that the time efficiency is like, you can't, you can't ignore. You can't ignore how efficient,

Starting point is 00:30:17 vigorous physical activity is. Yeah, some of these numbers were kind of incredible in the study. And like sometimes you look at them, you're like, does this like make any sense? But the numbers were insane for the health equivalence ratio of this light activity. Now moving from what you were just talking about moderate to what's the equivalence of light activity to vigorous activity.

Starting point is 00:30:35 So for all of the main outcomes, including cancer, light activity, one minute of vigorous activity was equal to 53 to 94 minutes of light activity. So to get the same mortality risk reduction as one minute of running, you might need, say, an hour or so of gentle walking, just kind of. of using a practical example there. Wait, just pause for a minute. One minute of vigorous physical activity. So let's, you know, let's just listen to this, an hour, equivalent to an hour of like gentle walking.

Starting point is 00:31:06 Time efficient right there. For sure. For diabetes prevention, it was nearly an hour and a half. So 94 minutes of light activity was equal to one minute of vigorous intensity activity. For the cardiovascular disease outcomes, 73 minutes for cardiovascular disease more test. 806 minutes for major adverse cardiovascular events. And then for cancer mortality, this one was the largest one. One minute of vigorous activity was equal to 156 minutes, so nearly two and a half hours

Starting point is 00:31:36 of light intensity activity. So I think all those numbers, again, they seem a little bit extreme, but, you know, that's what the data were showing. And I just think it goes to show that even like, as we just talked about, not even high intensity interval training, just vigorous, purposeful kind of effort, zone two above have this massively outsized benefit on health outcomes compared to light intensity activity. And I think, you know, this, I think, you know, you know, I've talked about high intensity before. And this isn't to say that the light intensity activity is useless.

Starting point is 00:32:08 Obviously, we both agree, any movement is better than just sitting around. But the study did find some benefits. So for all cause mortality and diabetes prevention, there were some benefits to doing more light intensity activity. but there were some outcomes, so say, for cardiovascular disease, mortality, stroke, heart attacks, it actually didn't really seem to have much of a benefit. Doing more light intensity, physical activity didn't significantly reduce. So there were, you know, five to 10 percent risk reductions, which the authors actually didn't consider to be meaningful in the context of this study. So

Starting point is 00:32:40 doing more physical activity, if it were light, didn't seem to produce an extra risk reduction for a lot of these outcomes other than diabetes and all-cause mortality reduction, which I think it's kind of important to point out there was a quote in the study from the authors. They said not even the largest amounts of daily LPA or low intensity physical activity can elicit the health benefits of moderate or vigorous intensity. So I think that tells us kind of all we need to know about the study that was kind of a very apt conclusion. Yeah, I agree. I mean, I think I was reading in the paper that, you know, it was the for light physical activity, it was capped at like 15% you got like a 15% reduction in you know cardiovascular related mortality in some of these things but like you know it just it didn't go beyond that even if you did hours and hours and hours that's like that's what you were capped at or like 10% for cancer something like that so it's like again you're just like you could for hours be doing light physical activity and you're only going to get that like 10% cap right there wasn't really there wasn't really a dose response a potent dose response is there in the study whereas with the vigorous intense

Starting point is 00:33:48 physical activity there was, but like before I get to that, I do want to, I did forget to mention the risk of having a heart attack or having a stroke. So these are these adverse events you were talking about with vigorous intensity, physical activity. For every one minute of that vigorous activity, you needed about 5.4 minutes of moderate intensity activity. So again, you know, heart attack, strokes, like those are major events that you want to avoid. And so, you know, you could, you could be so much more time efficient if you're doing bigger as physical activity versus the moderate even. It's certainly light.

Starting point is 00:34:23 I mean, that's like, again, I don't want to, like you said, being sedentary is a disease. We know that being sedentary is an independent risk factor, particularly for cancer. And I think that was where you were saying there was actually more, was it. Yeah, cancer. Yeah, it was, let's see. I think it was just for all-cause mortality and diabetes was for light activity. For light activity. For light. Cancer did have that huge equivalence when it was.

Starting point is 00:34:46 came to the light versus vigorous. So it was like 256 minutes, I think, of the light activity you needed for the risk reduction of vigorous. But yeah, no dose response for cancer for light activity either. Right. But yeah, so being sedentary is bad. So anything that makes you not sedentary is better. But, I mean, if we really, if we're talking about being physically active, I'm going to be, I'm going to be honest. I think we'd need to be talking about at least moderate, at least, preferably vigorous. And in fact, vigorous, it doesn't even have to be as vigorous as we usually talk about on this podcast. I mean, I talk about a lot about the benefits of going high intensity for the brain and all the, you know, it is still time efficient. But

Starting point is 00:35:25 right now we're talking about vigorous and it has a little bit of a wider range, right? So a little more room. Yeah. Which I think is a, I think is kind of liberating as well because we're not saying, oh my God, you need to do 300 minutes of high intensity interval training. The Norwegian 4x4. Right. Yeah, exactly. The Norwegian four by four. It's you just, I mean, if you get that amount of zone two just exercise is, is beneficial. So it's not, we'll maybe, you know, we'll talk about this later too, but it doesn't, you don't need to be doing constantly hit. It's just these crazy benefits with this purposeful zone two, even intensity movement is pretty pretty incredible. It's that we're really just dramatically underestimating the power of doing exercise, you know, and getting our heart rate up. I know we're not measuring heart rate, but essentially they do correlate. right? With the dose response curves with vigorous exercise, we did see a linear effect, both vigorous and moderate intensity both. But with the vigorous, I know that you could spend about 30 to 40 minutes per day doing this vigorous type of exercise. And that was associated with

Starting point is 00:36:27 50% or more greater reduction in like many of these categories for health outcomes, you know, cardiovascular related mortality, all cause mortality. So type 2 diabetes incidents, right? 50% or more, like reduction. That's pretty robust. And again, that was at the higher end of the vigorous intensity, physical activity. But there's definitely a dose response that was seen there. Yep. And with moderate too, so up to about 50 minutes per day, you kind of saw this linear dose response, this risk reduction, up to about 50 minutes per day of moderate activity. And then after that, you didn't see more risk reduction basically from getting more moderate activity. And then moving on to light activity, as we sort of already just mentioned, not much of or zero dose response relationship. So

Starting point is 00:37:09 you do some light activity, you get about a 10 to 15% risk reduction, but doing more of that up to, say, even two to three hours a day of that extra light activity didn't really seem to reduce risk much more. Right. Okay, so let's, I think that's pretty clear that we're dramatically underestimating the value of vigorous intensity, physical activity in terms of reducing the risk of a variety of different, you know, negative health outcomes, right? And so that's pretty clear, but the question is, why is that, right? And this is something that I would say we've sort of talked about on the podcast before. I've had a lot of different exercise physiologists, Dr. Ben Levine, Dr. Martin Cabala on the podcast, and we've talked a lot about the adaptations to physical activity. So I want to kind of start

Starting point is 00:37:56 off with the effects on cardiovascular health and the adaptations that occur in the cardiovascular system because I think it's probably one of the most important concepts here. And it does really come down to this idea of the stronger the stimulus is, the greater the adaptation, right? Now, obviously, you can always take something to the extreme case, right? If you were to exercise all the time nonstop, like, that's not good, but we're not talking about that. So the stronger the stimulus, the better the adaptation. And one of, just to kind of reiterate to people, before we talk about the adaptations, you know, remember one minute of vigorous physical activity was equivalent to almost eight times, right? So eight minutes of moderate intensity

Starting point is 00:38:45 physical activity. That's a big difference. And so one of the big adaptations here really comes down to increased blood flow. It's just getting your blood pumping, moving, because what happens is this causes what's called sheer stress on your vascular system, on the interior lining of the arteries. And what sheer stress is is essentially just the friction of the blood flow against this interior lining of the arteries in the vascular system, right? There's a friction there. And so the stronger the exercise, the more vigorous the exercise, the faster your heart is pumping, and that's why heart rate does come into this, the more your blood flow is moving, right? So you're getting a stronger sheer stress. And that is actually not a bad type of stress. It's a good

Starting point is 00:39:34 type of stress. The sheer stress causes your endothelial cells lining your arteries to adapt in a way where it improves vascular function. It improves endothelial function. And it causes these endothelial cells to secrete beneficial molecules. So one of those would be nitric oxide. Many people have heard of that. And the other one would be prostocyclin. And both of these compounds are causing vasodilation, you know, they're improving blood flow. But over time, and as you continue to repeat this sheer stress, what happens is you're improving the flexibility of your arteries, you're making them more resilient, they're able to handle stress better, you're improving their overall functioning, and you're making them more resilient and resistant to atherosclerosis.

Starting point is 00:40:26 Right. And that is essentially, I think, at the crux of what's going on here with respect to why vigorous intensity exercise is so beneficial for cardiovascular health. We know Dr. Levina's come on the podcast and talked about, you know, some of the benefits of doing more vigorous intensity exercise and how you get more stronger cardiovascular adaptations. And if we look at even that study he did in middle-aged adults where he took, you know, 50-year-olds and put them on a pretty, you know, I would say the exercise program, if you look at it, it was like all vigorous according to this definition of vigorous. And it was, what, five hours a week? About five hours a week. Yeah, five and six hours a week. Right. And so if we're talking about the definition in this study,

Starting point is 00:41:09 it was pretty much all vigorous because they were either running doing like a zone two type of run or they were doing Norwegian four by four, some high intensity interval training, some resistance training in there. And after two years, they reversed the structural aging of the heart by about 20 years. You know, and that's pretty profound. So the cardiovascular adaptations are real. They are real. Yeah, and I mean, a lot of the, if you read any of the randomized control trials to just comparing moderate intensity training to high intensity interval training, if you look at the effects on endothelial function, like you mentioned in artery stiffness, it's not, it doesn't even come close. Like even when they're volume matched, so you say you do the same amount of volume of moderate intensity and high intensity interval training, it's high intensity interval training. It's high intensity interval training always wins in terms of improving vascular function. And it's just, it all comes down really that sheer stress that you mentioned.

Starting point is 00:41:59 And it's so higher intensity, more sheer stress, it's good. The sheer stress is almost like a bad name for it. Because like you said, it kind of sounds bad. You don't want sheer stress. But like you do, the more sheer stress you get, the better. And it's not just a simple dose response. It's just not like an area under the curve, I guess, type of thing. It's you can't just do more low intensity because you're not getting the, it's the intensity of the sheer stress, not the amount over time that actually matters for those endothelial adaptations.

Starting point is 00:42:24 So it's really important to do hit in that respect for sure. That's a really good point because it's kind of. like thinking of a light breeze blowing across your face versus a strong wind. Yeah. Right. Like, there's a difference between a light. Like, you can't have a, you could have a light breeze last for a really long time, but it ain't going to knock over some trees, right? Like, it's not going to, like, you need that, you need that stronger wind. And that's what you need with the sheer stress in your vascular system. It needs to be stronger to cause, you know, to basically signal to your body, hey, this is stressful. Let's respond to that stress. But it's not so stressful. It's not a heart

Starting point is 00:42:57 attack kind of stress, right? Like, that's too much stress, right? It's just enough to, like, give you these adaptations so that when you have really stressful situations happening, your arteries and your vascular system respond better, right? So I really like that. You pointed that out. Let's talk about, you know, how heart and lung function together, right? Like the cardiorespiratory, you know, system and how vigorous intensity activity really plays a role there as well. Yeah. So I think similar to kind of the cardiovascular stress, the endothelial stress, higher intensity of exercise are going to increase metabolic demand, increase your oxygen demand in your muscles, which is going to force your body to need, it needs to deliver more oxygen to your working muscles.

Starting point is 00:43:42 That means your heart is going to work harder. Your stroke volume is going to go up. So stroke volume for people who may not be familiar, it's the amount of blood that your heart is pumping out per beat. So it fills with blood and it pumps it out and usually expressed in something like liters per minute. That would be your stroke volume. It forces your stroke volume to go up. Your heart rate obviously goes up during more vigorous exercise, but also your lungs are going to fill and, you know, be stressed more to deliver more of that oxygen to your body. And so that's another one of these reasons why vigorous and, you know, even zone two intensity of exercise up to a point, they're going to stress the cardiac system, the heart and the lungs

Starting point is 00:44:16 more. That's going to force your body to adapt and your heart is going to get stronger. Your lungs are going to get stronger. And I think one of the key adaptation, there is obviously, again, the increase in stroke volume that you get. That's one of the best predictors, or that's the main thing that increases when VO2 max increases. So if you look at these studies showing, you know, what's the main adaptation that gives you a better VO2 max? It's higher stroke volume because that gives you a greater cardiac output. Your heart can punt more blood to your body. You can use more oxygen during exercise. And so that's one of the reasons why hit is so effective because it increases your oxygen to demand more. It forces your heart to work harder,

Starting point is 00:44:54 and you're improving that stroke volume. And then same thing with the lungs. I think the lungs are a little bit not less adaptable, but they do adapt less because in a lot of people, once you have asthma or something like that, the lungs are a little overbuilt maybe for exercise. Like most of us have plenty of lung function, but the heart is really what's going to adapt there. And so I think that, you know, again, is why we see this efficiency with his vigorous intensity

Starting point is 00:45:16 exercise in this study and in others because you're just, the heart is being stressed more and you're going to have a stronger heart if you're engaging in more. higher intensity activities that are forcing the heart to adapt. Going back to Ben Levine, I think he cited, you know, that similar study, but he talked about how, especially after, say, age 50, 60, 70, you need these higher intensities. Again, it doesn't have to be hit, but it has to be pretty vigorous to force the heart to adapt and prevent cardiac fibrosis, cardiac stiffening of the heart. If you don't get that high intensity training, you know, like low intensity really just doesn't cut it. And so, you know, in this study, the cohort that we're talking about, they were aged 40 to

Starting point is 00:45:55 79. So that might be why vigorous exercise had this outsized benefit on specifically cardiovascular outcomes, that 8 to 1 ratio, like you mentioned, that incredible, like higher than some of these other outcomes. So I think that's why was that outsized benefit as well. Yeah, I think for people, with respect to like, why is it important to improve your VO2 max, you know, your cardio respiratory fitness, that being a pretty important marker for longevity and, you know, for lowering your risk of death from all causes of mortality, right? So essentially, like, we've talked about this before last podcast we did together, right? People with the highest cardiorespiratory fitness as measured by VO2 max. They had a five-year increased life expectancy compared to the lowest

Starting point is 00:46:38 people with the lower or lowest cardiorespiratory fitness or the eight, they had 80% lower all-cause mortality. Right. So, any way you look at it, you know, if you are in that higher cardiorespiratory fitness range, you are talking about, you know, a lifespan, life expectancy, you know, extension compared to if you were not in that, in that range. For sure. And after about age 30 to 40 into your 50s, your Vuteumach starts to decline about 10% per decade. So if you're not doing something to maintain that, yes, you can build it up as much as you can

Starting point is 00:47:09 into your 30s and 40s. But if you aren't engaging in moderate to vigorous intensity exercises at age 40, 50, 60, 70, your view of 2 max is just going to continue to drop 10% per decade. The only way to maintain that or even build that is to do these more vigorous types of exercise. Yeah. And I think this is kind of important. Again, you know, I know people are going to be confused because we've talked about vigorous intensity exercise in such a different context than this study. And also then the physical health guidelines.

Starting point is 00:47:38 And, you know, just going back to this study that, um, Marty Gabala cited on the podcast a few years ago where he talked about, you know, 40% of people that are meeting the guidelines for moderate intensity physical activity. So that would be 150 minutes to 300 minutes a week doing this, what is defined as moderate intensity activity, right? They are unable to continue to improve their cardiorespiratory fitness, their VO2 max, unless they're engaging in more vigorous types of exercise. So again, in this regard, it seems as though the vigorous intensity,

Starting point is 00:48:10 exercises is not as vigorous as perhaps one's thought. Right. What are your thoughts on that? Yeah, I would agree. And I think one of the reasons maybe why we're seeing that signal there is because when we talked about the methodology of this study, these devices were capturing all the activity that they were doing throughout the day. And you and I are going to talk about, I think, exercise snacks and Vilpa a little bit later.

Starting point is 00:48:33 But, and I think that's why we're seeing this extra added benefit of this vigorous and moderate activity is because this device was capturing everything, not just those intense, those sessions that people remembered. So it was really getting like the full spectrum of activity throughout the day and seeing this massive risk reduction. But yes, I mean, with regard to the non-responders thing, I think that specifically might refer to, you know, adding some deliberate high intensity interval training into your, you know, schedule during the day. But yeah, I think it's another illustration of how just like the low intensity kind of doesn't cut it. And the guidelines, you know, some people don't respond well to the guidelines.

Starting point is 00:49:12 And we either need an update or you need to do more or probably some combination of the both. Yeah, more emphasis on vigorous, I think, too, as well. Okay, so some of the other adaptations, let's talk about, you know, the type 2 diabetes, lowering the new diagnosis of type 2 diabetes was very profound, right? Here we're talking about almost vigorous intensity was almost 10 times as effective, right? That's big. So why is that? And again, that is something that I've talked about.

Starting point is 00:49:38 a lot. And I did a podcast like a solo cast on vigorous intensity exercise and talked about, you know, why vigorous intensity seems to be really key for improving metabolic health. When, you know, when you are working harder, when you're working your muscles harder, when you're basically forcing your muscles to produce energy quicker, what ends up happening is you're not using your mitochondria all the time. You're sometimes, you're going to be using your mitochondria, but you're sometimes going to be making energy without them as well. And so you're going to be making something called lactate as a quote unquote byproduct, which is not necessarily a byproduct.

Starting point is 00:50:16 It's an active metabolite. And why is that important? Because lactate is not only a metabolite in some ways it actually acts as a hormone, is a signaling molecule that's signaling to, you know, other proteins, to other organs to basically work harder and, like, respond to this hard work that is going on, right? So with improved insulin sensitivity, we do know that vigorous intensity exercise. For one, it does cause your muscles to contract, right? So you can actually just in and of that of itself, if your muscles are, you know, contracting, you can basically cause 50 to 100 times more contractions than at rest. That's a lot, right?

Starting point is 00:50:56 And that actually forces glucose to come into your muscle. So your muscle is a big sink for glucose. But your muscle also has to transport that glucose across it. And that's where lactate comes in. in because when you're working hard, your muscles are producing lactate. And that lactate essentially signals to your muscle to increase these glute four transporters. These are the transporters that are responsible for bringing glucose out of your circulation, pulling it into the muscle. And so lactate's actually what is responsible for that, for that, you know, signaling to

Starting point is 00:51:30 increase the glute four number or translocation to the cell surface, muscle cell surface. And so what happens is that you're basically with the more intense or the more vigorous intensity of the activity, the more glucose you're going to bring in because you're having more of those transporters there. And the transporters actually last around for a while. So there's a lasting effect. It's not like they just, they're there when you're working out and then they go back. No, they stay active for quite a while, right? Bringing more glucose in. And so it's, it's unbelievable to actually think about how beneficial, vigorous intensity activity. is if you're thinking about, you know, a 10 times efficient. I've seen, and I know that there's been a couple of studies showing that vigorous intensity activity, you can do like 15 minutes of vigorous intensity activity, and that's equivalent to like 45 minutes of moderate intensity in terms of glucose regulation. I would say there's even other studies out there showing like a one to five ratio as well. But this study itself, if we're talking about outcome, not just biomarker data, we're talking about outcomes. We're talking about new diagnosis of diabetes.

Starting point is 00:52:36 it suggested a 1 to 10 ratio almost. It was 9.4, but almost 1 to 10. So I really do think that this confirms that, you know, obviously we've looked at a lot of biomarker data with these randomized controlled trials. We've had Marty Cabala on the podcast talking about, you know, tons of these, the, you know, trials showing that if you do high intensity interval training for volume-matched moderate intensity continuous exercise, you will get improvements in insulin sensitivity and blood glucose regulation and a lot of different metabolic markers. Again, volume matched. It wasn't necessarily one to 10, but there were improvements, whether it was like a one to three, one to five, you know, whatever it was. It was definitely for volume matched. It was better. But we're talking

Starting point is 00:53:21 about, again, even more than that if we're looking at the actual type two diabetes diagnosis. Yeah. I mean, I feel like it aligns with a lot of his studies that he's done because, I mean, I know his group has done some of these sprint interval training studies where they're doing less than 10 minutes of exercise per workout. And then you compare that to a 45 to 60 minutes. So it's, it almost kind of lines up with what we're seeing in this study, the one to 10 ratio with, you know, in some of his actual randomized controlled trials, that one to 10 sort of ratio between the sprint interval training and the moderate training too.

Starting point is 00:53:54 And one of the things, though, I wanted to mention, I think, I think the signal here for diabetes risk was probably the most drastic. one to 10 ratio of moderate to vigorous. And obviously, you know, exercise is important for it. But I think what's important probably why this signal is showing up in this study is because the movement throughout the day is what I think is so important for glucose control. Yeah, if you do it work out in the morning and don't do anything the rest of the day, you're going to be probably pretty insulin sensitive throughout the day. But what really is better is doing, you know, 10, 15 minute kind of bouts of movement throughout the day if you're really trying to improve your

Starting point is 00:54:28 glucose control. And so I think that's one of the reasons why in this study that objectively measured every single type of physical activity people were doing, the vigorous exercise was shown to be so beneficial because if you're just moving more throughout your day, you have better glucose control. You're definitely going to have better long-term outcomes than for diabetes risk and things like that. You're going to have lower HBA1C, better insulin sensitivity, lower fasting glucose. And so I think that's sort of why that's showing up here in the actual outcomes, like you said, which for most people are more important than the biomarker data, probably. Right, yeah.

Starting point is 00:55:02 And I also just want to add on to that, like a couple of things. One, you know, that makes a lot of sense to you, by the way, you know, doing the exercise throughout the day and the fact of the matter is this specific study that was published in Nature Communications did pick that up because of the accelerometer data. But I do want to emphasize the lactate signaling here and just knowing that as you are getting that vigorous intensity exercise, that is really, like, it's not just a muscle control. is glucose in thing. It's a glute 4 transporter where you are for a longer period of time throughout the day and perhaps even the next day somewhat, but definitely for 24 hours,

Starting point is 00:55:39 those transporters are active and ready. And so I think that's another really just powerful effect of, you know, the intensity of exercise on top of the fact that we also know that when you engage in more vigorous intensity exercise, the lactate also signals to another protein called PGC1 Alpha, which is responsible for the growth of new mitochondria. This is mitochondrial biogenesis. So this is happening in your muscle cells as well. And this is improving metabolism of not just glucose, but other substrates like fatty acids as well. And so I think there's this long-term effect. And if we're looking at, you know, type 2 diabetes, we're not just looking at biomarkers. I don't know you necessarily would pick that up on biomarker data if you're just looking

Starting point is 00:56:22 at blood glucose regulation or insulin sensitivity. But if you're looking over the course of like, you know, several years and you have better mitochondria, more healthy mitochondria on top of, like, you know, improved glucose regulation through the glute transporters and all that, you probably are also going to just see a healthier metabolic profile, right? I mean, that's something else to... For sure. I think unless you were measuring, like, with a continuous glucose monitor, you really wouldn't measure that. You know, I think sometimes he's fasting. I don't know how much stock to put in, say, like a fasting biomarker of your fasting blood glucose taken

Starting point is 00:56:55 one time per year, like every single year, like what does that really mean? But now that we have access to CGMs and technology like that, I think you could actually, you would actually see it in that data. Right. Especially, well, you know, and we don't really have any good biomarkers for mitochondrial health. Like that's like not, it hasn't been translated to the clinic yet. It's something that researchers can do. In fact, I'm looking at, talking about some of the studies that Marty Gabala cited on the podcast previously for volume matched exercise, high intensity, interval training is better at increasing mitochondrial biogenesis than moderate intensity exercise. Again, it has to do with that stronger stimulus causing the adaptation when you're forcing your muscles

Starting point is 00:57:36 to work so hard that they can't produce all the energy they need from just using their mitochondria alone. It forces them to also use just glucose without mitochondria. Your muscles like, dude, I need more mitochondria. This isn't working, right? So that's an adaptation that's happening and it makes sense. And so I know a lot of people for, for, I've at least gotten a lot of questions from people talking about, but I thought zone two training was the best for mitochondria. And, you know, it depends on what we're talking about here. We're talking about mitochondrial biogenesis, you know, great. Zone two does increase mitochondrial biogenesis. But, you know, if you start to go a little more vigorous, you actually can get a stronger stimulus. And I know that's, um, what we're talking about

Starting point is 00:58:17 here, vigorous includes zone two. But I'm just saying, generally speaking, um, it, the more, it just gets back to this whole idea, right? The more intense the stimulus, the greater the adaptation to a degree. Obviously, you don't want to go to the complete extreme where it's like, all you do is work out. Like, I'm not going to say that's all you do, but you definitely work out a lot. Sometimes it seems like that. My wife will tell you maybe sometimes it seems like that. But yeah, regarding the biomarkers of mitochondrial function, I know that's not where we're like talking about, but it is interesting to, you know, hopefully someday we have like an ability to look at, you know, a non-invasive test of, say, your mitochondria, I think the best thing right now,

Starting point is 00:58:54 which a lot of, which people have access to, but it's kind of burdensome is to test your lactate during exercise or your resting lactate. If your resting lactate is elevated or if you do low intensity exercise and your lactate levels are spiking up, your mitochondria probably are good. That's like a poor way to describe it. But either poor mitochondrial function, not enough mitochondria. So I think like a lactate test during exercise is probably the best way, like currently non-invasively without having a muscle biopsy done. But sooner or later, hopefully we have some sort of biomarker to say, you know, what do your mitochondria look like? Yeah, no. And people, yeah, people can buy these lactate meters and it's a little finger prick test you can do. And I've done it

Starting point is 00:59:33 several times. And it's kind of fun to do as well. So I encourage people to try that out. I think another sort of surrogate marker in my mind is also looking at oxidative stress markers, because when your mitochondria are not functioning well, if they're damaged, if they're unhealthy, they will produce more reactive auction species. They are the major generator of reactive auction species. And so, you know, that's another sort of surrogate marker, I would say, as well. But yeah, it's kind of annoying that we don't have a direct marker of mitochondrial function. And I know people are working on that.

Starting point is 01:00:04 But, you know, everything takes a long time to make its way to our homes. Yeah, for sure. Unless you want to go get one of these huge, like, health panels done, that costs probably several thousand dollars to do. But I mean, honestly, like maybe it doesn't matter too much, but it would be interesting for people to know, you know, does this protocol actually increase you mitochondria or not? I mean, the biohackers out there want to know, right? They do for sure. And we were talking about this urolithin A compound on the drive up here and how that's important for mitochondrial health. And we're actually going to cover it in a newsletter.

Starting point is 01:00:36 But I'm taking it right now. And I'm like, it's all, what am I measuring to know if it's really doing anything, right? I guess V-O-2 max would be something to measure, but you have to have good baselines and I don't have all that. So, you know. Yeah. Sometimes it's all, I guess, exercise in faith maybe. Hoping this boost my mitochondria. At least I think it does.

Starting point is 01:00:57 Okay. Well, I want to circle back to sheer stress because that also plays a role in some of the mechanisms behind the reduction in cancer mortality as well. And that's something that Dr. Kerry Kernier talked about on the podcast. So, you know, the reductions in cancer-related mortality weren't as high as, you know, the type two diabetes risk reduction, but there's still significant enough, right? You're talking 3.5, for every one minute of vigorous activity, you have to spend 3.5 minutes of, you know, moderate intensity activity, almost four minutes, right? If you round up, I would say it's almost four minutes. Why is that the case? Well, there's probably a lot of, again, mechanisms, but one that I think

Starting point is 01:01:39 that's super interesting is that sheer stress that's improving your endothelial function, that's improving, you know, the function of your arteries and in your blood vessels. It's also playing a role in killing cancer cells. And you might go, what are you talking about? So when people, when people have a primary tumor, the cancer cells that make up that primary tumor don't all necessarily stay at that site of the tumor, right? So what happens is oftentimes, you have these cancer cells that will escape the primary site, either through the lymphatic system, they get into circulation. And when they're in circulation, they're called circulating tumor cells. And those circulating tumor cells are not like your normal blood cells. They're not like your

Starting point is 01:02:25 normal white blood cells or red blood cells in your circulation. They're all kinds of messed up. They have tons of different mutations. Your body is ready for them to die. Like they are ready to die. They are primed to die. And the only reason why these cells are not dying is because they have found a way to increase all of their proteins that are basically stopping them from dying. And it's like a balancing. There's like these proteins inside your body that promote death. And there's these other ones that like stop death. And it's really just a balance. So like when the balance goes into promoting death, the cell dies. If you've got that anti-death, so they're called anti-Apeopotic proteins, if they're higher, like even if they're like supposed to die, as long as that signal is saying,

Starting point is 01:03:11 no, don't die, they won't die, even though they're all kinds of messed up, right? And so cancer cells are, that's, that's kind of why, you know, chemotherapy, radiation, these things that are very, they're damaging, right? It's a, it's a major stress on all cells. It's a death signal. It's why it's, it does effectively kill cancer cells is because they're, they already have so much of that pro-death signal there. There's just a little bit of the. anti-yapoptotic signal and they're just waiting to raise above it. And so that's what those things do, chemo and, you know, and so on. So unfortunately, they also kill normal cells as well because it's a very strong death signal. When it comes to the circulating tumor cells,

Starting point is 01:03:50 they're ready to die. And I know I went on a tangent. I'm sorry. I studied cancer in my graduate school. They have these mechanosensors on their cell surface. And so they're very sensitive to mechanical forces and movement. And that is something that can act as a death signal. So if you think about the shearing forces, right, shering forces of blood flow, that is friction against these cancer cells that, again, are responding in a way that it's a negative stress to them and they die. And that's something that's been shown in vitro. It's something that if you look at people that have circulating tumor cells, if they engage in physical activity, they're less likely to have cancer recurrence or cancer metastasize. So the circulating tumor cells,

Starting point is 01:04:34 why is it so dangerous to have them in circulation? Well, for one, let's say you already had cancer and you were treated with cancer successfully, quote unquote. Let's say you're, you know, you got chemo radiation, maybe surgery, maybe all of the, all three of them, right? And now you're tumor-free, whatever. So you're in remission. But the problem is, is that currently in the clinic, we're not looking, we're not doing single cell analysis and looking at every single cell and every single organ to make sure there's not even one cancer cell left, right? Like we're just saying, oh, the tumor, we don't see the tumor, therefore we, you know, cancer's gone. What happens is these single cells, they do escape. And if they get into circulation, they'll maybe go some, maybe they'll

Starting point is 01:05:16 travel to another organ, like the liver or something. And it might take a couple of decades, three, four decades. And all of a sudden, you're having symptoms and you're like, well, I have liver cancer now, right? So cancer recurrence happens. Maybe it's even in the same, the same organ, whatever. The point here is that the circulating tumor cells are really, they play a role in cancer metastasis to other organs and they play a role in cancer recurrence and people that have already had cancer and perhaps been treated successfully with that cancer. So the shearing forces are really important here because they do kill the circulating tumor cells that is associated with improved outcomes either in cancer recurrence and mortality. And that is reflective in what this

Starting point is 01:05:55 study here is showing that vigorous intensity physical activity is associated with a lower cancer mortality. And I know that was a very long-winded way of explaining it, but it is a little bit of a passion of mine. So I think there's other mechanisms at play, but I do like the shearing forces one, because it's something that people don't think about. But it is, I think, once you hear it and you think about it, you're like, oh, that makes sense. It makes sense to me. I mean, I've heard you explain it, you know, multiple times. And even the studies that, you know, Kerry Cunier was involved in that we kind of researched and you guys talked about in your podcast, it's like exercise. directly kills it, kills the circulating tumor cells, which I think is interesting.

Starting point is 01:06:35 I was wondering, you know, whether you think the stronger sort of risk reduction maybe from exercise in this study could have been due to just the fact that, you know, cancer does have obviously a genetic and kind of environmental components. So maybe that's why we're seeing that one to, it was like four maybe ratio instead of the one to ten or one to eight ratio with cardiovascular disease or diabetes risk that we saw in this study. Yeah. I mean, there's obviously cancer. There's so many things that are involved. And, I think you're going to talk a little bit about some of the hormonal and other cellular responses, which, I mean, hormonal response, like there's a lot of things going on with cancer. But, yeah, there's a genetic component and there's other environmental factors that play a role as well.

Starting point is 01:07:14 Yeah. So then just moving on to, I guess, we had two more mechanisms sort of the hormonal cellular responses, as you mentioned. I think you kind of covered that pretty well. But obviously, with these vigorous intensity activities, you get more adrenaline, more cortisol, more growth hormone. Anything that you get with low-intensity activity is sort of just, heightened with high intensity activity. Hence the idea that you don't want to overdo high intensity exercise because you get too much cortisol, too much, you know, adrenaline. And if you don't let that recover and then go back to normal and do it again,

Starting point is 01:07:43 it could lead to, you know, burnout or overtraining however we want to define it. But you just get sort of this more, better hormonal milieu, I guess, during high intensity and vigorous exercise that you get during low intensity exercise, which I think explains probably the reduction in all of these, you know, different outcomes. diabetes, cancer, cardiovascular disease. But the last thing I think that is important with vigorous exercise for, especially when we're talking in the context of older adults, is this muscle fiber recruitment. So most people will be aware that muscle fibers are categorized into different types. We have type 1, which are referred to as slow twitch muscle fibers. Then we have

Starting point is 01:08:23 type 2. There are subsets of type 2 and maybe don't need to go into the details of those, but we have to A, to B, and then to X, they kind of go on this spectrum from very fast oxidative glycolytic to sort of this mix between aerobic and glycolytic fibers, but we'll just put them in these buckets of type 1 and type 2 for now. Type 2 are fast twitch, type 1 are slow twitch fibers. During low intensity activity, we're going to activate those low or those slow twitch fibers. So if you're leisurely walking, you're doing the dishes, just to use some of the examples from this study, you're going to be activating those low intensity, those type 1 fibers. even if you're doing something like endurance exercise for the most part, probably type 1 fibers

Starting point is 01:09:04 are going to be activated. And then as you increase the intensity of exercise, increase the force of, you know, or the weight of something that you're moving if you're lifting weights, that you're going to progressively activate more type 1 fibers and then move on to the type 2 fibers eventually. And so in the context of this study, I think, you know, why are we seeing this outsized impact of vigorous movement throughout the day? Well, if you're doing more vigorous movement, you're activating these type two fibers more, and you're giving them more of a stimulus. And type two fibers are the type of fibers that will atrophy first and lose strength first with age. So you lose type two fibers first, and then we move down to losing those type 1 or weakening of type 1 fibers.

Starting point is 01:09:44 And so the more vigorous exercise you're engaging in, just even if it's just chores, even if it's, if you pick up a box, you're engaging type 2 fibers, depending on how heavy that box is, obviously. If you're carrying your kid, you might be engaging type two fibers. So just doing this more vigorous activity throughout the day and then obviously engaging in high intensity exercise and vigorous exercise, you're going to engage more of those type two fibers. And those play, I think, a role, an important role in a few things. So for diabetes, going back to what you talked about, more glucose. So if you can activate those type two fibers, you're going to be able to use more glucose,

Starting point is 01:10:18 better your insulin sensitivity, lower your fasting blood glucose. But with all-cause mortality, too, it's kind of interesting because, you know, I know that one of the people who talks about this most is like Peter Attia, but, you know, the leading cause of death or one of the leading causes of death among older adults is you fall, you break a hip, you're in bed for several weeks, you never recover from that. Well, what type two fibers are important for, these are these are the power fibers, these are what, if you trip over something and you need to catch yourself or you need to just prevent yourself from falling, the type two fibers are what are going

Starting point is 01:10:49 to be responsible for that. And if you have more power producing fibers, stronger type two fibers, you're going to be less likely to fall, hence you're going to be less likely to experience these disuse atrophy or these catabolic crises, as you've referred to it before. And so I think that when you look at a cohort of adults like this one, over 70,000 people who inevitably are probably experiencing falls at older ages, and that could be one of the reasons contributing to their all-cause mortality rate. They're doing more vigorous activity. They're less likely to fall. They probably have a lower chance of experiencing all-cause mortality. And so just trying to tie that into maybe a few of the different outcomes in this study, diabetes and all-cause mortality, I think that's

Starting point is 01:11:33 why we see the benefit there is because if you're doing more of this low or this high-intensity activity throughout the day, you're engaging more type two fibers. And we've got to protect those. So the ones that go first, power and strength decline with age. And that's a result of the loss of type two fibers primarily. Really good points, Brady. I 100% agree. I mean, I think that's probably really tight into the reduction in all-cause mortality. And it's also, you know, one of the big reasons why I engage in CrossFit. I do a lot of CrossFit types of training because I'm getting, I'm getting the functional, I'm getting the explosive power, I'm getting the strength, you know, I'm doing all that type of resistance training, but it's mixed in with aerobic and these

Starting point is 01:12:15 high-intensity, vigorous, you know, types of workouts. And so you're really just getting it all. And for me, it's a very time-efficient, great way to get the whole shebang, right? It's not just the cardiorespiratory improvements, but also the effects on the muscle improvements and muscle health and strength as well. So the other thing that I wanted to mention with respect to the adaptations was inflammation, right? I mean, so the more intense, the exercise stimulus, you're actually generating inflammatory compounds, IL-6 being like the big one, and that I'm, you're, you're Isle 6 is actually signals to, you know, have this anti-inflammatory response. So it's funny if you look at the curves, you'll see like a timing effect where it's like IL6 peaks. And then like it shifts like,

Starting point is 01:13:04 I don't remember how much later it is, maybe an hour or so. You start to see IL-10, which is an anti-inflammatory cytokine. And I'm not talking about in this study. I'm talking about other studies that I've looked at inflammatory biomarkers. But you'll see this strong anti-inflammatory response. And this is part of that, you know, something I've talked about before in the podcast. for several years is this hormetic response where you're engaging in this type of stressful activity, which in this case we're talking about physical activity and the more vigorous it is, the more stressful it is. And that is a stress on the body.

Starting point is 01:13:36 And that does cause inflammation. It does cause oxidative stress. It's causing it, it's a stress on the body. But your body is able to adapt to that. And the adaptations is really what we're going for, right? And so the stronger, you're getting this inflammatory response, you're getting that anti-inflammatory response that then lasts, right? It's like, it's not just like countering the a little bit of inflammation that you generated during your workout. It lasts throughout the day. And so like as you experience other

Starting point is 01:14:01 stressful things in life, whether it's you ate your, you know, ate a bag of chips or whatever. I mean, obviously you're going to have the calorie intake, but, you know, the inflammation generated, you're going to deal with it just a little bit better than if you hadn't have been physically active, right? And so the inflammation and the anti-inflammatory adaptation that's responding to that inflammation is also important because inflammation is a driver of many chronic diseases, including cardiovascular disease, including cancer, type two diabetes. It plays a role in everything, brain aging. And we didn't get into that, but I do feel like this is a good time to just mention it because we're talking about mechanisms. And I've mentioned, you know, the lactate signaling molecule. We know that lactate

Starting point is 01:14:39 generated from exercise, particularly as you get into that vigorous type of exercise, that it does get into the brain. There's actually human studies showing that it gets into the brain. And we know it's a signaling molecule for brain-drive neurotrophic factor, very important growth factor for brain health, to grow new neurons, to, you know, improve the neuroplasticity of the brain, plays a role in brain aging. So it's not, it just goes everywhere, right? It's not just the outcomes we're looking at, but also brain, I think brain health, I wish that would have been looked at like Alzheimer's disease, right? Like, that would have been another really, I really wish they would have put that on there. Yeah, I think, and I don't know if we've covered it,

Starting point is 01:15:18 but I'm sure that there are studies out there because the UK Biobank is so huge and they've published hundreds of studies at this point, but I'm pretty positive and I can't cite a study off the top of my head, but I know there are studies linking some of the same UK Biobank physical activity data to slower brain aging. And what's cool about the UK Biobank is they literally have measures of not just Alzheimer's risk, but physical atrophying of these different brain areas. And so, yeah, again, I don't have a study, but I know that they've published studies from the UK Biobank showing probably dose responses with moderate and vigorous exercise and physical aging of the brain and then lower risks of dementia, Alzheimer's, you name it. I mean, it's, you know, it's pretty inevitable that

Starting point is 01:15:59 you're going to see that risk reduction there. Right. It's pretty clear. Again, like if you can do that vigorous intensity activity, you're going to get, you're going to get more bang for your buck. It's going to be worth so much more than we previously thought. It's not just two times as good. I mean, it's, it's much more than that. It's four times as good. It's eight times as good. It's 10 times is good, right, depending on the outcome we're looking at. It's just so much better than we thought. Yeah. And I think that I think us discussing the mechanisms, you know, while I think it's super important because it, the mechanisms explain why vigorous exercise is more beneficial for health outcomes than we thought with that two to one ratio. And that's why it has such as outsized benefit because it's,

Starting point is 01:16:42 it's setting this louder signal to the body, regardless of what you look at. You look at cancer. You look at blood glucose. you look at the cardiovascular adaptations. The overall signal is just louder, and it's not just a matter of, oh, you burn twice as many calories, so it's twice as good for your health. No, you can't really quantify it. It's an exponentially better increase for X outcome

Starting point is 01:17:02 that you're looking at, this physiological mechanism. It's an exponential increase when you up that intensity. And so I think it's important for people to know what mechanisms are responsible. And then knowing that, you can see, well, this is obviously why vigorous exercises is better, or vigorous physical activity, rather, to use the correct phrase, compared to lighter in modern intensities. Brady, I totally agree. And I think that, you know, obviously, like, for people that are focused on weight loss, like, great, two to one ratio, you know, that's perfect for you to consider as well as counting your calories or, you know, figuring out, you know, what you're consuming because that's obviously an important factor for weight loss. But like, we're not talking about weight loss here. We're talking about reducing our risk for, you know, cardiovascular disease and cancer and type diabetes. And so it is really important. important to realize that two to one ratio is just out the door. It's out the door. And, and, and we didn't talk about all the mechanisms. I mean, we could, we could spend like five hours

Starting point is 01:17:54 just talking about mechanisms and people would be so angry with me. But like immune related responses, I mean, there's so many other things going on. When you exercise, there's like 500 different molecules changing and, you know, different physiological processes happening. I mean, you just, that's why you can't pill up exercise. Like, you just can't. It won't ever happen. Yes, I said that. It won't ever happen. Someone's going to come out with an exercise pill. And it's going to totally not be an exercise pill. And it's going to be one aspect of it. But like you just, there's so many different physiological adaptations that are occurring

Starting point is 01:18:24 in different organs. And you're just, it's, it's really a panacea. It really is. Yeah. Everybody wants to say, oh, well, PGC1 alpha, that's like the exercise pill. It's like, well, that's just, that's just one part of it. Small part. Small part.

Starting point is 01:18:38 I know. I mean, there's so many things to focus on. I mean, that's why I really like in the past few years, exercise. has been like the focus of not only this podcast, but just in my personal life. Like I have, it's a priority. Like, no matter what, I get exercise. And it could just be 10 minutes. It could be 10 minutes of vigorous intensity exercise. And now after this study, I'm even more excited about my 10 minute workouts because I'm really getting more than I even thought I was. Totally. So let's talk about some of these, you know, sort of short bursts of physical activity, starting with the vigorous,

Starting point is 01:19:13 intermittent lifestyle activity studies. These are the Vilpa studies. We've talked about these before on the podcast. Marty Kabbala came on. He's been a co-author on some of these papers, talking about this concept where, you know, researchers are using these accelerometers. They are measuring people's everyday movement in these short bursts that they don't necessarily consider if you sit down and ask them about their physical activity for the past week, right? So these short bursts of, you know, carrying groceries up three flights of stairs or I race to get to catch my you know subway because I didn't want to miss it or yeah I was playing with my new four month old puppy puppy like I do twice a day or whatever like these are short bursts of your physical activity where you're getting your heart rate up in everyday situations

Starting point is 01:20:00 it's not necessarily a structured exercise snack which you know also is another way of doing that but it's again it's the stuff that people are just sort of everyday doing as part of their lives and um there's just I think mounting evidence now, there's beneficial outcomes with these types of short bursts of physical activity that we just can't ignore. We just can't ignore it anymore. And I've probably cited this one nature study like a million times. So forgive me for the people that have heard me say this a million times. I think you're responsible probably for the, I don't know, however many like downloads of that article on their website they have. Yeah, it's pretty popular. It's pretty popular study. So people, these short vilpas can be anywhere between one

Starting point is 01:20:41 minute to three minutes in length. They're not super long. It's certainly that 10 minute on the Peloton, right? One to three minutes. And they're done multiple times a day, right? Because it's like just your everyday life is what we're talking about. And so one of the most profound findings of the study I like to talk about one of the one of the Velpa studies is on the upper end of that. So people that are doing like the three minutes short burst and they're doing that three times a day. So a total of almost 10 minutes a day. It's like nine minutes a day. They're getting this physical activity. And those individuals have a 50% reduction in cardiovascular related mortality, 40% reduction in all-cause mortality, 40% reduction in cancer-related mortality. Pretty robust. I mean, especially if you start looking at some of these other studies

Starting point is 01:21:26 where people are engaging in their structured physical activity based on their memories and their brain's ability to recall in the last week what they've done, it's even more robust than some of that. And the reason I like that, and I know that you feel the same, is that because it's actually capturing what's really going on. It's capturing the real movement here. And so these studies, these vigorous intensity lifestyle studies, there's multiple studies of them. There was one also that was recently done in women and looking at like some of their, their cardiovascular disease risk. And it was pretty profound. I think so some of the, some of the risks in the women. Let's see if I can find that study. Yeah. So it was a 45% lower risk.

Starting point is 01:22:09 of major cardiovascular events in women doing Vilpa, and they were just doing 3.4 minutes per day. So this is much less than nine minutes, as I just discussed. So they were doing 3.4 minutes of filipas per day, and that's a 45% lower risk of major cardiovascular events, a 67% lower risk of heart failure compared to the women that weren't doing any of these physical activity bursts throughout the day. And if you think about that, that's not a lot of time. And, you know, we all have aging parents. Like, just imagine if we could get them to do four minutes a day of some kind of vigorous intensity activity. Now, maybe your parents are retired and they're not necessarily trying to get to the subway or the train or whatever. It's going to be more of a structured exercise snack.

Starting point is 01:22:54 And I'll let you kind of talk about some of that. But, like, you know, they can engage in jumping jacks or maybe chair squats or people that are, you know, maybe not older. They can do burpees or, you know, body weight squats or, you know, pushups, like a combination of all these things. And we're talking about really having a pretty outsized effect on reducing some of these negative health outcomes. And the other thing is, is that what was so interesting is there's another study that really, it was a Vilpa study. When I say Vilpa, again, people, I'm talking about vigorous, intermittent lifestyle, physical activity. This is not something, this isn't going to the gym and doing Peloton. This is just your movement throughout the day being as measured by, with an accelerometer.

Starting point is 01:23:34 the benefits were equivalent to people that were doing structured exercise, right? So there was like 62,000 people who actually did exercise and they compared that to people that were doing VILPA. And it was crazy, but the same outcomes in terms of risk reduction, it was comparable. And I love that. I love it so much because it really shows that your body doesn't care if it's structured exercise or not. It just wants the movement. It just wants the movement. So super important to point out. Yeah. And a lot of those studies, most of those studies, too, were in non-exercisers. So they were in people who reported or said that, you know, I don't regularly engage in structured exercise. And I just, then they just did vilpa. So the non-exercisers

Starting point is 01:24:21 benefited that. And like you said, similar to people who exercise, which is kind of a crazy finding. And it's interesting because reading all these studies and in the past few years is, is something that I definitely had changed my mind on in that I used to think if you're not going to the gym for 30 to 40 minutes and obviously it depends on the goal you're training for if you're training for a competition or something you need to do a dedicated training session but if it's kind of just for health outcomes it used to be 15 minutes at least and if you're not doing 30 to 45 it's kind of a waste of time but now it just seems that even if it's less than 10 minutes and they even removed it from the physical activity guidelines the guidelines used to say 75 to 100 50 minutes of vigorous or 150 to 300 minutes of moderate performed in bouts of 10 minutes or longer. And they actually nixed that part from the guidelines. It's not even in there anymore. So they no longer acknowledge that you need to do it in 10 minutes or more. You can do it in whatever length bout you want to. Obviously probably a minute, maybe minimum, but to four minutes is great. And so it's something that I've changed my mind on personally in regards to if I'm talking to people

Starting point is 01:25:23 about how they should do activity, it's no longer, it needs to be 30 minutes or more. It's just like accumulate. Accumulate, accumulate, as much as you. You can. Like you said, your body, it really doesn't care. It's not, your body doesn't have a watch or a clock where it's measuring your physical activity. It kind of just knows like how much you're doing over the day and the stimulus that it's getting for sure. Yeah. And I was talking to someone yesterday about this who, you know, is interested in health and wants to be healthy, but like hates exercise. And their response was, thank God. Like the running with my dog that I'll like do in burst or like with my kid like counts. And I think that's important because it's not that we're disincentivizing people to not engage in structured exercise. We're rewarding people who do this unstructured exercise. And we're saying keep doing it. It matters. It adds up. And I'm totally with you on, you know, these these Vilpa studies, these vigorous, intermittent lifestyle, physical activity studies have really changed my mind as well. I was probably less of a snob than you because you're an endurance athlete. But I was somewhat of a snob thinking, like, no, you have to

Starting point is 01:26:26 like you have to have structured time and like, you know, get your heart rate up and really like dedicate time to this. And, and these studies, even at first I was kind of like, well, how is it, you know, okay, let's say 10 minutes a day. You're doing that every day. So that's what, 70 minutes. It was even less than that. It was nine minutes. So it was even less, right? So like you're like, okay, around 70 minutes a week, I'm getting a 50% reduction in cardiovascular mortality. But the guidelines say 75 minutes a week is the minimum. Now I get it. Like this. This study is saying, no, we underestimated what the vigorous, you know, activity really is giving you in terms of benefit for these health outcomes, right?

Starting point is 01:27:05 Because of the way everything was calculated. It wasn't based on health outcome data. And it wasn't based on, you know, actual empirical data measuring, you know, how vigorous, you know, your exercise is and how that correlates to health outcomes. And so this is all, it's so important. It's unbelievably important. And I'm so excited about this paper. Yeah.

Starting point is 01:27:25 And I mean, it makes total sense, too, because if you look at that these are separate studies, but if you look at the vilpa studies, okay, so say you're doing four minutes a day of vilpa, well, then what is that, that's equivalent to maybe for cardiovascular disease, that's equivalent to 45 minutes a day of moderate activity or, you know, 100, maybe 200 minutes of low intensity physical activity. So if you use the equivalence ratios that we were just talking about and apply it to the opa studies that also kind of adds up with like the risk reduction. So it's kind of exciting to me. Also, you see this convergence. Some of it is coming from the same biobank data, which is

Starting point is 01:28:00 interesting and it's the same group. But you see that convergence there of, okay, well, this story is actually like making sense now that we this, or at least like the data are lining up with one another, which is exciting to see. I love, I love how you put that because, you know, like even just this morning, I spent, you know, sometimes I'll spend 10 minutes like just sprinting around with my puppy, like playing chase or tag, or a bit of like a five-minute bow and another five-minute bow. And now I have to think about that in terms of, okay, if that's, if I'm looking at, you know, cardiovascular-related mortality, let's multiply that by eight because that's how much moderate intensity, you know, physical activity that's equivalent to. And it really does incentivize you to

Starting point is 01:28:39 find ways to like engage in this sort of like everyday life, like intermittent burst of physical activity where you're like, I'm going to find a way to like move around. Like, hit, like run around and play soccer with my kid or whatever, you know, sport with your, with your kid or your puppy or your dog. I mean, it's just, I just love it. I think it really helps reinforce the importance of this like movement throughout the day, right? I mean, this is how humans used to be too, right? It is. It's a more natural way. I mean, exercise is inherently sort of this weird kind of thing. I mean, the fact that you're taking time out of your day to go move is kind of weird. It's not how we would have evolved. You know, we just evolved with like lots of

Starting point is 01:29:18 movement throughout the day, low intensity, and then sometimes it would be high intensity. So it's like the fact that I woke up this morning at 630 and went and just ran 15 miles and then came back to my hotel. It's like, it's weird. That's not what we were like designed to do. But, you know, obviously it's kind of fun to do that because you're training for stuff. But yeah, I think we were more designed for just this different type of activity throughout the day. And Vilpa, it was like, would be inherently a part of that. Right. I mean, we've created this problem of being sedentary. right because of the way we work with exercise right now we have to like find a solution to that problem we've created and that solution is now we have to like designate time make it like the thing you know and so yeah and then it becomes like this work it's like oh and it's some people in their mind they're like oh i have to like take time to do this whereas like if they were just to you know do some of these structured exercise snacks right like you know some examples would be again like you could just do some jumping jacks or i don't know if you want to get into any of those but yeah we can talk about some of the exercise snacks right we can talk about some of the exercise snacks right we can talk about some of the exercise snacks exercise snack stuff. I think before, I mean, a lot of people have heard exercise snacks because you've

Starting point is 01:30:23 talked about it before, but I think what makes them different from Vilpa is that exercise snacks and some people don't like the name I've posted about studies on exercise snacks on social media and people don't like it. I don't know if it's because it has this connotation with food, but I like the idea of calling them like micro workouts or maybe like microdosing exercise or something, but the difference between exercise snacks and Vilpa is that snacks are planned. So you kind of set out time to do them. They're still short, but it's say an example of, so you gave some examples of Vilpa. It's, oh, if you're commuting to work, you know, you're going to run up the stairs, maybe with your suitcase if you're traveling or something. So that's a minute of Vilpa,

Starting point is 01:31:00 or you're going to sprint to catch the bus. It's not something that you plan, but it's something that you injected intensity into. With exercise snacks is different. It's you set aside time and they have more of a protocol aspect to them. So I'm going to do five, 30 second sprint. Maybe you have a peloton at home and it's next to your desk, you know, you're working. You get on the peloton and you just cycle as hard as you can for 45 seconds and you get off. You do that five times throughout the day. Maybe, you know, every hour you do it or something. So you don't even really have to change and exercise clothes, but it's structured. You planned on doing it. Or you go out to your home gym and you do a set of squats or you do a set of, you know, bench press or something like that. So

Starting point is 01:31:40 the exercise snacks are structured, but they're still short and they're sort of just still injected in throughout your day. So you don't have to change. You don't have to go to the gym. You probably don't have to shower after doing them. That's kind of the idea behind those. And examples of that, I mentioned a couple, you know, what would be like a lot of the studies, they'll use sprints on a bicycle or something like that. And what's crazy is that I think you can't do the vilpa. A lot of that comes from the observational studies, but with exercise snacks, people like Martin Gabala, other groups have actually done studies on them. And they've shown improvements of VO2 max of 2 to 3 milliliters per kilogram of oxygen with just,

Starting point is 01:32:14 you know, six to eight weeks maybe of just performing these exercise snacks regularly. And that's similar to what you're going to get through structured exercise training. A lot of these people are untrained when they start. So they have a lot of room to improve. And if you're somebody who regularly trained, you might not see that magnitude of an improvement. But I think it goes to show again that you can get these adaptations with exercise snacks if you don't have the time or don't want to make the time to set aside 30 minutes a day to say exercise. You can really just get on the rower, get on your Peloton for 30, 45 seconds, do that five to 10 times throughout the day. So that's kind of the idea behind exercise snacks. You plan them, you set them out. They have a protocol to them. That's a little,

Starting point is 01:32:51 makes them a little bit different than Belford, but it's still sort of the same philosophy where you don't have to exercise for 30 to 45 minutes at a time. Yeah. My favorite snacks that I do is are just actually air squats. And doing three minutes of air squats, burns. Like, you don't have to have any weight. It's like a different kind of, ouch, you know, than like heavy lifting, which I also do. And, you know, you can, again, you just like, you don't even need any equipment. You just get up and do them. But it's nice to know that it's like, okay, three minutes. Well, if we're talking about, you know, reducing my cardiovascular disease mortality, you can multiply that by eight because that's how much time I just spent doing moderate intensity, physical activity. Or let's say you only do one minute. Again, multiply it by eight. It really, it really puts things in perspective. And I think, you know, these sort of short bouts of structured exercise snacks or these, you know, vigorous intensity physical activities that we're doing. running with our kids or dogs or whatever running up the stairs all these things now i think we've talked about them before and all the benefits you know but now i think we can even put numbers to them right where we can start to go oh i just you know this is really like worth eight times the

Starting point is 01:33:57 amount of moderate intensity that i really did save time dopamine okay reinforcement i'm going to continue to do that right the behavior is going to be repeated it gets it gets past the phrasing of oh i only have i only did four minutes of exercise Well, yeah, it's only four minutes, but we need to stop thinking in terms of minutes and steps, I think, because it's, those are like outdated metrics. Minutes are important, but what is the value of a minute of, a minute of different type figures or different intensity of exercise is different. A minute is not a minute is not a minute. So we need to just, I think, get past this idea of, you know, it was just like four minutes or it was just, you know,

Starting point is 01:34:37 just 10,000 steps. Because what 10,000 steps of how intense, how, what was, you know, we're going upstairs. It's, right. Context is key there. I challenge people, like, to what Brady just said. I mean, a minute, if you just go for a minute leisure stroll, just walk for one minute. And compare that to how you feel after doing just one minute of air squats or burpees, if you really, like, when I, like, you're going to see the difference. They're not equivalent.

Starting point is 01:35:06 They're not equivalent. And you can feel it. You can feel it, right? I mean, that in and of itself. And I think that brings us to implications for these public health guidelines, which we've been hinting at, you know, I'd say all along. We can also talk about some of the tech in wearable device as well. But I mean, I think the bottom line here, and I don't know what it takes to get updates in these types of guidelines, but I think there needs to be an update. Like,

Starting point is 01:35:34 this is something that needs to happen. You know, we have empirical evidence here. We're just look at that weight loss. It's not all about, you know, caloric expenditure, energy expenditure here, right? We're looking at actual health outcomes and we're looking at what it took in terms of, like, you know, the types of exercise to achieve those risk reductions and those health outcomes. And right now, the 75 minutes to 150 minutes of vigorous intensity activity, you think that's just that's what you need to do to get, you know, 150 minutes to 300 minutes of moderate intensity the activity that one to two ratio out the door out the door would you agree i mean it's really i would agree with that as well and i think if you just look at some of the newer i mean i think clearly you know

Starting point is 01:36:20 there are people out there in public health who have more experience in public health than me creating guidelines i'm obviously probably not qualified to make exercise you know guidelines or but if you look at a lot of the data out there i mean we were talking about this in the drive here it's they are obviously based in some evidence on health outcomes but I think that they probably need an update. And I think that a lot of the data would show you need a lot more moderate intensity activity or the dose response of that is much higher than the 153 minutes, which actually had been increased a little bit.

Starting point is 01:36:51 They recently added the 300 minutes. It used to be just 150. But I think, yeah, based on what we've been talking about today, I mean, they certainly need an update and probably an update where we exclude a lot of these earlier self-report studies and just say, we have so much. data from wearable devices now. We have big health data. I mean, you know, and we have companies like now Google and ORA and Fitbit.

Starting point is 01:37:16 I think Google probably owns Fitbit, but it's just everybody has a wearable these days. And the fact that we can't mine some of these larger data sets like the UK Biobank or the N. Haynes and formulate better guidelines that are based of objective evidence, I think is kind of a disservice probably to public health. Maybe it's similar to the food pyramid. I'm not even sure anybody looks at those guidelines and is like, okay, I need, I'm going to get 75 minutes per week of vigorous activity. But I think they need an update. And I think that the idea that we're just saying, yes, you know, twice as much moderate.

Starting point is 01:37:48 If you're, you know, been vigorous, that certainly is a little bit outdated based on what we've talked about today and just other data that's out there. Yeah. I do, I do think that I don't know that people look at the food pyramid, but I do know that people ask me all the time about how much exercise is optimal for, like, like, you know, aging the best and lowering my risk for, you know, disease X, Y, and Z, right? And so I do, there's definitely a lot of people that are interested in health that look at those guidelines. And even people like me who are trying to figure out, like, what are the guidelines and how do I communicate this information to the public? I mean, I'm, I am using those guidelines as well. And now I feel like my, my, my, you know, I've shifted my understanding of that,

Starting point is 01:38:30 those guidelines. And I have a different sort of take on them where, where it's like, okay, well, maybe we're really undervaluing the importance of vigorous physical activity. And so that needs to be communicated to people, you know, maybe we don't say, look, this is the new guideline. Because obviously, like you said, we don't make the guidelines. And there's probably a lot that goes into making these guidelines that we don't quite understand or maybe there isn't. I don't know. But, you know, I think we can at least communicate to people that, hey, look, there's new studies out there now showing that it's not just a one to two ratio. And in fact, depending on the health outcome, we're looking at, that ratio changes. You know, and that's how biology is. It's not just this big blanket thing, right? I mean,

Starting point is 01:39:11 we always try to make things simplified for everyone, but they're not simplified. Like, there's lots of nuance here. And I think that this should be communicated in our public health, you know, guidelines. They should be, they should be communicated to anyone that's interested in improving their health. And I do agree with you. I think we have so much data now on these wearable devices. And as I mentioned, you know, before, I'm on the health advisory board for Google's pixel. They did by Fitbit's now Pixel. And I know that they're, they do publish a lot. Like they're one of the few groups that have this wearable data that does academic publications and really are evidence-based. And so I know they're going to be probably working on this as well,

Starting point is 01:39:48 at least updating some of their, what they're doing as well. And WOOP does a lot too. They, I feel like every other week I'm seeing a WOOP study usually published in nature where they, they do a lot of interesting stuff with their data too. So it's just, you know, showing that, you know, physical activity and different types of exercise and even like when you perform it at different times of day. I mean, I think this kind of going back to the idea of simplicity, the public health guidelines for some people, like, they have to be simple. And I think that go, that has informed sort of this, well, we're just going to say 150 to 300 minutes or 75 to 150 because it is simple. If you make it too complex, people get confused and they just say, forget it. Like,

Starting point is 01:40:27 I'm not even going to try to do it. So I think from a public health. health messaging perspective. It's important to sort of have these blanket ranges of physical activity, but I don't know. Imagine a scenario where you have, you know, how much exercise do I need to do? Well, for what? Are you concerned about cardiovascular disease? Then you probably should do this much. If you're just concerned about cancer or diabetes, maybe you need to do this much. So we could almost get more granular with the guidelines in a way, but I think I understand the idea that public health messaging at some point needs to be you can't turn people off from the idea that well this is just too complex I'm not going to exercise at all um so it would be interesting to have a scenario where you

Starting point is 01:41:06 have different guidelines for different outcomes you know do you want to age better do you want to are you trying to be like a super high performer or are you just trying to like you know control your blood glucose better you obviously need a different level of activity for those different I would say if we're going to simplify the guidelines that we at least have to get rid of the one to two and maybe go with the lowest ratio which was one to three point five right like that would be, but the question is, are these guidelines based more on the outcome data that was used for vigorous activity versus moderate, right? And again, going back to the questionnaire data, because it was questionnaire data too, right? Like, we need, there just,

Starting point is 01:41:45 there needs to be an update, first and foremost. They need to, they need to look at more actual empirical data that, you know, as measured by accelerometers. And then from there, it's like, okay, are we looking at how much, how much do we need for either vigorous or moderate and then make the ratio and adjust it there instead of this two, one to two, based on energy expenditure? Right. I agree. And it's like we don't even need, because we have so much data, I don't even think we need to use that assumption anymore.

Starting point is 01:42:11 We can really say, like, what is the range where you get this maximal risk reduction? We have that. And then we can just say, okay, for the guidelines, like, let's use that 5 to 35% risk reduction and say, for 5% risk reduction, you need X a minutes and then up to 35%. you need that. That's where the dose response is and that's how much activity you need. I think it would give us much probably different numbers than we currently have. Similar to kind of steps. I mean, we do it all the time for steps, I think, with the recommendation of how many steps you need. Another thing that probably needs an update, but. Definitely needs an update. I mean, I think

Starting point is 01:42:43 steps need to go out and it needs to be, it needs to be more like the minutes of either vigorous or moderate, probably mostly vigorous because that's like the easiest. I mean, you could do, you know, four minutes of vigorous activity a day and it be actually meaningful, at least according to the data with the women reducing the risk of heart attacks and stuff. So, but that also reminds me with respect to these guidelines. I know you had mentioned how in like 2018 the guidelines were updated to, they removed the point that exercise had to be in bouts greater than 10 minutes. So that was at least removed. But I think that we need to go even a step further. And it needs to say you can accumulate these, you know, in bouts of one, even as low as one minute, right? Like,

Starting point is 01:43:26 it can be accumulation of short bouts of exercise. Like, if people read that, it really does, like, incentivize them to engage in these, like, short things where they're, again, playing with their puppy or if they're working and they're, you know, commute to work. It's like, it's, it's really incentivizing them to keep doing that and perhaps even speed up the pace a little bit, right? Pick up the pace. Yeah. I think an explicit statement. of accumulated in about some minute to however long you want to make it. I think that would be a great addition probably. Yeah.

Starting point is 01:43:59 And then the fitness trackers and apps. I mean, that's another thing, right? Yeah. I mean, I just think about, and again, I'm not, you know, I'm not in this sector and I'm not, you know, creating these devices. But I'm just imagining, you know, a scenario where, like, how cool would it be if, one, your wearable activity trackers kind of, and a lot of these do it. I know my aura ring does where it will automatically just.

Starting point is 01:44:21 kind of track and suggest activities that I do. But, you know, if you have an activity tracker, you go and play for your puppy 10 minutes during the day, you come back, we sensed an activity that you just did for 10 minutes and you can, you know, press a button where it'll log it into your day's activity. And then it will reward you in some kind of like, this was worth, you know, 10 minutes of vigorous intensity activity for your heart points or whatever you're getting. Or maybe you're, you get some sort of metabolic point for that activity. I think wearable devices integrating that type of technology. in there for the incentives that dopamine boost like you mentioned would be fantastic.

Starting point is 01:44:55 I mean, gamifying it. If throughout the day, like, oh, I sprinted to catch the bus and my watch logged it. And I could look in there and see, like, what was that? What was that worth regarding the day? I mean, we have so much data and the ability to do that. It would be cool. It would gamify it.

Starting point is 01:45:07 And I think in terms of adherence, putting that kind of things in there, some people find that silly. Some people, that's what they need in order to engage in that type of activity. You need that constant, oh my gosh, I just gained like 20 heart points from that Vilpa that I did or from that exercise snack that I did. So I think one, that's where I see a lot of this being implemented where I think it would be super cool and then also just updating. Yeah, the value of the physical activity in these devices where it's, it's not just, oh, that activity was more vigorous. So I got twice as many points as if I did a moderate. Let's put these health equivalence

Starting point is 01:45:40 ratios, like integrate them into the algorithm. Yeah, 100%. 100%. I mean, I think that is, that needs to be done for all the devices. And, you know, the one to two, it's like it's worth so much more than that. Now, I'm the kind of person that actually doesn't, I just go off the way I feel. Like I work out, I do a workout and I like, it's so important for my brain and my mental health and my mood. So that's kind of what I am seeking when I'm doing my, you know, even my short exercise next. I do one minute of like air squats. And I feel really good after that. It's just one minute. I really do. So that's what I need. But like you said, some people really, and I know people like this who they like love all this like

Starting point is 01:46:19 gamified stuff. And I'm like, hey, that's more power to you. That's great. If that's what it takes and if that's more rewarding and that's getting the dopamine and it's reinforcing the behavior and a lot of people, it does, then we need to do it. It needs to be, we need to be reinforcing that behavior because at the end of the day, that's what it's all about, right? Which I think gets us into this other conversation of, you know, all out, all intensity or nothing, right? Like, you know, I've definitely gotten some pushback on social media for being the person that likes to talk about going, going hard, or going home. But I don't necessarily say that. But I think it's important to just, again, pointed out, it doesn't mean that everything you do has to be vigorous, right?

Starting point is 01:47:03 And I think, again, we keep going back to the definition of vigorous in this study and the guidelines. Like, it just means that you need to do purposeful stuff throughout the day. It doesn't mean you always need to do hit. You do you do you do need to do some hit, you know, during the week, maybe a couple times per week. But yeah, I think the idea that we're not, this isn't to say that low intensity activity is meaningless. But it's just, you know, the purposeful stuff has an outsized impact on health. Yeah. It's not, you know, it's not meaningless, but boy, it's close when it comes to like reducing disease.

Starting point is 01:47:38 Statistically meaningless. You have to do a lot of it. Right. You really do. have to do a lot of it. Right. I mean, I guess if you are willing to, right, if, if somebody is just like, I'm not going to ever exercise, the only thing I'm going to do is light walking and house tours, well, okay, that's fine, but you probably need to do, you know, 10 hours a week of it. And if that's what you want to do, I guess that that's fine. So yeah. Yeah, not meaningless.

Starting point is 01:48:01 And I guess, like, again, what's your definition of meaningless? You know, is it statistically? Because based on this study, it's statistically no risk reduction, but clearly better than sedentary. So is it, is it better than what? I think that's the key question. question to ask. Yeah. It's better than being sedentary, but it's not better than putting a little more effort into whatever movement you're doing. Right, right. And I also think that, like, this vigorous activity isn't necessarily like going all out either, right? So, like, some of these people, if they like going for their leisure walk, very light walk, they can pick up the pace and do some interval walking. And that is, that is something I think a lot of people, like, even people with

Starting point is 01:48:38 diseases, you know, and stuff can do, right? Like, that's a very, like, because you, if you, if you pick up the pace for like 10 seconds even, 20 seconds, right? You're doing a little bit of interval walking. You're just, you're just cranking it up a little bit and then you can continue your light walking. I think that's something that people can experiment with at home, especially the ones that really just love doing their light walking 10 hours a week. You know, so. But that kind of gets, transitions us into this special populations, you know, does, is there, is there any population that we have to be concerned about for doing, you know, vigorous intensity. And I do get this question a lot from people, older adults. I'm old. Can I do a vigorous type of workout? Again, we're not talking

Starting point is 01:49:23 necessarily about just high intensity interval training, although that does include it. We're also talking about, you know, maybe cycling or, you know, running or jogging to a point. I think even jogging was considered more vigorous, right? So like you had pointed out, you know, this study included adults that were up to age 79. So they're definitely older adults, 65 and older, right? So older adults did massively benefit from engaging in vigorous intensity, physical activity. I would say that, you know, most of people that are older and let's say they've never really done any kind of vigorous intensity activity, it's not that you have to just start it right away. You can work your way up progressively, right? I mean, that's just something to

Starting point is 01:50:06 keep in mind. Like, it's easy you kind of just work your way up to it, start out with interval walking and then like start in doing a little bit of light jogging in sometimes or or maybe you're just going to be that person that does these short you know one minute chair squats or you know something that's you're going to accumulate more of the shorter intervals throughout the day as well but it is important to point out that um as you're getting older as you mentioned you know the muscle mask engaging the type two fibers because they're really going your cardio respiratory fitness is decreasing i mean all of these things they're so much, I would say, there's so many reasons why older adults should be trying to engage in some

Starting point is 01:50:47 form of vigorous intensity activity and not just following the moderate intensity aspect of the guidelines. Yeah, absolutely. I mean, I think that for one, any, you know, obviously even old or young, if you've never done hit high intensity vigorous exercise, you need to ease yourself and do it. You need to kind of, you know, adapt to it before you do it. But there are, I mean, hundreds of studies on let's just keep using the Norwegian 4x4 for example, but adults can do that protocol safely, effectively, several times per week, and they're not burning out, they're not, it's not unsustainable. I mean, you hear all these words and it's just like for the people doing the research and even in graduate school, I was a part of several of these different studies where we used

Starting point is 01:51:30 the Norwegian 4x4 and we were looking at the effect of on endothelial function and we had people who were 65 years old with diabetes coming in and they were doing a couple of these. these four by four protocols a week, 85% heart rate max, it's like, you can do it. I mean, it's the only exercise that they're doing. It's a couple times per week. And even if it's 85% max heart rate, it's a fairly low absolute intensity because they're not that in shape. So people can do it. And then I think it's important, you know, older adults can do it and they need to do it, going back to what Ben Levine was talking about. I mean, at a certain age, past a certain age, if you don't engage in the vigorous exercise, you're just not going to,

Starting point is 01:52:10 adapt, especially with regard to the cardiac, the cardiac adaptation, the cardiovascular system. The heart just needs that extra stimulus, and without it, the heart's just going to continue to stiffen fibrosis as you age. I know we already sort of mentioned that. But so, yeah, not only is it feasible, but it's probably necessary for older adults to engage in this high-intensity interval training. I just think that there's this skewed idea when you talk about doing hit that people think they're training like Olympic athletes. And it's really not. It's... Thank you, Brady.

Starting point is 01:52:40 Just read some of the clinical steps and it's pretty apparent. There's definitely a group of people who like to push back when I, you know, anytime I like post or talk about doing the Norwegian 4 by 4 for some reason, it's really, I'm not, I mean, I'm not talking about like nonstop Norwegian 4 by 4, like four times a day, every, you know, five times a week. I mean, this is like, you know, once or twice a week, you can do it. Like, it's not... And again, like you said, it's a, you know, the relative...

Starting point is 01:53:09 you know, heart rate changes, right? So for someone who's not that fit, you know, 85% of their max heart rate is not that, it's not that hard. I guess it's hard for them, but like. Right. It might be 50 to 100 watts or something if they're on a bike, which is a fairly low. Low. It's like spin class, something like that. Yeah. Right. The other question that often I get has to do with women. And like, there's this idea that, oh, women really can they engage in high intensity interval training? Can they really go. And again, we're talking a little bit more on the high end of vigorous here, right, in regards to like high intensity interval training. Can women do an hour long high intensity interval training session? Is it bad? Are there stress hormones going up? Is it, you know,

Starting point is 01:53:51 all those, all those things that you hear from influencers on the internet. My take and my read of the literature and my experience. So I do high intensity interval training. I do like a CrossFit type of training three hours a week right now. Now currently I'm going to start doing four. And two of those hours, it's like the full hour is like, it's a pretty, pretty intense. And then two of the other days where it's an hour each, I'm doing like strength training the first half, which isn't really getting my heart right up that much, except for when I'm lifting heavy.

Starting point is 01:54:23 And then I do like a 20 minute hit at the end. And hey, everything's going great for me. I'm not burning out. I mean, I don't feel like I, you know, I'm like burning at both ends at all. But let's talk about actual evidence here. I think yes, women can engage in high-intensity interval training. Yes, they can do high-intensity workouts. I think where this whole thing originated from was these studies where women were

Starting point is 01:54:47 massively reducing their calories and they were doing caloric restriction and engaging in a lot of high-intensity exercise. And that can, like, cause amenorrhea. It can shift hormones, right, where you're not ovulating. And that's really like the origin of like some of this, like, I don't even know. where it's gone. It's gone to places where I'm like, people are like, oh, you can't do hit. I'm just like, what are you talking about? Yes, you can do hit. Like being a female doesn't mean you can't do hit. Obviously, you have to listen to your body. If you are on your cycle and you're feeling like all

Starting point is 01:55:20 the time when I'm on my cycle and I'm starting to do a hit, like I tone it down. I tone it down. Like, yeah, I mean, there's obvious things here where you're not going to perform your best, you know, depending on what the day is. But that's even for people that are not female, right? I mean, like, you have those days too, right? Yeah. Right. Right. I shouldn't do hit all the time either. Mention do hit all the time. They should listen to their bodies. They should listen, you know, program it strategically into their training cycle. I also don't really know where this idea that I think it refers to maybe more so like a perimenopausal, postmetapausal women should be careful with hit. But like, sure. And there are certain, you know, hormonal changes that happen at

Starting point is 01:55:55 that time. But again, if we look at what the studies are showing, if you do it in a smart way, that women can benefit just as much as men. There's not really a biological reason, I think, to think that there would be any detrimental effects as long as you do it smartly. and get like you mentioned fuel adequately, you know, relative energy deficiency in sport. Red S is a thing. If you're doing more activity than you're fueling your body for and women are more prone to kind of that under fueling than maybe males are, especially kind of in the endurance sports realm, yeah, you can overdo it just like anything.

Starting point is 01:56:26 But I think to scare women and say, oh, you shouldn't do hit because it's, you know, going to be like too much cortisol or something. I mean, the point of it is kind of to increase cortisol and then you recover and do it again. I mean, just do it smartly. So, yeah, we're not, I don't know. I'm not sure where it has gone to weird places, this idea. You will get, I'll get an Instagram real every now and then where it's like, you know, you shouldn't do, you need, women need to train like this a different way. And a lot of evidence out there for strength training and endurance training doesn't just really support that idea, I think. I, you know, it's funny that you mentioned the cortisol because that

Starting point is 01:57:00 you just brought up one of my little pet peeves. Like, you actually, like the spikes of the stress hormones. Again, you're having this hormetic response where your body adapts to it. The problem with cortisol isn't the little spikes that you're getting from like working out hard. The problem is like the chronic activation of a cortisol like every single day with all the stress. It's not it's not the you know the types of exercise stress. Now are people doing these high intensity workouts like every single day? I mean like maybe tone it down a little bit. But you know, again, listen to your body as long as you're not overdoing it and most people are not overdoing it. Okay. Most people are not overdoing it. No, most people aren't. I think one thing to consider too is like, yes, if you're also a working

Starting point is 01:57:44 professional and doing also training on top of that, you know, if you're not a professional athlete whose only job is to train, then you also have to consider life stress. You have a family. You have kids. You have a full-time job. But again, I think this, you know, that applies to everyone, not just males, females. So. Right. It applies to everyone. And now we know how, incredibly efficient hit workouts are more than we previously even thought we were underestimating. And so, again, all the reasons to do it. When it comes to chronic illnesses and stuff, again, it's another thing where you have to like talk to your physician, listen to your body. I mean, you know, there's there's ways that you can do these sort of exercise snacks,

Starting point is 01:58:23 whether it's the interval walking or a little bit of step above that and you're doing maybe some chair squats. I mean, I have my 70-year-old mom who isn't the in greatest health. You know, she's doing CrossFit two to three times a week for it's a senior's class. But I mean, she's doing things like chair squats and she's doing, you know, she's doing lifts and stuff with very light weights. And, you know, there's, there's a progressive way to like get, this is definitely vigorous exercise for her, for sure. And so I think that, you know, again, people can, even with chronic illness and chronic conditions, you know, definitely talk to your physician, but there's ways that they can engage in particularly these, you know, shorter bursts of exercise as well.

Starting point is 01:59:04 And then athletes, right? I mean, that's something that you're the athlete in the room. Yeah. And obviously, when it comes to athletes, you know, this discussion that we're having, I think is totally separate from, you know, athletes are training. They are training towards a goal. They're training for a marathon or a CrossFit competition or something like that. So I think some of these maybe guidelines on physical activity you want to like integrate movement throughout your day, they still apply, but maybe a little bit less, because if you're doing dedicated activity, you know, I think most athletes aren't concerned about getting the recommended physical activity. Most are getting just, you know, fine physical activity. Regarding hit and vigorous

Starting point is 01:59:42 exercise, you know, obviously athletes are going to need to engage in that. So the conversation is, is a little bit different. And you do, when you are training, you need to be a little bit more deliberate about maybe you only do one or two higher intensity exercise sessions per day, because you are training every single day or maybe six or seven, you know, six days per week. So it's a little bit different. And I think there are some studies you can certainly overdo it. You can certainly overdo high intensity interval training. There are a interesting study that I read recently. It showed that if you do too much, it actually like harms your mitochondria and causes mitochondrial dysfunction. So athletes can certainly overdo that. I think the takeaway here,

Starting point is 02:00:20 if we go back to our study is athletes, you know, outside of training, you're definitely improving your health and I think good, you know, focus on your long-term health. If you're not getting paid to do it, I'm not getting paid to train for a marathon. So I still want to run fast, but I also am like concerned about my long-term health. And so thinking about it that way, you want to make sure to balance it so that you don't harm your long-term health in the pursuit of, you know, being healthy. Sometimes you can be kind of counterproductive in that way. So I think balancing it, there's this common thing in athletic circles, the 80-20 kind of split where, you know, if you're doing six exercise sessions per week, four of those are easy, two of those are hard.

Starting point is 02:00:55 I think that's kind of a good framework, a good juristic for people to follow. And I tend to sort of balance my exercise that way, like 20% of my weekly exercise is maybe harder. 80% is typically pretty easy in terms of the distribution. But yeah, I think, you know, if athletes are thinking about how to balance it and if they're concerned about the long-term health implications and they also want to reduce their disease risk like everybody else. I think kind of the same principles here apply. Just don't overdo it. Make sure to integrate hit a couple times per week and balance that with recovery.

Starting point is 02:01:29 Yeah. Just since you are the athlete and you mentioned your 80-20 rule, how many, everything you do would be considered vigorous, by the way, according to this study that we're talking about here today, nature communications. How many hours a week do you spend being physically active? Now, you're not probably not going to count when you run with your dog or you run around with your kids. So we're talking about the structure is not everything, just the time that you set aside to do your actual like runs and hits. So the running and biking stuff during the week probably combined 13 to 15 hours of that like a week. I mean, I'm working out seven days per week most days. I'll take a rest day every couple weeks. So 13 to 15 hours of that, a couple hours of probably dedicated strength

Starting point is 02:02:10 training. And then the physical activity stuff I do actually, despite being very, you know, just training, I do try to get decent physical activity. So walk. 30 minutes maybe a day, just do a couple walks also just to kind of break up the monotony of like sitting in a chair, which I don't think is good even for highly active like athletes. And I'll also do some of the exercise snacks, which is kind of interesting. But my exercise snacks are actually in the form of these resistance training exercise snacks. So I all in my office, I have a pull-up bar in the door frame. I have kettlebells and stuff. So every like little bit, if I need a break during the day, I'll do these, I'll do hit, but in the form of resistance exercise to sort of build strength.

Starting point is 02:02:48 if I don't have time to like make it to the gym or something during the week. But yeah, that's kind of what my activity looks like. So it's a lot of volume. And you're right that based on this study, it would be categorized as probably vigorous. But obviously a lot of it is light. If you looked at my heart rate, you know, it's 60, maybe 70 percent of heart rate maxes a lot of that stuff. So it's still at a fairly low heart rate. Even your runs?

Starting point is 02:03:10 Yeah, a run. You know, I might do a run. If I go pretty easy, my heart rate's going to be 120 beats per minute, which is pretty low. What's easy for you, Brady? easy in terms of like speed like seven minutes per mile you guys hear that that's easy for brady seven minutes per mile

Starting point is 02:03:25 oh my goodness like sometimes I'll be on a run with Dan and we're just I mean it's like you know 10 minutes a mile we're talking and like yeah it's a fun leisurely yeah it's definitely like we're having conversation we're talking

Starting point is 02:03:38 and it's like it's time that we get to hang out like I go for runs with like friends and it's like we we catch up on our run right so it's like it's a leisurely run it would be considered I think vigorous according to the study but I'm just sitting here going if Brady's dude this is like nothing to him he runs like for 20 miles at seven minutes a mile I mean that's insane it's insane yeah it takes a lot of time to build up to that but again you know if we did a if we did a cross

Starting point is 02:04:02 fit workout that you probably would be able to outdo me in that one probably smoke you I'm really I'm really becoming a crossfitter but you know your your exercise snack that you that you talked about I think you just described crossfit like that's what crossfit is like my workouts you know it's like we're doing these like intent we're doing kettlebell swings and it's not strength training so it's like a lighter weight but you are getting your heart rate up and you are you are you are you know doing resistance training so you are obviously like working your muscles and and challenging your muscles as well and it's why i just love it it's just so efficient it's time efficient for like everything yeah i think if i think it's probably the ideal regimen the high the crossfit and then

Starting point is 02:04:38 the high rocks is kind of what everybody is interested in doing now i think i want to train for one i think those are probably the best if i had to pick an ideal like this is the ideal workout regimen for life. It's probably one of those, obviously. I mean, what I'm doing is not, I'm optimizing for one thing. I love doing endurance training and that's what I'm going to do. But if I had you know, pick was ideal, certainly those are the best because you're getting kind of the best of both worlds, especially with high rocks, which has a little bit more of the running component compared to CrossFit. So I think you're, you need you really aerobically fit and strong to do high rocks. Not to say that you don't with CrossFit, but there's not, there's not a lot of running with

Starting point is 02:05:13 crossFit. No. No, there's more like shuttle sprinting and stuff. Yeah. Yeah. Um, Lastly, I want to mention before we kind of just conclude this up, children. And, you know, a lot of people are like wondering what I think, I think the take home here with children is sports are important, right? Like, get them involved in some kind of sports, whether it's team sports or individual sports. Those things all matter. They're important. Not only just to their long term health, but also there's studies showing that cardiorespiratory fitness, like the higher the cardiorespiratory fitness is, elementary school children, the better they perform on academic test, the better they behave on playgrounds. So it's just improving their overall brain function as well. And that's something that we didn't talk about a lot today. Definitely talked about it previously on the podcast. But brain function is definitely affected. I can't say that enough with more emphasis. And it's across the lifespan, young children all the way to older adults. Physical activity, and particularly the vigorous type of physical activity, really does

Starting point is 02:06:16 improve, you know, cognitive function in the short term, in the now, but also the way your brain ages as well. Yeah, absolutely. The topic of children with training is always tough. And I think, you know, everybody has their own individual perspectives on that. But it's like kids naturally will engage in physical activity if you give them time, I think put them in sports. But even being the endurance athlete, I'm like, it's going to be hard for me, but I know I'm going to need to just sort of like refrain from, you know, until they're really participating in organized sports and, say, elementary school or junior high, like, I don't think your kids should probably be, you know, doing structured interval training sessions during the week to try to get them.

Starting point is 02:06:53 I find in anecdotal, obviously, but like the kids who were doing that when I was younger whose parents were pushing them to actually train to run, they're the ones no longer doing it because they just got tired of it and burnt out. Yeah, there is, there's also an aspect to that with sports. I mean, when you, if you start to push your, your child to, um, be the best, you know, if they're if they're not good enough and you want them to really be the best on the team, you can push them to the point where they actually don't enjoy it. And like when they're young, it's all about exposure. And it's all about like letting them have fun, letting them not be the best on the team.

Starting point is 02:07:26 I mean, some kids are just naturally athletic. Like they, they have to put in less effort, you know, less deliberate practice time to get to be good. Not to say that you should ignore deliberate practice. We all know you shouldn't. But, you know, some kids, like my son is not a natural. athletic, you know, boy. But, you know, he has done soccer over the years and he's really put in practice and he loves it now. And he's still not like on like one of the high, high teams. He's like on a development team. But like I like this level because there's not a lot of stress from the parents where it's like, we have to win. We have to win. It's not about, it's really not about winning. It's about the kids trying their best, having fun, having sportsmanship. I mean,

Starting point is 02:08:07 all those, these are all life skills that they're learning. And I know I'm going on a tangent here. I'm a mom. What can I say? But that said, I don't know that we need to do a lot of conclusions here. I think that we've really concluded a lot throughout this episode. The take home for me here, honestly, is a couple of things. One is that I feel like even myself, I was underestimating the power of this vigorous, intense physical activity that I get, you know, throughout the week in terms of reducing my cardiovascular disease risk, my risk for having a heart attack or a stroke or, getting type two diabetes. I mean, it's really exciting to me to think that I'm actually getting a lot more benefit than I previously thought. Certainly, you know, if you look at the 30 to 40 minutes per week, a vigorous intensity activity, or sorry, was it, yeah, it was 30 to 40 minutes per week, right? That was associated with like a 50% reduction in some of these outcomes. And I'm getting way more than that. So that's, that in and of itself was exciting that one, we're dramatically underestimating the power of, vigorous intensity, physical activity. I do think that we all should be aiming for it in some shape or form, particularly if we're able to. And knowing that the vigorous intensity exercise doesn't necessarily mean the Norwegian four by four, although I still say I think we should be doing that type of hit at least once a week to improve our cardiorespiratory fitness. But that said, even these runs that I'm going on that I have conversations with, that's great. That counts as

Starting point is 02:09:41 more vigorous where I previously wasn't really counting that it's vigorous. And then also just knowing about the short burst of activity, like, I'm so excited now like I got a new puppy a couple of months ago. She's four months old. And like, I sprint around with her all the time. And I've never been counting that, you know, and that stuff matters. That's also very exciting to me as well. So, you know, for me, I think that those were the major take homes. I know you probably have your own? Yeah. I mean, what you said is it's certainly, I think, reassuring for a lot of people. And they should reframe how they think about the activity throughout their day, like, count a lot of stuff and do things deliberately that you can either gain, like, a reward from or know that you're just,

Starting point is 02:10:22 like, benefiting your health. I think it's reassuring to see that those little short ballots have value, not just from the Vilpa studies, but from this study and just from like everything that we've talked about regarding like the mechanisms. I think my key takeaway was this study, I mean, it was one of the most interesting studies I've read in a while, and that's kind of why I wrote about it. I wrote about it on my substack and, like, we're talking about it today. It reframed how I think about devices in a way, and I think it should reframe how a lot of people look at their wearable and the data that it is telling you. I'm not to, this is obviously to say that you should ignore it, but I think that you should

Starting point is 02:10:56 look at the data from your wearable in a different way and really think about what is it telling you? When you're looking at how many steps you got during the day, does that really matter? or like what is the context of those steps? Or, you know, one, what's your goal? And then two, you know, what value are those steps giving you? Because if you're just chasing a number like steps, it might kind of be meaningless. So should you shift your goal into thinking, you know, let's maybe look at the intensity

Starting point is 02:11:20 of my workouts. It'll depend on the device that you have. But just reframe how you look at it. And maybe don't just take what it's giving you right now until maybe these evolve a little bit, which they hopefully will. Don't take it at face value in terms of, oh, I got enough activity today. You know, look at that. Maybe think about what you and I talked about in the context of the study today and then say,

Starting point is 02:11:41 did I do maybe more or less? Like, should I do more? So just don't rely on your wearable solely. It should be a tool, but you should also evaluate, you know, in the context of your health goals, what your activity means and what data you're wearable are giving you. I think that was my biggest takeaway. And it's certainly going to look at reframe, maybe how I look at some of the data on my wearable and look at the guidelines and the recommendations and what they mean for health.

Starting point is 02:12:07 I think this just sort of reframes like how we should think about all of this stuff. And it's not just a this amount of activity is good for everything. We need to really think about it in the context of our overall health and our personal goals. And it can be complicated, but for a lot of people, this is fun. I mean, if people are really interested in optimizing their longevity or whatever health outcome it is, I think you should really think critically about this stuff. So that was kind of my takeaway from this study. Well, certainly the people that are listening to this podcast are interested.

Starting point is 02:12:33 that. How long do you think it takes to take 10,000 steps? It's actually longer than I think most people think. I think if you walk for, I think it takes about maybe 90 minutes to two hours, oh no, probably longer. 90 minutes to two hours to probably get 10,000 steps of like dedicated kind of walking. Okay. It's about 6 to 7, it's about 10K of walking, 6 to 7,000 or 6 to 7 miles, rather. And so that would be, I mean, I guess depending on the pace you're walking, but if you're just during the light walking, you know, you're really not getting more than a 10 or 15% reduction and risk for any of these disease outcomes. So something to think about people. Brady, this has been so fun. I love this new Journal Club podcast. I think that I look forward

Starting point is 02:13:19 to the next interesting paper that we're going to cover because I know there was going to be one. I want to tell people about your book that I have here, V-O-2 Max Essentials. I mean, if you want to know anything about VOTMX, Brady's the guy. I mean, he has everything in here about, you know, explaining what VOTOMX is, the role it plays in aging, what limits it, tools and protocols for improving it. I mean, just everything you want to know. So I highly recommend that VOTU Max essentials, and it's also really cheap. You can find that on Amazon. You also have a substack. You mentioned that you covered this study in your substack. Maybe you can tell people about your substack. You're on social media. You're very active. You post a lot of really interesting stuff, especially when it

Starting point is 02:13:56 comes to exercise related studies. Yeah, social media, people can find me at B underscore Homer. I'll post, it's a mix of stuff for my life and mostly science. I try to keep it mostly science, but it's a personal account too. So I will post on there. My substack is physiologically speaking, and I publish a weekly newsletter on there. I also just will publish whenever I have maybe an interesting thought or idea. I'll publish like a thought piece on there. Sometimes I post my training too. I know not everybody's interested in that, but right now I'm training for a marathon in December and I'll post my weekly training log on there. A lot of people find value in there.

Starting point is 02:14:31 So you can find all that stuff and subscribe. It's free. You can pay either one. And yeah, that's kind of where main two channels you can find me. The book, it's probably due for an update, but there's just evergreen stuff in there.

Starting point is 02:14:44 If people want to learn the science of you to max, it can get pretty nerdy. But again, if you're listening to this podcast, you're probably interested in mechanisms and protocols and things like that. And you can find that. all in that book. So I appreciate you giving that a little plug. Yeah, my pleasure, Brady. Well, thanks again for joining me on the podcast. And until the next one, I look forward to it.

Starting point is 02:15:05 This was great. I think the journal club style will, hopefully it's here to stay. I enjoyed this. Yeah, definitely. Same. I hope you enjoyed this new journal club podcast. Thank you all for listening and supporting the podcast. Your enthusiasm and engagement mean a great deal to me. If you've already subscribed on Apple Podcast or Spotify or perhaps on all three, even YouTube, thank you. If you haven't yet, please take a moment to subscribe to any or all of these platforms. It really does help me. On Apple Podcasts, you can leave a five-star review if you think we've earned it and a comment to let us know your thoughts.

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FoundMyFitness - #108 The Best Type of Exercise for Longevity

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