Transcription
So now let's talk about two scenarios. The first is the person who is new to this type of training. So they've listened to this podcast, or they're one of my patients, and I've made the case convincingly to them that you really need to do this type of training. I want to come back by the way to a justification for that. So let's explain why high-intensity training is not sufficient, but we'll, we'll park that for a moment. But they really don't have much of a background in this type of training, right? They, you know, maybe they do some high-intensity training, they do some weights, they play some tennis, uh, but they really don't do the sort of steady-state sustained cardio that we're talking about. Um, how would you structure a training program in dose, duration, frequency, uh, for that individual? And tell me a little bit about the choices that you would make if they're agnostic to running, walking, cycling, rowing, swimming? You know, again, I have my biases there, but I want to kind of hear what you have to say about it.
Yeah, no, yeah, that's a great, um, question. And I also know before that, I want to apologize to many of your audience, um, um, uh, because I, I, I get a lot of emails, you know, asking me about these questions, and it's hard to, uh, well, that's why we're doing the podcast, so you don't have to apologize. It's easier to do. Appreciate it, uh, this way. But still, I get emails, um, and, uh, and, and before I used to see people here at the university, university, but now the university, you know, we don't have these services. So I'm trying to convince them that these services are important to offer to, to population. But anyways, I want to apologize because I cannot answer to everybody. But yeah, so, uh, my, my, I have the three, three main rules or parameters I have learned over the years. So one is the duration, right? Um, we have in, in mind sometimes that this is like endurance training, long day, like, like I only have six hours a week or seven hours a week, most, right, to do this type of training or less. So there's no way I can do that. It's usually less because they might have six hours a week for total exercise. Exactly. And we're going to take half of that for strength training. Exactly. Because which is very important, as you know, uh, um, uh, and it's, it's my, it's where I fail because I, I should do more of that, and I try to, to get a little bit more of time to do that, but I, H, it's not easy, but I aspire really to, to dial that in. But, uh, but yeah, you're right, they might have less than six hours, and they might think like, well, I'm not an endurance athlete, so you need to do four hours to do to accomplish this. Therefore, I'm just going to move to do just high intensity and just get out of the way. Well, that, that's not completely true, right? Uh, you can accomplish very important mitochondrial adaptations and very important, um, um, metabolic adaptations by exercising in one hour, right? So this is one is the, uh, uh, um, uh, the duration. Let's start by the duration, right? So, uh, um, if you try to do that one hour to one hour and a half range, uh, you're on target.
And is that in one setting? Hours, I'm sorry. Is that total or one setting? What do you mean? Uh, meaning is it one to one and a half hours per week, or does that need to be in one continuous exercise? About, yeah, I'm sorry. Let me, let me maybe go back to that. The frequency, right? That the dose. So the frequency that I see is that, uh, this type of training, uh, ideally needs to be done between three to four days a week, ideally. Uh, um, what I've seen, and how can I know this? Uh, I know this because I've seen in the laboratory, everything, right? The person who trains one day at these, um, zones, or two days, or three days, or four days, or high intensity, low intensity, and the adaptations. How do I see the adaptations? Again, looking at M, I mean, at fat oxidation, lactate threshold, VO2 max, well, surrogates of mitochondrial function, right? So I've been identifying that the dose of that training, so if you train once a week there, uh, chances are that, uh, you're going to deteriorate over time, and especially as we age. Uh, something that I see, for example, in high-intensity exercisers and bodybuilders, that they have a very poor mitochondrial function compared to people who do more, a little bit of everything, right? So, so one day a week, it's not going to work. Two days a week, it might maintain what you have, but if you're new to an exercise program, might not be enough. Three days a week, now we're starting to, to, to see for sure. Four days a week, now we're talking ideally five days a week or six, but not, not everybody has obviously six days a week to train. But I think that we all can, I mean, you are a very busy guy, I'm a very busy guy, uh, and we try to squeeze four, five days a week, maybe six in the summer, but four to five days, it's achievable for most individuals. And, and, and put aside an hour to an hour and a half, right? So I would say that four days a week is ideal, right? That's the, that, that, that's the first principle. The second principle is the duration, going back to what I was saying, right? With, with, with one hour, maybe Petra needs four hours, five hours, uh, uh, to keep increasing those huge mitochondria for a long time. But a normal person, and especially someone who might be pre-diabetic, or might be out of fitness, or, or hasn't exercised in a long time, or, or someone who's coming from a disease, or, or, or a mother who just had a baby and has been out of shape for a while, you know, one hour, um, if you walk or if you run, might do, might be very, very good for you. Uh, one hour walk, you know, you, or run, you might have to bring it up. That's that's part of the plan too, right? You cannot start off the bat with one hour. You might start by 20 minutes, 30 minutes, 40 minutes, increasing it, but maybe about an hour. And if you bike, for example, about an hour, 20 minutes, hour and a half, that's what I see. That if you do that for four days a week, things are starting to move. Even, even if you bike on a trainer where you can be much more efficient, and you can really get straight to the wattage and stay there. Because we, we tell patients, you know, again, it depends where they are in their cycle, but if they're starting out, I mean, we'll be happy if they give us 30 minutes, four times a week of aerobic exercise.
So, so do you see a difference between, I don't, I can't do zone two on the road. I can really only do it on the trainer. I just can't stay at a constant level on the road with starting and stopping and wind and hills and stuff like that. That's a very good point. That's why an hour and a half on the bike, it might actually be one hour or so, right? Because you have all these artifacts. But you're right, when you're on the trainer, you isolate everything completely. And, and what I also recommend is about an hour, if you can get there. But again, you know, like, yeah, sure, you might, it's, it's to me, it's, it feels like a torture sometimes, you know, to be an hour on the trainer. I hate it. I like to be outside. Uh, but we have to do it. I do it. I, I watch a movie or, or just catch up on work. I have one of those special desks, right, where I can type or read articles or answer emails. Low-key activity because again, you know, you're not very sharp to think, uh, very intellectually. But, uh, but yeah, one hour might do the trick. Uh, what I've seen is like, yeah, in those people who haven't done much at all, even 30 minutes, 20 minutes, might start moving the needle, but eventually, it's not enough. Those, right? Uh, um, uh, it's like if, if the body needs more, right? So if, if you can get to a goal about an hour to an hour and a half, that's that, that should really work in my modest opinion, in my experience. So that's, that's the, um, the duration.
This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice. No doctor-patient relationship is formed. The use of this information and the materials linked to this podcast is at the user's own risk. The content on this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice from any medical condition they have and they should seek the assistance of their healthcare professionals for any such conditions. Finally, I take conflicts of interest very seriously. For all of my disclosures and the companies I invest in or advise, please visit Peter aam md.com/disclosures where I keep an up-to-date and active list of such companies. [Music]