Transcription
I've spent a lot of time thinking about that question. What type of exercise is the best to improve the quality of life, to extend, you know, lifespan, to basically reach your maximum genetic potential? And from everything I've come down to, it seems as though actually vigorous intensity exercise is, I think, one of the most important types of exercise for longevity. And when I say vigorous, I mean getting your heart rate to at least 80% of your maximum heart rate.
Um, and what I've looked at to kind of come to that conclusion is a variety of different data, starting with VO2 max or cardiorespiratory fitness. I mean, this is one of the best indicators that we have of longevity. Um, VO2 max is the maximum amount of oxygen you can take in during, you know, maximal exercise, and it's a biomarker for cardiorespiratory fitness. Sometimes I kind of use those terms interchangeably. But essentially, if you look at VO2 max studies looking at VO2 max in individuals, you know, in their various age groups, the biggest benefit for VO2 max improvements are people going from low to low normal. So they're below, so they're low, and then they go to low normal. That's associated with about a 2.1-year increase in life expectancy. So just getting out of that low zone is like the best thing you can do, right? Going from low to high normal is almost a three-year increase in life expectancy. Going from low to high is almost a five-year increase in life expectancy. So, you know, that's a big difference. And I think on average, it was like for every one-unit change in VO2 max, it's associated with a 45-day increase in life expectancy.
And then there was another huge study that came out, was published in JAMA in 2018, that looked essentially, it was looking at cardiorespiratory fitness as part of the equation. Um, and the people with the most elite fitness, so they had like the highest VO2 max, they were the highest cardiorespiratory fit people, um, they had an 80% reduced all-cause mortality compared to people with the lowest fitness. And, um, you know, so essentially, I think that study, if I remember correctly, in the discussion, they said there was no upper limit to the life expectancy benefits of high VO2 max or high cardiorespiratory fitness within normal human potential ranges, of course, right?
And so, um, with respect to VO2 max, I mean, right there, you look and you go, "Okay, well, how do I improve my VO2 max?" Because that's really where it's at, right? I mean, if I'm not an elite endurance athlete that's training 20 to 30 hours a week, if I'm just a committed exerciser, which I am, someone that's working out, you know, about five days a week, how do I improve my VO2 max? How do I get to that, you know, that status where I'm high VO2 max level? And, um, looking at a lot of literature, really, it seems as though high-intensity vigorous exercise is one of the most important ways to get there.
So there's been, there was a study, Marty Gabbala, who I had on the podcast not too long ago, brought this to my attention. There was a huge study that was done looking at people that are engaging in moderate-intensity exercise. This is more like the Zone 2 type of training where you're, you know, doing endurance, you're doing aerobic exercise, but you're, you're able to like have a conversation somewhat. It's like you're breathy, but you can, you can still have a conversation, right? And, um, those individuals that were still meeting the standard guidelines, so they were doing like two and a half hours a week of this type of aerobic exercise, were unable to improve their VO2 max. Um, and this was 40% of those people, of the whole population. So 40% were what they called non-responders. So they were not getting VO2 max improvements from just two and a half hours of moderate-intensity exercise every week. And I was like, "Wow, that's really surprising." You know, you think that people doing two and a half hours of aerobic exercise would be getting some improvements in VO2 max. Well, not everyone was until they started doing vigorous-intensity exercise. Then they were able to get VO2 max improvements.
And, you know, you can look at a variety of studies. There's lots and lots of evidence. I mean, yes, you can get VO2 max improvements when you're doing a lower or moderate-intensity type of exercise, especially if you're clocking in a lot of hours like elite athletes are, right? I mean, they're training, you know, 20, 30 hours a week, and plus they're getting a lot of, they do a lot of vigorous-intensity exercise on top of that. Um, but if you're just talking about the average sort of committed exerciser or even casual exerciser, which is even less, like two to three days a week they work out, then it's, it's, it's getting to the point where I think vigorous-intensity exercise should be most of the workout. Most of the exercise, um, time that you do should be during that vigorous-intensity exercise.
Um, and that's, you know, the VO2 max is, is, is one aspect of it. But I think one of the studies that really sort of, I don't want to say changed my mind, but really motivated me and was very much a turning point in my mind. And this was a couple of years ago out of Ben Levine's group at UT, UT, um, Southwest. He took people that were 50 years old. They were healthy individuals. So, these were 50-year-olds that were not, they didn't have hypertension or type two diabetes or any of that, but they were sedentary. So, they weren't physically active. So, they were quote unquote healthy, but essentially, I would say they're more just not unhealthy, right? More than anything, they weren't, they weren't, they didn't have disease states that were at least measured by our standard biomarkers. And he said, "Okay, we're going to go, we're going to put you on a two-year exercise program." And, and Ben really studies a lot of the heart structural changes. Um, so as we age, our heart gets smaller and it gets stiffer. And, um, so the question was, can we take these people, put them on an exercise program, and sort of reverse the aging of the heart?
So, um, the exercise program was a progressive program. So it starts out a little bit more moderate intensity, but not for long. They quickly progress to vigorous-intensity exercise. So, um, this is, this is like, you know, these people were getting close to like an 80% max heart rate, 75, 80% max heart rate, and they were exercising five days a week. Um, I think it was like 30 minutes, 20 to 30 minutes. It was, it's the kind of exercise intensity that you can maintain at 20 to 30 minutes. So it's, it's that intensity where you're close to like 80% max heart rate, right? Um, when you start to get above 80% max heart rate, it's hard to maintain that for 20 to 30 minutes for most people. And, um, so they were doing this five days a week for about 20 to 30 minutes. And then one of those days, they were doing the Norwegian 4x4 training protocol. So this is a type of high-intensity interval training that you, you, um, you do. It's a longer interval. And by the way, um, longer intervals is what has been shown to be the most important for improving VO2 max, probably likely because you're putting such a, you're getting the best of both worlds. You're getting the intensity, which is, you know, you're, you're, you're stressing your cardiovascular system in such a way that it's forcing it to respond by becoming more efficient at delivering oxygen to your tissues, which is why you're probably getting VO2 max improvements, but you're also getting the duration aspect. But you're talking about a four to five-minute interval, right? So, you're getting kind of the best of both worlds, the intensity and the duration. And, um, so it's a four, it's four minutes of like, as intense of an exercise workout you can do to maintain it at that intensity for four minutes, and then you have a three-minute recovery where you're essentially going to like Zone 1. I mean, you are recovering because you're about to do that again for another four minutes, and you repeat it. It's a four, it's a four by four, so you're repeating it four times. And so they did this once a week.
And after two years, these 50-year-olds reversed the, the, the structural part, like the aging part of their heart by essentially 20 years. So their hearts looked like 30-year-old hearts versus 50-year-old's hearts.
So, so they five days a week they worked out for two years. And it was, this wasn't low moderate intensity type of training. This wasn't Zone 2. In fact, the control group, quote unquote sham control, they did the same amount of exercise, but they were doing kind of, um, stretching and bodyweight sort of body resistance weight kind of training, kind of like yoga and stuff like that, which is of course very beneficial. Muscle mass is very important. Um, however, they had no, none of those, they experienced none of those changes in their heart. Did they have metabolic changes that were beneficial? Probably. Was there muscle mass improvements and strength improvements? Probably. But we're talking about the heart here. We're talking about the heart, right? And so, um, it was, it was that vigorous exercise that was important for reversing the structural aging changes on the heart, the stiffness and the, and the, the small, you're getting, getting smaller, and all sorts of other, you know, very technical terms that I don't really even quite understand myself, honestly. Um, that was reversed after just two years of vigorous exercise in these, in these 50-year-olds. That was like, blew my mind. And that was like, "Okay, there's something to this here, right?"
Um, with that all said, obviously exercise is hugely beneficial. Any type of exercise, any type of aerobic, cardiovascular exercise, and the habit is important, like being able to do it consistently. Um, I think vigorous exercise is really the key here. And there's a lot of other reasons that I'd like to talk about. But I do want to caveat this with, look, if you just absolutely will never do intense exercise, but you'll go out and do a Zone 2 run and you'll do that multiple times a week, then that's the exercise for you, right? I mean, like with that said, you know, any, so any exercise is beneficial, right? In some way, you'll, you'll find metabolic changes, like that stuff. There's many different endpoints to look at for health, right? But I do think if you're really trying to optimize that perfect, like, I want to do like the best thing I can do for my heart, for my, you know, for my brain, um, for mental health, I think, I think, um, for my lungs, I think that vigorous-intensity exercise, I'm convinced, is it.