“This Workout Makes Your Heart 20 Years Younger” - Dr Rhonda Patrick
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Dr. Rhonda Patrick emphasizes VO2 max as a critical biomarker for longevity, noting its significance in assessing cardiovascular health and exercise capacity. She highlights that while vigorous exercise is beneficial, it must be performed at high intensities over sustained intervals to effectively improve this metric. Specifically, she advocates for the Norwegian 4x4 protocol, which involves four minutes of maximal intensity effort followed by three minutes of light recovery, repeated four times in a single session. This approach ensures the heart rate drops sufficiently between sets to allow for repetition without slowing down too much during the intense intervals. The efficacy of this high-intensity training is supported by a study conducted at UT Southwestern Dallas involving 50-year-olds who were healthy but physically inactive and sedentary. Over a two-year progressive intervention, these participants engaged in approximately four hours of weekly exercise, with a significant portion dedicated to maximal intensity sessions lasting around thirty minutes alongside strength training. The results demonstrated a remarkable reversal of cardiac aging; after just two years, their hearts exhibited the structural characteristics of 30-year-old hearts rather than those typical of someone aged fifty, effectively reversing twenty years of age-related decline in heart structure and function. Dr. Patrick explains that achieving true maximal intensity does not mean going all-out at ninety-five percent capacity for a short burst, which would only last about a minute; instead, it requires maintaining an effort around seventy-five to eighty percent of maximum heart rate without being able to talk comfortably. This level of exertion is sustainable for the required duration and provides significant benefits compared to Zone 2 training alone, which often demands longer durations that can be difficult to maintain consistently. She suggests that while running or cycling are excellent alternatives for achieving this intensity over twenty minutes, individuals should choose activities they enjoy to ensure consistency in their routine. For those seeking daily motivation without the commitment of a single weekly hard day like the Norwegian 4x4 protocol, Dr. Patrick recommends incorporating shorter high-intensity interval training (HIIT) sessions into everyday routines. She personally utilizes various formats, such as ten-minute Tabata workouts with work-to-rest ratios ranging from three to one or two to one, often performed on a stationary bike to boost energy and mental focus for the day ahead. While she acknowledges that some protocols involve shorter intervals like sixty seconds of effort followed by recovery periods, she maintains that consistency is key regardless of whether one performs this rigorous training once weekly or integrates smaller bursts into daily life alongside other forms of exercise like yoga or bodyweight movements. The discussion concludes with a strong emphasis on the psychological barrier to starting such demanding regimens and how finding an enjoyable activity helps overcome procrastination. Dr. Patrick notes that while Zone 2 cardio has been popularized recently, it often requires high volume which can be challenging for busy individuals, making targeted high-intensity efforts more practical for improving VO2 max efficiently. By combining these specific protocols with a balanced approach including strength training and lighter activities like yoga, individuals can effectively combat the natural stiffening of the heart associated with aging while maintaining overall physical activity levels without needing to engage in exhaustive daily workouts every single day.
Read the full video transcript
Petra Tia told me that V2 Max is the
single most important metric when
looking at someone's longevity how much
truth do you thinks in that I I think
that absolutely he's right I think VO2
max is one of the single and and and the
thing I love about it is that it's
something that you can measure it's a
biomarker I think it's one of the most
important things absolutely and there's
you know there's there's some evidence
that like doing doing this vigorous
exercise is important but it has to be
like a longer interval type of exercise
so you know at least 1 minute that would
be sort of the minimum but like better
if you can get to four minutes so
there's something called the Norwegian
4x4
protocol and that's four minutes at the
highest intensity that you can maintain
for that entire four minutes followed by
three minut minute recovery of like
light light exercise I mean you want
your heart rate to come down so that you
could do it again four times right so
the miserable sounds absolutely
miserable the norian
4x4 um and
you know there's there was a study and I
like I like this is one of the studies
that inspired me and this is this was a
study out of uh UT Southwest and Dallas
and um the study took 50y olds that were
healthy but they were not physically
active so they didn't have like type two
diabetes and all that but they weren't
active they're also drained exactly
they're drained and they put them on a
pretty intensive training protocol for 2
years okay two years
it was a 2-year intervention and it was
a progressive protocol so obviously when
you have an untrained person you don't
just ride out the bat Norwegian 4x4 day
one no that's not going to happen so it
took them six months to kind of work up
their their their training right their
endurance and by the time they got to
their six-month Mark they were doing
about you know four hours a week of
what's called maximal intensity exercise
so this is vigorous this is this is
hours a week of maximal intensity yeah
wow so they were doing so they were
basically
doing it was like is as high as you can
maintain you know vigorous intensity
workout for 30 minutes basically so
they're doing these 30- minute workouts
where you're doing like 75 80% max heart
rate for 30 minutes okay so they're
doing that eight times a week yeah I
mean so no they're also doing they're
doing other things as well so they're
doing it's not when I say four hours a
week they're exercising four hours a
week they're also I thought you meant
they were doing 4 hours of this
Norwegian 4x4 no no no no no they were
doing exercise four hours a week okay um
but they were doing um a majority of
that was maximal intensity exercise so a
lot of that was they were doing like 30
minute sessions of this and I think they
were probably doing like one and a half
to two hours of that and then they were
also doing some strength training and
then they were doing the Norwegian 4x4
so it was kind of a a nice sort of
balanced and then the control group was
doing this sort of I say strength
training but it was more I guess body
weight you know kind of stuff um the
control group was doing that so it was a
type of sort of body weight training but
it wasn't high intensity like it wasn't
like the the CrossFit kind of stuff that
you could do it was it was more like
lower stretching kind of stuff maybe
yoga is kind of thing and um so so after
two years these people like the cardiac
structure so as we age our heart gets
smaller and it gets stiffer and this
happens it's like part of aging um that
results in a lot of things so
cardiovascular disease risk goes up but
also like your exercise performance and
capacity goes down so so after that two
years of you know doing this pretty
vigorous intensity exercise protocol
their um the people the 50-year-olds
they reversed their cardiac structure
aging by 20 years so their hearts were
looking more like 30-year-old Hearts
versus 50-year old hearts and this is
after 2 years of doing this and to me it
was so motivating ating to go wow these
50-year-olds can do this like these were
untrained people who don't usually work
out and by the end of these two years I
mean they were like getting at it um and
so I've you know kind of stepped up my
my game a bit also like I've got a coach
coming and I'm working with um two two
days a week and to do I'm doing a lot of
uh it's like a resistance training but
like kind of interval as well so I'm
getting the high heart rate and and that
interval it's so funny to see Peter here
and yourself kind of converge on this
new it's not it's not as if it's new but
it was definitely something that I
wasn't hearing about four years ago I
wasn't hearing people talk about this
everything was zone two it was you know
like go slow to go fast or whatever the
tagline is and um one of the problems
with Zone 2 is that you need quite a
high duration like by Design because you
know 45 minutes or an hour multiple
times per week which is actually
difficult so lots of benefits of
improving V2 Max what are take us
through the Norwegian 4x4 again and then
what else is in there if there was a
protocol or a number of protocols you
were going to design here's a program
that you can take away today into your
gym and do that will help to improve
your V2 Max what would you tell people I
would say the Norwegian 4x4 is by far
the best and you're going to get the if
for the people that are really um
determined and committed that would be
it that would be the four minutes of the
exercise intensity is hard as you can go
and maintain it for that entire four
minutes so obviously dig into that what
what do you mean as hard as you can go
and maintain it what does that mean it
means you don't want to go like all out
like like 95% of your your max heart
rate um because then you can only last
for like a minute you know and so so
then you're going to go down you're
going to you're going to slow down right
so what it means is like you want to go
you know it might for some people it
might be like 75% max heart rate right
so some people might be 80% but you want
to go as hard as you can for the 4
minutes uh without like really slowing
down so you kind of have to past
yourself a little bit but you don't want
to go too slow right like you you
definitely can't be talking like you
should not be able to talk for sure when
you're doing it so it's hard enough that
you just absolutely can't talk but it's
not all out so four minutes four minutes
and then 3 minutes of totally light like
you're going all the way this is like
you know you're you're like back to like
Zone one if you want to call it
something if can come come down come
down yeah and you're doing that for 3
minutes because you want to give your
you want to recover so that you can do
it again and it and you repeat it it's
it's a four it's a four-time protocol so
you do it once and then you repeat it
three times or you just call the 4x4 I
think that's probably one of the the
best protocols to improve V2 Max now uh
Dr Martin gabala um I've had him on my
podcast he's a real expert on these
high-intensity interval training
protocols he does a lot of research on
it at McMaster University um in Ontario
Canada and he also says you there you
know there there's evidence that a one
minute protocol so like just even doing
like an interval like one minute
interval and then doing that like you
know a few times also can improve V2 Max
so that's a little easier and ALS it's
easier like I like I I do one minute
intervals um I'm trying to now
incorporate the 4x4 into my routine um
which is coaches help with that so um
but it I imagine it's a motivation thing
which is probably one of the biggest h
to get over that just if you've got any
program in front of you that isn't the
Norwegian 4x4 for the day you go maybe
it's back in biceps or maybe I'll just
go for a little jug it's like Manana
Manana Manana yeah it is but again like
I said you do have to do you try to make
it consistent so uh frequency per week
well the Norwegian 4x4 would be like one
time a week oh okay and that's that's
the that's the hard day that's less
that's less Mis hard day it is okay okay
is there any benefit to going twice per
week probably
yeah but it been so much better said but
these 50y olds yeah these 50-year-olds
did it one time a week for two years and
they reversed their cardiac structure
aging by 20 years um of course they were
they were also doing other vigorous
intensity exercise it wasn't the
torturous Norwegian 4x4 yep you know
like so if Norwegian 4x4 is gold
standard at the moment for improving V2
Max what would be some examples of other
vigorous
exercise uh workouts what else is in
that bucket well people can do what they
enjoy doing so you can go for a run like
I often go for a run and you know I'm
doing 75 80% my max heart rate uh
usually it's like a 20 minute run that I
do that you know so like is as as
intense as you can maintain for 20
minutes like that's what you want to do
you want to kind of get that you get a
feeling for that um so if you like runs
because there's a lot of benefits to
running you're out in nature well I
guess some people do it on treadmill I'm
not so big on treadmills like I I'll do
them like when I go to a gym or
something traveling but I like running
out in nature I think there's it's just
there's lots of benefits to doing that
um some people like to get on their bike
and cycle so like you can just get on
your bike and do a 20 to 30 minute uh 75
80% max heart rate cycle right so what
what aiming for here is 75 to 80% max
heart rate for around about 20 minute
Expo you can or you can do you could do
like a high-intensity interval training
so um so high-intensity interval
training would be you're going to you're
going to go more than 85 80% right you
might go you're going to do like more of
like a submaximal perhaps um perhaps
even a maximal interval so you can go up
to 90 95% max heart rate so that would
be I mean obviously you can only
maintain that for like so long right
some people might be 30 second pushes
style thing I do a lot of tatas as well
um often times I like to do something
every day um most days of the week and
it's funny I kind of adopted this this
routine when I was I was kind of trying
to uh do a little bit like Joe Rogan
sober October but it was like every day
October I was trying to work out every
day and I noticed I was like I could do
this I'm doing it for like one month and
I don't I wasn't going as hard as like
the this guys doing the sober October
where they were like competition it was
like they were just in the if you do
something every ex do something every
day so sometimes I'll do like a 10
minute Tata where I get on there and I
just go hard for 10 minutes to 20 you
know it's most of the time I'll do a 45
second on um 15sec off so it's a 3 to1
ratio I really like that one but
sometimes I'll do 20 second on 10 uh 10c
off so it's like I do both but like even
just 10 minutes again I time it around
like like I got I'm going to go do work
I'm I want to feel motivated I want to
feel better I want to be more focused in
all my game and I just get on there for
the bike for 10 minutes and do it we'll
get back to talking to rondre in one
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slod wisdom thank you very much for
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