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“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.
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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 minute but first I need to tell you about Ketone IQ 60% of tode France Riders use Ketone IQ to help them with their energy and mental Clarity and that's why I use it as my pre-workout I don't want to have caffeine upon waking but I still want to have energy to make sure that I have a good session which is why I use this gives me really clean energy there's no Jitters there no crash afterward and it massively helps with mental Clarity ketones are the brain and body's preferred fuel source but getting into a state of ketosis is hard you often have to fast for a long time or restrict carb intake or exercise your glycogen stores away but that can take days Ketone IQ delivers ketones to your bloodstream within minutes it has no sugar no caffeine and hundreds of 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