Why Vigorous Exercise Is 4–10x More Effective Than Moderate (New Evidence)

For decades now, we have these [music] physical activity guidelines looking at optimal health, saying you want to be engaging in about 150 minutes to 300 minutes of moderate intensity physical activity per week, but there's a new study that really kind of overturns that idea and we just can't ignore it anymore. So, I think the biggest headline from this study was that vigorous [music] intensity physical activity is four times as potent at reducing the risk of all cause mortality. That's pretty big. [music] But it actually gets even bigger when we look at cardiovascular related mortality. >> For all of the main outcomes, including cancer, 1 minute of vigorous activity was equal to 53 to 94 minutes. >> Wait, just pause for a minute. 1 minute of vigorous physical activity equivalent to an hour of like gentle walking. >> Time efficient right there. >> That's insane. [music] It's insane. >> We need to stop thinking in terms of minutes and steps. Those are like outdated metrics because if you're just chasing a number like steps, it might kind of be meaningless. Welcome back to the podcast. Today we're going to be discussing this almost universally accepted rule that for every 1 minute of vigorous intensity exercise, that's equivalent to 2 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 overturns that idea. 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 B2 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 Found My Fitness. So um you know hopefully we'll do more of these. So let's uh what do you think? Let's get started. >> For sure. Yeah. I think this will be a 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. Um, so yeah, let's get into it. >> 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 they 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 activity guidelines, which essentially are for optimal health, which is kind of 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 um vigorous type of physical activity that would be more like 75 to 150 minutes. So that's essentially your you're 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 2 minutes of the moderate intensity activity and that's kind of um 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. Yeah. And that was kind of like the biggest not surprise 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 what's the foundation of these recommendation it is based on the idea of this thing called metabolic equivalent or metabolic equivalent of task. People maybe will um have heard that referred to as METS or MES. 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 0 to three mets moderate activity 3 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 um the more moderate intensity activity. 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 for what what health outcomes are we looking at? Are we just focused on calorie burn? So yes if 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. um 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 um in different ways, >> right? Um 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? 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 it's it's kind of unfair because you know these guidelines if they not aren't necessarily indicating how much exercise we need to do or what type of exercise we need to do to to really age better um 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 or vigorous. So for example, they say light activity is like 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 you're maybe doing a leisurely cycle or you're doing some yard work. That's considered considered moderate intensity physical activity. And then vigorous activity is running, 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 those are sort of some of the guidelines, you know, in terms of how you define light, moderate, or vigorous physical activity. Um, >> 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. But when it comes to the guidelines, vigorous is a lot less vigorous and people are probably familiar with zone 2 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 2 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, >> 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 and I it like you said, you know, it's 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 have, you know, say a few sentences while they may be breathy, 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, um, it's just not accurate. And then the third one would be that it's not it's not actually able to capture um some of these like you know you're playing with your kids or you're you're sprinting around with your puppy right these short bursts of physical activity that do matter right so you're not you're not including that as well. So why don't we get into this new study it was pub p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p published in nature communications wearable device based day wearable device-based health equivalents of different physical activity intensities against mortality, cardioabolic disease and cancer. very good study. Um 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 um it was by a group led by Stamatakus is the first kind of author on it and importantly they're the 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 bio bank that's just a huge it's kind of similar to like the NHANES in the United States where just lot cohort of a ton of individuals looked at for you know decades or more um they have all this health data on them objective data subjective data so for this study they focused on um 73,000 more than 73,000 adults from the UK bio bank who were aged 40 to 79 so that's kind of important I think as well they were you know middle-aged to to older aged adults and they tracked them over 8 years. So the follow-up period in the study was 8 years on average. Um and the important part of the study is how they measured their physical activity. It was measured using these wearable devices, these wristworn accelerometers. They wore it for a week at the baseline of the study and so then they took all their physical 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, uh 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 or something like that. Um so, >> well, it's also I mean you 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 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 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 want to get >> can we pause for a minute when you say what the intensity their activity is and their accelerometer right 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, not 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. 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 activity intensity light intensity 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, you know, 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 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 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 a heart rate. What I what I was thinking about um when when kind of reading 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? Cuz 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 be? Cuz 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 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 um speed or the intensity at which your body is is kind of moving. >> Okay. 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 the 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. And then um obviously we talked about what 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 uh light household chores. So even maybe you're um you know, emptying the dishwasher or sweeping or vacuuming or something like that. That would be considered like light activity based on 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 you're running or you're riding a bike or exercise. Exercise would be categorized into that vigorous bout, but or that vigorous type of activity, but really anything, you know, purposeful movement I think is, you know, I were chatting offline. It's anything that would be 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. 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 kids or you're playing with your dog or you're um sprinting up the stairs you're walking to work or things like that. 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 a 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 for, but physical activity can be things done throughout the day, just integrated into your daily life as well. >> Right. Right. Um, okay. So, health outcomes that were tracked in this study, we have, do you want to mention the health outcomes? >> 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. Um major adverse cardiovascular events or MACE. So that's heart attack, stroke, cardiovascular death. Um type two diabetes incidents and then cancer incidents and that included physical activity uh related cancers as well. Um 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. Um 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 take care of this sick user or healthy user bias which I think strengthens a lot of the the outcomes in the study. >> That's a really uh important point. Um, okay. So, I'm going to I'm going to kind of get into some of these major findings in the study. And I think before getting into that, um, I just want to talk about that when we're 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% risk reduction in in, you know, reducing those mortality rates or disease incidents in the case of type two diabetes. Um, 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 any anywhere between 5 to 35% 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. So it was this they called it the health equivalence ratio in this study. They they were basically looking at you know does this one to two going back to the 1:2 rule that we talked about does this one to two rule hold up? Do you need if you do twice as much um moderate activity, does it give you the same disease reduction as a mo a minute of vigorous or is there like this skewed ratio? Is there more vigorous activity? You know, does that give you more risk reduction compared to a minute of, you know, light or 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 study was this health equivalence ratio thing that we're going to talk about because it really um sheds some light on the impact of vigorous activity. That's great. I love it. Um, 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? We're talking anywhere between four times better to almost 10 times better than moderate intensity exercise, which is pretty big. Um 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 4 minutes of moderate intensity activity. So basically in terms of reducing all cause mortality right so this is the death from all non non-acalental causes right [snorts] and um 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 at reducing the risk of all cause mortality than moderate intensity physical activity. That's pretty big. Um 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. Um 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 in [snorts] for every one minute of vigorous intensity physical activity you had to perform 7.8 eight 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 it kind of like you know if you're thinking about I'm spending 75 minutes doing mo 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 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 >> um Another big one is type two diabetes. So, this one isn't so surprising to me either and probably not to you as well. Um, vigorous for every 1 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 it it's not that um 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. Um and then the last big I would say 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 um 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 beneficial for my overall health and for like the way I age." Um, so >> 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 um, you know, the rewarding aspects of the activity that you're doing. >> Oh yeah, definitely definitely we should talk about that and I 100% agree. Um, but before we get there, let's you're they're going to talk a little bit more about the insane difference between vigorous physical activity and light physical activity. I mean, it's it's so crazy to think about um the difference between those that the time efficiency is like you just you can't you can't ignore you can't ignore how efficient vigorous physical activity is. >> Yeah. Some of these numbers were kind of incredible in the study and like some 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. So for all of the main outcomes including cancer light activity u one minute of vigorous activity was equal to 53 to 94 minutes um of light activity. So to get the same mortality risk reduction as 1 minute of uh running, you might need say an hour or so of gentle walking. Just kind 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. >> Time efficient right there [laughter] for sure. Um for diabetes prevention, it was nearly an hour and a half. So 94 minutes of light activity was equal to 1 minute of vigorous uh intensity activity for the cardiovascular disease outcomes. Um 73 minutes for cardiovascular dis disease mortality, 86 minutes for um major adverse cardiovascular events. And then for cancer mortality, this one was the largest one. Um 1 minute of vigorous activity was equal to 156 minutes. So nearly 2 and a half hours of light intensity um 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 efforts zone 2 or above had this massively outsized benefit on health outcomes compared to light intensity activity. And I think you know this I think you know you and I have talked about high intensity before and this isn't to say that the light intensity activity is useless. Um obviously any we both agree any movement is better than just sitting around. Um 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. Um 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, 5 to 10% risk reductions, which the authors actually didn't consider to be meaningful in the context of this study. So 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-c cause mortality reduction, which I think is kind of important to uh 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 I I agree. I mean I think I think I was reading in the paper that you know it was it the for light physical activity it was capped at like 15%. you got like a 15% reduction in, you know, cardiovascular related mortality and 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 know, you just 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 a there wasn't really a dose response, a potent dose response observed in the study. whereas um with the vigorous intensity physical activity there was but like before I I get to that I do want to I did forget to mention um 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 um 5.4 minutes of moderate intensity activity. So again, you know, heart attacks, strokes, like those are major events that you want to avoid. And so, you know, you could you could you could be so much more time efficient if you're doing vigorous physical activity versus the moderate even and certainly light. 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 um particularly for cancer. And I think that was where you were saying there was actually more was it? >> Yeah, cancer benefit. Uh it was uh let's see I think it was just for all cause mortality and diabetes was for light activity. Cancer cancer did have that huge equivalence when it came to the light versus vigorous. It was like 200 156 minutes I think of >> you know light activity you needed for the risk reduction of vigorous. Um but yeah no dose response for cancer for light activity either >> right. Um but yeah so be 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 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, we're talking I talk about a lot about the the benefits of going high intensity for the brain and all the, you know, it is still time efficient, but but 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? [laughter] >> Yeah, exactly. The Norwegian 4x4. It's you just I mean, if you get that amount of zone 2 just exercise is is beneficial. So, it's not Well, maybe, you know, we'll talk about this later, too, but yeah, it doesn't you don't need to be doing constantly hit. It's just these crazy benefits with this purposeful zone 2 even intensity movement is pretty pretty incredible. >> It's that we're really just dramatically underestimating the power of doing exercise, you know, and and getting our heart rate up. I know we're not measuring heart rate, but essentially they do correlate, right? um 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 50% or more greater reduction in like many of these categories for health outcomes you know cardiovascular related mortality all cause mortality so type two diabetes incidents right 50% or more reduction. That's pretty robust. And again, that was at the higher end of the vigorous intensity physical activity. Um, but there's definitely a dose response that 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, uh, 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 you do some light activity, you get about a 10 to 15% risk reduction, but doing more of that up to say even 2 to three hours a day of that extra light activity didn't really seem to reduce risk much more, >> right? Um, okay. So let's I think that's pretty clear that we are dramatically underestimating the value of vigorous intensity physical activity in 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, Ben, Dr. Ben Lavine, Dr. Martin Cabala on the podcast, and we've talked a lot about the adaptations to physical activity. Um, so I want to kind of start 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 um, 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 non-stop, like that's not good. But we're not talking about that. So the stronger the stimulus, the better better the adaptation. And one of um 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 8 minutes of moderate intensity physical activity. That's a big difference. Um, 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 there cause this causes what's called sheer stress on your vascular system on the interior lining of the arteries. And what shear 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 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 type of stress. The sheer stress causes your endothelial cells lining your arteries to adapt um and 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 prosttocyc. And both of these compounds are causing vasoddilation. 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 atheroscerosis, 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. Um we know Dr. Lavine has 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 if you look at look at it, it was like all all vigorous according to this definition of vigorous. Um, and it was what, five hours a week, >> about five hours a week, >> five to six hours a week, I think, >> right? And and so if we're if we're talking about the definition in this study, it was pretty much all vigorous because they were either running doing like a zone two type of run or they were doing Norwegian 4x4, some high-intensity interval training, some resistance training in there. And after 2 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. Um >> yeah and I mean a lot of the if you read any of the randomized control trials too 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 it's not it doesn't even come close like when 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 always wins in terms of improving vascular function. And it's just it all comes down to really that sheer stress that you mentioned. It's so higher intensity more shear stress it's be it's good sheer stress is almost like a bad name for it because like you said it's 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 so it's really important to do hit uh 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, right? Like there's a difference between a light like you can't have 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 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 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 your your arteries and your vascular system respond better, right? So, um I really like that you pointed that out. Let's let's talk about, you know, how [snorts] 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 intensities of exercise are going to increase you know 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. 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 and usually expressed in something like liters per minute. That would be your 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 2 intensity of exercise up to a point, they're going to stress the cardio the cardiac system, the heart and the lungs 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 adaptations there is obviously again the the increase in in stroke volume that you get. That's one of the best predictors or that's the main thing that increases when V2 max increases. So if you look at these studies showing, you know, what's the main adaptation that gives you a better V2 max, it's higher stroke volume because that gives you a greater cardiac output. Your heart can pump 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 demand more. It forces your heart to work harder and you're improving that 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 unless you have asthma or something like that, the lungs are a little overbuilt uh 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 exercise in this study and in others because you're just the heart is being stressed more. 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 Lavine 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, um, 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 79. So, that might be why vigorous exercise had this outsized benefit on specifically cardiovascular outcomes, that 8 to1 ratio like you mentioned, that incredible like higher than some of these other outcomes. Um so I think that's why there was that outside benefit as well. >> Yeah. I think for people um with respect to like why is it important to improve your V2 max you know your cardiorespiratory fitness that being a pretty important marker for longevity and you know for lowering your 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 V2 max they had a 5year increased life expectancy compared to the lowest people with the lower or lowest cardiorespiratory fitness or the they had a 80% lower allc 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 if you compared to if you were not in that in that range >> for sure and after about age 30 to 40 into your 50s your v2 max 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 into your 30s and 40s, but if you aren't engaging in moderate to vigorous intensity exercises at age 40, 50, 60, 70, your V2 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 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 than the physical health guidelines. And you know, I just going back to the study that um Marty Gabbala 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? Um they are unable to continue to to improve their their cardiorespiratory fitness, their V2 max and unless they're engaging in more vigorous types of exercise. So again in this regard it seems as though the vigorous intensity exercises is not as vigorous as perhaps once thought, >> right? >> What are what are your thoughts on that? Yeah, I 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 the 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 vulpa a little bit later. 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, uh, schedule during the day. But yeah, um, I think it's another illustration of how just like the low intensity kind of, uh, doesn't cut it. and the guidelines, you know, some people don't respond well to the guidelines and we either need an update or you need to do more or probably some combination of the both. >> Yeah. More emphasis on on vigorous I think too as well. Um okay so some of the other adaptations let's talk about you know the type two diabetes lowering the new diagnosis of type two 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 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 uh for improving metabolic health um when you when you are working harder, when you're working your muscles harder, um when you're when you're basically forcing your muscles to produce energy quicker, um what ends up happening is you're not using your mitochondria all the time. You're sometime 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. It's an active metabolite. And why is that important? Because lactate is not only a metabolite in some in some ways it actually acts as a hormone. It is a signaling molecule that's signaling to you know other proteins to other organs to to basically work harder and like respond to this hard work that is going on. Right? So um with improved insul in 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 um you know contracting you can basically cause 50 to 100 times more um contractions than at rest. That's a lot right and that actually forces glucose to come into your muscle. So your muscle is a big sink for glucose. Um but your muscle also has to transport that glucose across it. And that's where lactate comes in because when you're working hard, you are produc your muscles are producing lactate and that lactate um essentially signals to your muscle to increase these glute 4 transporters. These are the transporters that are responsible for bringing glucose out of your circulation and pulling it into the muscle. And um and so lactate is actually what is responsible for that for that you know signaling to increase the glute 4 number or transllocation to the cell surface muscle cell surface. Um and so what happens is that you're basically with the more intense or the more vigorous intensity 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 un it's unbelievable to um to to actually think about how beneficial vigorous intensity activity is if you're thinking about, you know, a 10 times efficient. I've seen I know that um 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 um glucose regulation. I would say there's even other studies out there showing like a 1:5 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, it suggested a 1:10 ratio almost. It was 9.4, but almost 1:10. >> Um, so I really do think that this confirms that, you know, obviously we've looked at a lot of biomarker data with these randomized control 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. Um, again, volume matched. Um, it wasn't necessarily 1 to 10, but it was there there were improvements whether it was like a 1 to three, one to five, you know, whatever it was, it was definitely for volume matched, it was better. >> Um, but but we're talking about again even more than that if we're looking at the actual type 2 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 minute. So, it's it almost kind of lines up with what we're seeing in this study, the 1:10 ratio with the in, you know, in some of his actual randomized control trials, that 1 to 10 sort of ratio between the sprint interval training and the moderate training too. Um, 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, that 1 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 a workout 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 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 you're if you're just moving more throughout your day, you have better glucose control. You're definitely going to have better long-term outcomes then for diabetes risk and things like that. you're going to have lower HBA1C, better in insulin sensitivity, lower fasting glucose. Um, and so I think that's sort of why that that's showing up here in in the actual outcomes like you said, which for most people are more important than the biomarker data probably, >> right? Yeah. And I also um just want to add on to that like a couple of things. One, you know, that makes a lot of sense too, 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 the 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 contractions glucose in thing. It's a glute 4 transporter where you're you are for a longer period of time throughout the day and perhaps even the next day somewhat but definitely for 24 hours it's 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. Um and this is improving metabolism of not just glucose but you know 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 two diabetes, we're not just looking at biomarkers. Like you I don't know you necessarily would pick that up on biomarker data if you're just looking 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. Um, you probably are also going to just see a healthier metabolic profile, right? I mean, that's something else to 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 these fasting I don't know how much stock to put in say like a fasting biioarker of your fasting blood glucose taken 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? um especially well you know and we don't really have any good biomarkers for mitochondrial health like that's like not it's it hasn't been translated to the to the clinic yet it's something that researchers can do in fact um looking at talking about some of the studies that Marty Gabbala cited on the podcast previously for volume matched exercise highintensity 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 to work so hard that they can't produce all the energy they need from just using their mitochondria alone, they it forces them to also use just glucose. Without mitochondria, your your your muscle's 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 2 training was the best for mitochondria." And >> you know, it depends on what we're talking about here. If we're talking about mitochondrial biogenesis, you know, great zone 2 does in 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 here, vigorous includes zone 2, 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, I regarding the the biomarkers of mitochondrial function. I know that's not what we're like talking about, but it is interesting to you know hopefully someday we have like a an ability to look at you know a non-invasive test of say your mitochondria. I think the best thing right now 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 not 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 biioarker to say, you know, what do your mitochondria look like? >> Yeah. No, and yeah, people can buy these lactate meters and it's a little fingerprint test you can do and I've done it several times and it's 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 oxygen species. they are the major generator of reactive oxygen 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 but you know everything takes a long time to to make its way to to our our homes >> yeah for sure unless you want to go get one of these huge like health panels done that cost probably several thousand dollars to do but I I mean honestly like maybe maybe it doesn't matter too much but it would be interesting for people to know you Does this protocol actually increase your mitochondria or not? >> I mean, the biohackers out there want to know, right? >> They do for sure. >> And we were talking about this urthan a compound on on the drive up here and and how that's important for mitochondrial health and we're actually going to cover it in in newsletter, but um I'm I'm taking it right now and I'm like it's all it's all >> what [snorts] am I measuring to know if it's really doing anything, right? I guess B2 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 uh I guess exercise in faith, maybe. Hoping this boosts my mitochondria. At least I think it does. So, >> before we continue, I just want to mention something important. If you're finding these episodes valuable, please consider subscribing to the channel and clicking the notification bell. It's the only way to ensure you'll be notified when a new episode goes live. Many people assume they'll be alerted automatically, but unless the bell is clicked, they won't be. We cover a lot of detailed evidence-based content here and I want to make sure that you don't miss any of it. Now, back to the episode. Okay. Well, I want to circle back to sheer stress because um that also plays a role in some of the mechanisms behind the reduction in cancer mortality as well. And that's something that uh Dr. Carrie Karnier talked about on the podcast. So, you know, the the reductions in cancer related mortality weren't as high as, you know, the type 2 diabetes risk reduction, but they're still significant enough, right? You're talking 3.5 you for every one minute of vigorous activity, you have to spend 3.5 minutes of, you know, moderate intensity activity, almost four minutes, right? You if you if you round up, I I would say it's almost four minutes. Um, why is that the case? Well, there's probably a lot of again mechanisms, but one that I think that's super interesting is that sheer stress that's improving your endthelial 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 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 of the tumor, right? So what happens is often times you have these cancer cells that'll 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 normal white blood cells or red blood cells in your in your circulation. They are 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 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-apoptic proteins, if they're higher, like even if they're like supposed to die, as long as that signal is saying 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-aptopic 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, um, unfortunately, they also kill normal cells as well because it's a very strong death signal. Um, when it comes to these circulating tumor cells, they're ready to die. And I know I went on a tangent. I'm sorry. I studied cancer cancer in my in graduate school. Um, they're they have these mechano sensors on their cell surface and 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, shearing forces of blood flow, that is a friction against these cancer cells that again are responding in a way that it's it's a it's a negative stress to them and they die. And that's something that's been shown in vitro. Um it's 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, why why is it so dangerous to have them in circulation? Well, for one, um let's say you were you already had cancer and you were treated with cancer successfully, quote unquote. Let's say you're you you know, you had chemo, radiation, maybe surgery, maybe all of the all three of them, right? And and now you're tumor free, whatever. Um 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 in 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 travel to another organ like the liver or something and um 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 in the even in the same the same organ whatever um the 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 in people that have already had cancer and perhaps been treated successfully with a cancer. So, um 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 study here is showing um that vigorous intensity physical activity is associated with a lower uh 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, um I think I think there's other mechanisms at play, but I do like the shearing forces one because you know it's something that people don't think about, but it is I think once you once you hear it and you think about it, you're like, "Oh, that makes sense. It 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, Carrie Kier was involved in and 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 um interesting. Oh, 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 component. So maybe that's why we're seeing that one to it was like four maybe ratio instead of the 1 to 10 or 1:8 ratio with cardiovascular disease or uh 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 there's a lot of things going on with with cancer but yeah there there is a genetic component and there's other environmental factors that play a role as well. >> Yeah. So then just moving on to I guess we had two more mechanisms sort of um the hormonal cellular responses as you mentioned I think you kind of covered that pretty 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 it could lead to you know burnout or overtraining however we we want to define it but um you just get sort of this more better hormonal millu I guess during um highintensity and vigorous exercise that you get during low inensity exercise which I think explains probably the reduction in all of these you know different outcomes diabetes cancer um 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 one which are referred to as slow twitch muscle fibers. Then we have type two. There are subsets of type two and maybe don't need to go into the details of those but we have 2 A, 2 B and then 2X. They kind of go on this spectrum from very fast oxidative glycolytic to sort of these this mix between aerobic and glycolytic fibers. But we'll just put them in these buckets of type one and type two for now. type two or fast twitch, type one or 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 from this study, you're going to be activating those low intensity, those type one fibers. Even if you're doing something like endurance exercise, for the most part, probably type one fibers 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 one fibers and then move on to the type two fibers eventually. And so in the context of this study, I think, you know, why are we seeing this outsized impact of of vigorous movement throughout the day? Well, if you're doing more vigorous movement, you're activating these type two fibers more um 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 with age. So you lose type two fibers first and then we move down to losing those type one or weakening of type one fibers. 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 two fibers depending on how heavy that box is. Obviously if you're carrying your kid, you might be engaging type two fibers. Um, so just doing this more vigorous activity throughout the day and then obviously engaging in highintensity exercise and vigorous exercise, you're going to engage more of those type two fibers and those play I think a role 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, better your insulin sensitivity, lower your fasting blood glucose. Um, 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 Peteria, 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 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 um 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. um that go, you know, they're doing more vigor vigorous activity, they're less likely to fall. They probably have a lower um 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-c cause mortality, I think that's why we see the benefit there is because if you're doing more of this low in or this high intensity activity throughout the day, you're engaging more type two fibers and we got to protect those. Um they're 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 I 100% agree. I mean, I think that's probably really tied into the the reduction in all cause mortality. And it's also, you know, one of the big reasons why I I I engage in CrossFit. I do across 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 I'm doing I'm doing all that type of um resistance training, but it's mixed in with aerobic and these high-intensity vigorous, you know, types of workouts. And so, you're really just getting it all. And and for me, it's it's a very timeefficient great way to get the whole shebang right. It's not just the the cardiorespiratory um improvements but also the effects on the muscle improvements and muscle health and strength as well. Um, so the other thing I that I wanted to mention with respect to the adaptations was inflammation, right? I mean, so the more intense the the exercise stimulus, you're in you're actually generating inflammatory compounds. IL is 6 being like the big one and and that IL6 is is actually um 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 isleisle 6 peaks and then like it shifts like I don't remember how much later it is, maybe an hour or so, you start to see isle 10, which is an anti-inflammatory cytoine. And I'm not talking about in this study, I'm talking about other studies that have looked at inflammatory biomarkers, but you'll see this strong anti-inflammatory response. And this is part of that um you know something I've talked about before in the podcast for several years is this hormetic response where you're in 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 and that does cause inflammation. It does cause oxid oxidative stress. is causing is 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 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 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 in inflammation and the anti-inflammatory adaptation that's that's responding to that inflammation is also important because inflammation is a a driver of many chronic diseases including cardiovascular disease, including cancer, type two diabetes, you know, 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 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 gets into the brain and we know it's a signaling molecule for brain drive neurotrphic factor very important growth factor for brain health to grow new neurons to, you know, improve the neuroplasticity of the brain. Um, plays a role in brain aging. So, it's it's not it it just goes everywhere, right? It's not just the 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 because >> I I think and I don't know if we've covered it, but I'm sure that there are studies out there because the UK bio bank is so huge and they've published hundreds of studies at this point, but I'm pretty positive and I can't site audit off the top of my head, but I know there are studies linking some of the same UK bioank physical activity data to slower brain aging. And what's cool about the UK bioank 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 bio bank 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 uh inevitable that you're going to see that risk reduction there, >> right? It's 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 as good, right? Depending on the outcome we're looking at. It's 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 2:1 ratio. And that's why it's has such this outsized benefit because it's 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 um 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're this. You can't really quantify it. It's an exponentially better increase for X outcome 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 um compared to lighter and moderate intensities. >> Brady I totally agree and I think that you know obviously like for people that are focused on weight loss like great 2:1 ratio you know that's that's perfect for you to consider as well as counting your calories or you know figuring out you know how what you're consuming cuz that 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 diabetes. And so, it is really important to realize that 2 to1 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 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. Y >> 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 in different organs and you're just it's it's it's really a panacea. It really is. >> Yeah. Everybody wants that say, "Oh, well PGC went out, but that's like the exercise pill." It's like, well, that's just that's just one part of it. >> Small part. It's one small part. I know. I mean, there's so many things to focus on. I mean, that's why I I've really like in the past few years, exercise has been like the focus of not only this this podcast, but just in my personal life. Like, I've 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 there I'm really getting more than I even thought I was. Totally. So, um, let's talk about some of these, you know, sort of short bursts of physical activity, starting with the vigorous intermittent lifestyle activity studies. These are the Vilpa studies. Um, we've talked about these before on the podcast. Marty Kabala came on. He's been a co-author on some of these papers. Um, 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 burst of, you know, carrying groceries up three flights of stairs or I raced to the 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. 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 I 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 um study. So people these these short vilas can be anywhere between 1 minute to 3 minutes in length, you know, they're they're they're not super long. It's certainly not 10 minute on the pelon, 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 I one of the most profound findings of the study I like to talk about one of the one of the Velpa studies is um 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, right? It's like 9 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 where people are engaging in their structured physical activity based on their memories, their their brains ability to recall in the last week what they've done done, it's even more robust than some of that. And and the reason I like that and 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 um so these studies these these vis 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 um their cardiovascular disease risk and it was is pretty profound I think. So some of the some of the risks in the women um let's see if I can find that study. Yeah. So it was a 45% lower risk of major cardiovascular events in women doing Vilpa and they were just doing 3.4 4 minutes per day. So this is much less than nine minutes as I just discussed. So they're doing 3.4 minutes of filas 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 like just imagine if we could get them to do 4 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. is going to be more of a structured exercise snack. And I'll let you kind of talk about some of that. But like we, 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, you know, body weightight squats or, you know, push-ups, like a combination of all these things. Um, and we're talking about really having a pretty outsized effect on reducing some of these negative health outcomes. Um, 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 is this isn't going to the gym and doing Pelaton. This is just your movement throughout the day. Um, being as measured by with an accelerometer. Um, the benefits were equivalent to people that were doing structured exercise, right? So there was like 62,000 people um who actually did exercise and they compared that to people who 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 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 to point out. >> Yeah. And a lot of those studies, most of those studies too were in nonex 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-ex exercisers benefited that and like you said, similar to people who exercise, which is kind of a crazy finding. Um, and it's interesting cuz 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, oh, 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, oh, you 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 150 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 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 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 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 it. 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 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 10 minutes a day you're doing that every day so that's what 70 minutes it was even less than that was 9 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 in cardiovascular related mortality but the guidelines say 75 minutes a week is the minimum now I get it like 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? 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. And I mean it makes total sense too because if you look at the these are separate studies but if you look at the VPA studies okay so say you're doing four minutes a day of vila 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 um you know 100 maybe 200 minutes of low inensity physical activity. So if you use the equivalence ratios that we were just talking about and apply it to the Vilpa studies that also kind of adds up with like the risk reduction. So that's kind of exciting to me. Also, you see this convergence. Some of it is coming from the same bioank data, which is interesting, and it's the same group, but you see that convergence there of okay, well, the story is actually like making sense now that we this or at least like the data are 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 I spent you know sometimes I'll spend 10 minutes like just sprinting around with my puppy like playing chase or tag and um or like a 5-minute bout and another five-minute bout 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 find ways is to like engage in this sort of like everyday life like intermittent burst of physical activity where you're 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 your puppy or your dog or I mean it's just I I just love it. I think it really helps um reinforce the importance of this like movement throughout the day, right? I mean this is how humans used to be too, right? >> 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 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 6:30 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 in 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 vila 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 a 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 snack stuff. Um I think before I mean a lot of people have heard exercise snacks because you've 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 um maybe like micro doing exercise or something, but the difference between exercise snacks and vila 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 vila 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, it's 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 pelaton at home and it's next to your desk at, you know, you're working. You get on the pelon 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. into 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 uh, you know, a bench press or something like that. So, 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. Um, that's kind of the idea behind those. And examples of that I mentioned a couple you know but 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 Gabbala other groups have actually done studies on them and they've shown improvements in V2 max of two to three milliliters per kilogram of oxygen with just you know 6 to 8 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 trains, 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 um a day to say exercise, you can really just get on the rower, get on your Pelaton 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 makes them a little bit different than Bila, 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 3 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 lift like heavy lifting, which I also do. Um, and you know, you just 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 1 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 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 amount of moderate intensity that I really did save time. Dopamine, okay, reinforcement. I'm going to continue to do that. Right? The the behavior is going to be repeated. Um, >> it gets it gets past the phrasing of, oh, I only have I only did four minutes of exercise. Well yeah you only 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 it's minutes are important but what is the value of a minute of a minute of different type figures or different intensities 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 yeah it was just like four minutes or it was just um you know just we it's 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 want to like you're going to see the difference. They're not equivalent. 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 they need there needs to be an update like this is something that needs to happen. Um, you know, we have empirical evidence here. We're not just looking at 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 activity. That 1:22 ratio out the door out the door. Would you agree? I mean, it's really I 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, there are people out there in public health who have more experience in public health than me and 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 I 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 150 to 3 minutes, which actually had been increased a little bit. 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 Aura and Fitbit. I think you 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 bio bank or the NHANES and formulate better guidelines that are based on objective evidence I think is kind of a disservice probably to public health. Um 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. I think they need an update and I think that the idea that we're just saying yes, you know, twice as much moderate if you're, you know, been vigorous, that certainly is um 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, you know, aging the best and 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. Now I feel like my my my you know I' I've shifted my understanding of that 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. Um, 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 oneto two ratio and and in fact, depending on the health outcome we're looking at, that ratio changes, you know, and that's that's how biology is. It's not just this big blanket thing, right? I mean, it's 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 they 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 um we have so much data now on these wearable devices. And as I mentioned, you know, before um I'm on the health advisory board for Google's Pixel. They did buy Fitbit. It's now Pixel. And um I know that they're they do publish a lot like they're one of the few um 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. Um at least updating some of their what what what they're doing as well. Um >> and Whoop Whoop does a lot too. They I feel like every every other week I'm seeing a Whoop 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 I'm not even going to try to do it. So, I think from a public 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 um 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 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 1:2 and maybe go with the lowest ratio, which was 1 to 3.5, 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 that there just there needs to be an update first and foremost. there needs to they need to look at more actual empirical data that you know as as measured by accelerometers and then from there it's like okay we 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 1:2 based on energy expenditure right 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 do use that assumption anymore we can really say valid like what is what is the range where you get this maximal risk reduction we have that and And 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 am 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 steps need to go out and it needs to be agree. It needs to be more like the minutes of of uh either vigorous or moderate. Probably mostly vigorous because that's like the easiest. I mean, you could do, you know, 4 minutes of vigorous activity a day and it be actually meaningful um at least according to the data with the women reducing the, you know, risk of heart attacks and stuff. So um 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 the 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 even as low as one minute right like 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 playing with their puppy or if they're working then they're and they 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 I think an explicit statement of accumulated in bouts of one minute to however long you want to make it. I think that would be a great addition probably. >> Yeah. Um 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 tracker kind of and a lot of these do it. I know my aura ring does where it will automatically just kind of track and suggest activities that I do. But you know if you have a 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 um technology in there for the incentives that dopamine boost like you mentioned would be fantastic. I mean gamifying it >> if if throughout the day like oh I sprinted to catch 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 I mean we have so much data and the ability to do that it would be cool it would gify it 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 would be super cool and then also just updating yeah the the value of the physical activity in these devices where it's it's not just uh oh that activity was more vigorous so I got twice as many points as if I did a moderate let's let's put these health equivalence ratios like integrate them into the algorithms. >> Yeah 100% 100%. I mean, I think that is that needs to be done um for all the devices and you know, the one to two it's it it 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 I 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 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 I really do. Um, so that's what I need. But I, like you said, some people really, and I know people like this who they like love all this like gamified stuff and and I'm like, okay, 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. Um, 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 push back um on social media for being the person that likes to talk about going going hard or or going home, but um I don't necessarily say that, but uh I think it's important to just again point it out. It doesn't mean that everything you do has to be vigorous, right? Um, and I think again we keep going back to the definition of vigorous in this study in 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 need to do some HIT, you know, during the week, maybe a couple times per week. But, um, yeah, I think the idea that we're not this isn't to say that low inensity activity is meaningless, but it's just um, you know, the the purposeful stuff has an outsized impact on health. >> Yeah. It it's not, you know, it's not meaningless, but boy, it's close. When it comes to like reducing disease, statistically meaningless, >> you have to do a lot of it, >> right? >> You really do. You 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 I'm not going to ever exercise. The only thing I'm going to do is light walking and house tours. 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. Um, so yeah, not meaningless. 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 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 pe like even people with diseases you know and stuff can do right like that's a very like because you if you pick up the pace for like 10 seconds even 20 seconds right um you're doing a little bit of interval walking you're just you're you're just getting you're 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 um at home especially especially the ones that really just love doing their light walking 10 hours a week. Um you know so um but that kind of gets it 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 [snorts] talking necessarily about just highintensity interval training although that does include it we're talk also talking about you know maybe cycling or you know running or jogging and to a point I think even jogging was considered more vigorous right so um 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 uh physical activity um I would say that essent you know most most of people that are older and let's say they've never really done any kind 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 keep in mind. Like it's easy to kind of just work your way up to it. Start out with the 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. Um but it is important to point out that um as you're getting older as you mentioned you know the muscle mass engaging the type 2 fibers because they're really going uh your cardiorespiratory fitness is is decreasing. I mean all of these things there's so much I would say um there's so many reasons why older adults should be trying to engage in some 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, highintensity vigorous exercise, you need to ease yourself into 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 use 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 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 4x4 protocols a week, 85% heart rate max. It's like you can do it. I mean, they're 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 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 Lavine 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 adapt, especially with regard to the cardiac the cardio cardiac adaptations, 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 um so yeah, not only is it feasible, but it's probably necessary for for older adults to engage in this highintensity interval training. I just think that there's this skewed idea when you talk about doing HIT that people think it's they're training like Olympic athletes and it's it's really not. It's >> Thank you, Brady. >> Just read the some of the clinical studies and it's pretty apparent. There there's definitely a group of people that like to push back when I you know anytime I like post or talk about doing the Norwegian 4x4 for some reason. It's it's really I'm not I mean I'm not talking about like non-stop Norwegian 4x4 like four times a day every you know five times a 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 it's a you know the relative 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, you know, it's like spin class, something like that. >> Yeah. Right. Um 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 the high end of vigorous here, right? In in regards to like high-intensity interval training. Um, can can women do an hourong high-intensity interval training session? Is it is it bad? Are there stress hormones going up? Is it you know, all those all those things that you hear from influencers on the internet? Um, my take and my read of the literature and my experience. So, I do I do highintensity interval training. I do like a crossfit type of training three hours a week right 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 um days where it's an hour each, I'm doing like strength training the first half half, which isn't really getting my heart rate up that much except for when I'm lifting heavy. Um and then I do like a 20-minut hit at the end. And hey, I'm everything's going great for me. I'm not I'm not burning out. I mean, I don't feel like I, you know, I'm like like burning at both ends at all. Um but let's talk about actual evidence here. I think yes women can engage in high-intensity interval training. Yes, they can do highintensity workouts. I think where this whole thing originated from was were these studies where women were massively reducing their calories >> and they were doing caloric restriction and engaging in a lot of like highintensity exercise and that can like cause amenorhea. 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 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? >> Right. I shouldn't do Hit all the time either. Men shouldn't do Hit all the time. They should listen to their bodies. They should listen, you know, program it strategically into their training cycle. I I also don't really know where this idea that I think it refers to maybe more so like I don't permenopausal postmenopausal women should be careful with HIT but like so sure and there are certain you know hormonal changes that happen at 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 again like you mentioned fuel adequately you know relative energy deficiency in sport red S is a if if you're doing more activity than you're fueling your body for. And women are um more prone to kind of that under fueling than maybe males are. Um especially kind of in the endurance sports realm. Yeah, you can overdo it just like anything. 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, that's just do it smartly. So, yeah, we're not I don't know. I I'm not sure where it has gone to weird places this idea. Um you will get I'll get an Instagram reel every now and then where it's like you know you shouldn't do you need to women need to train like this a different way and a lot of ev evidence out there for strength training and endurance training doesn't just really support that idea. I think >> I I you know it's funny that you mentioned the cortisol cuz that thing 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 the problem with cortisol isn't the like 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. Um it's not it's not the you know the types of exercise stress. know, 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 most people aren't. I think one thing to consider too is like, yes, if you're also a working 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. Um, 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. Um, 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, the there's there's there's ways that you can do these sort of exercise snacks, whether it's the interval walking or a little bit a 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. Um, 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 there's a progressive way to like get this is definitely vigorous exercise for her for sure. Um, and so I 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. Um, and then athletes, right? I mean, that's something that you're the athlete in the room. >> Yeah. And obviously when it comes to to athletes, you know, the 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 are getting just, you know, fine physical activity. Regarding HIT and vigorous 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 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 um 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 study 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. Um I think the takeaway here um 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. Um 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, um, I think balancing it, there's this common thing in athletic circles, the 8020 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. I think that's kind of a good framework, a good uristic for for people to follow. And I tend to sort of balance my exercise that way. Like 20% of my weekly exercises maybe harder, 80% is is typically pretty easy in terms of the the distribution. Um, but yeah, I think, you know, if 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 um balance that with recovery. >> Yeah. uh just since since you are the athlete and you mentioned your your 8020 rule, how many everything you do would be considered vigorous by the way according to this study that we're talking about here today in 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 structures, not everything, just the the time that you set aside to do your actual like runs and 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 couple hours of probably dedicated strength 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. Um, 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 and the door frame. I have kettle bells 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 uh build strength 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. Um, but obviously a lot of it is light. If you looked at my heart rate, you know, it's 60 maybe 70% of heart rate maxes. A lot of that stuff. So, it's still at a fairly low heart rate. >> Even your runs? >> 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. No, like 7 minutes per mile. >> You guys hear [laughter] that? That's easy for Brady. 7 minutes per mile. Oh my goodness. So, 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. I'm like, we're talking and like, you know, it's a it's a fun leisurely. Yeah. It's definitely like we're having conversation. We're talking 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 we catch up on our run, right? So it's like it's 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 do this is like nothing to him. He runs like for 20 miles at 7 minutes a mile. I mean that's insane. It's insane. >> Yeah. Takes a lot of time to build up to that. But again, you know, if we did a if we did a CrossFit workout, you probably would be able to outdo me in that one. Probably >> smoke you. I'm really I'm really becoming a crossfitter. Um, 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 intense we're doing kettle bell 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 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 the CrossFit and then the high rocks is kind of what everybody is interested in doing now. I think one of >> 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 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 to, you know, pick what's ideal, certainly those are the best cuz 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 to be 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 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, uh, children. And, you know, a lot of people are like wondering what what I think I think the takehome 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 and they're important not only um just to to their long-term health, but also there's studies showing that cardiorespiratory fitness like the the higher the cardiorespiratory fitness is in elementary school children, the better they perform on academic tests, 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 young children all the way to older adults. Physical activity and particularly the vigorous type of v physical activity really does improve you know cognitive function in the short term in the now but also the way your brain ages as well. >> Yeah absolutely. the 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 I 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 in say elementary school or junior high like I don't think your kid should probably be you know doing structured interval training sessions during the week to try to get I find in 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 u 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. It's all about like letting them have fun, letting them not be the best on the team. I mean, some kids are just naturally athletic. Like they they have to put in less effort, much, you know, less deliberate practice time to get to be good. Not 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 naturally 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, all those these are all life skills that they're learning. And I know I'm going on a tangent here. Sorry. I'm I'm a mom. What can I say? Um 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 this episode. Um the take-home for me here honestly is a couple of things. One is that I even feel like even myself I was underestimating the power of this vigorous intense intense physical activity that I get you know throughout the week in terms of reducing my cardiovascular cardiovascular disease risk my risk for having a heart attack or a stroke or getting type two diabetes. I mean, um, it's really exciting to me to think that I I'm actually getting a lot more benefit than I previously thought. Um, certainly, you know, if you look at the 30 to 40 minutes per week of 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, um, that's that in and of itself was exciting that one we're dramatically under underestimating the power of vigorous intensity physical activity. I do think that we all should be aiming for it um in some shape or form um particularly if we're able to and knowing that the vigorous intensity exercise doesn't necessarily mean the Norwegian 4x4, although I still think I I'll still say I think we should be doing that type of hit um at least once a week to improve our cardiorespiratory fitness. But that said, you know, even these like these runs that I'm going on that I have conversations with, that's that's great. That that that counts as more vigorous where I I previously wasn't really counting that as vigorous. Um, and then also just knowing about these short bursts of activity. Like I'm so excited now. Like I got a new puppy a couple of months ago. She's 4 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. Um, that's also very exciting to me as well. Um, so you know, for me, I think that those were the the major takehomes. 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 like benefiting your health. I think it's reassuring to see that those little short bouts 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 not this is obviously to say that you should ignore it, but I think that you should look at the data from your wearable in a different way and really think about what is it telling you. Does it are you you know 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 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 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, did I do maybe more or less? Like, should I do more? So, just don't 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 your 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 um and look at the guidelines and the recommendations and what they mean for health. I think this just sort of reframes like how we should think about all of this stuff. And um 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 uh listening to this podcast are interested in that. Um, how long do you think it takes to take 10,000 steps? >> It's actually longer than I think most people think. Um, I think if you walk for I think it takes about maybe 90 minutes to 2 oh no probably longer than 90 minutes to 2 hours to probably get 10,000 steps of like dedicated kind of walking. I think 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 doing the light walking you know you're really not getting more than a 10 or 15% reduction in risk for any of these these disease outcomes. So >> something to think about people. Um >> Brady this has been so fun. I love this new journal club journal club um podcast. I think that um I look forward to the next interesting paper that we're going to cover because I know there's going to be one. Um, I want to tell people about your book that I have here, V2 Max Essentials. I mean, if you want to know anything about V2 Max, Brady's the guy. I mean, he has everything in here about, you know, explaining what V2 Max is, the role it plays in aging, what limits it, um, tools and protocols for improving it. I mean, just everything you want to know. So, I highly recommend that V2 max essentials, and it's also really cheap. You can find that on Amazon. You also have a Substack. You mentioned that you covered the 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 comes to exercise related studies. >> Yeah, social media. Um, people can find me at B Homer. Um, I'll post it's a mix of stuff from my life and a lot mostly science. I try to keep it mostly science, but it's a personal account, too. So, I 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 a thought piece on there. Um, 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, but um, so you can find all that stuff and subscribe. It's free. You can pay either one. Um, and yeah, that's kind of where main two channels you can find me. the book it was, you know, it's probably due for an update, but there's just evergreen stuff in there if people want to learn the science of U2 max. You 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 uh all in that book. So, I appreciate you uh giving that a little plug. >> Yeah, my pleasure, Brady. Well, thanks again for joining me on the podcast, and until the next one. >> Yeah, thanks forward to it. >> This was great. I think the journal club style will hopefully it's here to stay. I enjoyed this. >> Yeah, definitely. Same.