#108 The Best Type of Exercise for Longevity

0:00Hello, friends. Today, we're diving into a fascinating discussion about exercise intensity. Most of us have long accepted this simple guideline that one minute of vigorous exercise equals two minutes of moderate exercise. It's intuitive, neat, convenient, but what if it's fundamentally inaccurate? That rule has shaped global physical activity guidelines for decades, yet it was largely based on calorie burn, not hard endpoints like mortality,

0:31cardiovascular events, diabetes, or cancer. Joining me to explore this important topic is endurance athlete Brady Homer, who has a master's in human performance and has collaborated with me before on the Found My Fitness Comprehensive Training Guide. Today, we're breaking down a groundbreaking new study published in Nature Communications that used objective device-based data to challenge decades of conventional exercise wisdom and guidelines. We break down the methods, the limitations, and what the data actually supports. This is a Journal Club-style

1:05episode. In this episode, Brady and I discuss how wearable accelerometers offer a more accurate picture of physical activity than traditional self-reported methods. The surprising new finding that one minute of vigorous exercise could offer health benefits equivalent to four to nine minutes of moderate exercise, dramatically altering our understanding of exercise efficiency. Specific outcomes showing vigorous activity is up to eight times more potent for cardiovascular health and nearly 10 times as

1:39effective in diabetes prevention. Why vigorous exercise uniquely triggers potent physiological adaptations like improved cardiovascular function, insulin sensitivity, mitochondrial health, and even reduced cancer risk through targeted cellular mechanisms. We talk about the practical implications for everyday life, including the powerful health habits of vigorous intermittent lifestyle physical activity. These are VILPAs. They're quick, sometimes unstructured, everyday lifestyle ways that we're getting our heart rate up.

2:09But we also talk about the structured exercise snacks. This new research really could rewrite the existing exercise guidelines entirely. It challenges fitness trackers, challenges exercise apps, and public health messaging to completely recalibrate the way we value and measure physical activity. Before we dive into today's episode, a quick reminder about our free evidence-based resource, How to Train According to the Experts. If you haven't downloaded this free guide yet, or even if you have,

2:40we just released major updates you'll definitely want to check out. You can find that at howtotrainguide.com. We've expanded our coverage on creatine supplementation with updated dosing protocols. We also have fresh insights into how it impacts brain health and cognitive function. We've also refined our recommendations on exactly how much exercise is needed to maximize longevity, and also how exercise snacks and even VILPAs can contribute meaningfully to our fitness goals. So this guide really condenses the best evidence-based

3:12strategies from our leading scientists that have been on this podcast into a real single actionable toolkit. You'll find precise protocols in there for building muscle mass, building muscle strength, targeted training methods that are proven to enhance cardiorespiratory fitness. This is a really important marker for longevity. We have updated science-driven strategies to support both metabolic health, cognitive performance, and then we also have some practical exercise routines that are really crafted for people with time-constrained schedules. Again, it's entirely free, and it's available right now at howtotrainguide.com. Again, howtotrainguide.com.

3:52And also, if you're intrigued a little bit more about the creatine and you want to explore it more deeply, we also have a comprehensive collection of resources on the FoundMyFitness topic pages. So FoundMyFitness.com forward slash topics. You can go to the creatine section, which is under the C, and you can find and read all about creatine there. As always, everything we produce is made possible entirely through the support of you, our listeners. Our mission here really is to deliver rigorous,

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5:28foundmyfitness.com forward slash premium. Again, that's foundmyfitness.com forward slash premium. Thank you so much for supporting evidence-based health and fitness education. Now let's jump into today's episode. Welcome back to the podcast. Today, we're going to be discussing this almost universally accepted rule that for every one minute of vigorous intensity exercise, that's equivalent to two minutes of moderate intensity exercise. And we're going to talk about whether or not that's accurate and where

6:02it 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, VO2 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

6:33also was a collaborator on. So I'm pretty pumped to sit here and have this first episode of a journal club for foundmyfitness. So, you know, hopefully we'll do more of these. So let's, 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 eyeopening one in my mind. So yeah, let's get into it. Eyeopening, but not surprising, right? Totally. So, okay, well, let's, I'm going to start off by just talking about what this,

7:04you 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 sort of vague, but for optimal health, you want to be engaging in about 150 minutes to 300 minutes of moderate intensity physical activity

7:38per week. Or if you're going to be doing more vigorous intense, vigorous type of physical activity, that would be more like 75 to 150 minutes. So that's essentially your, your, your 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 two minutes of the moderate intensity activity. And that's kind of 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

8:11cardiovascular 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.

8:47Yeah. And that was kind of like the biggest, not surprised 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 recommendations? It is based on the idea of the thing called metabolic equivalent or metabolic equivalent of task. People maybe will have heard that referred to as METS or M-E-T-S. 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 zero to three METS, moderate activity, three to six METS, vigorous activity over six METS. And

9:20it'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 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

9:54focused 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

10:25focused 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,

10:55how much exercise do I need to do to really age better? And so it's, it's kind of unfair because, you know, these guidelines, if they 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,

11:28which aren't necessarily what I would think of as moderate or vigorous. So for example, they say light activity is a casual stroll, or maybe like you're standing, so just not sitting, or you're 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

11:59outside, 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

12:29people were probably familiar with zone two 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 two 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

13:00into the 80% max heart rate or above, you know, and like you said, you know, 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

13:33guidelines. 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. It's just not accurate. And then the third one would be that it's not it's

14:07not actually able to capture 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 published published in Nature Communications, wearable device based date, wearable device based health equivalents of different physical activity intensities against mortality, cardiometabolic disease and cancer. Very good study. Maybe we can kind of start off with, you know, the how the

14:39study was set up, like some of the methods. Yeah, sure. So this was by it was by a group led by Stamatakis 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 biobank. That's just a huge it's kind of similar to like the NHANES in the United States, where just a lot cohort of a ton of individuals looked at for, you know, decades or more. They have all this

15:11health data on them, objective data, subjective data. So for this study, they focused on 73,000, more than 73,000 adults from the UK biobank who were aged 40 to 79. So that's kind of important, I think, as well. They were, you know, middle aged to older aged adults, and they tracked them over eight years. So the follow up period in the study was eight years on average. And the important part of the study is how they measured their physical activity. It was measured using these wearable devices, these wrist worn accelerometers. They wore it for a week at the baseline of the study. And so then

15:43they 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, 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 something like that. So it's also I mean, it's measuring everything, right? It's measuring

16:18the 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

16:50was objective data. And yes, it captured, it captured what physical activity they were doing, what exercise they were doing, I guess. So they're 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 into the- Wait, can we pause for a minute? When you say what the intensity their activity is and their accelerometer, right? Yeah. So people might be confused and they, again, might be going back to heart rate. Like when they hear wearable device and

17:20they'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 that wearables we have today, like your, you know, Apple watch. So an accelerometer is literally a

17:52device 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

18:24seconds 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

18:58based, or they're, you know, you're 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, 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? Because your wrist is moving, but you're not really walking, you're not really moving distance wise. So is that

19:30something that would be picked up by this device and considered and what bucket would it be? Because some people can be like moving fast, right? It would. And that would be, I think, even regardless of the 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 arms. 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

20:02speed or the intensity at which your body is, is kind of moving. 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 obviously we talked about what, what examples are considered that for the health guidelines, but they're pretty similar.

20:36They are similar. This study, they said, you know, light activity, they gave some examples of it. That would be just a light household chores. So even maybe you're, 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

21:07exercise. Exercise would be categorized in that vigorous bout, but, or that vigorous type of activity, but really anything, you know, purposeful movement, I think is, you know, we're 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

21:38show 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, spreading up the stairs,

22:10you're walking to work or things like that. Like 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

22:42things 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,

23:12cardiovascular 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

23:43these 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 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

24:16about this range between five to 35% risk reduction in, in, you know, reducing those mortality rates or disease incidents in the case of type 2 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 anywhere, anywhere between five 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

24:46calculated 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 the study that we're basically looking at, you know, does this one to two, going back to the one to two 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 give you the same

25:18disease reduction as a moderate, a minute of vigorous, or is there like the skewed ratio? Is there more vigorous activity, you know, does that give you more risk reduction compared to a minute of, you know, lighter, 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 day was this health equivalence ratio thing that we're going to talk about because it really, um, shed 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

25:54twice 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 four minutes of moderate intensity activity. So basically in terms of reducing all cause mortality, right? So this is the death from all non non-accidental

26:25causes, right? 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 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

27:02that'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 for every one minute of vigorous intensity physical activity, you had to perform 7.8 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 kind of like, you know, if you're thinking about, I'm spending 75 minutes doing mod, sorry,

27:37doing 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 one minute of vigorous intensity physical

28:08activity, 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 two diabetes. And it's really not, it's, it's not that 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

28:40nuts. 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

29:12health 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 talked 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,

29:48you know, the rewarding aspects of the activity that you're doing. No, yeah, definitely. Definitely. We should talk about that. And I a hundred percent 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.

30:19Yeah. Some of these numbers were kind of incredible in the study. And like, 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, um, 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 one minute of, uh, running, you might need say an hour

30:51or 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 for sure. Um, for diabetes prevention, it was nearly an hour and a half. So 94 minutes of light activity was equal to one minute of vigorous, uh, intensity activity for the cardiovascular disease outcomes. Um, 73 minutes for cardiovascular disease, disease mortality, 86 minutes

31:25for, um, major adverse cardiovascular events. And then for cancer mortality, this one was the largest one. Um, one minute of vigorous activity was equal to 156 minutes. So nearly two 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 two or above have this massively outsized benefit on health outcomes

31:58compared to light intensity activity. And I think, you know, this, I think, you know, you know, I've 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

32:29benefit. Doing more light intensity physical activity didn't significantly reduce. So there were, you know, five 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 a extra risk reduction for a lot of these outcomes other than diabetes and all cause mortality reduction, which I think is kind of important to 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

33:01elicit 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 agree. I mean, I think, I think I was reading in the paper that, you know, it was 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

33:33that. 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 with the vigorous intensity physical activity, there was, but like, before I get to that, I do want to, I did forget to mention 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 5.4 minutes of moderate intensity activity. So again,

34:10you know, heart attack, 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, particularly for cancer. And I think that was where you were saying there was actually more, was it? Yeah. Cancer. Let's see. I think it was just for all-cause mortality

34:40and diabetes was for light activity. Cancer, cancer did have that huge equivalence when it came to the light versus vigorous. So it was like 200, 156 minutes, I think of middle light activity you needed for the risk reduction of vigorous. But yeah, no dose response for cancer for light activity either. Right. But yeah, so, 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'd need to be talking about at least moderate,

35:12at 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 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 four by four. Yeah, exactly. The Norwegian four by four. It's you just, I mean, if you get that amount of zone

35:46two, just exercise is, is beneficial. So it's not, well, maybe, you know, we'll talk about this later too, but it doesn't, you don't need to be doing constantly hit. It's just these crazy benefits with this purposeful zone two, 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? With the dose response curves with vigorous exercise, we did see a linear effect, both vigorous and moderate intensity, both, but with the vigorous,

36:19I 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 like reduction. That's pretty robust. And again, that was at the higher end of the vigorous intensity physical activity. But there's definitely a dose response that, that was seen there.

36:49Yep. 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 two to three hours a day of that extra light activity didn't really seem to reduce risk much more.

37:20Right. Um, okay. So let's, I think that's pretty clear that we're 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 Levine, Dr. Martin Kabbalah on the podcast, and we've talked a lot about the adaptations to physical activity. Um,

37:55so 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, nonstop, like that's not good, but we're not talking about that. So the stronger the stimulus, the better, better the adaptation.

38:28And 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 eight minutes of moderate intensity physical activity. That's 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 their cause, this causes what's called sheer stress

39:03on your vascular system, on the interior lining of the arteries. And what sheer stress is, is essentially just the friction of the blood flow against this interior lining of the arteries and 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 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

39:36causes 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 prostacyclin. And both of these compounds are causing vasodilation, you know, they're improving blood flow. But over time, and as you continue to repeat this sheer

40:10stress, 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 atherosclerosis, 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. We know Dr. Levine 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

40:44stronger, 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. And it was what, five hours a week, about five hours a week, six hours a week, right. 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

41:15Norwegian four by four, some high intensity interval training, some resistance training in there. And after two 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. Yeah. And I mean, a lot of the if you read any of the randomized control trials to 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

41:46their 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 sheer stress. It's bet. It's good. It's bad. Your 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

42:18because 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 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. Yeah, right. Like there's a difference between the light, like you can't have, you could have a light breeze last for a really long time, but ain't gonna knock over some trees, right? Like it's not gonna 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

42:49to 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 arteries and your vascular system respond better, right? So I really like that you pointed that out. Let's talk about, you know, how heart and lung function together, right? Like the cardiorespiratory, you know,

43:21system 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

43:52pumps it out and in usually expressed in something like liters per minute, that would be 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 two 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

44:24key adaptations there is obviously, again, the the increase in stroke volume that you get. That's one of the best predictors, or that's the main thing that increases when VO2 max increases. So if you look at these studies showing, you know, what's the main adaptation that gives you a better VO2 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 HIIT 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

44:56the lungs. I think the lungs are a little bit, not less adaptable, but they do adapt less because in a lot of people, once you have asthma or something like that, the lungs are a little overbuilt, 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, and 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 Levine, I think he cited, you know,

45:30that 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, 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

46:00outcomes, that eight to one ratio, like you mentioned, that incredible, like higher than some of these other outcomes. So I think that's why there was that outsized benefit as well. Yeah. I think for people with respect to like, why is it important to improve your VO2 max, you know, your cardiorespiratory fitness, that being a pretty important marker for longevity and, you know, for lowering 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

46:30cardiorespiratory fitness as measured by VO2 max, they had a five-year increased life expectancy compared to the lowest people with the lower or lowest cardiorespiratory fitness or the eight, they had a 80% lower all 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 VO2 max starts to decline about 10%

47:04per 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 VO2 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 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

47:39this study that Marty Gabala cited on the podcast a few years ago, where he's 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? They're unable to continue to improve their cardiorespiratory fitness, their VO2 max, 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.

48:15Right. What are your thoughts on that? Yeah, 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 VILPA 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

48:47activity 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, schedule during the day. But yeah, I think it's another illustration of how just like the low intensity kind of 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 both. Yeah, more emphasis on on vigorous, I think, too, as well.

49:20Okay, 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 for improving metabolic health. When you know, when you are working harder, when you're working your

49:52muscles harder, when you're when you're basically forcing your muscles to produce energy quicker, what ends up happening is you're not using your mitochondria all the time, you're sometimes 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 is a signaling

50:27molecule 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 with improved 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, you know, contracting, you can basically cause 50 to 100 times more 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

51:00glucose. 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 producing, your muscles are producing lactate. And that lactate essentially signals to your muscle to increase these GLUT4 transporters. These are the transporters that are responsible for bringing glucose out of your circulation, pulling it into the muscle. And, and so lactate's actually what is responsible for that, for that, you know, signaling to increase the GLUT4 number or translocation to the cell surface, muscle cell surface.

51:37And so what happens is that you're basically with the more intense or the more vigorous intensity of 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, it's unbelievable to, 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, and I know that there's

52:11been 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 glucose regulation. I would say there's even other studies out there showing like a one to five 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 one to 10 ratio, almost, it was 9.4, but almost one to 10. So I really do

52:42think that this confirms that, you know, obviously we've looked at a lot of biomarker data with these randomized controlled trials. We've had Marty Kabbalah on the podcast talking about, you know, tons of these, 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, a lot of different metabolic markers. Again, volume matched. It wasn't necessarily one to 10, but it was, there were improvements, whether it was like a one to three,

53:15one to five, you know, whatever it was, it was definitely for volume matched. It was better. But, but we're talking about, again, even more than that, if we're looking at the actual type two 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 minutes. So it's, it almost kind of lines up with what we're seeing in this study, the one to 10

53:45ratio with in the, you know, in some of his actual randomized controlled trials, that one to 10 sort of ratio between the sprint interval training and the moderate training too. 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 one 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

54:16a 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 than for diabetes risk and

54:48things like that. You're going to have lower HbA1c, better insulin sensitivity, lower fasting glucose. And so I think that's sort of why that that's showing up here and in the actual outcomes, like you said, which for most people are more important than the biomarker data, probably. Right. Yeah. And I also just want to add on to that, like a couple of things. One, you know, that makes a lot of sense to you, by the way, you know, doing the exercise throughout the day and the fact that matters, 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 lactate signaling

55:20here 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 GLUT4 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 the, 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

55:55another 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. 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 2 diabetes, we're not just looking at biomarkers. Like you, I don't know how 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

56:29mitochondria, more healthy mitochondria on top of like, you know, improved glucose regulation to 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 he's fasting, I don't know how much stock to put in, say like a fasting biomarker 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,

57:03you would actually see it in that data. Right. Um, especially, well, you know, we, 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, I'm looking at talking about some of the studies that Marty Gabala cited on the podcast previously for volume matched exercise, high intensity interval training is better at increasing mitochondrial biogenesis than moderate intensity exercise. Again, it has to do with that stronger stimulus causing the adaptation

57:35when 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 muscles 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 what I thought zone two training was the best for mitochondria. And, you know, it depends on what we're talking about here. We're talking about mitochondrial biogenesis, you know, great zone two does increase mitochondrial

58:09biogenesis, but you know, if you start to go a little more vigorous, you actually can get a stronger stimulus. And I know that's what we're talking about here. Vigorous includes zone two, but I'm just saying, generally speaking, 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 biomarkers of mitochondrial function,

58:43I 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 are probably 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

59:18probably the best way, like currently non-invasively without having a muscle biopsy done, but sooner or later, hopefully we have some sort of biomarker to say, you know, what are your mitochondria look like? Yeah, no. And people, yeah, people can buy these lactate meters and it's a little finger prick 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

59:52major 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 costs 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 know, does this protocol actually increase your mitochondria or not?

1:00:25I mean, the biohackers out there want to know, right? They do for sure. And we were talking about this urolithin 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 a newsletter, but I'm, I'm taking it right now and I'm like, it's all, it's all, what am I measuring to know if it's really doing anything right? I guess VO2 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, I guess, exercise in faith, maybe hoping this boosts my mitochondria.

1:00:56At least I think it does. So. Okay. Well, I want to circle back to sheer stress because that also plays a role in some of the mechanisms behind the reduction in cancer mortality as well. And that's something that Dr. Carrie Kernier talked about on the podcast. So, you know, the, the reductions in cancer related mortality weren't as high as, you know, the type two diabetes risk reduction, but there's still significant enough, right? You're talking 3.5 for every one minute of vigorous activity, you have to spend

1:01:263.5 minutes of, you know, moderate intensity activity, almost four minutes, right? You can, if you, if you round up, I would say it's almost four minutes. 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 endothelial 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

1:01:59tumor, 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 oftentimes 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're all kinds of messed up. They have tons of different mutations.

1:02:33Your 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-apoptotic proteins, if they're higher,

1:03:07like 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-apoptotic signal and they're just

1:03:37waiting to raise above it. And so that's what those things do, chemo and, you know, and so on. So unfortunately they also kill normal cells as well, because it's a very strong death signal. When it comes to the 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 graduate school. They're, they have these mechanosensors 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

1:04:08forces, right, shearing force of the blood flow, that is 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. 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, let's say you were, you already had cancer

1:04:40and you were treated with cancer successfully, quote unquote, let's say you're, you know, you got chemo, radiation, maybe surgery, maybe all of the, all three of them, right. And, and now you're tumor free, whatever. 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 and 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

1:05:11single cells, they do escape. And if they get into circulation, they'll maybe go, maybe they'll travel to another organ, like the liver or something. And 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. 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 and people that have already had cancer and perhaps been treated successfully with that cancer. So the shearing

1:05:46forces 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 that vigorous intensity physical activity is associated with a lower 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 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,

1:06:17once 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 Curnier was involved in 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 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 components. So maybe that's why we're seeing that one to, it was like four, maybe ratio instead of the one to 10 or one to eight ratio

1:06:53with cardiovascular disease or can't, or a 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's 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 the hormonal cellular responses. As you mentioned, I think you kind of covered that pretty, pretty well, but obviously

1:07:23with 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 want to define it, but you just get sort of this more better hormonal milieu, I guess, during high intensity and

1:07:54vigorous exercise that you get during low intensity exercise, which I think explains probably the reduction in all of these, you know, different outcomes, diabetes, cancer, 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

1:08:27into the details of those. But we have to a to be and then to x, 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 are 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 use some of the examples from from this study, you're going to be activating those low intensity, those type one

1:08:58fibers, 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 vigorous movement throughout the day? Well, if you're doing more vigorous movement, you're activating these type two fibers more, and you're giving them more of a stimulus and type two

1:09:33fibers 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. So just doing this more vigorous activity throughout the day, and then obviously engaging in high intensity exercise and

1:10:04vigorous exercise, you're going to engage more of those type two fibers. And those play, I think, a role of 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. 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 Peter Tia, 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,

1:10:36you 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 catabolic crises, as you've referred to it before. And so I think that when you look at a cohort of

1:11:07adults 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. That good, you know, they're doing more vigorous, vigorous activity, they're less likely to fall, they probably have a lower 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 cause mortality. I think that's why we see the benefit there is because if you're doing more of this low or this high

1:11:37intensity activity throughout the day, you're engaging more type two fibers, and we got to protect those. So 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 100% agree. I mean, I think that's probably really tied into the reduction in all cause mortality. And it's also, you know, one of the big reasons why I engage in CrossFit. I do a lot of CrossFit types of training because I'm getting the functional, I'm getting the explosive power, I'm getting the strength,

1:12:09you know, I'm doing all that type of 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 for me, it's a very time efficient, great way to get the whole shebang, right? It's not just the cardiorespiratory improvements, but also the effects on the muscle improvements and muscle health and strength as well. So the other thing that I wanted to mention with respect to the adaptations was inflammation, right? I mean, so the more intense the exercise stimulus,

1:12:45you're actually generating inflammatory compounds, IL-6 being like the big one. And that IL-6 is actually 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 IL-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 IL-10, which is an anti-inflammatory cytokine. 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

1:13:18part of that, you know, something I've talked about before in the podcast for several years is this hormetic response where 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 oxidative stress. It's causing, it's 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,

1:13:49you'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 know, 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 inflammation and the anti-inflammatory adaptation that's, that's responding to that inflammation is also important

1:14:21because inflammation is 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 it gets into the brain and we know it's a signaling molecule for brain drive neurotrophic factor, very important growth

1:14:54factor for brain health, to grow new neurons, to, you know, improve the neuroplasticity of the brain, plays a role in brain aging. So it's, it's not, it just goes everywhere, right? It's not just 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. Yeah. 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 biobank is so huge and they've published hundreds of studies

1:15:25at this point, but I'm pretty positive and I can't cite a study off the top of my head, but I know there are studies linking some of the same UK biobank physical activity data to slower brain aging. And what's cool about the UK biobank 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 biobank 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.

1:15:56I mean, it's, you know, it's pretty inevitable that you're going to see that risk reduction there. Right. 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 the, I think us discussing the mechanisms, you know, while I think it's super important because it, the mechanisms

1:16:30explain why vigorous exercise is more beneficial for health outcomes than we thought with that two to one ratio. And that's why it's has such as outsized benefit because it's, it's sending this louder signal to the body, regardless of what you look at, you look at cancer, you look at blood glucose, you look at 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

1:17:02that 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 compared to lighter and moderate intensities. Katie, I totally agree. And I think that, you know, obviously, like for people that are focused on weight loss, like great two to one ratio, you know, that's, that's perfect for you to consider as well as counting your calories or, you know, figuring out what you're consuming, because

1:17:35that that's all 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 two to one ratio is just out the door is 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 will 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

1:18:06happening. I mean, you just, that's why you can't pill up exercise. 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 to say, Oh, well, PGC-1 alpha, that's like the exercise pill. It's like, well, that's just, that's just one part of it. Small part, one small part. I know. I mean,

1:18:39there's so many things to focus on. I mean, that's why I 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 have, 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 I'm really getting more than I even thought I was. Totally. So let's talk about some of these, you know, sort of short bursts of physical activity, starting with the vigorous

1:19:13intermittent lifestyle activity studies. These are the VILPA studies. We've talked about these before on the podcast, Marty Kabbala came on, he's been a coauthor on some of these papers, 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 bursts of, you know, carrying groceries up three flights of stairs, or I raced to catch my, you know, subway because I

1:19:49didn't want to miss it. Or yeah, I was playing with my new four month old 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 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

1:20:21ignore it anymore. And I've probably cited this one nature study like a million times. So 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 study. So people, these short VILPAs can be anywhere between one minute to three minutes in length. You know, they're not super long. It's certainly that 10 minute on the Peloton, 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 one of the most

1:20:55profound findings of the study I like to talk about, one of the VILPA studies, is on the upper end of that, so people that are doing like the three minutes short bursts, and they're doing that three times a day. So a total of almost 10 minutes a day, right? It's like nine 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

1:21:27engaging in their structured physical activity based on their memories and their brain's ability to recall in the last week what they've done, it's even more robust than some of that. And the reason I like that, 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 so these studies, these 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 cardiovascular disease risk, and it is pretty

1:22:01profound, I think. So some of the risks in the women, 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 minutes per day. So this is much less than nine minutes, as I just discussed. So they were doing 3.4 minutes of VILPAs 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

1:22:32bursts 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 four 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, it's going to be more of a structured exercise snack. And I'll let you kind of talk about some of that. But like, 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 weight

1:23:05squats, or, you know, pushups, like a combination of all these things. And we're talking about really having a pretty outsized effect on reducing some of these negative health outcomes. 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 Peloton. This is just your movement throughout the day, being as measured by, with an accelerometer. Um, the benefits were equivalent to people that were doing structured exercise, right? So there

1:23:39was like 62,000 people, um, who actually did exercise, and they compared that to people that 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, to point out. Yeah. And a lot of those studies, most of those

1:24:10studies too, were in non-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-exercisers benefited that. And like you said, similar to people who exercise, which is kind of a crazy finding. Um, and it's interesting because reading all of 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

1:24:43session. 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

1:25:15to, 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 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

1:25:47health 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 bursts 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