This episode comes from my keynote lecture at the American Academy of Anti-Aging Medicine LongevityFest 2023, in which I describe several powerful health habits that delay biological aging and improve healthspan. The core idea: You don’t have to move mountains to make a big impact on aging. Starting with a few key areas of focus (vitamin D, magnesium, omega-3s, and vigorous exercise) can make a big difference. Thanks @A4MEvents for having me!
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*CHAPTERS:*
(01:38) Vitamin D
(05:58) How vitamin D deficiency affects mortality risk
(09:24) Optimal vitamin D levels & supplementation
(11:10) Why magnesium deficiency impairs DNA damage repair
(14:50) Dangers of inadequate omega-3 intake
(17:07) The correct omega-3 index level
(21:32) How to correct vitamin D, omega-3, & magnesium inadequacies
(23:17) Vigorous exercise is the best longevity drug
(24:50) How increasing VO2 max affects life expectancy
(29:36) Protocols for increasing VO2 max
(32:27) How to measure VO2 max
(33:34) What it takes to reverse 20 years of heart aging
(36:31) Blood pressure benefits of vigorous exercise
(37:48) The BDNF brain benefits of vigorous exercise
(40:58) How vigorous exercise improves focus & attention
(42:11) Exercise protocols for maximizing BDNF
(43:13) Anti-cancer effects of vigorous exercise
(45:30) Exercise snacks
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So people that had a I high omega-3 index but smoked had the same life expectancy as people that didn’t smoke but had a low omega-3 index so essentially if you just look at this data alone smoking was like having a low omega-3 index if you could pel up what
You can do with vigorous exercise then I think that is like right now what the best longevity drug we have for delaying the aging process and improving Health span and improving lifespan good morning nice to be here today I was just uh mentioning that my son eats about two cups of pomegranate a
Day so his Euro lithan a levels must be off the charts and maybe he’ll live to be 100 but probably gene therapy is going to be involved in that so uh today we’re going to be talking about some of the what I think are powerful lifestyle
Habits that can affect the way you age so there’s some what I call lwh hanging fruit so these are things that I think are really easy it can be as simple as a you know dietary modification or a supplement you take and then there’s some things that are a little more
Effortful which um require effort um and so that would of course be exercise and so we’re going to get into that as well um so the first part of the talk we’re going to just talk about optimizing micronutrient deficiencies and in the second part we’re going to be talking about what
Kind of exercise and how it affects the way we age um on a molecular level as well so first up um I think there’s really three main micronutrient deficiencies that I want to talk about for a couple of reasons one because they’re widespread um prevalence in terms of either deficiency or
Inadequacy and two because I think they played a very important role in a lot of physiological processes in our body and that affect the way we age so first we’re going to talk about vitamin D and most of you guys probably have already heard enough about vitamin D but um it’s
Important to talk about because it’s it’s more than a vitamin so vitamin D gets converted into a steroid hormone and it goes into the nucleus of cells and interacts with DNA so it recognizes a very specific sequence of DNA called the vitamin D response element and and
This is encoded in our DNA um and that interaction then either turns genes on and activates them or it does the opposite it sort of turns them down and represses them so it’s very important for orchestrating I mean we’re talking about over 5% of the protein encoding
Human genome is regulated by vitamin D which is quite a lot um and so you know you can imagine if if you’re running a car and your Pistons are are firing um out of sync with each other I mean that’s kind of what’s happening when you when you don’t have adequate levels of
Vitamin D your genes aren’t being regulated in the way they’re supposed to be so things aren’t being activated when they’re supposed to be or repressed when they’re supposed to be so things are kind of you know going going arai um and as I mentioned about it’s widespread prevalency in terms of inadequacy so
About 70% of the population has inadequate levels of vitamin D which we’ll talk about in a minute it’s about 30 nanograms per milliliter or less and it’s a very simple solution and that’s also I like to talk about it because um it’s almost just as simple as taking a a
Basically a supplement that cost a penny a pill Vitamin D supplements are one of the most affordable supplements out there and and there’s really just no reason other than lack of you know education about vitamin D for people to be so deficient and insufficient a lot of reasons for the
Widespread deficiency um you know you know we make vitamin D3 in our skin so UVB radiation is essential to make vitamin D3 anything that blocks out UVB radiation is going to stop that production of vitamin D so we’re talking sunscreen um melanin which is the dark skin pigmentation that protects us from
The burning rays of the sun um also is a natural sunscreen so that is also a form of sunscreen also depending on where you live so a northern latitude um UVB radiation can’t even reach the atmosphere you know several months out of the year so when you combine some of
These factors let’s say you take someone with darker pigmentation from let’s say East Asia and they move somewhere like Chicago or they move to Sweden where you know six months out of the year you’re not even getting that UVB radiation you’re talking about just a you know compounding effect on vitamin D
Deficiency because um you know there have been studies out of the University of Chicago that have shown that for examp example African-Americans have to stay in the sun anywhere between 6 to 10 times longer than Caucasians with fair skin to make the same amount of vitamin D3 In
Their Skin So you’re talking I mean it’s it’s a very um it’s it’s a compounding effect with respect to to the to the melanin production as well and then age plays a role so as we age you know everything is less efficient um so you know a 70-year-old makes about I think
It’s four times less vitamin D3 in their skin than their former 20-year-old self so and then of course modern day Society so we have we’re inside indoors we’re at our computers we’re in our cubicles we’re technology you know we’re not out we’re it’s it’s not an Agricultural
Society we’re not outside you know as as much as we used to be and so um vitamin D is just not being made in our skins like it was 100 years ago so there’s a lot of reasons why it’s it’s widespread um I like to show this this
Slide it was a study published several years ago was 2009 and and it’s it’s showing um when you knock out the vitamin D receptor in in mice that it affects the way they age um so the top of the panel you can see that both mice
That wild type and then the vitamin D receptor knockout sort of Aging the same and then four months later the vitamin D receptor Mouse is is just it’s a it’s a accelerated aging model and you know yeah it looks terrible but like the organs on on every level things were um
Sort of accelerated in the way they were aging so um it’s just kind of a nice visual to see but of course we’re not mice and I’ve always often wondered why mice even need Vitamin D because you know they’re nocturnal and they it’s just one of those things where it’s like
I don’t know how much of that actually translates to humans so let’s talk about some human studies um we know that there’s a lot of data out there observational data that’s correlated vitamin D levels to low vitamin D levels to higher all cause mortality risk higher uh cancer mortality but there’s
Always that question of healthy user bias maybe people with higher vitamin D are outside and more physically active and of course you try to correct for as many you know confounding factors as possible but you never really can establish causation that’s where melan randomization comes into play so this is
We you know we have a variety of genes that are responsible for converting vitamin D3 into 25 hydroxy vitamin D which is the um most you know active circulating form of vitamin D and then subsequently into the steroid hormone which is 125 hydroxy vitamin D um some of these G genes that
Make enzymes we all are different and so some people have ones that don’t do it as efficiently um and so melan randomization takes these genes this these single nucleotide polymorphisms in these genes and says okay we’re going to randomize them people that have these genes that we know make them basically
Have lower levels of 25 hydroxy vitamin D and see what they’re you know correlate that to health outcomes like all cause mortality so it’s kind of in a way a way of randomizing people and people that have genetically low vitamin D levels independent of what their
Lifestyle is they have a much higher all cause mortality they have a higher cancer related mortality and they have a higher respiratory disease mortality um with very little or no effect on cardiovascular mortality and there’s also been um with randomized control trials obviously you’re not going to have a lifelong randomized control trial
Looking at mortality but there’s you know there’s other biomarkers that can be looked at one is epigenetic aging which I’m sure youve guys heard about yesterday so um one study that took people that were vitamin D deficient and that’s it’s important to to start out with a cohort of participants that are
Deficient sh right because if you already have someone that’s sufficient giving them a vitamin D supplement really shouldn’t do much because they’re already at a sufficient level so um these were African-American individuals that were also overweight and um so they were they were very vitamin D deficient
They were given a vitamin D supplement with 4,000 IUS of vitamin D a day and it decreased their epigenetic age by almost 2 years so the question is what is deficiency insufficiency um adequacy uh so technically it’s kind of I I would say depending on what institute you’re
Looking at but the um Endocrinology Institute defines deficiency as Vitamin uh 25 hydroxy vitamin D levels less than 20 nanograms per Mill sufficiency is about 30 getting you know so if you’re insufficient you’re less than 30 but if you’re sufficient you’re more than 30 and it seems as though The Sweet Spot
For vitamin D is between 40 to 60 nanog per milliliter and um you know there’s there’s all cause mortality studies also looking at vitamin D levels there’s metaanalyses of these you know ranging for from 1960s all the way to the you know mid like 2015 and it’s it’s really it seems like
40 to 60 is a really good sweet spot for the lowest all cause mortality with vitamin D as I mentioned 4,000 I mentioned 4,000 I use of vitamin D a day because um that’s the the tolerable upper intake for vitamin D so it’s quite safe and um in general 1,000 IUS of
Vitamin D generally raises people’s blood levels by about five nanograms per mil so the key is to just get get a vitamin D blood test do it you know after you’re supplementing make make sure your your levels are adequate because again a lot of these single nucleotide polymorphisms and genes that
Affect our enzymes that are metabolizing vitamin D also affect how we respond to um supplemental vitamin D and some people can require a much higher dose than other people so really the key here is blood test and measuring um you don’t know what you don’t measure right so the next micronutrient I want
To kind of shift gears and talk about is magnesium and this again um it’s widespread inadequacy here about half the US population has inadequate levels of magnesium so magnesium is found at the center of a chlorophyll molecule so plants you know you know chlorofil gives plants their green color so dark leafy
Greens are a really good source of magnesium and essentially people aren’t needing enough greens which is why half the country doesn’t have adequate levels of magnesium magnesium is a co-actor for over 300 different enzymes in the body uh a lot of metabolic processes so it’s important for the production of energy
In the form of ATP it’s it’s important for the utilization of energy in the form of ATP but it’s also important for repairing DNA damage so DNA repair enzymes require magnesium to function and um this is where I think the Aging its role in aging comes into play
Because DNA damage is something that’s happening every day it’s happening right now and all of us as you know are we’re metabolizing food was we’re breathing in oxygen um immune system slightly activated whatever it’s constantly happening and and our bodies are repairing that damage um but it’s it’s
An Insidious type of damage right it’s not something that you can just wake up and look in the mirror and see right you’re not you’re you’re scurvy is like okay my gums are bleeding and things something’s wrong you can see that right Dy damage isn’t something that you
Really think about on a daily basis but it’s happening and it accumulates with age um so you want to be able to repair that Pro that damage effectively right um for many reasons so DNA damage can lead eventually over the course of several decades to oncogenic mutations
That could lead to cancer and so there have been actually a variety of studies that have looked and correlated magnesium levels magnesium intake with cancer mortality so there was one study that found for every 100 milligrams of magnesium intake there was a 24% decrease in pancreatic cancer um risk
And also another study that found that people that had the highest levels of magnesium they were in the top quintile had a 40% lower all cause mortality compared to people in the lowest and then they had a 50% decrease in cancer mortality compared to people in the
Lowest so magnesium is one of those um again I think it’s best to try to get it from dietary sources dark leafy greens are a great source but also supplemental forms of magnesium I think is a great sort of insurance so to speak so um magnesium glycinate magnesium malate
Magnesium citrate these are all pretty bioavailable forms of magnesium the requirements for magnesium depend on age gender so you know men require a little bit more than women it’s somewhere like 400 milligrams a day for men and somewhere like 300 to 350 or something like that for women um if you’re
Athletic if you’re sweating if you’re you know Physically Active a lot use the sauna um you actually can require anywhere between 10 to 20% above the RDA because you do lose magnesium through sweat so if half the US population isn’t meaning even that our da then you can
Imagine the Physically Active people are probably you know fairing even worse because they’re already their requirements are even higher so it’s a simple solution simple dietary dietary modification supplement you can take um to help sort of get your magnesium levels higher so omega-3 is the is sort of the
Last micronutrient that I want to cover before getting into the next part of my talk and um omega-3 there’s three forms of it so there’s ala which is found in plant forms like black seed walnuts there’s EPA and DHA which are Marine sources so they’re found in Thief food
And um there’s a study out of Harvard that was published gosh it was like 2009 and this study identified the top six preventable causes of death so these are these are things that are you know lifestyle related so hypertension for example smoking of like not having you know avoiding
Hypertension avoiding smoking those were those were one of the you know some of the top six preventable causes of death well omega-3 not getting enough omega-3 from Seafood so this was the marine source of Omega-3 EPA and DHA was in that top six and um researchers from Harvard had identified that not getting
Enough omega-3 from Seafood was responsible for about 84,000 deaths a year and that was compared to trans fats so trans fats were also in consuming trans trans fats were uh one of the top avoidable um you know preventable causes of death well eating trans fats were responsible for 82,000 deaths per year
Pretty much the same as not getting enough omega-3 from seafood and you know what’s funny is that you everybody knows about trans fats you walk into any Supermarket any grocery store everything’s marketed oh zero trans fats zero trans fats but nobody’s thinking about they’re not getting enough omega-3
They’re not eating enough seafood or fish or taking uh microalgae or or you know fish oil supplement to get omega-3 and so I I just kind of like to highlight that because it’s it’s again I think that the way thinking about food in that you know what are we what do we
Need to feed our our body our metabolism we need co-actors magnesium you know vitamin D omega-3 like these are things if we focus on what we need to consume we don’t end up eating all the other stuff and so you know people sort sort of get fixated on what to avoid and
Don’t think about what they’re actually supposed to be taking in what they’re supposed to be eating so the omega-3 index is one of the best measures of Omega-3 so this was pioneered by um Dr Bill Harris and uh his calling Von shaki many years ago back in 2004 and um it’s measuring
Omega-3 levels in red blood cell membranes as opposed to plasma phospholipids and the reason for that is because it is a long-term biomarker of Omega-3 so your red blood cells take about 120 days to turn over whereas your plasma phospholipids it’s more like if you you get your omega-3 levels measured
And it’s plasma phospholipids it’s more like what did I eat you know the past week or you know something like that so um it’s kind of a comparison is you know fasting blood glucose would be the immediate you know biomarker and then the hba1c right is your long-term blood
Glucose level so it’s sort of similar here so omega-3 index is a really important way to measure omega-3 and um it’s now being increasingly used in many scientific studies of course many I think a lot of conflicting data out there also has to do with the fact that plasma phospholipids were measured and
Again it goes down to this well was it just that they didn’t eat omega-3 in the last week or they did and so we’re saying they have high omega-3 because of that just recent dietary um choice right so Omega index was um this is again from
Bill Harris’s group he found him and his colleagues found that people with a high omega-3 index which is defined as 8% at least 8% had a 90% reduced risk of sudden cardiac death compared to people with a low omega-3 index of 4% um the standard I in in the US the omega-3
Index most people it’s about it’s less than 5% so it’s about 4% so most people in the United States are are at a very low omega-3 index they don’t eat enough seafood and fish um you know so sudden cardiac death is reduced by 90% if you’re in that high high omega-3 imix
Group cardiovascular disease is the number one killer in the United States and and actually most all developed countries every 33 seconds someone dies of a heart attack so um anything you can do to improve cardiovascular health is really really on your side in terms of improving Health span improving your life
Span High Omega the high omega-3 index also from Bill Harris’s group found that people again with an 8% omega-3 index had a 5-year increased life expectancy compared to people with a 4% omega-3 index so that was the low end and um it’s interesting because in Japan their
Life expectancy on average is about five years longer than in the in the United States our average life expectancy is five years less here than in Japan and they happen to have an omega-3 index in general above 8 %c whereas again I mentioned we’re below 5% so um sort of
An interesting sort of observation that also correlates with the increased average life expectancy in a country that eats a lot of seafood but this is what really I think is almost is is eye opening um it’s part of the same study from Bill Harris’s group where they stratisfied these participants and
Looked at their omega-3 index and then also look at their smoking so the very very top curve the green curve people live the long if they had the 8% omega-3 index and they were non-smokers and the very very bottom curve the red one was people that were
Smokers and had a low omega-3 index 4% so those they had the the lowest life expectancy but this is what blows my mind if you look at the orange and blue curves they’re I they’re completely overlaid on top of each other so people that had a I high omega-3 index but
Smoked had the same life EXP expectancy as people that didn’t smoke but had a low omega-3 index so essentially if you just look at this data alone smoking was like having a low omega-3 index and it just again it’s one of those things where of course it’s observational data
And you can never really establish causation but I just feel like that’s really eye openening um because again everyone knows smoking is bad for you but nobody’s thinking about how we’re not getting enough omega-3 and how easy is it to take a a fish oil supplement for example or increase your you know
Salmon intake so to summarize this part of my talk with respect to micronutrients we talked about vitamin D low hanging fruit um as simple as a supplement 4,000 I use a day is a pretty good start to get most people who are deficient to a sufficient level that’s been shown in several
Studies getting people from a you know deficient level up to a sufficient level can be done with 4,000 I of vitamin D A Day omega-3 fatty acids um omega-3 index I’m getting the omega-3 index test you want your levels to be in the 8% you
Want to be High um and then there’s been studies showing that it takes around two grams of supplemental omega-3 to get from a 4% omega-3 index to an 8% really not that hard and then um again um omega– 3 is is found in prescription form I didn’t go into all the randomized
Control trials today because that would take the remainder of my my time here but um you can get omega-3 in purified ethylester form either in the form of EPA only BPA or DHA plus EPA laesa and those are prescribed in four grams a day
Per dose and so what I said was you know sort of conservative it takes about two grams a day just to get from a 4% on average 4% omega3 index an 8% and again it’s as simple as getting the test done and and you know supplementing and then
Testing again and seeing if you’re getting your your index up to 8% and then magnesium we talked about uh you know getting getting that RDA hitting it um with either you know increasing or a combination ideally increasing leafy greens and also taking a supplement magnesium glycinate citrate malate are
All pretty bioavailable sources of magnesium okay so GNA we’re going to shift gears and we’re going to get into the effortful part of uh this presentation this talk this this this requires putting in the work right this isn’t this isn’t as simple as taking a
Pill um but at the very least I think that you know taking the pill is is is easier for a lot of people um but then there’s the of course the people that want to go the step further and they’re willing to put in the effort so let’s
Talk about that um we’re going to talk about why I’m convinced that vigorous exercise is the most powerful longevity drug that you’re going to get more than metformin more than rapy more than any of those things if you could pel up what you can do with vigorous exercise then I
Think that is like right now what the best longevity drug we have for delaying the aging process and improving Health span and improving lifespan so when I say vigorous exercise what do I mean um generally speaking of course there there’s there’s a sliding scale here because you can take someone who’s
Completely sedentary and never really done any aerobic exercise vigorous exercise for them is going to be probably more what light to Moder exercise is for people that are Physically Active but generally speaking once you kind of adapt and get you know used to phys being Physically Active vigorous exercise is about getting to
80% your max heart rate or estimated max heart rate um that’s that’s really what I’m talking about 75 to 80% of your your ma your maximum heart rate so cardiorespiratory Fitness this is one of the best biomarkers for longevity in my opinion um so cardiorespiratory Fitness is measured empirically by V2 Max so
That’s the maximal amount of oxygen that you can take up during maximal exercise so when I use V2 Max all you know sometimes these are like interchangeable cardiorespiratory Fitness BO2 Max I kind of use them interchangeably in this in this talk um but BO2 Max is just directly measuring cardiorespiratory Fitness so
Cardiorespiratory Fitness is associated with improved longevity it does improve longevity um and and the biggest improvements you’re going to get is if you’re going from low normal so for your age group for your for your gender if you’re low normal and going anywhere above that is is where you get the
Biggest bang for your buck so people that have a low normal V2 max if they just go up to a um if they’re below sorry if they’re below um normal and they go up to just low normal they get about a 2.1 increased life expectancy if
They’re below normal and they go up to high normal normal they get almost a threeyear increased life expectancy and then if they go from below normal to the upper amount of normal so this is the top 5% of the population this is more like you’re getting into the elite
Athlete level that’s associated with almost a fiveyear increase in life expectancy um so just to give you some perspective here about half of the US population is they have a low normal cardiorespiratory Fitness and the other half has about a high normal uh cardiorespiratory Fitness so again just
Mostly having to do with being physically active or not being physically active and on average um for every unit increase in V2 Max it’s It’s associated with a 45 day increase in life expectancy and there was a really important study published in Jama back in 2018 um that I just like to mention
Because it it kind of established that there was no upper limit to the mortality reduction of having a high cardiorespiratory Fitness I mean obviously within human normal human life expectancy ranges right so um people that were in the the bottom 25% of cardiorespiratory Fitness or their V2 Max and also I like these
Studies because they’re measuring something empirically I’m talking about V2 Max right this is a fitness test that’s done it’s measured it’s empirical versus a lot of studies and conflicting data out there when you have these questionnaires how Physically Active are you you know and you so you think about
Your last week or or month and then that’s like you extrapolate it out and they go okay well based on this last week this is how Physically Active we think this person is over the you know their their lifetime or whatever and I just it’s not a very the you know it’s
All we have in some respects but um if you can if you can measure something empirically it’s going to really help clear up a lot of the confounding and a lot of the um you know conflicting data that you see out there so I really like studies that measure V2 Max because it’s
Something that’s actual actually empirical rather than going off a questionnaire right with that’s those have all sorts of problems so going from the low um bottom 25% of V2 Max up to the elite level so you’re talking about the top 2.3% I mean this these are the Elite athletes that’s associated with an
80% reduction in all cause all cause mortality so comparing those two groups people in the low 25% group versus the like the elite level um but even going from the high cardiorespiratory Fitness so this uh this is the top 25% of the population they’re good I mean these
These are people that are they’re communed exercisers they’re really they’re physically active they if they go up to the elite level um they they get a you know even 20% more reduction in all cause mortality so if you compare the elite to the high cardiorespiratory Fitness um you’re you’re you’re still
You’re still getting a 20% lower all cause mortality by just moving up to to that Elite level um and what was really interesting about this study was that being in that low 25% group that the you know they’re they’re in the the bottom 25% for v2x that was comparable to a either same
Risk or greater risk than for mortality early mortality as type 2 diabetes as smoking and as um having heart disease so again putting that into perspective you know we all think about these diseases and how they’re you know they’re um you know increasing our early mortality risk but like just not having
A good cardiorespiratory Fitness can do the same thing so how do you improve your V2 Max how do you improve your cardiorespiratory Fitness well any exercise any aerobic exercise is is obviously going to be good for um small changes in cardiorespiratory Fitness but in particular there have been meta
Analysis that have found that vigorous intensity exercise as I mentioned and particularly high-intensity interval training which we’re going to talk about so this is where you’re doing sort of short bursts of you know very vigorous exercise you’re at least at 80% max heart rate sometimes going even above
That and then and then having rest periods and you’re doing those intervals um and why that’s important is because there have been some studies that have found that even people that are meeting the guidelines for moderate aerobic exercise so they’re doing 2 and a half hours of moderate intensity aerobic exercise per
Week do not about 40% of those people do not respond in other words they do not get V2 Max improvements they are not improving their cardiorespiratory Fitness by doing two and a half hours of moderate intensity exercise every week um and it’s not really known why exactly there’s this non-responder effect but
That’s large percent of the population um however when those people do more of a high-intensity interval training workout they they do more rigorous exercise and they start to respond and improve their V2 Max and it’s thought because you know V2 Max cardiorespiratory Fitness to get those changes to get those improvements you
Really have to increase cardiac output um so the stronger the signal the strong the more intense the signal the adaptations are greater so your body responds by improving the delivery of oxygen to your tissues right so that’s essentially what um you’re wanting to improve your cardiorespiratory Fitness
And so that’s it’s kind of thought why vigorous intensity and particularly high intensity World Training is so important for improving cardiorespiratory Fitness um and the and one of the there’s been several studies looking at this and U for example Dr Martin gabal gabala out of McMaster University over in Ontario
Canada has done a lot of studies looking at different high-intensity interval training protocols and it really seems if you’re really wanting to improve that cardiorespiratory Fitness that you have to do longer intervals so 3 to 5 minute intervals of just the maximum intensity that you can maintain for that 3 to 5
Minutes and so a really good um and well studied a lot of evidence on the Norwegian 4×4 protocol so this is 4 minutes of the highest intensity that you can do and then it’s 3 minutes recovery so you’re really going down to like light light exercise you want your
Heart rate to go down you want to sort of really give yourself some rest so that you can do it again so you repeat this four times that’s why it’s called 4×4 and this is one of the best protocols for improving V2 Max
Um if you don’t want to go into a lab to get your V2 Max measured or you don’t have access to it for whatever reason um one of the the best evidence-based ways of measuring BO2 Max um at home so to speak not necessarily home is what’s
Called a 12 minute run test or walk test depending on your Fitness level um essentially you need uh some sort of you know wearable device that can track your your distance so Apple watch your Fitbit whatever and you need to you need to have like a flat surface that you can
Run on so like a track field and you want to run for 12 minutes or walk depending on your Fitness level the maximum am intensity that you can maintain for that 12 minutes and you that basically your distance is going to be covered and then you look up this
Equation and it converts you know your V2 Max based on that distance and the reason you don’t want Hills and stuff is because that’ll make you run um you know the distance will be less so you want to make sure you’re giving yourself a a flat surface so that you actually are
More accurate in terming what your distance is during that 12-minute run test this uh this this study out of um UT Southwest um in in Dallas by a do Ben LaVine was is really what has convinced me that vigorous exercise is extremely important for for for the heart and the
Way the heart ages so I mentioned cardiovascular disease I mean that’s the number one killer in developed countries right um so as we age our heart go under go certain inevitable changes um it it gets smaller it shrinks it gets um stiffer less flexible and this affects a
Lot of things that affects our cardiovascular disease risk it affects our cardiorespiratory Fitness the have ability for us to do aerobic exercise um and so what Ben did in the study Dr LaVine did in the study was really remarkable he took a a cohort of participants that were 50 years old on
Average and these were sedentary individuals that were otherwise healthy so they didn’t have any you know type two diabetes hypertension Etc they they were quote unquote healthy but they were sedentary and he separated them into two groups so the first group was the control group who did sort of stretching
And yoga for two years and then the second group was the exercise intervention group so these are the people that were going to be doing the exercise on and it ended up being a vigorous exercise protocol but because they were sanitary it started out sort of lower to moderate intensity and by
The time it was six months these individuals are doing five to six hours a week of aerobic exercise with a large percentage of that time um being in What’s called the the maximal steady state so that’s what I’m talking about when you you’re you’re you’re going as
Hard as you can and you maintain that for about 20 or 30 minutes so it’s usually around 75 80% % max heart rate and you’re doing that for about you know 20 to 30 minutes they also did the Norwegian 4×4 protocol once a week and after two years they essentially reverse these
Structural changes in their aging Heart by like 20 years so their their hearts were essentially looking more like a 30-year-old heart after that two years of vigorous intensity exercise now like I mentioned they were doing five to six hours a week a vigorous a lot a large portion of it in vigorous vigorous
Exercise but it’s simply astonishing um you know the structural changes that they found so there was more more than 25% Improvement in the elasticity of the heart after those two years um particularly in the left ventricular um muscle of the heart um of course they did increase their their their V2 Max by
About 20 20% as well so um it’s just quite a sounding that you can take a 50-year-old put them on a pretty intense exercise program for 2 years and essentially reverse a lot of the structural changes that happened you know in in with the heart with the aging process blood pressure improvements are
Also um you know for people that are willing to put in the effort most of the time and there’s always non-responders but they can have drug-sized effects in other words it can be comparable to some drugs that are given to reduce hypertension so there’s been an analysis of 24 different randomized control
Trials found that six weeks of a pretty you know moderate to rigorous intensity um exercise 20 to 60 Minutes of that 3 to 4 days a week like had almost drug size effects and reducing blood pressure so you know High hypertension is not only a a risk factor for cardiovascular
Disease um it’s also a very very important risk factor for dementia and Alzheimer’s disease so there’s every reason to want to not have hypertension and 20% of young people aged you know 18 to 39 have hypertension and then half the you know about half the US population of you know older adults have
Have hypertension so it’s a very common um you know thing that um again can be modified to to quite a bit of an extent with aerobic exercise particularly vigorous intensity exercise um let’s talk a little bit about on the molecular level why why I’m talking about vigorous exercise and and
Really that 80% max heart rate it has to do with the fact that you are pushing when you push your muscles to work harder than um the oxygen can get to them to make energy they shift to um from using mitochondria and using oxygen for energy to using glucose through
Glycolysis and it’s a quick process that doesn’t require oxygen it it makes lactate as a byproduct only it’s not a byproduct we often thought about it as a metabolic product byproduct but it’s so much more than that so lactate generated from muscles is um is what it it’s an
Extra Kine it’s a mocine and it’s a signaling molecule it gets into circulation and it is consumed by the brain it’s consumed by the Heart by the liver also by the muscle it’s it’s consumed as a a very easily utilizable source of energy but also as a signaling
Molecule as we’ll talk about and this is called the Lac shuttle it was pioneered by Dr George Brooks at um out of UC Berkeley and when I say A signaling molecule it’s a way for your muscles to directly communicate with other parts of the body like the brain um and so
Lactate itself has been shown to be responsible for increasing braind derived neurotropic Factor both in the plasma this is in human studies um humans at exercise lactate correlates with the bdnf activation in plasma bdnf can cross over the bloodb brain barrier but also animal studies showing that it directly increases brain derived
Neurotrophy factor in the brain so bdnf is um a very important neurotropic factor it’s respons responsible for um neuroplasticity so that’s the ability of your your brain your neurons in your brain to adapt to changing environment it’s very important during the aging process you know as things are you know
Changing and stuff uh you you want your your your brain to adapt to those changes it’s also important for depression um people with depression don’t often adapt to the changing environment and it is partly responsible for some of the depressive symptoms but a brain Drive neurotropic Factor also is
Important for neurogenesis the increase of new neurons particularly in some brain regions like the hippocampus which is involved in learning and memory um it’s it’s it helps you know existing neurons survive there have been animal studies that have shown that when you when you induce them to do exercise and
They get those learning and memory improvements that have also been found in human studies that if you give them a drug and block brain Drive neurotropic Factor they don’t get those learning and memory benefits so really seems as though brain Drive neurotrophic factor is important to get those learning and
Memory benefits from exercise and again lactate is a key signaling molecule that increases brain dve neurotropic Factor lactate is generated from your exercising muscles when you’re forcing them to work hard this isn’t just going on a brisk walk this is really getting your heart rate up swe sweating getting flush in the
Face lactate is also a singling molecule to increase neurotransmitters in the brain um this has been shown in both human studies and animal studies so uh it’s important for the production of Serotonin so Studies have found that people that exercise produce a lot of lactate this correlates with an
Increased in serotonin which also correlated with improved impulse control uh serotonin plays an important role in many neurological processes including impulse control so they’re being able to to um um have this inhibitory effect which also plays a role in focus and and attention uh norepinephrine is another
One that’s been shown so as we’re exercising really hard our muscles are working harder our heart is working harder but our brain is also working harder and there have been human studies out of I believe it’s Norway that have found that the lactate produced during vigorous intensity exercise crosses the bloodb brain
Barrier is consumed by the brain and this correlates with a burst of norepinephrine production um which fuels the brain to work harder during exercise it’s also important for focus and attention and some of those effects that you get after uh you know after you do like a vigorous intensity
Workout so there’s some protocols that have been shown to maximize brain derrive neurotropic factor in humans and some of these have also correlated with lactate levels um it seems as though like the the the best is getting getting the The Best of Both Worlds so you want vigorous intensity about 80% max heart
Rate but you also want duration so you want to get like 30 to 40 minutes of that is the most robust at increasing brain Drive neurotropic Factor as measured in plasma and people but 20 minutes will also increase it as well just 30 to 40 minutes does it even more
Um there’s also some protocols that are more high-intensity interval training so doing six rounds of 40 second intervals where you’re going as hard as you can for 40 seconds followed by a recovery period um also really increases brain Drive neurotrophic factor in fact it increases it four to five times more in
People um compared to to individuals that are doing about an hour and a half of more lower intens intensity cycling at about 25% they their BO2 Max Peak I want to just um shift gears for a minute and talk about some of the anti-cancer effects of vigorous intensity exercise um you know
Independent of the immune system so the immune system exercise activates the immune system there’s a robust effect on a variety of um you know anti- antimetastatic effects there but um just the mechanical force of blood flow blood flow actually affects what are called circulating tumor cells so circulating
Tumor cells escape from the primary side of the tumor get into circulation eventually travel to distant sites and then they take residence and establish a new tumor elsewhere so this is the metastasis um so circulating tumor cells you obviously uh do not want to have them in circulation because they can uh
Play a role in metastasis well the shearing forces of blood flow itself can kill these circul circulating tumor cells because on every cell surface we have a mechanical um we have these mechan mechano receptors that respond to movement and cancer cells are all wonky and disrupted and messed up and so they
Just can’t handle that movement and they die so the um the more intense the exercise the more the greater the blood flow the the higher um proportion of circulating tumor cells that are that are actually um undergo apoptosis and die there have been some studies looking at people that undergo about six months
Of arobic exercise anywhere between 50 to 70% max heart rate for 150 minutes a week that significantly reduces the circulating tumor cells in people with anywhere between stage one to stage three colon cancer other Studies have found and correlated that circulating tumor cells are linked to a three times
Higher risk of Cancer recurrence and a four times higher risk of cancer mortality in people with cancer um also stage three colon cancer patients that engage in aerobic exercise have a 40% reduction in Cancer recurrence and a 63% reduction in cancer mortality so exercise is also a very important plays
A very important role in in you know cancer metastasis and also in in helping as an adjunct therapy to treating cancer as well but you don’t have to do the 40 minutes of you know vigorous intensity exercise you know every day to get benefits so there’s something called
Exercise snacks um these are very short anywhere between 1 to three minute bursts of intense exercise you’re you’re getting your heart rate up 75 80 90% max heart rate um you can be doing anything from jumping jacks to you know sprinting stairs to high knees to air squats um
You know there’s a lot of ways to do it and you do it just in a short burst so it’s it’s a really great way to break up you know the workday it’s also a really great way to improve metabolic Health particularly when you time it around
Mills um which we’ll talk about in a minute and the way it does that partly well there’s a lot of mechanisms out play but one of them again comes back to lactate being generated you know very acutely from exercising muscle which then causes glucose Transporters on the muscle surface to translocate to the
Muscle surface so these are glute four Transporters these then allow glucose circulating and circulation to then be taken up into muscle therefore improving your blood glucose levels and it also improves insulin sensitiv sensitivity as well when they’re timed around Meal Time anywhere between 30 minutes to an hour
Um dramatically has an effect on on blood glucose levels and insulin sensitivity um particularly in people with metabolic syndrome type 2 diabetes so it’s a great way also you just get up do some high knees for a minute or you know jumping jacks or do something that
You can do quickly to um you know get that exercise snack in and another way it’s approving metabolic Health I’ll just mention briefly because we’re running out of time is is through improving mitochondrial biogenesis the generation of new healthy young mitochondria it’s been shown to do this
In muscle cells and this is also happening through lactate lactate is in is a signaling molecu yet again increasing the expression of uh a very important protein involved in mitochondrial biogenesis called pgc1 Alpha and um so it plays an important role in increasing new mitochondria in muscle this has been shown in human
Studies but also animal Studies have found that exercise increases lactate which crosses the bloodb brain barrier gets into the brain and increases mitochondrial biogenesis in the hippocampus um and neurons in the hippocampus so mitochondria in neurons in the hippocampus are being increased I I don’t know why that mechanism wouldn’t
Be conserved in humans so um you know the fact that it’s happening in animals is is also encouraging but exercise snacks are also associated with um improved longevity so um I was talking about this sort of deliberate form of exercise snacks where you’re doing high knees or jumping jacks
Well there’s there’s large studies that have have been under underway and been published and there ongoing studies looking at vigorous intermittent lifestyle activity so it’s a type of exercise snack where use everyday life situations to get your heart rate up high for a minute or 2 minutes or 3
Minutes for example you you have to take the stairs every day to get to work well instead of walking up the stairs you sprint so people are wearing these accelerometers and um and you know so so their heart rate is being measured and you know scientists have have been able
To gather all this data and they found that people that have engaged in one to two minutes a vigorous intermittent Activity three three times a day have a 40% reduction in all in Al cause and in cancer mortality and a 50% reduction in cardiovascular related mortality um this
Is compared to non-exercisers now also people that even identify themselves as non-exercisers so and you know they’re doing this this vigorous stair climbing and stuff but they don’t actually go to the gym or take do any Leisure Time activity they still get these improvements so it’s a really great way
To break up sedentary Time s being sedentary itself is an independent risk factor for all cause mortality cancer mortality so in other words just periods of when we’re sitting like now is a risk factor even if you you’re going to go to the gym you know later today um so
Breaking up sedentary time is really important there’s a lot of ways to um break up your sedentary time and I think that these exercise snacks are a great way to do it you just get up and you do high knees for 1 minute two minutes 3
Minutes and I really kind of wanted to just have everyone do it for 30 seconds if we could do that real quick and then I’m ending my talk so if you guys could just get up and we’re going to do high knees right now now so that is where you
Do the you try to get your leg as high as you can and you do the opposite hand up and and then we’re going to just do it we just do it for 30 seconds but really try to do it as hard as you can if you’re wearing heels take them off
You Ready set go all right yeah your heart R up you really want to get your heart rate up they go fast now remember we’re doing 30 seconds and I said one two minutes you do this you’re actually going to be you’re probably like oh my gosh is it’s not up
Yet all right we’re only going to do 30 seconds because of time all right time but as you can see it works right so maybe maybe we get a little more brain dry neur neurotropic factor a little more um attentive for the next talk and I just want to close by saying
Yeah we’ve talked a lot about vigorous intensity exercise but the reality is that any exercise you can do to form a habit to that you can do on a daily basis if it’s not vigorous intensity any kind of exercise is beneficial so keep that in mind I was
Kind of going for the top here like you want to reach for the stars but really what you want to do is to form a habit so that’s the most important thing um with that said we talked about a lot today I think I’ve covered a lot of the summaries avoiding micronutrient
Insufficiencies addressing the lack of you know a vigorous intensity exercise but again forming that habit do what you can do I think I’ve given you guys a lot of tools here to measure things try to implement some Norwegian 4×4 which is brutal um or just do exercise snacks you
Guys tell the next you know speaker you know in a couple of hours we got to get up and get our blood blood flow higher heart rate up and with that thank you so much for listening today hope you guys learn something
