Exercise and Longevity: Enhancing Health Through Physical Activity Suggestions

Exercise 0:33 0
“Endurance Sports were were always sort of something that meant the world to me and once I even made that decision to go to medical school a big part of it at least was you know kind of understanding physiology better.”

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Exercise 1:36 0
“I actually volunteered to be a subject in a study on the lactate threshold or Anor robic threshold when I was 19 at the University of Arizona.”

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Exercise 2:19 0
“I saw what they did in anesthesia which is a lot like an exercise test you're measuring people's breathing you're measuring their blood pressure their heart rate and you're giving them drugs that affect their autonomic nervous system.”

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Exercise 5:25 0
“I'm really passionate about this idea of longevity right we think about longevity through the lens of five sort of modifiable behaviors exercise sleep nutrition um emotional health and all the tools around distress tolerance and then exogenous molecules those are the five things that as far as I can tell mostly you can manipulate and corre they can both impact your lifespan and your health span.”

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Exercise 6:15 0
“exercise is in a league of its own in terms of its potential uh both on the lifespan axis so it you know its ability to extend life and reduce all cause mortality is well documented we'll talk about that right uh but also on the health span side it has no rival.”

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Exercise 7:19 0
“the risk factors that contribute to cardiovascular disease all more cause mortality are all influenced by exercise and physical activity these would be blood pressure diabetes uh to some extent lipids and cholesterol and also how you deal with stress so I think you get the big three there.”

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Exercise 11:08 0
“they compared them to match controls from the Swedish record system and they showed again about a 50% reduction in cardiovasc and all cause mortality”

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Exercise 13:35 0
“the relative risk of dying of heart disease in any given period of time whether it's a year five years 10 years whatever the study's doing is is 50% lower”

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Exercise 16:05 0
“exercise has more potential to offset all of those things than anything else sleep nutrition certainly any medication”

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Exercise 16:52 0
“if you work out every day intentionally and relatively hard but then something happens to people in their middle 70s where there seems to be a steeper rise in physical limitations.”

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Exercise 17:20 0
“70% of 70 year olds can't get off the floor without assistance, and this significantly impacts their quality of life.”

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Exercise 18:00 0
“one of the things that people have to think about especially as they get into their 40s and 50s is adding strength or some sort of circuit training and agility training to their program.”

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Exercise 18:15 0
“I have the jump rope my mother gave to me when I was 14... I carry it with me when I travel because you can always jump rope.”

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Exercise 22:25 0
“whether it's you know taking a flight of stairs once in a while or intentional working out it's really the way to go”

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Disease prevention 22:40 0
“you mentioned and alluded to the danger of a fall in in later life and um this is something we've been doing a lot of research on internally um given our concern around bone mineral density in the Asian population”

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Exercise 24:43 0
“the fittest people are also the most active and they divided people into three or four groups of fitness and then had them look at a so-called healthy eating index”

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Exercise 27:50 0
“6,000 calories a day they weigh about 150 pounds yeah some and they have a hard time keeping their weight we they they are catabolic throughout the tour they finish correct in pretty bad shape correct they they they they look like you know uh you know not surv not death camp survivors but but people who certainly haven't had a lot to eat for a few weeks.”

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Exercise 28:10 0
“explain to folks what the autonomic nervous system is how it differs from the sympathetic nervous system and why it plays such an important role in our health and of course how exercise impacts it.”

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Exercise 28:56 0
“we can increase our metabolism 10 or 20 fold with exercise but our body temperature only Rises a degree or two and so this happens due to the actions of the autonomic nervous system.”

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Exercise 30:26 0
“exercise really keeps these things tuned up and by having your autonomic nervous system a bit better tuned up it can do a better job regulating your internal environment the classic example being for examp your your blood pressure.”

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Exercise 33:52 0
“So the faster it goes down the faster it goes down the better the action of your vagal nerve the nerve that slow your heart rate the vagus nerve is also responsible mostly for your heart rate variability and that means that that that and this nerve also is is suppresses funny heartbeats and is protective when it's it's in good shape against uh you know arrhythmias and and ventricular tacac cardia ventricular fibrillation sudden death all of those things.”

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Genetics 34:36 0
“Heart rate variability can be quite genetic right Mike the the absolute number in milliseconds between any two individuals can be quite distinct and it seems to be not nearly as modifiable as some other factors.”

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Exercise 35:00 0
“Most people can get a nice training braid of cardio which again is vagal tone and most people if they're trained can can uh go from you know slow heart rate recovery to fast heart faster heart rate recovery and and and also have more heart rate variability.”

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Exercise 39:21 0
“this study that we're talking about put people into the bottom 25th percentile, 25th to 50th percentile, 50th to 75th, and then the last group it basically divided into you know 75th to 97 and A5 and then they had that little sliver of people that they called Elite that were at the top two and a half percentile and all cause mortality just went lower and lower and lower and lower.”

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Exercise 40:00 0
“the hazard ratio moving in that direction was 5.04 my memory Serv me correctly that means there's a fivefold increase in all caused mortality between the fittest 2 and a half% and the least fit 25%.”

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Exercise 41:38 0
“if you screened people for physical fitness and again just did the routine kind of cancer screening and you could even argue that you could probably cut back on the routine cancer screening for most things except for skin cancers because fit people tend to be outside a bit more.”

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Exercise 45:57 0
“if you did that four times a week and that was the only thing you did you'd be at 40 met hours per week of activity.”

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Exercise 46:20 0
“if you look at the literature the epidemiology on this it would say my mortality risk might be higher that would be the headline than someone who's doing 40 met hours per week”

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Exercise 47:58 0
“the dispositive study here is the real world data from from the vasal lopet uh story”

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Exercise 48:51 0
“people who who train uh the way you're talking about for for their entire life have some increased risk of atrial fib compared to people that are just super healthy otherwise and and physically active at that 50 to 70 Med hour per week thing you're talking about”

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Exercise 50:21 0
“data that came from Ben's lab and other things you see that this sort of training keeps the ventricles compliant, flexible and able to handle the increased demands and pumping demands of exercise.”

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Exercise 50:43 0
“the large coronary arteries in people that are habitually physically active vasodilate better, they probably are less likely to generate a clot and then we've just simply said and you're protected against fatal arrhythmia.”

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Exercise 51:55 0
“how is it that people in the top 2.3% of the population for VO2 Max have the lowest mortality by a long shot if they're not training significantly.”

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Exercise 52:58 0
“people who do some longer intervals three or four times a week can get a lot of bang for their buck in terms of VO2 Max.”

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Exercise 56:20 0
“the reason we push so hard Mike for our patients to have as high a V2 Max possible as as as possible when they're in their 40s or 50s is based on this inevitability of Decline and with the hopes that we're extending Life by a decade so that hey even though actuar you might only be expected to live to 81 we're kind of hoping you're going to get to 91”

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Exercise 58:03 0
“if you want to be able to run you know 10 a mile in 10 minutes that would be 35 V2 Max yeah yeah 35 or 10 Mets”

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Exercise 59:49 0
“if you're trying to reverse engineer ending your life with a V2 Max in the mid 20s to high 30s the good news is you are never going to not be able to do something that you want to do”

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Exercise 1:01:20 0
“if you look at in Japan for example and couple places you know the the hilliest parts of Japan and some of the hilliest parts of Italy and Greece are where the longevity is the highest and people have argued it's because people have to walk up and down uh walk up and down the the the hills and also um and so they they they keep their balance they keep their glute strength they don't fall that sort of thing”

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Exercise 1:03:02 0
“in general you know oxygen uptake is is cardiac output how much blood you're pumping per minute times arterovenous oxygen difference how much blood you're extracting or oxygen you're extracting out of the blood and it turns out that if you look at all the studies and all the people fit unfit trained untrained in general the biggest issue is how how how much blood can you pump and and so what is that heart rate time stroke volume equation where does that leave us”

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Exercise 1:06:45 0
“my Peak heart rate was like 185 or 188 I can't remember and over the period of 12 weeks of training it went up to about 10 beats a minute.”

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Exercise 1:07:58 0
“Lance was winning the tours between 28 and 35 right he was still holding 200 beats per minute for the entire time right.”

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Exercise 1:09:53 0
“that lowend aerobic efficiency I always try to explain to my patients if your V2 Max represents the height or peak of your pyramid The Wider your base the higher your your Peak do you agree with that sentiment.”

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Exercise 1:12:34 0
“if you look in terms of the runners running is limited to some extent because of the there's almost you know Orthopedic issues become a problem impact right and and so you it's really difficult for people to run more than about 120 or 130 miles a week and and ever run do do hard training uh for prolonged periods of time.”

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Exercise 1:13:18 0
“the cyclist can do more because you don't have that issue but remember that with Cy clean you know you're going up and you're going down and and and you have always a a chance to take a break here and there”

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Exercise 1:15:27 0
“the total amount of time he's running is is somewhere between 14 and 18 or 20 hours a week.”

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Exercise 1:17:58 0
“his morning workout would be 40 times 100 meters with a short jog in between and his afternoon might workout might be 20 times 400 meters”

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Exercise 1:20:05 0
“the health benefits of just kind of uh less than brisk walking, you know purposeful but not really brisk walking, they're substantial.”

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Exercise 1:21:10 0
“the biggest benefit people get healthwise is the first 10 or 15 minutes a day”

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Exercise 1:24:29 0
“I'm a big believer in what's called hard easy hard day easy day and I think that that that and so what I what I'll do uh like tomorrow will be a hard day so I'll get on on you know a stationary bike in my in my uh workout room and and and on the bike and the rowing machine do some sort of warm up for 10 to 15 minutes then I will do a circuit that starts with um uh 15 uh or really kind of 25 squat thrust a minute of jumping rope static walls set to failure and then some drop sets where you go down you know where you you go down the weight stack drop set then then drop sets with with uh incline flies then drop sets with leg extensions and drop sets with a combination of of uh pull-ups and lat pull downs and military press then some additional stuff for my legs then some uh uh push-ups bar dips and upright rows followed by something else for my leg so I alternate arms and legs and I work my way through this with no rest drop sets on each thing…”

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Exercise 1:26:54 0
“my easy days will be something like you know like this morning I I uh and I got I want to go do 20 more minutes not because I need to do 20 minutes I want to because I wanted to watch the uh first bit of Obi-Wan Kenobi and so so so my easy days are built around what what documentary or or you know how many times can you watch the Mandalorian how many Clint Eastwood movies can you watch that this started during lockdown right so my easy days are 30 to 40 minutes of of light cycling transition to rowing back and forth of around 30 to 40 minutes sometimes I do one sometimes if I come home from work and I I do another one but the goal there is is is an old concept called active rest so I'm not trying to get a real training effect I'm trying to loosen up from the day before it's workout because I'm sore that you know if you do what I describe uh you know you warm up for 10 or 15 minutes do do 20 minutes of drop sets and and that type of intervals…”

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Exercise 1:28:05 0
“just doing kind of Maintenance circuits in terms of the strength so not quite is maybe only twice a week and I'll start doing longer rides we have a pelaton and I started doing this hour of Truth to see how many watts I could average for an hour”

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Exercise 1:28:29 0
“I think my best during lockdown last year was 360 average 316 Watts for an hour”

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Exercise 1:31:20 0
“my training is really polarized I mean like really polarized”

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Exercise 1:33:30 0
“the classic training you know among Elite Runners is mile repeats you know people doing you know four or five times one mile and then they jog a quarter mile or half mile in between”

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Exercise 1:35:21 0
“one of the things I I think we've learned from the cyclist is a terrific phrase called manage your suffering”

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Exercise 1:36:06 0
“Michael Phelps swim the butterfly and watch his stroke he was a he was good at everything but he was especially good at the butterfly”

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Exercise 1:40:09 0
“we try to get 80% of their time which might start out at two to three hours per week as we want you to be able to talk but not enjoy it right I don't want you to be any higher than that right and then once we build up a bit of a reserve in that after maybe six months of that kind of training we're sort of ready to move them to that next phase of of hey once a week I want you to do kind of four on four off for four rounds”

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Exercise 1:41:53 0
“once people start doing more than about five or six hard hard sessions every two weeks you're beginning to ask for some sort of load management issue whether it's Orthopedics whether it's just you're fatigued whether it's this whether it's that”

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Exercise 1:54:26 0
“we started this discussion Mike by talking about the Miracles of exercise correct went through all of these things that exercise is doing physiologically and how the net impact of these things is so profound correct on the length of your life and the quality of your life”

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Exercise 1:54:44 0
“there's no shortage of Pharma companies out there that are trying to understand how can those benefits be put into a pill exercise pill sure”

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Exercise 1:55:12 0
“the efforts for sort sort of exercise memetics so far have been primarily things that increased mitochondrial biosynthesis so uh and that appears like it it it at least Works in animal models”

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Exercise 1:56:19 0
“I think that I'm not particularly enthusiastic about it I don't think you're ever going to get one that does any more than a little bit.”

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Disease prevention 1:56:30 0
“if you look at the data on people who get a combination one pill a day of of lotos statins low dose blood pressure meds and maybe one or two other other components it it causes you know pretty nice reductions in risk factors in most people.”

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Immunizations 1:21:52 0
“whenever covid sort of finally winds down about two to 3% of the population is what we call B cell deficient so B cells are the cells in your body that make antibodies help you respond to fight the virus or respond to the vaccine and and uh about two or 3% of the people don't have any or don't have very many and those people continue will continue to get Co and other forms of infectious disease and antibody therapy is essential uh to help those folks”

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Disease prevention 2:03:09 0
“we now have people that have been both vaccinated and they've had a breakthrough infection or they've had an infection and been vaccinated right so they have hybrid immunity and those people make uh you know really really uh their plasma has a whole whole lot of antibodies in them and they're broad spectrum so they cover all the variants and they almost anticipate future variants because of the of the the way the immune system works”

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Exercise 2:08:01 0
“we need to do something and I think really reflects our our society in general I think that you have you know for lack of a better word upper middle class kids who have access to superb coaching to superb facilities and to programmatic things I think we've got a tremendous problem with Play and unstructured play and I think we've got a whole lot of people that are are things that when I was growing up in the 60s and 70s that were done through the park park district and the school School District I think a lot of those opportunities are U are uh have fallen by the wayside”

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Exercise 2:09:58 0
“I'd start a national open gym movement uh you know uh winter summer whatever because a lot of we have a lot of nice facilities that are used just you know a limited number of time per day”

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Social connection 2:11:03 0
“these these folks would go down and walk at lunch and they're literally you know they'd bring bring their tennis shoes to work and they they would meet up with their Pals and uh you know they'd go do 30 40 minutes a day of laps at lunchtime uh with the secretaries all over the hospital and it was uh I think terrific for them uh I think it was a social event for them and and I think that they solved a lot of problems too”

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Peter AA’s Lifelong Interest in Endurance Sports and Medical Studies

Peter AA’s lifelong passion for endurance sports significantly influenced his decision to attend medical school, where he sought a deeper understanding of human physiology. His early engagement in a lactate threshold study at the University of Arizona further ignited his interest in exercise physiology.

Anesthesia and Exercise Physiology

The similarities between anesthesia procedures and exercise tests, such as physiological monitoring and manipulation through medication, drew Peter’s interest in the overlap of these fields during medical school.

Modifiable Behaviors for Longevity

Peter emphasizes the role of modifiable behaviors—exercise, sleep, nutrition, emotional health, and exogenous molecules—in enhancing longevity and health span. He particularly highlights the unmatched effects of exercise in extending life and reducing all-cause mortality, alongside its influence on major health risk factors like blood pressure, diabetes, and cholesterol levels.

Physical Activity and Cardiovascular Health

Robust data, including studies like the Swedish record system study, demonstrate a significant reduction in cardiovascular disease and all-cause mortality among physically active individuals. Exercise notably reduces the risk of heart disease and arrhythmias by improving autonomic nervous system efficiency and heart rate variability.

Risks and Adjustments with Aging

Physical activity necessitates adjustments as individuals age. Peter notes a steeper rise in physical limitations around the mid-70s, prompting the need to possibly modify exercise intensity to maintain health and prevent injuries. A significant percentage of elderly individuals face challenges in physical tasks such as rising from the floor, highlighting the need for strength and agility training.

Exercise as a Primary Intervention

Peter places exercise above nutrition, sleep, or medication when it comes to its potential to improve health outcomes. Regular training improves autonomic function, benefiting internal health management, including blood pressure regulation. He suggests cardiac training to enhance vagal tone and support cardiovascular health.

Potential Risks of High-Intensity Exercise

Long-term high-intensity training could increase the risk of atrial fibrillation. Thus, maintaining a balanced regimen of 50-70 MET hours per week is recommended for optimal health without increased risks.

Exercise and Orthopedic Considerations

Peter discusses the limitations imposed by orthopedic issues in sports like running, where maintaining less than 130 miles a week is advised to avoid injuries. Conversely, cycling allows more extensive training due to less impact stress.

Exercise Program Recommendations

Peter advocates for polarized training, mixing high-intensity with low-intensity sessions, and emphasizes the importance of load management to prevent overtraining and associated health issues. For beginners, he recommends starting with moderate-intensity exercises and gradually introducing structured interval training.

Broader Impacts and Societal Recommendations

Highlighting unequal access to exercise opportunities across different societal classes, Peter proposes initiatives like a national open gym movement to utilize existing facilities more effectively and enhance public health through increased physical activity.