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Welcome to ask me anything episode number 38, I'm joined once again by Nick Stenson. In today's episode, we dive in really deep to this question around exercise. And if there is such thing as too much exercise, obviously we talked a lot about exercise on this podcast and that's for pretty obvious reasons, namely it's perhaps the single most important tool we have to live longer and live.
However, we often get asked a lot of questions about the optimal dose of exercise for longevity. So, it's a topic where there's a lot of confusion in the literature. And we've even had previous guests on the podcast who disagree with each other on what those answers ought to be with respect to the dose of exercise. So, for this am a, we compiled all the questions that you've asked around this. And we've now taken the hard look at this, which studies say, what things, how contradictory are the results and we do this primarily by looking at the so-called j-curve? The J curve.
Curve. Meaning that as you go from being sedentary to being active, your risk of all-cause mortality, declines. But then something paradoxical seems to happen, which is after bottoming out, it starts to uptick again, the so-called Jay suggesting that once you go beyond a certain point that is to say, once you exercise Beyond a certain point your risk, no longer stays low but actually starts to go back up now, this episode took a lot of time. In fact, we were going to record this episode about two months earlier, but I just didn't feel we had done a
If dive so we delayed it and the reality of it is there's so much here that we just can't discuss in a podcast because the podcast would be too many hours. So what we do is we talk about everything in summary. We Deep dive into a handful of studies, we discuss some of the illustrative critiques on all sides. But really, if you want to see this at the deepest level, I would encourage you to look through our show notes where we're going to link to all of the analysis has been done on each of the studies. So,
If you're a subscriber and you want to watch the full video this podcast, you'll find that on the show notes page. Also, if you're not a subscriber, you can watch a sneak peek of this on YouTube. So without further delay, I hope you'll enjoy am a
number 38
here. How you doing? I'm good, Nick, how are you?
I'm doing good man. You ready for another am a shura? All right, well, this one, I think, is on a topic year, a little more excited about than maybe the fruits and vegetables. One looking at exercise,
There's been no shortage of things that you've spoken about exercise and how positive you are on it. You've often talked about how it's one of the most potent things we have in the toolkit for longevity. And whenever you talk about it, we get a lot of questions from subscribers. A lot of people wondering, how should they think about exercise? Like, what is the optimal dose of exercise for longevity? And I think we see this any time, we do an exercise podcast because you have your four pillars of exercise. And so people are always wondering
During how do I get everything in, how much should I be working out? I think some of the confusion can also come from passed gas. May be having different opinions. I think, when you look at the literature it also doesn't quite agree with each other, you know? So if you take someone like Alex Hutchinson and you take maybe the AMA you involved in on vo2max and you talked about how important that was and then you have a podcast like we did with James O'Keefe, where he and his research talks about a.j. curve. It's kind of hard for subscribers at times.
You understand the literature, right? How do you get an elite vo2max when some of the other research, says, the best thing you can do is play badminton. You know, those two things don't quite add up. And so what we did for this one is we compiled all these questions around this to really try and answer the core question, which is what is the optimal dose of exercise for longevity. And quick disclaimer is we're not looking at what is the minimum dose? Which I think it's written about a lot, and I know we've
Done weekly, emails kind of responding to articles that are like 10,000 steps. 10 minutes of walking a day, all these little things are all you need to do, so we're going to focus on that. Core question is like, what is the optimum dose? So before we get into those types of questions that we compiled, anything you want to add to what I just said to set the stage.
Yeah, I would add that we're also going to explore it. Can you do too much? Because most things in biology occupy ago,
The lock space. Not too much. Not too little clearly that's the case with nutrition. Too much nutrition. Just look around you too, little nutrition. Well, that's frankly, the problem that lots of parts of the world still experience and have historically experienced a lot of. So, with exercise, I think that's less clear. And that's a topic. We also want to really get into today and even if that's not relevant to the majority of the population, in other words, even if majority of people aren't in the situation where they're butting up,
Against potential limits of exercise, in terms of Crossing from being benefit to risk. I think it's a very important question. Nevertheless. And it might speak to some of the mechanistic insights around exercise, and of course, for those people who do want to push the limits, it probably gives us some insight as well. So maybe we just
start with one of the first questions and it's something that you've covered before. So we don't have to go into an insane amount of detail, but I think it might be helpful for people just to set.
They are on why they should care about this and why it's worth putting in the time to exercise how is exercise. So beneficial not only for our health span but also for a lifespan and you kind of try to summarize it in a cartoon you put on Instagram the other week at this point which kind of looked at the guy in the doctor's office and the doctor asked him like what would you rather do exercise one hour a day or be dead 24 hours a day and so anything that you can kind of do to set.
The stage on why this is so important and why people should make the time for it, should put the effort in to understand this,
to your point. I think, at this point, there's really no need to spend time discussing this Beyond, just stating that regardless of which chronic disease, you're looking at, whether it be a SUV, D, cancer, type 2 diabetes. Alzheimer's disease, all-cause mortality. It doesn't matter. Exercise is going to reduce the toll of
Tality across all of those things. The mechanisms by which it does. It can be interesting, so it can improve lipids it, can reduce inflammatory markers, it can reduce flow, mediated shear, stress, in arteries can cancer. Truly, it's a little bit less. Clear, I suspect much of the benefit in cancer comes through the metabolic benefits of exercise. So we know, for example, that the second leading environmental or modifiable risk of cancer
After smoking is in fact obesity and as I've probably talked about another podcast, I think it's really less the adiposity of obesity. That's the problem and the metabolic consequences of obesity that are found in many, but not all obese patients. Obviously diabetes is probably one of the most clear places where you just dramatically see an improvement. And this of course, has to do with glucose disposal and insulin sensitivity within the muscle. And again, I think the list just goes on and on and on, but there really isn't any
Here. And again, we should sort of celebrate this fact because there's a ton of ambiguity in a lot of things that pertain to life span and health span. It's actually nice. For once to have a slam
dunk, I think what would also be helpful for people is another term. I've heard you mentioned before internally as you think about your exercise and how you plot out how you attack all this problem is Mets. So do you want to let people know what a met is? And then why it can be beneficial in looking at a variety?
He of different exercises.
I do talk about it a little bit and I think most people have heard of this idea of a metabolic equivalent or a Met and it's basically an energy currency in the body. We think about energy currency and sort of ATP. But, you know, that's on such a cellular level. This is kind of a global way to think about it. One met is the energy cost of Being Alive At rest. So obviously not a whole lot worth noting. That one
That is equivalent to 3.5 ml per minute per kg of oxygen utilization and that relationship for the most part just holds. So in other words if you are doing 10 Mets of exercise, you are consuming 35 ml of oxygen per minute and that becomes relevant as we start to think about vo2max now when you
want to get a sense of what certain activities look like. And again, so much of what we talked about on this podcast, even what we've already gone through, like I glossed over some of the details of the benefits of exercise in the show notes. We will include so much on that. So that if you really want to go deep on every single aspect of Health span and life span, and the mechanism for each, we've got all of that in great references. But again, when you want to think about how many Mets do you get doing various things? Well, again, sitting there doing nothing. Is one man.
Walking, your dog might be three Mets going for a slow bike ride. Kind of ten miles an hour or less formats. Mowing your lawn might be five and a half minutes playing golf four-and-a-half. Mats, resistance, training, vigorously, six Mets. So you kind of get a sense. Now, where does this go? Well, rowing at 100 Watts, which really, isn't that much of a killer effort here at 7 W upon me at seven Mets. Now, you can look at the speed change, right? So once you're running six miles, an
Or just a 10-minute mile. Can that's still a jog you're almost at 10 Mets at that. Point once you're running 10 miles, an hour six-minute mile, this is a pace that a fit person can hold for a while but most people couldn't hold for very long. There's about 14 and a half minutes. So you get the sense of the non-linearity of this meaning, 14 Mets versus seven Mets, you wouldn't hold seven Mets for or you wouldn't hold 14 Mets for half the time you hold seven
minutes.
Just to double, click on it Mets, you get per activity as per an hour of
activity. No, it's all normalized per time. So if you're running a six-minute mile pace for an hour, we would say you did 14 and a half met hours of work. So, here's the way to think about it. It's the difference between W and jewels. If you think about, if anyone who's a cyclist, will think of things that way on a bike, your power meter, tells you instantaneously how much work you're doing. That's wattage.
Which is really joules per second and then you multiply that over the total time that you do it you take it back to total energy. So the Met is an instantaneous measurement and you normalize it over time to give the total volume. So the work that's done is really the Met our. So for example if you don't know do a hike for six Mets worth of activity or six Mets worth of exertion and you do it,
It for 45 minutes, that would be for met hours of work done.
Peter when people think about their Mets, how is it that knowing how many many hours you're putting out? How is that helpful to someone as I think about exercise on a whole,
you know, look, I think for most people, it's not truthfully. I'm probably one of the few people who tracks my met hours per week, I don't do it down to the gnat's ass. I just mean, I have a spreadsheet where I'm basically putting in my activity, the amount of time I spend doing
It at various different intensities and I can at the end of the week, say look, I'm doing 100 met hours per week during this phase of my training, during this phase of my training, it might be 80 back in the old days. It was 200 man-hours per week. It was a much greater workload. If you're doing one thing that's tied to a power meter. Like in cycling, you know, we tend to keep track of kilojoules and normalized power and power. So, so all of these things are just sort of ways to track the work you're doing. Now, I think it partially becomes relevant when you want to evaluate the research because
the research has to be able to take into account, not just how much time you're exercising, but what's the intensity of that exercise? It would be very difficult to provide guidance. If we didn't know this, for example, do we want to say just the amount of distance you run a week tells us everything we need to know. Our two people who are running 15 miles per week, experiencing the same metabolic benefit or harm. Well, certainly not one could be
Them all a 10-minute, mile Pace one might be paying just imagining, this one might be running them all, as 400 all out repeats. So you have to have some way to kind of normalize that and in the case of the latter you would probably see a much higher met our because of the intensity.
And so with that kind of background now we're going to kind of get to the core of what we can ask about. And so the first question is to the best of our knowledge. Are we even able to say if there is a minimum
Um, efficient or most effective dose of exercise. When you look at many hours per week, is that something that is that our understanding
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