The science and practice of enhancing human performance for sport play and life Welcome to perform. I'm Andy Galpin a professor of Kinesiology
and the center for sport
performance at Cal State Fullerton
in today's episode. We're going to be talking about the
heart and I'd like to start with a very simple question and that is why do you breathe?
Now that may have caught you off-guard and so I'll let you think about it for a quick second.
Why is it that you
breathe?
The first couple of answers probably rushing to your head or something like well, if I don't breathe I'll die. And yes, that's true. But why why is it that if you don't breathe you'll die.
Without prompt and you're now probably thinking about well, I've got to get oxygen into my system because oxygen is needed as the fuel for metabolism to produce energy and to keep my cells and heart and brain alive.
Well, it's not exactly the right answer of course oxygen is critically important and you will die without it. But there are many other things going on that determine how you breathe. Why you breathe how often you breathe and why that's vital to both your health and performance given that the focus of this show is to discuss the science and physiology of maximizing performance. I think it's pretty prudent of us to then spend a little bit of time learning more about how and why your heart functions in order to do that. We're going to cover what I call the three eyes.
The first being investigate another way of saying how do I understand and analyze whether or not my heart is functioning at the highest level possible.
The second eye is interpretation. How do I value those numbers? Is that great terrible amazing best in world history Etc. And then the third one is intervene, which is way to say, what do I do about it? How do I improve various markers? How do I reduce others so that I can maximize my overall functionality and performance of my cardiovascular.
Vascular tissue or in other words your heart in order to do that. We're going to have to expand our conversation past just the heart itself. This is going to include things like respiratory rate. In fact, I opened up the conversation here by asking you why you breathe and so we're going to take a look at not only the cardiac function itself. Say your resting heart rate maximum heart rate cardiac output vo2max and things like that, but we'll also get into other important and relative metrics like your heart rate variability your respiratory rate CO2 tolerance and other things.
You need to understand to fully appreciate and then therefore improve
function of your cardiovascular system
before we get started with all that though. We need to take a quick step back and go through really what the heart is how it functions what
it's made of and that will then give us insights and understanding about how to measure it interpret it and then therefore improve it now
before we go too much further. I'd like to take a quick break and thank our sponsors because they make this show possible. Not only are they on this list.
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again, that's
rom.com / perform to get 25% off your first order. Okay, the way like to get started is actually with an apology you see I'll admit
All you forthright that skeletal muscle is my favorite cardiac is a distant second and I
probably spent too many years
not giving the heart it's
do and that's honestly because I
came from what would be typically called as an anaerobic sport background. You see I was much more interested in things like football a little bit of basketball baseball and
things that require not a lot
of endurance but a lot of power and so I didn't really necessarily appreciate. In fact, I directly said that the heart was not nearly as important as your skeletal muscle.
I've come since to learn that that was the wrong approach and I'll tell you more why about even if you're into those types of activities, you should care deeply about the functionality of your heart and how that can absolutely improve your performance even in situations and scenarios like
that. Okay. So as a quick reminder here remember your body has three main
types of muscles smooth cardiac and skeletal now, there's a number of structural and functional differences between these three
and just very quickly smooth muscle.
Lacks contractile properties. And so some of the things were going to get into later the micro anatomy of smooth muscle it doesn't have and so it lacks the ability again to contract it can
isometrically hold in place. And so this is really
something you don't have cognitive control over. It's the stuff that regulates kind of your background physiology digestion things like that cardiac tissue again, when I say that think the heart and skeletal muscle think everything else. So the muscles you can actively control whether they
the small muscles like in your fingers eyes or toes large muscles like your hamstrings your glutes spinal Erectors and things like
that. So kind of everything
else is a skeletal muscle now, there's a lot of similarities between skeletal and cardiac muscle, which I'll talk about a little bit later
but there's also some major differences in that actually is going to explain a lot
about how you need to approach these interpret diagnose and then actually train these things differently
and so I didn't appreciate that earlier in my
career. I kind of gave all of the credit to
Muscle and and didn't understand how important and vital something like my respiratory rate is in terms of performance as well as tracking and monitoring ongoing progress and then particularly signs of things like non-functional overreaching or overtraining or general fatigue.
So I hope that's the vices as a small apology for all of you
heart experts and aficionados out there.
Okay. So let me wind the story back just a little bit. So I'm going to set the
stage appropriately and you'll understand why I felt the way I did
coming out of high school. I knew I
Was interested in sport
performance and so I will actually want to go to college to learn more about the physiology and science of performance, but those
programs really didn't exist.
And so I remember being taken on recruiting visits and they would ask kind of about your academic interests and I would say that and they say, well we have a athletic training program which is really injury prevention and treatment of management and stuff like that or we've got pre-med and I didn't want to do that
and really the only kind of exercise physiology programs involved exercise, but it was really more public.
Of disease prevention treatment management stuff like that. And so I never really found a home academically at least
initially. So I remember going through school. And again why the exercise
was a part of that he was really from the perspective of oh, yeah, you know athletes do that
and then there's kind of exercise
you should park your car in the end of the parking lot. You should get more steps in and you can go upstairs and and it was kind of that public health message, which is awesome stuff and Incredibly important. It just wasn't my passion.
So I kind of remember almost feeling like I didn't really have much
of a home.
Home academically and I would learn stuff and I was excited about learning the human body and that stuff fascinating to me and still does
so from the cardiovascular perspective. I just really didn't care
that much about that stuff
until we got into doing things like testing the VO2 max.
I'll tell you what that is a little bit later and we'll walk through it, but that got my attention right because like hey, this is a maximal exercise test and it was something we could do for athletics to see who's the most fit who had the best
endurance and if you look at the research on sport performance, there are
I'm clear associations. In fact, some of them are very highly tied to success in sports and your VO2 max now classically you would think of something maybe like an endurance Runner a marathon on a per se and while the VO2 max is not the only thing at all that predicts
performance clearly. It is
higher in those individuals relative to athletes and say baseball or golf or something like that.
So some sports in mattered a lot and others that didn't and there was
a way that we could assess and test and identify performance and it all made
a sense to me and I grasped it. Well when I never did was make that connection across two basic physiology
and I don't blame myself because no one else did either now what's funny about that is it really didn't come into my purview
until really close to 2010 or so
and I was fortunate enough to as a graduate
student to have a gentleman by the name of Jonathan Meyers a legendary physiologist out of the University actually of Stanford and he came and visited our laboratory and gave a wonderful talk.
About the relationship between vo2max immortality and I was stunned and now you're talking about and I'll give some actual studies later. But you're talking about research and papers that used in 10,000 subjects. 100,000 subject is massive databases and they're finding incredibly strong predictions of your VO2 max and how long you're going to live
and my eyes just exploded and I went that's it. Oh my gosh being healthy performing physically at your best.
Is almost the same thing. So now I got really excited about this metric and said, hey man, I want to know what this stuff looks like. What is this is Jonathan the only guy that found the sound well learning more about the
history of exercise physiology and going back and I realized we actually had known this since the late 1980s. So there's another legendary physiologist who unfortunately very recently passed away named Steven
Blair and he spent the vast majority of his career running these
giant studies the first one most iconic
One came out in a journal called Jama. So Journal of American Medical Association, one of the preeminent journals in all of Science and Physiology and Medicine in 1989.
And in that initial study, he was really the first one that said hey when we look at
vo2max and we compare that to say smoking or cardiovascular disease.
It's as strong. If not a stronger
predictor of how long you're going to live than any of these other metrics
and then actually if you look at you two, you'll see you'll see study after study and you can pull up
meta-analyses.
he's and and and that's has really caught actually attention lexicon in the last say five or so years people have really jumped on board and it's it's really warmed my heart actually for that to happen because I
felt like it was something that Us in the exercise scientists World
a strength and conditioning folks and again scientists of exercise
have been screaming from the top of our lungs for 20 years and no one really paid attention to her cared about and then people found this stuff out and started
talking about it as if it was a new finding and I was getting our world were saying oh my God
We've been telling you this for 20 plus years.
So that's okay. It's a free pass. I'll give you that. I apologize to you.
I'll accept your apology for ignoring us exercise scientists for so
long, but I think it really highlights another
theme now this entire show, which is the
importance of understanding what maximum performance
looks like if you want to be a better athlete, that's great. It's my personal interest, but that doesn't have to be yours.
But the value that creates to the rest of
society is unmatched
vo2max.
Is
one of those examples I will share with you many many more of those and and other episodes
but that is to me one of the best
examples of when we
stopped looking at health and
performance
differently and start looking at it as hey if your physiology performs
at the highest level possible, you're going to be healthy, right Bill Bowerman if you have a body you're an athlete so I just want your physiology to be functioning at the highest level that can
you can then choose to use those skills.
However, you'd like to be better at playing golf or basketball or pick a ball or riding mountain bikes. I don't really care whether you want to have more energy more recovery better sleep about the day
something like a VO2 max is going to be
intricately involved in all of those things.
Now for those of you that absolutely
love numbers I'll give you some but please don't get too specific and particular about these couple of studies. I'm going to go
over think of them just as really
highlights of the overall field depending on which population is set.
Deed in a certain
setting or database. These numbers will vary slightly. But again, this is going to
represent what you would generally find across dozens. If not hundreds of similar studies that looked at vo2max and overall health and
wellness quick point of clarification when we
say Fitness scientifically referring to vo2max
in the actual strength conditioning and performance
settings. You might have a different definition of it. That's absolutely fine. But scientifically those terms are pretty synonymous. So Fitness means we've tested your VO2.
And almost every scientific situation. So let's start off with that first Seminole Stephen Blair paper from 1989 in
Jama in that they had about 10,000 men
and about 3,000 women or so and what's actually interesting about this study and many others
like it. They typically follow the individuals for
years. I believe in this actual study. It was something like nine
years and within that several hundred people actually
died, and so it's a bit more but I understand but it makes the
The science incredibly compelling because we can look at a number of people wait for several of them to die and then come back and say what actually was different between those people who died at Baseline versus those who didn't die, you know, again a Baseline and after that and so we can get really strong insights about what predicted death now what they found in this initial study and this is directly from the paper itself was after age adjustment. So again, they would kind of factor in their age and say let's take that out of the equation. So after age adjusted,
All cause mortality meaning died for any reason
declined directly across
Fitness levels. So as you reduce your Fitness, you increased your all-cause mortality risk,
and it went from a number of what is referred to as
64. So 64 deaths per 10,000 people.
That was the highest rate their it reduced from that
to about 18.6. And so again if you're looking at that saying all right,
if I go from the least fit category to the most fit my risk goes from 64 death per 10,000 people down to 18. That's per 10,000 people
if that part is confused. You just run the 18 verses the 64. So another way to think about that is if my risk of dying is 18 and now it also goes up to 64.
It's a huge increase in your risk of dying and nobody wants that similar story for the women. The numbers are actually went from the risk per 10,000 was 39 .5 and reduced all the way to 8.5. And so again clear evidence that this thing was happening. And what's also interesting here just because someone will ask I'm sure this was true once they factored out things like again as I mentioned age, but also smoking habits cholesterol levels systolic blood pressure fasting blood glucose.
Bubbles parental history of coronary artery
disease and then follow-up and other metrics.
So they're basically saying is even if you take those things into
account you still see this massive reduction in health when we have a reduction in cardiovascular fitness.
Now, I realize following numbers like that
is sometimes difficult. If you're only listening to this now audio version, so we will have this paper in the show notes the actual title of the paper is physical fitness and all cause mortality a prospective study of healthy men and women
And again first author Stephen Blair from 1989. So if you Cruise onto table to of that paper, you're going to see that they actually ran the analysis and split up the men and women into quintiles. So this would mean the lowest 20% of Fitness the next 20 x 20 next 20 next 28. So
take everyone
across the Spectrum lowest to highest and split them up top 20% etc. Etc. All the way down. And what I will read off to you is the relative risk. And again, this is risk of dying.
As we go from the most fit 20 percentile to the next most fit to the middle kind of 20% to the second to last twenty percent all the way to the bottom 20% That's a way to view this.
So if you start at the highest
level of fitness and we put that as just a number of 1.0, right? So this is the saying okay, you're at a 1.0. If I go from the top 20 percentile to the next 20 percentile. So think of this as like 62 80th percent if you will
my wrist goes from
12 1 .7 this is a 17% increase in Risk. If I go over to the next one down, it's gone from one 21.72 1.46 the next after that 1.36 and then here's where it explodes. So again think of this as if you are somewhere between the 20th to 40th percentile 100 being the best 0 being the absolute worst. So just being the second to last category your risk is one point three seven.
You go from that category to the bottom 20th percentile. So just one category below your risk goes from one point three seven, two three point four
four and this is why people will highlight you don't have to
necessarily be the fittest on the planet from a health and cardiovascular risk perspective,
but you cannot be the
lowest the magnitude of improvement you see from going from the least fit people around to just a second least fit
is almost half.
Two
three times the risk reduction.
So massive improvements. You'll see the exact same thing in the women in the
study. So not running through everything but really talking about improvements as you go from the healthiest or most fit kind of going all the way down to the bottom 20th percentile that risk factor is 2 point 4 2
and then the lowest goes from 2 point 4 2
all the way up to four point six five.
So similar message between the men and
women just being the bottom of that category.
He's incredibly dangerous and problematic for your help. So if you can just do a little bit to bump up one level that's going to do a lot for you.
Now again, there's a ton of studies you could pull from here the numbers again. I don't want you to be super specific on that
because they will differ depending on the population
a little bit of context on that.
I grabbed another study for you. Also in Jama far more recently called The Association of cardiorespiratory
Fitness with long-term
mortality among adults undergoing.
Exercise treadmill testing
and this is actually going to tell you a similar story
but wanted to show you how even the studies that are a little bit different are going to have the same take-home message
in this particular analysis.
Now, they've got over a hundred and twenty two thousand patients. So, okay great. Maybe there was something unique about Blair and is little population of 15,000 people are so what about if we 10x that number roughly do we see the same basic results in the answer is effectively. Yes. So
in this almost
18,000 people
died throughout the course of the study. So we're getting same kind of idea pretty healthy people some are going to die. But what does it really look like in terms of the folks have stayed alive and those that did not I'll Zoom you all the way down to the end to not make it so painstaking as the previous one but similar
stuff here. In fact, it's even more jarring because they're able to do more in-depth analysis here of some of those other cofactors, which is what I want to highlight so
You know directly from the paper again here the increase in all-cause
mortality is associated with reduced cardiorespiratory Fitness which was comparable or to or greater than traditional clinical risk factors such as coronary artery disease smoking and diabetes now, I'm certainly not trying to tell you that as long as you're in shape that it's okay if you smoke or do anything else again, just from this one particular study really profound there right the cardiovascular fitness.
Again, vo2max
was more
predictive.
Than traditional risk factors, like coronary artery disease smoking and diabetes, right?
So I'll put numbers by this because it gets even more
interesting
the cardiorespiratory Fitness is inversely associated with
long-term mortality and not observed to be an upper limit what that also means is
there doesn't seem to be any reduction in the benefit.
By continuing to increase your VO2 max. So another the higher your VO2 max goes the more it seems to preserve all cause mortality risk. So there doesn't appear to be in this study. In fact, you'd see the same thing. If you looked at almost any other study in this area there seems to be no upper limit. And so there's just really not a rationale of saying well, I'm good enough here. I'm okay, this is enough and if I get any better, it won't really help that much. You actually do see that sport performance. So a classic example here is in the sport of mixed martial arts.
If you examine the VO2 max has of the athletes in that you would see that it's kind of on an average of about fifty five milliliters per kilogram per minute. And if you get past that the benefits of
performance continued to go up but even but slightly
and once you really start getting passed north of 65, it seems to be really no more association between improved performance by the by that I mean winning
fights does it mean it is detrimental of course
or not advantageous to be in better Fitness prior to a mixed martial arts fight.
But
we're just saying the rate of increase in
performance against the rate of increase in VO2 max starts to taper off. We don't see a similar thing with cardiovascular health.
I'd like to take a quick break and thank our sponsors. Today's episode is brought to you by a G1 H. G1 is a foundational nutrition
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receive five free travel packs plus a year supply of vitamin D3 plus K2. Okay, so hopefully I've made my point here about the importance of yield to Max
but in case I
haven't just one more final study that I thought was of Interest here to bring this point home even more actually. This is one of Jonathan Myers more recent papers called cardiorespiratory Fitness and mortality risk across the spectrum of age race and sex published in
the last couple of years here.
This is actually in 750,000 US
veterans between the ages of 30 and 95 and I like this paper because the sample size is enormous again. It takes into account things like race as well as age look at that Spectrum, right almost a 65-year spectrum
and within that 175,000 people are so died. So if it held up against 15,000, then it held up against 150,000 and now it's holding up against
A thousand I just don't know how much more evidence when we need to see to believe not only in this as a factual finding but the relative risk ratio seems to be lining up across all these studies as pretty similar. And so what they found in this again same idea, they found no reduced benefit of Extreme Fitness and other words the higher the vo2max just the higher the risk reduction there seemed to be no upper limit there.
And in addition what they found was a couple of
metrics, so if you take into account what are called the comorbidities and so you look at things like diabetes diabetes in this particular study took their risk factor from 1 to 1 Point 3 4, so that's a big deal. However
going from the highest Fitness level
to the next highest Fitness level.
representative and increase the risk of 1.66
So again, I'm not saying that
diabetes is okay or anything like that again. I'm not a medical doctor and I don't do really anything with disease, but just look how staggering this is. And in fact, if you run this all the way out examples in this paper and here I'm looking at a figure to by the way if the case you want to go look at yourself you're talking about the addition of age represented a 1.06 increase in risk factor hypertension smoking arterial fibrillation Cancer. All these things are plot and you can see how
Much they increase risk and all of those the highest one was chronic kidney disease, which represented 1.49.
When you look into the vo2max numbers.
the
lowest
risk factor was 1.39
and then it just escalated from there to 1.66 22.1 22.9 again with the least fit people having a 4X higher risk of
mortality.
That's
how important your heart is. And so it's hard for me to make a cogent argument that even as
a who are interested in say again dunking a basketball or these anaerobic high power low fatigue Sports
very difficult.
To say your heart is not playing a big role in your Global health and that that isn't going to limit your performance in somehow.
So at this point if I haven't
convinced you of the importance of your VO2 max, I don't think I can so let's go ahead and move on regardless
now, you're probably interested to know. How do I
assess that? How do I value that and then do something about it? We're going to cover that a little bit later. I promise I'll give you a full breakdown of how to know whether your VO2 max is good based on whether you're male or female your age and where that puts you in the categories and percentiles will cover all those data and
Of course plenty of links directly to tables in the show notes,
but I think before we do that, we actually need to talk more about what
makes the cardiac tissue. So special and
unique. I'm going to talk a lot about
skeletal muscle in other episodes.
And so what I want to do here is really focus on what is unique and
special about the
muscle fibers in the heart as this is going to explain a lot
about how we interpret it what we do
about it and how actually there's more things to pay attention to
to than just review to Max to get us started here.
I'd like to actually ask you a question that is
you ever thought about why
your heart never gets sore.
I mean as I said at the beginning you've got three types of muscle right smooth muscle, but it doesn't have contractile properties and it's not important or relevant to force production or human movement. You've
got skeletal muscle, which is everything else. It's your arms
legs neck shoulders things like that and then cardiac muscle your heart
and you know, when you exercise really hard or do something unique and novel
trained over a large range of motion do more eccentric working all these other things your muscles get
sore.
But why does your heart ever get sore if you went out right now and you haven't exercised in years
and you ran a vo2max house you would get extremely tired, but you would not wake up the next day with a sore heart your intercostals your ribs or low back or something like these were but not your heart. Well, why is that?
Well, actually the answer to that tells us a lot about how we should
assess the functionality of our cardiovascular system
as well as how we need to think about training it
differently than we trained skeletal
muscle.
You see it always comes back to physiology right now. There's a reason we're going to walk you through how the heart is set up the structure of the fibers why it contracts the way it does because again, this gives us insights into why
we need to totally change our mindset about how we're going to
train and improve it
relative to how we talked about and we'll talk about training our skeletal muscle.
So the heart is made up of really for
Unique areas and we call these Chambers. It's got two of the top called your Atria your left and right.
Two at the bottom called your ventricles and really the idea is you take blood from the
Atria you squeeze and contract the Atria that pushes blood into the ventricles the ventricles in squeeze and that pushes blood out of your heart and into your system. There's a lot more detail in there, but that's close enough for now of
primary interest is the left ventricle. That's
actually the reason why when you see a heart it isn't that perfect unique symmetrical shape that you envisioned when your five-year-old daughter
draws it it's actually slightly tilted to the left.
A little bit that's because the left ventricle itself
is larger than the right ventricle primarily because the right ventricle just needs to pump blood to the other side of the heart, but the left ventricle pumps it out of your heart in throughout the entire rest of your body down to the tip of your toes and then all the way back up into your
heart. So it has to have enough Force to have all of that blood movement Up
Against Gravity fighting through muscular contractions to get blood all the way to return now, you have
some ways that you can help that blood return.
Along the way but primarily that's what the
left ventricle has to be able to do. And so because it is asked to have a higher function and it was other words produce more force.
It actually is larger. There is an association at all times between muscle
size and muscle strength though that is not linear and we'll discuss that in other episodes.
And so globally the left ventricle is larger. What's also unique about the heart is that the way that the muscle fibers themselves are made up and so you see your heart like any
muscle is just a composite of many.
Hundreds if not thousands of individual muscle fibers and we will talk again about the nature of those in the skeletal muscle episodes.
But for now we need to think that they are actually
quite different and so why you think of muscle your biceps muscles are hamstrings muscles or quadriceps muscles, they are meant to have specific functionality a term that we're going to use in muscle science. All the time is structure equals function. So the
structure the way that it is built equals the functionality so as a quick example your hamstring muscles,
Are primarily meant for
explosive movements to run Sprint jumps up like that.
And so the way that they are
built that way that they contract and oriented and attach to the Bone are
different than say your
spinal Erectors your low back muscles that are meant to just keep you up in vertical all day. They're not really meant to be exploded or contract with a lot of force.
They want to be on and contracted mildly to keep you
vertical and direct with that nice great posture
when we go to the cardiac side then we
stand you start thinking.
Okay. What is the actual need and demand?
And of the heart and so while we want to be able to turn
skeletal muscle on and off a lot and to have really specific and precise
movement. That's not the role of the heart. In fact, we need to head towards something else. We just want the heart to contract. We don't need to contract in different ways. We don't need High Precision. We need a full contraction. And in fact more importantly we need to hedge against the possibility of not
having a contraction
if your hamstrings don't fire appropriately or you think
Glutes are turned off or they're not as strong as you'd like that's not going to really change your ability to live. If
your heart fails to contract even one time. You have serious problems if it fails to do that for just a couple of minutes you're dead.
And so the demand is quite
different it needs to be very consistent and it needs
to basically do the same thing every time and it needs to have fail-safes. So some problem exists, it can still contract and so the nature of the
fibers in your heart are quite different in
So there are very very long. So you'll see them up that, you know, five to six inches in length of a single muscle fiber and say your quadriceps.
They are quite short and thick in the heart. The
diameter cross-sectional area is roughly the same you're talking about something like four to five thousand micrometers squared in terms of cross sectional area,
but the length is very very short. Now you're talking about something like
0.1 cm in length.
And the reason we want that or Reason as
actually is happening.
Running is because the fibers themselves are what are called single
nucleotide.
And so this differs significantly from skeletal muscle that
has thousands of nuclei in the cell the nuclei as real quick reminder are the place in which you hold your DNA. It is the control center of the cell. It determines how the cell responds to external stimuli recovers repairs goes through protein synthesis or adds more mitochondria. Delete some or whatever the case may be. This is being run by the nuclei and so by having more
more of them in skeletal muscle it allows it to be extremely plastic and adaptable and responsive to exercise or interventions are lack of exercise or anything else going on. I don't need that and cardiac tissue back. I don't need it to be growing and shrinking and dying really quickly. What I needed to be doing is extremely consistent with both its Activation. So it's contraction and the force applied and that contraction. So the fact you've got a single nuclei in the cardiac tissue tells you it's primary.
All is not actually adaptation. In fact, depending on the study you look at you're going to see that the muscle fibers in your heart are going to turn over somewhere between 50 to maybe up to 70% throughout your lifetime meaning many of the
fibers in your heart that you have as a child. Especially past puberty
are going to be there the rest of your life. There isn't a huge turnover. Now that differs considerably if you look at something like the skin
That's probably going to turn over you will have all new skin cells
every you know, 30 to 50 days or
something like that red blood
cells will be more like every
120 days and you know, skeletal muscle can
actually have a life span of maybe a decade or something like that maybe a little bit longer
but your heart tissue is going to very rarely turn over. It's not meant to be hyperplastic that does not mean
it doesn't respond and adapt and change to stimuli like high blood pressure like exercise. It absolutely
does but it
Is much slower that's not the primary
job. So the fibers themselves are shorter, they are nice and thick and they have a single nuclei but they have a couple of actual special unique advantages that skeletal muscle does not have for example, they are connected to each other through what are
called intercalated discs. Now, these are specific and unique to cardiac tissue
and what actually allows to happen is for there to be what's called Gap
Junctions. So there's almost a little entry points from one of the fibers to the next one
and what that does.
Is it gives the ability for an action potential which is the electrical
voltage that goes into the fiber that causes it to contract
it allows that voltage to leak
from one fiber to the
next you wouldn't want this in your skeletal muscle because that means when you
contract one fiber or set a fibers, you might accidentally contract other ones not
good. Remember we want High precision and control of movement in skeletal muscle with cardiac tissue. We just wanted all the go and so the fact we
have these these open Gates through these intercalated discs and through these Gap Junctions that says hey, if for some reason we struggle to get intervention or activation of an action potential as long as we get it into one of the cells it'll be able to leak into the rest of them as well. So in this case, we want to hedge guaranteed contraction Over Control now in a similar point.
If you go to skeletal muscle it exists in what are called motor units. So you might have several hundred to even many thousands of muscle
fibers all innervated or controlled by one basic nerve as a way to think about
that. Okay. This allows you again to up regulate how many of your muscle fibers in your muscles
are Contracting at a given time by turning on or off more total motor units.
The heart doesn't have any
there is no motor unit in the heart. We don't want to have the consequences of what if a nerve fails or is blocked or dies and now we can't contract those fibers. And so in fact, the heart is not dependent upon nervous system activation to contract now, I'll say that again the heart does not require any nervous system activation to contract and this explains exactly why you can do really awesome and interesting.
See things like in the movie Indiana Jones Temple of Doom where the gentleman reaches into the guy's heart and he pulls it directly out of it and he stares at that man's heart that's in his hand and it still continues to beat this happens because again, unlike skeletal muscle which requires nervous system activation. The cardiac tissue does not it has its own intricate rate and can spontaneously produce the electricity needed to contract independent of the nervous system.
Now that does not mean the nervous system does not have a role
in your heart. It absolutely does and we're going to talk a lot about that. In
fact, it's incredibly important to understand that as a way to monitor Global fatigue Readiness performance and overall nervous system activation. Another thing that differentiates the skeletal from the cardiac
tissue is how and how long the contract
in skeletal muscle. We actually want the ability to do what's called summation to reach technium. And so what
happens is the muscle fibers in say your biceps brachii.
E I will contract without electrical potential and then actually almost
before it gets all the way back to Baseline it will contract again and then we'll contract again the contract again and so those mini contractions start to stack on
top of each other or some 8 and in fact, if you do that long enough, you can reach what it's called Full techne think of this as a muscle cramp. So this is the muscle fibers themselves Contracting permanently instead of doing this kind of on off on off
Rhythm cardiac tissue doesn't do
that and I think you could probably imagine why it would be a very bad thing for you to reach.
Have your heart remember when we first started talking about the anatomy of the heart the primary job of the heart is to move blood from the Atria or the top of the heart to the ventricles in the bottom and then move that out to the body.
So if this thing we're to reach tetany blood wouldn't
move anywhere you wouldn't be able to circulate any blood throughout your body. And of course you would die.
So while it's okay to have a cramp in your calf and it's
painful and it's annoying and it's all those things having a cramp in your heart would be far
worse.
And so your body Hedges against that and what it says is all right, if I have
this extremely fast what's called refractory time in skeletal muscle the ability to kind of contract multiple times in a single muscle fiber.
I want to extend the time of contraction in the cardiac tissue so that
I don't have that repeat in summation. So in addition to
not wanting tetany, you also need to allow time for blood to fill up the ventricles. Remember this we're going to come back to this later in the
episode when we talk about determinants of
You too, Max what to improve and some of these these other numbers and why that relates to your resting heart rate your maximum heart rate why that's not trainable why there's no difference in maximum heart rate between highly fit people and unfit people and things like that.
So the ability of your heart to fill back up with blood is critical. So it's got a contract allow enough time for blood
to fill back into the Atria ventricle and then contract again
so big long smooth contractions, not a lot of plasticity in the
the tissue itself. We want to hedge against having lots of fine motor control. We
want consistency over specificity here.
So another way to build on top of that.
Is going back to what I said a second
ago. How does it produce a contraction independent of the nervous system? I gave you the potentially little bit crude example from the Indiana Jones movie. But another way to think about this is how can my heartbeat if I'm unconscious right? If I've got the brain turned off line will it will continue to do that because it has this intrinsic rate. You've got four or what are called Pacemakers in your heart. The one I want to cover in talk about the most is the SA node. So the Sino atrial no, this is
Right Atria and it controls for the most part your heart rate. Now,
you've got other ones like the AV
node purkinje fibers and bundles of his and things like
that. But those are really
backup systems. So in case the SA node fails, it'll go to the next one go to the next one and all the way down there.
So we've got various fail-safes that give us the ability to say. Alright if we have a problem. We're still going to get contraction because remember all we've got to do is get one chunk to
Fire and they will spread through those Gap Junctions and get everything else.
It's to contract in the appropriate
fashion. And so we want to have that in position. This is also
why if you have something like a heart attack and several of your tissue
in your heart die, you can still
survive because you can get contraction of everything else but it is complicates the process right because we start to lose electrical impulse through the parts of the
tissue that are dead. Now. The SA node itself is actually a bit of a Marvel you could sort of think about this in actually remember in school being told that
We have no idea. It's one of the modern Mysteries the world of how the SA node intrinsically develops his
Pace. Well, that's not exactly true. I think my teacher they
didn't know the answer or is just trying to Hype me up a little bit. We know a lot more about what controls in fact, there's
a number of things that go into that. It does have a little bit of Wonder. I don't want to steal that we don't know exactly how or why
this thing beats the way it does why it's somewhere between almost every human and how it can just spontaneously create these Action potentials
that is regulated by a number of things
including
various endocrine or Peregrine this hormones that are circulating your system
now blood pressure the strength of your contraction the amount of blood that comes
back into your heart called preload and various other factors. So it's actually a fairly complicated milieu that go into it. I'm actually still okay with you think of it as this modern mystery that it has this magical property where it contracts and causes electro-stimulation Action potentials out of nothing. I'm cool with that too. But we do know more about though is how this regulates the rest of your body.
So when we talk about skeletal muscle we know specifically there is a neurotransmitter
called acetylcholine that is required for muscle Activation. So the reality of it is your nerves are actually not directly attached to the skeleton. Also, there's a little space in between them. What
happens is acetylcholine is on the presynaptic
nerve. So this is the nerve that comes in there. It gets released into this little space in between
actually attaches to little ligand
Gates on the muscle itself. They open up
Yup, they let sodium and into the tissue and they cause a whole series of electrical things. We call this an
electrical to a chemical back to electrical signals. What you
transfer an electrical signal down your nerves
into a chemical signal back into
an electrical signal that allows muscle contraction.
So once again acetylcholine is the primary
neurotransmitter that excites our activate skeletal muscle
but shocking enough
if you put acetylcholine on to the heart it slows it down. Yeah, it does the exact opposite and so you have a number of nerves that are coming in probably the most famous is the vagus nerve. Now. This is a v AG u.s. Not a VA gaas like the city. So the vagus nerve and several others are what are known as parasympathetic drivers. And so the autonomic nervous system is split up into two large branches. The first one is the parasympathetic. This is rest and Digest.
This is relaxed sleepy depressed chilled all those things over there, right the other side of the equation and it is more complicated than
this. But this is all we need to know for right now.
Is this sympathetic? This is fight or flight.
This is freezes action anxiety aware aroused and all kinds of things like that. We want both of these they are critically important
for everyday life. We need these for
high-performance. We need these for health. We need these to just be alive
and so we want to be able to fluctuate back and forth
between these two.
States appropriately, they are not on off
switch. They are more like a gradient or a toggle. There are there are dimmer
switch more so than they are, you know getting flipped on or flipped off.
So what happens is the intrinsic rate of that SA node is probably higher than your resting heart rate. In fact, it probably wants to beat more like 100
to 120 beats per minute. Most people's resting heart rate is more like 60 to 80 beats per minute. So you
kind of have this vagus nerve that is constantly applying this drip of acetylcholine to
Slow your heart rate
down. Now. This is actually really cool mechanism because what allows you to do is if you want to increase your heart rate, the very first thing you have to do is not necessarily turn on sympathetic drive. It's just to reduce parasympathetic drive another way to say that is imagine you're
driving downhill say you're in San Francisco or someplace that has a ton of heels
and you're going at 60 miles per hour and you decide you want to go faster. Well, the initial instinct is
to maybe hit the accelerator hit the gas think of that as the sympathetic nervous system. We don't actually have to do that. The first step is just to make sure your foot isn't on the brake the parasympathetic nervous system. So kind of what's happening is at all times when you're driving the vagus nerve is slowly keeping its foot just a little bit on that break to keep
you relaxed. Now it's
doing that again so that if you want to go faster really quickly all we have to do rather than giving out additional resources, like epinephrine or adrenaline all actually have to do is stop.
Us from slowing you down its kind of those classic double negatives, right? So I find Hibbett the inhibitor I can actually go
faster. So if I remove my foot from that break, my heart rate will increase to again somewhere in that
100 to 120 beats per minute range plus or minus here
without us doing anything if I want to continue to accelerate past that so now I'm going down that Hill. I was going 60 miles an hour. I've removed
my foot from the brake now. I'm going 80 miles an hour 100 miles an hour, but
that's not fast enough. I want to go 150.
Now I can hit the accelerator.
Now. I can push down on the sympathetic nervous
system increase adrenaline turn on
faster rate and pop my heart even more to produce more work more energy or whatever. I'm trying to accomplish
great. Now, we've got that down. Let's go back and answer our question. Why doesn't the heart gets sore? Well, let's think about what are the reasons that cause skeletal muscle tickets
or remember?
All skeletal muscle with the exception of
one and I wonder if you know what that which one that is why the way
all skeletons with the exception of one is connected
to Bone the attendance. And so when we contract the muscle connects pulls on the connective tissue pulls on the bone to get you movement. Our cardiovascular our heart is not that it is not connected to Bone. That's not the point. We're not trying to cause movement. It is really just connected to itself. So because of that we can't ask it to go over any additional range of motion. So that factor gets thrown out. The only thing we can possibly
What we do is put more blood back into the heart which puts it on a nice eccentric stretch. That's our only mode here. Now eccentric exercise does lead to excessive soreness. If done
especially heavy or in a novel fashion with traditional exercise and so eccentric exercise something to pay attention to but the fact is we don't have the ability to overload the heart more than the maximum amount of blood we are going to have in our system. So there's no novelty. We
can add to it that it's not already used to by the way to answer your question. What's the only muscle not directly? That's the bone. I'll give you hit you can see it on me right now.
And if you are my five-year-old, you would love to show it to me all the time. It's your tongue. Pretty cool, right? All right going back to business here. So it's not range of motion. It's not the eccentric training other things that cause soreness are higher intensity not really applicable here again, if you're used to Contracting it a maximum heart rate. We're not going to be able to go past that more volume. Well, we could do that but more volume tends to mean more exercise over me or more range of motion your heart beats.
All day it is not subject to that much change in volume. If you looked at the total amount of heartbeats that you go throughout the day a little bit of exercise is not changing that volume too much. So it's really difficult to add much volume relative to the standard or Baseline there.
As always you just continue to go down all the other
factors that influence muscle soreness and you see they don't really apply to muscle again. That's not as primary role.
And so while you may get
fatigued from exercise, especially endurance based exercise,
the heart itself is not really subject to fatigue.
In fact, the heart rarely gets tired. It has far more
mitochondria in it than skeletal muscle. We used to refer to this
as the Ultimate slow-twitch Muscle. It is not meant for force of contraction going back to motor units. We actually can't alter force
of contraction in the muscle fibers themselves in the heart. We can only
do it by changing the stretch on the
tissue same thing in your skeletal muscle,
but in that case, you've got both options right change stretch or strange
contractile properties. We really can't change the contractile properties in the
heart, especially acute.
What we can do is put on more stretch. This means more
blood back into the system again preload. We'll talk about that a little bit later after loads another
way. But if we put more back into it,
we put the muscle on a bigger stretch and this allows it to then respond. I think about like a rubber band if I pull it a little bit it snaps back by put a lot it snaps back harder.
That's all we can really do but it is not meant to be regulating
Force up and down. We don't even have motor units. It's an all-or-nothing ideally as
we've got a lot of mitochondria in there. We are phenomenal at a row.
Book metabolism and can specifically within the
contractile properties are not talking about aerobic metabolism of your entire system or heart. We're talking about the capillaries surrounding
the heart itself the ability to get blood into the
tissue of the heart. Not the blood actually in the chambers that you're using this and the rest of your body. Remember your heart
has its own blood supply not the
stuff is trying to give out there everybody else
think of this like as
Halloween, where are you you're sitting in house and you've got this giant bucket of
candy and the
candy you're giving out to the rest of the world. You're not eating that.
Candy as well, you've got another supply of candy in your back pocket and house and you're pulling out of that candy if you will.
Okay, so the heart itself is meant to be incredibly robust against fatigue against damage and soreness and against changing any of its inherent
contractile or I owned a Tropic is with the cardiovascular folks are probably call. It properties that said it does respond somewhat similar to skeletal muscle.
With exercise adaptation. So just like in skeletal muscle more you can add quality contraction force and speed and power and you can add quantity muscle size the same thing actually happens in the heart the heart can get physically stronger this would result in you pumping out more blood / pump. Again, the fibers themselves
on necessarily change their inner nerd
properties, but the hard can contract with more Force.
We'll talk about that a little bit later
that's going to be referred to as ejection fraction and stroke volume.
It can also get larger and in this particular case typically what you'll see in response to
exercise or healthy lifestyle behavioral changes
the enlargement in your heart. You'll see will be primarily in the left ventricle. Again, this is the one that's going to have to deal with the
pressure of the aorta getting that blood out the rest of your body
and will ideally happen is the amount or size that chamber. So the inside the amount the space that can be filled by Blood will either stay the same or even
get slightly bigger, but what you'll be
Scooby-Doo is your pack on
tissue to the
outside of the ventricle? So it gets bigger allows it to produce more Force, but it doesn't compromise the size of the chamber. So again think about the left ventricle as a balloon if that balloon gets smaller and you can fill less
blood in it. That's going to be a
problem. We don't want to necessarily be extremely large either. And so if the backend grows, but the chamber size the balloon size saves the same then we're gonna be able to track with more Force.
Source and not compromise our total blood flow if you achieved adaptation like that and it allowed you to pump out more blood per pump. That number is called stroke volume. So the volume of blood that comes out per stroke or / contraction the percentage of the blood that gets emptied out of that ventricle is called your ejection fraction. So let's just say there was 100 ml of blood in your left ventricle and you contracted and fifty percent or 50 ml was left in The ventricle your ejection.
It would be 50 and so we would like to see high ejection
fractions so that we're not wasting our time Contracting and blood still sitting in the ventricle.
If you improve either of those things and I'm really focus mostly on stroke volume here that will allow your heart rate to drop and so one of the classic
adaptations we see of any type of physical training but think more specifically endurance type training is a reduction or a drop in resting heart
rate see at rest right now as
Sitting here listening. The amount of oxygen
required is the same whether you're fit or unfit. It doesn't necessarily matter. There's a minimal amount of oxygen based on your body size and other factors that don't really matter your Fitness level. And
so we call that your
cardiac output. Okay. So what that is is it's the stroke volume multiplied by your heart rate. So how much is coming out per pump and how many times do you pumping in a given minute?
You multiply those together and you get a cardiac output. Let's just say that number is 5 liters per minute. So very standard resting cardiac output. If you are fit and we improve your stroke volume since the total demand again, the backend of this equation is still 5 liters per minute, but I've increased one of the numbers that allows me to decrease the other number and so your heart rate, as I said, the SA node is paying attention to many things and one of
Them is that
preload? So how much blood
is coming back in and how much it's going back out and various other
factors, so it knows if I'm getting say this 100 ml of Blood Out per pump.
I don't have to pump as often. So
increase the acetylcholine drive slow the heart rate down and let's chill out.
In fact, what we'll cover some of these numbers
later about what a good heart rate is what the best we've ever seen. Well, I don't want to be too high or too low
and stuff like that, but that's basically what's happening and so we can identify whether or not we're struggling in either the stroke volume portion.
The cardiac output side of the equation or heart rate just based on that understanding of how the heart works that will then tell us what style and type of training we need to do
to make the most efficient improvements and not only our heart rate, but more importantly are vo2max. Now your heart rate and how many beats per minute you're using at rest or during exercise
is incredibly telling as I mentioned earlier. It doesn't actually
change though in response to exercise training at
Maximum the only really thing that matters in this particular case is your age and we know that maximum heart rate goes down as you get older but it doesn't alter that much with Fitness. And so
what it can tell you though are things like your heart rate
variability and so let's just use the example of a heart rate of 60 beats per
minute. So one would think and
assume that if my heart rate is 60 beats per minute. That means I'm having 60 beats in 60 seconds. That would be one beat per second.
And if you calculated the total amount of beach you had over the course
of the minute you would in fact achieve 60. That's what that number means
but it doesn't necessarily mean it's on the exact same Rhythm. So it would not be like on a metronome your heart would
not be beating every second on the second. There is a
variability in this
space between heartbeats. So while you again you would achieve the same number by the end of the minute and this case 60,
it might do two or three fast
ones in a row have a little bit of a pause a little bit of a pause a
15 fast ones Etc that so there's a variability in that rate now. It's not very long. It's actually so small that you won't even be able to perceive it but we can measure this with a number of different Technologies. This is called heart rate variability. You may have heard of it
before it's been around for over
60 years and there's extensive evidence and research on this
originally most of the work there again came
from these disease and health models HRV has been associated with cardiovascular.
Our
health mortality mental health
depression anxiety,
but more importantly for me
was when HRV started coming on long for things like athlete
Readiness recovery sleep and performance. And so as always the case physiologies
physiology friends if it's dysfunctional is dysfunctional if you're leading that to long-term Health implications if that's leading
to short-term performance detriments. It's really the same.
Saying
right so understanding the role of HRV is something we're gonna
have to get into a lot later in future episodes. I would love to talk to you more about that. There's a lot of nuance and interesting things we can pull their
but globally something we want to pay attention to so as we go into our next
section here where we cover those three eyes, right? How do I investigate my current cardiovascular fitness? How do I interpret how good that is and then how do I intervene? What do I do about it?
I want to make the point
that just looking your view.
You too. Max is not enough. Just looking at your resting heart rate wouldn't be enough. You would also want to pay a tremendous attention to your HRV and then various other factors like your respiratory rate again, I'll do respiratory rate in a future episode. I would love to talk to you for many hours about that. I would actually tell you right now a little bit of a spoiler alert. I think that is the most underappreciated of all these metrics. I think it should be considered a Vital sign and is potentially the most important thing that you can measure for overall fitness and health.
And quite honestly, it's something I pay the most
attention to on a day-to-day basis of all of these metrics more on that later. You're gonna have to wait for now though.
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We're now at the part of our conversation where I can answer the question we started
off with which is why do you breathe?
And we talked about how that's oxygen. And we need that well oxygen is not really a fuel for metabolism. It's needed to go through aerobic metabolism. But the fuel is coming from your fat and carbohydrates. I only need oxygen during aerobic metabolism, but I'm very effective at anaerobic which means I can produce energy without the need of oxygen but to finish those processes. I've got to have the oxygen around.
And so it's a little bit of a Twist here. This is also explaining why even if you're an anaerobic athlete you still care deeply
about your Aerobic System because this is what allows you to recover
to completely metabolize your carbohydrates
to finish that process and restore yourself back to homeostasis. The faster you can do that the faster you can repeat your anaerobic processes. You can recover you can get back to training get back to competition the more you practice the better you get
the better you perform
and so what's actually fully happening is this when you take a breath in and you inhale you're bringing in amongst other things but primarily
oxygen when you take a breath out your breathing out CO2
the oxygen you bring in is
primarily there to regulate metabolic processes, but the
CO2 you're exhaling is regulating your pH. Now, there's a handful of things your body will regulate almost anything else. One of them is
Our pH it does not like the mess with this if you were to look at other
markers, like say your blood glucose you realize that that's highly variable.
It can be as low as 70 milligrams
per deciliter as high as 150 during exercise or
something like that. And so you can see it all on double or maybe even triple the
amount in the
blood you would never do that with ph it has an extremely tight window that it will not move out of that's because all the enzymes that are required for you to go through any metabolic process.
Need to be in a certain PH range if it gets
out of that becomes too
acidic or to alkalotic.
They can't function. You can't create energy. You're going to die very very quickly.
So pH is insanely important to hold into a tight window. And so what happens is you don't feel that are Hunger or that desire to breathe because oxygen starts getting low remember specially at rest or even during exercise you can produce energy anaerobically.
When you start getting low on oxygen, you'll just switch to anaerobic metabolism. It's not necessarily a reason for you to panic to stress or to change your behavior.
Increases in CO2 though will do that. And so remember your muscle is whether it's using
fat as a fuel or carbohydrates as a fuel.
It's trying to generate a
molecule called ATP. This is the energy currency in all of biology
and it doesn't matter what you use that ATP for by the way.
It doesn't matter if we're talking about skeletal muscle. We're talking about cardiac muscle or anything else. So whether you're using this for exercise to power your brain to recover to digest food, it's irrelevant here, right? We're going to use carbohydrates or fat as a fuel.
We're going to make ATP and then at the end the final Bob product of all metabolism is going to be water CO2 and ATP. So the CO2 concentration increases as metabolic rate increases as a result of that you start then moving CO2 from your tissue into the blood concentrations of CO2 then and blood go up. You've got chemo receptors in your brain stem and various.
Places that are going to be paying extreme
attention to the amount of CO2 in your
blood if CO2 gets really really high we call this
hyper cap Nia if it gets
low it's called hypo cap Nia remember those terms so hypercapnia increases in CO2 concentration actually signal your red blood cells to drop the oxygen on them making it easier for your muscle to extract and absorb the oxygen effectively think about it this way.
If CO2 is high in the blood your body is under the assumption you're going through a lot of metabolism. So it's on the assumption that we want to use and need a lot of oxygen. So it reduces that Affinity. This is called the Bohr effect. If you get hypocapnia kick again, too low of CO2, it does the opposite now this is going to be counterintuitive when we talk about things like CO2 tolerance and respiratory rate in future episodes as to why you could potentially have problems with hyperventilation or overbreathing.
And so it's happening. This context is those signals are being sent to your brain and that is interpreting at a saying CO2 is too high. Let's reduce that the way you reduce CO2 concentrations in your blood is to Exhale. And so this would cause you to increase your respiratory rate and to start either mildly or excessively hyperventilating. This is why as you exercise your respiratory rate again, the amount of breaths you're taking goes up. It is in part to increase
And bring in oxygen of course,
but when we're doing it anaerobically, we're not using oxygen anyways, so the real reason we're breathing so hard where panting
and all that stuff is we're getting harder and harder to exercise is because we're trying to dump and get rid of all that CO2 build-up. Remember excess CO2 is altering pH. This is making us more acidic. This becomes an extreme problem. So another way to think about this is when you inhale
That's actually a sympathetic driver. And so your heart rate increases during inhalation when you exhale it is parasympathetic and it drops so effectively what's happening is your body is sort of saying, oh you're inhaling we're assuming then you're bringing an oxygen. Let's get prepared to deliver this auction throughout the system when you're exhaling it's the opposite. I don't want to be in a situation where I'm hyperventilating. I don't need to be breathing too much because if
Again, that CO2 gets too low instead of being acidic. We are now in respiratory alkalosis. So the opposite direction we're two basic and so it slows the heart rate down. So every time you take a breath in your hurry jumps up a little bit every time you take a breath out it goes down a little bit. So if I'm all during my respiratory rate on then altering my heart rate and this is why things like HRV are so intrinsically tied to things like respiratory rate.
Let us move off this point without saying one final thing. I know we
want to get to our three eyes here in one second.
But a lot of people are aware and in the coaching world people use HRV very often and there's a lot of data to support this. There's a lot of critical
information we can get for assessing say exercise volume fatigue Readiness and things like that tons of value there, but I
don't think enough people are paying attention to respiratory rate.
This is really highlighted in a paper that just came out and the last few months and so I'd like to
bring this to your attention.
What they did is looked at College age
students and then simply measured their
respiratory rate and one of the things that they found that's interesting is for every breath
per minute that increase so if a respiratory rate went from 15 breaths per minute to 16 breaths per minute, they increase their likelihood of experience stress by one point two five x
and what I found particularly interesting about this is they found that irrespective
of changes in things like a charm
Total hours of sleep sleep efficiency, sleep onset and various other things that are typically the metrics used
to measure overall stress and autonomic nervous system functionality and things like that.
And so we're we're going over here
is not to say that HRV or sleep or not good metrics to take they clearly are
it's that you're going to find things in the
respiratory rate that you're not necessarily going to see in other places that give you
great clues
about overall stress. So strongly encourage you to pay attention to respiratory rate and we'll talk about
about that plenty in the future. So
at this point we've now got a much better understanding of
why our cardiovascular system matters to both
performance and health. We know a little bit more about how it contracts of some of the
unique properties that exist within it that differentiates it from some of our other tissue like skeletal muscle
and then of course we've learned why we breathe and how that
relegates many other functions like our sleep recovery, and of course overall performance using all that we can now discuss
The three eyes which are how do I investigate? How do I interpret? And then how do I intervene on improving my cardiovascular fitness? Let's start with the first I investigate
now, depending on the metric you're interested in something like a heart rate can be done with no
technology whatsoever. You can simply put your fingers up to your neck
count your heart
rate divide that by the time domain and get your heart rate. He's example their
most classic when we teach
is start a stopwatch countdown.
How many times your heart beats in 15 seconds multiply that by 4 and then you'll understand how many beats are taking per minute. You could also simply just measure it for one minute count those numbers and that's fine.
But in reality most of you probably have
some sort of Fitness technology app or watch or something of that sort that's going to tell you that number already
as far as things like HRV
and respiratory rate. We're going to have to cover those in their own individual episodes as you've got a lot of options and there's some context there. I will tell you again.
Most Fitness technologies will give you some inside of that whether directly on the app or something you can get if you dive in to the data a little bit further HRV is really challenging though because there's a lot of ways to measure its not standardized and there's just a lot more context we have time to get into right now. So unfortunately we're going to take a little bit of a pass on that respiratory rate is actually quite simple. You probably want to focus and least initially on respiratory rate over night rather than during the day but both are acceptable as well.
Now and again probably already coming in any of the technologies that you may be using to track your sleep recovery or performance or anything else. So I'd like to focus most of our attention here on the cardiovascular stuff that we spent most of our time in our conversation with and get into some of those details right now the gold standard to measure your VO2 max is going to be in a laboratory with a metabolic cart. You can get this stuff in various equations. You can use any of your Fitness Technologies. I will strongly
Encourage you though that if you care about this number
if it's possible and it may not be spend a couple of hundred
dollars and get this actually tested in the laboratory the data are quite clear at this point. I have not yet seen really any standard over-the-counter Fitness technology that gets an accurate number of your VO2 max when the number gets high and particularly for people who are already fairly fit if your VO2 max is really low and might give you a decent number but folks that are kind of moderate idly.
Trained it's just really challenging to get an appropriate estimate from a watch or a ring or things like that. Perhaps those will improve in the future. In fact, I quite expect them to but as of now the margin of error is a little bit too high for me to be comfortable with when you care about accuracy. If you're trying to just get a global sense. They're fine. In fact, if you want to do that, you can use any number of absolutely free estimate equations examples of this would include something like a two minute step test where you would take your heart rate step up and down on a very small box.
Say 12 inches or so you do that because continuously for two minutes and then measure your heart rate at the end. You
can enter that score
into an equation and get an estimate of your VO2 max. Those are scientifically validated methodologies. The 12-minute test ends up being something like a mile-and-a-half run. So you could simply in fact you can do this if you'd like as well run a mile and a half as fast as you can take that time enter it into occasion and get an estimate if you have that time as well as your heart rate you can enter
It in as well and get a more accurate
picture. And so again, all of these are closed we call these
submaximal estimates because they are that they are not the direct measure.
So I would encourage you again if
at all possible to actually go into a laboratory and get this measured
in addition. If you do something like that, you can get a bunch of other
metrics. You can't get with them as some of these estimate equations,
like what percentage of fat versus
carbohydrate you're using your anaerobic and lactate threshold.
Your maximum ventilation. So how much total are you can bring in and out and a bunch of other stuff that we talked about on the show and we'll get into in a second
again. If you don't have access to any of that that's
fine. Use any of those other free or extremely low cost options and you'll get yourself pretty close. Our next I is interpretation. So sticking with heart rate and VO2 max
as I mentioned a little bit earlier resting
heart rate will go down as you improve Fitness, but your maximum heart rate will not really change.
And in fact, if anything, it will be reduced because you're a little bit older.
And so to say that one more time. There's no real
association between highly fit people and their maximum heart rate and unfit people.
So it's not a metric that we should be overly
concerned about of you know, where is your maximum heart
rate? It is relevant to again your stroke volume,
but the heart rate itself is not going to tell you that much so not something to be concerned about your resting heart rate though or your heart rate at any given intensity.
Is very important. So if you're going to be running say a standard Pace say 7 mph and your heart rate at seven miles per hour was 150 beats per minute
and now a couple of
months later your heart rate at the exact same speed as now 115 bits per minute that would represent a significant Improvement in cardiovascular fitness stroke volume would be much higher and because of that that allows your heart rates come down
resting heart rate is a similar story giving you a little bit of context here. And the reason this is
top
Of mine is because there's a humming bird that lives in my backyard in my wife and kids look at it every single day and they get so excited. They call her mom's Little Helper. They named it squirt actually and so they get really excited when this little hummingbird is flying back there because it's super fast
hummingbirds have a resting heart rate of something like
1200 beats per minute.
It's absolutely insane. So you're talking about
putting an order of magnitude on top of almost a human maximum heart rate you contrast that to a larger animal like a giraffe and
Found her a blue whale and you're talking about a heart rate of something like five to six beats per minute.
And so humans, of course our are somewhere in
between if you were technically to Google this you might see something like a normal resting heart rate is 60 to 100 beats per minute. I am here to tell you. I cannot fathom a situation in which somebody's resting heart rate is over 80 beats per minute and they are healthy and I absolutely would not think that that would happen if somebody who's performing at their maximum. And in fact I even will tell you this is off the Record.
This is not the science. This is me and my
professional opinion even a resting heart rate of 60 or
so. Particularly in a man is that's catching my eye I would like to see most folks probably in the 40s to 50s somewhere the range again, you might be fine as 60 but getting much above 60 is quite a bit High. I also personally tell you I've worked with plenty of athletes specifically in this case several UFC fighters whose resting heart rates were in the
low 40s.
If not high 30s, so 37 38 40 things like this.
That's the lowest. I have personally seen that said there are
classic stories of plenty of endurance athletes. You're talking about Elite cyclists and cross-country skiers and marathon runners and sector
who are in the low 30s lowest. I'm aware of
is the the legendary cyclists Miguel end around having a resting heart rate of Twenty Eight beats per minute. As far as I can tell
that's the lowest ever
reported in the scientific literature though, please if you've seen any lower, let me know.
I'm sure there are plenty of stories of anecdotes of people and personal training records and stuff who think they're lower but if you've ever seen anything verified scientifically, I would love to see that
interpreting. Your VO2 max is more interesting in my opinion because there's a lot of components to it. And so in order to not truly understand this let's
talk about how we calculate vo2max to begin with the
easiest way in my opinion is to think about VO2 max equals your cardiac output
X what's called your AV O2 difference.
Now as I've stated cardiac output
is simply your stroke volume multiplied by our heart rate. So if we were to combine this entire thing we would see your heart rate multiplied by your stroke volume, which says
okay how much blood am I getting out /
pump how many pumps am I getting and I multiply that by what's called your AV O2 difference now the a stands for arterial V stands for Venus and the 02 is oxygen. So what literally this means is what's the difference in oxygen?
Is between the arterial side and the venous side remember arteries generally go away from your heart,
which means they're going to
exercising tissue and veins come back.
And so what we're really looking at is saying okay how much blood how much oxygen is in the blood when it leaves the
heart this is going to be the highest concentration of oxygen possible.
And how much is in the blood when it comes back having passed through muscle this then directly tells you how much
oxygen
Your tissue extracted in the process. So to give you some numbers here to make this easy. These are not accurate to representing the math here. If you had 100 molecules of oxygen that left your heart and went into your quadriceps and then once it's gone through the capillaries that surround all the muscles and tissues and fibers in your quadriceps, and it went in is 100 and then it came back out the other side and went back to the heart and lungs to be re oxygenated. Well,
If it went in that 100 and came out of 75 the difference between the arterial and venous side is 100 minus 75 which would give you a score of 25. Now what that means and I'm going to be using those round numbers to make this simple.
You've extracted now
25% of the oxygen that came in your system. You only got 25 percent of it out. That's not a very good score you want that number because it's a multiplier to be as high as
possible. So of 100 goes in I don't want 75 coming out.
Out I want zero coming out. Let's say maybe you got 10 out. So now 101 in 10 came out you extracted a 90
percent of the oxygen that was available to
you and got to bring it into muscle and use it
for everything. We talked about earlier. And so now your AV O2 difference is 90 much higher than 25. So we get the multiply that by our cardiac output which brings our vo2max even higher the easiest way to think about VO2 max is to use What's called the Fick equation
vo2max
according to the thick
In is your heart rate and there are how many beats per minute X your stroke volume how much blood coming out per pump
X what's called your AV O2
difference to be perfectly honest with you. The AV
O2 difference numbers are difficult to
convey over Audio Only. So I'm going to spend most of our time on the other side of the
equation when it comes time to interpreting your VO2 max numbers. There's a lot of
charts and papers you can use will provide some of those in the show notes for you want to give you some numbers though to give you a rough context?
Typically, we think about vo2max and what's called a relative term now scientists and people that are more advanced was filled might like to use the absolute versions depending on the scenario that make more sense.
But for now, let's just stick to the relative what that means is how many milliliters of oxygen are you using per kilogram of body
weight per minute. So you'll see them expressed as things like your VO2 max is
50 milliliters per kilogram per minute. So 50 mL of
oxygen per kilogram of body.
Wait a minute.
You can kind of think about vo2max almost on a scale of 0 to 100. And so the average person that would kind of say walk out of my classroom somewhat
moderately trained male or female that's you know in the neighborhood of 170 pounds or 70 kilos something like that
is probably gonna be able to Max around 35 to 45. Ml per kilogram per minute
something in that range.
If you fall below 18 milliliters per kilogram per minute.
You're probably Crossing below the threshold.
Hold of what we call Independence for women, that's about 15 or 16
which means it's very difficult to live independently and by
yourself because your Fitness is solo going through basic activities of daily living become
challenging. So what I like to share with you is not only the normative values but also the highest we've ever seen in terms of VO2
max cardiac output and stroke volume.
Now, there's so much data on vo2max. We can actually break this down by age and by sex in really
specific
Vic number so
if you know your exact
age, you can go ahead and look these up in the discharge, but I'll give you a couple again just to give you a
ballpark. Let's say you were a female
between 40 and 49 years old and your VO2 max was 28 that
would put you as what we consider to be below average if you wanted to go
from below average to average you'd have to go into the 32 to 36 milliliters per kilogram range
if you wanted to go all the way to Elite tell me. What's the best
ever you?
Be needing to surpass the mark of 47 ml per kilogram per minute any of you that are maybe older. Let's go ahead and jump way down. Let's say you are 71 years old
again. Talk about 71 year old female here below 18, you know, you're still above that line of Independence, but it would still be considered low. You would really want to be looking at something like 20 to 24 to be considered above average and then really over
36 to be considered lead now. I
know my friend
Tear likes to tell people he wants them to be considered Elite
in at least the decade before their actual
age. If not two decades before
and that's a phenomenal way to think about it. So just as an example, if you were that incredibly ambitious and vigorous 71 year old Elite for you would be 36 milliliters per kilogram per minute the decade before again 60 to 69 that would be 40. But if you wanted to be that extra person and get that double gold stamp
from from Peter you'd want to be above 40.
6 so the difference is going from 36 to 46 with give you that Elite category for two decades younger than you
for the men. It's a similar story. You just
add a little bit of numbers to it. So a male who is say between 50 and 59
years old above average would be 36 to 40 milliliters per kilogram per minute and you need to be above 50 to be considered Elite at that age. Now in my personal opinion. I kind of like to say there's no excuse to be under
Unless you're over 50. Meaning you have no reason to be having vo2max of lower than 50 unless you're over 50 years old and even then 50 to 60. I don't want you anywhere near below 50. So that's a nice number to go after will also talk about a second how changeable that is and how much it
responds to various types of
training. And so it's going to give you a little bit of hope you have some room to move there and it will respond to your
training and so there's some light at the end of the tunnel if you're looking at those numbers and you've had a vo2max done.
Recently and you're thinking oh my gosh, I am way below
when Andy said there that's fine. You still have within your
capabilities to change that. Now while I
said that those are technically Elite and would probably put you in the 99th
percentile. They aren't necessarily the highest we've ever seen. In fact, it is very common to be much much higher than the scores. I just
described. So as always I love to share with you what the best in the world are it's important for us to reset our standards and
Recognize and challenge what we think is possible and to not accept just being in the 99th percentile. Let's see what it's absolutely possible and human physiology and those numbers and scores go far
higher than that 55 and 60 just described.
So for many many years and history the highest documented
vo2max that we would
acknowledge scientifically was from an Austrian cross-country skier. Now, this study was actually published about
four years prior
to him than winning a gold medal.
Well and the Olympics
and so he was obviously a very high-profile in highly successful athlete
he came in if you know these values. If not, that's okay with a hemoglobin
concentration above around sixteen point eight, which is outrageous most folks are going to be 14 or 15 or something like that. Hemoglobin is the molecule that carries oxygen around on your red blood cells. So innately, he's got a huge ability to do that. His VO2 max was reported to be 90 point six milliliters per kilogram per minute, which is incredible so that actually stood
Around for a very long time and people thought that that's basically it again there have been talks of people in the 92s 93's and stuff like that, but nothing had really been independently verified whether you think that's important or not hard to know, right?
Until a few years later and this
is one of the most miraculous and cool
stories. I ever remember being a part of in fact. I remember when this happened live and it was fun for me getting prepared for the show to go back and read the updates on this individual because it was such a stark and and massive change its it
was one of those LeBron
James or Tiger Woods moments for the endurance and exercise physiology world's guy came on. The scene was an absolute Phenom. What I'm talking about, of course is a story of the legendary Norwegian cyclists Oscar svendsen.
Oscar came on as an 18 year old that I remember hearing these murmurs coming and people were saying some kids some eighteen-year-old just hit 100 on a VO2 max score and everyone was like no way again. We've heard all these stories before may or may not be true and everyone was basically like, okay prove it prove it. You've got to do it in a verified way. We got to send some independent scientist out there. In fact, they sent the manufacturers for the the metabolic Cart Company out to the facility that says you need to be here need to verify this thing as a
Great. Nobody really believed it. Not the first time we had heard stories like that.
And so of course actually that the team
out there that was coaching him connected with a guy named Mike Joyner. Mike is a legendary exercise physiologist at the Mayo Clinic one of these
people actually use probably potentially published more in this area did a lot when we were considering in early
2000 whether or not a two hour marathon is even physiologically
possible Mike that a lot of these
calculations so really involved the film
they connected with Mike they published this paper and it turns out that they were actually able to verify that Oscar was able to hit a vo2max of 96.7 milliliters per kilogram per minute. If you're more familiar with absolute terms would be an absolute of 7.4 liters per minute. Just phenomenal phenomenal record.
What's also really interesting about this story is he actually
retired just a few years later at the age of 21 or 22? I think
he has some success and competitive cycling but
perhaps not as much as one would think given his VO2
max was so extraordinary.
I think this is also an interesting message, right it tells you this is one of the reasons why we love sport. It's just because you have some physiological
parameter you're tall or have
some skill that doesn't necessarily mean you're always going to win
endurance events are
based on more than just vo2max and Sports in general have a lot of things going on in them besides just physiology. I love physiology. I'm obsessed with it, but it's also why I love watching sports because you never know what's actually going to happen the world record for
Vo to Max for females is also phenomenal
impressive this belongs to of course
the iconic Paula Radcliffe, or
she had a vo2max reportedly of about 75 milliliters per kilogram per minute.
If you're unfamiliar with
Paula multiple time world record holder in the marathon
again, iconic is maybe even
not enough to describe how successful and talented follow us. She reportedly ran somewhere in the distance of 140 to 160 miles per week. And this is actually really cool because this is a
Document that you can go look up she had a very
well
respected and known exercise physiologist Sandy Jones. He's actually one of the gentlemen probably most responsible for bringing beetroot juice and Arginine and things like that on to the scene from a supplementation and nutrition perspective. But Andy worked with her for I believe almost 20 years and was able to document her training and her performance and metrics and things like that. So was able to take her through a bunch of world records and so has this stuff as something you can go.
Download and take a look at before we move into our final category of intervention.
I think it's important to give you some context. I realize many of you are probably familiar
with a vertical jump test a 40-yard dash. Maybe you're one at max bench, press those numbers kind of make sense.
Perhaps these ones they
have less context for you. It's hard to grasp how impressive they are
outside of seeing how much
bigger are higher. These numbers are for world champions road to the rest of us. The numbers don't make a lot of sense. So
what I've done is is of
A couple of quick calculations here to give you a little bit of context of what it means physiologically to
have a VO2 max is high what that means in terms of how much blood you're pumping throughout your system how efficient your muscles are getting that in and so just as a couple
of examples when I hit you with some fun numbers here as we talked about earlier a standard cardiac output at
rest is something like 5 liters per minute
and remember cardiac output is
heart rate X stroke volume. So if we assume a resting heart rate of 60 beats per minute, and we wanted
to get to that number of call at five liters per minute that would mean your stroke volume would need to be somewhere in the area of about 80 to 90. Ml. All right now for some of you depending on where you're at ml make complete sense those here in America, maybe not and so I've converted that at something in the neighborhood of like, you know, just under three ounces. And so while you're sitting here resting every time your heart is beating is kicking out about three ounces of blood every time.
Watch how high this number gets when we get the maximal exercise in the case of these phenomenal athletes like Paula or Oscar. We don't actually know their stroke volume, but we can run some quick calculations and get a pretty close estimate. Oscar would have had to be in the neighborhood of about 225 ml at his max to reach the cardiac output of around 40 to 45 litres to give him a vo2max in the 100 or so. Ml per kilogram per minute. I get I know I'm moving from liters to milliliters so run the
Ask yourself if you want to challenge that number
on the back end. As I said
AV O2 difference is really kind of complicated. So
most people are probably in the neighborhood of about 70 percent extraction rate.
So of all the auction going into tissue, they're able to get about 70 of
it higher trained athletes though are looking something more like
93 94 95
percent and so the ability to extract get it into tissue Which is
far higher than the average person in that 70 to 80% range coming backwards into stroke volume
and
We assume that he or she is in the neighborhood of like, you know 200 to 225
ml or so. This is what that math would look like. So if we'd said Oscar was call him 20 years old to make math a little bit
easier. His predicted maximum
heart rate would be about 200 beats per minute. If you're not familiar with that equation if you take 220 subtract your age and that gives you a very rough and place. This is just a rough estimate of your maximum heart rate,
but I
Maximum heart rate of 200 beats per minute is
maybe a little higher than what you'd really see but not out of the question. So if we took 200 multiplied that by
225 that stroke volume so heart rate multiplied by the stroke volume, that would put us right near that 45 litres per minute Mark again. That's the highest
I've ever seen in terms of cardiac
output perhaps there's some conditioning and endurance coaches out there that have seen higher but but that's that's phenomenally high. In fact again many of the best performing endurance.
It's ever are still in 40 42 liters per
minute. And so Oscar would have had to again be able to get at least up to 200 beats
per minute. And if not, if he could only say get the
190 his stroke volume would have had to been even higher than 225 what that functionally represents for those, you know, not familiar with the metric system 45 litres per minute is just under 12 gallons of blood pumped per minute throughout your body.
I'll say that one more time 12 gallons of blood being pumped throughout your entire body every single minute another way to think about that that 225 ml is around seven point five seven point six ounces. So if we go back to earlier remember when I said you're kicking out, you know, something like under three ounces per contraction now you've over doubled that number, right? So you giving you know half a bottle of water out / pump, but you're pumping three times per second remember?
Heart rates no longer at 60 beats per minute as in one beat per second. It's over triple that
so you're beating 3.3 or so times per minute. So you're not getting out seven point six
ounces per second. You're getting that out / pump, but what
you're really getting out is closer to like 25 or 26 ounces per second.
General water bottle is 12 to 16 ounces a large one is 20 you're doing that entire thing every second
that you're exercising and that your heart is
beating if you were then to extend that throughout the entire minute, it would mean you've pumped over fifteen hundred
ounces in a single minute through your heart.
I don't know if and how any of that information actually helps your life. But me personally find it just endlessly fascinating to think about not only the performance
side.
This equation right how fast can I run a marathon and things like that
and that's really awesome and cool. But what's the physiology behind it? What does my body have to do to enable something like
that to occur and
thinking about the fact that man I'm gonna have to pump 12 gallons of blood through my body per minute to be able to execute on something like that me that's
that's maybe even a bigger Joy than seeing somebody perform a race at a certain time both equally impressive and fun, but
Love to see the physiology behind that
to round this entire story out. Let's move on to our third and final
I which is intervention. In other words. What can you do about these things how much they change and what do I have to do to see improvements in them?
If we work backwards through this
vo2max equation as we've talked about
can we see improvements in our av O2 difference? Absolutely how so were primarily looking for a couple of things one
increase in capitalization. So the amount of capillaries in are exercising
muscle and
Or some sort of
combination of improved mitochondria
size or content. If you do those things, you'll be better at extracting the
oxygen that's coming in into the tissue as well as utilizing it to go through aerobic and anaerobic recovery metabolism
back off of that. We now have stroke volume. And in fact, one of the things that makes this interesting is as we go towards maximal exercise and start improving our stroke volume. We start to run into a little bit of a problem you see if our heart
Is too high we don't have enough time to fill the ventricles in the arteries back up with blood. And so we start actually reducing our stroke volume. And so this is one of the reasons why you would not actually
want to have your heart rate continue to increase as a training adaptation.
It's now at the point somewhere around 200 beats per minute or so where it's compromising with called filling time. If
you don't have enough time there we can't get enough blood in so while you have extremely strong tissue
and you can pump a lot
lot of blood out of their / pump. Your ejection fraction is massive, right? You're getting all the blood in the left ventricle out of there every single time. You can track you have got to have some physical
time to actually fill it up.
And so you will see
adaptations in the heart tissue itself. In
fact, if you look at the actual size of the left ventricle kind of an average number to
think about there is like 150 grams or so in a non-athlete where it may be upwards of 200 and an
athlete is something that we see respond and
is
Generally Associated as a positive adaptation to exercise
and so we know we need to increase the strength of the left ventricle as a starting place. If we do that that will
allow or actually produce and result in an increase in stroke volume.
So what does that mean for training? Well fundamentally outside of things like exercise technique and timing and
nutrition and all that other stuff if we're just talking about the background
physiology. We have two Avenues or areas to
Push on to improve our vo2max we have our
stroke volume
and our av O2
difference. So there's a lot of ways we go about improving both of them. I am of the opinion
that you need to train across a wide spectrum of exercise intensities
to optimize both factors. If you in fact look at Classic training logs of endurance athletes going back to even what we know about Oscars training, they are typically going to spend something like 70% or so of their time.
At a low intensity. What's that mean exactly depends on the athlete, but you're probably talking about something like between 60 to 80 maybe up to 82
percent of their heart rate Peak.
Most of their time is there I'll explain why in a second then you've got another additional maybe 20 to 25 percent of your time being
spent at a moderate intensity typically something like again 82 to 90 or so percent of your her a
peak and then 32 maybe six percent of the time.
I'm
at the remaining higher heart rate. So this is 92 93 percent or so plus
the reason I'm giving you kind of rough guidelines. There is every scientific paper has those zones if you will a little bit differently all kinds of different endurance coaches historically have set different landmarks. And so there's no exact numbers there. And so as a very rough guideline, I think it is very safe to assume some split like that.
Should be highly effective at improving your VO2 max. What's that mean in terms of exercises? Well, actually it's entirely up to you VO2 max is rimmer depending upon how many mL of oxygen per kilogram of muscle per minute which means the more muscles you utilize the higher the VO2 max has if you were to go to get a VO2 max test done and let's say you were not specifically trained on like a bike.
If you want to get that same exact
test done on a bicycle versus a treadmill where you're running versus cycling.
The score on the treadmill is going to be about 10% or so higher than it is in the bike and that's simply because there's a small
increase in amount of muscles involved.
When it comes to running versus cycling
now, if you are specifically trained on the bike and you cycle a lot that may not actually be the case. And in fact
highly endurance trained folks on site and cyclists rather will score higher on a VO2 max test on the bike then they will on a treadmill but that really is now coming down to test specificity efficiency, like all other things that are that's not what we're trying to talk about here.
And so generally the more muscles involved the more oxygen being
utilized the higher that VO2 max.
So when it comes to training we want to think about the same thing the exercise mode. I don't want to say it
doesn't matter. It is relevant.
But you have unlimited options if you want to
bike or swim or cycle or
row. That's great. If you don't like any of those traditional modalities and you want to use something like an assault bike or pull a sled run uphill drag something. Those are also incredibly viable options is not the exercise per se that determines the adaptation. It's the
Application of the exercise
right the Body Works and Physiology works on a principle called the said principle with stands sa ID which stands for specific adaptation to imposed demand. So you put a demand on a tissue.
To bring in and utilize oxygen at a high rate. It will add that that specific demand. So challenging your muscles continuously to bring in and utilize oxygen at a rapid rate is all fundamentally that needs to happen for you and prove that and so again the mode of the exercise is not that big of a deal. If you are new to exercise, I would generally recommend you being careful of exercises that involve a lot of eccentric action so jumping and Landing because you're going to get really sore really fast, but if
if not, feel free to choose whatever exercise modality or combination of them switch it up a little bit do some cycling do some running uphill jump in the pool really up to you the intensity, which you do that is more like what I just explained as I apologize to the beginning of program. I earlier in my life grossly under appreciated the cardiovascular system as a whole and I certainly under appreciated the importance of low intensity exercise. Also be candid with you here.
I am not as fond of Zone 2 exercises some other folks are I don't certainly don't think it's bad. It is good for you.
I just don't think you need to be that worried about what's exact Zone you're in you want to be something probably in that lower intensity
6280 ish percent of your heart rate. I don't really care where your Miller molars
are in any of those low intensities. You're going to be
challenging the ability to bring in and utilize oxygen over a long period of time
look at any amount of research on that it is
Very clear steady-state lower intensity
exercise, especially over time six months to a
year.
Is generally going to improve vo2max probably upwards of five to ten
percent depending on the person the training history and other contexts like that.
So it's very very effective and something I have absolutely Incorporated more and more into my world my life personally as well as my coaching practice. So really important to do that stuff on the other end of the equation you can do things at an extremely high intensity for a short bow, depending on the study you want to pull here you can see things like high intensity intervals this
It'd be a combination of 30 seconds of maximal exercise resting 30 seconds and repeating that anywhere between like four and 12 times can equally improve VO2 max if not, greater and more so than your steady state exercise.
There's a lot more context that go into that. It's not
necessarily meaning high intensity is better. There are some
significant downsides and concerns with only doing high-intensity exercise. Another thing. I've
changed my opinion on
and so I think we want to use high
intensity exercise. There's clear benefit there.
It's fundamentally different though than low
intensity exercise. So we're challenging a different part of the system, which is why I am going to argue. You should be incorporating
both. Most
of the time doesn't have to be always in all of your training
but you wouldn't want to leave either one of these things entirely off if the pure goal here
is to maximize the 02
Reason is when you do something at a higher intensity the point of failure in the tissue becomes different. So extending my ability to move at a lower or moderate intensity for a long period of time is challenging different aspects than it is when I asked it to introduce any tremendous amount of fatigue. So I'm now in the anaerobic metabolism when I'm going really hard and really fast I can't use oxygen. So I'm building up a ton of byproducts pH is being
Herb potential damage is happening. All other things
are occurring CO2 is getting extremely high.
That's all enhancing my ability to deal with that is a similar thing in
terms of increasing mitochondrial
biogenesis. So more
mitochondria higher functioning mitochondria larger model Condrey increasing aerobic capacity all of these same things occur.
And so again, I don't want to make the argument that one
Higher intensity or low intensity is better than another I think you should do both.
I will make the same argument for modern intensity.
Well that isn't as specific and precise in terms of what it's challenging. It's reasonable to build some of that into your equation as well. Another thing you're going to find commonly and the research is a longer bout of intervals. The this is described in a lot of different ways a good friend of mine and an expert and endurance physiology Joel. Jameson has talked a lot about high intensity
continuous training H IC T. If you're not familiar with our stuff, I wouldn't
Urge you to look it up. It's very very
effective. Lots of different things and tools we can pull out here one example would be something like let's go. What a classic Runner would do is something more like one mile repeats. So
run a mile as fast as you can this is going to take most folks, you know, six to eight or nine minutes or so. However long it takes you to run that mile rest that same amount of time. So it's a one-to-one work to rest ratio. So six minutes of running
six minutes of rest, and then you repeat that.
Again for a total of
two or three or perhaps for repetitions.
That's a very long workout in the average
person would not be able to do that. But those
of you that are not average and our that are good too high too strong
performers listening right now. That's
absolutely within your capabilities and proper fact, you've probably done it before it doesn't have to be that extreme. You could use shorter durations. Say two minutes three minutes four minutes is a
very very common one. You'll find in research. So
four minutes of all out exercise
four minutes recovery, repeat it again, too.
Four times
what's critical to understand here is these work when you're actually achieving a maximum in that
time domain so you
can't do four minutes at 70% rest for 4 minutes and do that again, that's going to bring you some
calories and has other benefits of just making you feel better today and some other stuff like that. But
in terms of VO2 max, that's probably
not the most efficient thing you can do
so to summarize all of that stuff spend a good amount of
time at a lower intensity.
That's going to drive efficiency common adaptation there since it's going to be the highest activity you can do to maximize utilizing fat for fuel. You're still going to be burning primarily carbohydrates. Don't get that confused. But that's the best way to burn some fat. So this is typically associated with higher metabolic efficiency getting better at using fat as a fuel source and things like that. It's also easy to recover from it's not going to change your autonomic nervous system that much so you typically
we don't see big drops in HRV scores. We don't really see as much over training or non-functional over reaching elevations and respiratory heart rate other signs of hunger fatigue not want to train things like that doesn't really happen. When we spend time at lower intensities higher intensities are phenomenal really really really time efficient, but they've got consequences as well. They're going to be entirely or mostly anaerobic which is okay, too.
Because you're still use the aerobic side of the equation to recover from that so super important,
but there's a price to be paid their people can run into
problems and you will you're more likely to see issues with those metrics. I just
described if you're doing too much intensity too often,
especially if you're combining this
with a normal stressful life. So you're doing this kind of exercise then you're going right back into your
day job, you're having
difficult meetings, even if they're exciting and
Happy meetings. You're thinking hard. You're working. You're going back to Fourth and year and I
kind of a long high stress environment all day
really really challenging on the system to be in that high of a stress at all times. So
other ways you can mitigate that we can talk about
those in future episodes, but just wanted to say while
high intensity exercise is very time
efficient. It's not necessarily a free pass either
low-intensity not a free pass either. It's going to leave things on the table that you're missing. So it around all that up again. I would recommend and
Nation of lower intensity
moderate intensity and high intensity
training the mode of the exercise
in terms of the
what you choose bicycle kettlebells circuit training is
entirely up to you spin class. Whatever you'd like to do
frequency can be as high or as low
as you'd like there are plenty of studies
showing kind of the higher intensity stuff done two to three times per week can improve VO2 max, but you can also do the lower
intensity stuff everyday
or combination. So really you can modify this.
This based on your lifestyle and what's going on and finally rest animals, they're not incredibly applicable here. In fact, we've already
baked them in if you're not doing intervals, then there is no
reasonable. If you are we typically look for something like a one-to-one work to rush ratio, but you're welcome to do 2 2 1 1 2 2 or any
combination of that
if you trained appropriately and of course, you've got all
the other factors like your nutrition and sleep and Stress Management under control.
It's not
unrealistic to expect a 30 to 50 percent Improvement in VO2 max.
It's after 6 to 12 months.
You'll find plenty of studies that land in that ballpark the rate of increase
obviously goes down as you become more and more
trained now candidate. You don't have the ability to improve your VO2 max probably as much as you do something like your strength, but you can improve it significant unless you will find plenty of studies showing even a ten to twenty percent increase and highly trained individuals after a year.
An untrained folks that probably takes about
half that time so 10 to 20 percent Improvement in four to six months or so.
So if you know what you're at right now, you trained appropriately fairly consistently again, those are reasonable numbers to
expect after half a year or so of training
and as we understand it the biggest limiting factor at this point is probably the time needed to fill the ventricles back up with blood. I know we covered a lot of ground in this episode and I hope you had as much fun listening
to it as I did talking about it.
But before we walk out here, let's quickly recap.
Recap what we discussed most importantly we talked about why you actually breathe how you can pull a heart out of a living
animal and it can continue to beat on
its own and why your heart unlike any of
the rest of your muscles never gets or
along the way of course we talked about what your heart is why that
tissue is special and
unique and how it functions. We talked specifically about your VO2 max how to test that score how to know where you are that spectrum of good great. Terrible Elite and then really,
To do about it at the end
and covering that stuff. We also gave some hints about things like
CO2 tolerance how that influences sleep and Recovery respiratory rate HRV
and a number of other factors that are not directly but highly
associated with overall cardiovascular health.
If you were of my opinion
when I first started my full rate and exercise physiology and you
didn't really give cardiovascular
health and performance the credit it
deserved. I hope that I've changed your mind a little bit and warmed you up to it.
It if you're the opposite direction coming in being a champion
of the cardiovascular system. I hope I just gave
music to your ears and let you double or triple down on your joy and biases towards the heart and its importance in overall health and physical performance. Thank you for joining for today's episode. Our goal is to share exciting scientific Insight that helps you perform at your absolute best if the show resonates with you and you want to help ensure this information remains free and accessible to anyone in the world.
There are a few ways that you can support first. You can subscribe to the show on YouTube Spotify and apple and an apple and Spotify you can leave up to a five star review given that we're a new podcast subscribing and leaving a review really does help us a lot second. Please check out our sponsors the show would not exist without them and they really are exceptional products and services. And then finally you can share today's episode with a friend who you think would enjoy it. If you have any content questions or suggestions, please put those in the comments.
A section on YouTube. I really do try to read these and see what you have to say. I use my Instagram and Twitter also, exclusively for scientific communication. So those are great places to follow along for more learning. My handle is dr. Andy Galpin on both platforms. Thank you for listening and never forget in the famous words of Bill Bowerman if you have a body you are an athlete.
