The tide turns on vo2max?

#61

Yes, there were a lot of zone 1-2 stuff at high levels - but there was very little zone 5, HIIT, and type of strength training that we do today - most of evolution was not while we were farmers or had fire

(So there is no risk of misunderstanding I think a lot of things can be good even if not part of evolution, like HIIT/zone 5, strength training)

More importantly though, there were a lot of breaks from being in revved up calorie burn mode from high “exercise” periods and abundant food and often calorie deficits and (forced) fasts due to famine, etc were the norm. That is the type of second state that I’m talking about the scientific aging field has a general consensus of being important to enter often/sometimes.

Where in the life of the top % of VO2 max trainers (ie not just high VO2 max, but the very highest ones and people going way beyond 5 hours a week of exercise) are they able to enter optimal autophagy, mitophagy, etc? Those are also types of things that if one has decades to be exposed to vs decades of not being exposed to likely will have a big impact on someone approach their 90s.

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#62

This I agree with.

And think it might actually be that the optimal is closer to 5 hours than 10 hours or more.

People will get a massive exercise generated health boost to both healthspan and longevity at 5 hours in my understanding, but will likely risks the net effect diminishing and eventually facing a negative effect with ever increasing doses of exercise (and all that comes with that).

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#63

I posted two studies on this thread that literally refute the notion that anything over 5 hours would be harmful. If you have studies that prove otherwise, post them.
I was reviewing multiple studies for years because of my own of fear of ending up with A. fib, but if you execute it correctly and stay under 10-15 hours there is only a ton of benefit to reap.

Below is yet another study that apparently points to 10 hours of moderate exercise (that’s my Zone 2) as maximum benefit. However I have read a great JAMA or NEJM review article that took that number to as much as 15 hours, I can’t find that article for the life of me.

https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.121.058162

Long-Term Leisure-Time Physical Activity Intensity and All-Cause and Cause-Specific Mortality: A Prospective Cohort of US Adults

Dong Hoon Lee,

Leandro F.M. Rezende,

Hee-Kyung Joh,

NaNa Keum,

Gerson Ferrari,

Juan Pablo Rey-Lopez,

Eric B. Rimm,

Fred K. Tabung and

Edward L. Giovannucci

Originally published25 Jul 2022https://doi.org/10.1161/CIRCULATIONAHA.121.058162Circulation. 2022;146:523–534

Abstract

Background:

The 2018 physical activity guidelines for Americans recommend a minimum of 150 to 300 min/wk of moderate physical activity (MPA), 75 to 150 min/wk of vigorous physical activity (VPA), or an equivalent combination of both. However, it remains unclear whether higher levels of long-term VPA and MPA are, independently and jointly, associated with lower mortality.

Methods:

A total of 116 221 adults from 2 large prospective US cohorts (Nurses’ Health Study and Health Professionals Follow-up Study, 1988–2018) were analyzed. Detailed self-reported leisure-time physical activity was assessed with a validated questionnaire, repeated up to 15 times during the follow-up. Cox regression was used to estimate the hazard ratio and 95% CI of the association between long-term leisure-time physical activity intensity and all-cause and cause-specific mortality.

Results:

During 30 years of follow-up, we identified 47 596 deaths. In analyses mutually adjusted for MPA and VPA, hazard ratios comparing individuals meeting the long-term leisure-time VPA guideline (75–149 min/wk) versus no VPA were 0.81 (95% CI, 0.76–0.87) for all-cause mortality, 0.69 (95% CI, 0.60–0.78) for cardiovascular disease (CVD) mortality, and 0.85 (95% CI, 0.79–0.92) for non-CVD mortality. Meeting the long-term leisure-time MPA guideline (150–299 min/wk) was similarly associated with lower mortality: 19% to 25% lower risk of all-cause, CVD, and non-CVD mortality. Compared with those meeting the long-term leisure-time physical activity guidelines, participants who reported 2 to 4 times above the recommended minimum of long-term leisure-time VPA (150–299 min/wk) or MPA (300–599 min/wk) showed 2% to 4% and 3% to 13% lower mortality, respectively. Higher levels of either long-term leisure-time VPA (≥300 min/wk) or MPA (≥600 min/wk) did not clearly show further lower all-cause, CVD, and non-CVD mortality or harm. In joint analyses, for individuals who reported <300 min/wk of long-term leisure-time MPA, additional leisure-time VPA was associated with lower mortality; however, among those who reported ≥300 min/wk of long-term leisure-time MPA, additional leisure-time VPA did not appear to be associated with lower mortality beyond MPA.

Conclusions:

The nearly maximum association with lower mortality was achieved by performing ≈150 to 300 min/wk of long-term leisure-time VPA, 300 to 600 min/wk of long-term leisure-time MPA, or an equivalent combination of both.

Going above and beyond the recommended minimums reaped greater longevity rewards, especially for moderate physical activity. Extra moderate-intensity exercise – 300 to 600 minutes per week – was associated with a 26%-31% lower risk of death from any cause compared with almost no long-term moderate-intensity exercise. By comparison, people who hit just the minimum goals for moderate physical activity had a lower risk of 20%-21%.

Keep in mind that regular joe’s vigorous is athlete’s moderate exercise.

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#64

From the paper

Compared with the cumulative average of repeated physical activity measures, use of a single measure at baseline showed weaker inverse associations with mortality and tended to show a U-shaped association (Table S3).

Eyeballing table S3 looks even worse than indicated here: for baseline and 10 year average the effect is not obviously apparent at all. This is really worrisome, since naively exercise at baseline should be predictive of exercise over the 30 year interval. Because at first blush what I’m seeing here is consistent healthy-exerciser bias (or neglect of geroscience phenomena) combined with no or negative long term benefits. (Other sources of evidence, of course, tell a more complex story).
What did I miss?

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#65

We can nit pick all day long. My main takeaway is that there’s rapidly diminishing marginal returns beyond a few hours a week provided that one is very consistent about it and those few hours are carefully split between running (apparently ANY speed), HIIT, and SIT. Only thinking it in terms of the 80 20 principle. Yes you can probably reap benefits by going over that baseline but if you don’t like that lifestyle, what’s the point? The benefit isn’t really a benefit if you’ve marginally increased your lifespan by over investing every week in hours upon hours of activities you really don’t enjoy. So that’s when it turns into a Rorschach test and everyone will read his own tea leaves. Blessed are those who really enjoy it! In 2019 I signed up for a very expensive gym with trainer led classes and I’m so sick in the head that only having paid for something gets me off my ass to go use it, so I found myself doing kickboxing 2-3x week, something very much like cross fit (HIIT) for another 3x, and yoga / barre / cardio maybe another 2x, each session at ~30-40 min. I hated with a passion how I felt during each class except yoga. I mean hated it… during class. You can best believe that after a few months of this plus basically keto diet I looked and felt great OUT of class. COVID closed the gym and put an end to the experiment but I don’t know that I could have kept it up for life just because I hated doing it and the only thing that kept me to it was a no-show fee after each class had been “booked.” Looking back I think I was overdoing it too, and sprained my ankle a couple of times (with repercussions I’m still dealing with).

If someone asked me, would you keep it up forever to live an extra 5 years…. I’d really have to think about it long and hard. Those sessions I hate add up to more than 5 years cumulatively. Now lately I’ve fallen off the wagon in the opposite direction and I know full well I’m not doing close to enough. Not trying to rationalize the status quo, just getting my head wrapped up around what the ideal would be.

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#66

We simply seem to be talking about different things

  • I believe you are generally talking about all cause mortality metrics (and often over generally “short” periods like 10 years), in populations that are not doing all they can to maximize health and lifespan otherwise.
    The “controls” in those cases are just capturing people who do not exercise as much (or who have more disease and cannot/end up not exercising as much or genetically are less “fit” and do not end up exercising as much or are genetically less fit and do not get the same VO2max benefit from the same amount of exercise).
    These are generally not clinical trials, but just associations and the correlations could hence be coming from a whole range of things.

  • I’m talking about something fundamentally different. Take a large group of people who are really optimizing things based on current understanding of longevity, think about @Joseph_Lavelle , Michael Lustgarten, Bryan Johnson or even me for an approximation - people who are very optimized on sleep, stress, mindfulness, HRV, nutritional content AND nutrient signaling (mTOR, AMPK, IGF-1, testosterone, etc), metabolically optimized, who have taken diabetes and heart disease almost completely off the table, spend time on flexibility / yoga / stretching, etc etc. Imagine a group of these people. This phenotype is generally exercising perhaps 6-7-ish hours a week.
    Would these longevity optimizing controls really do better longevity and health in their last decades and that decade occurring later if they doubled their exercise?
    For that question there are no human clinical studies that can really help us. There are no real populations like this that we can even run association studies on. (You could perhaps look at your blue zones and would see that the super centenarians are not elite athletes nor max VO2max seekers nor massively muscle building, rather are active up to a good, but not extreme level).

The best studies I can (and have been trying to) point you towards is the vast amount of geoscience and aging and longevity research. Look at the hallmarks of aging, look at the calorie restriction literature, look at the nutrient sensing field, look at the papers from the ITP were they draw conclusions on what is common across successful interventions, and so on. How familiar are you with this growing field of research, if I spend time pointing to a serious of papers would that be helpful?

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#67

Amen to that. I have looked at many papers about exercise, Vo2max, etc, and I am content to be doing the level that reaps 90% of the benefits.

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#68

The two other studies posted. You don’t draw conclusions from someone’s theory based on one table, you draw conclusions from all the data from multiple studies with greatest number of subjects.

  1. Conclusions and Relevance Cardiorespiratory fitness is inversely associated with long-term mortality with no observed upper limit of benefit. Extremely high aerobic fitness was associated with the greatest survival and was associated with benefit in older patients and those with hypertension. Cardiorespiratory fitness is a modifiable indicator of long-term mortality, and health care professionals should encourage patients to achieve and maintain high levels of fitness.
  2. An overwhelming majority of studies included in this review reported favorable lifespan longevities for athletes compared to their age- and sex-matched controls from the general population… In particular, our review supports previous conclusions that aerobic and mixed-sport athletes have superior longevity outcomes relative to more anaerobic sport athletes.
  3. Higher levels of either long-term leisure-time VPA (≥300 min/wk) or MPA (≥600 min/wk) did not clearly show further lower all-cause, CVD, and non-CVD mortality or harm .
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#69

None of the study I posted support that notion what-so-ever. Again, you are making baseless statements
Show me the evidence to back up your statement, otherwise you are just posting your wishful thinking. Again not helpful to people that are trying to learn.

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#70

risk adjusted and people with hypertension received the same fitness benefit
Extreme cardiorespiratory fitness (≥2 SDs above the mean for age and sex) was associated with the lowest risk-adjusted all-cause mortality compared with all other performance groups.

Conclusions and Relevance Cardiorespiratory fitness is inversely associated with long-term mortality with no observed upper limit of benefit. Extremely high aerobic fitness was associated with the greatest survival and was associated with benefit in older patients and those with hypertension.

Show me a study of an intervention with 20,000 participants and that reduce the mortality by 5 to 1 odds ratio… THAT’S 500% !!!
Exercise is a powerful longevity tool, I know it’s much easier to pop pills but evidence is very weak for supplements comparing to exercise and they might yet turn out be harmful, like Vitamin E or Niacin in high doses.
Rapamycin seems promising. But pills for me are very small part of the longevity approach. I am personally looking at rapamycin in terms of specific diseases of aging. For me that’s my recalcitrant periodontal disease (currently being studied) and my mother’s MCI (also being studied). Those have very limited treatments and I don’t have luxury to wait for the results of these studies before starting. HOWEVER, if the those studies fail to prove any benefit, I’m dropping it immediately.

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#71

Does not feel like you want us to try and understand each other and rather may me trying to intentionally misunderstand me to shoot down straw men vs discussing the main fundamental questions and arguments.

Feel free to have the last word if you want.

Totally. Do you think anything I have said is saying that people should take more pills (and not exercise a lot)?

I don’t even take rapa (yet), even if I believe that you do. (Which btw, is an example of how you appear to agree that longevity based decisions can be made even in contexts without strong human data of the totally of data and risk/reward is reasonable).

At the same time, I don’t think there is any normative reason to think that hard vs easy matters for human health though - some good things are hard, others are easy (eg lowering Apo B is very easy, but will have a meaningful impact on mortality and probably longevity). Modulating total calories to be in a slight deficit and doing occasional full multi-day fasts are not as easy for me as just working out a bit more than my approx 6 hours a week, but I think doing both types of longevity practices is better than just maximizing exercise.

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#72

I haven’t gone through every study you’ve posted — sorry, the matter doesn’t warrant further digging for me at the moment. I did look very carefully at the supplemental data of the study Attia and his fellow travelers cite as a basis for their claims. The sample was pretty huge and the study well conducted. There’s only a 10-15% delta between the most fit and the least fit once people reach their 70s. So to be sure I am not currently among the least fit and I plan to get even fitter but the cost benefit calculus doesn’t work for ME personally to try to make it into the upper quartile.

Not sure why you keep accusing me of derailing other people’s decisions reading this. I’m only sharing my own calculus and I fully acknowledge that depending on how much one enjoys the sorts of activities that up VO2max, that calculus could look very different to mine. Also if anyone makes their exercise decisions based on what I, as an anonymous commenter, muse about out loud, that person is vying for the Darwin Award, not a chance at the longevity Olympics—besides I’m not THAT persuasive.

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#73

The biggest problem with using Vo2max as a marker of our fitness is that it is both expensive and inconvenient. You can get a lung capacity measurement using a spirometer available for less than $100 and use it to keep track of your training. Lung exercise apparatuses are also available for less than 100$.

“Lung capacity can provide a rough estimate of VO2max potential.
Direct measurement of VO2max via maximal exercise testing is the gold standard.”

I see no evidence of any 100-year-old claiming that intense exercise and a great Vo2max were responsible for his good health and longevity.

Some of the longest-lived people are Indian yogis. They are not running, bicycling, etc. Instead, they eat little, meditate, and do yoga exercises, none of which raises their heart rate very much
There is evidence that they can increase telomere length or at least slow down its age-related shortening. They do this despite not living in a “Blue Zone”

“Mindfulness, meditation, and yoga have garnered growing attention for their potential influence on cellular aging and longevity through their impact on telomeres and telomerase”
There are many different forms of yoga with some having odd beliefs. I remember reading about a yogi who said you are allotted a certain amount of breaths and heartbeats.

I’m not a yoga practitioner myself and it is not for everyone. I tried it for a while as a teenager but didn’t stick with it as an adult. As for meditation, I have tried it many times including in a guided class. It may be great but I just fall asleep.

Vo2max:
For Men
18-25 years old: >45 mL/kg/min
25-35 years old: >40 mL/kg/min
35-45 years old: >35 mL/kg/min
45-55 years old: >30 mL/kg/min
55-65 years old: >25 mL/kg/min
For Women
18-25 years old: >38 mL/kg/min
25-35 years old: >35 mL/kg/min
35-45 years old: >32 mL/kg/min
45-55 years old: >28 mL/kg/min
55-65 years old: >23 mL/kg/min
This is certainly not cost-effective or convenient for the average person.

The contest for advocating an ideal Vo2max is more like bragging. “See what I can do!”

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#74

I don’t even take rapa (yet), even if I believe that you do. (Which btw, is an example of how you appear to agree that longevity based decisions can be made even in contexts without strong human data of the totally of data and risk/reward is reasonable).

I made it very clear my role for rapamycin is off-label use of a prescription medication for a medical condition where rapamycin is being investigated NOT for longevity.

At the same time, I don’t think there is any normative reason to think that hard vs easy matters for human health though - some good things are hard, others are easy (eg lowering Apo B is very easy, but will have a meaningful impact on mortality and probably longevity). Modulating total calories to be in a slight deficit and doing occasional full multi-day fasts are not as easy for me as just working out a bit more than my approx 6 hours a week, but I think doing both types of longevity practices is better than just maximizing exercise.

I enjoy exercising but believe me I’m free of confirmation bias because I wouldn’t mind just staying home playing my guitar or xbox. The evidence for maximizing benefits of exercise is strong and from the research I have done 10-12 hours or so a week puts me on top of the logarithmic curve, going beyond that it’s just diminishing returns in terms of limiting my time for work, family, etc.

Exercise gives me a caloric deficit of 500-700 calories on average per day, so that keeps me in a calorie restriction. I have done keto and IF and abandoned the practice due complexity, poor evidence and some personal side effects.

Every other low hanging fruit like ApoB is managed by my very deliberate dietary choices to maximize nutrient variety and density without excess calorie intake and of course, various exercise regimen.

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#75

I was specifically talking about the one paper, which is interesting to me due to the cohort size and follow-up time involved. You posted that paper so presumably you think it supports some conclusion.

From a naive reading that specific paper does not seem to support the claim that very high levels of activity now are protective 30 years later, and worryingly leaves open the conclusion that high activity now could actually be detrimental 30 years later. Apparently you disagree (or aren’t making related claims in the first pace), since you posted it.

I didn’t pick through carefully, so I surely missed a lot. I’m literally asking for what evidence is in that paper that supports heavy exercise for benefit decades down the road.

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#76

The biggest problem with using Vo2max as a marker of our fitness is that it is both expensive and inconvenient.

There are tons of way to estimate Vo2 max, I personally use my Garmin watch to estimate it for me. Who cares if it’s off by 5-8 points, it’s the trends that matter.

Some of the longest-lived people are Indian yogis.

Sorry but that’ anecdotal evidence. However I did reluctantly add one hour yoga weekly and it’s great for stretching, balance and core. I do practice mindfulness throughout the day, especially during zone 2 running.

The contest for advocating an ideal Vo2max is more like bragging. “See what I can do!”

So is longevity itself and people bragging on these forums how healthy they are for their age. I say good for you !
The evidence for Vo2 max correlation to longevity is very strong.

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#77

This paper studied former athletes, so that should give you some clue.

#78

Not really… easily estimated via one of the newer sports watches that tracks Vo2Max (Garmin, Apple, Coros, etc.), or via the Cooper running test as talked about here: Vo2 max reference values - #21 by JuanDaw

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#79

Hi Lost, Thx for this synthesis. Can you point me to where I can see that / which paper and part of that paper?

#80

I don’t know anything personally one way or another but in the video at the top of the thread, they discuss how all these secondary measurements are widely inaccurate compared to the official method.