Exercise, VO2 max, and longevity | Mike Joyner, M.D

New paper from Seiler :

It’s about the long game, not epic workouts: unpacking HIIT for endurance athletes

High-intensity interval training (HIIT) prescriptions manipulate intensity, duration, and recovery variables in multiple combinations. Researchers often compare different HIIT variable combinations and treat HIIT prescription as a “maximization problem”, seeking to identify the prescription(s) that induce the largest acute VO2/HR/RPE response. However, studies connecting the magnitude of specific acute HIIT response variables like work time >90% of VO2max and resulting cellular signalling and/or translation to protein upregulation and performance enhancement are lacking. This is also not how successful endurance athletes train. First, HIIT training cannot be seen in isolation. Successful endurance athletes perform most of their training volume below the first lactate turn point (<LT1), with “threshold training” and HIIT as integrated parts of a synergistic combination of training intensities and durations. Second, molecular signalling research reveals multiple, “overlapping” signalling pathways driving peripheral adaptations, with those pathways most sensitive to work intensity showing substantial feedback inhibition. This makes current training content and longer-term training history critical modulators of HIIT adaptive responses. Third, long term maximization of endurance capacity extends over years. Successful endurance athletes balance low-intensity and high-intensity, low systemic stress, and high systemic stress training sessions over time. The endurance training process is therefore an “optimization problem”. Effective HIIT sessions generate both cellular signal and systemic stress that each individual athlete responds to and recovers from over weeks, months, and even years of training. It is not “epic” HIIT sessions but effective integration of intensity, duration, and frequency of all training stimuli over time that drives endurance performance success.

https://cdnsciencepub.com/doi/full/10.1139/apnm-2024-0012

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@tj_long Great paper. Thank you. This chart from the paper is a great reminder of the time course involved in improving athletic performance (and connected health / ACM benefits). Some bits come quickly (and go quickly if not used) while others take time (but also stick around).

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Several recent cohort studies have used proteomics to correlate measured plasma protein levels with cardiorespiratory fitness. However, each study had a single population with limited follow-up time. The recent study, by Perry and colleagues, used the Coronary Artery Risk Development in Young Adults (CARDIA) trial proteomics data to create a model that outputs an integrated proteomics CRF score, using 1569 participants to develop the model and 669 to validate.2 The model was then tested to determine how well the proteomics data correlated with measures of CRF in 12,000 additional participants from three other cohorts (Fenland, BLSA, and HERITAGE trials) and another 22,000 subjects from the UK Biobank to correlate the proteomic CRF score with all-cause mortality (ACM), cause-specific mortality, and incidence of chronic disease. The UK Biobank data were also used to assess the interaction of a proteomic CRF score and polygenic risk scores for chronic diseases.

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Where do you go to get the CRF score? I think my doc gets me the total protein, this looks like something slightly different.

The proteomics CRF score is still likely just available in labs as a research tool, I’m not aware of any such tests being available from a clinical source yet.

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Fragmentation of exercise was found to be negative. People who moved in continuous 5-minute, 15-minute, or 60-minute bouts were less likely to die of any cause than people whose bursts were more sporadic. The researchers give as an example someone who briskly walks at random intervals for a total of 15 minutes during the day; if this person were to briskly walk for 15 minutes all at one time, that person would have a substantially reduced mortality risk.

Therefore, while every minute does count, it is still a good idea to have time set aside for steady amounts of relatively intense exercise. The researchers hold that their research differs from WHO’s recommendations due to their differences in data collection and handling techniques.

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You want the trait, not the state.

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Yes.

None of that is an argument against increasing your VO2max: it’s an argument against gaming the VO2max formula by dangerously losing muscle and bone. It’s like saying one is against the advice to drink when thirsty on the basis that one might drink bleach. And of course, 70% of the US population is overweight or obese, so most people are in the category where some intelligently-executed weight loss would do them good.

That doesn’t seem to be supported by the data. Here the most fit group are in the 98th percentile:


Figure 2 from JAMA Netw Open. 2018;1(6):e183605.

I suppose it depends in part on what you mean by ‘an athletic level,’ and where a person starts off. Certainly for the great majority of people (who either don’t exercise at all or who don’t even meet the US physical activity guidelines), VO2max is likely to be a very weak link indeed.

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Boosting techniques

“Intensive interval training is a particularly effective method,” Sperlich says In other words: run or cycle for a few minutes close to your maximum performance, then take a short break. If you do this often, you can increase your oxygen intake in a short time, by around half a percent per week.

https://worldcrunch.com/culture-society/vo2max-health-life-expectancy

Linearly? Forever? I wonder if I quit during harvest whether it decreases at that rate as well.

This guy both distorts what Attia and others are advocating and misrepresents the study he cites as evidence.

Patrick: there’s been a very another form um that’s become very popular of training for improving VO2 Max which is Zone 2 training as defined by a lower intensity sort of lactate threshold training however that type of training does require a pretty big time commitment I mean anywhere between to six hours a week. So can someone achieve similar improvements or really good improvements in VO2 Max from doing let’s say 20-25 minutes of high-intensity interval training three to four times a week? And if so, you know, are we leaving anything on the table if you know we’re not doing that long duration sort of Zone 2 type of training?

Guest: yeah so in short I I think you can do more vigorous or high-intensity exercise for shorter periods of time and at least see similar improvements in VO2Max so for the individual who is time pressed. I don’t there think there’s a need to do three to four hours of what I understand to be Zone 2 training uh weekly in order to maximize improvements in V O2Max. In fact there’s evidence that would suggests that more vigorous intensity exercise higher intensity exercise can uh potentially lead to Greater improvements in in V02max or eliminate what’s known as non-response so some people engage in training and it’s very frustrating because their V02max doesn’t change at all … For example some evidence has shown that moderate intensity continuous exercise even for six months or so uh doing guideline based based evidence uh roughly 40% of people don’t see a measurable Improvement in their VO2Max. Now some of that non response was eliminated in a group that was doing the same total amount of exercise but engaging in a in a more vigorous manner. So that would seem to argue against uh Zone 2 uh somewhat but I I think you know there’s all all roads lead to Rome you know there’s many different strategies that you can engage in successfully

The question was not “is doing HIIT or high-intensity training alone an efficient way to increase VO2max?” — of course it is. The question was “are you leaving anything on the table by not doing Zone 2 on top of that?” To do that, you would have to test one group doing a good amount of high-intensity training alone and another group doing the same or a smaller amount of high-intensity training plus a large amount of Zone 2, for a greater total volume of exercise. The study he cites for this (visible at 1:30 in the video) commpares low-volume low-intensity (no one advocates that for VO2max), high-volume low intensity (something like Zone 2), and high-volume high-intensity. But no one is claiming that long rounds of Zone 2 alone will maximize VO2max, let alone if the amount of time invested is compared minute-for-minute with high-intensity training alone.

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Source: x.com


The Paper (Open Access):

How to Be 80 Year Old and Have a VO2max of a 35 Year Old - PMC.

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