Cardio fitness is a strong, consistent predictor of morbidity and mortality

How much time do you have to get into shape?

When it takes 50 years, the statistic probably doesn't hold because you will be dead by then due to the negative influence of smoking on your health.

reminds me of the bicycle helmet stuff.

There was a ted talk that said bicycle helmet laws would kill more people than save.

The reasoning was preventing people from riding would also prevent increased fitness, and more lives were lost from that than saved from accidents.

EDIT: I think this one: https://www.youtube.com/watch?v=07o-TASvIxY

That sounds like the sort of stuff you’d remember because it validates what you already want to believe

Getting back to the baseline isn’t a bonus

I've been streak running (so running at least a mile per day with no exceptions, mostly 5ks during the week, 10-20k on weekends) for almost 8 years (2817 days). The single best tip I give to everyone is "slow down! run slow!"

Of course, almost no-one adheres to it unless they are already well practiced. It's just deeply ingrained in peoples heads that "only if it's hard or painful it must work". Then people check out of running because it feels like crap, which it does if you always push too hard.

In my opinion, three of the most important rules are:

- slow down! does it feel "too slow"? Great, that's the right speed for most runs

- small steps! feels awkward at first, but is sooo much more efficient and soo much better for your joints

- land on mid- or forefoot (that happens mostly automatically with small steps)

There's also value in spending some time in zone 5 [1]: this is where the heart is really trained as a muscle, and where the cardiovascular system is pushed to its limit (the famous vo2max: increasing vo2max is done in zone 5, for ex. with HIIT [2]).

Zone 2 is all about giving the mitochondries a chance to get better at providing a steady energy flow over a long time, mainly by optimizing for burning fat as fuel instead of glucose, avoiding lactate accumulation during the process [3].

In between, in zones 3 & 4, you get a little of both those ends of the spectrum, it's still helpful to a degree, but it's not really optimized: that why it's deemed preferable to spend the bulk of your training time in either your zone 2 or zone 5.

The ideal composition of a training period seems like 90% zone 2 and 10% zone 5, and going for more than 1h of zone 5 per week seems not that interesting. Also, mixing zone 2 and zone 5 in the same training session is not ideal, it's better to stay focused on one thing at at time.

[1] https://peterattiamd.com/category/exercise/high-intensity-zo...

[2] https://peterattiamd.com/category/exercise/vo2-max/

[3] https://peterattiamd.com/category/exercise/aerobic-zone-2-tr...

I do love running and indeed it's better to jog slowly for longer time... though, to avoid injuries - please do exercises before and after because you can easily injure your (lower-)back and knees (talking from experience, chronic lower-back pain after ~20y of running…)

Are you carrying excess weight? I've been overweight most of my life. For a while in my 40s I hiked a lot and my BMI dropped into the normal range. When that happened, I became a runner. It felt amazing. I would run 5+ miles and felt like I could keep going forever. Once I put the weight back on(new relationship with someone who liked to eat), I couldn't run. It hurt and didn't feel good.

I don't know what the current research says, but I believe jogging is pretty hard on your joints vs running. I'd recommend hiking and fast walking as an alternative if you're looking to transition into running.

I too hate to run. And I do it everyday. To me it's the time I get to be alone with my podcasts for an hour. Now I look forward to it every morning. I'm not sure in what zone I usually run, but my pace is usually around 6min/Km.

A part of become a good runner is letting go of expectations. There is a lot of quasi meditative written on the topic, but even if that’s not your thing: even if you walk/jog/walk to retain a constant, middle to low heart rate you could easily have the same effort as a trained runner doing some great mileage. The humbling part is part of the experience. Stay away from anything with speed for the first thousand miles. It will only lead to injuries. The good thing is, both condition and speed will improve very fast and the happy run feeling isn’t based on speed or distance. It’s being outside, alone, in silence with sounds and weather while doing something actively (but not overly). Did I mention I miss running? (Alas I am now missing some necessary cartilage.)

I watch all streaming shows on a rowing machine with not-so-high speed and not-so-high resistance. The show keeps me entertained and sometimes I even forget that I'm rowing. Previously I did that with an iPad 12.9" next to the machine, but I've just started watching shows on the Quest 3 and that's way better.

Then it hit me. I’ve probably been jogging a lot in Zone 3. Or higher? Because the harder you go the more benefit, right?

That's unfortunately not fully how it works. For maximum benefits, you would want to train your aerobic energy system, and to do that without risking injury, zone 2 is the recommended zone. The claim is that pain is gain, but more often than not, pain is your body telling you you are over the limit. By the description of your running experience, you were possibly closer to zone 4.

Of course, the body gets lazy, so you will want to vary your training. Repeat the same type of load, and your body will get efficient operating at that load, meaning your fitness gains will eventually stagnate. That's where the other zones come in.

At the zone 3/4 threshold you start using your anaerobic energy system more, with a stronger build-up of lactic acid as a by-product. Training in that range means your body will get more efficient at faster-paced work. Of course, as you build-up lactic acid, it also means that it is not a pace you can sustain.

But if you do short bursts of exercise at the lower-end of the anaerobic zone, you are actually contributing to making you aerobic energy system more efficient, without over-straining your body too much. And it's exactly the type of exercise variation your body needs to not get into the "lazy" mode.

The traditional way of approaching that is to have a base of zone 2 days (say 80% of your runs), and a few days of zone 3/low 4 days (say 20% of your runs), so that you alternate your loads.

Another approach with similar benefits, especially if you train less often, is the Fartlek approach, developed in Sweden in the 1930s. That's a type of training where you mix-up the load intensity during your runs, in about the same proportions. Fartlek means "speed-play", and it describes the method well. It's generally about approaching your training as you feel it that day. At some point during your run you might decided to increase the pace for a short time. Or you see a small hill that you can decide to attack at a faster pace, thereby changing your training zone. It's all about having fun and making your trainings less boring.

There was this belief in some circles until not that long ago that if you would enter a zone 3 or zone 4 training load during a zone 2 training day, you would mostly destroy the benefits of a "pure" zone 2 training. (Or the other way around, having some zone 2 stretches on zone 3/4 days). That turned out to be nonsense.

All in all, for good progress, and against boredom, Fartlek is the way to go, all the while keeping the bulk of your training in zone 2.

Yes, most of experienced runners' running is at a conversational pace, often literally (this is why running groups are popular).

To explain why harder isn't better: improvement in running comes only a little from muscular strength, so that mental model is bad.

Improvement is primarily based on aerobic development of the cardiovascular system. This is your body's ability to burn mostly-fat with oxygen, deliver the energy (ATP molecules) to muscles, and remove waste products. So you develop more capillaries, your heart gets literally stronger, and this fat-burning pathway gets more efficient.

Going too hard pushes into the anaerobic zone (burning sugar without oxygen). This is good training in some ways, but it can be counterproductive to aerobic development and, most important, it's too hard to do very much volume so the amount of stimulus is limited. By keeping it easy, you can do a higher volume of purely aerobic stimulus.

And try to not let my groin fall asleep.

I was "forced" into biking a few years ago (had an injury that prevented running) and had the same problem with the groin. I thought it was a natural thing with biking, but it can actually be quite bad for you in the long run, and it's very fixable! Sitting position and saddle makes a huge difference. Ofc position is the cheaper thing to fix, but saddle is easier.

Go to a bike shop and explain the problem and they'll help you find a saddle that fits you, don't go on with getting your groin numbed.

I watch TV-series on the treadmill. The fastest walking pace where I can still keep up with the story and keep the shaking low enough to have a steady picture.

I love running and doing it consistently over ~10 years, always longing to get out again.

I'm the only one among my friends that do this, and I find this to be highly correlated with my running style: Really comfortable pace 7-10km through local forests, only (I tend to do more 10km more than 7km as I like it so much).

I learned this one time when I ran on a threadmill and realized the enormous difference between a slight variation in speed (from 11 to 9 km/h in my case, but the exact numbers don't matter), where I realized with this slight change I could go on indefinitely instead of being quickly exhausted.

All things need balance- don’t go too slow, don’t go too fast. If it feels right you know

It's natural to run in these cases:

- chasing an animal during hunting;

- being chased by a beast;

- playing.

You don't have to really run for good cardio fitnes. In addition to HIIT, now there's IWT (Interval Walking Training), which yields similar results. Also, slow running seems to be more beneficial, too [0].

[0]: https://www.youtube.com/watch?v=z71aHZ4scMs

You can improve cardiac fitness by just walking an hour a day. the top distance runners are at bmi of 19 or lower. longevity is maximized at bmi of 26.

I’ve been doing ultra marathons now for over a decade and the key is slow. Walk a lot at first if you have to. Some key resources getting started are Jeff Galloway and his run walk method. Once you build up to mostly running just mix in a few “strides” a week: pick two workouts and run 5x 30s at a “not quite sprint” speed. That’s it. Anything else you mix in (tempo, intervals, progressions, blah blah blah) is the last 10% and completely optional.

Your zone 2 speed will change over time. I do most of my training in zone 1 now, and that’s like a 9 minute per mile pace. When I started more than 15 years ago a 9 minute mile felt like death. Patience. This takes a lot of time.

Nassim Taleb wrote in recent months about Zone 2, 3 and relevant statistical analysis.

Yeah as someone who (unfortunately) has the habit of exercising on and off that's what I heard/did as well: cardio where you're pushing yourself a little, but not so hard you feel like you want to stop right now or that you couldn't have a chat with someone running beside you.

Its weird though because HIIT is meant to be amazing for your body as well.

I suppose a mixture of both is good, and if I really think about it, we pretty much evolved to do that - low energy wandering to find prey, medium energy to chase prey and exhaust it, brief high intensity to catch up and finish the job. Then you get dinner.

Man, I should go back to the gym.

This has been the biggest game changer for me. People often think they need to push it hard and they quickly fatigue, burn out and hate going running. The trick is to do a 80% of your running sessions in zone 2 and 20% in high intensity to increase VO2 max. If you are at the start that means sometimes walking on hills and that is ok. There is a great book about this: https://www.amazon.com/80-20-Running-Stronger-Training/dp/04...

I had a very similar experience years ago, I tried to start running and I hated it. I went and got a heart rate monitor and found that after I was going for a while where I started to hate it, my heart was up at 180 or so. I started doing alternating run/walks so that I was averaging more like 145, and it was actually enjoyable and I'd get in the zone sometimes. After a while I managed to get up to half marathon distance. I'm a little skeptical about the zone 2 craze that's hit recently, but definitely, if you're just starting out, it's very easy to try to run like the other people you see on the trail and exhaust yourself. A heart rate monitor is very useful to help keep yourself in a reasonable range that's actually enjoyable and sustainable.

I've recently come to the same realization. I've always considered myself a more short-distance athlete, having been a sprinter and played more "burst" sports in high-school like football. My wife is a more long-distance runner. I've never understood why people like her were able to run for miles and miles without stopping. I could maybe keep up with her for the first mile, maybe 2, but then I was toast.

It's only recently when I learned about Zone 2 training that I came to understand that my training approach has always been backwards. I have always indexed my pace on what has always been a "respectable" mile time, on the assumption that if I run at that pace over and over, eventually I'll be able to go for longer at that pace. And that kind of is true, but not ever to the extent I can keep up with my wife.

Now, I am attempting to approach my running from a "time spent running > speed", and I'm finding that I indeed can run for 40+ minutes straight with no stopping, at a much lower pace than what I had been, and that it is much easier to make progress by running slowly for 40 minutes and gradually increase my pace over time than it is to run quickly for as long as I can and gradually increase the distance.

If you don’t like running, find an exercise you do enjoy. Running isn’t the only cardio out there. If you’re jumping through hoops to force yourself to enjoy it, try a few other activities. Me, I can only get myself to run if I’m engaged in sports.

For cycling you don't need the talk test, it should just feel easy. My breathing isn't elevated, my legs can feel there's resistance but there's no strain. Feel free to go 25 minutes on 5 minutes off, that really helps with the saddle comfort.

When I was a kid I loved long-distance walking because it was "me-time". I have some introvert genes and I really needed to be on my own, away from people, and going for a walk was the only way I could achieve that.

Then I moved to a bike-friendly country and I started biking all the time. 30 minutes commute one way, 30 minutes back. I live right next to subway but god I hate public transport, and owning a car in this city is a massive headache.

Often I go for a small one-hour ride in the evening. I put on some music, start cycling, and thinking about things. I feel like I get into some kind of trance. When sitting at home I constantly feel "now what now what now what now what", but while cycling, I get into a rhythm and often; not always, but often; I get into a state where my thoughts kinda flow more easily, I can just think about something happy and focus on it, or maybe listen to the music. I live in a low-density area with biking lanes separated from most car traffic, so sometimes I get drunk or high and go cycling, which feels amazing - I have to focus and make it through one intersection, and after that the worst thing that can possibly happen is falling off the bike and getting a few bruises.

Sometimes I go for longer whole-day trips. When I reach the point of complete exhaustion the part of my brain that constantly worries about getting fired or possible WW3 shuts down and it's like being high but without drugs. I plan these trips so that I fight against the wind on my way "there" and then enjoy the help of the wind on my way back which becomes almost efforless. When I come home exhausted, the body experiences relaxation in ways impossible to achieve in other ways.

If you want advice, from my experience: 1. Stationary machines are a scam, 90% of pleasure comes from being outside. 2. Do exercise at a pace "I could keep on going like this forever" and then after an hour "oh not anymore" 3. Get something that keeps you entertained but doesn't require your attention. I don't recommend audiobooks because you need to keep actively listening. I recommend music or radio because if you zone out and stop listening, nothing bad happens. And sometimes try not having anything at all, just watch all the things around you.

It took me some time to readjust my brain to stop aiming at extremes and focus at ~harmony. Doing exercise that don't burn you most of the time. Maybe later my body will be able to take a bigger hit, but in the mean time I'll take the slow maintenance mode.

Another trick was to focus on the whole body, I had a bad back but ran all my life like this, I now do light deadlift to restore better posture and better range of motion. Bad posture will make your muscle shrink and impede your running too.

No need to run even, you can stay in Zone 2 via walking. Incline on a treadmill makes required speeds quite low (2-3mph for most people).

I prefer it since it's at a pace where you can easily use your phone/browse the web at the same time.

Walking is also far more practical given that you walk 99% of the time in modern society. Might as well train for the thing you actually functionally do

I've heard the same thing, but for cycling. However I wonder if that is not mostly for people who train much more than a normal person, like a pro or your ultra marathon friends.

I understood the idea was that by running / cycling mostly in zone 2, you can put in more distance / time as you can recover more easily. It would not be possible to bike 30 hours in a week in zone 3, you would trash yourself.

But for someone like me, biking like 6-8 hours a week, I could easily do a lot of higher intensity, recovery time is not a bottleneck, other obligations in life are. So I really wonder if that still applies if you're only running / biking a few hours per week?

Zone 2 works on a bicycle, too.

I'm a cyclist, 100km without much effort, but a year ago I started running and it was super hard. The muscles are used differently, the body get impacted with every step and it takes some learning to find the right speed to reach whatever your target is. Pain kills the fun, the only way to succeed is to start slow and on short distances.

My goal was strengthening hip (one side has a three plates and a few screws in it) and knee mobility, with losing weight being an extra that I only reach this spring due to diet changes. I did find my Zone 2, where I can chat with a running buddy, and slowly extended the distances I run: Now 5km at 5:40m/km are the norm and 10km is just as possible. Injury-free so far and no ambition for a Marathon. The thing I now have to work at is the cadence which I (at 193cm) had trouble with on the bike as well, but shorter strides at a higher cadence are important to prevent knee injuries.

Whatever you do, I think sticking to it at least three times a week so you look forward for the next run, feel well during it and keep healthy. This is more important than beating records or running insane distances. Those goals are for those with the right genetics.

I've heard about this zone 2 as well, it makes sense. its a decent stable pace.

when i've been running i do similar. though i also do accellerate a bit and slow down, because its... more fun.

I think the oft missed bit about zone 2 is that the goal is to increase volume. If you simply reduce intensity without increasing volume, you'll get worse, not better.

If you only run 30 minutes once a week, you won't see as many gains if you do it in zone 2 than zone 3/4. But you also can't run 10h/w zone 4/5, so that's where the zone 2 comes into play. It allows to increase volume without increasing fatigue/risk of injury too much.

I think conventional wisdom is "zone 2 for fitness / endurance, zone 3+ for performance." The interesting thing about this meta-analysis is it's discussing "baseline cardiorespiratory fitness" which - as I understand it - does correlate with vo2max.

As I understand it you can increase vo2max with exactly the type of training you are describing. Long efforts at zone2 can improve vo2 max, but the best improvements involve training at higher zones.

I certainly remember all the stories / headlines "walking is as good as running for cardiovascular health" etc which support the "just train zone 2" approach, but this study seems to me (a layperson) to contradict that.

Can anybody who is more versed in the research chime in? Does this study suggest that HIIT could reduce all cause mortality by improving vo2 max which improves baseline CRF (which is the value this the meta-analysis actually examined)?

I find way more enjoyable zone 4-5 training, but i do shadow boxing in front of the mirror, so it might differ. It's intense. zone 2 means it's a long thing that i don't want to do and i have time to think about it

I always hated running, but I had always been doing it for exercise. Perversely, this meant if I moved inefficiently and made the movement harder, I was doing better. I characterized running as "competitive suffering". No pain no gain, right? And like you, I always did more than felt good, and figured that meant I was doing it right.

But I don't think that way now. I want to enjoy moving. I want to move playfully and powerfully and efficiently. Exercise until it feels good, not until it feels bad. Love the body you have and take care of it and build it up, rather than hate-exercising to change it.

This is absolutely true, when I started, I didn’t have a zone2 while running and running is just suffering.

But gradually I could hold a lower heart rate while running and now my zone 2 runs are actually faster than my fastest pace I could hold a year ago. Now I enjoy running more than cycling (though my fitness are still probably mostly derived by cycling).

The poor VO2Max estimates on the Apple Watch is why I'm phasing out of wearing one.

I track my actual VO2Max measurements in Apple Health via a shortcut, and I don't need a daily made-up number messing up my data.

VO2 max is also exercise dependent. If you trained riding bike for 3 months, then went to run down the street, your VO2 max would not transfer over.

I wonder how it estimates VO2Max and how often depending on the model. On my Series 3, it seems to make a data point two or three times a month and it’s concerning to me because it seems like it isn’t trending up even though I have started to do more cardio exercises. Instead, it has consistently reported a range that it says is below average.

Could it be that it’s just pretty difficult to improve VO2Max in general? Some people’s hearts have to beat harder or they breathe in less than fitter people?

Cardio still counts even if you don't measure it and share it with Apple.

I've been seeing strange downtrends on my VO2Max numbers with Apple Watch: they have dropped from 40's to 20's over a matter of a few days and have been steadily trending down. I haven't changed my exercise patterns at all for years now. There are others on the Apple forum facing similar abrupt drops, anyone else here seeing it? I'm hoping it's the watch messing up and not my health!

I love my Garmin Fenix 6 pro.

But do you really need a botnet on your arm to get motivated to do sports once a week? Weird society

Note that there's lots of complaints about the VO2Max estimates on Apple Watch. For example, this reddit thread:

https://old.reddit.com/r/AppleWatch/comments/m5q7yx/cardio_f...

https://old.reddit.com/r/AppleWatch/comments/yte3zd/the_vo2_...

You should know that vo2 measurements that aren't performed via gas exchange or blood measurement are a complete guess.

The other thing is the denominator of vo2 is weight. So losing weight without working out at all will increase vo2

2 hours a day is a ridiculous amount

I love these kinds of posts. They are ridiculous.

First:

    > Fortunately, this seems relatively simple to change

    > the extra energy I gained from 90-120 minutes of aerobics per day

What sort of workouts do you do? I've been trying to do the same thing, but I'm finding it difficult to get VO2max to go up consistently.

that’s an amazing change. Could you elaborate on your training regimen?

40 to 57 is a huge increase in a year - kudos!

Even if Vo2 is inaccurate on Apple watch , relative increase in your Vo2 is a positive metric. Kudos to you.

Congrats. You’re an inspiration to me. :)

Instead, people try to fix it with antidepressants, benzodiazepines or something else.

It feels a bit like the US approach to pain management – instead of massages or physical therapy, some opioid pill is cheaper to prescribe.

is it not? I thought the suggestion "have you tried exercising" to depressed people had reached meme status based on its frequency

The problem is that, if you're in a position where you are having serious depression, for example, it doesn't really matter how objectively or subjectively helpful it is, you can't even bother getting motivated to do things you are certain you enjoy, let alone something unknown.

This is the same problem with CPAP machines - they nominally have a huge efficacy rate, and a rock-bottom rate of people sticking to them, because for a lot of people, they're deeply invasive and uncomfortable, and insurance (in the US) in many cases has stopped paying for them if their obsessive babysitting doesn't swear you've used it 95% of the time, so people just say "hell with it" and stop stressing about, say, not being able to take a hike for a few days of camping because their insurance will stop paying for it.

It all goes back to the fundamental premise of "if your solution requires changing people, you will not succeed."

I struggle with anxiety and have below average HRV and VO2max.

I started jogging a month or so ago and have definitely seen an improvement in my mental health.

It wasn't before I had a good place to run (away from cars and the city) that I started running. Yes, it's free, but it's very hard to pick the habit if your environment doesn't help.

I deal with pretty severe depression and running is far more effective than antidepressants. It varies for everyone, but I know I’m not alone.

It’s tough because I’ve known this for 15 years or so, but when I’m in a hole it somehow seems like it’ll only make things worse. I understand why someone who hasn’t had the experience of feeling better from exercise would see the entire premise as unlikely or absurd.

Exercise is the perfect treatment for mental health: it doesn't cost the "provider" anything, and when the patient doesn't do it because they're depressed or disordered, you can blame them for not cooperating. It's not a solution, it's something you can say so that it's not your problem any more.

(Would be great if there were actually prescribed work-compatible supervised exercise sessions on offer, but AFAIK that's not a thing offered anywhere by any health service)

I think it's partly because as it also works as prevention of those same mental illnesses, many patients will have a higher than average barrier to clear to exercise (including just getting out of the house for a walk).

I've had friends able to start exercising a few months in their treatments, when the medication gave them more mental leeway. Before that they were fighting to wake up and properly eat, and do anything really.

Exercise is a four letter word for many on HN. Content posted here touting the various benefits of exercise is always met with mental gymnastics from commenters who would rather do anything but go out and break a sweat.

No sorry but this is not how causality works. When event B happens a thousand times after event A, you cannot conclude that A causes B. For example, there could be a confounder, that is, a third event that triggers A and then B (so not A triggers B, but this third event triggers B). See The Book of Why by Pearl for more information on causality.

Well, I don't doubt that cardio fitness decreases the chance for morbidity and mortality, but in this study they only established correlation.

I think that in science we have to be extra careful just what we are saying. And saying that this study proves causality would be wrong. I am sure there are other studies that could (do?) prove it but this statistical analysis can only prove correlation.

People implying that the study shows only correlation really don't seem to understand how we establish causality in science.

Or perhaps you don’t fully understand the challenges of establishing causality? Just because an intervention causes an improvement in some bio markers that are associated with lower mortality (unfortunately) does not mean that the intervention will cause lower mortality.

The classic example is vitamin D supplements: Higher vitamin D levels are associated with lower mortality in many medical conditions. Vitamin D supplements increase vitamin D levels. But vitamin D supplements seldom lower mortality.

Why? Probably because vitamin D is produced in the skin when we are in the sun. The more healthy subpopulation of any study will typically spend more time outside, so they will have higher vitamin D levels. But it’s (relative) health that causes higher vitamin D, not the other way around.

The only way to reliably establish causality is really an end-to-end randomized controlled trial (RCT). Stitching together two RCTs is not sufficient.

(Not saying that exercise does not lower mortality BTW, just that it’s complicated, and a study such as this is probably picking up two signals: one causal and one purely correlational.)

People implying that the study shows only correlation really don't seem to understand how we establish causality in science.

This is where explaining how causality is established really helps people understand what they are reading better, especially when confronted with something that is not light reading and summarizes a much larger, even heavier read. In other words, instead of saying people don't understand, maybe help people to understand.

For better or worse (worse), people don't go to the doctor for lifestyle analysis and rarely take lifestyle advice from their doctors.

They go to their doctors to know when to start medical interventions.

Even simple waist-to-hip ratio assessement would be a big win for identifying lifestyle concerns, but neither that nor the far more involved VO2Max and DEXA rests are going to become standard unless they becoming a gaiting condition for some celebrated drug or procedure.

And that's as much because of the patient's perspective of what they want from doctors as it is because of the doctors or broader establishment.

Pretty sure Dexa scans and VO2Max tests are HSA/FSA eligible.

"It could easily be made better by including a VO2Max test and a DEXA scan every few years."

Frankly, the vast majority of people don't need fancy tests. The thing is, the healthcare system is not about optimizing health or performance. It's mostly about fixing problems and heading off the most common ones in the easiest ways. If the goal was to optimize, it would be relatively easy for a trained individual to examine most people and tell them to lose weight and exercise more. Hell, you could blindfold the person and their advice would still be right like 80% of the time.

Have to weight it against whether people are meaningfully willing to act on that information. Bluntly, I go to a Dr for meds. I have never been willing to make any lifestyle changes.

The highest impact diagnostic of all cause mortality is a scale. The next best is a mirror.

Most people have these at home and fail to take meaningful action based on the results.

What would be the point of measuring VO2Max and a DEXA scan in a mostly sedentary, obese population?

"Excuse me sir, I have you VO2Max and DEXA scan results. It shows your cardiovascular fitness and body fat is problematic. But we already knew that since your BMI is 35 and you told me you don't exercise at all".

What's the advantage of a VO2max test compared to e.g. measuring speed or power in your (standardized) intervals?

That's what you hypothesize. Research like this affirms your hypothesis with fact.

There are historically lots of things that "seemed obvious" but couldn't hold up under research, which is why we do research. It confirms what you think or maybe it forces you to question what you think. Either way, it is good.

Case and point, there is a rising opinion lately which Trump has promoted that your heart only beats a set, finite number, of beats in a lifetime. Therefore, according to this opposing hypothesis, it makes sense to not perform intense cardiovascular activity throughout your life, because it accelerates your heart hitting that finite limit that it is capable of. This opinion has gained traction in recent years and to some people it "seems obvious" that a faster heartrate might wear it out more quickly, leading to premature death. So to those people, research like this defeats their assumptions and helps them feel more confident about performing exercise because it is research-backed that Cardiovascular Fitness prolongs life.

That's why research is important. Obvious shouldn't stand for anything.

The less in shape you are, the sicker you can possibly get.

I remember reading somewhere that, to maximize your health, run as much as you can each week, you won't hit the upper bound when it gets bad.

In the example you cited, that's 36 hours (!) of runnning in a week: meaning I'd have to run 6 hours a day and only take Sunday off each week before I was officially running too much. And I've noticed I can't run more than 4 days a week anyway, so even that's off limits. 6 hours a day, 6 days a week, even under optimal conditions, wouldn't be something I'd approach even if I was retired.

So practically speaking, "run as much as you can before your body aches stops you" seems like a good rule of thumb.

Great share! That meta-analysis was a good read.

I'd disagree slightly with your characterization of the author's findings on over-exercising; quoting from the discussion section:

"Our findings do not provide evidence for increased mortality risk with physical activity amounts as high as seven times above the current recommended target range. All cause, CVD and CHD mortality risks were lower at physical activity levels up to approximately 5–7 times the recommended level but the additional reduction in risk of mortality with engagement in activity at levels beyond the recommendations was modest and with increasing uncertainty, as reflected by the wide confidence intervals. Thus based on all of the available studies, we did not identify a higher mortality risk at any level of physical activity above the recommended level, although the lowest point estimate for all cause mortality was approximately 2000 MET min. Our analyses suggest that 10–12 hours of weekly vigorous physical activity cannot be considered harmful to longevity."

My reading is that the authors did not draw any conclusions about increased risks at higher MET levels due to the broad confidence intervals caused by the cancer risk data.

    > 2200 MET-minutes/week is about 3 hours of 8mph running per week

Luckily, very few people are in danger of extreme fitness. That is what the word extreme means.

If the authors don't draw conclusions from that, I wouldn't either.

For example, suppose the main impact of exercise on cancer risk were simply the correlation with time spent outdoors in the sun. Then you would expect to see a chart like this. But a conclusion like 'limit running to 3 hours/week, while walking can be up to 12 hours/week' would be totally wrong.

One of my few regrets in life, and something I advise to all younger people, is that I didn't work on my upper body strength when I was younger. Now I'm 60, and it's going to be essentially a battle against muscle loss.

So I suppose the message needs to be: Both are important.

I see a similar effect too. I usually do just lifting but I recently started doing a bit of cardio (rowing and that resistance treadmill thing) and it improved my lifting even at 5 reps. Granted my cardio was pretty bad but I felt more steady and felt like I could do more volume.

Non-intense aerobic exercise exercises a narrower metabolic aspect of your cells than intense anaerobic exercise. You have to be be very careful what you consider is beneficial "cardio".

A lot of it comes down to how your body responds.

I found that cardio tended to severely limit my lifting gains if I did anything more than 30 minutes in a week. I stopped entirely and found my lift increased more rapidly.

But that's just me. Just like all the other variables you have - number of sets, number of repetitions, frequency of workouts, rest periods, it's good to try a few options and see which one your body responds to the best.

You can turn weight training into cardio, by keeping breaks between sets down to just a few seconds.

If you go to a fitness center, some have machines set up for this. Mine used to call it circuit training. At home, if you're using free weights, have enough that you don't waste time changing plates.

Something similar happened at the gym I went to years ago, although I wasn't there when it happened. The poor guy collapsed while lifting weights. WEIGHTS. I kept reluctantly going for a few days before stopping. Then on the radio I heard about a guy collapsing while running on the treadmill, just like your fellow gymgoer, and it was the last drop in the bucket that kept me from doing any exercise other than slow to moderately paced walks. The prospect of collapsing from something that should make me healthier terrifies me.

The data in the linked article from 20 million observations vs your 1 observed incident suggests you should keep going to the gym.

You have no idea what his pre-existing medical conditions were.

You don’t need a watch. You can estimate VO2 max yourself by doing a max effort 1.5 mile run and applying a regression equation: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4795745/

That’s all the watches are doing anyway. Even if you do buy a watch, keep in mind you need to run regular max effort runs to get an accurate value.

About lifting weights: The trick for me is to keep a diary of my current exercises and weight levels. (It's very simple -- just 5 mins or less to maintain each workout.) This will be very motivating if you can increase weight, reps, or number of sets ("total volume").

You should add some diversity in your activities and you will perhaps identify some that you enjoy more at a given time.

Your comment just gave me a thought of how cool would it be if society had a mandated activity hour in the morning. I’m imagining loud speakers attached to poles outside making announcements and all businesses closed for that hour, and people all out and about exercising, walking, running, talking. Yes it’s a bit like school but society can be so much better if we prioritized good living!

Causality is likely bidirectional here.

Exercise does have some positive contribution to inflammatory response. Chronic pain is a pretty big bucket, though.

Because you couldn’t say “in mice” :-)

Assuming 80 year lifespan -10 years of childhood this comes out to approximately 1 year spent on exercise. That does not include preparation and recovery times.

It's a logarithmic curve. On a 1 to 10 scale, increasing activity from 0 to 1 provides a large decrease in mortality. Going from 1 to 2 another big jump. But 2 to 3 is less, until finally it plateaus.

But yes, people don't realize that even just walking at a moderate pace for 20 min 3 times a week provides huge benefits if you are otherwise completely sedentary.

Congrats on the progress!

It's also a myth, perpetuated by highly trained athletes that you cannot gain muscle and do cardio, or that you cannot do these things while in a caloric deficit.

I think it's more accurate to describe this in terms of definitions: "gains muscle while in caloric deficit" is possible for the untrained/beginners.

For the first 2 months, cardio was not part of it.

It's really easy for bad diet decisions to counteract the effects of even a significant amount of cardio; and it's easy to fatigue the body by trying to do too much cardio.

For aiming for calorie deficit, I think it makes sense "do what's least awful out of: reduce calories in food, or add cardio".

Cardio health is life changing.

I noticed my chess.com rating improved just from improving cardiovascular health.

started isolated training for muscle hypertrophy utilizing machines for 5+ days a week

My impression as a beginner was that free weights were scary and that there were many exercises you'd have to choose from. (Whereas machines seemed idiot proof). In practice, "squat, deadlift, benchpress" would be a good start. (Or a starting point to read about, anyway).

https://exrx.net/ is an outstanding website that I wish I'd come across sooner.

Damn bro you’re going beast mode. Keep it up. That’s awesome.

If you have a power meter (e.g. assault bike) just measure with what power you can do the Norwegian 4x4 protocol.

Probably a cooper test -- run as far as you can in 12 mins. Then there is a formula to convert that distance to vo2 max.

Do you need to measure VO2 max specifically? If your form of exercise is jogging/running, you will easily be able to tell if you're improving by tracking distance and time of your runs. If you want to be precise, you can e.g. race a timed 5k once per month under the same conditions. But if you're a beginner, you won't need that to be able to tell you're improving, just the feel of difficulty to maintain a certain pace will change noticeably.

As someone else mentioned, a classic poor man's test of VO2 max is simply to time trial a set amount, such as seeing how far you can run in 10 minutes, and use a calculator. So the same thing with extra steps.

Well I think you have that backwards, most people concern themselves with the former because they are the easiest to address. It's very easy to just eat less and buy healthier food. Getting your running shoes on and going for a run when you're out of shape and overweight is extremely hard for most people in that category.

Exercise is a factor in reducing the risk of several types of cancer. And fitness does reduce the effects of COVID even if it wont stop you getting it.

It turns out having the intelligence to not listen to JRs advice on most things will likely increase your life expectancy.

Yeah. I started walking with a backpack like he does. Its so much more enjoyable then jogging and I feel the impact on my whole body. Instead of slow jogging for Zone 2, rucking works well.

There is a ton of research supporting this. It’s really important information.

Elsewhere in this topic I mentioned exercise helps me with depression. I’ve speculated that it’s due to simply making my brain work better. Depression often feels like your brain isn’t working. Sometimes it extends to your body. There’s more to it, but what exercise does to me feels a bit like turning the lights up a bit and taking some weights off (mentally and physically).

Cardio is aerobic exercise. If you have to ask, you’re not a world class athlete and the answer is longer and moderate.

I’ve recently taken up the erg machine doing an hour a day, and it’s been phenomenal. The one problem I’m faced with is canabalizing my chest muscles for increased legs and back. Eating enough calories is actually impossible.