#090 How Exercise Prevents & Reverses Heart Aging | Benjamin Levine, M.D.
May 28, 2024
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Dr. Benjamin Levine shares how structured exercise can reverse heart aging by up to 20 years. Topics include balancing exercise for heart health, effects of bed rest on cardiovascular health, optimizing cardiovascular health through exercise, cardiorespiratory fitness as a vital sign, challenging non-response to exercise, cardiac function and athletic performance, strength training impact on heart health, optimizing training through recovery, heart rate variability measurement, gender differences in cardiovascular performance, endurance activity and atrial fibrillation risk.
Structured exercise reverses significant heart aging, achieving up to 20 years of improvement.
Integrating varied exercises into daily routines maintains youthful heart function and overall health.
High-intensity training boosts aerobic power, supporting heart adaptability and longevity.
Monitoring and boosting cardiorespiratory fitness improves cardiovascular health and prevents age-related diseases.
Personalized exercise regimens enhance joy, compliance, and fitness outcomes over time.
Deep dives
Reversing the Effects of Sedentary Aging
With dedicated exercise commitment, individuals sedentary most of their lives can reverse significant heart aging, demonstrating up to 20 years of improvement. Dr. Benjamin Levine's research reveals structured, graduated training regimens culminating in five to six hours of weekly physical activity over two years can achieve remarkable outcomes.
Ideal Exercise Routine for Aging Well
Dr. Levine emphasizes the importance of integrating exercise into daily routines akin to personal hygiene practices. A successful lifelong fitness regimen includes a variety of exercises such as long-sessions, interval training, moderate intensity sessions, and strength training. Balancing these components ensures the maintenance of a youthful heart and overall health, promoting cardiovascular adaptability and preventing age-related declines.
Cardiovascular Adaptations and Benefits of High-Intensity Training
Engaging in high-intensity training elevates aerobic power, supporting a flexible heart structure, optimal autonomic tone, and enhanced endothelial function. Dr. Levine advocates for incorporating vigorous intensity workouts like Norwegian 4x4 sessions to boost maximal oxygen uptake and improve cardiovascular health. These workouts also address risks associated with sedentary behavior, providing substantial benefits for heart structure and longevity.
Cardiorespiratory Fitness and Longevity Correlation
Higher cardiorespiratory fitness levels are linked to improved mortality rates due to multiple physiological adaptations like vascular structure preservation, enhanced autonomic function, and mitochondrial efficiency. Monitoring and boosting cardiorespiratory fitness helps manage cardiovascular risk factors and prevents age-related diseases, emphasizing its vital role as a health biomarker for an active and healthier lifespan.
Importance of Proper Dose Response in Exercise
Different doses of exercise can impact individuals' cardiovascular fitness differently. Non-response to exercise is influenced by the dose individuals are given, similar to how medication doses affect outcomes. Studies show that adjusting training doses based on individual responses can lead to improvements in cardiovascular fitness, demonstrating the importance of personalized exercise regimens.
The Influence of Training Mix and Novelty on Fitness Maintenance
Consistently challenging oneself during workouts and incorporating varied exercises can enhance joy and compliance with physical activity over time. Different types of exercise play distinct roles in improving and maintaining fitness across a lifespan. While some individuals may prefer repetitive routines to preserve fitness, others benefit from changing their workout regimens to experience more complete fitness enhancements.
Factors Affecting Heart Adaptations in Different Athletes
Athlete-specific adaptations to exercise play a crucial role in cardiovascular health and performance. Strength training induces concentric hypertrophy, while endurance activities lead to eccentric hypertrophy, affecting stroke volume and cardiorespiratory fitness. Athletes engaging in combined strength and endurance training, such as rowers or skiers, exhibit unique heart adaptations, highlighting the complexity of training impacts on cardiovascular health.
Gender Differences in Cardiovascular Performance
Testosterone plays a significant role in the physical differences between men and women, affecting muscle mass, fat reduction, blood volume, and heart size. Men, generally being faster due to the effects of testosterone, show enhanced performance compared to women, even with equivalent training. Biologic differences between sexes have been extensively studied, highlighting the importance of understanding how testosterone influences athletic performance, as evident in accomplishments by top male versus female athletes.
Impact of Extreme Exercise on Coronary Health
High levels of exercise beyond 10 hours a week are considered extreme and can impact coronary health. Studies have shown that extreme exercise can lead to higher coronary plaque calcium levels, which while not directly causing heart attacks, indicates higher atherosclerotic burden. However, athletes with significant exercise regimens showed a reduction in events and mortality. The risk of atrial fibrillation, associated with excessive exercise, can be mitigated with adequate fitness levels and monitoring to prevent potential stroke risks.
Today's guest, Dr. Benjamin Levine, has shown that with the right exercise protocol, people who were sedentary most of their lives could reverse up to 20 years of heart aging. Dr. Levine is one of the world's leading experts in understanding how the heart adapts under a variety of conditions, whether that's exercise, elite athleticism, or hospital bedrest. Or even highly exotic conditions, like prolonged exposure to microgravity. He is the founding director of the Institute for Exercise and Environmental Medicine at UT Southwestern in Dallas.
Timestamps
(00:00) Introduction
(06:21) Bed rest vs. aging
(11:40) Does exercise protect against long COVID?
(17:14) How 12 weeks of bed rest affects heart size
(18:42) Why a brand-new rubber band mimics a lifetime of endurance training
(22:14) The exercise dose that preserves youthful cardiovascular structure
(24:22) The exercise regimen that reversed 20 years of heart aging
(28:05) What it takes to reverse vascular age by 15 years
(33:29) Benefits of starting an exercise regimen in your 70s
(39:17) Risks of high-intensity exercise
(42:42) Balancing high-intensity & moderate-intensity training
(47:39) Training for health vs. training for performance
(49:58) Make exercise a part of your personal hygiene
(51:01) Why does VO2 max correlate with longevity?
(58:29) The 2018 JAMA study on cardiorespiratory fitness & mortality
(1:04:06) How does change in fitness over time affect mortality?
(1:06:19) Why exercise non-responders should consider "increasing the dose"
(1:10:08) The 2 limiting factors for improving VO2 max in competitive athletes
(1:17:20) Heart adaptations in purely strength-trained vs. endurance athletes
(1:23:09) Why pure strength-trainers should incorporate endurance training
(1:26:53) How strength training affects blood pressure
(1:31:27) How exercise influences cardiac output in mitochondrial myopathy patients
(1:33:25) Does CrossFit count as endurance training?
(1:35:50) What's the best exercise for improving blood pressure?
(1:40:57) Lifestyle strategies for treating hypertension
(1:43:26) Why recovery is key to reaping the benefits of a training stimulus
(1:47:22) The best indicator of being overtrained
(1:54:46) Why HRV is a poor indicator of recovery
(2:00:02) Why do men tend to be faster runners than women?
(2:03:34) Can women achieve similar aerobic exercise benefits doing 2x less than men?
(2:05:06) Are there cardiovascular benefits of HRT in women?
(2:08:45) Exercise volume vs. coronary plaque calcification
(2:15:35) How exercise duration & intensity affect coronary calcium levels
(2:18:48) Why high exercise duration & intensity increases risk of Afib
(2:26:00) Why you shouldn't become an endurance athlete to "live longer"
