Can you exercise too much? [AMA 38 sneak peek] | Peter Attia, M.D.
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- Опубліковано 30 чер 2024
- Watch the full episode and view show notes here: bit.ly/3C89kM9
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In this “Ask Me Anything” (AMA) episode, Peter dives deep into the question of whether there is such a thing as “too much exercise.” He explores the theoretical “J-curve” relationship between exercise and longevity, whereby mortality risk declines with increasing activity levels only to see an uptick above a certain exercise volume threshold. While Peter maintains that exercise is perhaps the single most important tool we have to live longer and live better, he explains the challenges involved in identifying an optimal dose. He takes a hard look at studies-many of which have contradictory results-to highlight major limitations in methodology and how readers could be misled. Additionally, he discusses the rare, but real, risks associated with extreme levels of physical activity and concludes by weighing the benefits against the risks of exercise.
In this sneak peek, we discuss:
00:00 - Intro
00:08 - How exercise reduces risk for all-cause mortality
06:15 - Defining the metric called “MET” and how it’s useful for evaluating different exercises
In the full episode, we also discuss:
-The challenge in determining the optimal dose of exercise and the limitations of methods used to study the effect of exercise;
-Using VO2 max as a proxy for fitness to better predict mortality risk;
-Reviewing data which support the theory of a “J-curve” relationship between exercise and longevity;
-Importance of understanding p-values and statistical significance;
-Deconstructing the studies that show a J-curve: major limitations and how one could be misled;
-Peter’s takeaways on the theoretical “J-curve” relationship between exercise and longevity;
-Risk of sudden cardiac death from vigorous physical exertion;
-Atrial fibrillation associated with extreme levels of exercise;
-Parting thoughts: benefits of exercise far outweigh the risks;
-More.
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The Peter Attia Drive is a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking…and a few other things. With over 45 million episodes downloaded, it features topics including fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more.
Peter is a physician focusing on the applied science of longevity. His practice deals extensively with nutritional interventions, exercise physiology, sleep physiology, emotional and mental health, and pharmacology to increase lifespan (delay the onset of chronic disease), while simultaneously improving healthspan (quality of life).
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This UA-cam channel saved my life! No joke! Thank you Dr Peter Attia. Thank you for having Dr James OKeefe on who became my PREVENTATIVE Cardiologist!!! Spend the time to help your health! Spend the money to help your health!!! NOBODY is coming to save you! You need to take responsiblity to learn and take action!
This is about prevention! Healthcare in general is 99% about intervention. Most doctors dont do anything until you have a symptom!
SPEND THE MONEY! SPEND THE TIME!
US should change the name to sickcare.
The question in the title was not answered: "how much exercise is too much?"
I’ve noticed the small videos he does that they never answer the question so it always leaves you with more questions
@@longshanks5531 Because he's trying to sell stuff not give you information :)
AHA recommends 150-300minutes of moderate or 75-150minutes of vigorous exercise per week. Even if you exceed the recommendations tenfold you can still see some marginal benefits. There is still no upper limit defined when it comes to the benefits of exercise on heart health.
BUT dont overdo it. If you dont recover properly some strucural changes in and around your heart may happen that could bite you in the ass eventually
The jargon makes this discussion incomprehensible to most people
With due respect, I would suggest that ordinary people want to know how much exercise per week, what kind of exercises to perform would give the best results, and if there is one period of the day that would be best to exercise. That would answer most questions.
Very insightful. Great episode. Thanks Dr. Peter. ❤
You have to first define exercise. Any full body movement is exercise, walking for instance is exercise. Then you have to determine how much exercise above a certain heart rate for X amount of continuous time is too much. Then you have to look at the physiological stress of said amount of exercise and whether, being a stressor, the body can adapt over time so it is no longer 'too much' for that individual.
Ok, let's be real. Walking is a life function. Not exercise. That is one of the issues I have with this type of discussion. You need to get your hrs up to 85-92% 2 to 3 days a week. This is part of problem with obesity and disease in the US. I'm 67yo and train 5 days a week or more. If people can't or won't invest 2-6 hours per week, are in big trouble. But big pharma will love you.
Walking is not exercise - Exercise is when you hit Z2-Z5 and strength training.
Came with the hope of some practical application and left with a spreadsheet of MET
If you use Apple Health you can check the average METs for the activity. So that way you can measure the amount of exercise you doing, regardless of the type of exercise. You just need to be careful when averaging them up (eg. 30 minutes at 7 MET, plus 10m at 3 MET, etc)
Minimum amount of exercise for health benefits is 150 min per week at moderate intensity or 75 min at vigorous intensity. Once you get past 300 minutes per week, the health benefits will level off. People are capable of exercising above that level without negative effects to a certain degree, but won't experience any additional decrease in disease, mortality, etc. So the question is what are you training for? Training for health and training for a specific task are 2 different things.
That does not work for everyone.
When you look into the studies that support those guidelines, you quickly see that the exercise measured really is of the lowest caliber. There is no accounting for the diversity of physical training out there. Studies tend to look at cardio respiratory fitness as measured on a stationary bike or leg extensions or grip strength, for example. These are very gross measures that do not reflect all the various sports, training zones, regimens and routines, methods of cardio and strength training, etc etc out there. You would find vast differences between 75 minutes of "vigorous intensity" on a spin bike vs MMA vs crossfit and 95% efforts done at an elite level vs old person who never worked out level for example. Completely different modalities, as it were. Assuming they all impact the body similarly, all affect various disease risks the same way, and all affect the various systems of the body vis a vis aging in the same way is absurd. Research is still in the stone age on this topic.
@@jasonwaters382 But you can talk about the commonalities. Raising the heart rate and increasing blood supply, and pressure will have common consequences. Some people that have no time, or inclination for exercise can get great results for very short time high intensity all body exercise which can be done 3 or 4 times a week and have the same benefits on blood work that long training regimes can have.
@@chazwyman8951 There is some data showing what you mentioned regarding HIIT training. I'm not sure we know yet how that will translate into longevity. Blood work is a positive sign, but I have doubts that some of these HIIT protocols have the same overall long term health benefits. I would incorporate them into a training program that also includes some longer duration exercise.
@@jasonwaters382 If you use intensity measures such as HR, HRMAX, HR Reserve, METS, etc. , you can standardized exercise intensity across modalities. When looking at strictly health benefits, I doubt there is much difference in outcome between various exercise modalities. If you do 75 min of MMA training at a high enough HR, will that really be more helpful for your health than 75 min of spinning at a similar workload? I doubt it. The biggest factor is the exercise itself, no matter the actual exercise being done.
Short answer: of course. We need to get to know our bodies, aiming to do enough exercise but not overdo it.
A lot of variables in play. It depends on the INTENSITY of the exercise. If it’s light to moderate, you can do that every day. Hard or intense requires more time to recovery, especially the older you are. I’m 51 and I work out with weights or resistance 4 times per week. Walk around 8000 to 12000 steps almost daily. Your body needs both type of stimulation, strength training and cardio for optimal health.
Regarding the 10m mark, on how the cycle's power meter shows the instantaneous power output (1kw.. or 1000 joules per second).. and that you multiply it by time (seconds) to get the total energy exerted during that time (joules)..
instead of defining the intensity, duration, and frequency of exercises to do, perhaps it would be useful to test just how much one should be capable of doing, normalized by age as a minimum for optimal-health? For example, number of push-ups, sit-ups, number of curls of xx pounds, peak heartrate (220-age).. as well as blood markers..
ApoB < 60 or the ratio (ApoB/ApoA1 < .7)?
Trig/HDL < 1
He didn't answer the question (big surprise Peter), but his ideals are: elite VO2 max of someone ten years younger than you, and (maybe) reach strength potential and maintain it indefinitely
These sneak peeks do the trick in making me want to subscribe, shame I'm too broke 😭 😂
the annoying part is when the sneak peek doesnt even answer the question in the title of the video
@@wmfbmp5743 exactly
I bet in 5 years Peter will support the Body By science workout. It’s great
Never addresses question in the title.
True. The answer is of course YES
Curious about relationships between calorie burn/heart rate and METs?
Too much weight training and injured my ac joint. Worst injury I’ve had. Tried to keep working out and only made it worse. Took 8 months to finally heal and I’ll never train again the way I used to.
I think joints are one of the limiting factors with resistance training, if you are going hard. I find higher rep lower weights to be easier on the joints as long as the frequency isn’t too high
You can lift around ac joint injuries. Certain movements cause more problems than others. Grade 5 ac joint separation surgery here. Among other injuries.
Do it again, with less weight to maintain your muscle system!
I had my AC joint basically destroyed and put back together. You absolutely can continue training after the fact, but it takes quite a while to get back to normal. It took me over a year to be able to lift every day items above my head or at a distance. Find a good physical therapist, and keep at it. It isn’t a life sentence.
Also had various joint issues with heavy lifting. Built my own simple basement gym and use light weight flexible bamboo bars with the weights hanging by rubber bands (mainly overhead presses and bench press). This results in much less load on joints and all the stabilizer muscles activated. No more joint issues. Bought the bars from Rogue.
Not sure who the source is, but I recently read “movement is medicine, motion is lotion…”
Perhaps
Graham Tuttle, AKA the Barefoot Sprinter
Absolutely you can. And people do it all the time. Not a good idea to 1. Limit the amount of glycogen in your diet and 2. Run off of stress hormones like cortisol, glucagon and adrenaline
No one eats glycogen in their diet.
@@chazwyman8951 yes I understand the terminology. What I meant is foods that contribute into glycogen stores in the muscle and liver.
@@TumbleSensei That's fats, protein and carbs, all have pathways that lead to glycogen.
@@chazwyman8951 carbohydrates have the shortest pathways with the least amount of drawbacks. Fats and proteins require stress hormones like cortisol and glucagon to be used.
@@TumbleSensei If you are losing weight as I am then slower processes are better, as eating carbs tend to increase hunger. And being fat adapted obviates the need for loads of glycogen.
"Rowing at 100W.... Not much that of a killer effort". I will jump off the building as my life is worthless. But seriously, rowing at 100W for 1 hour, for 10K or better, is that a different MET calculus than a 2K or a 4K? And that 100W pulling the greatest drag versus pulling half the max. I'm thinking if different kinds of power (watts), relative, total, reactive, etc. Just a question.
Agreed. My Erg reports me around 62 watts average over an hour. I’m pretty fit.
100W for an hour? I’d have to train exclusively Z2 and Z5 4x4 on the Erg very hard over a couple of years to adapt specifically to that. Even then I might not get there.
@@aaronsinspirationdaily4896 It's been a year since my post and am reading your reply. I had some disk in the CV5-7 and hadn't rowed much since then. I occasionally rowed 10Ks that were abysmal per the usual metrics. Then, I went on a strength training regimen that included a variety of rows, landmine, cable, dumbbell, sand bag, henny. I retuned to rowing and did a 5K. BLUF - increased rowing power + concentration on form -particularly the leg push, and the final pull, got me to a regular 85+ in power without killing me. My gym has a Matrix magnetic rower. Good luck, stay healthy.
I think Peter is the gold standard for those seeking advice on how to optimize their behavior for wellness/longevity. That said, this is the worst "bait and switch" video I've seen in a while. The title says "Can you exercise too much?" They proceed to discuss metrics like METs and Watts etc. Then, just when you expect them to get to the point where they talk about the optimal targets for those metrics, the video stops and Peter basically says if you want the answer, sign up for my paid podcast.
I realize the guy has a right to make money from his knowledge but, cmon.
I hope this saves somebody the fifteen minutes.
1 hour walk per day
Does it matter if I break my hour a day up say 30 mins first thing in the morning and 30 minutes at night walking?
You can absolutely excercise too much.
Tracking "met hours" IS down to the gnats ass 😂😂😂
Gotta worry about Afib when pushing exercise limits.
Majority of people do not move enough on a daily basis. Most average punters do not push themselves like athlete pros do.
Long distance runners and body builders/power lifters (non competitive) have shorter lifespans than average. Long distance runners damage their heart because their body starts breaking down heart muscle for energy. Also issues like cardiac fibrosis. And those who lift extreme weight suffer from cardiac strain from the intense blood pressure necessary to lift so much weight. There is definitely a limit to exercise, but it is so rarely reached it shouldn't be a societal concern.
I doubt bodybuilders shorten their lifespan by their training. (Large amounts of) steroids, hgh, insulin, t3/t4 and stimulants like clen are more likely to blame. (Unfortunately a cocktail of all of the above is what's required nowadays to even compete at nationals level).
@@erikvanderveken1408 Higher caloric intake (which body builders require) is associated with shorter life-spans in every species studied so far. More calories = increased ROS production and other negative consequences. Doesn't matter if you burn the calories because it is the burning of calories that causes the aging. Unfortunately we have yet to study ourselves, mostly because it would be extremely difficult to have such a long and controlled study. There is anecdotal evidence from blue zone regions that support this.
In the latter case, do you think the massive amounts of hormones and drugs they take are the cause or lifting weights?
@@nancyj795 Yeah those are significant factors. I guess I meant power lifters and non professional body builder. The extremely intense lifting and high muscle mass is hard on the heart. I'm talking about those that are exceptionally huge but necessarily professional body builders.
@@DoctorJammer so what about combined long distance runners and bodybuilders ( but without the drugs just TRT) 220-225 lbs around 8/9% BF 39 RHR, about 6:30 mile split. 60-85 miles /week
Like limiting healthcare behind artificial paywalls?
Dang, I got second comment. 😕 🎰. Big fan of the podcast, Dr. Attia!
He really is amazing. Always an insightful podcast!
Too much rambling!
I found this lesson to be not very good at all…far too complicated…and using exercise physiology lingo that the average person (the very type of person we want to have start exercising - because most people do not do any) ..this lesson did not clarify anything to me…tue correct dose of physical activity is best explained by Professor Ulrik Wisloff and his team from Norway. He is a PhD in exercise physiology and has been Alen over 25 years of his t research and simplified it into a health impact software. I interviewed Wisloff, brilliant simplicity and immutable research volume and peer reviewed publications
To much minutia
Peter has the ability to start to explain a topic really well and then go so far into the weeds with the details that you end up more confused than when he started.
Too much jargon. WTF is VOC max (did he say?) Bad mitten? J curve? What a load of bollocks. ACVD? There are some conditions where ANY exercise reduces mobility. So there is no slam dunk here
You not understanding the content doesn't necessarily make it untrue.
@@wbeckmann6965 My objection to the jargon is not related to my objection to their interpretation. As you ought to have seen, they undermine their interpretation with their own words, should you have listened.
Why don't you educate yourself? VOC? VO2/VO2 max. In what conditions , pray tell, does exercise "reduce" mobility? None of your rambling makes any sense in trying to get any relevant point across.
@@quantumdecoherence1289 Why not educate myself? I have a life to live and far more interesting things to learn about.
@@chazwyman8951
You're killing me 🤣
I think the answer to this question that is not answered is rhetorical, as it has been answered many times before.
There is no such thing as too much exercise! We are still hunter gatherers that went days tracking prey without food.
1 glass of red wine is better than any exercise 😀
I wish you had paid ads🥲. You are in the top 2 doctors I study. I turned my health around since 2019. There are too many subscriptions now (Netflix, Hulu, Amazon, ESPN+, cable TV, UA-cam, NFL Network+, etc). Everyone wants a monthly subscription today, but the consumer can only pay so much$$$. Look what happened to CNN+👎. Right now, I am not able to continue to add your subscription🥲. Therefore, your AMA’s are very deceptive since I watch to learn the optimal amount of exercise and never get the content🙄.
Who is the 2nd doctor, please ?
@@laurihanstin4464 Nick Stenson I believe. Don’t think he’s a doctor
Dr. Mark Hyman🌞