This Exercise shrinks PLAQUE in your arteries (!) | New trial
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- Опубліковано 22 тра 2024
- New trial shows exercise reverses artery plaque. We look at type of exercise and implications for heart disease reversal, including classical risk factors like glucose and cholesterol.
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References:
1-academic.oup.com/eurjpc/artic...
2-jamanetwork.com/journals/jama...
3-www.jacc.org/doi/full/10.1016...
4-academic.oup.com/eurheartj/ar...
Disclaimer: The contents of this video are for informational purposes only and are not intended to be medical advice, diagnosis, or treatment, nor to replace medical care. The information presented herein is accurate and conforms to the available scientific evidence to the best of the author's knowledge as of the time of posting. Always seek the advice of your physician or other qualified health provider with any questions regarding any medical condition. Never disregard professional medical advice or delay seeking it because of information contained in Nutrition Made Simple!.
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0:00 New trial on exercise and plaque
0:44 The exercise program
2:07 The Results
4:08 Plaque size vs structure
5:20 BMI, HbA1c and cholesterol
7:13 What the results mean
Dear all: Just a quick clarification regarding the "peak heart rate" mentioned in the video. Multiple viewers asked if several minutes at 85-95% "peak heart rate" isn´t too strenuous, especially for patients with heart disease.
Although the study Methods aren't entirely clear, it seems they performed a ramp test prior to the study to determine each participant´s exertion limit. This test started at a comfortable intensity, which was gradually increased every minute until the participant stopped due to exertion (or until VO2max was achieved).
It seems, then, that "peak HR" refers to the highest HR recorded during this test before the participant chose to stop it.
In HIIT, it is customary to calculate "maxHR" by subtracting age from 220. It appears "peak HR" used in this study is unrelated to this calculation, and is instead a personalized measure obtained empirically. In other words, two participants with the same age could have wildly different "peak HRs" depending on their condition. This allowed them to tailor the exercise to each person's ability and tolerance.
Finally, the main takeaway from this study is that physical activity has the potential to deliver some plaque regression. The specifics (type and exact protocol used) may or may not be important (more work will be required to establish this).
Hope this makes sense and thanks to the attentive viewers for the inquisitiveness of bringing this to our attention.
Gil
Thanks for clarification
I'm no expert, but I have started doing this kind of 4x4 intervals and some even shorter intervals like 20s sprints. With shorter interval after recovery, it's not even possible at least for me to get average heart rate close to my max because the heart doesn't ramp up in 2 seconds but the heart rate gradually rises. So even with all out effort, average heart rate might just be for example 145. At least the instructions I have seen is, you run the 4 minutes as fast you can or at the fastest steady pace you can do the 4 minutes instead of any heart rate target. With longer steady pace runs like 5k it's when I really see the heart rate climb over 170 to the max if I'm pushing and I'm typically not able to hold that pace very long and either have to slow down or even walk.
The 220-age formula is an approximation (a bad one) that will never suit everyone. The HR Max varies to greatly between people. For my part my HR Max is now a little above 190. I read 192 on my watch during a training on the track. When I did my VO2 Max test in a lab a few years ago it was estimated to 196. The 220-age formula would give me only 156 (I'm 64) a value that is obviously very underestimated.
Anyway we shouldn't trust too much a formula where we substract an age in years (dimension = TIME) to a cardiac frequency in beats per minute (dimension = 1/TIME).
I really wonder how they measure plaque-buildup this precise !!?? CAN I HAVE MY PLAQUE-BUILDUP MEASURED ???
@@cyberfunk3793 I very much agree to "just ran as fast as you can" for your target duration (wether it be 20 seconds or 4 minutes).
It will take 30-60 seconds before one reach 90% (especially it will take some time in the first bout)
Running a full 4 minutes at an AVERAGE of 85-95% - is that even possible? Certainly brutal and VERY taxing!
Just remember, HIIT should be prescribed in moderation. Daily HIIT is no only unnecessary but it’s not sustainable. 4 sets of 4:4 (4 min max effort, 4 min recovery) twice a week is plenty and gives enough space for recovery while allowing you to participate in other activities like zone 2 cardio, sports, hobbies, and strength training 😊
What is Zone 2?
Agreed! HIIT also causes CNS severe fatigue. People don't understand HIIT should be done within seconds or maybe a minute of active rest then another round. Olympic level distance runners don't run to the point of 95 percent of max heart rate over a four minute interval. This is one study. Also, if someone/me lifts weights four plus days a week and also performed lHIIT, I would be overtrained and need to take weeks off to stabilize my CNS.
@@MeredithDomzalski zone 2 is just a term for any cardiovascular activity where your heart rate falls within a certain range, (70ish % of your max, I believe). It’s more of a steady-state endurance based form of cardio performed for much longer in duration (45-90 minutes), low-moderate in intensity, and easy to recover from.
@@MeredithDomzalski Similar to what michaeljuliano said. another way to put it is exercise where you can sustain full paragraph conversation. someone on the phone with you can tell you are doing some physical activity from your voice pattern.
@michaeljuliano5716 Could you please list an example of exercises based on 4 sets of 4:4? Thank you.
I exercised pretty much daily until last month when I did no exercise because of work. This is what happened.
1. I lost my sleep regularity.
2. I lost at least 3 points from my VO2MAX.
3. My resting blood pressure went up by at least 10 points on both my systolic and diastolic.
4. My fasting blood glucose went up by at least 10 points.
5. My body fat ran up by about 3%.
6. I believe my vision has deteriorated.
It was only about 33 days of inactivity. Yeah, it was a really bad idea to stop exercising. I guess what surprised me was how quickly my health deteriorated. I think it will take at least until the end of this year to recover from this lapse of judgment. Never again!
Do not forget the other factors. Maybe you had huge stress from your work. And maybe your food intake was not ideal either...
Return and made your body happy!
How do you measure your VO2 MAX?
Smart Watches
@@azmilezzuanzubad9527
@@azmilezzuanzubad9527 It is estimated by my Garmin running watch. If you ran sufficiently long, it will use your pace and heart rate data to estimate your VO2MAX. According to net wisdom, it is supposed to be accurate.
4 min at 95% peak heart rate is brutal.
In a cyclocross race it can be that you hit an average of 90% for max HR for 40 mins…
All is relative to fitness. I'm almost 57 and I can cycle at 160 BPM for 40 minutes continuously. My max would probably be 173, which I can hold only for a few seconds.
@@jsherrier1196 I haven't heard of such a long HIIT intervals. Typical interval length 20-40s, rarely 60s, and a rest for half of the interval length. For example in tabata: 20s/10s *6 (3min) with MAXIMUM performance during interval. 4min at 95% doesn't seem reasonable. Maybe it was 4min of series including intervals and rests.
I takes time for HR to rise...does the beginning count?
@@seanwhitehall4652it also takes time to drop so if you just aim to keep your heart rate at the target level until the 3 or 4 minutes are up, you should be doing fine. The most important is to actually do the exercise 😊
Of all the various health related activities, foods, supplements, etc.that I've done over the years, HIIT gives me the most immediate and positive feedback. My energy level feels great the next day. 3 times a week for about 30 minutes.
Thank you! You are one of the few credible sources on the internet.
this makes me very happy - I've been doing HIIT routines for the past few years!
Love how you really analyze the results and ask questions rather than just giving a surface analysis of the findings which could miss important nuances
So happy to learn how statins reverses plaque. My ldl-c is 28 and my cardiologist is thrilled. Now I know why!
As a child of the 70's HIIT would have been running for the bus.
I have to say though, these videos are really informative and very well presented. I live in North Wales, so any cycling I do has a bit of HIIT with the hills 😊
What country is North Wales?
@@jungtarcph
Either a part of Britain or a town in the USA. Towns are too small to have well-known geography, so he probably meant the part of Britain.
Jim Fixx who wrote the "The Complete Book of Running" proved that genetics wins over exercise.
1. Genetics 2. Diet and lifestyle 3. Exercise … maybe lol
great video - presentation and summation done well and thoughtfully - thanks for sharing!
Dr. C., fantastic channel, I learn a lot. I think you'd want to know this: At 2:37, the reduction from 49.5% to 48.3% is not "a 1.2% drop", it's a 1.2 percentage POINT drop". The actual percentage drop is 1.2 ÷ 49.5 = 2.4%. Seeing the numbers on the screen it's clear to see what you meant, but what about if someone quotes you and doesn't use the before and after figures?
Thank you for this video Gil, Six months ago, I was diagnosed with Moyamoya disease after having a TIA while watching a movie with my family. At 42 years old I have had to make major lifestyle changes to try slow the progression. The last few months of MRIs and CTs show my condition is stable. I like to think it is because of a combination of mediterranean diet, intermitting fasting, walking, HIT training and medications together. This information on those studies gives me hope I can reverse things even a little to reduce my risk.
My brother in law was diagnosed with Moyamoya and had to have brain surgery. This was 10 years ago. Have they decided lifestyle changes such as yours is enough? Just wondering as his surgery was brutal.
Interesting, thank you, Gil, for the content
Love the Nuance Gil! I’m really glad you emphasized the point that their LDL was essentially at the threshold for stagnation, which I think is a key point. Great video!
They were all on statin drugs.
Coincidentally that’s exactly what I’m doing. After 2 stents with no mi 1 yr ago I started slow. Now I’m up to walking @ 3.4 for 2 min and running @ 4.4 for 3 min. For 2 hrs on treadmill. My cardiologist hasn’t done a full follow up exam with a CAT yet but I’m looking forward to it and impressing the techs when I do my next stress test (I’m 67 now). Impressing the doc and the techs is rewarding after busting your but at the gym for months.
Wonderful news! Thank you.
A very good video doc. Very nuanced. Made me realise like everything they are not as absolute as they seem.
I wonder how old these participants were. HIIT is quite vigorous, so I guess having the instructor there was also a safety measure. Thanks to your videos, at 73 with a very low, lipid, lowering drug, I started the isometric exercise to lower my blood pressure. I really appreciate your videos because I think they’re the most truthful and realistic on the Internet. Thank you so much. Aloha.
Mean age 58.7 years in the control group & 57.3 years in the exercise group.
@@avoycendeether8869 I wonder how I can tweak it for my limited mobility. Thank you
@@avoycendeether8869 I doubt anyone that old with those risk factors can even complete that exercise routine.
Isometric (held positions) is usually contraindicated for high BP 🤔
@@sandyoptimismrules2512 Totally opposite. Check recent data with side to side comparison.
My version of it: 5 repeats of 4 minutes 7 miles an hour with 4 intervals of 4 minutes 3 to 3.7 miles an hour. I do not warm up. I just do it. The total time is 36 minutes plus, some times, "cool down" at 3 miles an hour. This is also close to 35 minuets of walking or walking and running that alleviates already existing peripheral artery disease or may even help to prevent it. No warm up means that I must necessarily exercise in the afternoon or evening. If I warmed up, after the warmup, I would just go home.
Super good info. Thanks man
Great information, thank you
the HIIT exercise you explain is basically a VO2MAX session which is probably one of the best way actually live longer. And to VO2MAX 2 times a week and 3 times of Z2 and you are set for a great cardiovascular health
Dr. Gil, you continue to be my go to source on lipidology. Always unbiased, with the rare ability to take a mass of information and reduce it to digestible portions. Keep up the good work!
This has been known for a long time but has recently been re-branded as HIIT. The California Longshoreman study showed very similar results in 1951. As a former track coach, we used FARTLEKS which was first used in 1930, where we used brief high intensity runs followed by brief walks or jogs and were very effective in improving running performance. This is all history re-visited.
Hey dullard, of course anaerobic intervals have been used since the beginning of time to improve performance. Food gravy. BTennis players were using them in 30’s too. The POINT is whether it can affect plaque size!
But I would assume you weren't doing fartleks to reduce the size of arterial plaque 😊
Thanks for the great video. Appreciate it!
Whahooooo !!! Who would have ever thought about that ????must be new discovery !!!!👍👍👍
Some doctors in India say that high levels of HIIT can cause the plaque in the artery to rupture and cause heart attack. This was in the background of many fit young people dieing from sudden cardiac arrests .Could you please share what the current literature says about this?
That’s because after people received a certain shot they started dropping dead and now they are trying to normalize kids and young people having heart attacks and cardiac events
Yeah totally nothing else that those athletes might have taken in the past couple years that could be a factor.
Those Indian doctors are full of it. Show us the clinical data!
This is why it's not healthy to just go into HIIT training of someone who is not healthy. Start slow cardio for for a while and work your way up to HIIT and switch it up .
@@rockbrd1 The two are unrelated, but yeah... whatever
Awesome content !
Excellent content as usual! I'm enjoying the shorter videos. I save your longer ones for when I'm on the treadmill lol
When plaque is reduce, where does it go? What is the mechanism of plaque removal? I have never heard a biochemical explanation so I suspect they don't know. Please enlighten me.
I drove my LDL to 55 with weight loss and diet. I do work out three times per week.
Curious about the specifics. Care to share diet-related changes?
@@guestguest747 stopped eating the shit. Lots of fruit, veggies, nuts, no processed. food.
LDL can drop while losing weight, but it doesn't mean it will stay low permanently. I would be surprised if your LDL stays at 55 without drugs, unless you are very young, genetically lucky or a vegan.
I always have doubts with small sample size groups, here its two groups of 30 - but I also didn't know that it's possible to actually shrink plaque size instead of just maintaining it. So it would be great to have a follow-up where:
- the control group then gets supervised non-HIIT exercise to see if the improvements in the other group were exclusive to HIIT
- the HIIT-group continuing supervision to see if their plaque levels decrease further
30 is actually pretty good sample size.
There is other evidence relating to shrinking plaque with lipid lowering strategies, including diet and statins. That's what the graphic is Dr Gil posted in the video at 6:55 . Various large studies (with much larger cohorts than 60 people) showing plaque regression when LDL goes below 80 mg/dL. HIIT exercise, or exercise in general, probably has an additive effect.
I totally agree - not enough people in the study for me to run to the gym. Would be interested in reading the paper.
I would view a small sample size the way you do. However, if a large enough % of that group had a similar change and if that change was significant, it would sway me to place less doubt on the size of the group. But, like you and others, a new study with a larger group would certainly be warranted to remove that group size doubt.
A 1% reduction doesn’t seem statistically significant. Would like to see follow-up studies with larger groups.
well its a nutrition channel but I love your videos on exercise
Last
Great content as always
Thank You 🙏
Consider 80/20 training. Just watched a new running video from Coach Parry. The presenter, having read 100 running books, says that the best training for even elite runners is 80 percent at LOW INTENSITY, and 20 percent HIGH INTENSITY. Another recommendation is interspersing walking with running. Indeed, walking has lately been touted as being as beneficial as more intense workouts. Recovery is also very important.
thanks for the great explanation!
And i like your microphone :D
Thanks! Very helpful to know. Will target to add 1 or 2 interval per week to my zone 2 rides.
4x4min hiit is standard vo2max training session. In endurance training a ratio of 1:4 of hiit : steady state low intensity is often recommended to be sustainable and optimal performance wise. Twice a week is doable for a limited time, but long term it requires a good athletic level with many training sessions per week.
Excellent.
WOW! Great information! As a 66-year-old with a strong heart but needed several stents due to angina, this is important stuff. In recent years, I’ve ramped up resistance training but only stuck my toe into the HIIT pool. Some studies have shown that training at lower intensities can have more benefits than at high intensities. But it seems to depend upon your goals. I’m going to try this routine on my rowing machine in a couple minutes.
Great video today with Dr. Gil on Physionic!
Do you think HIIT is suitable?. I had an MI and 5 stents (at age 42 unfortunately)and cardio rehab highlighted I should not do competitive sports anymore… due to stop/start intensity. Just wonder if HIIT is potentially dangerous for us?. PS. I am running 5k’s and resistance work just fine. Walking loads etc. good diet etc.
@@richgl31 Totally agree, for older ppl HIIT is not recommended because of the stress it can put on the heart
The main point is neither group plague grew - so if you are starting to get in the danger zone - pressurize your Dr for some drugs - suitable for you - plus exercise
Also this means if you start earlier - at say 25% plaque - you stabilise it there .
Also if this HIIT exercise continued - it should lower overall mortality - more efficient body , more plasticity in your veins and arteries
Just hold out till they get micro cleaning bots to safely remove plaque - most plaque. biofilms in nature are tough to remove - even with a scrub brush- say in bathroom on mold that is mature , or with teeth not brushed enough ( normally need a hygienist with ultra sound )
The other hope is new techs that can produced effects deep under skin at very targeted points -just tech now starting to be used for brain surgery I believe - ie a 3D generated waves that only work where various paths meet up - so not invasive surgury
Who knew my high school track coach in 1980 was a pioneer. We did intervals for 60% of our training. I kept the habit into adulthood and this makes me happy.
HIIT has been around since the 1930’s, pioneered in Sweden.. look up Fartlek methods. en.wikipedia.org/wiki/Fartlek
Happy Thanksgiving Gil!
happy TG!
I am 55 years young and Im going start sprinting tomorrow. This is HIIT. Feeling great!
How's it going so far?
Damn wish they also had VO2 max scores from the start and the end of the trial. Would be really interesting to see.
very useful !
Thanks for the video. Several Canadian University studies show the benefit of HIIT.
I apologize if this comment is going to be really long, but it's right up my alley as I have a lot of personal related experience:
I have heart disease, had a stent placed in a "diagonal" (smaller side-branching) artery when I was 45 due to angina symptoms, then a NSTEMI when I was 49 due to that stent (according to the cardiologist) - the stent was protruding into the LAD and caused buildup there that might otherwise not have happened, and created a 90% blockage which was stented. In that stenting procedure, the plaque was pushed into the same diagonal artery (I believe this process is sometimes called "jailing"?), then the diagonal is reopened via a stent or balloon. In my case, since there was already a stent in there, they went with a balloon.
This all went great until 5 months later I started getting angina again. What they found was that the angioplasty (balloon) had at least partially failed in the diagonal and it had close back up, at least partially. The lack of blood flow was still considered to be minor and so they suggested anti-anginal medication, which I tried maybe 5 different kinds and the only one that worked in any noticeable way had horrible side effects.
At that point, my cardiologist recommended a specific type of exercise that reminds me a lot of HIIT. The way he prescribed it, and the way that I have done it since, is to exercise in a way that brings on the angina symptoms. Once I notice them, I have to keep going for another 1-2 minutes, then I rest for as long as it takes to where I'm not longer feeling the angina anymore (which at least initially is 30-60 seconds). Then I go back to exercising until I trigger the angina again. He suggested I do this daily, or as close to daily as possible for 30 minutes per day. He said that this was to increase collateral blood vessels so that more blood could get to the heart tissue around the diagonal that was not getting enough due to the blockage. So it wasn't specifically for "decreasing" plaque.
I've been doing this now for over 4 years and I haven't experienced any other cardiac issues, thankfully, so it's kept me out of the hospital at least, but it also increases my overall quality of life, since when I first started getting the angina, I was having it just walking on relatively level ground at a normal (not too slow but also not very fast) pace.
What I've found with the exercise is that the more consistently I do it, the less angina I feel in general, and my exercise capacity goes up.
My current routine is to hop on my treadmill and go a few minutes at 3.5mph at an incline of 7.5 (although in the past I'd gone as high as 10.5). I keep it on the lower side because if I go higher, then over the course of 30 minutes, my heart rate can get over my max (peak?), and then I have to either make the intervals shorter or go down in incline. With 7.5 right now, I can do 40 minutes with only getting to about 85% of that peak heart rate. When I am really consistent about it, this can actually be increased because my exercise capacity increases. So basically, I start by doing about 4 minutes because the initial onset of angina takes a bit longer. After that initial interval, I do a few 3-minute intervals separated by 1 minute rests, as I do this, the onset of angina gets to be later in the interval, so that by the time I'm on the 4th interval or so, I can increase it to 4 minutes of walking. And soon after that, the angina is so subtle that I end up going 5-10 minutes per interval. The longer the interval, the higher my heart rate eventually climbs, so I will often stop simply to "reset" so that it doesn't get too close to my peak heart rate.
So, if this is indeed decreasing my plaque, that would be fantastic, but I'm happy with stable plaque and simply keeping my angina at bay. To give you a sense of where I am outside of exercise, as I mentioned, I eat a WFPB diet that is very low in saturated fat, and have been doin so for 6.5 years. I'm also on 10mg of Rosuvastatin (been on it for almost 5 years), and my LDL over the last 5 years has kind of gone up and down between 35 and 55. I've been at a normal BMI for about 6 years. I'm 55 right now.
I'm curious about similar exercise routines in terms of outcomes as well, but also in terms of anginal symptoms, exercise capacity, and general quality of life. I'm assuming that if done mindfully, exercise can only be beneficial for most people, but that of course I don't have all the studies to back it up, just get that general sense from everything I've read and heard about it. The caveat being of course that you can overdo anything!
THANK YOU VERY MUCH
tks for taking the trouble of detailing your experience and sharing it. I think you know your body more than anyone else so if it works by all means keep on with it. From the scientific explanation point of view could it also be due at least partly to angiogenesis whereby your heart has buillt micro capillaries in response to the increase in blood demand induced by the exercise routine ?
@@lionscurepipe Yes, I mean that's what I think I always understood it to be, not about plaque reduction, but just angiogenesis. I would be great if plaque were being reduced as well, since that would also potentially improve things...
Very interesting. I’m 49 , had MI at 42 and 5 stents. 3 circumflex , 1 in each of the others. Been ok, 5 km runs , weights etc.recent treadmill stress test though had to be stopped at 9 min, slight ST depression; returned to normal quickly though. I could have run on, but was stopped. So now waiting for angiogram (4 months time). Interestingly had just started walking a lot with new dog rather than running. I am also not sure I feel angina… I also apparently have a slight hernia- so hard to differentiate!. I am pescatarian mainly/ going low sugar now though to reduce inflammation and so reducing carbs too. I am building my fitness back for long runs- but chosen indoor bike now as you can warm up more gradually. Hopefully I can copy you in getting the heart going without issue again. Sure it is because I had a stressful patch and did not do the regular higher heart rate exercise🧐.
@@richgl31 Just be careful with "low carb" - that's a big part of what landed me in trouble to begin with. I bought all the low-carb rhetoric and just ate mostly meat and cheese and low-carb veggies, a very high-saturated diet for 12 years and after 12 years ended up needing a stent (at 45). If I could go back in time I would have stuck to my older pescatarian diet but made it only moderate amounts of fish with mostly whole plants. I've been eating a diet of only whole plants for the last 6.5 years and so far so good.
This is great. More studies will be positive news.
Very interesting. HIIT is effective, but I think it's tough for a lot of people to stick with.
Yes and some studies have show HIIT to be a potential problem for older people because of the stress on the heart. Also any HIIT exercises done in cold temperatures can also be more of an issue
There have already been studies on this at Toronto Western Hospital. I'll try to find the link later. A 1% reduction after 6 months isn't much - and not everyone got a reduction - but for every 1% reduction, blood flow increases 2 or 3%. Things only start getting dangerous after 50% blockage though, particularly in the left descending artery (aka "the widow maker.")
Braking hit interwall to shorter bursts and also recovery periods is as efficient but IMHO more mangable. I used to do 45 sec+45 sec and did many repeats. At the end of the session the heartbeat remains constant high also during the recovery period:) Bu resting pulse went below 40 Bpm
Awesome overview!
For me the question would be whether HIIT reliably reduces plaque or if the high blood pressure simply “blasts” plaque away for it to accumulate somewhere else in another form.
I think lipid reduction is smart because the approach is to lower the building blocks which are used for plaques.
That being said, I believe HIIT or any exercise is a good idea and should be incorporated into daily routines.
Can you explain whether it was hard plaque or soft plaque or some combination they measured before and after? I see in the study it says _"multivessel intravascular imaging was performed when feasible by a combination IVUS- and near-infrared spectroscopy (NIRS) catheter using an automated pullback system (TVC-MC8 model system with a 3.2Fr 40 MHz catheter, Infraredx, Burlington, Massachusetts). Following administration of intracoronary nitroglycerine, the NIRS-IVUS catheter was positioned as distally as possible in the coronary artery. To ensure matching coronary segments at baseline and follow-up, the distal starting points of the pullbacks were recorded angiographically to assist in registration of the corresponding segments at follow-up."_
I am only familiar with CAC and CIMT (which I'm not even sure is a widely accepted method) for measuring plaque thickness. This sounds like a sort of roto-rooter camera method that would measure the diameter of a partially occluded artery. How can it see and measure the thickness of plaque through the walls? How does it know the entire artery hasn't simply slightly expanded because of the HIIT?
A drop from 49.5% to 48.3% is not a 1.2 percentage difference. It's a 2.454% difference.
?
@@vaska1999 If plaque filled 100% of the artery lumen, then dropped to 98.8% after the HIIT program, that would be a 1.2 percentage difference in plaque volume.
If plaque filled 2% of the lumen, then dropped to 0.8% after the HIIT program (still 1.2% less), that would be an 85.7 percentage difference.
The percentage difference between 49.5% and 48.3% is 2.454.
Awesome commentary, interesting study! Maybe the hardest thing to believe is the level of compliance the authors achieved from the exercise group! Ha! I note that they mention this level of compliance would be unlikely outside the boundaries of a study. No kidding! Also, the authors though 60 participants was limited...I'll just say when I read 60 participants I thought it was a very good level of participation for this sort of study. Especially when the first thing you ask your 58 year-old CV patients to do is a GXT until they very nearly feel like they're gonna die. Well done Vesterbekkmo, Madsen, et al.
Been doing intervals for a while now. One session a week and one session sprints. Intervals is harder. Start out with 3 minutes and a longer wait between. Build up to 4 minutes. Definitely feel the improvement in stress, fitness and sleep compared with endless base slow runs.
Thank you
It took several months after my MI before I felt comfortable doing HIIT again. Agree with other comments about being worried about having another heart attack
This goes back to something I read half a century ago. Something I think was mentioned in Dr. Cooper's, _Aerobics _ .
A doctor had a patient with heart disease who improved vastly within several months. It turned out the patient had set himself the task of chopping wood every day. His endurance gradually increased, and his symptoms improved.
If you've ever chopped wood, you know it's kind of HIIT. You swing the axe until you get tired, rest, and then continue swinging
Clearly there are many ways to do HIIT judging by the comments. 🙂
I'm definitely going to do it now. I will build up to an intensity that feels right.
Interesting. Good to know plaque reduction is possible.
One nit of the study is that they should have supervised whatever type of exercise that supposedly took place in the control group. By "supervising" anything you are watching it and therefore changing its behavior (Heisenberg). The other group should have been "supervised" in the sense they were simply witnessed and verified to do whatever level of exercise they would normally do. Total physical activity levels should have been recorded for both groups as a comparator. I suspect the relatively small plaque difference between the two groups would have shrunk, because I would bet my LAD that unverified exercise compliance rates for already unhealthy people is not good.
Thanks for the interesting info. Most people just call it Hit workout and don’t say each letter.
Review of the study demonstrates BMI were about 29, and this is borderline obese. The single largest driver of longevity is activity and BMI from all large trials. Men specifically that had BMI's of 23 saw limited additional benefit of medication in large trials. A HIIT workout is typically an artificial gym workout. More advanced workouts associated with longevity include a 3-5 mile trail run, where the trail elevations vary, and also athletic activity like soccer, or gravel biking, where there are sustained aerobic activity and also natural recovery periods. Life long participation athletes have high longevity as well as life long musicians. The reason is the intensity of practice is very high and the interactions are natural. The most sustained natural activity is hiking, which is also the best activity for the body as this was the bodies natural migratory state evolutionary speaking. The challenge in daily life, we rely on machines and western diets are highly processed and high in fat.
Hey Gil, first of thanks for the video and the work youre doing, you helped me tremendously on getting to a healthier diet!
I wanted to give some general feedback. I really hope i dont come across as bashing your vids, i just dont know how to say this better cause im not a native english speaker:
What i heared from alot of big youtubers, and what i agree with, is that audio quality is the most important thing about youtube videos, because alot of people tend to click away when the audio isnt great. Also it can mess with headphone users if they have to turn up the volume on your videos and then the next video from some other youtuber plays (or your outro music) and blows their ears out. I think your gear is absolutely fine, but imo there is some audio processing missing that would improve it quite a bit. I have no experience in audio processing for podcasts, so take this with a grain of salt, but due to being a musician i can give you a general direction (should be doable in any video and/or audio editing software):
Normalize the audio, then do some equalizing (comes down to personal taste, i tried low cut at 130Hz, +3db at 550Hz 2oct bw, -5db at 1.4khz 0.6oct bw, -8db high shelf at 6khz 2oct bw, just to boost some important frequencys and cut out unpleasant or unessential ones for the next step), then a audio compressor (-21db threshold, 5:1 ratio, 50ms release, 6db makeup gain).
Maybe you can play around with this a little, or better, look through some youtube tutorials, or even better, find someone who knows exactly what he is doing.
Again, i love your vids and your work, so please dont read this as "your audio sucks, do exactly as i say", but rather like "hey i noticed this might be something you can improve, here is a rough idea".
thanks!!! feedback always appreciated!
@@NutritionMadeSimple forgot to mention 6db makeup gain after compression 😅
Dude many UA-camrs hint the video is close to ending soon. Listen out for that. Also check how many more minutes is left of the video. I do this all the time. Get into the habit.
What about an interview with Ford Brewer from Prev Med Health? Would be a good conversation. Love this channel!
Important news for me, TY. I'm 45, but want to be thinking about it now. The most encouraging takeaway for me from this video, is it is possible to lower plaque levels. TY much.
With the help of exercise, you can lower plaque levels when your LDL/ApoB is around 80 or lower. And you can lower your LDL/ApoB with diet and/or statins.
Agreed! Most things I've seen up until now said that plaque was permanent and unalterable.
@@jimcrockett9296 The most POWERFUL way to reverse plaque even more than this is prolonged fasting. At least 14 days of water fasting to significantly reduce arterial plaque
@@jimcrockett9296 In this study it went down from 49% to 48% in 6 months with statins and HIIT training. Honestly, for me, someone with constantly high LDL and low HDL levels, it's not very encouraging.
Good stuff. Bums me out that they only studied HIIT. Maybe lower intensity exercise is just as effective.
Interesting. I used to love HIIT but lost condition over time switching to just weights/no cardio
love your content , idk what happened to your lighting and mic. used to be massively better
I do HIIT on my bike. Pedal fast for 30 sec, then coast for 10 sec, do it again like 8 times. When i get home, my blood sugar is 80. Ive been doing this for 3 mos, combined with walking and push ups 3x a week. My average blood sugar is 113 now compared to 130 without HIIT.
That’s closer to the “intervals “ that i’ve seen
Just had cabg X4 five weeks ago. I’m walking a mile a day now but my goal is what was mentioned in this video.
This matches playing hockey perfectly
This is interesting, this is similar to what I do to train VO2 max, so might be another reason why VO2 max tracks so well with longevity.
I agree with you. My view is, VO2 max is merely a bio marker that you are already doing a lot of exercise which gives you the benefits.
You would think there should be hundreds of trials similar to this one by now, including some long term ones ...but we'll be having exactly the same conversation 10 years from now.
I like that you're doing videos looking at research on exercise now Gil. It would be great if you could look at research on sleep as well! Personally, I see diet, exercise and sleep as the big 3 to DO well
The number 1 to prioritize is prolonged fasting. At least 14 days or more. That's far more powerful than diet, sleep and exercise. Well maybe a combination of sleep and prolonged fasting.
@@RandomHuTaoSimp I strongly disagree.
Agree with you in that sleep, diet, and exercise are the big three!
An interesting topic that I don't know if you have covered yet is non-nutrition causes of higher LDL and other markers. I have been eating low saturated fat mostly plant based diet for over 40 years. My cholesterol levels reflected that until a few years ago when work and life became very stressful. Diet and exercise stayed the same, but cholesterol especially LDL shot up significantly.
Thnx, I have angina and this gives me a little hope. I think boxing is a HIIT like training and I start feeling better with it.
If you have never done any high intensity exercise before, don't jump into HIIT right away. Start slow and progress over time.
Very interesting news! I'm 45 with some risk factors but doing some things right. Weights, lots of low-intensity cardio, but usually at least a couple of HIIT sessions a week. I'll have to make a point of including more.
You don't need to include more HIIT if you're doing it at actual high intensity as there are some downsides to TOO much (joint pain, overtrainjng, etc). Add more traditional intervals vs trying to overdo HIIT.
Intuitively it seems like intense exercise that clears out the cobwebs is a good thing.
If you have clogged blood vessels, you are setting yourself up for a cardiac arrest with HIIT.
HIIT requires far more oxygen & blood flow to the affected tissues.
Start slow with light & medium intensity physical activities such as brisk walks, aerobics, swimming, floor exercises, deep stretching, resistance training, skipping, a game of badminton or tennis, perhaps !
Introduce very short internal HIIT only & only after your blood circulation, and vascular health has improved to the extent that your body has already adapted to light & medium intensity activities.
I've been practicing HIIT for decades, while my LDL-C has been at or above upper 'safe' limit (FH-determined, very high risk). I've never been on a lipid-lowering therapy and yet I have no plaque at all! At least the doctors haven't found it yet.
another great video, but please buy a 4k camera as 1080 looks really outdated on a monitor
I do HIIT once per week with light weights. I believe that apart from the plaque benefits, it helps on burning fat as well.
whole food plant based diet without salt, oil nor sugar can help manage and potentially reverse atherosclerosis (aka heart disease and plaque buildup). I imagine with the sheer amount of blood volume being produce through HIIT, you would get a compound effect
I love HIIT. I do it everyday. But if I were to do 4 cycles of 4 minutes, I wonder if it would give me a heart attack right on the treadmill.
haha it is intense. gotta ramp on to it :)
It's not HIIT if you can do it everyday. You Clearly have capacity to push much harder if you are able to deal with the intensity everyday. Food for thought!
Last year, I tried some HIIT a few times. At my favorite park, I’d jog a loop that included an incline. I’d sprint up the hill, and jog back down, repeating six or eight times. Not fun. Stopped doing it.
@@cybervoid8442 Tell that to Jim Fixx or Bob Harper. You can be fabulously fit and achieve very high levels of athletic performance, yet have large, fragile, soft plaque filled pustules lying inside your arteries just waiting for enough physical stress to pop them. Intense exercise stretches and dilates arteries. It also greatly increases both blood pressure and the shear forces of blood rapidly rushing past the fragile pustules. Put it all together and one day one of the pustules pops and it dumps its contents directly into the bloodstream, resulting in a massive clot.
@@Nicksonian perhaps doing fewer reps is better than doing none. Whenever I see stairs, I try to run up the stairs as fast as I can. Whenever I am at a crosswalk, I run as fast as I can. Just short bursts of extreme efforts. I have lost more weight and have a much higher energy level now.
The problem with exercise studies on old people with serious health challenges is that no one wants the subjects to have a heart attack while doing the exercise. None of these people were running like in your graphic. There is no way these people were doing 85%-95% actual max heart rate for 4 minutes. All the exercises were watered down to the point where is was just 43 minutes of them walking on a treadmill alternating between a 4% and a 0% grade. Love your channel, keep up the good work.
yes, the "peak HR" they used in the study is quite different from the "max HR" commonly used in HIIT. no doubt this was much milder or these patients wouldn't tolerate it :)
Great new video!🎉 How about this: since statins/lipid medications actually increase HbA1c, what if the added exercise helped them not increase their A1c, so in spite of the lipid lowering meds it didn’t go up?
Also, I’ve messaged you on this before… what about Lp(a) in this larger equation? Even if exercise doesn’t and can’t lower Lp(a) values, maybe it’s the number of *events* that can be avoided by adding exercise, esp. HIIT. Yes?
Interesting
Gil, can you look into oral and jaw health systemic effects? One side of my jaw has always been lower than the other and one day I realized that if I consciously keep it neutral, my posture and balance involuntarily fixed itself. Then I noticed my systolic pressure consistently dropped almost 10 point. I was shocked to find there is research on this.
Very interesting slide at 7:00 min. Do you have a video about that? I am curious as to whether that 80 ldl number is independent of other factors. Especially the HDL level. What happens if your ldl is 60 and your hdl is 30? Thanks for your great and easy to follow videos.
I wonder if other fitness routines have a significant impact.
I've been training for a 5k, am at 2.65 miles. At the end of each run I sprint the last 50 meters, that's my HIIT😂.
Going slow. I'm recovering from being pretty much bed ridden for a year, so this is exciting for me. Going to run my first 5k race in several years next month.
How are the measuring the plaque?
Holy crap that is such a tiny difference! Not very motivating. But then when you find out a 1% reduction in plaque results in a 20% reduction in risk, that is much more motivating.
Keep in mind it was a very short-term study so imagine if you stick with it over several years.
You didn’t listen to the video. 1% DOES NOT equate to 20% reduction. LISTEN. THINK. When a 1% reduction in size was seen taking drugs it equated to a 20% reduction! Huge difference there. We have no idea if the 1% effect contributed to the 20% or how much it contributed.
I do kettlebells about 4 times a week, which is hiit training, so I guess I'm on the right track. Thanks doc.
Sorry, but kettlebells are not HIIT at all.
@jm08050 that's bs how much swings can you do straight then 😂