How to add a decade to your life

Most people need to do more exercise. Despite us being aware of its obvious benefits to our health, we can still struggle to get active.

So, what’s holding us back? A persistent injury, lack of free time, or simply not knowing how to get started?

Dr. Andy Galpin believes it’s always possible to incorporate exercise. With evidence-based exercise regimes, he’s on a mission to make a fitter future achievable for everyone.

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Episode transcripts are available here.

Transcript

[00:00:00] Jonathan Wolf: Welcome to ZOE Science & Nutrition, where world leading scientists explain how their research can improve your health.

As we get older our bodies get progressively weaker, putting us at risk of frailty and even early death from diseases like dementia and heart disease. That's why staying physically active is so important for longevity. But what is the best type of exercise to keep us fit? And can it really prolong our healthy years?

Professor Andy Galpin joins us today to demystify a vast array of options and to help us choose the best exercises to support our health. Andy is a professor of kinesiology at California State University, Fullerton, and an expert in exercise and human performance science. He's also the author of the bestselling book, Unplugged.

Andy, thank you for joining me today.

[00:01:15] Andy: That's a pleasure to be here.

[00:01:16] Jonathan Wolf: So why don't we start with a quick fire round of questions from our listeners? And this is a tradition now on the show, and we have some quite strict rules, which we know professors always find a little challenging. And the rules are you can say yes or no. Or if you have to, maybe, or even a one sentence answer if you really have to. Are you up for it?

[00:01:47] Andy: Yeah actually I have to tell you, I like this.

[00:01:50] Jonathan Wolf: All right, let me start. Is there one correct fitness routine for all of us?

[00:01:53] Andy: No.

[00:01:54] Jonathan Wolf: Are most of us doing the wrong exercises to maximize our health?

[00:01:57] Andy: No.

[00:01:58] Jonathan Wolf: We had a great email from one of our listeners saying that she's always gone to the gym, but now that she's postmenopausal it feels like nothing really works anymore and her body is changing.

So the question is, do you need to change your exercise program as you age?

[00:02:23] Andy: That's a loaded question, but I'm going to say no.

[00:02:27] Jonathan Wolf: Okay, brilliant. Should women and men do different exercises as they get older?

[00:02:29] Andy: No.

[00:02:30] Jonathan Wolf: Is cardio exercise more important than strength training for healthy aging?

[00:02:32] Andy: No.

[00:02:34] Jonathan Wolf: I get a lot of no's. All right, I'm gonna let you off now. You don't have to say yes or no, you can have a whole sentence or two. I'd love for you to tell me, what's the biggest misconception that you often hear about exercise?

[00:02:50] Andy: I would probably say that it's a similar answer with the mind frame you put me in with those previous questions. And what I mean by that is that there is a singular magic specific thing that all people have to be doing.

Whether this is style of training, whether this is intensity you have to be at, whether this is a number of days, this is an exercise. Thinking that there is one thing all of us have to do, or really, really, really should be doing, or is critically more important than others.

If I had to summarize it for the people who I think are listening here, that would be my answer as the biggest misconception.

[00:03:27] Jonathan Wolf: And it's not true. There isn't like this one thing that everyone has to do?

[00:03:31] Andy: There's a lot of ways to get to the places you need to be at. Whether you're young, postmenopause, male, female, busy, not busy, any of those things.

It's not necessarily always about the exercise, or the style of training, or the amount of days, or the intensity. It's the fundamental physiological challenge that you're trying to place on the body. You’ve got a lot of ways to get there. And so you want to think about more, in that term than it is.

If I can give you a very quick analogy, it would be, if this was a finance podcast and you said, how much money does the average person in the UK need to have before retiring? And I would say, okay that's a number. That's different than you saying, what job should I do to retire? Oh, I don't know, there's a thousand ways to stack your money up. You just have to get to this amount of money. That's what we're talking about here. And so you can make your money early. You can make it late in life. You can make a little bit all the way, you could do all the way.

And I could give you all kinds of examples here. What matters though, is that you get to the certain end point. So once you get to a million pounds in the bank account, you can retire or whatever the number is, right? Doesn't matter.

So that's really the better way to think about this is, you need to improve certain physiological skills and abilities. How you get there, it's infinite possibilities.

[00:04:47] Jonathan Wolf: Now just before we run through, I should probably state and a lot of listeners will know this, that I do exercise regularly. I have a trainer who I try and see three times a week, and I think most people listening, they know that exercise is important for their health. It's also shrouded in a lot of terminology and complexity that can make it hard to approach and really confusing, you know, particularly for those of us who aren't professors.

I'd love to like, maybe just unpack right at the beginning, some of that. And actually, can I start with the new burning question that I have with the new bit of terminology that I only discovered in the last few weeks, you are a professor of kinesiology. Can you explain to us in simple words, what is kinesiology?

[00:06:09] Andy: The end of that word, -ology, anytime you hear that, this means the study of, and kines, kine means movement. So it's just the study of movement. So this is kinesthetics, this is, in general, kinematics, kinetics, all those things are coming from the same thing. So, globally, it just happens to be the name of our department, where it's all things human movement.

And so, what that means is, if you think about it, I am one of the directors for our Center for Sport Performance here. So what that means is, we are dedicated to sport performance, but from the movement side of the equation. There's a lot of different ways to think about kinesiology. It's movement for everybody. But my specific lane is movement for sport performance.

[00:06:45] Jonathan Wolf: The terms that I'd love for you just to help unpack are maybe the three terms that we hear most commonly. So one is just this word fitness. The other is this word cardio. And the other one is this strength training. Could you just help us to understand, like, how do those interrelate? What do they mean?

[00:07:06] Andy: The first one, fitness, depends on where you're at a little bit. So initially, if you go back to the history of our field, one of the reasons why it's called kinesiology is because it started in actually, the Karolinska Institute for the most part and Sweden started it. And definitions come generally from where they start.

And so fitness scientifically means specifically referring to your VO2 max, your maximal aerobic capacity.

Cardio training is really supposed to refer to the word cardio, right? Which is a way to say your cardiovascular system or more specifically your heart. And so cardio was referred to kind of anything that is more conditioning or endurance based. It tends to be longer duration, where the physical challenge on your part, the point of failure, is the way to think about it, is not necessarily your ability to pick something up, push it, pull it, or move it one time. It's about repeating over time. So in this case, failure is fatigue, right? Ran out of energy, pain got too high, couldn't take another step, and that's kind of the way to think about cardio.

Strength is generally the opposite, where the failure point was, it was too heavy. Right. For whatever reason, I couldn't do it. Lost technique, lost position, things like that.

Now in my courses, I'll actually challenge that notion quite a bit because there's just simply no type of exercise you can do that does not involve the cardiovascular system point blank, right? You can't do it, you can imagine actually doing like a one rep max deadlift.

One of the things people don't realize is your blood pressure, if you're healthy at rest, is something like 120/80. It is the numbers that you get to, right? So 120/80, during a one repetition maximum deadlift or squat or something like that.

[00:08:41] Jonathan Wolf: Which means just trying to lift the heaviest thing you can but you only need to do it once.

[00:08:46] Andy: Yeah. Or even if you did it twice or three times. Like so one rep, just like a very, very, very, very heavy one. Like the highest you can lift. Your blood pressure might reach as high as 450/350. And so you can quadruple your blood pressure instantaneously, which means you're actually basically getting full occlusion, which means you're blocking blood flow to the entire system.

It's a great way to reduce blood pressure for those that are high. Isometric exercise is super effective for reducing blood pressure, chronic blood pressure.

If you get to a position where your blood pressure is that high, Your cardiovascular system in response to that, will beat extensively high because it's trying to get blood through the tissue that is now being clogged down and blocked and so anyone again that does an exercise like that, you're going to set the bar down and instantaneously your heart rate will be as high as one can imagine.

Now, it comes down pretty quickly afterwards. So the point is I'm being a little bit facetious here, but it's just really challenging to do any form of exercise without having some cardiovascular insult and so it's a line between cardio and strength training has traditionally been like, okay, I lift some weights and then I run or I swim or a cycle.

At the highest level, fine if you think about it, but that does a really honestly, a disservice to people. Because it makes them think like either I lift weights or I run for an hour and anything else in between is not exercise. And that's just really, really problematic because it dissuades people away from tons of other activities that are as good for you, if not better for you than those two extremes.

So the way you said earlier, sometimes because of that, when people have too many options, that actually makes things worse. It's scary, it's intimidating, it's like, it's confusion. I don't know what to do. So I get that part of it. If it's easier to just say well hey, I’ll just do this or this and limit your choices so it's a little bit more relieving, that's fine.

But I want to flip that on its head a little bit and say, because it is that way, gives you the option. You can do so many different things. You don't have to worry about, oh my gosh, if I'm doing this style and I like it a lot, is it even effective? The answer is yes, it will definitely be effective. And that's why I answered those rapid fire questions the way I did because. If you're working out, and you're doing it hard, even kind of hard, and you're doing it consistently, it's working.

[00:10:53] Jonathan Wolf: You're saying that, like, most things are in some sense a combination of both this sort of cardio, which you're describing as like you're doing it over and over for a long time, uses your heart, and like, the strength, which is like, this is something heavy, and like, difficult to just do a few times. And you're saying that in reality, most things are actually a mix of both, and therefore you're getting the benefits of both as long as the exercise isn't too easy.

[00:11:16] Andy: I'm saying it can be, I'm saying lots of things can be. Yeah. So you have tons of options. If you have a certain routine that you like or a certain style or things you don't like. Then we can find success with those limitations, I guess. So I want it to be more of like letting folks know you have tons of options.

[00:11:33] Jonathan Wolf: You said one other thing that I've never heard before. I was intrigued, you said that fitness came originally from like these studies in a Swedish university a long time ago, and it was very much associated with basically sort of, you said this VO2 max, which I think is like this measurement, right, of sort of the maximum oxygen that you can use, if I understood from previous podcasts, it's very much sort of about cardio.

And is that right, and does that explain why for a lot of people when, you know, they think about fitness, it's very associated with going for a run, being able to do something for a very long time. And that for many people, I think they don't think about strength at all really as part of what being fit is.

[00:12:13] Andy: Yeah, so that's a really nice way to think about it. Yeah. Fitness itself, again, generally scientifically refers to just the VO2 max portion. So the maximum amount of oxygen you can bring in and utilize. This is your highest heart rate stuff, this is high intensity intervals, this is whether it's longer duration stuff, but it is the conditioning, the endurance, the fatigue inside of the equation.

But that doesn't mean you have to always be at your maximum effort to be working on that stuff. So it could be, you know, going for a light jog, could be going for a brisk walk, could be gardening, tons of things you can do that are still going to be working on that fitness component without necessarily being at the maximum fitness rate.

But the way that we would measure your fitness would be, what is that maximum?

[00:12:58] Jonathan Wolf: And so explain to me just for a minute, how would you measure that? Because it sounds like you've come around to that quite a bit. How would you measure somebody's fitness?

[00:13:07] Andy: Yeah. Tons of ways you can do it. The gold standard is to actually get a VO2 max test done and they're available actually all over the place, all over the world. And it's getting more and more popular because of how critically important it is to both overall health, how long you're going to live, as well as how well you're going to live those years. So both components there.

Or you can do a thousand different versions of free measures. So there's all kinds of VO2 max estimators. A lot of fitness wearables will give you a rough idea as well. A lot of them are, you know, not necessarily always perfectly accurate, but they'll get you close.

There are again, 2-minute step tests you can do literally, you can measure your heart rate, do a kind of standardized step test where you're stepping up on a very low box and stepping down for 2 minutes and measure your heart rate. This is sub-maximal. So you don't even need to go all the way to the max, but we have enough information to say, if you get this much of a heart rate elevation in this much time, we can project out to where the top will be.

And a lot of times with folks that are not comfortable or willing or wanting to go all the way to the true max. An estimate, a sub max, again, the term you want to Google is sub-max estimate equation. Those are out there, but lots of ways you can do this.

Another kind of standard easy test is to run a mile and a half and record your time. And then you can plug that number in and that'll give you another pretty good way to estimate you're getting to max. So it typically takes 8–12 minutes plus or minus to get one done. But again, you can do a sub max one in 2 minutes if you want. Or that's why a mile and a half run is actually, you know, a pretty good thing too, so it gives you, you know, 200 or 400 meters. It'll give you a pretty good idea of where you're at.

[00:14:42] Jonathan Wolf: Let's say somebody does this and they're using this to figure out their level of fitness. How can it help? And what does it mean?

[00:14:49] Andy: If you want to figure out how long you're going to live, there's a lot of ways you can measure how healthy you are now, and then also project out to how healthy you need to be at a certain age.

And so let's just say you're 60 years old now, and you want to live to be 100. Okay, great. Well, if I know how fit you are now, since we know that there is going to be a decline in physical fitness, no matter what you do, it's going to happen with aging. So I can say, okay, if you want to be at A right now, and we know you're going to drop X% over the years, this means it's going to put you at B by 40 years from now.

And so the number you want to think about is this, for men around 20 milliliters per kilogram per minute or so is what we call the age of in our line of independence. And for women, that is about 16 or so milliliters per kilogram per minute. This will make sense when you go to your VO2 excess.

When you fall below these lines, it becomes very difficult to be independent, meaning you can't live by yourself. And so you have to be in an assisted living home with some sort or have somebody in your house, things like that. Okay, great.

So if you are at 60 years old and right now your VO2 max on your test is 23, you're fine now. But you have nowhere to go.

You can also look at a ton of you know, Peter Attia actually did this in his book, Outlive, I think it is called. And he walks you through what fitness levels are required for different activities. Just climbing up stairs, putting your own luggage you know, on a bus and stuff like that. And a lot of these activities take between 25 to 30 milliliters per kilogram per minute.

So if you're already, you know, gonna walk around and, let's make it worse. Let's say you're 50 years old, you're a 50 year old male. And your VO2 max is 41. Like you have nowhere to go. You've got the next 50, you're halfway through life and you're barely already able to climb stairs. Like you're just above your, you know, you got 20%. That doesn't feel that bad.

Well, we know you're going to reduce, you know, every decade you're going down. And so you, you just don't have anywhere to go. You certainly don't have 50 more years. So the only option here is to just never move your physical body, which we know is not going to last very long or to improve that VO2 max.

Now what's also interesting about VO2 max is it's one of the very few metrics we have that scales linearly. So if we take everyone in the world and we took all their VO2 max and we split them up into say the top 25%, next 25%, next 25% and then the bottom 25%. If you go from the bottom 25% to just the group above you, right, your expected life, like how long you're going to live, is probably gonna go up 5 to 8 years.

Just moving up like a tiny bit. I'm not even talking about getting super fit or transforming your life. Just not being the worst or most unfit people on the planet. You just don't want to be in that number. Now that 5 to 8 years could be wildly different depending on what age group you look like, might be even way higher than that, and some could be lower. But the point is, it is a dramatic reduction in your risk of dying. Dramatic reduction.

If you go up to the next one, it continues to reduce. Up to the next one, it continues to reduce. And then it goes up from even the almost most fit to most fit. It can stay, it continues to increase your lifespan.

And so this is when I say, there's no cost to just getting higher and higher and higher. It's not one of those things where it's like, well, if you get too high, it actually starts making you unhealthy. It doesn't, it just continues to go up higher.

So, if you are in the 30s, I don't need you to be in the 90s, for sure, but if you can get from a 30 to 38, this gives you many years in your life, 38 to 45, this gives you, you probably have you know, at least a decade on your life and it's critical here.

And last thing I'll say, and I'll pause, it's not just a decade. It's a decade of well living that goes on in your life. So it is high functioning 10 years rather than just, you know, sitting around on a chair. It's super, super important to move this thing.

In fact, if you take, and you could do health test roulette. We could pick any test in the world you want. Full body MRI, blood pressure, smoking history, cholesterol, familial background. Put any metric in the world on a roulette table and spin it around. Almost nothing in the world will predict how long you're going to live more than your VO2 max number with exception to maybe one thing.

And that would be your overall strength. When you stack up strength, the VO2 max, it is generally in the same ballpark. If not exceeds. The ability to predict how long you're going to live and when again, we're talking all cause mortality, so die for any reason.

Strength, depending on the study you look at, and then when I'm talking about this, I'm talking about studies that include tens of thousands of people, sometimes hundreds of thousands of people. So not like a single cohort of six people, like a random study, you're cherry picking here. I'm trying to globally represent 20 years of research. That's why I'm kind of so confident and brazen about this is because this is not like a site. This is, this is so well documented. So if you were to get a rough, crude estimate of your overall strength and you'd be able to map, these two things are going to tell you more information about how long and how we're going to live than almost anything you could ever measure.

[00:19:48] Jonathan Wolf: And Andy, I was about to ask about what next, but then you suddenly like from left field said, oh, well, this is really important, but also your strength is at least as important.

Is there an equivalent measure that someone can do to understand what the status of their strength is?

[00:20:05] Andy: Yeah. So generally we think about this, legs are most important. And so there's a bunch of reasons why weak legs are very problematic.

Now, one of the things we know is leg strength is more important to longevity than leg size. So muscle mass is cool and we need to have muscle, but the strength is more important than how much muscle you have for longevity here.

One of the things that becomes a problem is as people's legs get weaker, as they age, they start declining general physical activity. And so if you can think about it this way, if standing up out of a chair is like, you know, doing a squat at 95 percent of your max, then you're not likely to stand up on a chair very often. Cause every time it's like doing a one rep max, right?

And so people whose legs get weak tend to lose physical activity, which means they stop going out with their friends. They won't go on that lunch day, so they lose social connectivity. They don't go to the grandkids soccer game because it's just going to be so hard to sit in that stadium with those deep chairs. And like, you can see the things right, I'm not going to go out and do this. I'm going to start ordering my food in. I'm not even go to the grocery store anymore.

Like just all these things start happening. So physical activity starts to plummet. So we lose social connectivity, we lose being outside, and we also lose the actual just physical benefits of being physically active, right? So then those tangential things as well as the direct ones.

So the leg strength to stop yourself from doing that, is a huge deal. And I could go on and on and on, but losing leg strength is a really big problem for aging.

So how do you test it? Well, any test of leg strength will work, a leg press machine, a leg extension machine, any of those things are generally fine, but I'll go even easier for you. There's a lot of research, a ton of research on grip strength. So grip strength is also an independent and significant predictor of all cause mortality. How strong your grip is, is going to tell us a ton about how you're going to live.

And this is actually very interesting. This is breaking stuff here. I'm going to share with you that almost no one's heard yet. So a lot of people think, okay, grip strength is a good predictor of mortality. And this is irrefutable, by the way. It's all over the scientific literature. So no one really questions whether or not this is true. But people will say, okay, grip strength is just a proxy for how overall healthy you are. And that's fine. That's true.

But there's more and more research coming out showing there is actually a direct cause here. And so actually a paper we just published in the last month or so found a couple of things, and we actually did this in the States. The UK has this too, but, presumably other countries do as well.

But you have these giant databases of public health studies that happen every single year for decades. And the one here in America is called NHANES and it's been going on for over 30 years. So you have thousands of people enroll in these studies. They collect all kinds of stuff from IQ to personality to physical stuff and blood and work and all kinds of things.

And then the governments throw open these big databases and they give it open access to scientists to say like, hey, if there's anything you can pull out of here, you know, grab it. So there's the UK Biobank and NHANES over here and things like that.

So we went into that database. We were able to find that grip strength was directly predictive of brain health and more specifically your cognitive health. And this is the first time it's been documented as likely causal. So it's not just a fact of, well, people that were smarter had stronger hands. Like, well, how does that make sense? There's no causal that way.

So the causal is this thing, the reason why, is because of the neurological component. So strength training is very specific and different than cardiovascular training because the neurological demand of strength training is very, very high. Which means you continue to keep neurological pathways activated and healthy.

You need those neurological pathways to make decisions and think and to keep your brain alive. So by challenging your ability to physically do something, that is either complex or complicated, or requires a lot of force, like a lot of strength. That requires neurological activation that requires those things to stay alive and healthy.

[00:24:09] Jonathan Wolf: I'm totally shocked to hear this. I think you're saying that, you know, we all have this idea that if you had to do the crossword puzzle or like, so some sort of complex task like that's going to keep your brain working. But I think you're saying something that doesn't sound at all obvious to me, which is if you have to do something like lift something that's really heavy that is also going to keep my brain having to think?

[00:24:33] Andy: 100%. In fact, the research on this one specifically, you mentioned crossword puzzles, brain games, or what things like that are called. They're good. The problem is, once you figure those things out, continuing to do them is no longer neurologically protective. And so it's the novelty aspect that is really important.

And so this is the same for folks who have really cognitively demanding jobs. And they're like, oh, no, no, I'm fine because my job is really stressful. Well, actually, after a number of years of continuing to do it may be stressful, but it's no longer cognitively challenging. Despite what you may think it is. And so you need to add some novelty in there.

So the crossword puzzle thing is great, but after a while, it's no longer going to have the neuroprotective benefits that it once did. Strength training will almost always have them.

[00:25:17] Jonathan Wolf: Even though I feel like lifting up, I mean, no disrespect, but I feel like I might lift a weight up from the ground that I've still been doing that stuff. It doesn't feel very cognitively challenging. I know it's going to sit there. I need to lift it up. Help me to understand, like it doesn't work with crossword puzzles. How does it work with lifting something heavy off the ground?

[00:25:36] Andy: How do you actually lift something above the ground? Well, there's three major steps to that. Going on the inverse here. You actually are, let's just say you're gripping something, right? You're holding onto something with your hand. You're trying to stand up with it. That means you're trying to make bones move, right?

Human movement is making bones move, period. Now, how do bones move? Well, muscle is not actually attached to bone. That's a misconception. Muscle comes together, attaches to connective tissue and tendons, tendons attached to bone. So step number one is, I'm going in reverse order on purpose here. You have to get connective tissue to pull on a bone. So connective tissue number one, it's number three, but you get what I'm saying going backwards here. Let's call it number three.

Number two then is you have to have muscle contract. Now how does muscle contract? Something has to tell it to contract. That would be your central nervous system, friends, and your peripheral nervous system. This is your brain, right? Call it your brain up here, extend it all out, call it your nervous system. Same thing here, right? And so really, you have to tell your nervous system, make this specific thing contract on this timing at this exact time.

Now, since that's a heavy load, that's just really, really heavy, the only way you can increase force production, individual muscles themselves cannot change how much force they produce. It's called the all or none principle. Muscle fibers can only contract at 100% effort. That's it. You can't go 95, 93. There's no dimmer switch. It is fully on or fully off. So muscle fibers only go 100%, so the only way you increase your total force production, so how much force you're lifting, you know, your arm with, is to turn on more total muscle fibers.

This means more motor units. This means more nerves is the way to think about this. So as you go to pick up that very light thing, you turn on just a couple of nerves. No problem. That medium thing, gotta turn on more. That heavy thing, gotta turn on more. That heaviest thing, gotta turn on the most possible.

Now those nerves are specific to that force production. Which means, when you don't do anything that's kind of heavy, you never, ever, ever, ever, under any circumstance, turn on those nerves that are dedicated to kind of heavy. When you never go really, really heavy, those nerves never get turned on. And so after many, many, many, many years and decades, they eventually die and go away.

When you're talking about crosswords, great, it is still cognitively active in the moment, but we're not accessing a broad spectrum of neuromuscular connection throughout the entire body that says, hey, there's a certain set of neurons that are dedicated to this type of activity that haven't been activated in a long time.

When you strength train, it is doing that, right? You're going to get a whole bunch of nerves that activate muscle contraction at a low level doing any daily physical activity, walking, standing, taking a bowel movement. All those things are going to do those activities of daily living. But the only way to get what are called those higher threshold motor units is to do something that is a higher threshold and a higher threshold again means force production.

So we have a whole cascade of neural activation dedicated to just force production. It's there. The only way really to do this. Is force production. This is why strength training is so special. It's one of the many reasons.

[00:28:50] Jonathan Wolf: And Andy, I think that's, it's amazing. I have to admit, I had thought that like doing a deadlift, you know, which is lifting something heavy off the ground, seems incredibly straightforward from the brain's perspective.

Because as you said, it's just sitting there. If you wait for a while, it's still just sitting there, you know, you have to lift it up. And I'd never thought about it as being anything like as complicated as you described. So you're describing all of these neurons that have to work.

Do they have, I think most people listening are saying when they think about neurological support, they're worrying about dementia, right? They're worrying about Alzheimer's. They're worrying what's going to happen. Are you saying that this lifting really heavy weights is actually protective against that?

[00:29:34] Andy: Oh, 100%.100% and not to say it can protect you 100%, but now you have a couple of different ways to think about this, right?

So on one hand, you have things like Parkinson's, which are mostly, they're neurological, but they're mostly musculature based, right? There's a cognitive component of Parkinson's, but it is a mostly like, usually you have spasticity and muscle control. Then you have things like Alzheimer's, you have early onset and late onset, and you have dementia, okay?

If we think about early onset Alzheimer's, that seems to be almost exclusively well, I don't know how to say this, but it's, it's very heavily driven by unknown factors, probably genetics, right? If you get Alzheimer's in your thirties or forties, there's no amount of strength training that was probably going to help that. It's just there.

Dementia and late onset Alzheimer's is extremely preventable. Extremely preventable. Again, tons of research on that I can't remember the actual numbers, but it is a large percentage of those things are preventable because of this. And it is a combination, by the way, of physical activity, sensory perception, which means you need to be seeing things at a different distance, you need to be smelling different things, you need to be hearing different things.

This is one of the reasons why the research on being out in nature is so potent because it requires you to see and look at things at different level. The vision and light amount is different. You're hearing different sounds. All that actually goes into what's called proprioception and sensory input.

And so you have, you know, you're all your senses, right? Your sight, smell, touch, sound, all those things, right? It's the same thing I talked about. When the nervous system is not activated, it goes away. Your nervous system is your brain, like, so when that goes away, your brain goes away. This is dementia, right? This is, this is what's happening.

[00:31:17] Jonathan Wolf: And I think we tend to have this view that the two are completely different, I think, you know, and I think we've tended to think that, and what you're saying is, that's wrong, that by losing all of these physical skills that you have with your brain, this is basically directly, links to the things that affect our memory and our, you know, ability to make sense of the world and these sort of, I guess, higher thinking, as we would think about it separate from sort of controlling our body.

[00:31:43] Andy: I mentioned grip strength being a predictor earlier. A new paper just came out in the last month or so that looked at asymmetry of strength. So how strong is your right hand compared to your left hand? And no one ever really thought about this, but the amount of asymmetry is defined as more than 10% more than 10% is actually potentially an early predictor of nerve denervation.

And so what they're saying here basically is it's not just that your dominant hand is stronger than your left hand. Okay, great. If it's more than 10% stronger, it may be an early indication of neurological degradation. I know not that you're losing nerve, but it's denervation specifically.

But the point is, it could be actually, it's not just about like, you can't open a jar with your left hand. Oh, no worries. It is, hey, this might be early science, something is happening.

[00:32:27] Jonathan Wolf:I'd love to come back, you mentioned something about blood pressure earlier and there'll be a lot of people listening to this are also worrying about blood pressure because it is something that's very easy to measure. So it tends to be something that people become aware of, and you said something about isometric exercise, but I don't know what that is.

Could you help us to understand?

[00:33:22] Andy: Yeah, sure. So this is going to tie together nicely. I've got a number of studies that have specifically looked at the impact of just grip strength training. There's no warm up required. You don't have to change. You can squeeze something as hard as possible. These are called hand grip dynamometers. They're fairly cheap. You can get them for 25, 35 bucks.

So no cardio, no strength. You go in and you squeeze and you hold these things. That's all you do. Typically something like 6 to 8 seconds, maybe a little bit longer. Contractions, so squeeze as hard as you can, just your grip. You know, you do some 8 to, I can't remember exactly 8 to probably 12 or so repetitions of that a couple of days a week.

And those have been shown statistically significant reductions in resting blood pressure in people that are hypertensive. So people that have chronic high blood pressure over, you know, 6 to 8 to 10 weeks, something like that. So grip strength training alone, is an isometric contraction. So you're grabbing, you're squeezing, you're holding it.

What that's doing is because all the muscles or many of them in a muscle group or around a joint are contracting. You're kind of squeezing all the muscles at the same time, which means blood can't go anywhere, right?

So it kind of gets, it's what we call occluded or stuck. It stops moving. So in the short term, your blood pressure shoots through the roof because you can imagine you're trying to circulate blood throughout your body and when it's coming out of your heart, it's getting squeezed down by all the muscles.

So it can't go anywhere. So the pressure in the heart gets really, really, really high because all the blood gets backed up, but it's pumping and it's pumping, it's trying to get it out of there. And so the pressure gets super, super high. In response to that, your body then will say, effectively, hey, we're having this consistent challenge, let's make the vessels more pliable, more elastic, more plastic. Open them up more by doing that at rest, now the blood pressure, the pressure at rest goes down because it's easier to get stuff through.

And so, almost always, this is what we call a hormetic response. And so, the body tends to work very well on short, very hard disturbances in homeostasis, or kind of the resting state, matched with recovery. And so if you get your blood pressure up really, really, really, really high in the short term and then you bring it back down and let it rest a lot, it will respond by causing an adaptation.

[00:35:32] Jonathan Wolf: I feel like quite a lot of people understand now that, you know, if you go and do exercise, then it's like, it actually can damage your muscles in the short term, but actually that makes you, you know, help, you know, it helps you to build them that this is tension. I think what I'd never heard of you saying is it's sort of something equivalent for your blood pressure. It's almost like you put the blood pressure up high in your body and actually magically effectively it's like, oh, I'm learning from this to make adaptations is actually going to reduce my blood pressure.

[00:35:59] Andy: Your brain works the same way. You do something really challenging. You do your crossword. You solve a really hard problem, you just get locked in and you write for 90 minutes, you do whatever it is, right? And then you recover. And what happens?

Motor control and motor learning, by the way, doesn't happen during acute stress. So when you're trying to learn a new physical task, or you're trying to learn something new, a new language, you're trying to solve a really hard problem you've been working on, in that moment, stress levels are way too high.

You just go on super alert. When you come down from that stress moment, though, that's when the new learning gets set in stone, physical learning, cognitive learning, all that.

So it's the same thing, really high pressure, really high fatigue, tons of stress in the system cognitively. Then when you relax and recover, new systems, new memories, new strategies get built in the brain.

It's the same for all of them. I don't want people to think, by the way, everything in your life has to be to level 10. All these things I'm talking about, by far the biggest benefit by far is going from the bottom 25th percentile to just the next level up. It is not, you know, level three to level one. It does not matter at all.

Just going from, in fact, I guess it was just going from the bottom 15th percentile to one percentile group up is the biggest gains you're going to see in your health of all of these groups. And so if someone is, you know, run 20 marathons and they're trying to get a PR for the next one, they want to get more fit. That will make them a little bit healthier. Maybe, maybe not. They're, they're going to get marginal gains, right?

[00:37:30] Jonathan Wolf: It doesn't really matter.

[00:37:32] Andy: It's not a huge deal, but again, you'll put years in your life, just being not the worst, least strong, least fit person, you know, in the entire city.

And I'm very specific in all my examples to use percentages because everything is relative. I don't talk about the weight you have to lift. I don't talk about the, it's a percentage, right? So if, if you go to the gym and you know, you go, you don't know what you're doing. You find one machine and you lift it and it feels kind of heavy.

I don't care if it's 6 pounds, kind of heavy is still kind of heavy. It is the same thing for you physically. So you're getting the same thing that I'm getting while lifting kind of heavy. If I have 600 pounds, it's irrelevant. It doesn't matter at all. And so it is always about just the individual person.

And so when I say speed or when I say strength, when I say, like as hard as possible. If you walk off that thing and go like, that is the fastest I could possibly move it, then you're getting the exact same benefit I'm getting or anybody else is. It is always about your internal physiology and your internal system.

If it's being challenged, it adapts. If it's not being challenged, it won't. You don't have to challenge things. We always say this, oh, think about it, you don't want to annihilate. You just want to stimulate, stimulate progress, stimulate adaptation, but you don't have to annihilate. In fact, there's excellent research on annihilation that gives you no more progress than stimulation.

If you want to think about this in terms of muscle growth. So the amount of soreness you get after you know, going through a hypertrophy or muscle growth training, is not a predictor at all of how much growth you will actually get. In fact, if you go to what is called reps and reserve, and so say you had a weight on a machine and you did 8 reps and you think I had 2 repetitions, maybe I could have done like maybe like 2 or 3 more, stopping right there is actually almost as effective as doing those last 2 more reps.

It is about basic stimulation and this is why when we open up the conversation, but I'm glad we're kind of closing in the same spot is, I really do want to let people like you have so many options.

If you love going into the class and it's a group fitness class and you have kettlebells and you do some sprints and you lift and then you're all on the floor sweating everywhere. You rip your shirts off and you throw… great. If you hate that stuff, you don't have to do a day that ever.

If you like jogging, amazing. If you hate jogging, great too. If you want to do yoga in your apartment. Okay, awesome. Like, and you want to just follow along with someone on Instagram live. All of those are options.

The biggest key that everyone has to get to though, like by far every single person, you want consistency over time. Adherence is the number one predictor of success with fitness and nutrition programs. Always adherence.

When you talk about this across the lifespan, you have to remember the benefits of exercise are so compounding over the decades, it's not about this month or this week or this day. You will need to be in this for the decade long thing.

So if you can stay consistent over decades, you're going to be fine. It's people that go and they do things to a level and they get hurt, and then they miss it, or they do, you know, they're so motivated to lose their weight, or to you know, change after a bad breakup.

These are like very common reasons people start fitness programs, and then you get really hard, you go so hard, you go 6 days a week. And you do 2 and a half hour workouts and you're there for 6 weeks and you're just like, okay, I haven't hung out with a friend, my company's going out of business. Like, I can't, cause this is not sustainable. Because it's not, and you don't need to do that.

And so put yourself in a position where you just don't lose big chunks of training.

A day or two, fine. You want to go on a week vacation? Fine, no problem. I'm talking about months, right? Where it's like, oh yeah, I gotta have it. It's been, well, no, it hasn't been that long, but I, geez, I guess it has been 7 weeks now that I didn't feel it. And all of a sudden it's just, it felt like, cause I hurt my back a little bit. And then I had that trip and then I had an awesome… but then I got a cold and there's… I skipped 4 days there and now it's been 7 weeks and now you've got to get started all over again.

So you just don't want these big ones. And so what I always, another way to think about this is don't let perfect be the enemy of good. Just get something in, just do something if all you can do is get a couple of walks in.

[00:41:55] Jonathan Wolf: A lot of people listening will say by this point they've got, they've accumulated quite a lot of injuries in their life that you know they're not just going to feel that they can be let loose in a in a gym and so I think they often say well so I can't really do any strength training because like, I don't have the capacity to sort of just go and you know, lift a heavy weight over my head or something. Does that mean, is it too late for them to do strength training? Does that mean that it's that's It's impossible if you've, if you've accumulated injuries.

[00:42:24] Andy: No, it's completely possible. If you can stand up from a chair or a couch or toilet, then you're doing a leg extension. It's the same thing, right? You can, you can do whatever. Work around your injuries for sure and do the parts that you can do.

Or if you just don't like the gym environment for a billion reasons, it's too far, too expensive. If there's another way you can do exercise that is not just walking. Get in a pool. Okay, great. There's going to be some contraction going on there. Put your back against the wall and just hold whatever angle you can hold for a while. That's going to be fine for this type of person you're describing.

So it's, at the beginning I said, don't worry about the external part. It's all about the internal change. So if you need a machine to help you turn your quad on, great. If you can sit against a wall to turn your quad on, great. Your quad will not know the difference. It has no idea. It doesn't matter.

[00:43:21] Jonathan Wolf: I find that really motivating. I love hearing that.

One final question, because we're maybe imagining somebody different, who doesn't have any injuries, but what they're saying is, like, I'm really time constrained. So, you know, there's a lot of listeners here who have a whole bunch of small children, and like, they're trying to squeeze this in around the edges of their life, or other things in their life, you know, that they're having to balance.

So they're like, oh, I'd love to be able to have the time to spend, you know, 3 hours a week at the gym and go and do some running, but they're really constrained. If they were saying like, I'd love to understand if I had 15 or 20 minutes, maybe two or three times a week, what are the sorts of exercises, what am I looking to do to have this best impact? Given the way you're describing this huge impact it can have on my long term health.

[00:44:10] Andy: Yeah. Well, for the record here, I have a 5 year old daughter and 3 year old son. I am a full college professor. I coach many professional athletes and I have six companies. I'm in the same boat.

[00:44:25] Jonathan Wolf: I wish you’d said that at the beginning because I had assumed that you were managing, you know, all of that exercise. So what do you do?

[00:44:33] Andy: Yeah. Okay. So similar thing. If you put those constraints on there, you want at least once a week, in my opinion, at least once a week where you can do a longer session with no breaks. Call this steady state, call it cardio, call it whatever.

So for Natasha, she's going to go on the spin bike. For me, a lot of times that's on a bicycle and I'm going to ride around outside on a bike, right? I'm going to hop on the bike. I'm Kenley, I'm not going to warm up. I'm not doing any breathing drill. Like I'm going to get on the bike and I'm going to go.

I live in Southern California, so it's tends to be nice almost every single day. Okay. I try to do that for like a 45 minute ride. I'm literally gone 46 minutes. Right, like I come back and I'm like, minute 46, I'm switching out, I'm grabbing a kid, I'm doing something, I'm getting back on a call, I'm like, I'm not laying around, and I'm getting right back after it. I'd love to go longer, but that's for this.

So, one session a week, Natasha does two, candidly, I'll do one generally. I will then also supplement that with as much general physical walking as I possibly can. This is any call I can take on a walk, I will. If I'm ever traveling, I will never sit down during a layover. I have just a 4 hour layover, I'm probably going to walk for 3 hours and 40 minutes, right? I'm like, I'm just going to get steps in if I can, but when I land it’s the same thing, like walking, walking, walking as much as I can. I don't like walking at all, but that's just, that is where it is, right? So when can I just get basic steps in?

And then one day a week can I go a little bit longer one day a week? I'm going to go very, very short, very high intensity. I've got an aerosol bike which is like the hand crank and the pedals in my garage. Right. So I'm going to do that, that's probably looking like a 5–7 minute warmup and then 10–12 minutes of any kind of extremely high intensity, max effort intervals. This could be 30 seconds as hard as I can. 30 seconds off. Could be 4 minutes hard, 4 minutes off, a couple of rounds of that. All kinds of stuff you can do. I might just go 10 minutes as hard as I possibly can. And come back off of that.

In addition I will try to do some sort of strength training at least three times per week. So squats or swings or split squats, process, set like movements, things like that.

[00:46:47] Jonathan Wolf: I know we're coming to the end. So I just love to try and do a quick summing up and you've covered a lot of stuff. So hopefully I will have caught the essence and please let me know if I get it wrong.

I think we started by talking a lot about the fact that this idea of fitness is both cardio and strength and there are ways we can measure this. And you talked about this VO2 max test and we'll put some links on the show notes, which actually is a better way to predict your long term health and the quality of your life than most of the things you'll get when you go and see a doctor.

And there's a sort of scale. I think you said from 1–100, like a super athlete is at 80 people are really fit at 60–70. And basically as a man, if you fall down to 20 or a woman down to 16, basically you lose independent living. So you want to stay above that. But I think the really positive thing, because there's something depressing about it falling, is you're saying actually if you move just up from the bottom 15% to above that, or if you get out of the bottom quartile, you can have a really profound impact on your long term health.

And there's really things that you can do relatively fast to change your health. So that's one thing that's really interesting, which is sort of on the cardio.

And then you talked about something which I think will be even more of a surprise, which is you know, on the strength, you could do something as simple as just measuring your hand grip that there is a machine I think, did you call it a dynometer?

[00:47:13] Andy: Hand grip dynamometer.

[00:47:16] Jonathan Wolf: Hand grip dynamometer. So we'll definitely find some links to that. In seconds, you can basically do this measurement, which is also this amazing predictor of your long term health, but interestingly, you can actually use it also to reduce your blood pressure.

So you can train yourself just with this device, and that can genuinely, I think again, you said in just a few months, reduce your blood pressure. So this again, there's things you can really do there.

We then talked about how surprisingly the work you do on strength directly affects your brain and that we tend to think about it as being like, you know, some brain puzzle or work will affect your brain.

But actually, amazingly, just lifting a really heavy but static object is having all of this impact on your neurological system, and that can actually reduce your risk of dementia and there’s a set of other things that you can do around dementia and we'll share the link there.

And then we talked about, okay, what about if you're not, you're not really, you don't have all this freedom of movement. Does that mean that all of this is impossible? And actually what you said, which is great, is sort of wherever you are, actually, if you're doing something that is hard for you, you're really going to be having this impact. And that even if you have injuries, there's things that you're able to do.

And I think we wrapped up with your own story where you do manage to put in, I would have to say, a very impressive set of exercises through the day. But you're interestingly saying that actually these are in lots of pieces. And again, coming back to this original story, like anything we can do across both this cardio or the strength is really going to have an impact on people's health.

[00:48:05] Andy: Nailed it.

[00:48:06] Jonathan Wolf: Thank you so much for spending the time with us.

[00:48:06] Andy: My pleasure, man.

[00:48:08] Jonathan Wolf: Thank you, Andy, for joining us on ZOE Science & Nutrition today.

We learned what the best exercises are to keep us healthy as we get older, and how to incorporate being active into our busy lives. If you want to understand how to support your body with the best foods for you, so you can enjoy many more active and healthy years, then you may want to try ZOE's Personalized Nutrition Program.

You can learn more and get 10% off by going to zoe.com/podcast. As always, I'm your host Jonathan Wolf. ZOE Science & Nutrition is produced by Yella Hewings-Martin, Richard Willen, and Tilly Fulford. See you next time.