Fitness limit and all cause mortality

(charlie3) #1

My starting goal, 20 months ago, was to be as fit as possible with zero health compromise and look the part. That has become a mix of low, medium, and high intensity exercise along with a low carb, real food diet. So is there such a thing as being too fit for optimal health? The answer seems to be no and the benefits are more dramatic with age (relevent to me since I’m 70). It’s always possible to be chronically over trained, presumably not healthy, but short of that I’m not going to worry about upper limits on fitness.

“In subgroup analysis, the benefit of elite over high performance was present in patients 70 years or older…and patients with hypertension…Extreme cardiorespiratory fitness…was associated with the lowest risk-adjusted all-cause mortality compared with all other performance groups.”

P.S. And somewhere recenly I read a finding that being too sedentary is comparable to smoking for all cause mortality.

(Windmill Tilter) #2

Great article. I’ve just been reading a bit more about this myself.

It’s kind of amazing that adding in 20 minutes of exercise a week drops your risk of all cause mortality by as much as quitting smoking. The vast majority of people would be horrified at the thought of smoking (cancer!!!); but not putting in 20 minutes of HIT a week has the same death risks as smoking (that’s been documented by multiple studies by the way)!

I’ve got a couple more studies around here somewhere that actually quantify the mortality risk reduction of increasing VO2 max by just 1 point (2% for avg folks) or by 1 MET. It was like 15% drop in mortality risk if I remember.

(Bob M) #3

Ok, people, there are many problems with this study, not the least of which is the following:

The primary limitation of the study reflects its retrospective nature, in that the association between CRF and mortality does not prove causation.

That is, this was not an RCT where they took groups of people and made them exercise at different rates to see what happened with them. Instead, this is epidemiological evidence. As such, it’s subject to the healthy user effect (healthier users exercise more), wealth effects (poorer people can’t exercise), and many, many more.

It’s interesting data of correlation, but says nothing about causation. In other words, if you exercise 30 minutes a week, and you start exercising 60 minutes a week, does that mean you’ll live longer? Absolutely not.

(Windmill Tilter) #4

Lol. The same is true for epidemiological studies of smoking. Same stats, same risk, same approach. Lung cancer may well be the wealth effect. Good point.

Dozens of studies support the conclusions of this one. The interesting thing about this one is that the sample size is so massive.

(charlie3) #5

Everything we talk about here interacts with each other. There may never be definitive answers. Adopting low carb eating is me taking a stand, not being certain of what’s best for everybody. Same goes for my approach to exercise (subject to change if I learn something new). I don’t need the study to prove something for the wider population. It’s more than enough for my purposes that the fittest 70+ year olds are outliving the less fit even if they have other advantages because I might be seeking those advantages too.

(Windmill Tilter) #6

Here is an interesting study that found that increasing VO2 max by 1 (an average middle age man’s VO2 max is ~40, elite is >60) resulted in a marginal 9% drop in all cause mortality. That’s pretty incredible!

https://www.mayoclinicproceedings.org/article/S0025-6196(16)30257-9/pdf

A second study that used MET’s (measure max intensity like the treadmill test you referred to) found that folks who raise their MET’s by 1 decreased their risk of all cause mortality by 15%. That mind boggling!

https://www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.111.038422

(charlie3) #7

I’m working my way through your articles, thanks. I spend time thinking about training status, meaning, if I’m recovered enough to train again how much training should that be so that the next session is optimal, etc., etc. ad infinitum. Wouldn’t it be nice if we had affordable technology that could monitor lots of biomarkers real time and give us feed back to guide traning and nutrition.

I don’t run and don’t do HIIT except 2 hours of lifting at a brisk tempo. I walk 1-2 hours a day (55% of max heart rate) and/or 45-90 minutes on a Schwinn Airdyne (70% of max heart rate). It works out to 2 1/2 hours a day. I’m weary at the end of the day (sleep well) but no where near over trained because mostly it’s lower intensity and low impact. My current belief is that lots of lower intensity work is just as healthy as HIIT if not more so in the lon run. I want to be very fit without overuse or overtraining.

(Windmill Tilter) #8

In Dr. Doug McGuff’s book Body by Science, he claims that a single high intensity resistance training workout a week is sufficient to boost VO2 max pretty close to genetic potential. No need to spend hours per week in the gym. That intrigued me.

I have an indirect calorimeter that measures Resting Metabolic Rate (I bought it to monitor metabolism during fasting), but I also have all the gear to measure VO2 max as well. I’ve never used it for that, but it seems a shame not to.

I’m curious to run an experiment to see how many points I can boost during 12 months in 2020 just doing a 20 minute Body by Science workout once a week. It would be a fun experiment, and a good excuse to keep me focused and consistent on my workouts.

(Windmill Tilter) #9

Yup. That would be nice. There are more and more gadgets that measure such things, but they ain’t cheap!

(charlie3) #10

VO2 max interests people training athletes but I believe it’s not the only thing that matters for health. Crono taught me to view activity/exercise partly as calories burned. I notice that burning 30% of daily calories in activities feels right. Now that I’ve got an Airdyne again it’s the same wear and tear to raise it to 40% of daily calories. The extra activity means more metabolic activity which I believe is inherently health promoting short of over training. I think lower intensity work is health promoting except getting a useful amount is time consuming. (Preparing food from scratch also takes more time.) Not so long ago there was no alternative to all this time consuming stuff and we were healthier, a lot healthier.

(Windmill Tilter) #11

It’s hard to say for sure. I’m a fan of minimum effective dose. If I can gain 70% of the strength, bone density, and cardiovascular fitness in 20 minutes a week that I can accomplish in 6 hrs, I’ll opt for the 20 minutes. It’s hard to say whether those metrics align with overall health however, which is a fair point that you make.

In my case I’ve got 3 young kids and a business to run, so I’m glad to get in what time I can. Everything is a tradeoff.

One thing is for sure, dropping down from 280lbs down to 180lbs will definitely be a step on the right direction for me!

(charlie3) #12

I have a very different situation. I’m in retirement mode and living alone. There’s time for whatever diet and exercise routines I choose. Modern lifestyle increases the difficulty. There’s no wood to chop, no chores, no animals to feed, don’t have to walk anywhere. Life is too easy so we invented this thing called exercise to compensate. My conclusion about food is people choose convenience. I hardly cook yet making satisfying meals from real food takes longer than what I could buy in the center isles. My combination of diet and exercise is time consuming. In the mean time I love the way I look and feel. There have been dramatic changes in 18 months. I’m asleep in seconds. Restless nights are rare. I wish all that would inspire others. In short, it doesn’t.

(You've tried everything else; why not try bacon?) #13

The relative risk ratio of smoking versus not smoking is somewhere between 10 and 30, with an extremely low p-value. There are several other criteria involved that allow us to be reasonably confident that smoking is indeed a major cause of lung cancer. For more information on those critiera, Google “Professor Austin Bradford-Hill.”

In the study under consideration here, the hazard ratios are much lower, although anything above 2.0 warrants further study, according to Prof. Hill. The large sample size is good, which greatly helps to cut down on the level of noise in the data. But the possibility of confounders has not been ruled out here, and @ctviggen is right to raise cautions about over-interpreting the data.

For example, the correlation between shoe size and reading ability is far stronger than anything mentioned here, but providing students with larger shoes is not going to make them better readers. This is because the correlation is confounded by the age and education levels of the people studied.

It sometimes happens that the correlation has the opposite cause and effect relationship than expected, and the researchers in the article cited in the OP did nothing to rule out the possibility that greater health leads to exercising more, rather than the reverse. It’s anecdotal data, of course, yet forum members report this all the time: with the extra energy they have from their far healthier diet, people who used to be couch potatoes often find themselves taking up a sport or starting an exercise regime—because they now can. (On the other hand, when I feel the urge to exercise, I just lie down until it passes. :rofl:)

Very true. On the other hand, there are now numerous radomised, controlled studies showing how effective a low-carbohydrate diet is for fat loss and for restoring metabolic health, not to mention enhancing elite athletic performance. And these studies are also accompanied by a quite detailed understanding of the hormonal and biochemical mechanisms at work, which adds greatly to our confidence.

Furthermore, not only is there no scientific evidence to support the dietary advice that has been standard since the early 1980’s, there is actually some evidence to suggest that said advice might be wrong (though it has to be said that this evidence comes from epidemiological studies, with all the weaknesses already discussed).

Wow! Did he happen to mention what blend he generally smokes? It might be worth finding a supplier . . . Or more seriously, did he happen to cite any data to back up this remarkable claim?

(charlie3) #14

I believe different approaches have different benefits. I suspect VO2 max gets a lot of attention from scientists because it can be measured consistantly and with sports coaches because it predicts sports performance. I’m not a scientist and not training for competition. What humans did traditionally is get up every day and do a lot of work, some high intensity and a lot of medium and low intensity. I’m betting that emulating that improves a lot of things besides skeletal muscles and lung capacity. In the end I have to go by how I’m feeling and performing and bio markers and adjust as necessary.

Right now I’m getting along with 2 45 minute rides on the airdyne daily, 2 hours of lifting weekly and as much walking as time allows.

#15

To go along with @charlie3 there is an Amish group in Tennessee one of my classmates spent a lot of time studying and living with. They don’t worry about diet or exercise, they also don’t really have Type 2 diabetes either.

I guess that’s what living like it’s the 1800s and doing manual labor all day will do for you. I’m going to get back to enjoying the recliner, heater set at 66, drinking some tap water, munching on some packaged pork skins, and watching National Lampoon’s Christmas Vacation.

(charlie3) #16

I led a big Amish family group through the local history museum where I volunteer. In and around the 1880’s buildings they looked like re-enactors, the clothing and the body types. They may be the closest thing we have to living proof.

I take advantage of all the modern conveniences, nothing compells me to live an old fashioned life and I’d rather not. If I’m going to be fit and healthy I need work arounds. I’m 20 months into low carb and exercise. It’s more and more dialed in. What’s made it easier is I’m addicted to the way I feel. My brain and body have connected the food and activity with feeling good. I don’t miss out on media. The phone is always showing videos or reading books aloud during exercise.

May be I’m driven by vanity. There aren’t many old fashioned working man physiques out and about these days because the people who have the muscle carry just a little be too much fat.