396 | The Best Exercise for Longevity | How to Move Well at All Ages

[00:00:05] Welcome to the Optimal Body Podcast. I'm Dr. Jen. And I'm Dr. Dom. And we are doctors of physical therapy, bringing you the body tips and physical therapy pearls of wisdom to help you begin to understand your body, relieve your pains and restrictions, and answer your questions. Along with expert guests, our goal of the Optimal Body Podcast is really to help you discover what optimal means within your own body. Let's dive in.

[00:00:28] So we're heading into a podcast about the best exercises for longevity. And I think arguably one of the best things for longevity is staying strong, having strengthened those muscles to support your joints. So I think it's only fitting that on March 3rd, we're going to be starting our Strong Healthy Joints course with a massive community all in our GenHealth platform.

[00:00:50] Now, strength and muscle volume is one of those things that we have seen decline every year, every decade after the age of even 30 or 40. But that doesn't have to be the case. And that's what this course was created for because strength is so important, not just for our daily activities like going up and down stairs, sitting to standing from a toilet even, or getting up and down from the floor, but it's so important to make sure our joints feel safe, strong, and stable.

[00:01:17] So we're going to be getting started on March 3rd, but if you go down to the link in the show notes, we'll email you an extra bonus discount code off of the already discounted price so you can get it now and be ready to start with us on March 3rd. Like I said, we're going to have a huge community going through this together, so there will be support along the way. There will be webinars. There's going to be a group chat that you can ask questions in and get answers from Jen and myself. So head to the link in the show notes, make sure you get that extra bonus discount code and get signed up before we start.

[00:01:45] All right, I'm excited for this topic today, talking about exercise for longevity, because I think what we're going to break down based on what the research is saying, it's not just our opinion, based on what the research is saying is different than what you are probably typically told as you're getting older. What are we typically told? Low impact, walking, slow down, don't get injured, be careful.

[00:02:09] Especially as we're getting older, that aspect of not wanting to hurt ourselves with exercise creeps in. And that's where I feel like a lot of providers, a lot of physical therapists, doctors, orthopedic surgeons, especially if you've had a surgery or an injury has resulted in a surgery, you'll come out with all these restrictions that really don't seem to have any sort of endpoint on them. They all have timelines.

[00:02:37] You'll come out and feel like you have this restriction. Oh, well, now I can't lift heavy because of this or I have osteoporosis, so I can't lift weights or else I'm going to hurt myself. And that really isn't the reality. In fact, it's probably further perpetuating some of these age-related changes that you might be seeing.

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[00:04:14] to stress and sleep support that supports all women in all stages, including those in perimenopause and menopause. So if you haven't yet, head over to thisisneeded.com, use code optimal, and you'll get 20% off your first order. That's T-H-I-S-I-S-N-E-E-D-E-D.com and use code optimal and get 20% off your order. And it actually reminds me of Jill Miller.

[00:04:43] She just popped into my head right now because she had her hip. She had total hip replacement. And then, you know, she did her rehab journey. She got really strong. And then the thing she said that really helped to get her stronger was actually doing a lot of my hip programming and getting back into high intensity, which is what we're going to dive into. I mean, so, yeah, you're kind of giving people a peep behind the curtain that we're going to be talking about HIIT or high intensity exercise.

[00:05:12] But before we get to that, like, why is that important? And so there's all these age-related changes that we start to, you know, notice in population. So, like, what we're going to talk about are averages here. I'm sure people have heard of sarcopenia, osteoporosis. Sarcopenia is the age-related decline in our muscle mass as we get older. Osteoporosis, of course, the decline in our bone density as we get older. And so just a few little tidbits.

[00:05:43] So once you hit your 30s, after the age of 30, on average, people will lose between 3% and 8% of their muscle mass per decade. Right? And that increases when you hit 70s. The average that we see is people will lose 15% of their muscle mass per decade. If you're not controlling and doing something about it. Right? And that's why I try to emphasize this is an average. Yeah. Because, like, this isn't a given.

[00:06:10] And I think that's what a lot of people submit to, which is like, oh, I'm 40. Just a decline in my muscle mass from here to death. Like, but no, we've seen the case studies of people who are in their 50s or their 60s and they start strength training and they get jacked. I know. And it's like, so you can build muscle mass. Oh, 100%. And this loss of muscle mass just increases the risk of falls twofold and leads to, which can lead to functional dependence and disability. And that is one of the most scary things, right?

[00:06:39] Because especially if you develop osteoporosis, which we'll talk about in another podcast, but, you know, you falling and potentially fracturing your hip or something, the increase to mortality after that is pretty significant. So that's why we want to reduce that risk of fall from the beginning. And I think that this point is not stated as much. It's not loss in strength that I even think is the most important. Right. It's loss in power.

[00:07:07] And if you don't know what the difference between strength and power is, power is how quickly we can use that strength. So it's like not just standing up from the chair, it's like exploding up into, you know, quickly standing up. Or if you're going upstairs, almost like hopping up the stairs. Like we lose power at a rate almost twice as fast as we lose strength. And again, that's where we start to see some of these things at the end of life where people struggle to just stand up from a chair.

[00:07:36] That often isn't a strength issue. It's often a power issue because people can't coordinate and use that strength quickly enough to get standing. You know, most people will have the strength to stand up, but it's like, can I do it fast enough to get my body, to get my butt out of the chair? Well, and think about catching yourself or falling. Like how fast do you have to be in order to react? And, you know, if we're losing that power, it's just going to relate to so many things.

[00:08:04] So it's, this is why then we're going to bleed into what are the best exercises for longevity. And first of all, when we talk about what are the best exercises for longevity, it's literally all of them, you know, because longevity doesn't just relate to heart health or muscle function, but it's how our brain is functioning. It's cognitive, it's mood, it's everything involved in longevity of our entire system as a whole. So I think that's what we have to be. You know, there's no one thing.

[00:08:32] And what I like to point out too, it's what is the exercise that brings you the most joy, that's going to make you the most consistent and keep you exercising and moving in general. That for me is going to be the best exercise for longevity because it actually keeps you moving. Like if you're doing something just because you were told you have to, and then you stop doing it, obviously you lose all those benefits.

[00:08:57] So, you know, I think that's, we're going to, hopefully you start to sprinkle in all the other things because we're going to talk about it, but I think that's a really main highlight. Yeah. If you take away one thing or if you stop listening right now, that's, that's it. You have the movement or the exercise that you're doing has to be something that you enjoy because that promotes consistency. Hopefully it promotes community. Hopefully you have found someone to go on walks with. Hopefully you found someone to go to a chair yoga class with.

[00:09:25] And again, it helps add in community and socialization, which is also a determinant of, you know, being happier, longer in life. And so you have to be doing something that you enjoy. And with the stuff that we're going to bring up, if it sounds like something that is not interesting to you, I promise there's a way that you can modify your understanding of what a high intensity workout is into something that you might enjoy more. And we'll get into examples. And we'll talk about that. Yeah.

[00:09:52] So the, along with, you know, what does all of them mean? You know, maintaining your mobility. That is one of the number one things is we lose the ability to bend all the way down because we're not putting our hips into a full range of motion. We're not putting our knees into a full range of motion. And just like the saying goes, you don't use it, you lose it. Right?

[00:10:11] So it's not just about stretching and, and think, but like literally using your full capacity of your mobility to maintain as much mobility as possible as you continue to age. I think sarcopenia, osteoporosis, many of them are heavily contributed to by what you just said. If you don't use it, you lose it. A hundred percent. And this age related, I put in big air quotes, age related changes. It's more so lack of activity related changes.

[00:10:41] Because when, when, when we're young and healthy and in our teens, twenties, thirties, you know, in general, we're just moving more. We're doing more. We're more active. When we start getting into our late thirties and forties, people's lives get a lot busier. You have kids, you've got a job, you've got a mortgage, you've got a car, you have all these things that you're worried about. And the things that start, you know, getting lost in the mix of the schedule is that workout that you used to do is that run that used to go on in the park.

[00:11:10] So I feel like a lot of these quote age related changes have to do so more with the busyness of life. And the priorities have shifted from maintaining exercise and activity as much to all the other important things in life. And so that's where, you know, then we will get into obviously walking, moving more throughout your day, steady state cardio.

[00:11:35] That's going to be something that's so incredibly important for your, your heart health, your respiratory health, your brain health, as well as strength training, maintaining your muscle mass, improving your muscle mass as you continue to age is so crucial to maintain. Like our, think about how our structure stays up, stays upright, stays good in posture is because we have these muscles that help are helping to maintain it. So we need muscle mass as we continue to grow. Yeah.

[00:12:04] And same thing that we talked about with high intensity interval training, all of these can be adapted and all of them are relative strength training. If strength training is not something you're into, that's fine. Are you into walking? Okay. On your walk, is there a staircase? You know, is there something that you and your friend or whoever you're walking with can walk up and then slowly go down the stairs a few times?

[00:12:29] Like in many ways, that's going to be strength training because the amount of weight, you know, there's, there's all these physics equations that talk about the amount of weight you're putting through your leg when you walk upstairs is like two to three times your body weight. Right. So great. Do a couple sets of stairs on your walk or make sure that you hit a hill here and there. I know. And that could be incorporating that aspect of strength into the walk that you enjoy. You get to the top, there's a little ledge that's a pretty, that's pretty high. You can do pushups.

[00:12:59] You can do, you can do slow pushups. Like there's ways that you can challenge your, your body weight by using body weight. You can challenge your muscles by using body weight. So now let's get into HIIT, high intensity interval training. That's the main one that we want to touch on. That's the one that we're seeing loads and loads of research come in on as the best exercise that pretty much everyone should be doing.

[00:13:23] But especially as we age, it can really help to reverse a lot of these age related changes that, you know, are purported because HIIT, high intensity training has positive impact on basically every single system in the body. You know, running through them quickly, we have our musculoskeletal system. Great. It can help prevent muscle loss. We have our skeletal system. Great. It can help stimulate healthy bone remodeling.

[00:13:53] Our brain. Yes, it's helping create what we call this brain derived neurotropic factor that is basically a super fuel for the brain. Yes, HIIT helps and has been shown to improve that lymphatic system. We're moving fluids by pumping our bones. Our circulatory system. Yes, we are improving the compliance of our vessels. It's going to help with blood pressure. It's going to help remodeling of our heart, all of this different stuff.

[00:14:21] And the impact of landing. And our respiratory system is, yes, we're going to improve and see improvements in our VO2 max, which basically just tells you how well your heart and your lungs are working to get oxygen to the body. All of it. I know. Like you said, the impact from landing or if you're not doing jumping from your heels, even just hitting the ground after doing certain exercises. That stimulates bone growth, I think, is what you're going for there. Yeah.

[00:14:49] So, I just wanted to hit all those quick. Like HIIT does it all. And you can get those benefits in as little as 10 minutes of exercise. And we're going to talk about that. What that relates to. And I know HIIT kind of scares people, especially when we're talking about women's health and women's hormones. It's like, oh, but I've moved away from HIIT because that was the thing that was destroying my hormones. Right. And this is where we're not saying you're doing it every day.

[00:15:16] This is where you're starting to sprinkle it in one to two times a week of like getting in this higher intensity exercise or changing the way that you're looking at it, where it's even dosed smaller so that it doesn't have that huge hormonal impact on our health. And I think that's where we really have to be aware of not jumping into the all or nothing. And remember, I go back to what exercise is best for longevity? All of them. Right.

[00:15:43] So, it's not just this one, but this has a huge impact if we start to sprinkle and add it in. What was the study that I'm trying to think of this study that I heard quoted at one point. So, this might be a little bit off, but it was something like doing HIIT, was it three times a week for eight weeks? It was reversed like 10 years of the changes seen in muscle loss or VO2 max loss.

[00:16:09] It was something pretty incredible that like just doing HIIT for eight weeks helped you recover like a decade of your VO2 max loss. We actually took a quick pause from the recording to find Jen mentioned we had this presentation that she did on HIIT workouts a while back. And this point, I had just like triggered in my mind that so HIIT training three times per week for eight weeks is able to improve our baseline VO2 max by 12%.

[00:16:37] So, the average person saw a 12% increase in their VO2 max. And then a point right before that said after age 25, our VO2 max for the average person declines by 10%. So, in just eight weeks of training, you can recover an entire decade's worth of loss in your VO2 max. That's huge. Which I think is insane. It really is.

[00:17:00] Eight weeks, just throw, every 10 years, just throw eight weeks of HIIT training in and you'll completely recover the VO2 max losses. Mm-hmm. I mean, I think that's huge because even if we just look at it, like barely increasing your VO2 max. So, even if you weren't going to commit to three times a week, but you're going to say, okay, I'm just going to add it in sometimes. Sometimes when I can remember, sometimes when I can get to it.

[00:17:26] Each increase in VO2 max equals 45-day life expectancy increase. And again, this is averages, right? So, you might not look at that and say that's a huge deal, but if you can add any life to your existence, how amazing would that be by just starting to improve the way that our body uptakes oxygen? I think that's incredible.

[00:17:49] And again, now is when I want to kind of talk about the fear that some people have when it comes to high intensity or HIIT training. It's like, oh, I don't jump. You don't need to jump. Oh, like I, you know, don't want to hurt myself. There is a scale of intensity for everybody. So, if high intensity stuff is something you haven't done in a long time, like put a minute on the clock and do as many sit to stands from a chair as you can.

[00:18:18] I promise, like our goal is to get our heart rate above 80% of our max heart rate, which, again, you don't even need to be really measuring this. But it's a high heart rate. It's a high heart rate. You just need to work to the point where you're like, I'm exhausted, right? And if setting a minute on the clock and doing sit to stands from a chair, you know, as many as you can in that minute gets you to the point where you're like, holy bleep, I'm exhausted.

[00:18:45] And then you take a minute or two minute rest and do that three or four times. That's an incredible HIIT workout. Right, exactly. And so, that's where it is tailored to you. And there are so many different versions and forms. If you have access to a battle rope, that can mean that you're in a squat and you're doing a battle rope. Whew, exhausting. Like, that's so exhausting. If you understand the technique for kettlebell swings, you can do kettlebell swings within a minute.

[00:19:09] There's so many different ways to access this HIIT without needing to go into the explosive work. I will say that is something that I would want everyone to work into because the only way that we're going to get changes in bone health is by starting to increase the impact in which we put within our body. And I don't want people to have fear of being able to jump as we age. Like, we should still be able to jump.

[00:19:37] It just will be modified based on where you're at. Maybe you're even holding onto a counter, you're holding onto something, and you're doing jump squats from there. There's ways that we can always modify, but we don't want to start to just stop doing it because I've hit a certain age or because of fear. There's always ways then that we can modify. Yeah. Does your mom do any of the jumping exercises? She does, and I have her hold onto something for support in order to be able to do it. Yeah. And she's 70.

[00:20:05] And there's always ways to, again, modify or work your way into that. Yes. And how empowering is it if you're someone in your 60s, late 50s, 60s, 70s, whatever it is, and you haven't jumped in a while, and you get to the point where you're getting air, and you're jumping, and you're landing, and you're like, to almost reverse that expectation in your body's ability. Yes. We are here to say that you can. We are not the PTs telling you to fear it.

[00:20:33] And I think one of the cool protocols, this was actually brought up by Dr. Rhonda Patrick, is the Norwegian 4x4 protocol. And this is one that's been studied to have those improvements in VO2 max. And essentially what it is, it's four minutes of high-intensity exercise that you can maintain. So again, this goes back to what's individual for you that you can maintain that keeps you into that 75%, 80% heart rate.

[00:21:00] You know, like it's pretty high, followed by a three-minute recovery. So you're completely recovering your body for three minutes, and then you get back into it, and you repeat this four times. So I look at this like I have a pretty intense protocol, actually, on Gen Health, where it is very, very much worse than that. But for four exercises, two circuits of this, and the first circuit you do for seven minutes as much as you can,

[00:21:28] and as intensely as you can, you take a 30-second pause, and then you go back into it for seven minutes. Right? And so I've told people, you could take those four exercises, do it for four minutes instead of seven, take a three-minute pause, repeat it again for a minute, and then do the next circuit, four exercises, four minutes, three-minute pause. So there's ways that you can, again, modify this for your intensity level. And the number one way to prevent injury when you're doing exercise, especially new exercise like high-intensity,

[00:21:58] is to make sure that you're focusing on form. So you don't want to sacrifice form in order to get the workout done. That is what often leads to more injuries. So make sure that you're focusing on technique, you're focusing on form, and that's going to help you to prevent injury. So kind of like I mentioned earlier, there are legitimate changes that we can see in every system of the body. So just a few of them I mentioned, cardiac changes. There was a study done in 50-year-olds that showed after the training they did,

[00:22:26] their hearts reverse-aged, they're like de-aged almost 20 years. So they had 20 years of changes with stronger, more malleable or flexible hearts. It took some of the stiffness out of their valves. And so literally, hearts of 50-year-old people were appearing 20 years younger. And that's insane. So that's what we're seeing. So we're seeing significant blood pressure changes similar to effects that would result from taking blood pressure medication.

[00:22:56] And there was one other change that I wanted to talk about having to do with the metabolic health of our body. Something that we notice, again, as we age is that our body might not handle glucose as well. And that's where we see diabetes or issues managing that blood glucose level. Some people might need to start taking insulin.

[00:23:20] We see significant resensitization of our insulin receptors and ability to manage glucose and manage our blood sugar with consistent hip training as well. I mean, hopefully you're starting to understand just how beneficial, you know, starting to implement hip training. And what's really cool is that you can do something called exercise snacks. Now, this is where you're not doing it for 30 minutes. That neuro-agent protocol might scare some people, right?

[00:23:45] So exercise snacks is when you're getting your heart rate up to at least 75% to 80% of that max heart rate for 1 to 2 minutes, 30 to 60 minutes prior to a meal. So 1 to 2 minutes of high, high, intense exercise. And you sprinkle this in about 3 times a day. And what they found is that it can improve the blood glucose levels, exactly what Dom was talking about, and increase mitochondria in the muscle tissue.

[00:24:11] Especially if you take just a little bit longer than 1 to 2 minutes, especially if you maybe do 5 to 10 minutes. But people who did this about 3 times a day, you know, just for 1 to 2 minutes, had a 40% reduction in all-cause mortality and a 50% reduction in cardiovascular mortality. This is huge. Huge.

[00:24:33] I mean, to be able to reduce those risks that significantly, just 1 to 2 minutes of, you know, I'm going to go up and down and run on my stairs 1 to 2 minutes prior to, you know, an hour before I get in my meal. Doing something. Sit to stand from your chair. Like all the different options that we kind of talked about. Jumping up and down from a curb.

[00:24:54] I mean, to be able to have that significant of an impact when you're doing that consistently rather than having to get the 30-minute HIIT workout in, I think is really, really cool. We've beat this to death already. Like all of the benefits. And we're trying to just bring the evidence. Like this is hard evidence.

[00:25:11] And I don't think you'll find many people in the exercise physiology world, especially people who research it that won't agree with this point of in any way possible, how can you start to implement high-intensity training? Again, refer to the first point that Jen brought up though. Like it has to be in a way that you enjoy. Right. Make it fun. If you are trying to insert this and you just hate it, great. Stop whatever you were just doing and try something different.

[00:25:40] You might have to try four or five things that you don't particularly like before you find the one that you do. For example, I'm not a huge fan of HIITS. No, you're not. No, I'm trying to find the way to say I am. I am after we do it. But you do sprint intervals. Yes. And then I was going to bring up that I've started running a little bit more, which I also hate.

[00:26:06] I enjoy it because I do it with my dog and I love like just how happy she is while we're running. So that's where I get my joy from it. But I changed it to sprint intervals where I'll just sprint for about 20, 25 seconds and then walk back, you know, and sprint and do that 20, 30 times. And it turns into an awesome, you know, 20, 30 minute workout. I enjoy it. My dog's running around like crazy. We're all happy. And it's exhausting.

[00:26:35] And yeah, that's the one time I do like HIITS is just like afterwards. I can feel my body and my physiology being like, that was awesome, you know, and just the adaptations starting. Yeah, exactly. So again, it doesn't have to be a lot. Sprinkle it in like once or twice a week. Try it after a workout.

[00:26:53] It's going to give you massive benefits and don't fear what, you know, the fear of injury and the fear of other things you might have been told. Just start small. Focus on your form. If you're wanting a community, though, to start working with about a week from today, the day this podcast came out, if you're watching it a little bit later, might be started already.

[00:27:21] But we are starting next week as a community doing our Strong Healthy Joints, you know, program or that's going on a discounted sale. So we're going to have a link to a wait list that's going to go in the show notes of this podcast. That'll get you an extra $10 off. So you actually get $10 off the early bird price because it goes up for early bird sale next week. And this is a strength program. But it has HIIT in it. It has some HIIT in it.

[00:27:48] And with heavy strength training, you do see a lot of the same adaptations and a lot of the same benefits as you'll see in HIIT training because our heart rate gets so high when we're doing heavy strength training as well. So check out the link in the show notes for that and start doing HIIT. Thanks for joining us for another PT Pearl. All about HIIT. If you know somebody or know someone who's struggling with some of these things, please pass this episode along.

[00:28:13] Remember, we're starting a community Strong Healthy Joints month of movement in a few weeks. So if you want to get on that wait list or join us, the link will be down in the show notes to get that extra $10 off the early bird price, which starts next week. If you haven't left a rating and review on the podcast, please consider doing so. And of course, we'll see you next time.