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so on that let's look at Cardio training
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first and say you know how would you put
00:00:07
someone on a program to help on the
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cardio
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side once we've established that a
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person you know has the basics you know
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they're they're not immediately injured
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that you know they've got the ability to
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start doing some cardio
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training um I like to really start with
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Bas building right I I really you know
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even even for someone like me who trains
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a lot
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remember 80% of my training volume is
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its own to uh only only 20% of my
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training volume is is is in that V2 max
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range um and and again I I've said this
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before but it's always worth reiterating
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understand that I am not training for
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anything other than the the sport of
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life if I were still training to be an
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athlete if I were still training to be a
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cyclist I would have to do something
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very different than what I'm stating
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what what I'm stating is far less
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intensive than someone who's you know
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trying to be a master's level athlete in
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you know pick your endurance sport um so
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again now we're talking about a person
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who's new to this what are we going to
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do I would be really happy if I could
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get them to start two days a week 30
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minutes a time now if I took a person
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who is relatively fit and we did two
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times a week at 30 minutes per session
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they're not going to improve enough
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right they're they're going to
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experience no improvement if I reduced
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my training volume to that level I would
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probably go backwards but you have to
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remember when you're starting with a
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person who's very deconditioned they
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will actually see a training benefit at
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such low volume so you know not going to
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throw them in 3 Hour 4 hour a week
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training um we're going to start them
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much lower now the question I get asked
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all the time is how do you help that
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individual calculate where their zone
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two is and this is worth spending some
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time on again for folks who want a bit
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of a primer when we talk about Zone 2 we
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are not talking about the same Zone 2
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that shows up on your Polar heart rate
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or your Apple watch or whatever other
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device you're talking about we're
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talking about um a very specific
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mitochondrial level of Zone 2 and it's
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it's it's referring to an um the highest
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level of work that you can do while
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keeping lactate at effectively in
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indefinite steady state which for most
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people tends to be below 2 Millo so um
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once you're exercising and lactate gets
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above two you're probably not going to
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be able to sustain that for you know a
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couple of hours which is effectively
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what we're talking about here um because
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metabolically you are going to um uh
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move to an area where you're generating
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too much hydrogen along with too much
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lactate and the muscles are going to be
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compromised so um if if you really want
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the gold standard for measuring Zone 2
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you got to be kind of checking lactate
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levels and I don't really Advocate that
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for people especially if they're
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starting out you know I do it but I'm
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probably an outlier here because I enjoy
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that level of precision so what I do
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recommend is two ways to be thinking
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about this the first is on the rate of
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perceived exertion which I've talked
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about at length in the past and that is
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the talk test um so you know and I've
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even posted a video I think somewhere
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that we can probably link to in the show
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notes showing people what I look like
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when I'm in zone 2 and what my you know
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difficulty in in speaking is so we'll
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we'll link to that so people understand
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but because I know that people really
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like you know a little more guidance
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than that I think using Phil mafat Ton's
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um map formula maximum aerobic
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performance I think is what maap stands
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for um but it's 180 minus your age is a
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target heart rate
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and then if you're really new to the
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thing which again is the audience we're
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now talking about you might even
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subtract 10 from that right so a 60 year
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old is going to potentially be as low as
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110 beats per minute at a Target and as
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they get fitter that's probably going to
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go a little bit higher now I want to
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point out that you don't want to be too
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wed to this as you get more and more
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involved in your training um because the
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fitter you get I think the more
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variability you'll experience based on
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recovery so my maone formula would have
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my heart rate be uh 129 okay well I can
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tell you 129 is never in zone two for me
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except on the worst day you know maybe
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once every two months I might have a
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zone two based on lactate where my
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actual heart rate ends up being 129 it's
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almost always going to be in the high
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130s and sometimes in the low 140s so as
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you get more conditioned the formula may
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be less and less valuable and you will
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rely more and more on RP or if you
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really want to you know take it to the
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next level you might even start using
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lactate final point I say on this
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lactate even if a person is
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deconditioned we will we will not use
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lactate on them because an individual
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that's coming in who's metabolically
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unhealthy tends to have very high
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resting lactates in fact there were
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people walking around with a lactate of
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2 Millo at rest clearly in that person
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using lactate provides no value and you
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should rely on heart rate and
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RP and in that person let's say they're
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doing two days a week 30 minutes a day
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how long do you like to see that
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consistency before you slowly increase
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either the duration or the number of
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days you know in part it comes down to
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what we talked about which is like how
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do they feel you know I almost want to
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uh you know Inspire within them an
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appetite to do a little bit more um so
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you know I mean this sounds silly but
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when you're starting out some of this
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stuff a lot of it is just the Growing
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Pains of being able to sit on a bike and
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your butt doesn't hurt or being able to
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walk on a treadmill and making sure that
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their knees aren't aching or things like
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that you know so um the you know I I
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would say within 8 weeks to 12 weeks I
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would want to start pushing frequency
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and or duration uh I I personally and
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and I don't think there's a right answer
00:06:26
here and if there is I'm sure someone
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will comment I like to push frequency
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before I push duration um so I'd almost
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rather go from 2 to 3 to four sessions
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at 30 minutes before we start going to
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45 um but eventually I'm going to want
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the sessions to be at least 45 minutes
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each and on the other side of cardio
00:06:45
respiratory V2 Max before we get into
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how you start to build that in for
00:06:50
people we do have a few other graphs
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here that I think are insanely helpful
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and looking at why V2 Max is so
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important as people like p and so I'll
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pull them up here but do you want to
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kind of talk viewers and listeners
00:07:04
through this side of it as well yeah
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this was this was a graph that I was
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able to get into the book so I was uh I
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fought hard for this one cuz boy nobody
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wanted this one in a in a book and and I
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can understand why it requires some
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explanation so um this is this is a
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figure that shows the hazard ratio of
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various comorbidities and performance
00:07:27
subgroups so again what's a hazard ratio
00:07:31
well it gives you an estimate of
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relative risk so let's start with the
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comorbidities because I think that's
00:07:37
easier to understand right so if a
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person is a smoker are they at increased
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risk and in this case the risk is all
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cause mortality so they are they are
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they at an increased risk of death from
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all causes I think anybody would
00:07:51
understand the answer that question is
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obviously yes the question is how much
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and in this analysis if you compare a
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smoker to a non-smoker and ask the
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question what is the probability of that
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smoker dying in the coming 12 months
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from any and all causes the answer is
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it's 41% greater than the non-smoker
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okay that kind of makes sense uh what if
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you take two people one with coronary
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artery disease known Cad and the other
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without well it's about a 29% difference
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in all cause mortality 29% greater risk
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I should say if I'm going to be more
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accurate what about somebody with type 2
00:08:27
diabetes well again it's a four 30%
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greater risk of all cause mortality in
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the coming year high blood pressure 21%
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end stage renal disease right so
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somebody who's on dialysis awaiting
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kidney transplant a whopping
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178% increase in all cause
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mortality so now what we do is we do the
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same mortality analysis on that massive
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cohort of people for whom we have V2 Max
00:08:56
data so these are the data that we
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showed earlier where we looked at people
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in those uh cor tiles and so um what I
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do every time I run a patient through
00:09:06
their V2 Max the first time is I figure
00:09:09
out where they are and if some let's
00:09:10
just say somebody shows up and they're
00:09:13
um in the below average Camp um so that
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means they're in the 25th to 50th
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percentile for their age I say look if
00:09:21
you just go from below average to above
00:09:24
average right if I were just to compare
00:09:26
you from you know your level at the 25th
00:09:30
to 50th percentile to someone who's in
00:09:31
the 50th to 75th percentile the hazard
00:09:34
ratio is 1.41 in other words you are 41%
00:09:39
more likely to die in the coming year
00:09:42
than somebody who is that much fitter
00:09:44
than you and by the way it's not it's
00:09:46
not lost on anybody that that's the
00:09:47
exact same Hazard ratio of a smoker to a
00:09:49
non-smoker that's how big the difference
00:09:52
is and if you want to go from below
00:09:54
average to high so now you're going from
00:09:57
say the second quartile to the third
00:09:59
quartile it's a
00:10:02
100% difference in Risk it's a doubling
00:10:05
of the risk of death for that coming
00:10:08
decade I won't go through the rest of
00:10:09
these numbers here but they're all
00:10:11
staggering um and by the way even just
00:10:13
going high to Elite
00:10:16
29% difference in relative risk so you
00:10:19
know when I talk about how V2 Max is the
00:10:22
single most important biomarker we have
00:10:25
for lifespan these are the data from
00:10:27
which I make that claim right and and
00:10:29
there are obviously other data that are
00:10:30
identical to this on different cohorts
00:10:33
but the point is there aren't other
00:10:35
biomarkers that will give you Hazard
00:10:38
ratios of this magnitude um now people
00:10:42
often ask why is that the case and I
00:10:45
think the answer is that V2 Max is
00:10:46
probably a remarkable integrator of work
00:10:50
so it is not a biomarker that changes
00:10:54
quickly and easily to the magnitudes
00:10:56
required to do this right um You Know
00:10:58
You're not going to take your V2 Max
00:11:02
from low to Elite in a year um you can
00:11:06
do it I would argue you absolutely can
00:11:08
do it but it's not going to happen in a
00:11:10
year and therefore when it happens it's
00:11:12
going to reflect an astronomical volume
00:11:17
of work that has been done and the
00:11:19
benefits of that work are what are being
00:11:21
captured in the V2 Max number
00:11:28
[Music]
00:11:33
no
