How Exercise Intensity Relates to Longevity

Dr. Rhonda Patrick: You want to be unable to have a conversation while you are working out. That is how you know you are getting into the vigorous zone we are discussing.

For every one minute of vigorous-intensity exercise—think jogging, or sprinting to play with your puppy or grandchild—you had to do four minutes of moderate-intensity exercise to get the same association with lower all-cause mortality. You had to do eight minutes of moderate-intensity exercise for every one minute of vigorous exercise to get the same association with lower cardiovascular mortality. You had to do ten minutes of moderate-intensity exercise for every one minute of vigorous exercise to get the same association with a lower risk of type 2 diabetes.

Katie Couric: From a clinical standpoint, what really moves the needle on extending a healthy lifespan? Is it mostly about lowering our risk of major diseases as much as possible?

Dr. Rhonda Patrick: Yes, lowering those disease risks is a very important part of it. Maintaining your cognitive reserve and muscle reserve is also important. If you do get sick, you want to be able to handle it well. Cognitive function and muscle mass are both important.

What moves the needle clinically, first and foremost, is physical activity and exercise. There are two components: aerobic exercise and resistance training. Together, they move the risk of cardiovascular disease, Alzheimer's disease, and metabolic disease in the right direction and can delay those diseases.

Aerobic exercise works the cardiorespiratory system. We can measure cardiorespiratory fitness with VO2 max, the maximum amount of oxygen your body can use during physical activity. It is one of the most important biomarkers of healthy aging and longevity. People with the highest cardiorespiratory fitness have about five years greater life expectancy than people with the lowest fitness.

You improve it by engaging in aerobic exercise, such as jogging, cycling, or rowing. If you cannot jog and you are a walker, mix in some interval walking. Get your heart rate up. Do not make every session the kind of exercise during which you can hold a conversation.

Katie Couric: Right.

Dr. Rhonda Patrick: Mix in high-intensity interval training. For some people, that means getting on a Peloton bike and going hard for 20 seconds, then taking 20 seconds off, or going hard for one minute. There are many ways to do it.

Not everyone is at that point yet. People who are new to physical activity can walk. Studies show that if you walk, pick up the pace for a short period, and then return to slower walking, that interval pattern can provide larger improvements in metabolic health and cardiorespiratory fitness.

Katie Couric: My doctor told me to raise my heart rate above 100 for 30 minutes, three times a week. Does that sound right to you?

Dr. Rhonda Patrick: Depending on your age, I think your doctor is saying that you want to reach a vigorous-intensity zone. For most people, that is around 80 percent of maximum heart rate or more.

If someone does not have a wearable device and is not measuring heart rate, the talk test can help. You want to be unable to hold a conversation while working out. That is one way to know that you are getting into that vigorous zone.

One of the most important points I can make is to include vigorous-intensity exercise. That could be jogging, cycling, or another activity. You want to get your heart rate to about 75 to 80 percent of your maximum heart rate.

New studies have challenged how we think about exercise-intensity guidelines. The guidelines recommend 150 to 300 minutes per week of moderate-intensity aerobic exercise or 75 to 150 minutes of high-intensity exercise. That is treated as a one-to-two ratio.

Moderate intensity is more like a faster walking pace, while jogging would be higher intensity. A new study published in Nature Communications challenged that one-to-two ratio. The older ratio was based largely on energy expenditure—the fact that vigorous exercise burns roughly twice as many calories as moderate exercise. It was not based directly on outcomes such as cardiovascular disease, all-cause mortality, cancer, or metabolic disease. Much of the prior work also depended on questionnaires in which people recalled how often they exercised.

New data measured physical activity with accelerometers and examined health outcomes. When investigators measured how fast people moved, they found that one minute of vigorous-intensity exercise was associated with the same reduction in all-cause mortality as four minutes of moderate-intensity exercise. One minute of vigorous exercise was associated with the same reduction in cardiovascular mortality as eight minutes of moderate exercise. One minute of vigorous exercise was associated with the same reduction in type 2 diabetes risk as ten minutes of moderate exercise.

That is an enormous difference in efficiency if you can get your heart rate up and move faster. I am sorry I went on a long tangent, but I think it is a very important point.

Katie Couric: It sounds like I need to do more vigorous exercise. Can you come to New York and be my personal trainer?

Dr. Rhonda Patrick: There are many great trainers and programs available, but it is important to get your heart rate up. Based on those observational comparisons, you may get four to ten times as much from a minute if you push a little harder.

We were talking about clinical endpoints and what really moves the needle. I went on a tangent about exercise because it is so important. Other factors matter, including a healthy diet, avoiding ultra-processed foods, and maintaining a healthy body weight. Obesity can take seven years off life expectancy, and in extreme cases, 14 years. Losing excess weight and maintaining a healthy body weight are very important. If you can stay at a healthy body weight, you are 50 percent of the way there.