Dr. Levine has done a whole lot of research, lots of different studies trying to identify how much exercise, what exercise is doing to the structure of the heart for one, and how much exercise is really needed to help really stave off a lot of those changes, those structural changes with age. And he had one, one of the studies that he had done early on, which were, were done in master's athletes. They are physically active every single day and they're competing at a national level in, in many cases. So they're, they're, they're doing a lot of cardiovascular and aerobic exercise. Their hearts structurally, so we're talking about seniors. So these are people that are older, their hearts looked like healthy 30-year-olds.

So 30-year-olds that don't have any identifiable diseases like cardiovascular disease or type 2 diabetes or hypertension, right? And so that's pretty profound when you're talking about 50, 60-year-old persons structure, at least looking very similar to what a healthy 30-year-old would look. But we're not all gonna be endurance athletes and masters athletes throughout our lives. So the, the next question is, well, what is the exercise dose that's really needed to get you most of the way there to have your, to maintain that youthful cardiovascular structure? And that's where, you know, some of Dr. Levine's follow-up studies have looked at some of that research. Maybe you can talk a little bit about that. Yeah.

Yeah, I think some of this might be kind of maybe not surprising to a lot of people, but I think it, based on, you know, everything he said, it seems like the dose appears to be maybe a little bit more, a little bit higher than a lot of people think it might be. And one of the things I think too, to add of, you know, when you were talking about the changes that occur kind of across the lifespan, one of the, I think, craziest statistics that Dr. Levine cited was that after the age of 70, it became nearly impossible to reverse the structure of the heart indicating that, you know, you basically need to do everything that you can before that age to improve the structure of your heart.

Because after that, it takes a, you know, an unsustainable maybe level of exercise to kind of reverse some of those structural changes, which I found very informative in related to, you know, how to train with age. So in the study that he was citing during your interview, yeah, he mentioned, you know, they did a study, an observational study where people self-reported their levels of physical activity, kind of throughout their life and they bucketed them into different days of activity. So this wasn't necessarily studying the dose in hours or minutes per week, but they looked at people exercising 1 to 2 days per week, 2 to 3 days per week, 3 to 4 days per week, 4 to 5, and then 5 to 6 or more days per week. And this was kind of a lifetime of physical activity.

So how long do you, have you exercised? How many days do you exercise per week for, for how long? And then they compared these levels of exercise to people who were sedentary, who basically didn't exercise at all. And so, what they found was that the people who exercised 1 to 2 days per week pretty much had hearts with the same structure as sedentary adults. So, 1 to 2 days per week provided zero protection basically against heart aging. When you moved up to 2 to 3 and then 3 to 4 days per week, those groups had some protection compared to the sedentary adults for their heart structure. So, structure of their hearts were a little bit better. than people who were sedentary. The 4 to 5 group, that's kind of when you experienced a significant level of cardiovascular protection with age.

And then the 5 to 6 day per week exercisers had nearly complete protection. They were similar to the master's athletes. And so what the conclusion from that study from Dr. Levine was, 4 to 5 days of exercise appears to be the optimal dose across the lifespan to prevent Cardiovascular aging. Now, again, this study didn't provide a number on how many hours or minutes per week you should exercise, but let's assume these people were exercising for 30 minutes, maybe an hour per day when they were doing it. That puts you in the sweet spot of like maybe 5 to 6 hours per week of, of exercise. But that 4 to 5 days appears to be important. And so maybe you don't even think about how much time the people were doing exercise, but just the frequency of exercise.

Make sure you're doing And when we say exercise here, we're referring to aerobic training in addition to resistance training, which we'll obviously dive deep into later. But this is just aerobic exercise. And again, that could be walking, that could be something that activity that raises your heart rate, dynamic exercise that raises your heart rate. But doing 4 to 5 days per week of that seems to be optimal for preserving cardiovascular structure. And I think the takeaway from that was really probably the 150 minutes per week that is cited as what the minimum recommendation. It might not be enough if the goal was to kind of maintain cardiovascular structure throughout life.

And yeah, it, this, I'll, I'll tell you, this study was a bit surprising to me because probably for that reason where, you know, you think the, the 150 minutes a week or even just 3 days a week of aerobic exercise, oh, you think you're doing really good, you know? And, and I absolutely increased my, my frequency of aerobic exercise. After hearing about this, because I mean, I was like, oh wow, I need to be doing more. I can do more, I should do more. And now I have every, I have evidence of why I need to do more. Right. But I do, it was a bit surprising where it's like, okay, if you do, if 4 to 5 days a week of aerobic exercise, then you're really, you're not quite at the master's athlete level in terms of your heart structure, but you're mostly there.

And I do think 4 to 5 days a week is pretty sustainable for most people. It should, it should be. Yeah, it should be. And if it's, and if it's not, you know, maybe you need to make it in your structure, your life in such a way that it should be. You know, he had a, Ben, Dr. Levine had a great quote where he says, you know, exercise needs to be part of your personal hygiene. It's like brushing your teeth. You wake up, you know, it's not something that you think, oh, should I do this? It's, I'm gonna wake up and I'm gonna do this cuz it's part of your personal hygiene. And so I think there's a lot of talk sometimes about, you know, if we prescribe the recommendations for exercise too high, does that deter people from doing it?

And maybe, but I mean, the reality is I think, you know, presents compelling data that if we wanna get serious about it and you're really serious about not aging cardiovascularly, you need to probably do more exercise. And so I think it's kind of a harsh reality, but just something for, for people to think about and how to structure their, their training. Uh, it is a part of both of our profiles, right? I mean, when you wake up in the morning, what's the first thing you do? Do you, I mean, I'm not the first thing, but like in terms of work, Versus exercise. Oh, it's definitely exercise. Drink coffee and exercise. Exercise is the first thing I do. I mean, I brush my teeth and yeah, I eat a little bit, but, but I do before I work, in most cases I exercise.

And that wasn't always the case for me, even, even dating back to when I was been, have been very interested in my healthspan and lifespan. It was like, okay, I'm working, you know, working out 4 days a week or, you know, No, now it's, you know, 6 days. It's, it is ev— it is every morning. And, and if I, if I don't get to, if I take off an hour of what would be my work time, so be it because that's what's gonna happen. I'm going to exercise. Yeah. You just, you make the, you make the time for it. And I'm, you know, that has to be the case a lot. I think the paradox kind of is that most people tend to exercise more when they're younger, which is kind of when you need less exercise. I think as you get older, you probably need to do more exercise.

And that's, I think what the evidence that Dr. Levine presents would, it would indicate too. But I also feel like as people get older, they might have a little bit more free time. Once you get into your 40s and 50s and 60s, you're reaching, you know, your kids are out of the house, you know, you're maybe still working a job, but once you get into retirement age, so maybe, you know, I think the way that maybe people think about exercising is that, yeah, you wanna do a lot in early life to kind of build up those reserves in your muscle mass and your aerobic fitness and things like that. But, you know, as you get older, think about exercising more as you maybe have more time to dedicate to it because not only, you know, you need probably that amount in order to kind of maintain some of these changes. So it's, again, I think a harsh, a harsh reality, maybe.