Cardio fitness is a strong, consistent predictor of morbidity and mortality

Some of my peers are deep into running. I don’t get it. Running is sometimes fun for me but most often painful.<p>Then I overheard one of them (the fittest) say to a budding runner that he [should] do mostly easy sessions. Okay what’s easy to him? He said that so slow that it can feel awkward and unnatural. What?<p>Then I searched around and found out about Zone 2 and how you should do most of your work in that zone when building aerobic fitness. And that it is characterized by being able to hold a conversation, although strained.<p>I searched around and found atheletes like amateur ultrarunners say the same thing.<p>Then it hit me. I’ve probably been jogging a lot in Zone 3. Or higher? Because the harder you go the more benefit, right? That seems to be the basic logic for everything.[1] Relatively short, painful sessions. Have I been conditioning myself to associate cardio with more pain than is necessary for the average session?<p>So maybe I should just go on the stationary bike today, do a “conversatitional” (talk to myself) pace and listen to my audiobook for an hour? And try to not let my groin fall asleep.<p>[1] With nuances like go-to-failure for hypertrophy in weightlifting and more back-off-a-little for strength training.

Weird that people seem to assert that causality is not established? There are hundreds to thousands of studies that show that pretty much all markers for mortality and morbidity go down with excercise, i.e. put someone regulalrly on a treadmill for a couple of month and pretty much all health markers improve.<p>People implying that the study shows only correlation really don&#x27;t seem to understand how we establish causality in science.

There’s amusing statistics that show that if you’re out of shape and a smoker, you get a bigger bang for the buck from getting in shape first than quitting smoking. Disclaimer: not an endorsement of smoking.

Fortunately, this seems relatively simple to change (compared to other things with this magnitude of impact).<p>It was a transformative experience to go from 40 VO2max to 57 (as reported by Apple Watch, and losing 30lbs on the way) over the past 12 months. The best part about it is that I didn&#x27;t even have to give up anything - the extra energy I gained from 90-120 minutes of aerobics per day also had the effect of making everything else more efficient.

Slightly related:<p>I have been engaging in powerlifting&#x2F;weightlifting for over a decade. In my initial years, I was in the &quot;just do weights, don&#x27;t need cardio&quot; camp. However, around 2018, I started doing cardio mostly to cut body weight as I wanted to hit my personal bests on squats, deadlifts, and bench at a lower body weight.<p>I personally experienced that my weights moved much better, especially when I was doing more volume work (higher reps) with cardio than without cardio. Cardio seemed to improve my working capacity and I felt more efficient at doing more reps.<p>So, I would recommend cardio even when one is trying to bulk up in weight and trying to get strong. Doesn&#x27;t have to be crazy cardio either - just 10 - 15 minutes of zone 2 cardio 4 days a week might be good enough. You can also do types of cardio which work certain muscles - like stair master can be made to specifically target the quads and calves. Or rowing can be good for building the lats. Swimming is good too.<p>Personally, I either do intervals on the stair master or intervals on an echo bike (fan bike).

It&#x27;s also absolutely amazing for mental health. It&#x27;s a shame it isn&#x27;t considered a first line of treatment for mental health because it&#x27;s super effective (and free).

The relationship isn&#x27;t linear, you can see in <a href="https:&#x2F;&#x2F;bjsm.bmj.com&#x2F;content&#x2F;54&#x2F;20&#x2F;1195#sec-16" rel="nofollow">https:&#x2F;&#x2F;bjsm.bmj.com&#x2F;content&#x2F;54&#x2F;20&#x2F;1195#sec-16</a> that above 2200 MET-minutes&#x2F;week there is increased cancer risk which outweighs the cardiovascular benefits. Now admittedly it is a very weak correlation, and MET measurement is imprecise, but I think it is safe to say that there are risks associated with over-exercising and while being in shape is good, being a ultra-marathon runner or other extreme fitness enthusiast is unhealthy long-term, and the risks start sooner than you might expect. (2200 MET-minutes&#x2F;week is about 3 hours of 8mph running per week)

The Apple watch has a decent cardio fitness monitor. The absolute values aren&#x27;t precise (since it uses VO2Max estimates, which is really only accurate if you&#x27;re doing a metabolic stress test), but it&#x27;s good to keep an eye on trends.

I was blown away at just how little exercise is required to significantly increase your lifespan: 20 minutes a day, 3 times a week. That&#x27;s it.<p>The Copenhagen City Heart Study, published in the Journal of the American College of Cardiology in 2018 found that light jogging for 20 minutes a day, 3x a week reduces all-cause mortality by 78%.<p>That&#x27;s insane.

I&#x27;ve been walking every day and lifting weights 2x a week. I feel good so far but the hard part is doing it for years and through seasons (both literal and figurative).

I’m going to plug Peter Attia, MD again here. In his podcast with Mike Joyner, MD (an exercise physiologist of Mayo Clinic) there is fairly detailed discussion of the literature on this topic.

For people who misinterpreted the title like me, thinking that exercising is negative:<p>Conclusion<p>Our findings showed that high CRF is strongly associated with lower risk of premature mortality, incident chronic conditions (ie, hypertension, heart failure, stroke, atrial fibrillation, dementia and depression), and poor prognosis in those with existing chronic conditions. The consistency of the evidence across a variety of health outcomes demonstrates the importance of CRF and the need to incorporate this measure in routine clinical and public health practice. Future studies should focus on outcomes with limited evidence and where the certainty of the evidence was rated as very low by improving study quality.

Sorta related: My boomer mother is experiencing cognitive decline, probably the early stages of dementia. Her doctor said that as we age, blood vessels in the brain can get starved for blood and eventually dry up, making them useless. This is the biological explanation of her loss of memory and difficulty thinking. I asked if there&#x27;s anything that can be done to at least slow this decline. She said the best medicine for the brain is <i>physical exercise</i>; it forces blood into the areas of the brain where blood vessels are at risk, prolonging its well-being.<p>BTW, I asked the doctor how much exercise is enough. Her response: If you smell the same when you&#x27;re done exercising as when you started, it&#x27;s not enough. I found that both humorous and helpful.<p>Disclaimer: I&#x27;m not a doctor or expert. If a loved-one is experiencing memory loss or difficulty thinking, see a doctor.

easy hack: maintain a garden in an area with poor soil. between clearing, aerating, digging, mulching and weeding you can get all of your cardio AND some fresh veggies!

Regardless of what it is, if I don’t get my morning run in, I am a very unpleasant person to be around! Running has changed my life in all ways- I am much more calm, tolerant, positive, energetic. If the whole country did a mandated morning run, assuming you’re able, I really think this world would be a much better place!!<p>Start slow, 5 minutes, breathe, go slow, and enjoy the beautiful weather here this time of year.

Can anyone give a sense of how much fitter 3.5 mL&#x2F;kg&#x2F;min is, in practical terms? e.g. distance cycled&#x2F;how out of breath?<p>&gt; For every 1-MET (3.5 mL&#x2F;kg&#x2F;min) higher level of CRF, we identified substantial reductions in the risk of all-cause, CVD and cancer mortality. We also identified significant reductions in the risk of incident hypertension, heart failure, stroke, atrial fibrillation and type 2 diabetes per higher MET.<p>&gt; For most, a 1-MET higher level of CRF is attainable through a regular aerobic exercise programme. For example, in a large population-based observational study of over 90 000 participants, nearly 30% were able to increase their CRF by 1-MET (median follow-up was 6.3 years) without intervention.

Sheesh, fine. I&#x27;ll start jogging

If anyone wants a shortcut to an extremely good workout, look into rowing (MAKE SURE you learn proper form!).<p>I focus on &quot;maxing out&quot; sets of 500m since it correlates well to basketball cardio, and I have infinite cardio even in my mid 30&#x27;s.

I was surprised how much cardio fitness improves by just losing weight. After losing close to 10 kgs I was able to run a 5K consistently 3 times a week and reached a respectable level of fitness for playing basketball

I am disappointed by how poor primary care is in the developed world. It could easily be made better by including a VO2Max test and a DEXA scan every few years. On my own dime, I took both (cost was ~ $150 total from a private provider) and the DEXA scan revealed I carried too much visceral fat and my cardiovascular fitness was only average, things that never came up in my yearly physical. The same applies for basic strength testing, another predictor of morbidity and mortality.

Been doing Brazilian Jiu-Jitsu for over two years now for twice a week. My cardio fitness definitely increased and I feel it has done great for my mental state.<p>But man, in all other physical aspects I feel it has not done well to my body. Neck cranks, twisted spine, sore throat from getting choked, occasional black eye.<p>So I&#x27;m kind of torn between the improvement to my cardio and mental health and on the other side every other physical aspect

I&#x27;ve been running a consistent 10-11ish kilometers 5 times a week for the last 13 years. Recent (old) re-injury has forced me to switch to weight training about 6 times a week - and absolutely loving it. I&#x27;ll probably switch to something like Crossfit next year to take up a more cardio-routine, but it&#x27;s showed how you don&#x27;t need to necessarily &quot;run&quot; to stay fit &amp; healthy (although I do miss it a lot).

Not sure how true this is, I heard in the Joe Rogan podcast, cardio vascular fitness, like the extreme kind correlates with nearly the entire disease spectrum. It doesn&#x27;t apply to something like &#x27;acts of god&#x27; type things like Cancer or COVID. But it seems to be the best bet against aging, and other diseases.<p>My favorite exercise in this regard is Swimming and Kettlebell training.<p>Disclaimer: This is not an endorsement for Swinning and Kettlebell training.

Yup, for all the risks that people focus on (microplastics, pesticide residues, etc), they don&#x27;t do the easiest thing to ensure health - exercise.

Volume trumps everything for cycling&#x2F;running - these are low skill so to speak sports. 60 mpw for 18 weeks will get most people into a Boston qualifying time. Zone 1&#x2F;2 also has the advantage of lowering the risk of injury, which is critical for volume.

Over the past 11 months, I&#x27;ve lost 122lbs, from 330lbs to 208lbs. (May 30, 2023 - Today)<p>For the first 2 months, cardio was not part of it. Really focusing on diet, reintroducing myself to portions of Whole Foods to hit macro goals. Really focusing on vegetables and protein, large quantities of low calorie foods that digest relatively slowly to keep me satiated for long periods. They&#x27;re also quick to digest.<p>I was always active, even at 330lbs I would mountain bike (ascending and downhill) comfortable on black diamonds, same with snowboarding. This continued, but I didn&#x27;t try to explicitly do and track cardio.<p>After I lost 35lbs, I added CrossFit once a week. Then 2 times a week. Then 3 times a week. I noticed that olympic lifts and squats would cause extreme systemic fatigue, and would leave me dizzy and out of breath. After a couple months,<p>I stopped doing CrossFit due to an injury caused that that effect, and started isolated training for muscle hypertrophy utilizing machines for 5+ days a week, but missed the cardio that CrossFit gave.<p>I was about 260lbs at this point, and started with incline walking at about 3mph at max incline for 40 minutes. Then I started to begin my cardio with a 6mph run until I was out of breath and a high heart rate, and then began the incline walking.<p>After a week or so, I began running the a mile at the fastest speed I could, then switching to incline walking until my heart rate dropped, and alternated running and incline walking for 40 minutes.<p>Then, in November, I ran my first 5k in 34 minutes. I was hooked. I walked a couple minutes of it in the middle, but was pround myself. Today, I can run a 5k in 25 minutes if I push myself.<p>Today, I ran 5 miles without stopping with several hundred feet of elevation gain.<p>Cardio health is life changing. I used to be tired walking up large sets of stairs, and it was embarrassing to not be able to hold a conversation for long while walking up stairs.<p>It&#x27;s also a myth, perpetuated by highly trained athletes that you cannot gain muscle and do cardio, or that you cannot do these things while in a caloric deficit.<p>I have lost nearly 1% of my body weight per week as a vegetarian while gaining significant muscle mass (today, I am about 15-17% body fat at 6&#x27;1 and 208lbs).<p>The biggest thing I can say is it&#x27;s never too late to start, and it&#x27;s important to be consistent and find what works for you. At 32 years old, I have added years to my life, and feel and look better than I ever have.<p>Also, cardio gives an amazing dopamine rush that beyond addicting. Highly recommend it. But don&#x27;t forget the resistance training.<p>Anyone can do it. One day at a time.<p>As someone in tech, the process of rebuilding yourself is addicting once you start to see progress on every front.<p>VO2Max Increasing. Resting Heart Rate Dropping. Waist Shrinking. Chest, Arms, Legs Growing. Muscle definition increasing. Lift PRs increasing. And you look better in clothing.

Okay, cool, but until science finds a way to teach my AuDHD addled brain to not scream in agony at the mere thought of doing exercise, this knowledge does nothing but make me depressed.

So the sicker you are the less in shape you are in? Seems obvious to me.

What’s the best way to accurately measure one’s VO2 max, or at least ballpark it sufficiently so that you can track improvement over time without it being lost in measurement noise?

This is why I keep cycling even in periods when I&#x27;m not that into cycling. At 54, I know that if I lose a lot of fitness, it&#x27;ll be much harder to regain.

Cardio fitness is an established predictor of mortality and longevity, but testing it requires a proper maximal-exercise treadmill test that one needs to reach their maximum heart rate (costly &amp; potentially risky).<p>Modern wearables can estimate VO2max but they require some sort of workout data, potentially excluding the majority of the population (=sedentary people). Our recent research at the University of Cambridge developed and validated one of the first models for <i>non-workout</i> VO2max estimation. Paper: <a href="https:&#x2F;&#x2F;www.nature.com&#x2F;articles&#x2F;s41746-022-00719-1" rel="nofollow">https:&#x2F;&#x2F;www.nature.com&#x2F;articles&#x2F;s41746-022-00719-1</a><p>TLDR: we can now estimate cardio-fitness just by tracking your everyday movement&#x2F;heart rate

Shouldn&#x27;t the title be &quot;Weak cardio fitness is a strong, consistent predictor of morbidity and mortality&quot;?

But do they establish a causal arrow? If you&#x27;re in chronic pain because you&#x27;re dying of something you&#x27;re not exactly going to be likely to do a lot of cardio workout. :)<p>Without care you might conclude, for example, that rock climbing prevents becoming a quadriplegic since there aren&#x27;t any quadriplegic rock climbers... when in fact to the extent that they&#x27;re related at all rock climbing sometimes causes it.

Are there cheap fitness bands or smart watches that can somewhat accurately track VO2 max?

unless you&#x27;re sprinting, jogging and any form of slow running destroys the knees, loses muscles mass, enlarges the heart and provides no health value. Bunch of amateurs.

This seems completely unsurprising.

With the caveat that everything fitness is mostly a bunch of non-researched beliefs...<p>Which is better for establishing cardio fitness? Short and hard vs longer and moderate?

Not sure about this one.<p>When in my fourties I looked in the mirror one day and thought &quot;my god man you have piled on a few pounds lately&quot;.<p>I immediately went out and joined a gym for a bit of indoor running<p>So, I went weekly for an hour or two. I thoroughly enjoyed it.<p>My I&#x27;m not sure!<p>I was happily running along on my treadmill one day, hreart rate at a constant 125bpm, whe suddenly there was an almighty commotion on the treadmill next to me.<p>The guy running next to me had collapsed.<p>He was 52 years old. I knew this because we had had a few chats.<p>He suffered a heart attack in the gym and died on the treadmill.<p>Poor guy. Poor family.<p>I gave up going to the gym after that.