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Whats Wrong With Cardio? How to keep your heart from weakening, your lungs from shrinking, and your metabolism from dying. Dr. Al Sears.

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Presentation on theme: "Whats Wrong With Cardio? How to keep your heart from weakening, your lungs from shrinking, and your metabolism from dying. Dr. Al Sears."— Presentation transcript:

1 Whats Wrong With Cardio? How to keep your heart from weakening, your lungs from shrinking, and your metabolism from dying. Dr. Al Sears

2 Traditional Cardiovascular Endurance Exercise (CVE) CVE (cardio) includes activities like aerobics classes and distance jogging. The recommendation is to keep HR between 70 – 80% of maximum for 30 – 60 minutes

3 Contrary to Popular Belief Cardio Fails to : 1.Preserve pulmonary function 2.Decrease risk of death from cardiovascular disease 3.Reduce overall mortality 4.Recondition metabolism for achieving and maintaining optimal body composition

4 Pulmonary Function

5 Vital Capacity Declines With Age Age Mean Vital Capacity (dL) Adapted from: Kannel WB, Seidman JM, Fercho W, Castelli WP. Vital Capacity and Congestive Heart Failure. The Framingham Study. Circulation. 1974;49(6):

6 FEV 1 Declines With Age Age FEV 1 (liters) Adapted from: Dean, W. Biological Aging Measurement. 1988

7 VO 2Max Declines With Age VO 2max (ml/kg/min) Age Wilmore J & Costill D. Physiology of Sport and Exercise:3 rd Edition. Campaign, IL: Human Kinetics. 2005

8 So, what does this all mean?

9 Pulmonary Function – The Most Important Consequence of Aging Framingham researchers followed 5209 participants over 18 years Biggest finding: the risk of congestive heart failure increased as lung capacity decreased Relationship was independent of: blood pressure, relative weight, pulse, smoking status, heart enlargement, ECG-LVH, blood glucose levels, and age Lung volume decreased BEFORE there was any clinical evidence of CHF

10 Incidence of Congestive Heart Failure According to Vital Capacity Rate of CHF/1000 Vital Capacity (L/height ) Age Adapted from: Kannel WB, Seidman JM, Fercho W, Castelli WP. Vital Capacity and Congestive Heart Failure. The Framingham Study. Circulation. 1974;49(6):

11 Even Moderate Pulmonary Impairment Increases Risk of Death Years Post Follow-Up FEV1 (%) Quintile: Relative Risk of Death (all causes) Cook DG, Shaper AG. Breathlessness, lung function and the risk of heart attack. Eur Heart J Nov;9(11):

12 The Age-Related Decline in Pulmonary Function Can Be Reversed with the Right Physical Challenge

13 Pre- and Post-Intervention Pulmonary Function VO 2peak (L/min) Adapted from: Baily S, Wilkerson DiMenna F, Jones A. Influence of repeated sprint training on pulmonary O2 uptake and muscle deoxygenation kinetics in humans. J Appl Physiol Jun;106(6): Training Type

14 Building Younger Lungs Max O 2 Uptake (ml/Kg min) Age Adapted from: von Ardennne, M. Oxygen Multistep Therapy. Theime p.31.

15 What We Know: There is an age-related decrease in pulmonary capacity Decreased pulmonary capacity increased risk of heart failure Even moderate decreases in lung capacity increase risk of death Cardio = does NOT reverse loss of pulmonary capacity High-intensity training = can completely reverse loss of pulmonary capacity.

16 Cardiovascular Function

17 High-Intensity Exercise Improves Cardiac Function – Study Design Patients with prior MI (n = 29) Control/no training (n = 8) Low-intensity training (n = 11) High-intensity training (n = 10) Adachi H, Koike A, Obayashi T, et al. Does appropriate endurance exercise training improve cardiac function in patients with prior myocardial infarction? Eur Heart J Oct;17(10):

18 High-Intensity Exercise Improves Stroke Volume at Rest Adachi H, Koike A, Obayashi T, et al. Does appropriate endurance exercise training improve cardiac function in patients with prior myocardial infarction? Eur Heart J Oct;17(10): Change in stroke volume (ml) P = 0.014

19 High-Intensity Exercise Improves Peak O 2 Uptake During Exercise Change in peak O2 uptake Adachi H, Koike A, Obayashi T, et al. Does appropriate endurance exercise training improve cardiac function in patients with prior myocardial infarction? Eur Heart J Oct;17(10):

20 High-Intensity Exercise Improves Ejection Fraction During Exercise Adachi H, Koike A, Obayashi T, et al. Does appropriate endurance exercise training improve cardiac function in patients with prior myocardial infarction? Eur Heart J Oct;17(10):

21 Cardio Reduces Change in Ejection Fraction Rest to Peak LVEF (%) 6-months12-months Oberman, A, Fletcher F, Lee J, et al. Efficacy of high-intensity exercise training on left ventricular ejection fraction in men with coronary artery disease (the Training Level Comparison Study). Am J Cardiol Oct 1;76(10):643-7.

22 Why Does Cardio Fail to Deliver on its Promise?

23 Endurance versus Capacity Endurance: the degree to which one can maintain exertion over a prolonged period of time. The extended duration of the activity requires a reduction in intensity. Capacity: the maximum intensity of exertion reached during an activity. The high intensity of the activity requires a reduction in duration.

24 Consider Our Native Environment Natural selection favored capacity over endurance Selection pressures for high-capacity exertion were immediate and powerful Periods requiring low-intensity, longer-duration activity coincided with unfavorable conditions (war, famine, etc.). This resulted in adaptations that were functional at the time, but are dysfunctional in the modern environment.

25 Whats Wrong With Endurance? The energy required for endurance comes at the expense of capacity, resulting in a decreased cardiac reserve Decreased cardiac reserve lowers energy expenditure during unfavorable conditions, but comes with a considerable cost if prolonged and repeated

26 Cardiac Reserve and Heart Failure Maximal level Cardiac Power Output* (w) * Cardiac Power Output = (cardiac output)(arterial pressure) Adapted from: Williams S, Barker D, Goldspink D, Tan L. A reappraisal of concepts in heart failure: central role of cardiac power reserve. Arch Med Sci 2005; 1(2) 65-74

27 HARVARD ALUMNI HEALTH STUDIES 17,321 male alumni followed for 20 years High-intensity exercise was associated with a significant decrease in all-cause mortality No relationship between low-intensity exercise and death Lee IM, Hsieh, CC, Paffenparger, RS Jr. Exercise intensity and longevity in men. The Harvard Alumni Health Study. JAMA. 1995;273(15):

28 Exercise Intensity and Mortality Harvard Health Study Exercise Intensity Relative Risk of Death (%) Lee IM, Hsieh, CC, Paffenparger, RS Jr. Exercise intensity and longevity in men. The Harvard Alumni Health Study. JAMA. 1995;273(15):

29 Improvements in Other Age-Related Bio-markers

30 High-Intensity Exertion Results in Improved Health Biomarkers 8896 recreation runners reported average exercise duration and intensity Relative to exercise duration, exercise intensity was associated with a: 13.3X greater reduction in systolic blood pressure 2.8X greater reduction in diastolic blood pressure 4.7X greater decrease in waist circumference Williams P. Relationships of heart disease risk factors to exercise quantity and intensity. Arch Intern Med. 1998;158(3):

31 High-Intensity Exertion, But Not Cardio, Increases Growth Hormone Felsing NE, Brasel JA, Cooper DM. Effect of low and high intensity exercise on circulating growth hormone in men. J Clin Endocrinol Metab Jul;75(1): in growth hormone (micrograms/L) P < 0.05 relative to baseline No significant change from baseline

32 High-Intensity Exertion Raises Testosterone Just 1-minute of high-intensity exertion raises testosterone by 38% Gray AB, Telford RD, Weidemann MJ. Endocrine response to intense interval exercise. Eur J Appl Physiol Occup Physiol. 1993;66(4):

33 High-Intensity Exertion Dramatically Improves Blood Flow Blood Flow (ml/min) RestLight Exertion Heavy Exertion Maximal Exertion Brain ,0001,400 Coronary Vessels ,100 LungsBasic Value (BV)1.4 x BV3 x BV4 x BV Skeletal Muscle 1,2004,50012,50022,000 Cardiac Output 5,8009,50017,50025,000

34 High-Intensity Exercise Preserves Telomere Length VO 2max (ml/kg/min) Mean leukocyte telomere length (kb) R = 0.44 P < 0.01 LaRocca TJ, Seals DR, Pierce GL. Leukocyte telomere length is preserved with aging in endurance exercise-trained adults and related to maximal aerobic capacity. Mech Ageing Dev Feb;131(2):165-7.

35 Bottom Line: High-intensity exertion reverses aging Cardio does NOT!

36 But Doctor, what does this have to do with me?

37 The Solution P.A.C.E PROGRESSIVELY ACCELERATING CARDIOPULMONARY EXERTION

38 Progressivity Regular and consistent increases in the intensity of demands placed on the cardiovascular system by making repeated changes in the same direction Analogous to hypertrophying skeletal muscle, training where muscle capacity is progressively increased by adding small amounts of additional weight KEY POINT: In PACE, high-intensity is a relative term. This means that each individual will work towards their own unique level of maximum exertion. This makes PACE the safest form of exercise

39 Acceleration Training to increase the speed at which the heart and lungs respond to increases in demand The same exertion level/target heart rate will be reached more quickly throughout the training process Recovery back to resting heart rate/respiration also happens more quickly KEY POINT: most cardiac arrests occur when the heart is unable to respond to a sudden and dramatic increase in demand. Training for acceleration helps the heart to respond quickly to potentially life- threatening demands – reducing the risk of sudden cardiac death

40 PACE - a New Exercise Principle

41 Cardio Exercise Uses Fat as Fuel Cardio trains body to use fat as fuel, training body to store energy as fat. Fat becomes main energy storage – NOT muscle!! ActivityProteinCarbsFat Cardio 2 – 5%40%55% High- intensity 2%95%3%

42 PACE Exercise Uses Carbs as Fuel By using carbs as fuel, PACE trains the body to store energy as ATP, creatine, and glycogen – making muscle the main energy storage

43 PACE Restores Youthful Energy Energy stored in muscle allows for IMMEDIATE access to the energy, along with a greater willingness to expend it!! Energy Storage Energy Release Maximum Power Fat Slow Low Muscle Immediate High

44 The Real Magic of PACE Happens AFTER Exertion!! PACE ignites the bodys after burner – During the 18-hours following high-intensity exertion, the body burns its fat stores in order to build more muscle!! – High-intensity exertion results in a far greater loss of body fat compared to cardio Tremblay A, Simoneau JA, Bouchard C. Impact of exercise intensity on body fatness and skeletal muscle metabolism. Metabolism Jul;43(7):814-8.

45 High-Intensity Exertion Burns 9-Times More Fat Than Cardio Change in of skin folds /energy spent (mm/MJ ) P<0.01 Tremblay A, Simoneau JA, Bouchard C. Impact of exercise intensity on body fatness and skeletal muscle metabolism. Metabolism Jul;43(7):814-8.

46 PACE – The Twin Study Female Fraternal Twins 18-years old 24.5% body fat 16-weeks of training PACE Twin Decreased body fat by14.5% Gained 9-lbs lean muscle Cardio Twin Decreased body fat by 5% Lost 2-lbs lean muscle

47 PACE Twin Study – Body Fat Loss Pounds of Fat Lost Weeks Post-Training

48 PACE Twin Study – Change in Lean Body Mass Weeks Post-Training Change in Lean Body Mass (lbs)

49 Terri

50 PACE Case Study – Terri 55 year-old female 250-lbs 50% body fat Elevated triglycerides Low HDL

51 Terri – Body Fat (%) Body Fat (%) Months Post-Training

52 Terri - Triglycerides Triglycerides (mg/dL)

53 Terri - HDL

54 Richard -- Before

55 Richard -- After

56 Richard – Weight Loss Month Body Weight (lbs)

57 Richard – Body Fat Month Body Fat (%)

58 The Newest PACE Program – PACE Express A fully-guided 6-DVD fitness program, with all the principles of PACE built in to each 12- minute workout No specialized equipment required Uses Progressive Muscle Sequencing

59 Progressive Muscle Sequencing Exercises rotate through all the large muscle groups This allows cardiopulmonary capacity to be reached prior to muscle failure

60 Dijon – Lost 119 Pounds of Fat

61 Elida -- Lost 27 Pounds of Fat

62 Ana – Lost 10 Pounds of Fat

63 Amanda – Lost 17 Pounds of Fat

64 PACE Palm Beach Study Weight Loss Month Weight (lbs)

65 PACE Palm Beach Study Group Body Fat Total Body Fat (%) Month

66 PACE Palm Beach Study Group Systolic Blood Pressure Month Systolic Blood Pressure

67 PACE Palm Beach Study Group Diastolic Blood Pressure Diastolic Blood Pressure Month

68 PACE Los Angeles Study Weight Loss Weight (lbs) Month

69 PACE Los Angeles Study Body Fat Month Total Body Fat (%)

70 PACE -- The Future

71 New, state-of-the-art facility currently under construction in South Florida Will contain a full exercise physiology research lab for research – our first goal is to answer the questions regarding exactly how the body stores energy. Will also host community and professional seminars.

72 Certification Program The PACE Certification Program will allow health and fitness professionals to become PACE-Certified Trainers. Elements of the Certification Program will include: The science of PACE Components of PACE (breathing, rest/recovery, hydration) How to tailor PACE to all fitness levels


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