are your lungs dying? how you can increase longevity with more lung power
DESCRIPTION
Dr. Al Sears MD explains why your lungs are the key indicator of how long you will live, and how modern "cardio-oriented" excercise and fitness advice has got it all wrong. Rather than long, extended endurance workout at medium to low exertion, he recommend his PACE 12 minute fitness program. PACE stands for Progessively Accelerating Cardio Pulmonary Exertion. It include intervals of high-intensity exertion mixed with recovery intervals. The purpose is to challenge your heart and lungs and build the strength of those organs. It also triggers an all day fat burn versus cardio which actually trains your body to store fat.TRANSCRIPT
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Are Your Lungs Dying?Reversing the Age-Related Loss of Heart
and Lung Capacity
Al Sears, MD
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A video is worth a thousand slides…
Add video of Dr Sears on top of K2
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Let’s look at what the “experts” are recommending:
• American Medical Association• Moderate intensity exercise for 30-minutes/day, at least 5
days/week
• American College of Sports Medicine• Moderate intensity exercise for 30-minutes/day, at least 5
days/week
• American Heart Association• Moderate intensity exercise for 30-minutes/day, at least 5
days/week
• National Institute of Health• “regular, moderate exercise”
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What if Everything You Thought You Knew About
Exercise Was Wrong?
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The “Big 3” Cause More Problems Than They Solve
1. Aerobics
2. Cardio
3. Weight training
These modern approaches to exercise don’t work.
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The Advice from the “Experts” Take You Down the Wrong Path
Modern Exercise Advice won’t help you:
1) Build functional strength
2) Make your heart stronger
3) Improve lung capacity
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INTENSITY VS. DURATION
• 8,896 recreational runners reported average exercise duration and intensity
• High-intensity exercise associated with:Lower blood pressureLower triglyceridesLower CHOL/HDL ratiosLower BMIsLower waist, hip, and chest circumferences
• Exercise duration had no effect on these parameters
Williams P. Relationships of heart disease risk factors to exercise quantity and intensity. Arch Intern Med. 1998;158(3):237-245.
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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):1179-1184
.
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Exercise Intensity and MortalityHarvard Health Study
Rel
ativ
e R
isk
of D
eath
(%
)
Exercise Intensity
Lee IM, Hsieh, CC, Paffenparger, RS Jr. Exercise intensity and longevity in men. The Harvard Alumni Health Study. JAMA. 1995;273(15):1179-1184
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The Data are Clear...
Prestigious studies like the Framingham Heart Study and the
Harvard Health Study have demonstrated that exercise intensity – not duration – is predictive of health
and longevity
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Are Your Lungs Dying?
Age
Mea
n V
ital C
apac
ity (
dL)
Adapted from: Kannel WB, Seidman JM, Fercho W, Castelli WP. Vital Capacity and Congestive Heart Failure. The Framingham Study. Circulation. 1974;49(6):1160-1166.
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FEV1 Declines With Age
Age
FE
V1
(lite
rs)
Adapted from: Dean, W. Biological Aging Measurement. 1988
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VO2Max Declines With Age
10 - 19 20 - 29 30 - 39 40 - 49 50 - 59 60 - 69 70 - 7920
24
28
32
36
40
44
48
52 MalesFemales
VO
2max
(m
l/kg/
min
)
Age
Wilmore J & Costill D. Physiology of Sport and Exercise:3rd Edition. Campaign, IL: Human Kinetics. 2005
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Even Moderate Pulmonary Impairment Increases Risk of Death
Years Post Follow-Up
FEV (%)Quintile:
Rel
ati
ve
Ris
k o
f D
eath
(al
l ca
use
s)
Schunemann H, et al. Pulmonary function is a long-term predictor of mortality in the general population: 29-year follow-up of the Buffalo Health Study. Chest. 2000 Sep;118(3):656-64.
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Framingham Heart Study
• Framingham researchers followed 5209 participants over 18 years
• Biggest finding: the risk of congestive heart failure rose as lung capacity fell
• 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
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Incidence of Congestive Heart Failure According to Vital Capacity
Rat
e o
f C
HF
/100
0
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):1160-1166.
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The Bottom Line
• Lung capacity decreases with age
• Decreased lung capacity increased risk of all-cause mortality and increased risk of heart failure
• Even moderate, non-clinical decreases in lung capacity increase risk of death
• Lung capacity is a clear and powerful marker of aging.
Kannel WB, Seidman JM, Fercho W, Castelli WP. Vital Capacity and Congestive Heart Failure. The Framingham Study. Circulation. 1974;49(6):1160-1166.
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Some Good News...
It’s possible to reverse the age-related
loss of pulmonary function … if you
focus on exercise intensity
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Pre- and Post-Intervention Pulmonary Function
VO
2pea
k (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. 2009 Jun;106(6):1875-87.
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Building Younger LungsM
ax O
2 U
pta
ke (
ml/
Kg
min
)
Age
Adapted from: von Ardennne, M. Oxygen Multistep Therapy. Theime. 1990. p.31.
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But what is happening to our heart capacity?
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Maximum HR Declines With Age
30 35 40 45 50 55 60 65 70 75140
145
150
155
160
165
170
175
180
185
190
Adapted from: Dean, W. Biological Aging Measurement. 1988
Max
HR
(B
PM
)
Age
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Cardiac Output Declines With Age
20 - 30 30 - 40 40 - 50 50 - 60 60 - 70 70 - 80 80 - 903.5
4
4.5
5
5.5
6
6.5
7
Car
diac
Out
put (
L/m
in)
Age
Brandfonbrener M, et al. Changes in cardiac output with age. Circulation. 1955 Oct;12(4):557-66.
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Some More Good News...
It’s possible to reverse the age-related
loss of cardiac function … if you focus
on exercise intensity
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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)
*Low-intensity: HR @ 80% of gas exchange threshold (GET)**High-intensity: (HR @ GET – HR @ peak exercise)(40%) + HR @ GET
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. 1996 Oct;17(10):1511-21.
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High-Intensity Exercise Improves Peak O2 Uptake 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. 1996 Oct;17(10):1511-21.
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High-Intensity Exercise Improves Ejection Fraction During Exercise
Cha
nge
in e
ject
ion
frac
tion
(%)
*P = 0.024
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. 1996 Oct;17(10):1511-21.
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Low-Intensity Exercise Reduces Cardiac Function
6-months 12-months
∆ R
est
to P
eak
LVE
F (
%)
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. 1995 Oct 1;76(10):643-7.
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The Faustian Bargain of Fitness
To keep up with popular trends, you will increase cardiac endurance but lose the one thing that
will save you from a heart attack:
Cardiac Capacity
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Do Humans Really Need Endurance Training?
Ancient man never had the need for long-duration, medium-intensity exertion. This is also true in
the animal kingdom.
Short bursts of high-intensity are the norm for both man and animals. This kind of exertion is natural for survival, i.e. – escaping from
predators, hunting, climbing
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Your Heart Doesn’t Need Endurance Training
The heart was designed by nature to last a lifetime. It doesn’t need training to pump blood for 80 or even 90 years.
If you train for endurance, you only increase efficiency in the narrow range of medium-intensity output.
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Endurance Training is a High-Risk Challenge
This kind of activity forces your body to make dangerous choices, via adaptive responses:
•Regulation of body temperature
•Metabolism of waste products
•Conservation of energy – forces the storage of energy to maintain supply for repeated duration challenges. This usually occurs
as the production and storage of body fat.
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Sacrificing Your Ability to Survive a Deadly Heart Attack
• The energy you need to fuel endurance training wipes out your heart’s reserve capacity
• In a weakened state, your heart has no reserve energy to supply a sudden demand for more oxygen
• During times of stress, this inability to rapidly supply more oxygen results in a heart attack
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Cardiac Reserve and Heart Failure
Maximal level
Car
diac
Pow
er O
utpu
t* (
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
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These Data Support the Need to Reclaim Native Fitness
High-intensity exertion – the kind practiced by our ancient ancestors – is the key to modern
cardiopulmonary health
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Exercise Intensity and Metabolism
What Does Your Body Use for Fuel?
ACTIVITY LEVEL PROTEIN CARBS FAT
Resting 1 to 5% 35% 60%
Low intensity 5 – 8% 70% 15%
Moderate Intensity 2 to 5% 40% 55%
High Intensity 2% 95% 3%
Adapted from: McArdle W et al. Sports & Exercise Nutrition. New York, NY: Lippincott, Williams & Wilkins;1999
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The German Secret to Olympic Gold
• Interval training was the first formalized style of high-intensity exertion used to train athletes in the 1930’s
• However...interval training is demanding and not suited for people who are deconditioned and/or grossly overweight
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The Solution
P.A.C.EPROGRESSIVELY
ACCELERATING
CARDIOPULMONARY
EXERTION
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The One Think Modern Exercise Lacks: 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 inflating a balloon: the best way to fill a balloon to capacity is by gradually adding more air during each inflation
• Similar to muscle hypertrophy training where muscle capacity is increased by progressively 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
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Improving Your Response Time: Acceleration
• Training to increase the speed at which the heart and lungs respond to increases in demand
• 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
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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
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PACE Twin Study – Body Fat Loss
4 8 12 160
2
4
6
8
10
12
14
16
18
Traditional CardioPACE
Pou
nds
of F
at L
ost
Weeks Post-Training
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PACE Twin Study – Change in Lean Body Mass
4 8 12 16
-2
0
2
4
6
8
10
Traditional CardioPACE
Weeks Post-Training
Cha
nge
in L
ean
Bod
y M
ass
(lbs)
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PACE Case Study –T.L.
• 55 year-old female
• 250-lbs
• 50% body fat
• Elevated triglycerides
• Low HDL
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T.L. – Body Fat (%)
1 2 3 4 5 6 7 8 9 10 11 12 13 1420
25
30
35
40
45
50
55
Bod
y F
at (
%)
Months Post-Training
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T.L. – TriglyceridesT
rigly
cerid
es (
mg/
dL)
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T.L. – HDL H
DL
(mg/
dL)
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PACE Case Study – M.P.
• 283-lb male
• 42% body fat
• Taking 11 prescription drugs to manage obesity-related conditions
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M.P. – Body Fat (%)
Initial 2 12 140
5
10
15
20
25
30
35
40
45
Months post-training
Bod
y F
at (
%)
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M.P. – Increase in Lean Body Mass
2 12 140
5
10
15
20
25
30
35
Months post-training
Cha
nge
in L
ean
Bod
y M
ass
(lbs)
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Sample PACE Log
Warm up:_______________
Exercise:_________________
Initial Sets
Set 1 Set 2 Set 3
Exertion Recovery Exertion Recovery Exertion Recovery
Additional (optional) Sets
Set 4 Set 5 Set 6
Exertion Recovery Exertion Recovery Exertion Recovery
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What Makes a PACE Workout?
• Running• Rowing• Swimming• Bicycling• Jumping rope• Calisthenics
• Stair stepping• Elliptical• Circuit training• Hindu squats• Kettle bells
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PACE is Safe, Effective and Non-Threatening
• Interval training requires high-performance and aggressive goals, which may not be realistic for the average person.
• In contrast, PACE is progressively challenging. This allows the individual to set goals based on their current level of conditioning. Over time, high-intensity exertion becomes possible
• PACE is not psychologically or emotionally threatening. Because you start at a level that is comfortable, even if all you can do is walk, the idea of exertion and exercise is non-threatening
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PACE Trial
My Wellness Research Foundation is currently conducting a longitudinal study to examine the efficacy of the PACE program
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PACE Trial – Study Design
• 20 men and women (18+) with > 26% body fat• PACE-style exercise program supervised by an ACE-
certified trainer• Variables assessed include:
• Weight• Body fat & lean muscle mass• Cholesterol• Glucose and insulin• Testosterone• CRP and homocysteine
• VO2max and pulmonary function