#090 How Exercise Prevents & Reverses Heart Aging | Benjamin Levine, M.D.

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Today's guest, Dr. Benjamin Levine, has shown that with the right exercise protocol, people who were sedentary most of their lives could reverse up to 20 years of heart aging. Dr. Levine is one of the world's leading experts in understanding how the heart adapts under a variety of conditions, whether that's exercise, elite athleticism, or hospital bedrest. Or even highly exotic conditions, like prolonged exposure to microgravity. He is the founding director of the Institute for Exercise and Environmental Medicine at UT Southwestern in Dallas.

Timestamps

• (00:00) Introduction
• (06:21) Bed rest vs. aging
• (11:40) Does exercise protect against long COVID?
• (17:14) How 12 weeks of bed rest affects heart size
• (18:42) Why a brand-new rubber band mimics a lifetime of endurance training
• (22:14) The exercise dose that preserves youthful cardiovascular structure
• (24:22) The exercise regimen that reversed 20 years of heart aging
• (28:05) What it takes to reverse vascular age by 15 years
• (33:29) Benefits of starting an exercise regimen in your 70s
• (39:17) Risks of high-intensity exercise
• (42:42) Balancing high-intensity & moderate-intensity training
• (47:39) Training for health vs. training for performance
• (49:58) Make exercise a part of your personal hygiene
• (51:01) Why does VO2 max correlate with longevity?
• (58:29) The 2018 JAMA study on cardiorespiratory fitness & mortality
• (1:04:06) How does change in fitness over time affect mortality?
• (1:06:19) Why exercise non-responders should consider "increasing the dose"
• (1:10:08) The 2 limiting factors for improving VO2 max in competitive athletes
• (1:17:20) Heart adaptations in purely strength-trained vs. endurance athletes
• (1:23:09) Why pure strength-trainers should incorporate endurance training
• (1:26:53) How strength training affects blood pressure
• (1:31:27) How exercise influences cardiac output in mitochondrial myopathy patients
• (1:33:25) Does CrossFit count as endurance training?
• (1:35:50) What's the best exercise for improving blood pressure?
• (1:40:57) Lifestyle strategies for treating hypertension
• (1:43:26) Why recovery is key to reaping the benefits of a training stimulus
• (1:47:22) The best indicator of being overtrained
• (1:54:46) Why HRV is a poor indicator of recovery
• (2:00:02) Why do men tend to be faster runners than women?
• (2:03:34) Can women achieve similar aerobic exercise benefits doing 2x less than men?
• (2:05:06) Are there cardiovascular benefits of HRT in women?
• (2:08:45) Exercise volume vs. coronary plaque calcification
• (2:15:35) How exercise duration & intensity affect coronary calcium levels
• (2:18:48) Why high exercise duration & intensity increases risk of Afib
• (2:26:00) Why you shouldn't become an endurance athlete to "live longer"

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