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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"

Watch this episode on YouTube

Show notes are available by clicking here

Today's episode features Dr. Ruth Patterson, a professor in the UC San Diego Department of Family Medicine and Public Health as well as Associate Director of Population Sciences and leader of the Cancer Prevention program at Moores Cancer Center at UC San Diego Health. If you enjoyed my last episode with Dr. Satchin Panda, I have good news! This will also be a great episode for you, since we talk about some similar ideas, but focus more on the human side of things, especially when it comes to time-restricted eating, since Dr. Patterson does primarily clinical research.

In this 45-minute podcast, we talk about...

• The importance of time-restricted eating as a practical public health intervention, mostly for it's ease of implementation, that may have a widespread impact on disease risk.
• Why you should probably make sure your time-restricted eating window occurs earlier in the day, rather than later.
• How the first 5% drop in weight loss can have disproportionately large effects on the metabolic factors associated with breast cancer risk when compared with subsequent weight loss.
• The association of longer fasting durations beginning earlier in the evening and improved sleep in humans, as well as spontaneous physical activity in their day-to-day lives.
• The relationship between metabolism and breast cancer risk.
• The effect of lifestyle factors, such as obesity, physical activity, what and even when you eat, whether or not you smoke tobacco... and how even modest changes, such as consuming food earlier in the day and only during an 11-hour window, can decrease breast cancer risk and recurrence by as much as 36%.
• The importance of starting your fast earlier in the evening, and how an earlier eating window has been shown to correlate to reductions in inflammatory markers.
• The association of higher circulating insulin levels with breast cancer risk, and how insulin itself has an important relationship with estrogen by affecting the levels of sex-hormone binding globulin.
• The dangers of having a cellular environment that is inflamed, as the case is with the obese, and simultaneously having elevated cellular growth signals, which is also characteristic of the hormonal milieu of the obese.
• The surprisingly small role heredity plays in determining overall risk of breast cancer when compared to lifestyle factors.
• How healthful lifestyle habits, like choosing to eat during the right window, ultimately helps us trend our risk for many of the diseases of old age in the correct direction instead of influencing only one or another.

If the concept of time-restricted eating especially piques your interest, make sure to...

1. Check out the podcast released just prior to this one: Dr. Satchin Panda on Time-Restricted Feeding and Its Effects on Obesity, Muscle Mass & Heart Health.
2. Make sure your data points go to good use! Visit myCircadianClock.org to learn how you can, by committing to a minimum of a 14 week "intervention" and submitting pictures of your food from your iPhone or Android phone, move human research on time-restricted eating forward.

Huge special thanks to Dr. Ruth Patterson for coming on. Enjoy the podcast!

Dr. Roland R. Griffiths is a clinical pharmacologist at Johns Hopkins and has been researching mood-altering compounds for over 40 years. As an unusually prolific scientist, having published over 360-times, he's also responsible for having started the psilocybin research program at Johns Hopkins nearly 2 decades ago.

In this 1-hour and 15-minute podcast, we discuss…

• 00:01:03 - the broader story of Dr. Griffiths 40 years of mood-altering drug research, including what got him started and how taking up a meditation practice ultimately influenced the eventual focuses of his research.
• 00:02:22 - the effect psilocybin has had in clinical trials in eliciting so-called mystical experiences that can act as a long-term catalyst for meaningful spiritual change and is amenable to being reproduced and clinically studied in a prospective manner.
• 00:03:45 - what distinguishes psilocybin from other drugs, particularly when reflecting backward on the experience months afterward.
• 00:05:11 - the process by which Dr. Griffiths and his team create an appropriate “setting” and facilitate feelings of safety for those participating in his trials.
• 00:06:42 - the elusive fundamental nature of a classical psychedelic experience whereby people often simultaneously describe the experience as ineffable (indescribable) but yet also often assign it a truth value that may even exceed that of everyday consensus reality.
• 00:07:36 - a description of the core features of a classical mystical experience that overlap with those found in a mystical experience induced by psilocybin.
• 00:08:58 - the qualities of the experience that Dr. Griffiths believes to most underlie the “reorganizational” potential it can have.
• 00:10:55 - the interesting potential areas for scientific exploration that the reproducibility of the psilocybin experience makes the substance amenable to.
• 00:11:25 - the promise psilocybin has shown as an effective therapeutic for anxiety and depression in patients with life-threatening cancer and also treatment-resistant depression in otherwise healthy patients (00:18:46).
• 00:13:04 - the lack of rigor in the very early trials on these compounds and the way in which cultural stigma surrounding psychedelic drugs ultimately played a role in impeding real, substantive clinical research for decades afterward.
• 00:16:31 - the long-term resilience of the antidepressant and anxiolytic effect, lasting six months and possibly even longer.
• 00:21:01 - the effect psilocybin has demonstrated in animal studies to increase hippocampal neurogenesis and enhance extinction of trace fear conditioning.
• 00:23:07 - the somewhat unintuitive neurobiological mechanism that may tie together some of the antidepressant properties of both psilocybin and ketamine, an anesthetic currently being studied as a rapid-onset antidepressant.
• 00:25:16 - whether or not the mystical subjective experiences are necessary for drugs like psilocybin to exert their antidepressant or anxiolytic effects.
• 00:26:43 - what the default mode network is and what its pattern of activity is in depression, long-term meditators, and after the acute use of psilocybin.
• 00:32:16 - the hard problem of consciousness.
• 00:37:26 - the challenge of finding the neurological correlates to match the phenomenology of individual’s subjective experiences.
• 00:38:16 - the promise psilocybin has shown in a small trial on smoking cessation where 60% of the treatment group were still abstinent a year afterward and plans Dr. Griffiths has to expand this area of research
• 00:41:10 - the possibility that the “reorganizational nature” of these experiences may open up new avenues as trials continue to try to embed the experience within different therapeutic contexts.
• 00:44:02 - the roadmap to FDA approval for use of psilocybin as a medication, particularly in the context of cancer-associated depression and anxiety.
• 00:45:05 - the risks inherent in taking psilocybin and the frequency of self-reported negative experiences in the general population.
• 00:47:22 - the criteria Dr. Griffiths and his colleagues use when screening for volunteers to participate in his studies involving psilocybin.
• 00:49:21 - the inability for clinicians to predict who is at risk of having challenging experiences defined by fear and anxiety (“bad trip”) and whether or not it is desirable, in terms of achieving a therapeutic outcome, to prevent these types of experiences altogether or not.
• 00:51:43 - the sort of dosages used in the trials.
• 00:54:45 - the clever ways devised by Dr. Griffiths to placebo control trials where expectation itself can affect outcome.
• 00:57:45 - some of the interesting anecdotes gleaned from Dr. Griffiths’ working with long-term meditators participating in the psilocybin tria...