216. Joel Jamieson: How to Improve VO2 Max, HRV & Longevity Without Overtraining

What if working out harder isn't actually making you healthier? And what if the secret to improving your fitness, recovery, and longevity is knowing when to push—and when to pull back? In this episode, I'm joined by Joel Jamieson, performance coach, HRV expert, and creator of Morpheus, to explore the science of VO2 max, heart rate variability (HRV), Zone 2 training, and exercise recovery. After decades of training elite athletes, Joel explains why the same principles that drive peak performance can help everyday people improve cardiovascular fitness, build strength, and age better. We discuss why more exercise isn't always better, how chronic stress and poor sleep affect your ability to recover, and how to use wearable data without becoming obsessed with every number. In this episode, you'll learn: Why VO2 max is an important measure of cardiovascular fitness and longevity How to use HRV and resting heart rate to understand stress and recovery The difference between Zone 2 cardio and high-intensity interval training Why recovery is when your body actually adapts and gets stronger How to balance strength training, cardio, and rest for sustainable results Why sleep, stress, and lifestyle should influence how hard you train The biggest takeaway? You don't need to train like an elite athlete to benefit from the science of performance. The key is finding the right balance between exercise and recovery—and building a fitness routine you can sustain for life. Learn more about Dr. Shah: Website: drshah.com https://drshah.com Clinic: next-health.com https://www.next-health.com/ Instagram: @darshanshahmd and @extend_podcast Book Pre-Order: https://www.amazon.com/YourNewHealthOS https://www.amazon.com/dp/1969905158?lv=shuf&channelId=500&plpRedirect=mhFallback&th=1 Learn more about Joel Jamieson: Website: trainwithmorpheus.com https://trainwithmorpheus.com Instagram: @coachjoeljamieson Thank You to Our Sponsors! Momentous: Head to livemomentous.com and use my code DRSHAH at checkout for up to 35% off! Next Health: Your destination for cutting-edge health optimization - from IV therapy to hormone balancing, peptides and stem cells. Explore at next-health.com https://www.next-health.com/!

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:03Dr. Darshan Shah?

  Welcome to Extend with me, Dr. Darshan Shah, a podcast dedicated to cutting-edge science, research, tools, and protocols designed to help you extend your health span. Having become one of the youngest doctors in the country at the age of 21, and trained and board certified at the Mayo Clinic, I've accumulated three decades of practice as a board-certified surgeon and longevity expert. Over that time, I've discovered that a mere 20% of health knowledge yields 80% of the results when it comes to your health span. We're living in a new era where we are creating a new healthcare system, no longer focused on disease management, but achieving optimal health and vitality. Join me as I interview world-renowned experts, offering you a step-by-step

• 0:41Dr. Darshan Shah?

  guide to proactively avoid disease, and most importantly, extend your health span. Today, I am honored to be sitting down with one of my favorite experts in all things training, Joel Jamison, a world-renowned conditioning coach, author of Ultimate MMA Conditioning, and the visionary founder of Morpheus, a wearable that helps you determine what your training zones should be for the day based on recovery metrics. Joel has spent over two decades training elite MMA world champions and special operations personnel. But today, he's helping us translate those high-performance secrets into a blueprint for a longer, healthier life. We're diving deep into the transcript-informed concept

• 1:25Dr. Darshan Shah?

  of autonomic fitness, a fascinating way to look at how your nervous system conducts the symphony of your health. We discuss why your lifestyle might be the hidden limiting factor in your gym progress, the truth about heart rate variability, and how to escape the paralysis by analysis that comes with modern wearables. If you've ever felt burnt out of your New Year's health routine by February, or confused by your Apple Watch data, this episode is your roadmap to sustainable, personalized longevity. You won't want to miss Joel's unique take on building true resilience, as we dive into the science of HRV, strength training, and so much more. Joel, really happy to have you out here. Been looking forward to this conversation

• 2:10Dr. Darshan Shah?

  for a while. Thanks for doing this.

• 2:11Speaker 01

  Yeah, I appreciate you guys having me out. Been looking forward to it as well.

• 2:14Dr. Darshan Shah?

  Yeah. You know, I've been following your work for a long time, ever since I did a deep dive into VO2 Max and recovery and HRV. And you're one of the prominent voices out there that is studying this, really looking at the science, and also giving people practical tools that they can use. So I was really excited to meet you through a friend of ours and get you on air. So, thank you.

• 2:35Speaker 01

  Yeah, no problem. Happy to be here, like I said.

• 2:37Dr. Darshan Shah?

  Yeah. So Joel, you know, I think before we launch into this, for people that don't know you, it'd be great for you to just give a little bit of background on why you have so much knowledge in this field.

• 2:46Speaker 01

  Yeah, honestly, it was, it was not something I'd planned to get into. I'd started out as a strength and conditioning coach, focusing mostly on the strength side of things. And then I opened a gym in 2003, and I happened to open it next to an MMA gym, which happened to be the best MMA gym in the world. And so very quickly, I had these very high-level combat athletes coming over, asked if I could train them for fights in Japan and fights all over the world. And I had to dive in really quickly to understand how to help these athletes perform their best, because if they went into the fight and they weren't prepared, they gassed out, I was the one who didn't do my job. So I dove in headfirst and understand the aerobic system, the anaerobic energy system. And at the same time, a few years before that, I had been introduced to heart rate variability, right around 2001, so way before anyone knew what heart rate variability was. And so as I was learning

• 3:30Speaker 01

  the energy system side, I was also monitoring them, looking at our heart rate variability, trying to understand the recovery piece. And it was just a concept, or a constant trial and error, and trying to understand what all these data meant, and then how to use it to coach them more effectively. So, over the last 15, 20 years, I've used that model with a lot of different athletes, a lot of different sports. VO2 Max used to be something that only was in the endurance realm, and heart rate variability was something only that elite athletes used. And that's really changed, obviously, right? HRV is everywhere. It's on Apple Watches, it's a million devices, and everyone's talking about VO2 Max, not for endurance sports, but for longevity. So I was fortunate that I was pushed down that path to help combat sports and understand how all these pieces fit together. And now I'm helping people translate that into not just performance, because most people don't

• 4:13Speaker 01

  want to be combat athletes, they just want to live the longest, healthiest life possible. And the same things behind the scene that drive performance in many sports also drive health and longevity.

• 4:22Dr. Darshan Shah?

  Yeah, and that's a really important realization to have, is what we learn from like combat sports, or just athletes in general, most of it translates into what the average human probably needs to be doing as well. But I also think, you know, and you know this, is that the athletes take things to extreme, also to their detriment sometimes, right? And I'm sure you're using some of the data on how to kind of meter in the right dose of fitness and exercise, and all the different things that we're going to talk about today.

• 4:49Speaker 01

  Yeah, the most important thing that I learned very quickly with heart rate variability is just how individual everybody is. Just because somebody is 45 years old, or they're a male or female, it doesn't mean they're the same as everybody else that falls in those categories. Because we have different genetics, we have different lifestyles, we eat different foods, we have all these things that make us unique individuals. And so when you try to apply the same training program to everybody, you just realize that people often fall short, because it's not designed for what's going to work the best for them. So most of what I try to help people understand is you need to find your own programming, your own methodology, your own approach, your own way to manage all these pieces in a way that's sustainable for you over a lifetime, because that's what health fitness is about for. People want to live longer. It's something they can maintain their entire life.

• 5:33Dr. Darshan Shah?

  Right, right. It's the sustainability of it. And I think, to your point, a lot of people can't sustain it, because they're trying to do what was recommended for like the majority of people, right? And so, they get, people get a lot of information nowadays, and they hear things on podcasts, on social media, you know, they hear that they have to do VO2 Max training, or they have to do so many hours of zone two. And if they can't do it, they get paralysis by analysis. You know, they just, it's just too much information, and if they can't do one thing, they decide to do nothing, right? And so I think that's where a lot of people are suffering from now. It's kind of like the opposite problem people had 20 years ago, when it was like, go to the gym, run an hour on the treadmill, burn calories, that was like the only way to do things, right? And now it's kind of the opposite problem.

• 6:15Speaker 01

  Yeah, no, it's, I think we've had, like you said, there's so much information out there. People don't know necessarily what to believe, but there's so many people saying, do this, do that, do this, do that. And then people just try it, and it's not tailored to what they need. And I think the biggest thing I've, again, seen over time with data is people don't understand the connection between their lifestyle and the limitations of their lifestyle, and what they should be doing in the gym, because those are completely connected. If someone doesn't have the best sleep, if someone doesn't have the best diet, let's say, if someone's psychological, mental stress is high, they're working long hours, that takes its toll, and it limits the amount of training that they're going to benefit from, because those are going to slow down their ability to recover from the exercise. So I see a lot of people jumping in the gym, and they want to go hard, they want to do high intensity, they want to do VO2 Max, they want to try to get there five days a week,

• 6:59Speaker 01

  and then they burn themselves out. It's why we see the January gym population double, and then the February population cuts in half, because people want to take this short-term approach, and think they have to do it all at once. It doesn't have to be like that for most people, because it's not sustainable. And so you have to tailor that, or understand that your lifestyle is often a limiting factor in what determines how much and what type of training you should be doing in the gym.

• 7:21Dr. Darshan Shah?

  Yep. And so, as your lifestyle improves, is it true that you can spend more time training, and more time maybe doing harder activities, because now you've got your sleep right, your diet right, your stress levels are managed? And so, over time, you can increase in the training, which then has more benefits. Is that what you're saying?

• 7:40Speaker 01

  100%. It's a cycle, right? So if I start getting in better shape, it becomes easier to sleep more, it becomes easier to stay on point in my diet, it becomes easier to manage my stress level. And then that enables me to train more, and it's a continuing cycle. The problem is the reverse end of it, is when I'm unhealthy and I'm out of shape, I can't do very much, because I can't recover very fast. And so that I'm easily overtrained or overreached, even though I'm not doing that much. And so they just have to realize your lifestyle and your training are all just extensions to one another, they're not separate.

• 8:08Dr. Darshan Shah?

  Yeah. So the person who's maybe overweight, or out of shape, because they haven't trained for a long time, it's much better for them to start off with smaller doses and work their way up, right?

• 8:16Speaker 01

  Yep.

• 8:17Dr. Darshan Shah?

  And so, you know, now we have a lot of data available to us. I think most people have a wearable, or have tried a wearable at some point in their life. And we have the data like around HRV, we have the data around time of you spend training, different types of training can be tracked now as well. How do you feel about the data that's available in wearables? And are people using that effectively nowadays?

• 8:39Speaker 01

  Yeah, I think, I mean, some are, obviously, but I think a lot of them are also getting confused, because there's so many different wearables telling them so many different things. And so I think it's easy, again, I got a lot of questions, is should we have a wearable company? Oh, my recovery score is this, can I do this? Oh, my recovery score is that, I can't do that then? And they're trying to read every decision into one number or two numbers. I think most of it is just about understanding, again, what is sustainable for you. And that often comes by looking at the trends, and seeing the right direction, and making sure you're going the right direction. It's less about micromanaging every aspect, every single day, to try to optimize, which people are doing, but I don't think it's necessarily the right approach for most of them. It's just understanding, am I on the right track? Am I finding the right balance between training, lifestyle, and recovery? And if the answer is yes, you'll see your trends improving, your resting heart rate

• 9:22Speaker 01

  will be going down, your HRV will be stable and going up, you'll see improvements in your strength and your different heart rate numbers. You'll see these things happening over time, but you can't get lost in the minutia of trying to micromanage 20 different metrics at once.

• 9:34Dr. Darshan Shah?

  Right, right, exactly. I'm a big believer in the trending. And so I stop looking at my wearable data on a daily basis. I just look at it like, once a week, maybe once every couple of weeks, and just make sure I'm going in the right direction or sustaining. And it's very obvious, like when you've been traveling a lot, or had a really stressful week, things don't go there. And you can always pinpoint it to that as well. So, makes complete sense. I do use some metrics on more of a daily basis, the main one being HRV, just to kind of see how much I should be training. But you've taken that to a whole other level, both with your wearable, and the way you look at that data. And I would love to kind of just dive, do a, you know, next five, 10 minutes, let's talk about HRV, because the way you've utilized it in, in the wearable that you created, is, I think...

• 10:18Dr. Darshan Shah?

  Provides people like a prescription or almost a way of thinking about what they should do for that day. So can you tell us a little bit about that?

• 10:25Speaker 01

  Yeah. So I think we have to back up for one second and understand what HRV is. Because I think that's an important part. I think to get at the heart of HRV, we have to understand that we are adaptable creatures by nature. And what I mean by that is when we put ourselves in a workout, over time, our body adapts to that. And we really are here because our ancestors out adapted the rest of the ancestors, non ancestors.

• 10:46Dr. Darshan Shah?

  That's a good way to put it. Yeah.

• 10:47Speaker 01

  So at the heart of adaptation is the body's ability to control and respond to the environment and both immediately. So if I work out, my body has to produce more energy. It has to be able to create more force and power. It has to turn up what we call the sympathetic fight or flight system. Right? So that's a key piece of survival. We have to be able to do that. And then after that period of stress has ended, we have to be able to turn those systems back down. We have to reduce inflammation. We have to go ahead and restore our bodies back to where it was. We had to repair tissue. We have to improve the tissue in the process. And so that happens through what's called the parasympathetic nervous system. Right? And so the balance between those two systems, and I call this autonomic fitness. I don't think people talk about it.

• 11:24Dr. Darshan Shah?

  Autonomic fitness. I love that.

• 11:25Speaker 01

  It's autonomic fitness. I put it down to two big factors here. One is what's your baseline autonomic fitness level? We measure that through HRV because we're measuring the parasympathetic, that resting level of parasympathetic function. Generally speaking, we know across multiple studies, people with higher resting HRV tend to have better outcomes. They tend to have better health and there's benefits to it for multiple reasons. The other thing is how, I would call this metabolic or, I'm sorry, autonomic flexibility. And we need to be able to switch over into that sympathetic drive when we need it. If we need a workout or we need a mentally demanding task to get done, we need that extra energy. We need that sympathetic system. But when that, when that, when it's over, we need to switch gears. We need to turn that stress system off and turn that recovery

• 12:06Speaker 01

  response system on, which is again, HRV going up. And if we can do that successfully across our lives, we're going to be much healthier. We're going to have better outcomes. If we do get diseases, we're going to feel better. We're going to move better. It's a big, huge part of longevity is what I call autonomic fitness. So again, when we look at HRV, that's what we're measuring. We're measuring someone's autonomic fitness. And we do it by again, looking at two things. Number one, what's someone's baseline HRV? There's genetics here. There's lots of things that are outside your control. But there are also things that you can control. Your aerobic fitness level contributes to it. Your lifestyle contributes to it. Your overall health contributes to it. All of these things will drive your baseline HRV. And then we want to look at, can we switch into that stress mode when we need to? And can we switch out when we don't? We see that by the variability across our

• 12:49Speaker 01

  weekly pattern. So if someone's very variable, highly variable, we're seeing constant swings up and down, that means that stress is having a big impact on the body. And over time, that big impact can wear it down and cause damage and accelerate the aging process. If we see stability, then we are going to be in a much better place because our autonomic nervous system is functioning the way that it should. And so in a lot of ways, HRV correlates to things because it's a readout of our general health. All of our systems have to work together to adapt to the world around us. So it's, it's our cardiovascular system, our metabolic system, our endocrine system. All these systems are working together and the autonomic nervous system is like the, the conductor of the symphony. So it's sending information from all these organs and all these tissues up into the brain. The brain then regulates functions back through the autonomic nervous system. And so again, a healthy autonomic

• 13:34Speaker 01

  nervous system reflects a high level of health. And so when we look at HRV, we're looking for those two things I said, what is someone's baseline HRV? Higher is better, but with also individual limitations. And then we want to see stability over time. And that helps us make better decisions about are we finding that right balance and are we heading in the right direction?

• 13:51Dr. Darshan Shah?

  Right. And so how does someone use that number to understand how they should be training that day?

• 13:57Speaker 01

  So what we do in Morpheus is, and this is something I think is really important because people tend to look at this idea of HRV being high, good, HRV being low, bad. And they really simplify that story down. But it's more about where is your HRV relative to your normal baseline, or your normal patterns look like. So if you are, let's say you normally between like 65 and 75, just to give you a number, and you wake up next morning and you're significantly lower than that.

• 14:20Dr. Darshan Shah?

  Got it.

• 14:21Speaker 01

  It tells us our body is still going through a period of stress. It hasn't turned on that recovery system yet, or it hasn't fully turned off the previous stress response. If I wake up the next day and my HRV instead is 10, 20 points higher than my normal, it means I've now activated a very strong stress response and I haven't completed that process of recovery. So generally speaking, the simplest way is the further you way, further away you are from your baseline, the further your body is away from finishing that recovery process. And that's good information to know. If your recovery is lower, it doesn't mean you can't train hard. It just means it's going to slow down that process of recovery even more and take you longer to get back to baseline. So that's what Morpheus and other, some other variables do is they take the, how far away your HRV is, and they just give you a recovery score. We're not measuring recovery directly. That's important to understand.

• 15:06Speaker 01

  Like recovery is not just one thing, right? We're trying to use recovery as a proxy to understand where your body is at in the process. Because we always have to recognize, we train, we recover, and we adapt. It's a process of recovery and adapting. Our fitness improves.

• 15:20Dr. Darshan Shah?

  Yes.

• 15:20Speaker 01

  It doesn't happen in the gym. It happens through this process of recovery.

• 15:24Dr. Darshan Shah?

  Yeah.

• 15:24Speaker 01

  And so the recovery score tells us where we are at in that process.

• 15:28Dr. Darshan Shah?

  Yeah. The recovery is important to actually make progress.

• 15:30Speaker 01

  It's where, it's where it all happens, right?

• 15:31Dr. Darshan Shah?

  It doesn't happen in the gym.

• 15:33Speaker 01

  No, the gym is the signal. Like the gym starts the process, but the way that our tissues get stronger, more efficient and more resilient is through this process of remodeling and adaptation. We build bigger muscles. We build more efficient muscles. We add mitochondria. We get rid of poor functioning mitochondria. All of these things happen after the workout, long after workout's over. When we sleep in the days between workouts. And so we want to make sure that before we put our body under more and more load, we've already completed that process because otherwise we're just adding load on top of load. We never actually let the body adapt.

• 16:01Dr. Darshan Shah?

  Yeah. That's a really good way to put it. The, the workout is a signal and the real gains happen during the recovery.

• 16:06Speaker 01

  Yeah, that's how that works.

• 16:07Dr. Darshan Shah?

  I love it. So, you know, you see a ton of people. A lot of people come to you for training, for pro athletics, MMA. Do you notice differences in their heart rate variability between different people? Like some people have really high variability, some people are low. And what do you think contributes to the differences in people's actual number?

• 16:26Speaker 01

  Yeah. So they, they've looked at this in multiple studies. They think somewhere between 40 and 50%. I've actually seen 40, 60% kind of depending on the paper you look at, is a genetic component to it. So it's like anything else. Some of this is hardwired into your genes. Some people have naturally higher HRV. Some people naturally live a lot longer. Right? My grandma smoked from age 14 till 87. She did not hold back on the drinking. She did, she was mentally stressed. She did everything wrong.

• 16:52Dr. Darshan Shah?

  Yeah.

• 16:52Speaker 01

  And she made it to 87.

• 16:53Dr. Darshan Shah?

  Wow.

• 16:54Speaker 01

  Right? So some people just have the luck of the draw. They have better genetics in multiple areas. And heart rate variability seems to again, kind of reflect that better, more resilient metabolism, more resilient overall thing that people get. And if you don't have it, it doesn't mean that you're unhealthy or that you're not going to live longer. It just, to me, it means you probably have less room for error. You have less margin for error, in my opinion, in my experience. So the athletes that have higher HRV, they tend to be able to do more training. They tend to recover faster in general. They tend to be more resilient, like I said, across the board, tend to get less injuries, those sorts of things. But again, it doesn't mean there's no athletes out there that have lower HRV that don't perform. I just think that it buys you, it buys you margin of error. And that's a good thing for most people. So you just kind of have to work with what you've got. You can raise your HRV to some extent by developing the cardiovascular system.

• 17:39Speaker 01

  That seems to be what drives the most long-term improvement up to a point. And like I said, overall, anything that's limiting your health. So if you have chronic inflammatory conditions, if your sleep is chronically poor, fixing those things will also raise your HRV a bit. But again, it's definitely an individual metric.

• 17:54Dr. Darshan Shah?

  Yeah. Yeah. I see people that just live at 30 and then other people just live at 60 and they're doing nothing. Like it's, it's like their first time even measuring and they're like, oh, wow.

• 18:03Speaker 01

  Yep.

• 18:03Dr. Darshan Shah?

  I had no idea. And so the people living at 30 are always very concerned when their significant other's spouse is there with one of 60. But I always say exactly what you do. There's a huge genetic component here. And just because you live there, doesn't mean you have to be concerned. But let's talk about the things that you can do to improve it.

• 18:19Speaker 01

  Yeah. And like I said, I do think in my experience is looking at people with chronic low HRV. It's, it is a reflection of something genetically, something lifestyle. And you want to make sure you are doing what you can. Because again, I truly believe if you have lower HRV, you generally have less margin for error with lifestyle, less margin for error with training, less margin with error with all these sorts of things. Because you tend to have a worse response to things than somebody who has higher HRV. They can get away with more, I'll put it that way.

• 18:43Dr. Darshan Shah?

  Yeah. You know, there's a big cottage industry now of people that have developed devices to help people with low HRV using Vayle nerve stimulators, right? How do you feel about those? And do you think there's any real benefit to them?

• 18:56Speaker 01

  I have not seen too much convincing evidence that it makes a huge difference, to be honest with you. It's kind of like, again, HRV to me is a readout. It's a readout of how your different systems are functioning. It's telling us there's the overall fitness of your autonomic nervous system. And maybe artificially stimulating it isn't really changing the underlying cause of what the readout is. So I think there's value in doing things like breath work and relaxation, meditation, because you're putting in actual input that's causing the response versus just an electrical signal that is stimulating the nerve. I'm not saying it doesn't have any uses, and maybe there's some science out there that supports some of it. But I think it's a very small piece in the grand picture if it is beneficial. There's lots of other things I would say you can do first.

• 19:34Dr. Darshan Shah?

  Yeah, I interviewed the president of HeartMath a few days ago, and they've had a lot of success with helping people improve their HRV, but it's all through just mindful breathing exercises and things like that. And I think giving yourselves those little breaks in between in your day can be extremely helpful, rather than living in a state of high stress all the time.

• 19:53Speaker 01

  Yeah, I think that's one of the most important things. So again, we need, like we talked about, we need autonomic flexibility. We need to turn it on, we need it, turn it off, we don't. Unfortunately, as we age, we get worse at turning it off. And some people, just they're hardwired to have a hard time turning it off. They're hardwired to just be going all the time. They're hardwired to have a very sympathetic dominant state. And I think they pay the price as they age for that, unfortunately. So even taking, like you said, five minutes out of your day to do a little breath work, to listen to something relaxing, to just go outside and be in nature, to just do a light walk, all those things I found to be incredibly beneficial for athletes I've trained and for myself, because you're just kind of taking some time to turn off that stress system. And I think the unfortunate thing is we live in society where we're bombarded with it.

• 20:35Speaker 01

  And in many ways, if you go back to, I'm getting, look like hunter-gatherers, like they were exposed to lots of different types of stressors. And then actually, to me, it sharpened their stress response. Like they had to walk for days and end to get food. They had food scarcity, they had hot and cold and different environmental stressors. And that's constantly activating the circuitry of adaptation. It's constantly forcing their bodies to have to adapt. And we turn on sirtuins, we turn on all these mitochondrial functioning genes. We do a lot of things that make that system stronger. And now people can sit at home, they can order food from wherever they want. They never have to be hungry if they don't want to. They don't have to move to do much of anything. They have, everything is temperature controlled. So we've turned off a lot of those environmental stressors that were positive in a way. And we've, at the same time, overloaded ourselves with the psychological stressors.

• 21:20Speaker 01

  And so I think we're in a state where we're just constantly bombarded with this and taking the time to turn it off and focus on the other piece of being relaxation. Recovery is a huge, important piece of all of this.

• 21:30Dr. Darshan Shah?

  Yeah, makes a lot of sense. And I think, you know, for those listeners that don't have like dedicated self-care time built into the day, you know, and even, not even just like one small 30-minute lunch. Like I'm talking like throughout every hour, two hours, taking a break. And just like you said, you know, maybe going for a walk, meditation, a breath work. It can be extremely helpful. And I see the opposite happening now. People use that time to just get on their phone and scroll. That's actually creates a stress response, too. And for some reason, people feel relaxed when they do it, but it's actually stressful because your brain is constantly switching.

• 22:03Speaker 01

  Yeah, I think people today don't understand how stressful life is because they're just so used to it. We've become accustomed to doom scrolling and news headlines and social media headlines. And they're just so used to these, these things that are stressful to us. And the best way to tell is look at your resting heart rate while you're looking at these things. Your heart rate's not going down. It's generally going up because your body is processing all this information. And social media and all these things are all competing for your attention. And the way to do that is things that you want to read by showing up, getting shocking headlines and big things. And they're like, oh, let me look at this. It's that constant reinforcement. So, yeah, I think people need to unplug as much as they can. So I try to not use my phone after a certain time at night. I try to use, I go to the pool a lot and float. That's been a hugely beneficial thing I've seen.

• 22:46Dr. Darshan Shah?

  That's a great one, yeah.

• 22:46Speaker 01

  Yeah, the pool, I would say if you have access to a pool, a gym, your house, wherever, the best thing about the pool is you're decompressing all the body because you're no longer having to fight gravity the same way. And you get this proprioceptive response, you get temperature changes. I've seen dramatic improvements in people's HRV because they're just in the pool, they're laying there, they're relaxed. You don't have to swim, you can just float.

• 23:05Dr. Darshan Shah?

  Wow.

• 23:06Speaker 01

  And it seems to be a very good way to turn off that stress response because you get all the stabilizer muscles, all the sympathetic input that's there to just keep you upright, walking around, and suddenly turn it down.

• 23:15Dr. Darshan Shah?

  Right.

• 23:15Speaker 01

  And you're decompressing in a way that I think has been, at least I've seen for myself and other people, hugely underrated. 10, 15 minutes in the pool can make a massive difference. And if you happen to have a gym where you have a sauna, sauna pool is a tremendously powerful recovery tool from everything I've seen over the last few years, testing it myself, testing with other people. It's just a really good combination.

• 23:36Dr. Darshan Shah?

  That's great advice, yeah. And so 10, 15 minutes in the pool after a sauna session can be massively beneficial for you, but also you can't have your phone with you in the sauna or the pool as well.

• 23:46Speaker 01

  Yeah, exactly. It's a double whammy, right? You get both effects. So I've just been experimenting, I'm 47 now. I probably spend as much time focusing on recovery and relaxation as I do on training. And I've just found that if I go all in on training, as much as I used to in my twenties, I just don't respond as well. And I've, as I've aged, I've lost some of that resilience. And so I spend a lot of time stretching and doing pool floating and sauna and relaxation and meditation and self-massage. All of those things should be a part of your repertoire. And hopefully you start that when you're twenties, you build habits versus way into your forties, because it all helps.

• 24:20Dr. Darshan Shah?

  No, that's great. And I've noticed a huge shift in just the last few years around recovery becoming as equally important to most trainers as, as the actual physical workouts and stuff. And you've been doing this for a long time, so it's great to see, you know, everyone's finally listening.

• 24:35Speaker 01

  Yeah, like I said, it's, we want to turn the system on. That's where training and stress is appropriate, but we want to turn it off.

• 24:41Dr. Darshan Shah?

  Right.

• 24:41Speaker 01

  And that's where focusing on the recovery, relaxation helps tremendously. And I've seen tremendous benefits for sleep. So all these things play a big role in making sure people are, again, finding the balance. That's what it comes down to.

• 24:51Dr. Darshan Shah?

  Yeah.

• 24:56Dr. Darshan Shah?

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• 25:38Dr. Darshan Shah?

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• 25:47Dr. Darshan Shah?

  So, you know, one of the other metrics you mentioned is resting heart rate. Let's talk about that one because I think that's underutilized. And then also, maybe we could talk a bit about heart rate recovery as well. Both of those kind of tie in together. Give us a primer on those.

• 26:01Speaker 01

  Yeah, so resting heart rate is correlated very well to VO2 max in general because the fewer times your heart beats a minute, it means you are, you have better stroke volume, you have better oxygen delivery. So endurance athletes can have heart rates down in the 30s, even 38, 39. And I've seen kind of across the board, most team sport athletes I've worked with will have resting heart rate somewhere in the low 50s. Combat athletes would be like upper 40s, low 50s. And it's just a sign that your body is very efficient in delivering oxygen to your tissues, so the heart doesn't have to beat 80 times a minute.

• 26:28Dr. Darshan Shah?

  Yeah.

• 26:29Speaker 01

  And also a part of what drives that is your resting vagal tone, your parasympathetic system. So lower resting heart rate is always going to correlate with higher resting vagal tone, higher HRV. They go together. So it's a very easy thing to measure, right? You can do it, again, with most wearables overnight, you can use the morning. And then heart rate recovery is also very well connected to that and very, very closely tied to autonomic fitness, like I said. Because what's happening is when I do something stressful, I do a workout, a run, a sprint, whatever, the thing that's decreasing my heart rate afterwards is what I talked about. It's the stress response decrease and the recovery response turning on. They're two dials. And so the more effectively my body is doing that, it's a sign that my body is better at managing that autonomic flexibility I talked about.

• 27:12Speaker 01

  So it's highly underrated because you can measure resting heart rate very easily and it takes no time at all.

• 27:18Dr. Darshan Shah?

  Yeah.

• 27:18Speaker 01

  And you can measure your heart rate recovery after events all the time. And so when I was training combat athletes at the highest level, when I was leading up to their fight, one of the most best correlated indicators, I would say, of how well they're prepared for the fight was what was their heart rate recovery between rounds and their training leading up to the fight? And so we wanted to see a fighter get down their heart rate into the 130s in 60 seconds between each round in their sparring. And we know it's not probably going to come down that low in the fight because there's all these mental, mental side of things. And it's a higher level intensity or stimulating training. But if we could see an athlete do three or five hard, close to fight level rounds and recover down in the 130s between each round, that was a very good indication that they were going to be able to go out in the fight and they were going to be able to last from the beginning to the end.

• 28:03Dr. Darshan Shah?

  Hmm, that's, that's a really powerful kind of metric right there. And basically telling you, is this guy or woman going to get gassed or not?

• 28:12Speaker 01

  Exactly.

• 28:12Dr. Darshan Shah?

  In between rounds, right?

• 28:13Speaker 01

  Yeah, I mean, it represents two things. One, it represents, like I said, how well they can manage that autonomic system to produce energy and recover from it. Two, we also know that correlates to what percentage of that energy came from the aerobic versus the anaerobic. Because the more energy comes from the anaerobic, the longer it takes to turn the sympathetic system off. Because the sympathetic system's driving the anaerobic with catecholamines, with cortisol, adrenaline, and noradrenaline. And so it takes longer for those things to come down and for the heart rate to drop. So it's a very good proxy for how much power was this athlete able to generate aerobically, which means they can sustain it, versus anaerobically, which means they can't. And if someone's heart rate's not coming down, it's because a lot of that energy came from the anaerobic side. And we know that's going to lead to much faster fatigue over time.

• 28:54Dr. Darshan Shah?

  Yeah, that's great. How does the non-NMA fighter, just regular person working out of the gym, use this information? Is there a certain time period, like recovery in one minute that you want to aim for? A drop in heart rate that's a certain number? How can we use this in our day to day workouts?

• 29:09Speaker 01

  First, generally speaking, yeah, do you want to look at 60 second heart rate recovery? That's the most way, it's the easiest way to standardize it. Now, it's going to be different depending on the exercise that you're doing. If you're on a bike, if you're running, it's going to have a bit different recovery. But you want to start out with some sort of baseline. So you do some exercise. I like, we were talking earlier about a five minute period where you're trying to do some, some distance, some as far as you can go. And then that 60 second heart rate recovery is going to tell you again, how that was driven. Was it driven primarily by the aerobic system? In which case your heart rate will drop quickly. And by quickly, I would say 30 to 40 beats per minute would be a pretty high level of recovery. Meaning you could probably repeat that fairly well. If your heart rate recovery is less than 30, it's down 20 or 10, you're probably not going to be able to repeat that very often

• 29:52Speaker 01

  because it took a big metabolic cost to get there. And so you just track it over time. You want to see that you are improving in a specific thing. So it doesn't have to be five minutes, it can be whatever. But anytime you're getting your heart rate up to, let's say, 160, 170s, it's valuable to just spend 60 seconds afterwards and see how much it's dropping. I like to see over 20, 30 or 40 is kind of the top end of where you're going to want to get to. And it's just a really good gauge of, am I improving and what kind of shape am I in?

• 30:15Dr. Darshan Shah?

  Yeah, a lot of the wearables now, they can tell you just, you know, while you're working out where your heart rate is. And you know, this ties into some of the workouts that I like to do, like Tabata training or sprint interval training. Yep. Because what I like to do is see my heart rate drop 20, 30 points. I feel better, I'll do the next.

• 30:33Speaker 01

  Yes, that's a great way to auto-regulate it, exactly. So it's a good way to make sure you are resting enough to be able to repeat that. Because I think a lot of times people think fatigue is the goal. Fatigue isn't necessarily the goal. The goal is to stimulate the body to get better. Fatigue is more of a byproduct than it is a goal. So I think a lot of times, again, people think, oh, I made myself really tired. It must have been a very effective workout. That's not always the case. They're not always the exact same thing. And so, again, I want to get the workout in at the highest quality possible. And a lot of times that means resting much longer than people necessarily think you should because I'm trying to get better, not just get more tired.

• 31:06Dr. Darshan Shah?

  Right, right, exactly. Can you double click on that, resting more time than they think they should? Is there a certain amount that you want to lower your heart rate before you go for your next step? But not just completely get into recovery mode, right?

• 31:18Speaker 01

  Sure, I mean, it kind of depends on what you're trying to do. If you're trying to increase, so in general, if I'm trying to increase how much power I can repeat over time. So I'm trying to get higher power, right? I'm going to rest long enough so that my power doesn't significantly decrease between reps.

• 31:31Dr. Darshan Shah?

  Okay.

• 31:32Speaker 01

  If I'm trying to just maintain that power for a little bit longer, that's where I can have a little bit more incomplete recovery to where, okay, I am starting before, I am 100% fresh. But even then, I want to do that to a certain point. I don't want to get to the point where I just fall apart from a technique standpoint. I don't want to get to the point where I'm so fatigued, I just can't do the exercise properly. So general rule of thumb, like if I'm trying to, again, increase that power, I'm going to rest 60 seconds or more in a lot of exercises, short explosive bursts, 60 seconds, or like I said, drop your heart rate to 130 before you repeat that. If I'm trying to increase what I call capacity, I can make, maintain my power a little bit longer. Then you can drop your heart rate a bit less and you're going to be a little bit more fatigued. That's normal. But again, you want to understand what am I trying to achieve here? And fatigue is not the goal, it's the byproduct.

• 32:16Dr. Darshan Shah?

  It's the byproduct, right? So a lot of people come and see me and they haven't worked out in a long time. And they want to know, how can they get back into shape? And to shape, to me, means there's two or three different buckets of that. There's strength conditioning, there's cardiovascular conditioning, even mobility and be able to do like functional movements, right? And so that's how I kind of divide it up for people. And most of my patients, where I think it's true for most of humanity right now, unless you're a professional athlete, you don't really have a lot of time to work out, right? And they want to know like, what's the most effective use of my time? And so on the cardiovascular front, how would you construct a workout for them using some of these data points?

• 33:00Speaker 01

  So that's a really good question. I think it comes back to the point of efficiency. And so there's a strong tendency, as we've talked about, for people that want to do things fast. And so they look at all the research, they look at Tabata and all these sorts of things. Say, high intensity is the best because it's the most efficient. We have to understand, it's the most efficient from a workout standpoint, but it's not very efficient from a recovery standpoint. It takes much longer to recover from high intensity. And again, most of this data I've seen from the average person is their recovery is already a bit lacking. And if they're just starting out, they're not very fit, their recovery is going to be even worse. So I'm not saying you don't do high intensity, but I think people tend to overdo it.

• 33:34Dr. Darshan Shah?

  Right.

• 33:34Speaker 01

  Particularly when they're starting out. So research is pretty clear, most people need two to three days a week of strength training and not huge amounts of it. The research shows like 30 to 45 minutes a day, two, three days a week is where we see the best prediction for longevity. It's not this, go hit the gym, do six days a week lifting weights, that's not the model. So let's say they do two to three days a week, let's say 30 to 45 minutes lifting weights. I would say they want to get as much as a lower intensity they can get to start with, the zone two, the zone one, just movement. And then one day a week, and this sounds small, but one day a week of 10 to 20 minutes of high intensity is all that most people are going to need for quite a while. Now, there may be some phases where they're going to go and do more of it, but they don't need near this amount of high intensity. They think they do because they have to pay the price on that, on the recovery side.

• 34:16Speaker 01

  And so we just have to recognize, all the high intensity research studies are six weeks, eight weeks, 10 weeks. They're designed to be short because it's hard to control studies for a long period of time. So yes, if we do a six week period and we want to make the fastest progress in six weeks, more high intensity is generally going to win. But we're not trying to get better for six weeks, we're trying to get better for the rest of our lives. So I just think people can, the average person, one day a week of a small amount of high intensity, at least at the metabolic side, and then two, three days of strength training and whatever low intensity can fit around that is the easiest recipe for success.

• 34:48Dr. Darshan Shah?

  Yeah, and that's super easy, I think, for most people to attain, even with a busy schedule, right? And what you just described, there's a lot of talk around zone two as well now, especially since, you know, like all the podcasts that you've been on and talked about it. And it seems to be becoming more and more of a core training modality. And I'd love for you to kind of maybe talk about zone two and how that fits into a program.

• 35:11Speaker 01

  Yeah, zone two is, like you said, it's gotten so much attention. And I think there's good justification for that with some caveats. But I think we have to again, kind of go back to what is zone two? And I think that's some of the problem. So if we look at traditional heart rate monitors, they just give you five heart rate zones and they're based on your max heart rate, right? So first of all, if you're not entering an accurate max heart rate in there, which a lot of people are not because they haven't done a true max heart rate test, it's not going to give you the best information. But let's say, assume you put a heart rate in there that's accurate. Now it's just going to take your heart rates and it's going to go 50, 60% zone one, 67% zone two. It's just going to increase your heart rate percentages, it's zone one, two, three, four, five. But the concept of zone two was more about two different things, I think, that people do recognize.

• 35:53Speaker 01

  One, it's where your body is burning mostly fat and using mostly a slower twitch muscle fiber to do that. But two, this doesn't get talked about as much, it's also a level where the heart is filling up with a good amount of blood. That's called stroke volume. So that over time, the left ventricle, the heart itself becomes bigger. Why do we care about that? Because a bigger left ventricle can pump out more blood and oxygen, we have more stroke volume. And so that's the biggest thing we see with endurance athletes. VO2 max is almost a direct relation, almost a direct offshoot of heart size. Bigger heart size, bigger left ventricle, bigger VO2 max. So we have to be able to deliver blood and oxygen. The problem is that takes time. It's not a fast process and it needs volume over time.

• 36:34Dr. Darshan Shah?

  Sure.

• 36:34Speaker 01

  So zone two should be more about the outcome we're trying to achieve than the specific heart rate that we're searching for.

• 36:40Dr. Darshan Shah?

  Got it.

• 36:41Speaker 01

  In general, again, we're trying to find a point where most of our muscle fibers are slow twitch, they're burning mostly fat and our heart rates are relatively high stroke volume. Because once our heart beats too fast, most people's stroke volume will go down because there's not enough time for it to fill. So again, zone two is an outcome we're trying to achieve. And that problem is that heart rate is going to be different for everybody where they achieve that. You and I and everybody else, we have our own individual factors, right? My slow twitch muscle fibers could be completely different than your slow twitch fibers, our mitochondria can function differently. So one person might hit that zone two range, let's say 60, 65% max heart rate, somebody else could be 80%. So it's very difficult to say, oh, just look at your heart monitor, go to zone two, your heart monitor, and that's it.

• 37:22Dr. Darshan Shah?

  Yeah.

• 37:22Speaker 01

  I think it's more about finding this pace where you're kind of at this high level conversation. Like you could still maintain a conversation, might be a little bit strained, but it's something that you could maintain over time. And that's one way we look at it, Morpheus gives you a zone two based on all your data as well. But it's a pace, it's a, it's a level of exertion where you can do that, not just this percentage of heart rate on my heart monitor.

• 37:43Dr. Darshan Shah?

  Yeah.

• 37:43Speaker 01

  Now that said, why is that beneficial? Well, like I said, you're burning fat, you're training the body to be more metabolically flexible. And then you're building a mitochondria that supports that. And then most importantly, like I said, is you're building that time under tension in the heart so that your left ventricle enlarges, it gets bigger over time. The best analogy I would say is if somebody wants to get really strong, they could lift really heavy weights, one and three rep max. They'd get stronger, but at some point they hit a ceiling because their muscles aren't bigger. You'd have to build bigger muscles to continue to get stronger.

• 38:11Dr. Darshan Shah?

  Sure.

• 38:12Speaker 01

  So it's the exact same thing with cardiovascular training. If all I did was high intensity, my heart might get stronger, I might get a little bit higher VO2 max from that. I will get higher VO2 max, but then I'll hit a plateau. And I'll hit a plateau because my left ventricle is not big enough.

• 38:24Dr. Darshan Shah?

  Got it.

• 38:24Speaker 01

  It's the equivalent of building a bigger bicep or quad to get stronger. I have to build a bigger left ventricle. That takes time, just like we have to lift weights for time. So just like you wouldn't expect to go in the gym and do three reps of heavy weights and progress for a long time, you can't expect to go in the gym and do five minutes of high intensity cardio for the long time and, and get a higher VO2 max over time. And again, it's long-term thinking. It's shifting our mindset from what's right now to what's going to be sustainable and improve our health over the long term.

• 38:53Dr. Darshan Shah?

  Yep.

• 38:59Dr. Darshan Shah?

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• 39:43Dr. Darshan Shah?

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• 39:56Dr. Darshan Shah?

  How does someone measure their zone two cardiovascular fitness? I know we have VO2 max for our high-intensity fitness. How does someone measure their zone two?

• 40:05Speaker 01

  Sure, so there's a few different ways. Okay, then they range from very complicated and expensive to easy. So one is if you do a metabolic test, if you do a zone two test, you're typically using gas exchange and it's going to give you this threshold, which is called your VT1, your ventricular threshold. In that range is where your body is primarily burning fat. And in that range tends to be where stroke volume is the best. So, all right, a tight point. So you can just get a metabolic test and that's going to give you a starting point. Two, there's a way to measure blood lactate, which is a real pain, right? So zone two is typically sized around two millimoles. Most people are not going to want to do blood pricks and see what their zone two is. And it's also going to be different based on different exercises. So if you go through the hassle of doing a blood prick and getting your zone two when you're running, it might not correlate to what it is when you're walking or you're writing or doing it.

• 40:49Speaker 01

  And then the other problem with both of those is zone two is not static, which people don't get, because my body's not static. If I'm fatigued, if I didn't good sleep, my readiness is lower, my HRV is different. My zone two could shift up or down. Because if I'm fatigued, it takes more muscle fiber to create the same power output. My zone two is not going to be the same every day. So we need to keep that into mind. So that brings me to number three and four is, again, what I talked about, the easiest way is a conversational level pace. It should be a pace where I can maintain a conversation without having to constantly stop to catch my breath. And that tends to be where that zone two is for that given day. So it should be the highest speed that I can do that, not just any pace where I can have a conversation. So go as fast as I can while still being able to carry on a reasonable level of conversation with somebody without having to constantly stop to take my, hold my breath

• 41:34Speaker 01

  or catch my breath. And then four is Morpheus. So what we did is we built a model around predicting someone's aerobic threshold using HRV and other data, and it shifts every day. So we give you a zone two that's meant for you on that particular day. But all those methods can be used. It just depends on what seems the most appropriate in your circumstances and how you want to do it. But I think in general, a conversational pace and or using Morpheus is a really good way for people to do it.

• 41:58Dr. Darshan Shah?

  Yeah, that's fantastic. It's really great to hear that this is like free to know what your resting perceived exertion is, right? Like if you can hold a conversation while you're working out, you're in zone two. For me, I do a lot of hiking. I'll do a lot of, if I can't go outside to hike, I'll bring the treadmill angle up to 13 and just go on that at three, with 3.5 miles an hour. And that gets me in zone two really well. And I use Morpheus quite often as well, especially I use it when, you know, I'm traveling a lot because then I really know that I need to modify, right? So, yeah. And just for the listeners, Morpheus is a wearable that you've developed that understands a lot more about your physiology and how it can change your training zones. And it gives you those measurements.

• 42:43Dr. Darshan Shah?

  So it's just a great training device for sure.

• 42:46Speaker 01

  Yeah, no, I appreciate that. And I built it with, like we talked about, everyone's different. And like, I think the, the old idea that everyone's heart rate zones are zone one through five based on max heart rate, they never change every single day. Our metabolisms aren't all the same. Where again, where I, where my zone two is not the same as yours. So why would my zone two be built on a static percentage of max heart rate? And the Morpheus is built on three heart rate zones, low intensity, moderate intensity, and high intensity. And those shift based on stress and recovery and fitness level, because we're always changing, we're never staying the same.

• 43:14Dr. Darshan Shah?

  Yeah, you know, one of the things that you said earlier was everyone's amount of zone two they need to train in could be different as well.

• 43:21Speaker 01

  Of course.

• 43:22Dr. Darshan Shah?

  And I imagine that's also shifting a lot, right? So how does someone know how much zone two is enough for them to get for the week?

• 43:27Speaker 01

  So I would say you start in the small end and then you build up over time and see if you're improving, right? So I would start with 20, 30 minutes, two to three times a week. That's probably enough for somebody who's deconditioned and just starting out to make some progress. They do that for, let's say, three or four weeks. Maybe they add 10 or 15, 20 minutes a week. It's just a progression. So there's, there's no, this is right for everybody. It's whatever is going to make you better is the answer. So start with the lead. I always want people to understand the smallest amount that will make you better is the right amount. It's not the maximum amount you can sustain, because I think, or you can do, that's a different way of thinking. People think, how much can I do to get better? No, it's how little can you do to get better? Because otherwise, you can't progress it. If you start out with this maximum dose, how do you keep going? So you start out with the smallest amount

• 44:12Speaker 01

  that you feel like is going to make you better. You see, am I getting better? Is my resting heart rate going down? Am I able to walk faster at a conversational pace? That's another good indicator. Can I go faster at the same conversational level? That tells me I'm producing more power. Again, primarily using fat and slow to muscle fiber. I'm looking for improvements. If I'm starting to see improvements, I keep going. If I'm not seeing the improvement, I make sure I'm not doing too much, I'll increase a little bit. So it's this gradual process of just looking for things that tell me I'm improving and then making decisions. How much more do I add? Not how much can I possibly do?

• 44:44Dr. Darshan Shah?

  Right. And would being trained well in zone two also improve your VO2 max?

• 44:49Speaker 01

  I would say it increases your VO2 max ceiling, right? Because like I said, the limiting factor in VO2 max is how much heart or how much blood oxygen your heart can pump out with each beat, right? So it's the size of the heart that's the limiting factor across the board. So if I'm building a bigger heart over time, it increases my ceiling, just like if I put on 10 pounds of muscle, it increases the ceiling of my maximum strength, because I have a bigger muscle contracting.

• 45:12Dr. Darshan Shah?

  Right, right. Okay, that makes sense. So we've covered VO2 max, you're saying once a week, VO2 max training, high-intensity training, the zone two we talked about as well. Let's talk about strength training and how you recommend people put strength. You already mentioned two or three times a week, we just need 20, 30 minutes. Are there any other tips you have for people building that piece of their workout?

• 45:31Speaker 01

  Yeah, I think two things. One, I think if you're doing two days a week, you can just do a full body exercise program. You don't need to have this very complicated body part split. So if you're doing, let's say, Tuesdays and Fridays, you're going to pick pretty big compound movements and you're going to get the total body in. Two, if you moved like a three-day-a-week schedule, then I would do like an upper and lower in a total. Generally speaking, like getting your total body in twice a week in smaller volumes is a good approach. You don't have to be like a bodybuilder and be like, I'm going to do biceps today and triceps tomorrow. And then legs on 30, like, those are fine for bodybuilding splits, but for the average person just trying to get stronger and trying to build some muscle twice a week of the total body is the way to do it, because you're not spending two hours doing it either. And then I'd also say rotational movements become overlooked. Like we move in rotational planes.

• 46:16Speaker 01

  We walk, we run, we do things that are rotational. And I think we can get locked into this. We only do compound powerlifting movements, the bench, the squat. Like those are fine movements. I'm not saying you don't do them. But incorporating rotational movements, single-leg exercises, those sorts of, I hate to use the word functional, but they are a bit more functional. Those sorts of movements become important as well. So you want to develop a wide range of strength across a wide range of movement patterns. You want to have the ability to squat and hinge and lunge and rotate and push and pull. You want to incorporate that full range. And then, you know, again, find exercises that you struggle with and then do them until you don't struggle with them. And then try rotating to new ones.

• 46:54Dr. Darshan Shah?

  Yeah, I think you're absolutely right about the rotational movements. You see people in the gym spend an hour there. They're not rotating their body at all. And then the first time they're asked to do this, they hurt themselves.

• 47:06Speaker 01

  Exactly.

• 47:07Dr. Darshan Shah?

  Yeah, and, you know, I think I'll just add to that. If you're going to be doing rotational movements, you definitely want to watch at least a YouTube video, get a trainer to kind of help you, because I've seen a lot of people hurt themselves.

• 47:17Speaker 01

  Yeah, I mean, start easy again. Just grab a medicine ball, grab a five-pound medicine ball and just rotate. Like, it doesn't have to be complicated or do a, do a lunge, but rotating, do the lunge. So it doesn't have to be this huge thing where you're trying to be a baseball player and throw med balls across the gym. You just need to get some rotational exercises, whether it's with a pulley, whether it's with the kettlebell, whether it's with a medicine ball, all these things. Just incorporate rotational movements. And as you said, make sure you're doing them correctly so that you're not injuring yourself. But I think, again, too many people are like, I'm just going to lift heavy weights. It's not as much about lifting hefty weight, heavy weights is about getting the movement patterns that you want to be able to sustain across your lifetime. The goal is not this bench as much as you can or squat as much as you can. It's move as well as you can for your life. Those are different things.

• 47:56Dr. Darshan Shah?

  Right, right. And when people are lifting weights, you know, there's a lot of questions around how many reps, how many sets, what should my one rep max be? Can you talk a little bit about that? How should people think about how much they're lifting?

• 48:11Speaker 01

  Yeah, so I would kind of. Put it back in the same sphere as the cardiovascular side. You need repetitions and you need a smaller amount of heavier weights. So I would say most people, you know, eight, 12, 15 reps, somewhere in there. We used to think that that muscle size only was in a certain rep range. And now we know the muscle size can be grown at any rep. You can grow muscles at a variety of rep ranges. You just have to get reasonably close to failure, not all the way to failure, but within one to two reps of failure. We know that somewhere that one to two rep range of an exercise, getting that close to failure is a stimulus for bigger muscles. And then again, that's kind of the same side of if we want to push our VO2 max up, we'd want to use higher intensities. If we're going to push our max strength up, we'd want to use heavier weights. Let's say three to five, six reps, somewhere in there typically. But it's a, it's a variety.

• 48:56Speaker 01

  You're not going to always go in there and do the same thing. But if we look across a week, the number of times you do heavy weight should be less the times you do a more moderate weight.

• 49:04Dr. Darshan Shah?

  Yeah, yeah. And that's very good advice. I think a lot of people work out with weights that are underweighted for them. They don't get close to their one rep max and they're wondering why they're not making any progress in the gym. And it's really about just selecting the right weight and getting close, right?

• 49:19Speaker 01

  Like I said.

• 49:20Dr. Darshan Shah?

  Without hurting yourself.

• 49:20Speaker 01

  Yeah, it's called reps in reserve, like how many reps more could you do? So like if you could do one to two more reps, that's about the right range. If you're not even close to that and you could do 20 more, you're probably not pushing yourself hard enough. At the same time, if every single set is to failure, you're going to take a really big hit on the recovery. It's going to take you a long time to be able to repeat that. And so I always think I want to be able to repeat something more often than just do it once and take two weeks to get back to it.

• 49:43Dr. Darshan Shah?

  Yeah. You know, one of the things that people ask all the time is like, how do I know if I'm making any progress? And I think for a lot of people, they don't really follow their, the amount that they're lifting per body part. I'm a big fan of keeping track of these numbers, right? I think after you hit the age of about 40 or so, if you're not making progress, you're going to be declining really quickly as well. Just because we're just naturally programmed to start eating up our muscles as we age.

• 50:09Speaker 01

  Yep.

• 50:09Dr. Darshan Shah?

  And so is there some tips you have around that, around tracking, around making sure that you're doing the right amount and the right intensity?

• 50:16Speaker 01

  Yeah, I think it's important to just log. You know, it's important to keep track of what you're doing, otherwise you're guessing. And so I tend to use what I'd call a volume to intensity progression. So when I first start doing something, I want to be able to add a couple more reps at the same weight. I want to get up to maybe, let's say I started, I can do eight reps at some weight. Well, maybe next time I can do nine, next time I can do 10. Progress up to 12 to 14 reps, then I'm going to add some weight and then probably drop it back down. So it's a really easy way to progress for someone who doesn't need to, who doesn't want to deal with this really complex periodization, all that sort of stuff. It's just, can I do something a little bit more, a couple more reps, a few more pounds? And like you said, you should always be striving to do one or both of those things across time. You're not trying to just show up and do the exact same workout endlessly because then you're not progressing.

• 50:56Speaker 01

  At the same time, I don't need to go in there and, and increase my strength by 20% of your exercise, every workout. It's not going to happen. So it's just about micro progressions. It's like, hey, last week I did 10 reps. I'm going to try to get 11 or 12 today. Hey, last week I did 12, I'm going to try and get 13. Okay, I'm 14 reps, 15 reps, I need to add some more weight and go back down. That's a really easy way to progress.

• 51:16Dr. Darshan Shah?

  That's exactly what I was hoping you'd tell me because I heard you say this before, I think a long time ago. And I was trying to find the podcast episode where you said this and I couldn't find it. But I've been doing this now for, since I heard that, probably about a year, two years. And it's been so much easier to track progress. I used to get all these apps on periodization, et cetera. And it's just very complicated and now I can just basically do it in my head.

• 51:38Speaker 01

  Yeah, you know, I think the problem with periodization, don't get me wrong, it has its place.

• 51:41Dr. Darshan Shah?

  Yeah, sure.

• 51:41Speaker 01

  But when you try to write out a program for like, let's say 12 or 16 or 24 weeks, I don't know how you're going to progress across 12 weeks. Like there's so many variables that drive how quickly you're going to progress. And so what I've written in there is my, my exercise prescription 12 weeks from now could be totally wrong. You could have progressed faster, you could have progressed slower, maybe hit right on. But it's really hard to have this plan, like I'm going to stick to this, this rigid plan for 12 weeks. It's more about, again, going for most people, it's more about here's what I'm going to start with. And every week I'm going to try and get a little bit better in something. And you do that until the point where like, okay, I'm, I've really mastered, like really good at this. Now let's try some other exercises, some other movements and keep progressing that way.

• 52:19Dr. Darshan Shah?

  Exactly. And it allows for a lot more flexibility because if you've had a tough week of travel, for example, you can still go to the gym and you know how many reps of a particular weight you can do. And you could take it back because you're not recovered enough. And then you can get right back to it when you're, when you're recovered. So it allows for that flexibility versus with periodization. It's like, if you don't do that, you miss that piece of the schedule.

• 52:39Speaker 01

  Yeah, I mean, as I said, I, I, my younger years of coaching, I would write out these very elaborate, like to every single, every single set was this set, this number of sets, this number of reps, this weight, this rest interval. And then you kind of realize when you start looking at your week four plan, you're like, he's nowhere near there, she's nowhere near this. It's totally different than I expected. And so I'm not saying you don't have a grand plan, but you don't need to micromanage every little detail across this long period of time. You can really keep it simple, especially if you're not an athlete trying to perform for a tenth of a second. You're just trying to live a longer, healthier life. You just make it easy and sustainable.

• 53:10Dr. Darshan Shah?

  Exactly. You know, and speaking of trying to live a longer, healthier life, I like to use grip strength and get a grip dynamometer with my patients. Just so we have some level set of like where you are compared to where you should be.

• 53:22Speaker 01

  Yep.

• 53:22Dr. Darshan Shah?

  And I always tell people like, don't just train your grip, like full body exercising to make that better. And since then I've also added a few other metrics as far as like getting people to understand where they should be for their age and their sex. Do you use any metrics like that? And what, where do you get yours from?

• 53:38Speaker 01

  Yeah, so I think we can look across four areas. Like I, I look at fitness from four buckets. Okay, so there's the aerobic fitness, we've just talked about that. So obviously VO2 max, resting heart rate, heart rate recovery, average HRV. These are really good indicators of just your overall cardiovascular fitness. Two, I look at the anaerobic fitness side of things. So aerobic fitness, cardiovascular, anaerobic strength, power, speed. Again, a muscle dynamometer is great, pull ups, planks, just basic gauges of strength. Can somebody have the vitality to do these basic exercises? And then I look at movement capacity. Again, can they rotate? Can they squat? Can they hinge? Do they have enough movement capacity to be able to do these things without be their body up over time? And then four, like I talked about is autonomic flexibility and autonomic fitness.

• 54:22Speaker 01

  So again, I look at what's their average HRV, we look at how stable is their HRV, those sorts of things. If you take all those four buckets, you're really talking about the big picture of health and adaptation. Because any detriment in health, their cardiovascular system is not healthy, their metabolism is not healthy, their immune is overactive. All those things will take a hit and cause all those numbers to be worse. So I think all these metrics we're talking about, they're reflections of a healthy system.

• 54:44Dr. Darshan Shah?

  Right.

• 54:44Speaker 01

  That's able to respond to stress and adapt to stress. And that means we're going to be healthier. I just saw a study where they looked at people in their seventies and the point one, they looked at, I think it was 72 or 73. Their 10 year risk was down by 12% for every point one meter per second in walking speed. Just their average walking speed.

• 55:00Dr. Darshan Shah?

  Walking speed is a great metric, right?

• 55:01Speaker 01

  Yeah, so people don't understand, like just, it's, to me, is it walking fast that's making you live longer? Not necessarily. It's, do you have the capacity to walk faster? Is your natural state really slow because you're deconditioned and you're unhealthy? Or are you able to walk rapidly? And this is a long story, I'll make condensed, but my mom had a stroke when she was 62. And then she had sarcotosis of the lungs, she ended up getting breast cancer, she had all these things and it just sucked the life out of her.

• 55:25Dr. Darshan Shah?

  Yeah.

• 55:25Speaker 01

  And she could barely walk towards the end. She was like 95 pounds. She definitely did not have high grip strength. And it just, you see the fragilities creeping with age and something like, you know, cardiovascular disease and strokes. It just sacks your ability to move and you can't be functionally healthy if you can't move. And so I really think all this sort of stuff comes down to maintaining movement across our lifetime. Because if you're, unfortunately, she was, she was stuck in a, in a old home, old folks home, a retirement community. And she was stuck in her room because she couldn't move very well. Then COVID locked her down. It was unfortunately, you know, a very hard thing to watch. And so I think when we keep all these things in our mind of, of strength and power and rotation and movement and cardiovascular fitness,

• 56:05Speaker 01

  ultimately it's so all our systems can do the job they're designed to do and we can move and do the things we enjoy with the people that we enjoy doing them with. Because if you can't do those things, your quality of life isn't what it should be. So you don't, you know, you, you need to take some perspective of what we're trying to actually get to.

• 56:20Dr. Darshan Shah?

  Exactly. And I think it's so important to talk about it now, whatever part of life you're in, if you're 20 years old, it's in this 30 or 40, it all starts from developing these habits and these realizations early so you can continue to build upon them over time. The more you put in reserve, the better. And I also think that, you know, it's never too late to get started, obviously, because our body's incredibly good at getting back some mobility, some strength. It wants to be in that state of health.

• 56:47Speaker 01

  It's designed to adapt. Your body is designed to adapt the world around it. And it's only when you do it in targeted, measured fashion through exercise that you can control it.

• 56:55Dr. Darshan Shah?

  Right.

• 56:56Speaker 01

  And you can make the body better deliberately.

• 56:57Dr. Darshan Shah?

  Right, exactly. And I think also it's not just about what you do at the gym. I think, you know, there's this whole other kind of bucket I have, which we talked about as well as mobility. And you and I both know Kelly Starrett very well.

• 57:08Speaker 01

  Oh yeah, great.

• 57:08Dr. Darshan Shah?

  Yeah, and I love his app where you can do a mobility assessment and really understand like where you're losing mobility. And that's incredibly important as well.

• 57:16Speaker 01

  It is. And again, I think this comes back to if I go to the gym, if I'm just trying to make my goal lift heavy weights, not improve my movement, I might take a different approach. That's why I think rotational exercises and dumbbell exercises and unilateral exercises, these challenge our bodies in different ways than just the traditional strength, heavy bilateral powerlifting type movements. And Kelly would be the first to tell you, again, we're trying to use mobility exercises and strength exercises together to drive movement. I call it movement capacity, the ability to move across the range of motions that we need to in a healthy way. And so again, we're trying to take the long term. I want to move when I'm 60, 70, 80 as well as I can now. If I let that degrade, I have low back problems, I have hip problems, I have knee problems, my movement's going to suffer. And then that has a downstream effect of, I'm not going to do as much.

• 57:58Speaker 01

  And that has a downstream effect of I'm not going to be as adaptable and it's this downward spiral.

• 58:02Dr. Darshan Shah?

  Right, exactly. And, you know, you had mentioned pull ups, I think, you know, just being, being able to hang from a bar.

• 58:08Speaker 01

  Yeah, pull ups, hang, exactly.

• 58:08Dr. Darshan Shah?

  Right, exactly. And, um, you know, if you have a sled at your gym, doing sled Pushes

• 58:12Speaker 01

  Oh, great stuff.

• 58:13Dr. Darshan Shah?

  Right. All that stuff is like

• 58:14Speaker 01

  Carries.

• 58:15Dr. Darshan Shah?

  Right. Exactly. Yeah. Yeah. Just even if you carry a sandbag across

• 58:19Speaker 01

  Yeah.

• 58:19Dr. Darshan Shah?

  Across the, um, the gym floor. All that stuff is really

• 58:23Speaker 01

  It is.

• 58:23Dr. Darshan Shah?

  Helpful to keep that functional mobility going as well.

• 58:26Speaker 01

  It really is. Like I said, I think if you, if you do that 30 minutes, 45 minutes a week, two, three times a week, it's enough.

• 58:32Dr. Darshan Shah?

  Yeah.

• 58:33Speaker 01

  You don't have to live in the gym. You really don't have to. And like you mentioned, go for hikes.

• 58:37Dr. Darshan Shah?

  Right.

• 58:37Speaker 01

  Go for walks.

• 58:38Dr. Darshan Shah?

  Yeah. But, uh, you know, put a weight, a weight jacket on or something like a ruck, a rucksack.

• 58:43Speaker 01

  Exactly. Going uphill and rocky terrain and improves your balance, improves your coordination as you age.

• 58:47Dr. Darshan Shah?

  Yeah. And it's super fun.

• 58:48Speaker 01

  Exactly. And, and, and you're hopefully get out of internet range. You're not seeing your phone while you're doing it.

• 58:53Dr. Darshan Shah?

  Right. Exactly.

• 58:54Speaker 01

  Double, double bonus.

• 58:55Dr. Darshan Shah?

  Exactly.

• 58:56Speaker 01

  Then you come back and jump in the pool and decompress.

• 58:58Dr. Darshan Shah?

  There you go. Get in the sauna and the pool after that.

• 59:00Speaker 01

  Exactly. Yeah. All those, all those things work. You know, they all, they all get our bodies into a state where we can adapt better, where we can turn the autonomic system on and off the way we need to, to where we can give our body a chance to, to become more efficient, become more, you know, stronger, more resilient.

• 59:14Dr. Darshan Shah?

  Yeah. And this is a really important conversation because even like you, I'm sure you have people that come to you that are bodybuilders and they have such limited mobility because all they've done

• 59:23Speaker 01

  Yep.

• 59:23Dr. Darshan Shah?

  is like five motions in the gym for

• 59:25Speaker 01

  Exactly.

• 59:25Dr. Darshan Shah?

  25 years, right? And you don't want to get into that situation either.

• 59:29Speaker 01

  Yeah. I mean, powerlifters, I would say powerlifters are the worst because they're bench squat, deadlift, dead squat, right? That's all they're trying to do is maximize bench squat, deadlift. And I, I have friends that are been doing that for 50, 60 years and they can't reach their wallet in their back pocket. So their, their, their wallet has to be in a side pocket because they don't have the shoulder mobility to turn around and get their wallet out. And unfortunately you see them pay the price of that oftentimes. You know, you see their, you see they have knee, knee pain, they have hip pain, they have, you know, degenerative uh, arthritis across different areas. Like that's where, you know, performance comes the cost of health, unfortunately. And I think people often don't realize that that happened until they actually have to pay the cost that comes due.

• 1:00:06Dr. Darshan Shah?

  Yeah. And that brings me to kind of the final question to wrap it all up. You know, does better fitness always translate into better long-term health?

• 1:00:15Speaker 01

  Yeah. Like I said, I think the answer is no, right? It depends on how you build that fitness. And if you're trying to chase a specific outcome, like maximum strength, like maximum power, like bodybuilding, those things are not often in line with, Billy, when we talked about which resilience, because you're doing limited movement patterns, you're just chasing one type of fitness, you're often doing excessive amounts of it.

• 1:00:35Dr. Darshan Shah?

  Right.

• 1:00:35Speaker 01

  And your health can pay the consequence for that over the long run. So the good news is, is I think most people, you know, they don't want to go that far. They just want to live a longer, healthier life. And again, it's, it doesn't take huge amounts of time. It doesn't take living in the gym. It doesn't take squatting and bench pressing the moon. It doesn't take these extremes that a lot of these athletes go to. It just takes doing the right things that work for you consistently, and then gradually improving small amounts over a long period of time.

• 1:01:00Dr. Darshan Shah?

  Yeah.

• 1:01:00Speaker 01

  That's what it takes.

• 1:01:01Dr. Darshan Shah?

  Yeah. Well, this is fantastic episode, Joel. I mean, we just covered such a huge breadth. And I think if people were to listen to this, take some notes, we'll put it in the show notes too, they can develop an incredible protocol around what their fitness routine should look like to lead to long-term health, longevity, move, mobility, all of it. And, you know, you gave us some really great metrics as well. Is there anything else you want to add to this conversation?

• 1:01:23Speaker 01

  Um, like I said, I think it just comes down to everyone's individualism. So I've wanted caution people of reading too much into what other people say and do on social media.

• 1:01:32Dr. Darshan Shah?

  Right.

• 1:01:32Speaker 01

  And I hate to say this, but AI is not your best coach. Like you, I'm not saying it doesn't have value.

• 1:01:38Dr. Darshan Shah?

  Right.

• 1:01:39Speaker 01

  But now I kind of see too many people defaulting to like, hey, what should I do today, Claude?

• 1:01:42Dr. Darshan Shah?

  Yeah.

• 1:01:42Speaker 01

  Like Claude doesn't know you.

• 1:01:43Dr. Darshan Shah?

  No.

• 1:01:44Speaker 01

  Claude doesn't know anything. It's just, it's repeating the average of the information that's been fed. And so again, I think it's, it's easy to try to look for other people's ideas or Claude's ideas or chat GPT's ideas. But I think you really have to learn your own body. And again, that doesn't come from like over tracking every metric on the face of the earth, but it does come with some data to help understand what's going on, keeping track of what you're doing. And then constantly saying like, oh, where can I improve? Well, my sleep's limiting factor. How can I improve that? Oh, my diet's not really what it needs to be. How can I improve that? I think if you take that approach of try to find one thing that you can improve and then focus on it until it's improved and then you move on and you drown out some of the noise or whatever else is doing, your own fitness journey is going to pay off in the long run versus trying to copy everybody else's.

• 1:02:27Dr. Darshan Shah?

  Agreed. Agreed. Well, thank you so much for this incredible amount of time you've spent with us and educating us. Where can people learn more from you?

• 1:02:34Speaker 01

  Sure. Train with Morpheus.com is the best place to find me. Uh, lots of content in there of live monthly calls, newsletter, all that sort of stuff. And, uh, yeah, I'm just trying to help people put the pieces together and, and, uh, live their best lives.

• 1:02:46Dr. Darshan Shah?

  Fantastic. Thank you.

• 1:02:48Speaker 01

  Thank you.

• 1:02:51Dr. Darshan Shah?

  Thank you so much for listening to the podcast today. Please remember to subscribe if you like this episode and give us a good review and share a link with your friends. It really helps to support all of our efforts. I also want to remind you that the information shared on this podcast is for educational purposes only and is not intended to replace professional medical advice, diagnosis or treatment. Please consult with your healthcare provider or physician before making any decisions or taking any action based on what you hear today, especially if you have any underlying health conditions or on any medications. Your doctor knows your personal health situation the best and it's always important to seek their guidance.