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The Neuro Experience with Louisa Nicola
#337: Why VO2 Max is the Greatest Predictor of Lifespan | Brady Holmer
#337: Why VO2 Max is the Greatest Predictor of Lifespan | Brady Holmer

#337: Why VO2 Max is the Greatest Predictor of Lifespan | Brady Holmer

The Neuro Experience with Louisa NicolaGo to Podcast Page

Brady Holmer, Louisa Nicola
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11 Clips
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Apr 9, 2024
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Episode Summary
Episode Transcript
0:00
People on the internet which it really bugs me when they say oh this, you know, lion's mane improves or helps with neurogenesis. I'm like, no, I don't think it does but it does help with synaptogenesis, which is you know, literally the the connections if that were true. I think we'd all be going out eating tons of mushrooms to just get bigger brains Runners and
0:18
cyclists. They have a high view to Max. So therefore it's important for endurance exercise performance, but it reflects now kind of what we're realizing why it might be so important for for like Health and Longevity it reflects your body's integrative ability to produce energy
0:32
what they are 2 max you need to have in order to just walk around the block or maybe just get up out of bed and just to maintain everyday function. Hi everybody. Welcome back to the show. It's Louise and Nicola. I'm a neurophysiologist and Human Performance coach. I'm the founder of neuroathlete is to democratize brain health education. So you can perform better think faster and live longer VO2 max is arguably the single most important metric.
1:00
For longevity VO2 max is the measure of our cardio respiratory fitness. Meaning how fit are you and it's a direct measure of how healthy you are and arguably how long you are going to live. So in today's episode we are going to go into the science of VO2 max and the best person to interview regarding this is Brady Homer Brady received a master's degree in human performance from the University of Florida. He is an endurance athlete and a full-time science writer and researcher Brady is also a good friend of mine and somebody who I am. So honored to bring on the podcast because he is the best person that I know to interview when it comes to the science of VO2 max. So we are going to learn about what it is. We're going to learn how it relates to health span lifespan. We're going to really understand what it does from a heart health perspective what it does.
2:00
From a brain health perspective how our VO2 max declines every decade that we get older. What are the correct ways of testing this whether it's in a lab or outside of a lab and we of course are going to touch on the best protocols to increase our VO2 max so we can perform better think faster and live longer. So I hope you enjoy the episode if you haven't done so yet please go through and smash the follow button on both Spotify iTunes and on YouTube will link YouTube below and if you haven't written a review, please go through and do so it really only takes around 30 seconds of your time Brady. Finally. We're here Welcome to the New York Experience Podcast. Um, it's going to be a very detailed podcast. I've been waiting to get you on the on the show for several reasons 1 we've been connected through Twitter for quite some time. I love your physiology Friday newsletters. You've uh, you've got so much information to share.
3:00
All highly credible and it's on a topic that I love which is VO2 max the intricacies of it. Um how it relates to longevity Peak Human Performance, and I have to say I got a lot of this information that we're getting today from your wonderful book.
3:17
So before we get into the Crux of it, why don't we you know act as if I don't know anything about you and give the audience a bit of a background on you
3:25
sure thing. Um, my degree my background is in exercise science. Um, that's what I got my undergraduate degree in and then I have a graduate degree in human performance. Um, I just graduated with that last fall and so I would say, um, I was involved during grad school in in some clinical research, um primarily regarding, uh, cardiovascular exercise physiology. So the effects of aerobic exercise on endothelial function, um, cardiovascular health things like blood pressure and whatnot. Um, I actually was you know, a part of several studies on that so that's kind of
4:02
I'm a little bit more formally trained in that but more broadly, you know, I I have an education in just exercise physiology exercise metabolism a little bit of strength and conditioning, uh, not a ton just because I didn't do a lot of Applied, uh, things like that. But so just to Broad background in exercise and um that stems from my interest in exercise. I'm also an endurance athlete I competed in Cross Country track and field in high school and in college and then I continue to um participate in Endurance Sports now recreationally, you know, I I'm decent still but you know, I'm not a professional Runner or or anything like that, but currently what I do. Um, I write on substack just about topics related to science Health Nutrition performance things like that. Um, as you mentioned I obviously I wrote a book last year. Um compiled actually just kind of a bunch of my blog posts on VO2 max and was able to turn that into a short book, um on V2 Max which has gotten some pretty good feedback and I guess you've read
5:02
Credit, so I appreciate that you've read it as well. Um, and I also work full-time for a company called examine.com and my role there is a researcher. I write about mainly nutrition and supplements. So we are a website dedicated to telling people what works and what doesn't when it comes to their health regarding, you know, if you're interested in should I take this supplement or not or does this particular diet work for weight loss we write about all of those topics based on the most recent up-to-date evidence and we don't sell supplements or sell anything on the site other than just membership. Uh, so people can read our content, but I've been working for them for about 2 years. And so there's a lot of overlap with that, um with my job at examining what I do on my substack just reading about science and and writing about that all the time. It's it's something I find very enjoyable. So these days my expertise is kind of a lot less focused on 1 thing, you know, I'm not like an endurance performance coach nor am I doing actual clinical research?
6:02
But I'm just exploring all these topics if it relates to like human health and performance and science. I'm you know, trying to write about it and understand it and and chat about it with people like you.
6:13
Yeah, and you do such a good job and it's an area that I love so you and I share something very similar. Uh, I was an endurance athlete and I was a triathlete which sparked my interest to get into my first degree, which was exercise physiology as well. And it was at the tender age of 18. That's when I first I won't I won't reveal how many years ago that was but um, that's when I first went into this whole exercise physiology field, you know, I was both a practitioner I was you know, a training 3 sports, but then I was also learning about what I was doing very different, you know, we were learning from textbooks back then and I actually remember looking at at a VO2 max test being done and that was that was quite some time ago, and we've definitely Advanced since then advanced in
7:02
The technology that we're using now we can do it portably if you will, uh advanced in our knowledge of it. I never heard the word longevity back then I never heard how VO2 max relates to health span and lifespan. We we learned it from an ex from a a cellular function endothelial function heart health, but I didn't really understand it from a longevity perspective and the beautiful thing about it is when you rip it apart for what it is and you really understand the science of it. You can keep learning like even with your book there was so many things that opened my mind up to energy expenditure and VO2 max Decline and maximal heart rate Decline. And so it's just it's ongoing and then with new research that's being published. It makes it an exciting field which is why we can focus this entire episode literally on the science of VO2 max. So with that said before going into the actual test, why don't we first
8:02
Lay the ground for ATP mitochondrial health and I guess energy production.
8:08
Yeah sure. So, you know we can maybe go as as detailed or keep it as like surface level as we want or maybe like a little bit of both but you know, if we think about energy metabolism, uh, or the production of like energy in our body and our cells, so most of that occurs, um, at least, you know during resting conditions in in the mitochondria people will know at the mitochondria colloquially referred to as the PowerHouse of ourselves. That's how like, we you know learned them and you know, whether it was high school or you know, elementary school or whatever. I don't know if people are learning about the mitochondria in elementary school. It's so underappreciated. Yeah, for sure for sure. We just learned a bit about them as like these little bean-shaped things that produce energy and you know not to
8:50
Sidetrack but they're actually not even shaped like beans that's to Total like misconception. They're actually like this, uh, mitochondrial like mesh like network type thing that they form but anyways, um, I digress so the mitochondria is where our energy is produced and we use 2 substrates primarily to produce energy, um, carbohydrate and fat under certain conditions. We may use protein to produce energy, but that's you know, very rare. Um, if you know for like under starvation conditions or or something like that our body might use protein or amino acids to to produce ATP, but
9:24
ATP what is known as the energy currency of our cell we need it for muscular contraction. Um, we use breakdown fat and carbohydrate to produce that and the mitochondria so fatty acids, they undergo beta oxidation. Um glucose is broken down. I say carbohydrates it's it's actually glucose that's you know, that energy substrate not carbohydrate but glucose is also broken down both of those broken down into something called acetyl coenzyme a um that enters the citric acid cycle. Kreb cycle TCA cycle goes by many names, um to produce ATP in the mitochondria and then they're also electrons that are produced during those processes which are used in the mitochondrial electron transport chain, uh, something called oxidative phosphor that also produces energy and then those would be aerobic energy, uh, producing processes. So aerobic meaning with oxygen so though they are oxygen requiring processes to produce energy. Um, and so again, we're
10:24
Cruising energy during aerobic using aerobic respiration primarily at rest at low intensity exercise. Um, and then at higher intensity exercises or um exercises that don't demand oxygen like heavy weightlifting or something like that. We can produce energy and aerobically, so without oxygen in that primarily occurs through process called glycolysis. So that's the breakdown of glucose and glycolysis. And then we also have a system called the ATP PCR system that produces energy anerobic. Um, and that's where molecule called phospho creatine so creatine and a phosphate molecule. Um, the creatine donates that phosphate to adenosine diphosphate produces ATP. And so there's a lot of hype and like talk about creatine lately and we may not probably won't get into that but 1 of the reasons why it seems to be so beneficial is because it's supplying um substrates for this PCR system and it might enhance like energy production in particular in the brain, which is
11:24
Kind of cool. Um, so again just to kind of reiterate that we have aerobic energy production Anarchy production at any 1 time we're using, you know, a little bit probably of both in the terms, you know, it's and we can produce energy heroically and Anor when we're doing primarily aerobic exercise. We may be producing a little bit of energy Anarchy. Um, but yeah, those are kind of kind of the 2 main ways in areas where energy is, uh produced in the body. So
11:52
put simply when we ingest food whatever food that may be that then gets broken down via goes into the mitochondria and then our mitochondria end up using that to produce energy.
12:04
Yes, exactly. And obviously, you know from when you ingest that food to when those you know, uh, the carbons are broken down and and used to produce energy in the mitochondria is a lot of lengthy steps. So it's not just automatically, you know, eat and then and then energy but, you know, we probably don't need to go into all of that detail that could be a whole podcast in and of itself probably
12:24
that can definitely be a podcast in and of itself. I'm going to actually read a quote from your book to set the scene for the next question the fantasy of maintaining youthful cardiovascular fitness throughout life may be just that a fantasy as it turns out there is a consistently observed and linear decline in VO2 max throughout life no matter how active you are when I read that I was like, oh great. That's just that's just great. Really.
12:52
It is depressing. Uh, but so what is it about the field? Like what what is VO2 max? And why is it so important? And why is it so essential for us to understand?
13:04
Yeah. Sure. So despite its like increasing in popularity lately the you know, the concept or the physiological I guess we could call it a phenomenon of of VO2 max isn't necessarily new. I mean it was discovered. Actually, I think last year it just turned it had 100. It had its 100th birthday. I guess since the discovery of of VO2 max. So it's you know, it's been well known in exercise physiology for literally a century. Um, but it's just becoming popular now recognized for its role in health span and Longevity. Um, but what V2 Max is, uh, V2 Max is the maximum rate of oxygen consumption that you're I guess maximum rate of oxygen consumption for your body and so during exercise to exhaustion and we can go we'll go into probably later like, what are
13:52
You 2 max test looks like but you eventually reach a point where your body cannot consume any more oxygen and use that to produce ATP. And so this would be indicated by when you're doing a V2 Max test. There's a line that's going up indicating your oxygen consumption that will eventually Plateau even if you continue to exercise harder, so it's not just a linear increase in O2 consumption it it eventually levels out. Um, and that would be your view to Max because your body, you know, despite you say running faster or cycling at a higher power output. It can't consume any more oxygen. So that's your VO2 max the maximum rate or VO2 Peak VO2 Peak, I guess right and there are a few different indicators whether like, somebody gets their VO2 Peak or their Max, um, their, you know, their important to like distinguish because sometimes if you're if you're reading a paper that will report participants VO2 Peak that essentially just means that they didn't meet the criteria on the VO2 max test for it to be a quote of a true quote unquote Max test. Um,
14:52
so the maximum rate of um, oxygen consumption and
14:58
why it's important is because you know
15:02
A long time for a long time. It was just recognized as like oh Runners and cyclists. They have a high view to Max. So therefore it's important for endurance exercise performance, but
15:13
It reflects now kind of what we're realizing why it might be so important for for like Health and Longevity it reflects your body's integrative ability to produce energy to take up oxygen from the atmosphere. So your lungs to take in oxygen for your heart and your vascular system to distribute oxygenated blood to your skeletal muscle your skeletal muscle to take up the oxygen from that blood and then turn that into ATP so it's not just oh you have a strong heart. So your V2 Max is going to be high. Well, that's 1 component of it. But it reflects again just like this integrative ability for your body to take oxygen and use it and you're not going to have a high vote to Max. If you are unhealthy in your body is not in good metabolic condition and your heart is not in good metabolic condition. You need kind of all of these parameters to be met to have a a very high do2 Max and so that's why it's
16:09
Kind of gaining, uh, notoriety as this important predictor probably 1 of the strongest predictors of of like lifespan and and health span.
16:18
Yeah. I um, I gen I I genuinely think that it is the greatest metric that we have for longevity. I think it outweighs
16:29
To a small extent at outweighs strength, even though strength comes, you know, very near in second. However, if you know arguably if you think about VO2 max and this is the state that I think about it. It's not the score.
16:43
That we're looking for it is the journey that it takes to get there. And if you look at all of the different biomarkers such as you know, we obviously cardiovascular wise we want a low APO B and ldlc okay. Uh, let's just say we have another metric. Let's just say we have a low or where vitamin D deficient, you know, arguably you could take maybe 5,000 even 10,000 IUS, which I don't recommend but let's just say you do you could up your uh vitamin D levels and it could you know drive that up in the matter of a month or 2. However, if I was to come in for a VO2 max test, uh, and then come in again a month later. It's not that you're going to drive up that VO2 max. Like you have to have a big engine in order to get there and that engine involves doing maximal work, which we're going to go over it also involves maybe doing some steady state cardio as well it also, you know metrically if you're going to look at like sleep and
17:43
Energy production. Um, how will your mitochondria functioning so it doesn't just mean you're looking at this 1 score. It really is an overview.
17:52
Of so many different structures in your in your life. That's going to Aid in how well you utilize energy at 80 years old how well you can get up out of bed walk to the bathroom. Maybe pick up your grand kids. Maybe go for a walk. So it represents so much.
18:09
Yeah, and that is why too that I think there's a lot of talk about I think 1 of the more, uh, probably 1 of the most measures in in most measured in most studied metrics probably in the longevity space is grip strength because it correlates so well with with all cause mortality, but
18:28
And I'm not discounting again. Like you said strength is obviously important for reduced improving Health span, particularly. Um, I do think that maybe V2 Max is probably a better indicator because with something like grip strength you could train just your grip strength to like almost game the system. So if I wanted to say improve my grip strength to increase my you know, or reduce my all cause mortality risk, I can just train my grip strength day in and day out with uh, in neglect all the other like muscles in my body. And therefore if my grip strength improves then I should in theory live longer. Um, but you know, what is your grip strength say about your lower body strength? I mean it probably has some correlation because a 70 year old with a high grip strength probably is in decent shape and they probably have good overall strength, but it may not necessarily indicate like that. They're at a lower risk of falling or that they you know have you know that they're in good credit metabolic Health whereas V2 Max and again, you know, my bias is
19:28
Coming out here, whatever but you can't have a high VO2 max. You can't like game the system when it comes to like V2 Max because your body, you know, you're teaching it to use energy and produce it more productively your increasing the ability of your heart, um, you know, the health of your heart and your blood vessel function your endothelial function. So it's like you it's more integrative. I think than a single measure like grip strength or something. So if we had a measure of whole body strength like a composite measure, um, I think that would kind of be something similar to you at 2 max, but
19:58
All the talk about grip strength. I think it's just like a is it necessarily the grip strength that's providing utility or grip strength? Probably just correlating with like, oh those people probably have more muscle mass and you know, maybe engage in exercise more at whatever age. They're they're measuring them. That's just kind of my opinion on that.
20:15
Yeah and look I um, I often go between uh, resistance training and cardiovascular training when it comes to brain health as you know, that's my area and I've just got a I've got a paper coming out really soon on the effects of resistance training on mild cognitive impairment and what we're seeing is that yes, both aerobic and resistance training both are extremely important, but what you know, I argue even in that aspect as a subtopic that cognitively, uh, you know, we want to be looking at strength training, but that's for another episode. So keeping with that theme actually with brain health. I want to talk about blood flow and therefore I want to talk about the arterial system if we
20:58
Increase our VO2 max and we arguably get fitter since it is a measure of our Peak respiratory Fitness. What is this doing in terms of blood flow in terms of artery Health in terms of like even cardiac remodeling. What is this doing to strengthen our cardio metabolic system?
21:17
Yeah, so 1 of the main, uh mechanisms by which endurance training and we'll lump together kind of endurance training here as or maybe aerobic training as high-intensity interval training and lower intensity like steady state training. So we'll call it aerobic exercise training, I guess, um 1 of the primary mechanisms by which increases VO2 max is by Remodeling and the heart. Um, so cardiac output um is the product of heart rate and stroke volume stroke volume is just the amount of blood that your heart can pump each beat and so
21:50
Um increasing view to Max often involves an increase in cardiac output because 1 of the if not the main limitation for most people especially highly trained athletes on VO2 max is the ability to deliver oxygen to skeletal muscle. So it's not the ability to take in oxygen from the atmosphere like with their lungs that's typically fine. The lungs are actually overbuilt for exercise. Um, so we have very well-developed lungs unless you have a pulmonary condition. Um, it typically isn't a limiter for v2 Max but but cardiac output it seems is 1 of the main limiters. And so when we do any type of aerobic exercise training high-intensity interval training low-intensity training our heart remodels, so our left ventricle, um gets larger. So the um the size of the ventricle the inside gets larger and the muscles actually get a little bit stronger as well. Um, and this is known as eccentric hypertrophy. There are kind of 2 types of heart hypertrophy that occur 1 is concentric
22:50
That's not necessarily the type that's typically seen as beneficial and can kind of occur in in conditions like heart failure where the heart walls just get bigger, but the ventricles doesn't actually dilate so it can't hold more blood, um, but eccentric hypertrophy with endurance training that's often 1 of the main adaptations that occurs. So your ventricle gets larger it can pump more blood with each beat and your cardiac output increases. So that's definitely 1 of the main mechanisms. That's why you also see athletes with very low resting heart rates, uh, because at rest at rest, you know, if you're a cardiac output at rest stays the same, you know, I just mentioned cardiac output is the product of heart rate and stroke volume. If you have a larger stroke volume more blood pumped with each beat your heart doesn't need to be as fast. So very low resting heart rate typically indicative of like a higher stroke volume. Um, so regarding the vascular system though, um in response to endurance training a few things happen, so endothelial function so the function of larger
23:50
Arteries, um, those are typically measured like in the arm or the femoral artery. We can also measure that uh carotid artery like blood flow. So 1 of the benefits on on brain health, but overall exercise is just going to improve the ability of Our arteries to dilate when something called shear stress increases shear stress. That's basically just blood flowing through the walls of the arteries it um is sensed by the endothelium, which is the inside of Our arteries. It releases nitric oxide, uh, people may be familiar with nitric oxide and that dilates blood vessels. So when we exercise,
24:23
Our ability to do that our ability of the arteries to dilate increases endothelial function improves. And that's also 1 way that exercise can improve VO2 max because you're improving your ability to deliver then blood to to skeletal muscle. Um, but something also occurs at smaller blood vessels, um called capillaries. So we get capillarization in response to endurance training so capillaries increase in number but also like their connectivity kind of improves, um, and so capillaries are where actually oxygen um exchange occurs so that the small blood vessels that are literally, you know in contact with the skeletal muscle their surface area is is very large and they're very thin so oxygen can diffuse easily from blood into the skeletal muscle. Um, so when we exercise again 1 of the other main mechanisms is improved capitalization, um, and that also allows us to distribute more blood to skeletal muscle to increase VO2 max. So those are mainly
25:23
Kind of the 3 main Pathways by which when we exercise view to Max increases it's going to be a stronger heart more cardiac output. So you can pump more blood to the rest of your body. You can deliver it more efficiently, uh, because your endothelial function improves, then you get increased capillarization. You can deliver more um oxygen to to skeletal muscle you'll get some improvement in like the lungs but again, like I said before it's kind of secondary, um, you know, there are a bunch of these like lung trainers and respiratory muscle trainers out there and those can help but in most people the lungs are
25:57
Pretty overbuilt and doing something like lung training may not necessarily improve your view to Max because if you don't prove improve anything Downstream of your lungs, then you're really not going to be able to you might get more oxygen in every time you breathe. But where's that going to go? You may not actually be able to to use it?
26:13
Yeah and during this entire process you're indirectly having an effect on the brain because we're evidently shunting blood to the brain and we know that the blood is delivering the oxygen and nutrients that the neurons need to survive. But when it comes to heart health and you mentioned left ventricular stiffness and uh, not hypertrophy. Oh was it hypertrophy
26:34
hypertrophy? Yes. Mhm,
26:36
hypertrophy. Yes. That's right. Um, there was a really great study which I'm sure you've come across from Ben lavine's group where he showed that. He actually reversed left ventricular stiffness in 50 year old. I think I think it was 50. Yeah. He took 53 50 year olds and he put them through 4 hours of maximal exercise.
26:57
Per week, which is a lot. I must say however what he found over the course of 2 years was that he reversed the effects of the age related decline that our heart endures and essentially he took the 50 year old Hearts, which then looked like 30 year old Hearts. I thought that that is absolutely that is medication right there that there is medication. So you could argue that exercise is the Elixir to health and vitality and Longevity.
27:29
Yeah, I would totally agree with that and been LaVine his group does so much and you know during graduate school. I mean, I read so much of you know, whether it was like reviews he wrote or studies that came out from his came from his lab because
27:42
In what? You know, there are multiple studies showing kind of like similar, uh to those results that you just presented on the reverse reverse kind of heart aging but I mean, if you take any older Masters athletes, you know, 50 60 year olds who have been exercising like their whole lives and you compare them to just a group of young healthy adults typically their hearts their blood vessels. They look similar to younger adults and their you know way better than age matched. Um adults who don't engage in exercise so it can yes reverse, you know, I I hate the word and you made too like anti-aging. I mean, it's it's an awful word because it's like we're not actually aging backwards we're you know, but it's it's fun to say and I use it all the time anyway, so anti-aging I mean exercise is anti-aging both in that it can reverse some of that stiffness, um in the heart and the blood vessels and the arteries and it can prevent some of that age Associated decline too. So, you know, there are some people who exercise from
28:42
The time that they're 20 into old age, it's not necessarily that they pick up exercise say at an older age. And so if you continue to exercise you can prevent some of that decline as well. So exercise kind of works works in uh in both ways too. Um, but yeah, the the studies that Levine does and that would 1 in particular was was pretty remarkable and I'm sure you know, you're the you're the brain expert here, but I'm sure you see some of the things with the brain in terms of preventing cognitive decline reversing cognitive impairment with age. I mean if the effects are just all over but a lot of it does just it a lot of it comes down to the effects on the blood vessels which which I think is kind of fun. I mean we think of the effects on brain health, but I think most of that is also just due to the fact that you get more brain blood flow. I mean if we don't have blood flow somewhere, we're not able to produce Energy and Metabolism in whatever area we're talking about is is going to decline
29:31
thank you inside tracker for sponsoring this episode of the show. We talk all the time about optimization and you can do a whole bunch of things through diet exercise and
29:42
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30:42
On their results just go to inside tracker.com Louisa. You can get 20% off the entire inside tracker store. Just use code Louisa 20 check out. Yeah, and arguably it is now saying, you know, it's now seen as a vascular disease when you look at Alzheimer's disease because it genuinely really is and it's it's just remarkable to see what happens to the brain as we age even you know, in in in instances such as hypertension, which dramatically just kill off the capillaries. So I wonder if though um, interestingly you mentioned um increase in capillary beds. I wonder if the capillaries are I say capillaries Australian so forgive me, I wonder if they are actually also increasing in the brain when we exercise. Um, and that was actually going to bring my next question which was around angiogenesis if that occurs during um, during steady state and and when you're actually exercising as well. Yeah.
31:41
That was I think
31:42
That it's kind of lumped into the capitalization. I mean angiogenesis just refers to to the growth of new blood vessels. I think there's some debate and um, maybe a little bit rough and not updated on this literature but um angiogenesis, you know, I think the idea of whether we actually grow new blood vessels or whether the connections between existing blood vessels improve. Uh, I think there's a debate on that. I think the latter seems to be more true like they may Sprout the blood vessels. We have may Sprout and kind of connect to 1 another and improve their ability to distribute like blood but um, I'm not sure the idea of like growing new blood vessels is too well established. So angiogenesis may refer to more like a a sprouting of of blood vessels, but I have to get more up to date on the literature on that. I haven't read that in a while.
32:26
It's very comparable to when a lot of people on the internet which it really bugs me when they say oh this, you know, lion's mane improves or helps with neurogenesis. I'm like, no, I don't think it does but it does help with synaptogenesis, which is you know, literally the the connections. I don't think
32:42
And I said if that were true, I think we'd all be going out eating tons of mushrooms to just get bigger brains. It doesn't unfortunately biology doesn't work as simple as that. Um, okay moving on. I want to talk about actually the metrics and the uh, and I've got an uh, I've got a graph that I'm going to pull up and talk about how because 1 of the most notable graphs that I've seen, you know, really benchmarks you in terms of age and gender and it goes into you know, you can do a below average average above our average and then Elite and I always aim to be either in the elite section, which sadly I'm not uh, or just um, I want to try and get below my age group, so,
33:28
I let's talk about the highest recording VO2 max, which is most likely going to be from a cyclist correct
33:37
from a cross-country skier, I believe and I think now though that may need to be updated and I'm mad I did not save this tweet, but someone yesterday, um, the coach of 1 of the top triathletes in the world. I believe tweeted out results of A View to
33:53
Max. Is that Igor?
33:54
Yes, I believe that is who it was. I think he recorded like above 100 on a V2 Max test or something like just yesterday. Yeah, something like that or in the high 90s. So 99998 before that. The highest ever was yeah somewhere around like 90. Um Oscars venson, I think he was a cross-country skier. The reason why it's cross-country skiers, they're obviously incredible endurance athletes, but what seems to be unique about cross-country skiing as opposed to say running or cycling is that it is truly whole body exercise. And so these guys
34:28
Are probably typically a little bit more well muscled maybe than say a runner, um or a try or you know a cyclist or even a triathlete so because you know, when your cross country skiing you're using, you know legs you're going to be massive but also your arms because you have the polls that you're using during cross-country skiing. So that tends to be why they have the sum of the highest recorded values. But yes several several recordings in the 90s, uh for males.
34:53
SE several on the high 70s for females. Um, Joan binoid Samuelson the um Olympic marathon runner, uh from the United States. She recorded 1 of the highest for for women. I think um, but yeah values in the 90s for men are
35:09
Uncommon but there have been a few so some of the highest recorded, uh are going to fall in that area, which is ridiculous. So, what is yours? Do you have have you done yours lately? I have so I 2 years ago. I think I did a view of 2 max tests and I've had probably 2 or 3 done in the past. Um, all of them have fallen somewhere between 75 and 80.
35:30
I think you're probably going to get better and better
35:31
maybe I don't know. I feel like I might be at my at my peak of view to Max and you know, maybe we'll get into this but due to Max's clearly important, but I think if if I'm looking for myself to to improve my performance, I don't think that's going to come from improving view to Max but improving rather my probably running economy or something like my lactate threshold and things like that. Um, because what I don't know the benefit for me of going to from 80 to to like a 85 what what what that might be. Um, it might take too much too much like volume training and I could probably focus on some different things.
36:03
So,
36:05
I've seen um, I've seen some research. I don't know if it was in your book or if it was somewhere else or if you know the exact data just to actually like break it down for everybody just to really understand the real importance of it. Do you know what level you need to have what metrics like what VO2 max you need to have in order to just
36:26
walk around the block or maybe just get up out of bed and just to maintain everyday function. Yeah
36:32
that has been established to be somewhere around 15. And so I guess for context like when we say all these numbers what we're referring to 15 would be 15 milliliters of oxygen per kilogram of body weight per minute. So that's a a relative view to Max and it's typically expressed relative to body weight. We can also Express V2 Max just in absolute terms. So like leaders per minute, but typically if we're looking at rankings and scores it's going to be relative to body weight which which obviously makes sense because if you're a larger person you're going to have a higher view to Max in absolute terms just because you're you're bigger. Um, but so 15 MLS per kg per minute is I kind of refer to it when I'm when people ask as the like like the Frailty threshold, so if your V2 Max is below 15, you have trouble engaging in activities of daily living, um that just require that amount of you know energy and oxygen cons.
37:26
Consumption just to to complete them. Like you said walking around the block or going up a flight of stairs. If you're view to Max is below that you're going to have trouble. Um engaging in in those activities
37:37
Oh, that's really interesting which is why we need to you know, that's just Baseline. Who who would you categorize as having a less than 20 VO2 max then is it somebody at the age of 80?
37:50
I mean, I wouldn't say just because you're 80, you're probably going to have a few to Max that low. I mean it typically will take some sort of like disease state. So someone with heart failure maybe for instance or I mean someone who is incredibly drained or has been you know subjected to bed rest for for a few years. So, I mean, I think there are plenty of 80 year olds out there again who are fully functional and you see them walking around and doing things. I mean, they probably have viewed to Maxes in like the mid 20s. Um, someone below 20, I mean, these are going to be very very sick probably individuals and again having trouble like doing
38:26
Doing things and you're going to get out of breath like walking up a flight of stairs. So, you know your typical again. I don't have all the data on this but you're typically typical like 80 year old 70 80 year old is going to have a few of 2 Max in you know, 25 30, maybe something like that.
38:40
Yeah. Um, I've just pulled up the graph and um, it's the uh, manned Mansa etal 2018 graph and so I'm looking at the metrics here. So for females around around 30 to 39, you're looking at having a VO2 max score of
39:02
39 to 48 and that would be high and above average would be 34 to 38 and
39:13
above 49 would be elite. So I am trying my hardest to get to over 50. What did you say yours was
39:22
between 75 and 80.
39:23
Okay. Um, yeah. Mine's I don't know what age group you're sitting in but yeah, I'm 30. Okay. Well look, you've got a bit a bit of age on me, but that brings me to my next um quote for you and which is
39:37
It's been shown that increasing your VO2 max by just 3.5 MLS per kilogram per minute reduces the risk for all cause mortality by 11% This much of an improvement is attainable in 6 to 8 weeks of focused aerobic exercise training.
39:58
So that's interesting. So
40:00
let's talk about actually before we get into like increasing. I actually want to talk about the actual lab tests that you can get done.
40:10
So what does that actually do? I you know at neuroathlete. We we have these it's not a lab. It's a you know, I've got an exercise physiologist on board Jonah and he does all of the testing it's not in a lab. He's got a portable. I think he's got the portable 1 but it's you know, it's probably the the best portable 1 that we can think of. So, why don't you just break down the actual test and we'll do it from a treadmill perspective as well. Thank you mudwater for sponsoring. This episode mudwater is a coffee alternative which tastes like a cow and chai had a beautiful baby together. It's the solution to your coffee Jitters if you are a coffee drinker,
40:49
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41:42
sure thing. Yeah, so the actual test, um, typically and I would encourage everyone just as like a side note, I mean,
41:49
I mean it's becoming more widely available. I mean if you live anywhere with like a a university that conducts research of some kind and they have like an exercise physiology or a physical education department. I mean, it's there's probably a good chance that they are either running a study or like you can buy a V2 Max test for probably, you know hundred dollars or or something like that. So I would encourage even I think they're about 150 probably a bit cheaper. Now I know here in Austin I can get 1 at University of Texas. I think they charged me like 150, but they'll give you the the full kind of breakdown and we'll sit down with you and talk about and they'll print out your report. So it's very it's very cool. Um, and it's worth it, you know, the the information you get from that is incredible. Um, so what you'll do for for the test, you know, depending on where you go they may use a different protocol but 1 of the more popular protocols again, we'll just use a treadmill as kind of the the reference here, um is known as the Bruce protocol and without naming specific numbers sort of like what the test involves is, you'll do a short warm-up on the treadmill of 6 minutes.
42:49
And during that 6 minutes, um, it'll kind of just be used to do to get a warm-up but then also to establish a speed where your heart rate is about 65 to 70% of your age predicted maximum heart rate. Um, and that'll just be flat on the flat portion of the treadmill and then once that test starts every 2 and a half minutes the treadmill is going to increase the grade of the treadmill is going to increase and the speed is going to increase and so I believe it's about a half a mile per hour. Um, I know you may speak in kilometers, but I'll use mile per hour, uh, half mile per hour, uh 2 and a half percent grade every 2 and a half or 3 minutes. And so you'll just do that until um, you're unable to to continue exercise until you give up till your rating is a 10 out of 10 on the you know, this sucks like score and during that test you're going to be fitted with
43:45
3 gas out. Really?
43:46
Yeah. Literally it will tell you uh till you gas out and you can't go any more.
43:49
Um during that test you will have a heart rate monitor on a chest strap. Um, you may wear an ECG, but probably not unless you're doing like a stress test and they're trying to look for like a heart arrhythmia or or something like that. Um,
44:03
That can get pretty burdensome because you're wearing a ton of stuff and it's like hard to run. So, um, it's not really fun doing that but you'll have a heart rate monitor just so they can measure your heart rate during the test because you want to see what your maximum heart rate is and if it's close to your age predicted maximum heart rate and you'll also be wearing a mask. So some of these masks will go over your entire face kind of like that. Some of them will just be like a snorkel mouthpiece and then you'll be wearing nose Clips. Um, some of the more advanced ones they just go over your nose and mouth so you don't have to worry nose Clips, which is nice. It can be kind of claustrophobic. If you have those nose Clips on um, it's also not very fun. So you'll be wearing a mask and Palio 2x is measured during this test is there's something called indirect calorimetry so that mask allows um, you know, it's measuring air flow and it's able to measure the amount of air that is coming in. So when you breathe in the amount of air that you're exhaling so the volumes of air and then also,
45:02
So just with the known concentrations of carbon, dioxide and oxygen in the inspired air, and then the ability to detect the concentrations of carbon dioxide and oxygen in the expired air. We're able to calculate how much oxygen your body utilized. So obviously the difference between what comes in and what goes out is what your body used up during that test. Um, so again that's called indirect calorimetry, but that's how your VO2 how your oxygen consumption is is measured during that test. Um, the tests typically lasts.
45:36
12 to 20 minutes, it's not very long but it does suck because you're you know, you're going as hard as you can, um in the in the researchers will often push you to your limits. They'll cheer you on at the very end just to try to get that lasts like 30 seconds out because every every 30 seconds or so can uh can make a big difference just if you want to go up like a point or 2 on that on that V2 Max test.
45:54
Now, I have to just understand some confounding variables in there. What if you come in and you're asleep deprived what if you come in and you're like and you haven't eaten or you're dehydrated or maybe you're a bit sick.
46:07
Yeah, I would recommend, you know, don't do it when you're sick. Try to get a full night of sleep. They'll often try to standardize if it's for a research study. They'll do their best to standardize, you know, make sure you abstain from caffeine for 3 hours don't exercise the day before don't drink alcohol the night before we were doing a v2x test once when I was in grad school and the participant came in and they were sitting down and we were doing like the the intake form before they actually do some of like the research protocols and and they were saying oh, well, you know, I had a couple shots.
46:36
Of tequila last night and we were like well, okay, you should you should probably go home today because you didn't follow the protocol that's gonna reduce your V2 Max. Um, so yeah, I mean if it's your first test ever and your sleep-deprived, you know, you don't have anything to compare it to but it's probably going to be lower than it than it otherwise might be um, because you it may not you know, physically reduce your body's ability to produce energy or get a high VO2 max, but your your motivation and your willingness to push yourself to your max is going to be lower probably and the way that that's going to be like indicated again. We we discussed earlier Louisa the peak versus max. So when you're doing that test we're measuring a few other things. So we're measuring your heart rate. Um, and we're also measuring something called respiratory exchange ratio, um, which is indicative of fuel utilization. It's a ratio of uh, CO2 production to 02 consumption and then um also measuring your rpe your rating of perceived exertion how hard
47:36
Hard do you think this is and so at the end of the test?
47:40
3 out of 4 of those criteria, uh need to be met, uh, including the plateau in V2. So you want to see a plateau in oxygen consumption you want them to have an rpe above 18 out of 20 on a borg rpe scale you want their heart rate to be within I believe 10 beats per minute of their age predicted maximum heart rate. And then uh, there are their respiratory exchange ratio is supposed to be above 1.1 which is typically indicative of your utilizing go you're totally like Anor um at that point. So if I believe it's you know, if you meet 3 of those criteria, you can consider it a maximal test. If 3 of those aren't met or only a few of those are met it's a peak and so if your sleep deprived if you um are sick, you probably won't meet those criteria. So in other words, you just won't be able to get to your your V2 Max
48:35
and I wonder also what it would do if you were um,
48:40
Older maybe, you know, let's just take a 70 year old who maybe not able to run let's say then they would just you just bump up the incline and just get them to walk really fast. It doesn't really matter that you're not running per se just means that we just have to get you to your page.
48:56
Yeah, most of the time I mean, I've you know performed many of these tests not actually done them myself, but like ran the test with someone else performing it and more often than not the people aren't walking granted. Most of our research studies were in maybe older adults, but because the grade gets so steep. Yeah most of the time
49:14
These people aren't going to be running. Even when I did a VO2 max test. I was running pretty slowly but the treadmill was at like a 12% grade. So I mean you're I mean you're working. Um, so yeah, if you can't run no big deal, I mean you'll you'll walk at probably a fast speed maybe something like 3 to 4 miles per hour and then as that gets deeper your your heart rate will increase rapidly.
49:34
Yeah, I I keep thinking like, how am I going to get my dad in there to measure it? That's all I think my that's all I think about. Okay before we actually move on to protocols. I actually want to talk about building your base. So we know that obviously, um, VO2 max we have to get to our in terms of training without, you know touching on it. We know that we have to get somewhere to our maximum heart rate in order to train it. We need to stress the system for it to adapt as basic biology. But what about the actual engine and I'm talking about endurance work and of course, I'm going to bring in zone 2 which right now is also, uh, I think we're going through another phase of Zone 2.
50:14
And lactate so let's just talk about that for a moment.
50:19
Yeah, sure. So Zone 2 training again if you kind of do research you'll see a lot of maybe
50:25
Definitions of Zone 2 training thrown out. Um, I think the kind of consensus is going to be like Zone 2 training is an exercise intensity. So maybe that's running speed or um cycling power output that elicits the maximal fat oxidation. Um, so it's a very lowish intensity. It's 1 that you could continue doing for a long amount of time. Um, it's an intensity that you could talk at, you know, there are many definitions because um, or it's a definition, I guess the intensity where your lactate levels aren't increasing. So you're kind of at like a a steady state of of lactate production and you're able to clear that lactate as most people don't have access to a lactate analyzer to use during all of their exercise tests. Um, typically things like the talk test or um,
51:17
Are utilized instead because it's like oh, can you hold a conversation at this? Okay, you're you're probably at Zone 2. Um
51:24
And unless really, you know, maybe this is controversial but I think unless you actually have like a access to a continuous lactate analyzer which are not really available or are testing yourself every single day.
51:36
Kind of using lactate to prescribe your Zone to exercise is sort of useless. For instance. If you go into a lab and you get a lactate threshold test done and then use that to prescribe your exercise training.
51:47
I'm not necessarily sure that that is totally useful because your levels of lactate are going to change uh on a day-to-day on a day-to-day basis based on stress based on sleep based on what you've eaten or whether you're fasted. So, um, I think using kind of these other subjective maybe metrics are just using heart rate again, or going to be a little bit better. So if you're looking at heart rate with Zone 2, it's going to be like 60 to 65% um of maximum heart rate between 60 to 70 percent something like that. Um,
52:15
But yeah, the the importance of it is again, like you said it's foundational its foundational work, you know, it improves our lactate clearance capacity. It improves our mitochondrial Health. It improves cardiorespiratory Fitness and cardiovascular health as well. Um, and so but again, I think it's it's good to think about it as being the foundation if you think of like Fitness like a maybe Fitness or you're training like a pyramid, um, you want that most of it a lot of your training to be that zone 2 training which is kind of the the base or the foundation of that pyramid and you know athletes have been doing it forever and it's obviously clearly important and important for metabolic Health as well. Even if you're not kind of a high level high performance athlete
52:55
it's um, it reminds me my coach, you know, we uh 6 a.m. Just swimming the black line every Monday and I was arguing I never missed a session. Um, I was you know, I was training for quite a number of years a decade actually and he used to always say to me Louise a slow down slow down and then he said bad swimmers.
53:15
Can't swim slow. He used to always say that to me and I used to think what are you talking about? Even when I was running we used to run and back then I had a metronome in my I used to wear a headband and he put this little yellow metronome near my near my ear and he would set it. So I would be like going so slow and I used to think I can like like I can write an essay while I run because I'm running so slow and never understood it until race time came and until the summer came in Australia and that's when we would be doing our brick sessions and our VO2 max sessions will hardly touching the Zone too, but I realized how fit I got from the slow, you know, I was running at 1. I mean I'm going to say kilometers even though I've lived in the United States for quite some time. I was running like, you know, my Sunday sessions were and my I was doing Olympic distance. So the 10 kilometer on my Sunday sessions were like 30 kilometers. I remember just breezing through them down on the water where I used to live just breezing through like listening to whatever I listened to back then now if I was to run 30 kilometers,
54:14
That's around 20 miles. I think I would be like I can't I don't think I can justify it. So there is something to be said around Zone 2 building the building the base and I do believe that it does improve the efficiency of mitochondria, right and improves efficiency and and biogenesis.
54:32
Yeah, definitely and I guess 1 of the things that I think about and maybe to ask you do you think that you know when you saw those?
54:40
Fitness improvements from the low intensity training I think it has independent effects. But do you think that some of it is maybe due to the fact that doing low intensity training on the easy days allows you to perform a little bit harder on the hard days. Uh, or do you think maybe it's a it's a contribution to both because that's kind of how I often think about it is like yes low intensity training is beneficial but you know, what's actually you know, that's contributing to my Baseline Fitness, of course, but if what's contributing to my actual race performance my ability to run faster is clearly those higher intensity workouts, which you're not going to be able to do if you're just doing every day sort of like in this weird Gray Zone of training. So you need to go easy on your easy days that enables you to go harder on your hard days not discounting the benefits that are independent to Zone like Zone 2. But
55:27
yeah, no I completely agree which is why it was so strict and regimented back then. Um, I know my my coach defined my entire day 7 days a week for an entire decade and I think he did that for raising, you know, I
55:40
Even had at 1 Point. Um, he used to put in my program, uh feet on the wall for like 20 minutes per day and that would just like I would have my feet on the wall with my with my other teammates and we'd be just doing it for you know an hour a day. It was so weird. So everything was regimented. I think specifically for that but I have to tell you it's the same for altitude training, you know, we would do altitude camps for 2 weeks and that was just, you know once out of the year and when I would come back to Australia, I was just flooring it. I would feel such an immense benefit from doing altitude training. So it's it's the same thing. That's why Brick and periodization is really important. Yeah,
56:23
absolutely, but regarding your um, comment about like the the mitochondrial efficiency. Yeah, I mean it doing that is obviously going to because again if you're training at the point where your mitochondria are sort of
56:34
Maximally, you know at their Max whether you know contributing to to Fat oxidation, you're going to improve their ability to to produce energy. So that is clearly an important training Zone to train in
56:46
obviously, we're going to wrap it up with protocols and you've put protocols, um in your book which outlines, you know, the best protocols to take as per the literature and you nailed it down to the
57:34
On 15 off so kind of like Sprint interval training. Um, some people might think of that as like Tabata training Tabata is technically 20 on 20 off. So, you know, you have a different set of like 5 seconds, but be shorter Sprints and then the Norwegian
58:34
Are probably ideal for for increasing V2 Max? Um
58:39
Around again. There's going to be around like probably 85 to to 95% of your maximum heart rate, which is hard. Um, but it's doable, you know, we've
58:49
uh, sorry to cut off. I think it's important to mention that it's not the time. It's not the 4 minutes because it's going to take you around a minute to get to the 85% of maximum heart rate. So let's just say it does let's just say we we we we start um, and we get there within 90 seconds. So are we taking that into consideration? So what about let's just stick to like how long do we have to spend with our heart rate at 85% of Max
59:18
know that's a good point that you bring that up. So what essentially you're going to do for that protocol is
59:26
first depending on the modality that you're using to perform that so are you going to be on a bicycle or are you going to be running find the
59:33
pace or the power output that will elicit 90, you know between 85 to 95% So we'll say 95% for the sake of this 95% of your age predicted maximal heart rate and then perform those 4 by 4 intervals at that pace or at that power output. So to answer your question, you're doing 4 minutes, you're not spending. You're not spending 4 minutes at 95% of your maximum heart rate because like you said it may take you a minute during each interval to get there. So you're not starting the timer When You Reach 95% you're going to start the timer and then just do 4 minutes, but you're going based on uh, you know a pace or intensity, but that should elicit that intensity of your heart rate. Does that does that make sense?
1:00:17
Yeah, it does. Um, I use the stepper a lot lately at the gym. Um, I reached I mean if I reached this morning, I got to like 18, which I thought okay, ah, I couldn't keep up but I was like my I just reached my Peak and it was
1:00:33
Like I call them spew sesh. This is what we used to call them in our in training days. Um, we have a spew session coming up and that's what I called it this morning and it was just reminding me back then of my Triathlon days. Um, and that was you know, it is difficult. But the the great thing to know about that and I want everyone else to know is you don't have to perform this every day. You can literally get by with was it 16 minutes per week that can increase it so that would be doing
1:01:03
4
1:01:04
by 4 4 times once a week.
1:01:06
Yeah, and there are also kind of other studies showing. There's kind of been this I think researchers are like always in.
1:01:15
A competition to find like what's the least amount of exercise that can improve your view to Max? So there's this increase lately in the Sprint interval training where they're doing like
1:01:26
15 Sprints of like
1:01:28
10 seconds each and just doing that once a week and showing improvements in V2 Max. So I mean if you do enough work and you keep it high intensity enough, yeah, I mean you can increase your your view to Max and doing that. Um, some of those studies on the 4X 4, uh, you know, you could improve your max in 1 week, but I think some of the studies using that protocol will actually have the participants maybe do make 2 or 3 of those sessions, uh per week. I know some of the studies that we conducted in the lab, you know people were coming in 3 times per week to to do that. Which again is hard. I mean, it's not a super long protocol, you know, it doesn't last more than you know, like say 45 minutes. So you're doing a total of Less Than 3 hours of actual exercise per week, but it's all fairly high intensity. You're getting those recovery periods. But yeah, I mean doing it once a week is is good. Um doing that 3 times a week whether that's sustainable I think is is obviously a questionable. So adding a 4 by 4 to your weekly, you know, uh conglomeration of Zone 2 training and lower.
1:02:28
Intensity training is definitely something that I think would be beneficial. And again, like you said, it only takes a total of 16 minutes at that at that heart rate, which isn't that is that not that long it feels long while you're doing it. Um, but in reality, it's it's not it's kind of a small snapshot of your total weekly duration
1:02:44
and just 1 last question if folks don't have a um, you know, they haven't done their VO2 max test yet. Um, and they don't know their maximal heart rate. Would you do the just a roughly just 220 minus your
1:02:58
age 220 - 8 there's a lot of variability in what someone's max heart rate will be but it's it's close enough. I mean again, I I really wouldn't recommend it because it can be kind of far off for some people. But yeah, if if you don't know what your max heart rate is take 220 subtract your age and that can give you probably a decent estimate of of what your max heart rate is um, or at least kind of a broad General range the best way would obviously be to to find out that heart rate during a during a V2 Max test, but not everyone is is able to do that. Well,
1:03:28
Oh Brady, this has been incredible. I've loved every minute of it. I definitely see us doing a part 2 in the future. Um, you hang out a lot on Twitter. I don't think you hang out as much on Instagram. So I'll link Twitter and I'm going to link your book. I think everyone needs to get it such an easy read. I've been reading it on my Kindle which is my new favorite thing. And is there anything else that you wanted to add there?
1:03:52
Um, if people want to read um, what I write about most of that is going to be on substack, uh, physiologically speaking.com. Yeah linking it would help because it's I think like the worst uh hardest to spell domain name ever. But um, yeah check out the book find me on Twitter say Hey, or I guess it's X now or find me on X and and then the substack that's really kind of where you can find me and yeah, you know Louisa, this was fun. Uh, I again, I think we could have like 5 more of these on just other topics. I mean, we you know V2 Max for an hour and a half is great and there's so many other topics. I think that we we both have like a mutual interested in but uh, yeah, this was
1:04:28
Awesome, and I guess 1 more thing maybe before we leave. I wanted to mention if people want to try to estimate their view to Max and don't have access to a test. You can do something called the cooper 12-minute run. I provide that in my book as well. Um, so you can do this stuff on your own without equipment which is which is kind of fun. Um, but again, that's my book. So maybe a plug for people to to check that out to find that protocol.
1:04:51
We'll link all of that. Thank you Brady for being part of the Euro Experience Podcast. Yeah.
1:04:55
Thanks a lot Louisa.
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