Optimal Exercise

Fol­lowup to: Lifestyle in­ter­ven­tions to in­crease longevity.

What does it mean for ex­er­cise to be op­ti­mal?

  • Op­ti­mal for looks

  • Op­ti­mal for time

  • Op­ti­mal for effort

  • Op­ti­mal for performance

  • Op­ti­mal for longevity

There may be even more crite­ria.

We’re all likely go­ing for a mix of out­comes, and op­ti­mal ex­er­cise is go­ing to change de­pend­ing on your weight­ing of differ­ent fac­tors. So I’m go­ing to dis­cuss some­thing close to a min­i­mum vi­able rou­tine based on meta-analy­ses of ex­er­cise stud­ies.

Not know­ing which sort of ex­er­cise yields the best re­sults gives our brains an ex­cuse to stop think­ing about it. The in­tent of this post is to go over the dose re­sponses to var­i­ous types of ex­er­cise. We’re go­ing to break through vague no­tions like “ex­er­cise is good” and “I should prob­a­bly ex­er­cise more” with a con­crete plan where you un­der­stand the rele­vant pa­ram­e­ters that will cause dra­matic im­prove­ments.

How much ex­er­cise?

Op­ti­mal­ity aside, I recom­mend start­ing with a very min­i­mal rou­tine for 6-ish weeks to build the habit of ex­er­cise in to your life. You’ll want a pro­gram that causes you lit­tle men­tal stress that you can ac­tu­ally stick with. You’ve got a few op­tions for achiev­ing this. The gains from weightlift­ing can be sur­pris­ingly quick—you’ll see dra­matic changes in your ap­pear­ance in 4 months—and see­ing your­self lift more weight ev­ery ses­sion can be a great mo­ti­va­tor. Couch to 5k is a ba­sic run­ning pro­gres­sion de­signed for seden­tary peo­ple. A daily body­weight rou­tine is a good way to achieve habit for­ma­tion through con­sis­tency. I recom­mend mak­ing a firm choice and stick­ing with it un­til it be­comes easy.

Once you’ve made ex­er­cise a habit, you’ll want to grad­u­ally nudge your­self to­wards the level that’s op­ti­mal. So what is that level? Most of the rest of the claims in this post are sup­ported by this re­view by Swiss re­searchers. As far as I know, this is the largest sys­tem­atic re­view of ex­er­cise stud­ies ever un­der­taken, re­view­ing 7000 stud­ies with 80 meet­ing in­clu­sion crite­ria cov­er­ing over 1.3 mil­lion sub­jects. Sheer size, how­ever, is not the only rea­son to take this study very se­ri­ously. As some­one who has read hun­dreds of ex­er­cise stud­ies, I can say that the method­ol­ogy of the meta-anal­y­sis done to de­ter­mine dose-re­sponse to ex­er­cise is ex­cel­lent. What is most en­courag­ing is that the study au­thors re­peat­edly point out short­com­ings, and ways their find­ings should not be in­ter­preted be­cause the un­der­ly­ing data does not war­rant it. They also check for pub­li­ca­tion bias. One po­ten­tial caveat is that this a re­view of co­hort stud­ies, not RCTs. But the au­thors note that RCTs of ex­er­cise al­most always show greater effect sizes, not smaller. This is likely be­cause peo­ple over-re­port how much ex­er­cise they do in ob­ser­va­tional stud­ies.

In or­der to com­pare the in­ten­sity of differ­ent ac­tivi­ties, ex­er­cise re­searchers use a unit called a MET, or metabolic equiv­a­lent. The MET is defined so that your weight (in kg) * METs = Calories you’re burn­ing per hour. An ex­am­ple MET table can be found here. For the pur­poses of ex­er­cise stud­ies, ac­tivi­ties are typ­i­cally clas­sified as low-in­ten­sity, mod­er­ate-in­ten­sity, and vi­gor­ous-in­ten­sity. Th­ese roughly cor­re­spond to 1-3, 4-6, and 7+ METs per hour. For typ­i­cal in­di­vi­d­u­als, this will trans­late to ap­prox­i­mately 200, 400, and 600+ Calories burned per hour.

On the low end, some stud­ies have found dra­matic benefits from just the first 15 min­utes of mod­er­ate-in­ten­sity ex­er­cise per week. Th­ese stud­ies in­di­cate that you gain about as much go­ing from no ex­er­cise to some ex­er­cise as you do go­ing from some ex­er­cise to op­ti­mal ex­er­cise.

The Swiss re­view finds that the first hour per week of vi­gor­ous-in­ten­sity ac­tivity gets you 2/​3rds the benefit of 10 hours per week, but the study au­thors make sure to point out that this is an im­plau­si­ble effect size and that there are al­most cer­tainly some con­found­ing and re­verse causal­ity is­sues go­ing on. Which is to say that peo­ple who have bet­ter health are sim­ply go­ing to be ca­pa­ble of more ex­er­cise.

How about on the high end? Stud­ies differ on where the point of diminish­ing re­turns is. Some put it at 1000-1500 Calories; oth­ers as high as 3500 Calories. (Re­mem­ber, a typ­i­cal in­di­vi­d­ual burns ~400 Calories per hour of mod­er­ate-in­ten­sity ex­er­cise.) I’ll shoot for 1500 Calories in my recom­men­da­tions; 3500 Calories is pretty hard to reach with­out ex­er­cis­ing like a pro ath­lete.

Es­ti­mates in­di­cate that each minute of ex­er­cise gets you 3-7 min­utes of ex­tra life on av­er­age, with higher re­turns for more in­tense ex­er­cise. So ev­ery week, you have the op­por­tu­nity to get a 3-7x ROI on time spent ex­er­cis­ing up to the point of diminish­ing re­turns. I recom­mend high-in­ten­sity ex­er­cise—not only does it save time, it’s also been shown to im­prove health more on a per-Calorie ba­sis.

Which ex­er­cises?

Weight train­ing programs

You may have shied away from weight train­ing in the past be­cause you thought you would turn into some huge gross body­builder. But body­builders and fit­ness mod­els take drugs and spend years train­ing in­ten­sively to look the way they do. You are not go­ing to gain 20lbs of mus­cle overnight mag­i­cally. This goes dou­ble if you’re a woman. You do not have testos­terone; you are not go­ing to be build­ing huge mus­cles no mat­ter what you do.

Of the forms of ex­er­cise I cover, weight train­ing has the most rigor­ous ev­i­dence sep­a­rat­ing what works and what doesn’t. This study (pdf warn­ing) ex­am­ines what sort of re­sis­tance train­ing re­sults in the most rapid im­prove­ments.

In weight train­ing lingo, AxB means A sets of B rep­e­ti­tions. So 4x10 would mean 40 reps with rest pe­ri­ods ev­ery 10 reps. Our study recom­mends start­ing with 4x10 3 times a week, and tran­si­tion­ing to 4x4 2 times a week as you be­come stronger. Aim for a weight you can barely com­plete all the reps with.

For an effi­cient full-body work­out, se­lect one ex­er­cise from each move­ment pat­tern:

Up­per push: bench press, in­cline press, over­head press, dips.

Up­per pull: ca­ble rows, bar­bell rows, dumb­bell rows, chin-ups, face pulls.

Lower push: squats, lunges, leg press.

Lower pull: dead­lifts, power cleans, hy­per­ex­ten­sions, ro­ma­nian dead­lifts, re­verse hy­per­ex­ten­sions, glute-ham raises.

So a good start­ing rou­tine would be

A: 4x10 each of squat, bench press, lat pul­l­down, hyperextension

B: 4x10 each of squat, over­head press, ca­ble row, hyperextension

al­ter­nat­ing A and B work­outs on differ­ent days of the week e.g. AxBxAxx, BxAxBxx.

You’ll try to in­crease the weight by 5lbs each ses­sion. As you im­prove, you want to de­crease the reps and in­crease the in­ten­sity so you can keep ad­vanc­ing. For ex­am­ple, if you stall a cou­ple times do­ing 4x10 at 125lbs on your squat, switch to 4x8 and keep in­creas­ing the weight, then 4x6, etc. un­til you get to some­thing close to an op­ti­mal trained rou­tine:

A: 4x4 each of squats, bench, weighted chins, deadlifts

B: 4x4 each of squats, over­head press, bar­bell row, power cleans

At this point, you’re go­ing to the gym only twice per week to give your­self more re­cov­ery time.

For learn­ing ex­er­cises, there are many tu­to­ri­als available on­line and I recom­mend check­ing some out if you are con­fused about form. You can always search for “<name of ex­er­cise> tu­to­rial” and get ar­ti­cles and Youtube videos. Many peo­ple feel silly prac­tic­ing their form with ex­tremely light weights (of­ten just the empty bar). But many world record hold­ers start EVERY ses­sion this way to warm up and ce­ment mus­cle mem­ory. Others are silly NOT to do this. Also keep an eye on your ego. It’s easy when set­ting goals for your­self to try to lift a weight that you can’t re­ally lift with proper form, be­cause you want to set that per­sonal best. But you’ll feel pretty stupid when you are forced to miss the gym for a month be­cause you hurt your­self.

On ex­er­cise se­lec­tion: I’m not a big fan of dead­lifts for ab­solute new­bies, un­like say Mark Rip­petoe in Start­ing Strength. Maybe add dead­lifts in af­ter you’ve gained some mus­cle and you have bet­ter aware­ness of form. I also differ from Rip­petoe in recom­mend­ing that new­bies high bar squat (the dis­tinc­tion be­ing that low bar squats place the bar across the shoulders and high bar squats place the bar on the trapez­ius). I have taught new­bies both forms and most find high bar squat­ting eas­ier to figure out how to do prop­erly. I spent months learn­ing to low bar squat and still in­jured my­self; high bar squat­ting can be taught in a cou­ple ses­sions in my ex­pe­rience. Pay at­ten­tion to whether a tu­to­rial video is try­ing to teach you low bar squat­ting; the cues for each ex­er­cise are differ­ent.

Free weights are gen­er­ally bet­ter than ma­chine ex­er­cises, but I recom­mend ca­ble rows and lat pul­l­downs to new­bies. The goal is to move from ca­ble rows to bar­bell rows, and from lat pul­l­downs to ac­tual chin-ups. The is­sue here is that a be­gin­ner won’t be able to do the req­ui­site sets and reps of chin-ups and rows with good form.

A note about equip­ment: Weightlift­ing shoes have an in­cred­ibly high re­turn on in­vest­ment. They make back in­juries less likely, and dras­ti­cally im­prove sub­jec­tive ex­pe­rience of squat­ting. You can get Rogue weightlift­ing shoes (use your size in men’s dress shoes to size them re­gard­less of gen­der) for around $120; there are cheaper op­tions available but good shoes will last years so the amor­tized cost is low. Here’s a full list of op­tions; note that even the cheap­est weightlift­ing shoes are miles bet­ter than lift­ing in ten­nis shoes. I don’t have any per­sonal ex­pe­rience with the Ree­bok CrossFit lifter, but they seem like a good op­tion un­der $100 for a shoe with the de­sired .75-inch rigid heel. I recom­mend a cheap belt (ex­pen­sive ones aren’t any bet­ter) in or­der to im­prove your ex­e­cu­tion of the valsalva ma­neu­ver dur­ing squats and dead­lifts which fur­ther pro­tects the spine from flex­ion un­der load.

Body­weight routines

For a be­gin­ner, some­thing like this is rea­son­able. Of course such a pro­gram will max out in fit­ness gains fairly quickly, even if you start do­ing sev­eral cy­cles of it. But this isn’t our worry as a be­gin­ner. For some­one se­ri­ous about pro­gress­ing with body weight ex­er­cises past this stage, I recom­mend a pro­gram like Over­com­ing Grav­ity or Build­ing the Gym­nas­tic Body. There is not re­ally for­mal sup­port for the effi­cacy of these pro­grams, but they are en­dorsed by coaches who train many peo­ple suc­cess­fully, and are con­sis­tent with the gen­eral prin­ci­ples of weight lift­ing (pro­gres­sive over­load, train­ing fre­quency, etc.).

Car­dio routines

For car­dio, I recom­mend against high-in­ten­sity in­ter­vals when start­ing out. High-in­ten­sity in­ter­vals carry a greater risk of in­jury, es­pe­cially if you’re not used to them. They’re also un­pleas­ant and not con­ducive to build­ing habits. For start­ing out, I recom­mend some­thing that is based more on psy­cholog­i­cal re­sults rather than perfor­mance op­ti­mal­ity, like Couch to 5k. As you progress, start adding in short bursts of more in­tense effort. The idea is to tire your­self out quickly. If your car­dio rou­tine lasts more than 30 min­utes you’re prob­a­bly go­ing too easy.

What type of car­dio should you do? Car­dio that is amenable to high in­ten­sity is prob­a­bly one of: run­ning (es­pe­cially up hills), swim­ming, row­ing, bik­ing, burpees, or jump rope. But you might be able to adapt oth­ers. I’m a huge fan of row­ing for a few rea­sons. One, it works more than just the legs. Two, you can have a row­ing ma­chine in your house, which dras­ti­cally low­ers ac­ti­va­tion cost. Three, I just find it less aver­sive sub­jec­tively. You can keep sta­tion­ary bi­cy­cle mounts in your house as well, and they have the ad­van­tages of be­ing com­pact and very cheap if you already own a bike. Burpees re­quire no equip­ment, but they both­ered my knees. They work great for some peo­ple though. Jump­ing rope is also very space/​time effi­cient but the skill re­quired acts as some­thing of a bar­rier. If you find learn­ing the skill en­joy­able, it’s a great op­tion. It is worth not­ing that run­ners, bik­ers, and row­ers have among the best VO2 max scores of any ath­letes.

What does the op­ti­mal high-in­ten­sity car­dio rou­tine look like? Data on this comes from this Meta-anal­y­sis of VO2 max train­abil­ity. VO2 max has been shown to be a ro­bust pre­dic­tor of mor­tal­ity. This re­la­tion has held across elite ath­letes, to av­er­age in­di­vi­d­u­als, to the over­weight (see Figure 2 from this meta-anal­y­sis of vo2 max train­abil­ity). Un­for­tu­nately, it ap­pears that the pro­to­cols elic­it­ing the great­est in­creases in VO2 max are so ar­du­ous as to have high at­tri­tion rates. 6 days/​week is not a sched­ule of train­ing I ex­pect any­one but pro­fes­sional ath­letes to main­tain. What sort of re­al­is­tic rou­tine can still achieve most of these gains? The meta-anal­y­sis sup­ports a mix­ture of 3-5 minute in­ter­vals, and longer du­ra­tion but still in­tense in­ter­vals (30-40 min­utes of con­tin­u­ous train­ing). The au­thors also note that they did not in­clude anal­y­sis of the ev­i­dence that very high in­ten­sity ex­er­cise (1 minute or less of max effort) shows unique health benefits. We could sim­ply con­clude that a mix­ture of in­ter­val times is good, and that ev­ery in­cre­ment of car­dio up to very high lev­els is likely good for us, but that doesn’t feel very mo­ti­vat­ing. What we want is a clear goal. I’m go­ing to com­bine data from the VO2 max study and the Swiss re­view to get a rough es­ti­mate. If we want to do re­sis­tance train­ing twice per week and car­dio at least twice per week can we re­al­is­ti­cally burn the 1500 calories we want? Let’s see. In­ter­val train­ing ses­sions can vary widely in num­ber of calories burned, but a sprint­ing ses­sion, a 4x4 pro­to­col (one of the more pop­u­lar pro­to­cols in the VO2 max meta anal­y­sis, con­sist­ing of four 4-minute in­ter­vals), and a 30 minute run can burn be­tween 200-450 calories as a first ap­prox­i­ma­tion. Twice weekly and we have 400-900 calories. This leaves 600-1100 calories for 2 weightlift­ing ses­sions. Es­ti­mates for calories burned weightlift­ing vary ex­tremely widely, most likely due to the huge num­ber of ex­er­cises con­sid­ered “weightlift­ing”, but even the lower es­ti­mates put it over 300 calories per hour. This puts 2-4 hours of weightlift­ing per week at 600-1200 calories ex­pended. How con­ve­nient!

All that re­mains is to sug­gest spe­cific car­dio rou­tines. I don’t have the ev­i­dence to say with any con­fi­dence what a truly op­ti­mal rou­tine would look like here, but I can at least give well stud­ied ex­am­ples of each.

Very high in­ten­sity rou­tines fol­low a pat­tern of a short warmup (5 min­utes at a slow pace) fol­lowed by sev­eral bursts of 10-60 sec­onds all out in­ten­sity. (30 on 30 off for 10 in­ter­vals is pop­u­lar and close to max­i­miz­ing vV02max)

VO2 max in­ter­val train­ing con­sists of four 3-5 minute in­ter­vals at 85%-95% your max heart rate in­ter­spersed with slower jog­ging for the same in­ter­val.

Longer in­ter­val train­ing con­sists of 20-40 minute runs at a con­sis­tent pace such that you are ex­hausted by the end.

I wouldn’t worry about the op­ti­mal fre­quency for each one. Don’t for­get that even train­ing pop­u­la­tions just con­sis­tently do­ing one type shows very dra­matic im­prove­ments in health. I’d sug­gest freely mix­ing them up and try­ing to have fun with it.

Sum­mary of my recom­mended routine

This is what I recom­mend grad­u­ally work­ing to­wards once you’ve made ex­er­cise a habit:

  • ~1-2 hour weightlift­ing ses­sions 2-3x a week. (A third weightlift­ing ses­sion is recom­mended for the first sev­eral months, for both gain­ing strength and build­ing habits.)

  • ~15-40 min­utes of vi­gor­ous car­dio 2-3x a week.

Don’t do vi­gor­ous car­dio on the same day as lift­ing weights! It’s a good way to in­jure your­self, es­pe­cially your lower back. Ex­er­cise doesn’t make you stronger; it makes you weaker. It’s the re­cov­ery from ex­er­cise that makes you stronger; give your body time to re­cover.

Nutrition

Don’t try to im­ple­ment a new diet and a new ex­er­cise plan at the same time. If you’re try­ing to choose, do an ex­er­cise plan first—effects on health are much larger.

If you are un­der­weight or nor­mal weight, you’ll need to eat more when you start ex­er­cis­ing. Cel­e­brate af­ter your work­outs by eat­ing to re­in­force the ex­er­cise habit. You may think eat­ing pizza is bad for you, but not ex­er­cis­ing is worse, so re­ward your­self how­ever you want. Or drink my nu­tri­ent dense shake, de­signed to be con­sumed af­ter work­outs. (John_Maxwell_IV and I are plan­ning to com­mer­cial­ize it af­ter we roll out our first nu­tri­tion­ally com­plete food.)

If you’re over­weight: I agree with Gary Taubes that ex­er­cise is NOT a good way to lose weight. But ex­er­cise has big­ger effects on health than weight loss, so I ac­tu­ally recom­mend pri­ori­tiz­ing ex­er­cise over chang­ing your diet. (Like I said, don’t try to do both at once.)

Note that you don’t need to stuff your­self with mas­sive amounts of pro­tein to build mus­cle. Stud­ies have never shown a mea­sured benefit to con­sump­tion above .64g/​lb of body­weight, which trans­lates to around 100g for a 150-160lb per­son. A sin­gle serv­ing (3oz) of chicken, for ex­am­ple, con­tains about 21g of pro­tein.


If you’ve made it this far, con­grat­u­la­tions; you are now as knowl­edge­able as any per­sonal trainer I’ve spo­ken with.