Nailing the Sweet Spots for Exercise Volume - Interview with Dr. James O'Keefe

In the video above, I interview Dr. James O'Keefe, a cardiologist with the Mid-America Heart Institute at St. Louis Hospital in Kansas City, about exercise dosing. He completed his cardiology training at Mayo Clinic.

If you’re sedentary and begin to exercise, you get a dose-dependent decrease in mortality, diabetes, depression, high blood pressure, coronary disease, osteoporosis, sarcopenia, falls and more.

People who are doing the highest volume of vigorous exercise start losing longevity benefits. If you’re doing full distance triathlons when you're in your 40s and 50s, your risk of atrial fibrillation increases by 500% to 800%.

In the case of moderate exercise — loosely defined as exercising to the point where you're slightly winded but can still carry on a conversation — there’s clear evidence that more IS better and cannot be overdone.

Every 1,000 steps you get on average per day reduces your mortality by 10% to 15%. Benefits plateau around 12,000 steps (6 miles) a day.

Strength training adds another 19% reduction in all-cause mortality on top of the 45% reduction that you get from one hour of moderate exercise per day. However, benefits cease once you go beyond one hour per week. The sweet spot is 20 to 40 minutes of strength training, two to three times a week. Above 60 minutes per week, the benefits of strength training are nullified, and you’re worse off than if you did no resistance training at all.

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