[00:01] calcification and how problematic it is. But a series of studies have found that your physical fitness and your degree of fitness, how physically fit you are, is as much or more important than how calcified your coronary arteries are.
[00:16] different studies. And it's not just me talking about this. This is the Journal of Atherosclerosis published in 2014. And since this article was published, there's been a dossier of literature finding that guess what? Fitness like
[00:30] having a high V2 max can offset or effects that are known to be correlated with coronary artery calcification. So this is really important. I know a lot of people have high LDL cholesterol,
[00:43] freaked out. They are told they have to go on a statin or they're going to drop fit people. or they go out and they do high rocks training or CrossFit training or they run or they hike or do all these things and they're like, "Look, I'm I my
[00:56] my blood pressure is really low. Every other biomarker is totally normal, but is freaking out." So, I just wanted to, you know, sort of share with you this being talked about enough. And so, this one of many articles, this one is titled
[01:11] physical fitness, the two best predictors of long-term survival. So, mentioned, this was published in the journal atherosclerosis. that younger patients with low fitness can be at a higher mortality risk than
[01:28] older patients who are physically fit. So, we hear about, oh, this person was young, they had a heart attack and this, but are they fit, right? Do they have physical fitness? Because this follow-up study found that the mortality rate even
[01:43] in people who have really calcified terrible coronary arteries like they are filled up with hard and soft plaque meaning that the passage of blood and nutrients is very low to the heart and they are at risk for having ashimia or
[01:56] low blood flow and having a infarct or heart attack. So, we know that having calcified stiff arteries is bad throughout the body. Uh, especially in these small coronary arteries that give the heart the nutrients it needs to
[02:10] continually pump. Your heart never stops pumping until the day that you die. So, it's constantly needing energy, nutrients, oxygen, amino acids, glucose, and so forth. Well, it turns out that people that have really calcified
[02:22] coronary arteries are at a much higher risk of dying from heart disease and all causes compared to people who don't have hard calcified arteries in the coronary a high degree of fitness? This is interesting. If you look here at this is
[02:37] the uh Kaplan Meyer survivability curves over the course of 10 years. So stratified them based upon their coronary artery calcification. the degree to which the coronary arteries are calcified using a CT androgram. And
[02:52] here's what's super fasting. You know, people who had really diseased arteries people who had really diseased arteries but didn't exercise about 25% of them just died over the course of 10 years. Like a lot of them died. Uh and but if
[03:06] individuals had really calcified arteries but they do intense exercise, course of 10 years. This goes to show and you can look at the slope of these curves here. um people that are followed because they
[03:20] have really you know calcified and and diseased arteries um yeah they're not surviving very well uh from a longevity perspective but even the people who had really sick arteries and part of this could be intense exercise is known to
[03:34] calcification but not the vulnerable soft plaque more of the hard plaque which is another conversation that we'll talk about later but patients reporting no exercise had a mortality rate that was 2.3fold higher than those who
[03:47] reported being highly physically active even though they had the same degree of coronary artery calcification. So I I share this information with you because I hear we hear so much about cholesterol. It's like it's incessant
[04:00] like it's like seemingly any everything the medical community can they they just keep talking about this over and over and over again. But are we doing V2 max testing? Are we testing people's physical fitness? uh you know what are
[04:14] we doing to assess strength and physical fitness because this study in the published in the journal of the American Medical Association tracked a group of firefighters for 10 years and at the start of the study they had them do a
[04:26] very simple task. They also looked at biomarkers LDL cholesterol total cholesterol and all that and they wanted to see survivability over time and based upon you know if there to see if there was any association with baseline
[04:40] strength i.e. do the ability to do uh 20 or more push-ups uh in one minute versus those that couldn't. And you can see here the risk stratification. Those that minute, maybe it was 90 seconds, but it was a it was a confined, you know,
[04:56] finite period of time. uh participants able to complete more than 40 push-ups were associated with a significantly lower risk of incidence of cardiovascular disease events compared to those who can complete less than 10
[05:10] push-ups. Okay, so again to all the frontline healthc care practitioners out there, family medicine doctors, internal medicine doctors, PAs, nurse practitioners, and so forth, you know, are we doing push-ups in the office?
[05:22] Like are we doing that? Like why aren't we why aren't we testing someone's strength? Instead, we're making what I think a mountain out of a mountain hood over one biioarker, which this study that was published in JAMA found no
[05:35] statistical differences in the people who had a higher independent association to those who didn't based upon their fitness. Right? There was no significant differences in these biomarkers that we constantly focus on and have
[05:50] pharmacologic agents to lower. There was no between group differences in in lipid levels. But what was different? strength. The people that could do, you know, 40 or more push-ups in less than, let's just call it 90 seconds, uh, and
[06:04] you followed them for 10 years, they had a much lower independent risk of dying. die. There are some outliers that died from other things, but from heart disease specifically, the ability to
[06:18] just bang out some push-ups. Now, it's not that like doing push-ups and exercising the pectoral muscles, you know, somehow strengthens the heart. No, it it's just that this is one way to independently or triangulate whole body
[06:31] strength and overall fitness. And so we know that and we also know this study that was published in the New England Journal of Medicine back in 2002, so Journal of Medicine back in 2002, so almost 25 years ago, looking at exercise
[06:43] capacity, uh finding that people that had really low exercise capacity had a really statistically higher odds of dying from all causes when you compare
[06:55] them in different quintiles here. And so low exercise capacity had a relative risk of death of 4.5fold compared to those uh who had high exercise capacity. So again to all the frontline healthcare practitioners, why aren't we looking at
[07:09] in the clinic? What about grip strength? What about push-up capacity? These are little bit more sensitive and specific and reflective of overall mortality risk I'm not sure why we're not doing these
[07:24] basic tests and and recommending basic fitness for people because we know that when we prescribe a statin, uh yes, it will lower LDL and total cholesterol, but it also is linked with muscularkeeletal defects and a reduction
[07:36] in strength and physical activity and output. And this is really why a lot of NFL linemen, they know not to take statins even though they have high lipid from statins because of the rabbtomyalysis and the problems that are
[07:49] linked therein. Uh and we also know that statins will increase your risk of resistance which in and of itself is an independent risk factor for incident cardiovascular disease. Right? So again, the whole point here is not to trash
[08:02] mainstream medicine. It's just to get us to think a little bit more broad uh to to look at this through a wider scope and lens and prioritize fitness. We now have really good data uh especially this study published in atherosclerosis
[08:15] finding that you know fitness is as much or more predictive of death from heart disease as is coronary artery calcification. So I wanted to share this helpful. If you did hit that like button, be sure to subscribe to the
[08:30] clicking uh the links in the description below. If you're into fitness, you with electrolytes during your workouts. This is a little hack a lot of people don't know about. Electrolytes help increase the absorption and utilization
[08:43] creatine helps draw water into your muscle tissues. And that's how it can help you have increased strength and performance during exercise. So, I'll put links in a coupon code podcast that you can use over at myiocience.com.
[08:57] We'll catch you on a future video down the