Why Exercise Doesn’t Replace Walking

Many people think that intensity can replace walking. And they are right to a degree. It does on the aerobic side.

But there are things it doesn’t replace: lipid clearance, and vascular remodeling. 🧵 To make this model conceptually simple, imagine you have a sink.

- Basin = your blood plasma
- Water in the sink = ApoB containing lipoproteins (VLDL, LDL, remnants)

Clearance is the drain. If the water stays in the sink too long, it gets stagnant.

So it needs to be drained.

Over the past few days, I’ve had many discussions with athletes and physiologists who claim that you can’t get a high VO2max from just walking.

Here is what I think they are missing 🧵 Most exercise physiology is based on training data and observation.

Therefore the studies on exercise are designed as interventions that are themselves based on those observations.

VO2Max - How Walking Can Create an Elite VO2Max

Many people think that the only way to raise VO2Max is by doing HIIT.

But you can achieve a high VO2Max just with walking.

Walking is arguably the superior way to build it 🧵 In 2001, there was a landmark paper published. They took a VO2Max measurement at baseline and tracked the cohort for 10.7 years.

What they found was an inverse correlation between VO2max and all cause mortality.

Many people report their health improving after removing fiber.

Why is this, and are they really improving their long term health?

Is this proof that fiber is “non-essential”?

Short answer: no
Long answer: 🧵 You could think of our microbiome as a fermentation vessel.

The fermentation feeds the 10^13 organisms living in your gut.

We have 3x10^13 human cells.

In that sense, we are at least as much microbe as we are human.

Why Don’t Hunter Gatherers Have Heart Disease? (Part 10)

We know what happens when you move subsistence populations to the city. They start developing disease.

But what happens when you move them back? 🧵 In the 70’s and early 80’s, health surveys in remote Aboriginal villages showed a disturbing trend:

- T2D was exploding in prevalence
- The onset was very rapid, occurring within a decade or two of lifestyle change

Why Don’t Hunter Gatherers Have Heart Disease? (Part 9)

In parts six we evaluated several groups with hepatic insulin resistance.

In part seven, we evaluated how this could happen with VAT being the likely culprit.

But what is VAT and how does it lead to insulin resistance?🧵 What are SAT and VAT?

SAT = subcutaneous adipose tissue
VAT = visceral adipose tissue

SAT (also SCAT) is the primary, low risk storage depot. It has the ability to expand but expansion is limited (hypertrophy, fibrosis, inflammation), then it starts spilling over into VAT.

Why Don’t Hunter Gatherers Have Heart Disease? (Part 8)

We have learned a lot in this series. Before going further, let’s build a model for what we are seeing.

The model will help explain why hunter gatherers aren’t getting chronic disease

Could this be a unified theory? 🧵 Before we start, it’s important to realize that all models are wrong, but some are useful.

Science has many examples of wrong but useful models. Bohr’s model is a good example of this. It was wrong, but led to quantum mechanics.

So our goal is to be wrong but useful.

Why Don’t Hunter Gathers Have Heart Disease? (Part 6c)

The Maasai taught us the case:

Hepatic dominant IR can be low risk until urbanization pushes it to multi-axis

Can the Pima prove the law?

What happens when you hold genes constant, but change lifestyle? 🧵 First, a little background about the Pima. This may seem like a bit of a detour, but it provides important context for how we ended up with such a perfect natural experiment…

Why Don’t Hunter Gathers Have Heart Disease? (Part 5)

Hunter gatherers have VO2max > 50

VO2max is strongly correlated with longevity.

So raise VO2Max fast with HIIT and you should be able to skip the walking, right?

Not so fast🧵 VO2Max Correlation is from Population Data

In 2001, there was a landmark paper published. They took a VO2Max measurement at baseline and tracked the cohort for 10.7 years.

What they found was an inverse correlation between VO2max and all cause mortality.

But there’s a problem

Why Don’t Hunter Gathers Have Heart Disease? (Part 4)

Hunter gatherers walk between 15-20k steps a day.

In a modern society, that takes a lot of time. Surely running for an hour would replace that, right?

No. This is why we see endurance athletes with heart disease 🧵 Cardiorespiratory fitness (CRF) cuts all cause mortality and CVD risk. Every extra MET of CRF reduces risk by 13%

Why Don’t Hunter Gatherers Have Heart Disease? (Part 3)

In Part 2, we explained how clearance can play a big role, and how it can be modified with exercise.

And while exercise can mitigate diet significantly, diet and genetics still play a big role. 🧵 Let’s look at a few populations and determine if the model holds.

Starting with the Amish.

Why Don’t Hunter Gatherers Have Heart Disease? (Part 2)

In Part 1, we explained despite radically different diets, hunter gatherers have elite lipid profiles and near zero rates of heart disease.

But how does this work? 🧵 It’s not what you eat, it’s what you can clear.

High physical activity load (PAL) expands clearance bandwidth, reducing ApoB exposure even when dietary saturated fat is high.

This is why the Maasai, despite high saturated fat intake, can still have low ApoB, and low rates of heart disease.

Why Don’t Hunter Gathers Have Heart Disease? (Part 1)

Heart disease is the number one cause of death in industrialized societies.

So it’s interesting to look at multiple populations that don’t have it, and ask why?

What is driving it and what can we learn from them? 🧵 The Tsimane, the Hadza, and the Masai come from different locations and lifestyles.

The Tsimane are from Bolivia. They hunt, fish, do slash and burn horticulture (plantains, rice, manioc), and have some market integration.

Their macros are 70% carbs, 20% fat and 10% protein.

You can live without fiber.

But your microbiome sees that as famine.

It reprograms itself for a different fuel source, metabolites, immune signals.

Its adaptation meant to get us through winters. But there are consequences if we stay in this state too long. 👇 Our microbiome acts as the firmware sitting between the outside world and us.

When it senses moving from a time of abundance (e.g. spring/summer) to scarcity (e.g. fall/winter), it adapts.

“We may be in a period where we have to consume a maggot infested carcass makes sense”

Did hunter gathers have low life expectancy and therefore not live long enough to experience heart disease. Short answer: no. Long answer 👇

https://twitter.com/gregmushen/status/1915140954107093193

It is true that hunter gathers as a population have low life expectancy. Average life expectancy is 30 years old and 35 years old for subsistence.

However, the mode is over 70…

My mental model for aging is built on 5 pillars.

Fail any one, and entropy accelerates.

Keep them intact, and most age-related disease becomes optional.

It’s not comprehensive, but tackles the most important elements. The Five Pillars:

- Circadian Alignment
- PGC-1α Activation
- Glycation Minimization
- Maximal Muscle
- Calcium Partitioning

Each one governs a system-level process. Nearly every chronic condition maps back to dysfunction in one or more of these.

Calcium is critical for our bones, muscles, blood clotting, enzymatic signaling, and mitochondrial health.

If you don’t get this right, you can end up with weak bones, calcified arteries, or weak muscles.

Here’s what the Illuminati doesn’t want you to know about calcium. Calcium relies primarily on vitamin A, vitamin D, magnesium, and vitamin K, in the right ratios.

Too much D not enough A —> kidney stones

Too much A, not enough D —> brittle bones

Too little vitamin K —> calcium in arteries

Too little magnesium —> vit D not activated

An ultra simple health blueprint

This is an ultra simplified health blueprint that would get you to the point of diminishing marginal returns. No need to overthink it.

Walking
- 30 minute walk upon waking
- 15 minute walk after every meal
- 30 minute walk before bed
- If you can’t walk outside, get a walking pad

Resistance Training
- 4-5x/week of resistance training

Cardio
- 30 minutes a day lower intensity. Do this either after lifting on lifting days or space it as far away from your workout

Nutrition
- Minimal to no processed food. No need to be militant
- Lean protein intake: your body weight in protein per day (lbs/g)
- 6-8 servings of diverse fruits and veggies
- 30+ kinds of plants each week
- < 10% of calories from saturated fat
- Fatty fish 3x week
- Daily handful of seeds and nuts (ideally soaked or sprouted, but that’s an optimization)
- Some fermented foods if you’re don’t have a histamine problem

Hydration
- 50-60% of your body weight in ounces of water

Sleep
- Asleep around 10’ish

Body comp
- Men: should be able to see abs in the mirror (<15%).
- Women < 22% bf
- If you can’t, reduce calories and make your morning and evening walks 45 minut

Supplements
- Consider K2 because it’s hard to get in sufficient quantities from food
- D3 if you live above the 40th parallel
- Plenty of others can be considered, but this is all individual

Bloodwork
- 1-2x a year. Schedule the next one when you’re at your appointment so you never forget. Excuse #1 - I don’t have time

- Walking pad under your desk or in the living room
- Cardio while dinner is in the oven
- Instacart for shopping with a cheap exercise bike off FB marketplace
- Food prep once a week or opt for a no cook menu
- Fill two 50 ounce containers of water every morning
- Walk while on calls for work

Many people that eating healthy requires a lot of time, money, and lots of cooking.

Let’s try to construct a healthy day of eating with no cooking, entirely from a Costco delivery 👇 There are times in life we need to buckle down, and we’re limited on time. During these times, you can either let your eating habits slide, or make some compromises, and make a “good enough” diet to get you through.

Spending time debating seed oils is like debating if a ‘72 Honda Accord is better than a ‘74 Ford Pinto.

It’s not relevant to high-performance nutrition.

Getting the right fats is critical for health and performance.

Let’s skip the debate and fuel your supercar. 🧵

Bookmark Fats are essential for energy, brain health, nutrient absorption, and hormone production. But not all fats are created equal. Here's a deep dive into every type, their structure, sources, and how they impact your health.

Scientifically proven to double muscle growth, yet almost no one talks about this ED drug that could catapult your gains. 💪👇 Tadalafil, aka Cialis, is a PDE5 inhibitor that boosts blood flow, enhances muscle growth by doubling hypertrophy, increases protein synthesis, speeds up recovery, elevates testosterone, supports cardiovascular health, and may even improve cognition.