How Micronutrients & Exercise Ameliorate Aging | Dr. Rhonda Patrick

This episode comes from my keynote lecture at the American Academy of Anti-Aging Medicine LongevityFest 2023, in which I describe several powerful health habits that delay biological aging and improve healthspan. The core idea: You don't have to move mountains to make a big impact on aging. Starting with a few key areas of focus (vitamin D, magnesium, omega-3s, and vigorous exercise) can make a big difference. Thanks @A4MEvents for having me!

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*CHAPTERS:*
(01:38) Vitamin D
(05:58) How vitamin D deficiency affects mortality risk
(09:24) Optimal vitamin D levels & supplementation
(11:10) Why magnesium deficiency impairs DNA damage repair
(14:50) Dangers of inadequate omega-3 intake
(17:07) The correct omega-3 index level
(21:32) How to correct vitamin D, omega-3, & magnesium inadequacies
(23:17) Vigorous exercise is the best longevity drug
(24:50) How increasing VO2 max affects life expectancy
(29:36) Protocols for increasing VO2 max
(32:27) How to measure VO2 max
(33:34) What it takes to reverse 20 years of heart aging
(36:31) Blood pressure benefits of vigorous exercise
(37:48) The BDNF brain benefits of vigorous exercise
(40:58) How vigorous exercise improves focus & attention
(42:11) Exercise protocols for maximizing BDNF
(43:13) Anti-cancer effects of vigorous exercise
(45:30) Exercise snacks ​

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[FoundMyFitness]

Here are the timestamps:

(01:38) Vitamin D
(05:58) How vitamin D deficiency affects mortality risk
(09:24) Optimal vitamin D levels & supplementation
(11:10) Why magnesium deficiency impairs DNA damage repair
(14:50) Dangers of inadequate omega-3 intake
(17:07) The correct omega-3 index level
(21:32) How to correct vitamin D, omega-3, & magnesium inadequacies
(23:17) Vigorous exercise is the best longevity drug
(24:50) How increasing VO2 max affects life expectancy
(29:36) Protocols for increasing VO2 max
(32:27) How to measure VO2 max
(33:34) What it takes to reverse 20 years of heart aging
(36:31) Blood pressure benefits of vigorous exercise
(37:48) The BDNF brain benefits of vigorous exercise
(40:58) How vigorous exercise improves focus & attention
(42:11) Exercise protocols for maximizing BDNF
(43:13) Anti-cancer effects of vigorous exercise
(45:30) Exercise snacks ​

[adhdself-love]

She is one of extremely few people whom I do not 2x speed. Straight to the point all the time. A pleasure to listen to.

[MrStarchild]

Introduction
- Dr. Patrick discusses some powerful lifestyle habits that can affect the way we age, including some "low hanging fruit" like dietary modifications and supplements, as well as more effortful interventions like exercise.
- She covers optimizing micronutrient deficiencies in the first part, and the impact of exercise on a molecular level in the second part.

Part 1: Optimizing Micronutrient Deficiencies

Vitamin D
- Vitamin D is more than just a vitamin - it gets converted into a steroid hormone that interacts with DNA to orchestrate over 5% of the protein-encoding human genome.
- About 70% of the population has inadequate vitamin D levels of 30 ng/mL or less. This is a widespread issue.
- Reasons for widespread vitamin D deficiency include: factors blocking UVB radiation like sunscreen, melanin, and living at northern latitudes; decreased skin synthesis with age; and modern indoor lifestyles.
- In mice, knocking out the vitamin D receptor accelerates aging significantly. Human studies show low vitamin D correlates with higher all-cause mortality risk.
- Mendelian randomization studies suggest low vitamin D levels have a causal effect on increasing all-cause, cancer, and respiratory disease mortality.
- Raising vitamin D levels from deficient to sufficient decreased epigenetic age by 2 years in one human trial.
- The optimal vitamin D range appears to be 40-60 ng/mL based on mortality data. 4000 IU/day of supplemental vitamin D is generally safe and effective to get most people to sufficiency. Individual response varies so the key is testing blood levels.

Magnesium
- About half the US population has inadequate magnesium levels, mainly from not eating enough magnesium-rich foods like dark leafy greens.
- Magnesium is a cofactor for over 300 enzymes involved in energy production, energy utilization, and DNA damage repair.
- DNA damage is constantly occurring and accumulating with age. Magnesium deficiency impairs ability to repair this damage.
- Studies show higher magnesium intake is associated with 24% lower pancreatic cancer risk per 100mg, and those in the highest vs lowest magnesium quintile had 40% lower all-cause and 50% lower cancer mortality.
- Magnesium glycinate, malate and citrate are bioavailable supplement forms. Requirements are ~400mg/day for men, 300-350mg/day for women, and 10-20% higher for very physically active people.

Omega-3 Fatty Acids
- A Harvard study identified inadequate omega-3 from seafood as one of the top 6 preventable causes of death in the US, responsible for ~84, 000 deaths/year (similar impact as trans fats).
- This is an unrecognized issue compared to eliminating trans fats.
- The Omega-3 Index, measuring EPA+DHA in red blood cells, is the best marker of omega-3 status. <4% is undesirable, >8% is optimal.
- An Omega-3 Index of 8% vs 4% was associated with 90% lower risk of sudden cardiac death, and 5 years longer lifespan. Omega-3 seems to counteract the mortality risk of smoking.
- Raising the Omega-3 Index from 4% to 8% generally requires 2g/day of EPA+DHA. Prescription ethyl ester forms provide 4g/day.

Part 1 Summary
- Three key nutrients to optimize are vitamin D, magnesium, and omega-3s. Simple solutions include:
1) Vitamin D: 4000 IU/day supplement + testing to achieve 40-60 ng/mL
2) Omega-3: Supplement with 2g/day EPA+DHA and/or eat fatty fish to get Omega-3 Index to 8%+
3) Magnesium: Increase leafy green intake + 200-400mg supplemental magnesium glycinate/malate/citrate daily

Part 2: Vigorous Exercise - The Best Longevity "Drug"

Why Vigorous Exercise
- Dr. Patrick is convinced vigorous exercise to 70-80% of max heart rate is currently the most powerful intervention for delaying aging and improving healthspan/lifespan, beyond any drugs or supplements.

Cardiorespiratory Fitness
- Cardiorespiratory fitness (CRF), measured by VO2 max, is one of the best biomarkers of longevity.
- Going from low to even low-normal CRF for age/gender provides a 2.1 year life expectancy benefit. Low to high-normal provides a 2.9 year benefit, and low to elite CRF (top 2-5%) provides almost a 5 year benefit.
- Each 1 unit higher VO2 max is associated with 45 days longer lifespan. About half the US population has low-normal CRF and half has high-normal.
- A 2018 study in JAMA found no upper limit to the mortality risk reduction from high CRF. The bottom 25% had massively elevated mortality risk vs high or elite CRF groups.
- Low CRF carried similar or greater mortality risk than established factors like smoking, diabetes and heart disease.
- To improve CRF, any exercise helps, but the most potent are vigorous intensity and high intensity interval training (HIIT).
- About 40% of people don't improve their VO2 max from moderate continuous training, but do respond to vigorous exercise.
- Longer intervals of 3-5 min at maximum sustainable intensity are ideal for boosting CRF. The Norwegian 4x4 protocol is well-studied for improving VO2 max.
- A 12-minute maximum effort run/walk test wearing a device to measure distance is a validated way to estimate VO2 max without lab testing.

Reversing Heart Aging
- A study by Dr. Ben Levine took 50-year old sedentary but otherwise healthy adults and put them in a 2-year aerobic exercise program working up to 5-6 hours per week at 75-80% max HR + one 4x4 HIIT session.
- After 2 years, the exercise reversed many structural changes of their aging hearts to look 20 years younger. Left ventricular elasticity improved over 25% and VO2 max increased 20%.
- This shows it's possible to meaningfully reverse age-related heart decline with a rigorous long-term exercise program even starting in midlife.

Blood Pressure Benefits
- 3-4 sessions per week of 20-60 min moderate-to-vigorous aerobic exercise can produce blood pressure reductions rivaling anti-hypertensive drugs.
- High blood pressure is very common, even in young people, and is a top risk factor for cardiovascular disease and dementia. Exercise is a potent non-pharmacological treatment.

Molecular Impacts on the Brain
- During intense exercise, muscles work so hard that they shift from aerobic to anaerobic glucose metabolism, generating lactate.
- Lactate is not just a metabolic byproduct but a signaling molecule / exerkine that communicates with other organs via the "lactate shuttle".
- Lactate produced during exercise crosses the blood-brain barrier and acts as a signaling molecule to increase BDNF (brain-derived neurotrophic factor).
- BDNF is crucial for neuroplasticity, neurogenesis, neuron survival, and the cognitive benefits of exercise. Blocking BDNF prevents the learning and memory benefits.
- Lactate also signals to increase serotonin, which improves impulse control, and norepinephrine, which increases alertness and focus after intense exercise.
- 30-40 min of sustained 80% max HR exercise or 6x40 second all-out interval sessions are most potent for raising BDNF 4-5 fold.

Anti-Cancer Effects
- The mechanical shear stress of increased blood flow during vigorous exercise can kill circulating tumor cells that have broken off the primary tumor site. Their dysfunctional mechanoreceptors can't handle the force.
- 6 months of 50-70% max HR exercise for 150 min/week significantly reduced circulating tumor cells in stage 1-3 colorectal cancer patients.
- Circulating tumor cell count is linked to 3-fold higher cancer recurrence and 4-fold higher cancer mortality.
- In stage 3 colon cancer, aerobic exercise was associated with 40% lower recurrence and 63% lower mortality.

Mitochondrial Biogenesis
- Exercise snacks - 1-3 minute bursts of intense exercise like high knees or jumping jacks interspersed throughout the day - improve metabolic health by promoting mitochondrial biogenesis (generation of new, healthy mitochondria).
- This happens via lactate signaling to increase PGC-1alpha, the master regulator of mitochondrial biogenesis, in muscle cells.
- Animal studies show exercise-generated brain lactate also travels to the hippocampus to stimulate mitochondrial biogenesis in neurons. This likely happens in humans too.

Vigorous Intermittent Lifestyle Activity
- Even short bouts of vigorous activity like stair sprinting during daily life, separate from structured workouts, have powerful longevity benefits.
- 3 bouts per day of 1-2 min vigorous lifestyle activity measured by accelerometers was linked to 40% lower all-cause and cancer mortality and 50% lower cardiovascular mortality vs sedentary adults.
- This applied even for self-identified non-exercisers if they did the intermittent vigorous activity, demonstrating the power of this strategy to break up sed ntary behavior.

[alienautopsy]

Listen up kids. When you were little you listened to your mama. You are now grown up so listen and do what Dr. Patrick says and you will have a happy life.

[ColtCommander]

Great presentation. I love that she is a normal person who just wants to help people.

[SusanBanthny]

The way you deliver information is digestible and actionable and just a gift! Thank you for giving folks an opportunity to learn and live healthier longer lives💜

[sarahamonson]

How can you listen to this and NOT want to exercise?! Amazing presentation I'm sharing with all my loved ones. Thank you.

[ketocrusader]

I've been listening to this as I drive to work and I absolutely love this lecture. On a side note, the Dr is very intelligent.

[MeHere]

Her talks just make me want to try harder. Such a good human being just trying to help us all. Thank You.

[gabrielledavis]

Dr. Rhonda Patrick is a blessing to us all

[filmerg]

Thank you for translating the latest longevity science into usable bits of information that every day people can use to motivate themselves to improve their health-span and life-span. I think all your media channels are dedicated to that endeavor, not just this talk. I appreciate all your hard work, Dr. Patrick.

[signupisannoying]

Not only that she delivers great information, she's also very effective in getting others to exercise. That 30 sec high knee is a great way to get everyone started. It's like in 30 sec she already got all her audience in a better path.

[sterlgirlceline]

🌟🌟🌟🌟🌟🌟🏆Dr. Patrick, you are a blessing to humanity 🕊️

[arjunks]

00:01 Vigorous exercise is like the best longevity drug for delaying aging and improving health span.
02:20 Vitamin D regulates over 5% of the protein encoding human genome.
06:40 Melan randomization can provide insight into the effects of low vitamin D levels on mortality.
08:49 Vitamin D supplementation decreased epigenetic age significantly
13:11 Magnesium intake is linked to lower cancer mortality and all-cause mortality.
15:33 Not getting enough omega-3 from seafood can lead to preventable deaths.
19:21 High omega-3 index linked to increased life expectancy
21:17 Micronutrients play a crucial role in aging
25:12 Cardiorespiratory fitness is associated with improved longevity
27:07 Higher cardiorespiratory fitness leads to reduced all-cause mortality
30:47 High-intensity interval training can improve cardiorespiratory fitness.
32:32 Measuring V2 Max through a 12-minute run test
36:23 Vigorous aerobic exercise can significantly reduce blood pressure and lower risk of hypertension.
38:30 Lactate acts as a signaling molecule and supports brain function.
42:13 Exercise duration and intensity impact brain neurotropic factor levels.
44:15 Exercise plays a crucial role in reducing circulating tumor cells and mortality rates in cancer patients
48:02 Vigorous intermittent activity reduces mortality risk
49:48 Importance of forming a daily exercise habit

[AlieKoroma-he]

Hello hello Dr Rhonda Patrick. Thank you very much

[jimg]

I love that Rhonda did those high steps at the end 🙂 Great presentation, the biggest and best takeaway is that diet and lifestyle intervention gives you control back of your health. Also the body can heal and wants to fix itself if you aren't pumping it with garbage all day.

[fatboydim.]

This upload just reiterated what I already knew, this is my favourite YouTube channel.

[jimbort_de_breces]

Dr. Patrick has been a major force in my reevaluating and optimizing my nutritional and fitness requirements. She's one of the best there is

[turbalejo]

I have been taking all three for over three years now after I found you on Joe Rogan podcast. Thank you!!!

[Elaba_]

Eating healthy makes you live 3 years longer than normal eating and 11 years longer than eating unhealthy on average. These were the results of a huge study in the UK (thousands of people participated over decennia.