Minimum Viable Workout Routine is Dangerously Misinformative

by betterthanwell6 min read24th Jun 201232 comments

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Exercise (Physical)
Personal Blog

Edit: Dangerously misleading on one crucial point.

 

This started out as a short reply to the Less Wrong post Minimum Viable Workout Routine. Unfortunately I was unable to summarise my points sufficiently, so this reply grew into a post of it's own. I realize that the following is a bit rude to the original poster, and I apologize. Minimum Viable Workout Routine seems to be backed solely by anecdotal personal experience. The majority of the post, which addresses strength training seems decent, and not obviously wrong. However, the following paragraph is dangerously wrong:

A note about cardio: Cardiovascular capacity (V02 max) has shown a high degree of correlation to all cause mortality.  Why aren't I recommending cardio?  Because the only way to increase V02 max is with high intensity exercise.  Between high intensity weight lifting and high intensity cardio, high intensity weightlifting easily wins for a newbie.  A newbie, especially a significantly out of shape one, will not be capable of a level of cardio exertion that results in a significant adaptation.  This can result in a lot of effort with very little in the way of improvement.  This is soul-destroyingly frustrating.

Leaving this uncontested could be dangerous to your health. As we shall see, cardiovascular capacity is indeed important to survival and longevity. It is also quite easily trainable, it needs not be soul crushingly frustrating, and it should not be overlooked. 

 

A couple of cool findings from the physiology of exercise:

Instead of having me trying to convince you, we'll take a look at the science, and see what we find.

You can assume with reasonable confidence that the findings are valid, well-corroborated, and furthermore, the findings quoted in this post have been found to apply to the general population, to the untrained, the athlete, the elderly, and the ill, even though I'm only able to present here a selection of these results.

Human physiology, and its response to exercise is surprisingly stable across genders, race, age and physical fitness. What works for the well trained athlete will also work for the utter newbie, the obese, and patients with heart disease.

Strength training is also important to health, increases in maximal strength of the large muscle groups tends to cause large increases in endurance, as measured in time to exhaustion. Why? Because if your muscles have to work slightly less hard at each movement, relative to the one repetition maximum of the muscle, you can work at moderate to high intensities for much longer.

So, let's first see that a brief strength training intervention can dramatically increase endurance:

 

Maximal Strength Training Improves Running Economy in Distance Runners

Purpose: The present study investigated the effect of maximal strength training on running economy (RE) at 70% of maximal oxygen consumption (VO2max) and time to exhaustion at maximal aerobic speed (MAS). Responses in one repetition maximum (1RM) and rate of force development (RFD) in half-squats, maximal oxygen consumption, RE, and time to exhaustion at MAS were examined.

Methods: Seventeen well-trained (nine male and eight female) runners were randomly assigned into either an intervention or a control group. The intervention group (four males and four females) performed half-squats, four sets of four repetitions maximum, three times per week for 8 wk, as a supplement to their normal endurance training. The control group continued their normal endurance training during the same period.

Results: The intervention manifested significant improvements in 1RM (33.2%), RFD (26.0%), RE (5.0%), and time to exhaustion at MAS (21.3%). No changes were found in VO2max or body weight. The control group exhibited no changes from pre to post values in any of the parameters.

Conclusion: Maximal strength training for 8 wk improved RE and increased time to exhaustion at MAS among well trained, long-distance runners, without change in maximal oxygen uptake or body weight

 

So a maximal strength training exercise of maybe 10 minutes, 3 times per week, for eight weeks, resulted in an increase in time to exhaustion of ~20% in well trained runners. So increases in strength can lead to large gains in endurance.

Cool, because endurance training is important. Endurance training makes you die less often, on average:

 

Exercise Capactity And Mortality Among Men Referred For Exercise Testing

Background: 

Exercise capacity is known to be an 

important prognostic factor in patients with cardiovascular disease, but it is uncertain whether it predicts 

mortality equally well among healthy persons. There 

is also uncertainty regarding the predictive power of 

exercise capacity relative to other clinical and exercise test variables. 

Methods: We studied a total of 6213 consecutive 

men referred for treadmill exercise testing for clinical 

reasons during a mean (±SD) of 6.2±3.7 years of follow-up. Subjects were classified into two groups: 3679 

had an abnormal exercise-test result or a history of 

cardiovascular disease, or both, and 2534 had a normal exercise-test result and no history of cardiovascular disease. Overall mortality was the end point. 

Results: There were a total of 1256 deaths during the 

follow-up period, resulting in an average annual mortality of 2.6 percent. Men who died were older than 

those who survived and had a lower maximal heart 

rate, lower maximal systolic and diastolic blood pressure, and lower exercise capacity. After adjustment for 

age, the peak exercise capacity measured in metabolic 

equivalents (MET) was the strongest predictor of the 

risk of death among both normal subjects and those 

with cardiovascular disease. Absolute peak exercise capacity was a stronger predictor of the risk of death than 

the percentage of the age-predicted value achieved, 

and there was no interaction between the use or nonuse of beta-blockade and the predictive power of exercise capacity. Each 1-MET increase in exercise capacity 

conferred a 12 percent improvement in survival. 



Conclusions: Exercise capacity is a more powerful 

predictor of mortality among men than other established risk factors for cardiovascular disease. (N Engl 

J Med 2002;346:793-801.)

 

If you want to live long and prosper, you should train your body, most importantly your heart, to be able to work hard when you can. So that it can work hard for you when it must fight for your life. With that, let us have a look at endurance training in the elderly:

 

Effects of High-Intensity Endurance Training on Maximal Oxygen Consumption in Healthy Elderly People

Each 60-minute training session included four repetitions of exercise at approximately 85% to 95% of maximal heart rate separated by 4-minute rest periods. The control group was encouraged to perform no additive strength or endurance training during the study period. Maximal oxygen consumption increased significantly (p < .05) (13.2%) in the TG compared to the CG. Walking economy and maximal walking speed were unchanged after the training intervention. This training study demonstrates that high-intensity endurance training significantly improves VO2 max in older adults.

Why is this interesting? Well, it seems that old people respond the same to vigorous exercise, as do young people. 

But! They tend to do less of it, and consequently they gradually suffer worse health. I'm oversimplifying, but there is a causal path from physical inactivity with old age, (not because of old age) which leads to deterioration of health which leads to death. If you are reaching retirement age, or you know people who are, try to get them to move their butts before it's too late. And don't stop moving. Don't stop moving even if you suffer heart failure. Let's have a look at the effects of vigorous training in patients with heart disease:

 

Interval and Strength Training in CAD Patients:

This study sought to study the effect of high intensity aerobic interval endurance training on peak stroke volume and maximal strength training on mechanical efficiency in coronary artery disease (CAD) patients. 8 CAD patients (age 61.4 ± 3.7 years) trained 30 interval training sessions with 4 × 4 min intervals at 85-95% of peak heart rate while 10 CAD patients (age 66.5 ± 5.5 years) trained 24 sessions of maximal horizontal leg press.

In the interval training group peak stroke volume increased significantly by 23% from 94.1 ± 23.0 mL · beat (-1) to 115.8 ± 22.4 mL · beat (-1) (p<0.05). Peak oxygen uptake increased significantly by 17% from 27.2 ± 4.5 mL · kg (-1) · min (-1) to 31.8 ± 5.0 mL · kg (-1) min (-1) (p<0.05) in the same group. In contrast, there was no such exercise training-induced change in peak stroke volume or peak oxygen uptake in the maximal strength training group, despite a 35% improvement in sub maximal walking performance.

So this is what heart patients get in return for sixteen minutes, three times a week for two and a half months. If you're still breathing, and able to move by your own power, you are capable of the level of cardio exertion that leads to significant adaptation. You don't necessarily have to run fast, you just need to be able to get your heart rate to 85-95% of your maximum heart rate, repeatedly. For a CAD patient or an overweight person, this could mean a brisk walk. If you're out of shape,  you don't have to fly across the terrain at amazing speed for your heart to get all excited.

How, exactly, does endurance training keep people healthy and alive?

Repeated intervals of brief, but high intensity endurace training causes increased stroke volume of the heart, when working at peak capacity. This carries over into the resting state, and lowers your resting pulse, your blood pressure, increases your maximal oxygen uptake, increases your working capacity when healthy, makes you less likely to get ill. If you get ill, your heart will be better at keeping you alive.

Closing thoughts:

Should you trust my opinion? I've only taken a single university course in exercise physiology. You should not trust my opinion, and this is not professional advice. But my opinion is backed up with well-corroborated scientific findings, and you should probably trust those.

The course i took was excellent. The teaching professors were were former national team coaches, they have applied their research to great effect on healthy, untrained students, CAD patients, COPD patients, youth athletes, elite athletes and billion dollar soccer teams.

Pursuing a regime of maximal strength training and high intensity interval training, you should see evident and mutually reinforcing gains in strength and endurance, and you'll not stop seeing benefits, even at the level of 100 million dollar soccer players. (Endurance and Strength Training for Soccer Players)

An final anecdote of my own:

I used to find physical exercise dis-congruent with my geek identity, I found it boring, painful, useless. Learning the very basics of exercise physiology, along with some nerdy details makes working out seem important. It helps to know why I'm doing it, I know what the expected effects are, and the expected sizes of the effects, how to avoid training fatigue, track my heart rate, track my progress, and on the whole, see that I'm on track to results like those mentioned in the studies above. I find it fun to try and figure out what is happening, and approach working out as something of a puzzle to be solved. Exercise, or the lack of it, is an experiment in health.

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32 comments, sorted by Highlighting new comments since Today at 9:11 AM
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As a general rule, it seems to me that if you're going to call something dangerous, it behooves you to spell out exactly what it is you think it is claiming and exactly how you disagree with it. I see very little disagreement between the two posts and no even attempt to justify the word "dangerous."

Excellent point. I should have thought of that.

I hope made the case that high intensity interval training is good for you, even if you're not very fit. Why do I think it is dangerous to advise people against endurance training? Because if you accept it, and update on it, and don't do endurance training because you read on Less Wrong that it is useless, soul-crushing and you shouldn't even try, you've increased your risk of getting sick and dying unnecessarily.

I also think it is dangerously misleading to warn people against certain vaccinations on the grounds that it may cause autism, if this claim is unsupported by evidence. If you tell people to not bother with endurance training they increase their risk of dying by listening to you. If you tell people to not vaccinate their children, they run a risk of getting sick children. Both are unsupported by evidence, and both are dangerous.

I started out writing "this paragraph is dangerously wrong", and when I expanded my reply into a separate topic on it, I chose an unfortunate title. I believe that the Minimum Viable Workout Routine was made with the best intentions. Calling the whole post dangerously misinformative, was harsh and uncalled for on my part.

But still, unsound information that can actually kill you (if you believe it) is dangerous.

Again, you largely agree with Romeo Stevens on the facts of exercise.

As to the consequences of the advice, I think you are very wrong. The fact that you misread his advice is a bad sign about his advice. It is probably evidence that everyone will misread it, but I am skeptical that they will misread it the same way you do.

As a general rule, giving vague advice attacking specific advice causes people to do nothing. It is your post that is dangerous.

The crude way I understood these posts:

  • When you're not very fit, maximum strength training is most rewarding.
  • It is better for your health to also directly train endurance.

There is a tension. However:

  • Maximum strength training also improves endurance.
  • This increased endurance makes direct endurance training more rewarding.

The call to action this suggest looks like:

  • If you're reasonably fit, train maximum strength and endurance.
  • If you're not, start with strength alone, it's more rewarding. Look forward to train your endurance, though.

Would that be sufficiently accurate, precise and non-dangerous?

Another issue is that "endurance training" is extremely misleading. The obvious interpretation of it is probably less effective for all purposes than obvious interpretation of "strength training."

It's dangerous to tell people they can't increase their cardiovascular fitness outside of lifting weights because that will make those people less likely to jog, skip, etc.

Did you get that message from Romeo Stevens? Were you less likely to jog, skip, etc?
Also, are you a beginner?

"a newbie will not be capable of a level of cardio exertion that results in a significant adaptation" seems to be saying most people who aren't actively exercising can't benefit from cardio without getting stronger first (via a high percentage capacity weightlifting scheme.

A bigger problem i neglected to talk about was that there are people who a lifting program is going to reinforce the bad biomechanics of, thereby damaging their long term fitness, or worse, straight up damage in the case of e.g. undiagnosed back problems which are quite common.

For example myself: I lifted weights for about a year with undiagnosed spondylolisthesis (I've heard the prevelance reported from 2-5%, mostly undiagnosed) before I noticed I was getting worse at stuff that wasn't bench pressing deadlifting or squatting. Apart from my adductors and shoulders now being ridiculously tight, it was also dangerous. For all I know I could have had spondylolysis (just a fracture) before, which turned into spondylolisthesis (slippage) one day lifting something. Whether or not that happened I was risking injury without knowing it and if it weren't for all the "one size fits all. Trust us we're experts, your instincts are wrong" attitude all around I would have known it was a bad idea (and wouldn't have known any type of exercise was a good idea.)

if you have trouble sticking to a program maybe it's because you shouldn't be doing a program.

edit: I should mention that I don't get that unfit even if I totally neglect exercise for extended periods, or at least I can get decently fit quite quickly. If you're someone who just turns to blubber if they don't exercise I've heard weightlifting is the best way to improve your metabolism and there's probably some safe lifting you can do.

Yes, there are dangers from lifting. Betterthanwell chose not to talk about them. Bringing them up in this subthread is a non sequitur.

Perhaps when I read RomeoStevens' post, I am reading it through my preconceptions about the 'factions' in the exercise world. But to me it read like just another weightlifter talking about how lifting will make you fit, and dismissing cardio while providing no evidence.

(I have an acquaintance who is a weightlifter and takes this opinion to its most extreme, and shares it condescendingly with anybody who will listen, which I'm afraid gives me built-in bias against lifting.)

The post does seem to be recruiting for a particular faction. If it turns couch potatoes into lifters with false beliefs, it seems to me to produce a pretty good outcome, though a small change in the article might avoid the false beliefs.

But will it produce false beliefs? In saying that cardio is bad for beginners, it seemed pretty clear to me that it was saying it was good for some people. But it doesn't matter what you or I think it says, only what it does to a beginner. The vagueness of "bad for beginners" will probably lead to more specific, likely false beliefs, but only if it produces beliefs at all.

If it causes beginners who have just started cardio to stop, that's pretty bad. It might be good if it got them to switch from ineffective types of cardio to effective types of lifting, but the risk of a change being a change to drop the ball seem to me to outweigh possible benefits. Anyhow, I don't think it will have much effect on beginners who have just started cardio. Maybe ones thinking about starting.

Seems like a good post on its own; no need to bring down its apparent quality by making it appear to be an emotionally heated response to another post of lesser quality

But my opinion is backed up with well-corroborated scientific findings, and you should probably trust those.

What are the well-corroborated scientific findings? The mere fact that you can link to articles is not very convincing to me, for a few reasons:

  • The articles draw very specific technical conclusions, which your plain-English paraphrasing glosses over in potentially important ways
  • Especially in health-related fields, for any article that claims "X", I can find an article that claims "not X" or even the opposite of X. The only potentially stable signal I can think of is field-wide consensus, and even that is dubious in some areas.

Is there corroboration beyond this? If not, why should I believe you to any greater extent than the previous post?

When I was younger, and had gotten seriously into jogging, I tried making it harder by carrying weights. Not being one to bandy about, I took 100 lbs of hand weights for a jog around the block. I got about halfway before I had to sit down, and I could barely walk them back to my house.

A few years and five dozen pounds later, I was -incapable- of jogging, then at my most overweight; I went straight into a high-intensity interval jogging training, and within three weeks had developed shin splints and knee issues (my legs, lungs and heart could do it, if barely; my bones and joints could not keep up), neither of which I'd ever had a problem with before. I had jogged before (and got into incredible shape doing so), and I'm picking it up again since losing forty pounds (by dieting), but I think it's misleading to suggest that endurance training is always a good idea starting off. Your muscles are one thing, but it's very easy to strain your bones and joints, which don't always let you know you're hurting yourself until it is too late. In my case, it was necessary to lose weight before I could get fit. (No, they're not the same thing.)

I will also add that losing forty pounds made jogging considerably more pleasant; the last time I picked it up, I had already been in shape. Having tried it both ways, my experience is this: sixty extra pounds on your frame turns an enjoyable activity into torture, and for me at least, resulted in lasting injury. Health benefits don't matter much if you can't keep doing it.

I view Romeo's comments on strength training as an alternate mode to my own path, dieting. And I suspect, based on personal experience, that he's more correct in his assessment that cardio is something that is best picked up after you're already started down the road to good health than you are in your belief that it should be the primary focus, provided you're in poor enough shape to begin with.

And if you disagree, I'll ask you to repeat my original exercise experiment: Take a hundred pounds with you, and just try to walk around the block, just once. Or try taking 50 lbs of weights with you the next time you jog. Tell me that's a program you could stick to.

Because most the people I see who push cardio as the best word in fitness have never really been there.

If you're very overweight, then unless you simply do not have the resources to do so available to you, then a better option than not doing cardio is doing low impact cardio, such as swimming or using an elliptical or rowing machine (or rowing an actual boat for that matter.)

Running is cardio, but cardio is not running.

At the time, I was traveling almost constantly (which figured a lot into having gained sixty pounds to begin with). The only resources I could rely on were those of my own body. Which has led me to believe rather firmly in exercises that require absolutely no equipment; if you can't keep up your routine, your routine is going to die.

I'm picking up calisthenics very deliberately this time around. I figure, for me, the value of memorizing exercises I can do anywhere at any time exceeds the value of exercises which are more effective, but require access to specific equipment.

I think you're confusing high intensity with high impact. Taking weight with you on a jog shouldn't, I think, make it much more effective as a cardio workout. It's just going to be harder on the joints and muscles bearing the weight.

A stationary bike would be a good alternative if one is having joint issues.

The point was less about the weights, which I decided later were a horrible idea, and I have no idea what made me think they were a good idea to begin with. The point behind that suggestion is that the weights show you how much extra body weight affects your ability to engage in cardio exercise. If you haven't been fifty pounds overweight, the effects aren't necessarily obvious.

I switched to zero-impact exercise, but had already hurt myself, and had significant trouble until I gave up on exercise and switched to the strategy of diet-first, exercise-later, which has worked better for me.

I took 100 lbs of hand weights for a jog around the block

I am at a loss for words.

It really puts the difficulty of getting into shape when you're already seriously overweight into perspective. My arms and shoulders bore the brunt of it, but by the time I got back, every muscle in my legs were screaming, and I had full-body nausea. If it hadn't been raining out, I probably would have had heat exhaustion to boot.

If you're still having joint issues or would simply like to become more spry, I'd recommend you look into Bikram Yoga. Apparently it was scientifically proven to confer health benefits (I've never attempted to vet this claim since personal experience supported it).

If the claim is true the study may have been done by Japanese scientists - if you find and wish to read the original article, but it's not yet translated, let me know and I'll summarize the sections you're interested in.

My joint issues have largely vanished since I lost weight, although I am taking yoga back up. (Yoga was one of my last experiments before I started gaining weight; I'm naturally quite flexible, but am approaching the age where this will start to decline, and wish to avoid this.)

The idea of a hot room is not at all appetizing. That sounds exactly like the kind of weather I routinely -avoided- as a youth in the swamps of East Texas.

I've performed strenuous activity in two types of hot rooms: a wrestling room, and bikram's room. The wrestling room was poorly ventilated, humid, and I could barely breathe. Bikram's room was extremely well ventilated, fresh, and I could breathe about as well as I can on a chill breezy day.

Make of that what you will.

I would support changing "dangerous" to "incorrect", as your post supports the latter claim but not the former.

I find it hard to correct you on this, though, because high-intensity cardio training is important and achievable; not for everyone, of course, but the people who can't do it have problems like clinical obesity, severe physiological disabilities, and so forth; the "newbie" to exercise can perform and benefit from high-intensity, but are likely to conclude they can't.

"You don't necessarily have to run fast, you just need to be able to get your heart rate to 85-95% of your maximum heart rate, >repeatedly. For a CAD patient or an overweight person, this could mean a brisk walk. If you're out of shape, you don't have to >fly across the terrain at amazing speed for your heart to get all excited."

This is the main point of contention as I see it. I hold that getting newbies to consistently attain 85-95% of their maximum heart rate just isn't going to happen most of the time.

also added to benefits list: an air of danger.

As a data point, I can sustain ~70% on a stationary bike more or less indefinitely, and I can certainly achieve ~85% in bursts. (This is approximating my max heart rate as 200 bpm; I am 27, so the standard estimator makes it 193, and 200 is slightly conservative. I do not know the actual value.)

It's possible I'm not in the class of people you're aiming at, but if so you may want to be more specific (i.e. "people who are substantially overweight and out of shape.") I am definitely not a veteran of purposeful exercise; but I am a person without a car, so I certainly do a lot more incidental walking than the average American.

My personal experience is that you get the person to do it 2-4 times and after that the activation cost goes up from feeling like you're dying at the end of a HIIT session and they never build the habit.

This is the main point of contention as I see it. I hold that getting newbies to consistently attain 85-95% of their maximum heart rate just isn't going to happen most of the time.

That's really not a problem, at least not physiologically. One cannot sustain this level of effort for more than a few minutes, which, it turns out, is enough. You'll need a heart rate monitor (cheststrap + wristwatch), get on a treadmill and warm up gently. Work out at around 4 x 4 minutes, with 3-4 minutes of lower intensity walking or jogging in between. Why 4 x 4 minutes, and not something else? Because this has been found to strike the balance between compliance, or self-compliance, as the case may be, and physiological benefits.

For an optimal workout, for a pro athlete you would want to do something like 30 or so 15-second intervals, but sticking to such a regimen is unrealistic for newbies if you don't have someone coaching you. It takes more willpower than most people actually have, so it doesn't really work. Most people do have just enough willpower to work hard for four times four minutes, and then go home.

Walking, jogging or running at a steady pace for an extended period of time at intensities below the lactate threshold does not confer dramatic health benefits. It's still good for you, but you won't be able to feel your body noticably improving from week to week.

At four minute intervals you are working beyond your lactate threshold, so walking, jogging or running is not sustainable at this level of effort for an extented amount of time. Push too hard, for too long and you'll can get nauseous or just feel terrible from burning lactate instead of glucose, if so you need to hold back. 4x4 minutes with 4 minutes rest in between should give an increase of around 0.5% per workout in VO2max, if memory serves. You should notice obvious increases in endurance within a few weeks. One needs to commit to any exercise regime, including this one, but it's not too hard or painful if you're doing it right.

One should also do strength exercises in addition to interval training. Your 3x5 schedule sounds great for this.

I hold that getting newbies to consistently attain 85-95% of their maximum heart rate just isn't going to happen most of the time.

Just curious: are you familiar with Tabata routines? I'm wondering if high-intensity interval training would have newbies attaining near-maximum heart rates.

I'm wondering if high-intensity interval training would have newbies attaining near-maximum heart rates.

Yes, reliably. I'm not guaranteeing they'll all survive but most of them should.

Just curious: are you familiar with Tabata routines? I'm wondering if high-intensity interval training would have newbies attaining near-maximum heart rates.

Personally, I was in my best cardiovascular health while I was doing high intensity interval training, and I also dreaded workouts the most. High intensity interval training was the most daunting prospect out of any workout routine I implemented.

never tried it personally.