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Old 05-28-14, 08:14 PM   #1
GeorgeBMac
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HIIT: Not just for performance & fitness anymore ...

I just got back from a visit with my cardiologist. He (and his exercise physiologist) were the one's who told me last year that even though I was logging 150 miles week, I was dogging it -- and I needed to get my heart rate up. WAY up!

This time they added HIIT to my regimen -- because, they say, it has proven cardiovascular benefits. I of course didn't ask them for the studies to prove it (most physicians would consider that bad form!) but they seem to know what they're talking about.

The exercise physiologist acknowledged that there are a number different HIIT routines and there is not a lot of evidence to prove which routine is best. But he said that they at the Cleveland Clinic have settled on:

4 minutes MICE @ 75-80% max heart rate
4 minutes HIIT @ >90% max heart rate
... repeat 3-4 intervals of each...

And here, I thought HIIT was strictly for performance and fitness. I had no idea it had cardiac benefits as well...

And, as a side note: as result of the diet and exercise regimen I've been following I am now, for the first time in almost 20 years, officially off all of my heart medications...

20 years ago my total cholesterol was nearly 300 and my LDL was 195. Today, after 6 months without a statin it was 175 & 106 respectively (not great numbers, but good enough).

And, 20 years ago my blood pressure was 160/95 and today, after a couple weeks without any blood pressure medication it was 118/68.

So, all this stuff we talk about on this forum DOES in fact work! We may quibble over the details but most all of us are doing our best to eat well and train well. For me -- this stuff is doing things that I never thought were possible.
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Old 05-28-14, 08:43 PM   #2
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Congratulations - those are some good numbers! And it speaks volumes that they think your heart can take that HIIT routine. Probably most of their patients couldn't begin to do that.
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Old 05-28-14, 11:31 PM   #3
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I wonder if HIIT has the same effect as very high revolution accelerations with a gasoline engine. Burns the muck from the engine. Probably not but it would be nice to think it like that.
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Old 05-29-14, 02:30 AM   #4
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I wonder if HIIT has the same effect as very high revolution accelerations with a gasoline engine. Burns the muck from the engine. Probably not but it would be nice to think it like that.
Isn't it a shame that we don't know the answer to that question?

This country and world is spending itself into bankruptcy paying to "fix" cardiovascular problems with stents, bypasses and medicines (which don't actually fix anything anyway -- or, not for very long anyway. Rather, they just postpone the inevitable). But when it comes to preventing those problems in the first place the research and the evidence are begged, borrowed and stolen from other disciplines -- namely nutrition, sports medicine and epidemiology...

So, it ends up with: "We don't know why it works, but "studies show" that it works..."
... And most cardiologists seem to be only vaguely aware that it works at all. And most take the easy road and just go straight to the medical procedures and pharmaceuticals. But who could blame them? That's what our system pays them and encourages them to do...
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Old 05-29-14, 02:37 AM   #5
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Congratulations - those are some good numbers! And it speaks volumes that they think your heart can take that HIIT routine. Probably most of their patients couldn't begin to do that.
Actually, he said that it has even been shown to be effective even in heart failure patients! But I suspect that most cardiac patients would not WANT to do HIIT -- that's why they ARE cardiac patients to begin with! But, even if they tried it, the rest of the world would tell them to: "STOP -- you need to rest your heart!"
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Old 05-29-14, 03:23 AM   #6
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Something to ponder about HIIT:

Why high intensity cardio exercise is bad for your heart | News.com.au
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Old 05-29-14, 06:53 AM   #7
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Yes, I saw those studies... But I have to say they confused me -- one talked about 5 hours of exercise a week which is not 'intense' by my definition. But, here is a link to a commentary on them by Dr John Mandrola (who is a bike racer and an electrophysioligist):
Exercise, over-indulgence and atrial fibrillation ? seeing the obvious

In it, he calls the results of those studies "obvious"...

And, it makes sense: Intense endurance exercise tends to promote enlarged hearts which in turn tend to promote A-Fib in later years....

I think the question is: How intense does it have to be and what is the duration & frequency needed to do that?

I should have asked my cardiologist about that -- but there was too much else to go over and too little time to do it. But I do intend to follow-up on that during my next appointment.

In the meantime, I do intend to follow his recommendation and start the HIIT as soon as an injury to one of my Piriformis heals up. I figure 2 or 2 1/2 hours a week for 6 months is not going to do any harm....

Which brings back memories of a joke from my teen age years:
"I you do that you'll go blind"
... "OK, I'll do it til I need glasses..."
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Old 05-29-14, 07:17 AM   #8
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I particularly liked how that article about heart problems in wrinkly 60 yr old men illustrated it with 20 yr old women
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Old 05-29-14, 07:31 AM   #9
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But this is the thing. I've always thought that the seemingly very common roadie mentality of HTFU and "if you got time for anything you're not riding hard enough!" is just silly, not that effective for performance gains and, not it seems, even dangerous. Riding in the FTP constantly with some even higher intensity goes completely against the ideal athlete training which someone sometime put so eloquently "people ride too hard when they should be going slow and ride too slow when they should be riding hard". This is one of the main reasons I quite dislike crossfit, as it promotes pure high intensity training without though to base building and other established training methods.

The other thing is: 5 hours of HIIT a week? not gonna happen. HIIT should be just that, extremely high intensity and I can tell you, an hour of maximum HR intervals is quite enough for the week. In addition I could maybe do two hours of tempo intervals per week but that would still be quite taxing. The volume then comes from the base training of very low intensity.

I like the 80/15/5 where 80% is base training of low intensity, 15% is tempo intervals and 5% is maximum intervals. This is of course not counting strength training which is usually pretty high intensity, especially with a kettlebell (and as I just got a 24kg kettlebell it's going to get even more intense)
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Old 05-29-14, 07:45 AM   #10
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Lack of links is always a red flag for me, both in news articles and BF posts. The article text is contradictory because the author doesn't understand the issues and misstates the study findings. I exercise 8-15 hours/week, but only about one hour is "intense."

For example,
Quote:
The most active men those who completed intense exercise for more than five hours a week were 19 per cent likelier to have developed an irregular heartbeat by age 60 than men who exercised for less than an hour a week.
The author is probably reporting on other reporting, rather than on the studies themselves.
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Old 05-29-14, 09:20 AM   #11
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..Lack of links is always a red flag for me, both in news articles and BF posts...
I think in this case, any links would have just pointed to the subscription only journal where the studies were reported. As I remember, it was the May 14th version of "The Heart".

But even the reporting on these studies that I read in another medical journal seemed incomplete and inconsistent.

I would love to see the original studies -- but that does not seem to be possible. So we are left to deal with reporting about the studies...
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Old 05-29-14, 12:07 PM   #12
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I think in this case, any links would have just pointed to the subscription only journal where the studies were reported. As I remember, it was the May 14th version of "The Heart".

But even the reporting on these studies that I read in another medical journal seemed incomplete and inconsistent.

I would love to see the original studies -- but that does not seem to be possible. So we are left to deal with reporting about the studies...
Well, no. We don't know what the Heart article said, or what studies it was based on. However, this subject has been discussed on many fora here, with links to the studies. The article posted above is, as I said, a POS. If anyone is curious about the facts, they can read:

Health Effects of Endurance Sports
http://well.blogs.nytimes.com/2011/0...ype=blogs&_r=0
Diverse patterns of myocardial fibrosi... [J Appl Physiol (1985). 2011] - PubMed - NCBI
Potential Adverse Cardiovascular Effects From Excessive Endurance Exercise
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Old 05-30-14, 02:43 AM   #13
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Lack of links is always a red flag for me, both in news articles and BF posts. The article text is contradictory because the author doesn't understand the issues and misstates the study findings. I exercise 8-15 hours/week, but only about one hour is "intense."

For example,

The author is probably reporting on other reporting, rather than on the studies themselves.
Less than two minutes following the links from the news.com.au article through Huffington Post to the media release resulted in this:

A reverse J-shaped association of leisure time physical activity with prognosis in patients with stable coronary heart disease: evidence from a large cohort with repeated measurements -- Mons et al. -- Heart

this:

Atrial fibrillation is associated with different levels of physical activity levels at different ages in men -- Drca et al. -- Heart

and this:

http://heart.bmj.com/content/early/2014/05/08/heartjnl-2014-305780.extract

Make of it as you will.
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Old 05-30-14, 03:14 AM   #14
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But umm... wasn't there a study which stated that pro cyclists live quite a bit longer than the average populace? They train like 20 hours a week with base miles, HIIT, gym work, tempo rides at FTP etc.
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Old 05-30-14, 04:32 AM   #15
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I wonder if HIIT has the same effect as very high revolution accelerations with a gasoline engine. Burns the muck from the engine. Probably not but it would be nice to think it like that.
haha
Not sure, but when I owned my rx8 (rotary engine) I was told to redline it on a regular basis and followed the advice.
Worst case you appreciate your car more.
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Old 05-30-14, 04:45 AM   #16
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But umm... wasn't there a study which stated that pro cyclists live quite a bit longer than the average populace? They train like 20 hours a week with base miles, HIIT, gym work, tempo rides at FTP etc.
Yes, there have been studies that show that. Actually, I think, almost all of them have shown that. But more recently they seem to be delving a little more deeply into it to cipher out the risks and rewards from different types and styles of exercise.

I think the link that Rowan sited says it well:
Exercise and the heart: unmasking Mr Hyde -- Guasch and Mont -- Heart
As physicians, we often face patients with cardiovascular risk factors or different kinds of heart disease. We prescribe statins, ACE inhibitors or β-blockers, but also (should) encourage our patients to engage in regular physical activity to reduce cardiovascular disease burden. Physical exercise, as a part of cardiac rehabilitation or a primary prevention programme, is seemingly one of a kind. ‘For most health outcomes, additional benefits occur as the amount of physical activity increases through higher intensity, greater frequency, and/or longer duration’.1 No other known therapy offers such advantageous characteristics. This even led some researchers to speculate, some 40 years ago, that marathon runners were immune to atherosclerosis.2 Running a marathon was quite unusual at that time, and cardiovascular adaptation to such a high load of exercise had been scarcely explored. Since then, the late 70s, the number of non-professional runners finishing a marathon has increased 20-fold, and current observational studies are jeopardising the notion of exercise as risk-free. Increased sudden death risk during exercise bouts is well established but extremely rare. An evolving core of evidence supports the hypothesis that regular exercise increases the risk of atrial fibrillation (AF), ventricular arrhythmias or even ischaemic heart disease.3 How do these findings fit with the well-known benefits of exercise? Two papers explore this subject4 ,5 and provide important insights

Unfortunately, the 'two papers' with the details are not available to the general public without a fee.

But this is very much a warning shot across the bow that exercise -- or at least all forms and intensities of exercise -- may be a two headed monster.
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Old 05-30-14, 04:56 AM   #17
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haha
Not sure, but when I owned my rx8 (rotary engine) I was told to redline it on a regular basis and followed the advice.
Worst case you appreciate your car more.
I never had the opportunity to own one of those things -- but I did rent a dumpy, economy sub-compact with one while in Indianapolis back in the 70's (I have no idea what model of Mazda it was).

Wow! Off the line an old lady in a wheel chair could beat it. But once it got the revs up nothing could touch it....

At one point, while merging onto an interstate a Chevelle 396 tried to pass the dumpy little economy car. That little Wankle blew his doors off and just walked away from him. When I finally looked down at the speedometer, it was doing 110mph -- with no sound and no vibration. And the Chevelle was a tiny speck in my rear mirror.

What an amazing engine! And, yes, it did seem to enjoy playing with the redline. (Unlike this tired old body of mine!)
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Old 05-30-14, 05:01 AM   #18
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^^They are really cool engines once you're up to speed. Merging onto interstate was one of my favorite things about owning the car, it had amazing pull in 2nd and 3rd gear. And that 9,000 RPM redline wasn't too shabby either.

That said, the car was a gas guzzler and ate a quart of oil between changes. And they hate cold weather. So it wasn't the most practical daily driver.
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Old 05-31-14, 05:38 PM   #19
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Well, no. We don't know what the Heart article said, or what studies it was based on. However, this subject has been discussed on many fora here, with links to the studies. The article posted above is, as I said, a POS. If anyone is curious about the facts, they can read:

Health Effects of Endurance Sports
http://well.blogs.nytimes.com/2011/0...ype=blogs&_r=0
Diverse patterns of myocardial fibrosi... [J Appl Physiol (1985). 2011] - PubMed - NCBI
Potential Adverse Cardiovascular Effects From Excessive Endurance Exercise
Don't forget to cite! Didn't I tell you to use APA format? I'm very cross with you! *wagging finger*



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Old 05-31-14, 05:43 PM   #20
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Less than two minutes following the links from the news.com.au article through Huffington Post to the media release resulted in this:

A reverse J-shaped association of leisure time physical activity with prognosis in patients with stable coronary heart disease: evidence from a large cohort with repeated measurements -- Mons et al. -- Heart

this:

Atrial fibrillation is associated with different levels of physical activity levels at different ages in men -- Drca et al. -- Heart

and this:

http://heart.bmj.com/content/early/2014/05/08/heartjnl-2014-305780.extract

Make of it as you will.
Are they the original articles? If not, I make nothing of it.

Boy, am glad I have access to original articles for free! it prevents me from believing over generalized, simplified, watered down generalizations.

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Old 05-31-14, 05:50 PM   #21
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Why don't you follow the links and find out, koffee? You might even find out for us what the research actually says beyond the link synopses.
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Old 05-31-14, 06:03 PM   #22
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Ok. Here's one of the abstracts. You can PM me if you want the full article.

I'm citing..... We can't have copyright issues here!

Atrial fibrillation is associated with different levels of physical activity levels at different ages in men.


Authors:
Drca N; Department of Cardiology at the Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
Wolk A; Division of Nutritional Epidemiology, The National Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
Jensen-Urstad M; Department of Cardiology at the Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
Larsson SC; Division of Nutritional Epidemiology, The National Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
Source:
Heart (British Cardiac Society) [Heart] 2014 May 14. Date of Electronic Publication: 2014 May 14.


Publication Type:
JOURNAL ARTICLE
Language:
English
Journal Info:
Publisher: BMJ Pub. Group NLM ID: 9602087 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1468-201X (Electronic) Linking ISSN: 13556037 NLM ISO Abbreviation: Heart
Imprint Name(s):
Original Publication: London : BMJ Pub. Group, c1996-



Abstract:
Objective: This study examines the influence of physical activity at different ages and of different types, on the risk of developing atrial fibrillation (AF) in a large cohort of Swedish men.


Methods: Information about physical activity was obtained from 44 410 AF-free men, aged 45-79 years (mean age=60), who had completed a self-administered questionnaire at baseline in 1997. Participants reported retrospectively their time spent on leisure-time exercise and on walking or bicycling throughout their lifetime (at 15, 30 and 50 years of age, and at baseline (mean age=60)). Participants were followed-up in the Swedish National Inpatient Register for ascertainment of AF. Cox proportional hazards regression models were used to estimate relative risks (RR) with 95% CIs, adjusted for potential confounders.


Results: During a median follow-up of 12 years, 4568 cases of AF were diagnosed. We observed a RR of 1.19 (95% CI 1.05 to 1.36) of developing AF in men who at the age of 30 years had exercised for >5 h/week compared with <1 h/week. The risk was even higher (RR 1.49, 95% CI 1.14 to 1.95) among the men who exercised >5 h/week at age 30 and quit exercising later in life (<1 h/week at baseline). Walking/bicycling at baseline was inversely associated with risk of AF (RR 0.87, 95% CI 0.77 to 0.97 for >1 h/day vs almost never) and the association was similar after excluding men with previous coronary heart disease or heart failure at baseline (corresponding RR 0.88, 95% CI 0.77 to 0.998).


Conclusions: Leisure-time exercise at younger age is associated with an increased risk of AF, whereas walking/bicycling at older age is associated with a decreased risk.


(Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com.proxygw.wrlc.or...ng/permissions.)
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Old 05-31-14, 06:06 PM   #23
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Why don't you follow the links and find out, koffee? You might even find out for us what the research actually says beyond the link synopses.
i meant to say, ok.... I'll follow the links and have a read. But... I'm heading out for a birthday dinner, so man... Don't expect a response like in 5 minutes. BUT..... If Carbonfiberboy PM's me for the articles, I'll hand them over to him if you want to see it and interpret it. My thought processes aren't 100% bikeforums focused these days.

also, I always have had a crush on CF Boy. He knows it. Deep deep deep DEEP down inside, he really knows it.

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Old 05-31-14, 06:22 PM   #24
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Unfortunately, no time to translate. Time's up! Time to celebrate getting old! But.... I was able to pull the editorial as well. That was a big ole "don't take the original article at face value" that I've read in a long time. Weird. I'll get back inline soon. Carbon, PM me if you want the full article. I'm sure you can cite it when you're done? . Heart ya!

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Old 06-01-14, 06:39 AM   #25
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Unfortunately, no time to translate. Time's up! Time to celebrate getting old! But.... I was able to pull the editorial as well. That was a big ole "don't take the original article at face value" that I've read in a long time. Weird. I'll get back inline soon. Carbon, PM me if you want the full article. I'm sure you can cite it when you're done? . Heart ya!

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