Previously: https://www.lesswrong.com/posts/bZ2w99pEAeAbKnKqo/optimal-exercise

Firstly, do the basic epistemics hold up? As far as I know, yes. The basic idea that lifting twice a week and doing cardio twice a week add up to a calorie expenditure that get you the vast majority of exercise benefits compared to extreme athletes holds up, especially when you take reverse causality adjustments into effect (survivorship bias on the genetic gifts of the extreme). Nothing I've encountered since has cast much doubt on this main takeaway.

What updates have I had, then, both in personal experience and in giving training advice to others as well as any research that has come out since then?

  1. A greater emphasis on injury prevention, as the dis-utility from injuries vastly outweighs positive effects from chasing numbers. This one was sadly a foreseeable update with aging, and thus I lose bayes points for it. I did in fact get an injury deadlifting despite a substantial emphasis on good form and not pushing to the limit as many do.

  2. Exercise selection and program optimization likely matter less than I thought, and research that has come out in the meantime has supported this.

  3. One and two combined imply that there is no real downside to picking exercises with lower injury potential for the joints and back.

WRT to cardio, running is a high impact activity and people shouldn't feel bad about choosing lower impact rowing, swimming, or biking (though biking near cars likely eliminates a lot of the health effects in expectation as it is somewhat dangerous). If you can run, great, I enjoy it quite a lot, but I also don't particularly like the hedonic gradient of pushing yourself to run at the volume and frequency that seems necessary to really git gud (many runners run 5-6 days a week).

WRT resistance training, I don't pursue any of the powerlifts (squat, bench, deadlift) anymore, instead focusing on other exercises that don't load the spine/knees as much but allow you to load the requisite musculature easily. Weighted step ups instead of squats can be loaded quite heavy. Hyperextensions, one-legged hypers, and reverse hyperextensions can work the posterior chain with 1/2-1/3 the load on the spine as deadlifts. Bench doesn't exactly load the spine but it is the most dangerous lift going by statistics (dropping the weight on yourself is the most common severe gym accident) and can be replaced with incline bench, dumbbell shoulder presses, and/or dips. These exercises are substantially easier to cue people on in a single session.

  1. Many people IME push too hard, on the intuitive model of suffering being virtuous and health being virtuous and therefore... Or something like that. People are generally surprised that going a rep or two shy of failure is still driving very large benefits. Never pushing your edge isn't too satisfying either of course, but it's something that can be felt into over time.

  2. Many people IME find exercise lacks intrinsic motivation because it doesn't feel like it's 'for' anything else in their life that they care about. WRT this, novelty, community, and skill acquisition winds up being very important relative to more sterile notions of optimal performance. Health is synergistic, and wanting better performance in a sport or activity drives a variety of other motivations from exercise choice, to diet, to sleep. A related thing is that home gyms seem intuitively appealing from an efficiency perspective, but many find they de facto do not exercise as much without the social reinforcement and teleological coherence of the gym environment.

  3. One of the top voted comments on the original post was about training the nervous system, and indeed I've spent substantial efforts here over the last several years to enormous positive effect. I now can experientially agree with the literature that indicates that yoga is an under rated intervention not only for physical but for psychological health.

That's all for now, I'll add more if I think of anything or in response to questions.

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[-]Ruby165

Curated. I find it very cool for someone to have a ~decade follow-up to advice they wrote long ago. A strength of the LessWrong community is that people will review available research and evidence, apply a higher-than-average epistemic approach, and figure out what actually seems like the best way of doing a particular thing. It's cool that LessWrong is now old enough that people can look back and reflect on that advice, and I'd love to see more of this.

(Plus personally, will be trying to build more of an exercise routine along these lines.)

The basic idea that lifting twice a week and doing cardio twice a week add up to a calorie expenditure that get you the vast majority of exercise benefits compared to extreme athletes holds up, especially when you take reverse causality adjustments into effect (survivorship bias on the genetic gifts of the extreme). Nothing I've encountered since has cast much doubt on this main takeaway.

I'd like to offer further reinforcement on this point:

  1. Any exercise, even trivial amounts like walking 20 minutes or doing two sets of exercise a day, can yield dramatic improvements in quality of life. Young-ish healthy-ish people don't tend to notice this because they're already above the "life isn't constantly painful and difficult" bar, but aging combined with a highly sedentary lifestyle can sneak up on some people. It can sometimes take very little to fix or avoid.
  2. Maintaining muscle mass that you've already built is much easier than building it in the first place. Some people find the thought of progressively overloading for eternity to be daunting- and if you don't want to, you don't have to! If you achieve a level of strength that satisfies your requirements, you can maintain it with relatively little effort. And if you do lose it, getting strong a second time will be easier.

In other words: when it comes to exercise, doing anything really does help! (Just don't hurt yourself.)

it seems to be extremely valuable to focus on fitness for, say, six months and gain some appreciable LBM that then becomes very easy to maintain.

I have followed your advice for over a year now, and have this note on my phone with a summary of the regime.

Gym routine

  • ~1-2 hour weightlifting sessions 2-3x a week. (A third weightlifting session is recommended for the first several months, for both gaining strength and building habits.)
  • ~15-40 minutes of vigorous cardio 2-3x a week.

Cardio: 

Very high intensity routines follow a pattern of a short warmup (5 minutes at a slow pace) followed by several bursts of 10-60 seconds all out intensity. (30 on 30 off for 10 intervals is popular and close to maximizing vV02max)

VO2 max interval training consists of four 3-5 minute intervals at 85%-95% your max heart rate interspersed with slower jogging for the same interval.

Weightlifting: A: 4x4 each of squats, bench, weighted chins, deadlifts B: 4x4 each of squats, overhead press, barbell row, power cleans twice per week to give yourself more recovery time.

I’m understanding from your article that the cardio advice stays, however the weightlifting should be replaced as follows:

A: 4x4 each of weighted step ups, incline bench, weighted chins, weighted hypertension B: 4x4 each of weighted step ups, dumbbell shoulder press, barbell row, weighted hyperextension twice per week to give yourself more recovery time

Am I reading it correctly?

Thanks

Good point, I can briefly outline how the research on volume has informed how I lift these days.

It used to be believed that intensity was basically irreplaceable, but more and better studies have shown extremely similar effects from lower intensity, approximately down to 60-65% of your 1 rep max, whereas a 4 or 5 rep scheme is going to be around 80-85% your 1 rep max. So I tend to work the listed exercises in the 8-12 rep range. This further reduces injury risk. The exercise choices are good, and I also add in an accessory or two, defaulting to face pulls for posture and shoulder health and abdominal work (body saws and bicycle crunches) for core stability, though I throw in some hip abductor work when I have access to the requisite machine. The lifts you mentioned are basically still how I train most of the time.

WRT cardio, besides rowing more, I also do more of my running up hills, as it substantially lowers impact and allows higher volume.

It used to be believed that intensity was basically irreplaceable, but more and better studies have shown extremely similar effects from lower intensity, approximately down to 60-65% of your 1 rep max, whereas a 4 or 5 rep scheme is going to be around 80-85% your 1 rep max. 

 

Can you list some of those studies?

https://journals.lww.com/nsca-jscr/fulltext/2017/12000/strength_and_hypertrophy_adaptations_between_low_.31.aspx

You can see that the difference isn't huge even when going down to much lower loads. So the difference between 60 and 80% intensity is unlikely to be very large.

WRT cardio, besides rowing more, I also do more of my running up hills, as it substantially lowers impact and allows higher volume.

 

What do you mean by 'impact' in this context?

Ankles, knees, mostly

So you're saying that for running, it's better to do a more intense (uphill) shorter duration run, than a less intense (flat terrain) longer duration run?
If I understand that correctly, it would imply that, for cardio, the rule is reverse the one for weights: "heavier" for "less reps"?

Running up hills means less impact per effort. You're dropping your bodyweight onto your joints less because your mass is rising.

I may be missing something, but it's not obvious to me from a physics perspective that running up hills is less impact-on-the-joints per effort, though from experience I agree it's true. Maybe I don't understand how impact is measured.

As long as your mass is rising at a constant rate, ascending vs. descending doesn't change the downward force your feet must exert. Yeah, there will always be some vertical acceleration, like when cresting a hill, but unless one is running staircases with landings every 10 steps this wouldn't be representative of the workout.

Inexperienced musing about other possible explanations:

Is it simply that effort-per-step goes up, so that fewer steps are required to achieve your goal? OTOH I've also been told that one should take faster, shorter steps while ascending, which would somewhat counter this effect. OTOOH maybe a short step is better on the joints than a long step. Then opting for steps that are both short and effortful could reduce a workout's total joint-impact.

Oh, and obviously you (and your legs?) don't move as fast. Maybe that is another contributing factor.

Did I get that right, or am I missing something?

I think poor form when running on flat ground is also a component. It is easy to magnify your impact by over striding, which happens less on ascent.

Re injury prevention, you may be interested in Stuart McGill, professor of 'spinal biomechanics' at Waterloo.

For example, you shouldn't exercise first thing in the morning. Something about your discs being more hydrated --> swollen --> vulnerable after laying overnight.

 

Very open questions, but curious if you have any thoughts on Olympic lifting vs powerlifting. Or on kettlebells and hip-hinge exercises.

WRT olympic: don't like loading the spine dynamically for newbies whose muscular strength is outpacing their joint and stabilizing muscle conditioning.

Kettlebells can be okay. Hip hinges really depends on the person and how they're doing them.

Agreed. I'd like to add that if you're avoiding heavy compound exercises, such as Squats and Deadlifts, due to injury concerns, you might not be adequately targeting your core muscles. It's common to see people at the gym performing numerous high-rep bodyweight exercises. However, your core muscles are not much different from the rest of your muscles. To achieve better hypertrophy and strength gains, you should apply the same principles as you would for other muscles, meaning you should aim for approximately 8 to 12 reps.

Reaching sufficient intensity within this range can be challenging with bodyweight exercises, which is why I suggest weighted machine crunches. They not only allow for heavier loads but also simplify the application of progressive overload, leading to improved hypertrophy and strength. These exercises have also been proven to provide superior EMG muscle activation compared to traditional bodyweight crunches.

For those particularly concerned with aesthetics, I recommend training your obliques by adding wood choppers to your routine, applying the same principles as you would for machine crunches.

I use weighted knee raises, and bodysaws, which have the most hilariously disproportionate ratio of actual effort:perceived external effort of any exercise I've tried.

I also don't particularly like the hedonic gradient of pushing yourself to run at the volume and frequency that seems necessary to really git gud

What do you mean by "hedonic gradient" in this context?

There are various psychological pushes to run more in order to run better and faster, but this pushes against your recovery abilities pretty quickly such that much of serious running is about managing recovery. This isn't great if it isn't a primary hobby.

For the resistance training, I recall the minimal program was something like deadlifts, bent rows, and inclined bench press, although I can't recall timing, intensity, or progression for those.

Given your update on spinal injury risk, what would be the minimal program now? Add planking or Pilates to reduce the risk? Or a completely different program?

Weighted step ups instead of squats can be loaded quite heavy. Hyperextensions, one-legged hypers, and reverse hyperextensions can work the posterior chain with 1/2-1/3 the load on the spine as deadlifts. Bench doesn't exactly load the spine but it is the most dangerous lift going by statistics (dropping the weight on yourself is the most common severe gym accident) and can be replaced with incline bench, dumbbell shoulder presses, and/or dips.

OK, that's the lift and the push. Is it still bent rows for the pull? That still seems like load on the spine, but I'm really not an expert here.

oh yeah, I mostly do dumbbell rows instead, and then face pulls as an accessory.

For injury prevention (and can help with exercise efficiency as well): use machines, not free weights.

The advice I've seen elsewhere is that machines are all very well for specialised physiotherapy needs, but outside of that, always to use free weights or bodyweight exercises. The machines fix all the degrees of freedom but one, so you don't engage all the muscles needed to control the movement, so those muscles and the control they give you get no training. To avoid injury, don't use weights heavier than you can control. Don't expect to go from bench-pressing 60 kg on the machine to a 60 kg barbell, or from that to a pair of 30 kg dumbbells. Thus have I heard, but I am not an expert.

I used to be pretty anti machine. I still think 100% machines is a bad plan, but they're useful training wheels.

I'd like to hear your thoughts on inspiratory muscle training (like with a POWERbreathe) vs cardio.

I've done some of it because of reduced lung capacity from childhood asthma, but am not under the impression that it replicates any of the benefits of cardio.

Working out just five minutes daily via a practice described as "strength training for your breathing muscles" lowers blood pressure and improves some measures of vascular health as well as, or even more than, aerobic exercise or medication, new CU Boulder research shows.

source

After six weeks, the IMST group saw their systolic blood pressure (the top number) dip nine points on average

Even six weeks after they quit doing IMST, the IMST group maintained most of that improvement.

that's pretty impressive! Thanks for the update.

The LessWrong Review runs every year to select the posts that have most stood the test of time. This post is not yet eligible for review, but will be at the end of 2024. The top fifty or so posts are featured prominently on the site throughout the year.

Hopefully, the review is better than karma at judging enduring value. If we have accurate prediction markets on the review results, maybe we can have better incentives on LessWrong today. Will this post make the top fifty?

You talk about it in snippets here and there, but I'd love for you to share your full up-to-date strength training program recommendation! 

it's mostly the same it's just exercise selection that has changed slightly

upper body push: dumbbell standing press, incline press, pushups, push press

upper body pull: dumbbell row, chinups

lower body push: step ups (full rom), front squat

lower body pull: RDL, hyperextensions, one legged bridges

accessory: hip abductor with band, face pull, body saws

I do one or two from each depending on mood. Usually 3x8-12.

Thank you! Surprised to see front squats and RDL given your comments about avoiding powerlifts, are these variations less injury-prone vs their more standard options?

much lower weight

Weighted step ups instead of squats

Lunges vs weighted step ups?

I can't get full range of motion without a significant box height (18 inches). And that's with leaning into it to get more ROM. Like this: https://www.youtube.com/watch?v=DqLMErck6A4

Weighted step ups instead of squats can be loaded quite heavy.

What are the advantages of weighted step ups vs squats without bending your knees too much? Squats would have the advantage of greater stability and only having to do half the reps.

I don't understand, a quad focused exercise is inherently involving the knee

why would a weighted step up be better and safer than a squat?

1/2-1/3 the spine loading for the same stress on the legs

Source please

Hold fifty pounds in each hand and add up how much you are loading a single leg. In my case it's 260lbs.

Dumb question: what about VR games like Beat Saber?

They're pretty low on METs, but much better than nothing. Beat Saber helped get me out of bed when I had mild depression.

You should link this post on the top of your old one

Can't, don't have access to my pre LW 2.0 account due to an email collision

The LW admins might help you fix this if you asked via Intercom.

I believe there were two attempts, guessing it's somewhat non obvious how to resolve.

Any good reading on switching away from powerlifting movements to less injury prone ones, pros and cons, studies etc? Also out of curiosity, are injuries from deadlift for example more permanently affecting or just putting you out of action for on average x% of time etc.

I think spinal injuries can be degenerative. I don't know of many serious studies on exercise selection.

Any advice for a rowing schedule? I picked up the sport three months ago and I've been doing 30 minute sessions at the upper limit of my Zone 2. Basically I slow down if I go above 150 bpm and ramp up when I go below 145 bpm.

I've been reading about doing some higher intensity intervals, but I've mostly focused on having good form for now.

Yeah ~1k intervals are probably the next step. You can start working them in gradually with just a single interval at somewhat greater than your easy pace then start increasing the number and intensity as feels good and you spot milestones that feel personally meaningful in the distance.