149 | GUEST SERIES - Dr. Marty Gibala (Part 1) - Maximizing Health with Minimal Time: The Science of Interval Training and the Power of Exercise Snacking

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Hey guys, welcome back to the podcast.
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My guest today is Dr Martin Gabala.
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He's a professor and the faculty of science research chair in integrative exercise physiology in McMaster University, which is in Hamilton, ontario, canada.
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His research examines the mechanistic basis of exercise responses in humans and impacts on health and performance.
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He regularly publishes and peer review journals and speaks at scientific meetings.
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He runs an exercise physiology lab that's internationally recognized for research on interval training, and his first study in 2005 generated headlines worldwide.
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In 2017, he coauthored a bestselling book, the One Minute Workout Science Shows a Way to Get Fit that's Smarter, faster and Shorter.
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Now.
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This book translates the science of time efficient exercise for health and fitness and is geared towards solving the number one obstacle to developing and improving cardio respiratory fitness, which is time.
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I wanted to talk to Dr Gabala because not only is he a world leader in exercise physiology research and interval training specifically, but because I wanted his insights and how we take this body of research literature and bring it down to the level of working with metabolically compromised patients that we typically see in the world of functional medicine.
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I think you'll find his insights pretty amazing.
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Hey guys, welcome back.
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It is the Funk Med Nation podcast.
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I'm your host, dr Steve.
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Those were the tremendous pleasure today to talk to Dr Marty Gabala.
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As you heard in the introduction, he's quite well credentialed, I'd go to imagine.
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At this point, marty, you've published.
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I did a PubMed search just with your name and you know it came back with 165 different hits and of course I'd have to comb through all of those to make sure that was you know, the MGA Gabala that usually shows up on your papers.
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But where do you stand now in terms of your total publications?
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Yeah, that's a reasonable number.
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You know, depends if you count original articles, journal articles.
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But you know probably upwards of 200 publications with book chapters and things like that, but original journal articles probably 150 or so.
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So that's fair.
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I think there's one other M Gabala out there.
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Oh, is there really?
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Yeah, but most of those are mine.
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Yeah, there you go.
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So I do have one question before we get into the nitty-gritty stuff, and that is whether or not you know I've listened to a couple of podcasts that you've done with other people over the years and I came away with the impression somewhere along the way that a lot of the research that you've done, or at least the direction that you took your research, was kind of an outgrowth of your own interest in maintaining your own fitness while you were doing your PhD.
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Is that like?
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Is that true, or is that a little bit of a stretch?
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No, that that's fair.
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And certainly when I was first a faculty member at McMaster.
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So I was hired.
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I've been a faculty member at McMaster for almost 25 years, and so when I was first out of graduate school, I post a lot.
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You know, you're, you're new to the job, you're, you're teaching courses, you're setting up a research program.
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My spouse and I had two young boys at the time, and so it's a busy time of life, and so, ironically for a professor of exercise physiology, I found myself with not a lot of time to exercise, and that led to both what I call a personal and professional interest in interval training.
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I've found it to be quite an effective way to maintain fitness, and my students were often interested in the training regimes of elite athletes, and so I would ask them you know why?
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Why does sprinting make you a better endurance athlete?
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And that led to a conversation of biochemistry.
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And so the more I'm in this field, the more I appreciate both the scientific and athletic history of interval training.
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And in some ways we readjust, we rediscover it every decade or so and sort of add a few new things.
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But you know, sometimes I'm referred to as the guru of interval training and I'm very uncomfortable with that because you know, athletes have been doing this and winning gold medals since the turn of the century.
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Sure, you know it's interesting.
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You say that I grew up in Newfoundland and I did my my first undergraduate degree was at Memorial there and I played volleyball.
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I played volleyball there and I actually went to Alifax and played for Dalhousie back here we're talking back in the 80s, right, so we're talking about a long time ago.
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And I remember the coach that we had at Memorial in.
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You know, newfoundland is is somewhat disconnected from the mainland and you know, we growing up we always kind of thought that we were about 10 years behind the rest of the country and pretty much everything.
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But our coach, keith Taylor God rest his soul he said one day he said, like you know, next time you guys to come to practice, bring your swim clothes.
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And we're like, okay, what's going on here?
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And so he brought us into the pool and he called it Russian step training.
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And so we basically went into the pool and and we did intervals of, you know, really fast treading water interspersed with rest intervals, and I'm a horrible swimmer.
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I mean it was absolute torture for me, absolute torture.
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And in retrospect, and it came to my mind when I read your book back, not long after it came out.
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And, by the way, I remember in the book, now that you say it, I think you tell the story of being young, having young kids and trying to find the time to keep your fitness up.
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But I thought it was pretty amazing that you know, kind of in a little backwater university in the east coast of Canada, that a coach who really didn't have all that much training and certification himself was bringing this kind of conditioning into basically an Atlantic Conference volleyball team.
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I mean, it was just.
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I mean, in retrospect it was pretty insightful.
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Anyway, I just thought that was an interesting anecdote.
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So let's just kind of frame the context because, to be honest, I would love to take this entire time and have you advise me on my own training.
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That would be horribly selfish of me, but it's really what it's what I want to do.
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But the audience for the podcast is predominantly functional medicine practitioners who quite often deal with people who are metabolically compromised, and so it's one thing for the average person to pick up your book, the one minute workout, and to follow your advice and follow your guidelines.
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But a lot of the people that I and others like me work with have you know, they're sedentary.
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But not only are they sedentary, they have very low exercise tolerance, and you know we can theorize that part of the problem is the inflammatory cascade, the oxidative stress, the impact on mitochondrial functions.
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So I think, ultimately, where I would love to go with the conversation is for us to have a sense of how to take the concepts that you've researched and really proven out through your research and tailor that to a subset of the general population that has specific needs.
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Now I know that a lot of the work you've done is not necessarily just college athletes or lead athletes.
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Sometimes you work with people who are metabolically compromised, whether it's a type two diabetic or just somebody who's obese, with cardiometabolic issues and I'm going off on a monologue because I've got so much in my head that I want to ask you about.
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Let me cone it down to this.
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If we can break this up into different sections, let's start talk about the basics.
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Maybe you know.
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Start with terminology, vo2 max and all that kind of stuff.
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I do want to talk at some point about the molecular adaptations that happen with high intensity interval training, because if there's anything that we as clinicians probably need to start harnessing, it's that.
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But we have to do it in a way that doesn't cause more problems than we're trying to fix.
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That's my concern as a clinician.
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So if we can kind of go through the science first and then talk about what you found in research and what applies to the general population, and then maybe we can narrow it down to, you know, the unique needs of the functional medicine community, is that okay with you and can you wrap your head around that?
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Yeah, absolutely and entirely fair.
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You know, and you noted about swimming, I was a triathlete and I was also a very bad swimmer and so I used to say that, you know, swimming was always interval training for me.
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You know, a couple lengths and stop up a bit.
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You know, yeah, that outline sounds great, you know from my outset, for me, so you know, I'm a PhD, not an MD or a clinician, otherwise, you know, certified and so I take a scientific lens to this.
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Obviously, I try to read widely and including, you know, for my book, as you would know, thanks for the plug.
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We interviewed a number, but when I say we, it was co-authored by a friend and journalist colleague, christopher Shogan.
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We interviewed a number of expert medical professionals and other clinicians, including some of those who are involved in physical activity guidelines.
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The question often comes up, you know, why is an interval training per se in the physical activity guidelines?
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And also, as you know, some of our work has looked at individuals with various chronic conditions, cardiometabolic disease, and, you know, obviously a lot of others have contributed to this work as well.
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So, yeah, happy to go with that template and whatever you would like to cover in the time that we have available.
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Yeah, so let's just start with defining cardiorespiratory fitness and then get into topics like VO2 max, what it is, how we measure it.
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I know that you have a sophisticated lab with lots of sophisticated equipment that we don't have.
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So some along the way, some insights into how does a clinician like me, who doesn't have access to that or at least not easy access how do I get a handle on someone's VO2 max.
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So let's back up and let's just start cardiorespiratory fitness what is VO2 max, and then we can kind of branch out from that point.
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For sure.
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So cardiovascular spirit fitness is the integrated capacity of the cardiovascular, the respiratory, the skeletal, muscular systems to take up and utilize oxygen.
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So the best objective measure of cardiovascular spirit fitness is a maximal oxygen uptake test, and of course, this would be a progressive ramp test, often on either a cyclerometer or a treadmill, most commonly not, unlike an exercise stress test, taking the stress test to the functional limit of the individual, while oxygen uptake is measured directly at the mouth.
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And VO2max is a common term that athletes are aware of.
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But, as I stated, it's the best objective measure of cardiovascular spirit fitness as well.
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We measure it in the lab using some sophisticated equipment metabolic carts but it can be estimated as well, and so there are non-exercise algorithms or calculators that are out there.
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Of course, you could Google these and find them on the internet, but I would direct your listeners to if they just Google world fitness level and an online calculator will come up.
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That is the best calculator out there.
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It's validated and it's based on extensive data that's been collected in Norway.
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The primary researcher there is Ulrich Wisloth, who's done a lot of studies, and so, even though, and what you would have to do if you go to the calculator input some numbers such as your age, your biological sex, some rough estimates of your typical fitness.
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Are you completely sedentary?
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Do you a little bit and it will give you a number.
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And even if the number is not entirely valid or accurate, it's a pretty good number to look at changes over time.
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So, are you trending positive?
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Are you trending negative?
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And then the intermediate between just an online calculator and having it measured in our lab would be there's lots of submaximal field tests out there.
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You know.
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A classic one is the Canadian home fitness test, where you would just step up and down on a single bench, step to a metronome and measure your pulse, which you could do just by feeling your neck or your wrist and based on your pulse, that's going to give you I think you refer to an amagram that's going to give you an estimate.
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There's beep test, shuttle run so many different ways to look at this.
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So from and I'm thinking clinically here and practically if we use that website and that calculator that you say is a validated algorithm, how closely does that match what you do in the lab, and is the correlation more accurate or tighter for certain populations, whether it's elite athletes or sedentary people?
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So certainly it's validated and correlated and again, we don't have to belabor it here but at the site of the calculator an interested individual could go into what is the science behind some of this and they could look at the scientific research that backs up the calculator.
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I don't know if it would be any better for a highly trained athlete compared to a sedentary individual, because it really comes down to these six or seven basic questions and I would suspect that typically people on either ends of the far tail, it's maybe less accurate.
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You just think about a normal distribution.
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Most people are going to fall in the middle and so it's probably going to capture again most accurately those.
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But we've in many of our research participants we're measuring objectively VO2 max and then we'll have them refer to the calculator and again, our ad hoc or subjective impression of that, without doing a scientific study, is it's not bad, it's certainly reasonable if that's all you have available.
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And let me just emphasize as well why is cardio respiratory fitness so important?
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Well, clinically, there's been strong calls.
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It should be clinical vital sign that we measure along with things like body temperature and blood pressure.
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I totally agree Because, again, as many of your listeners I'm sure would be aware, individuals who have a one met higher cardio respiratory fitness, so that's maybe a 10% higher value for the average person.
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Your all cause mortality risk is 15% lower.
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The risk of developing cardiovascular disease is about 19% lower, and so it's just such an important metric, but it's not typically something we assess in a clinician's office.
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Yeah, and I'll tell you just maybe for some context for you, but certainly for anyone listening like, in the field of functional medicine you have credential practitioners like myself, chiropractors, we have medical doctors, nurse practitioners, dos, oriental medical doctors and natural paths, and then we can get into things like dietitians and nutritionists, and obviously we all have different backgrounds from education and experience and everyone practices functional medicine kind of in their own way.
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Right, there's no universal governing body that says this is what functional medicine is and this is how you should do it.
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And so the circles that I run in, and particularly when we teach weekend seminars, we teach a clinical model that places tissue perfusion and oxygenation at the top of the list.
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Like that's the base of your hierarchy, that if you can't perfuse your tissues, if you can't deliver oxygen to your cells to drive ATP production through oxidative phosphorylation, then you're not going to get much else in different places because of the importance of ATP, you know, just for general physiological function, and to me you said that you think that this should be another vital sign.
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I cannot agree any more wholeheartedly than I do for that particular reason, which is why I think it's important for us in the field to be able to assess it without necessarily having access to, like an exercise FIS lab like you run, and so I'm glad to hear that we do have some options.
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But it begs questions to me, like, for example, we're in the age of wearables right now, so I've got my eye watch in it If I go for a walk with my wife, you know.
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So you got an oar ring, so I look at the VO2 max that's estimated in my health app on my phone and with my watch, and I've been to the website that you referenced and I've put all my data in and there's like a there's like a 10 point difference between what my watch tells me and what the calculator tells me.
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So where are we in terms of wearables, and is there are all wearables off to a certain point?
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Or there's something like the oar ring, for example and I'm asking because you're wearing one like which one rises to the top in terms of accuracy?
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No-transcript.
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Yeah, so I don't have an expert opinion on this.
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My general opinion is all of the wearables have limitations.
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My understanding is it really depends, obviously, on the underlying algorithms, which vary.
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My own experience with a number of wearables is they're not particularly great at even measuring heart rate, particularly at high intensity or intermittent exercises.
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It just doesn't capture it well compared to, for example, if I wear a pole or heart rate strap and measure it that way.
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The corresponding numbers that are invariably generated are not necessarily great either, I would say.
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My sense is the validity of some of these is not great, but probably, like a lot of things, they're reasonably reproducible.
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Again, regardless of what the actual number is, probably people shouldn't trust the number as being fully accurate.
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They should rather use it as a guide point.
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Again for this idea of trending positive or negative or looking at changes over time.
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The reason I purchased an Aura is again based on my reading.
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It's one of the best devices out there for tracking sleep and so.
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I'm a committed exerciser.
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I know what YouTube Max is.
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I'm going to do this.
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I don't need external validation or encouragement, but one thing that I'm trying to do, especially as I age, is really sleep better, and I get very objective data that helps me, although most of the time if I haven't slept well, I know it and the Aura ring just reinforces that and my friend and colleague, Dr Stuart Phillips at McMaster I know he ended up just abandoning all of this because all it did was reinforce that he's not a particularly great sleeper a lot of times and I wonder what we did before all the wearables hit the market.
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I think about working out 15, 20 years ago.
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It's like you know, when you're pushing yourself hard, you know when you needed to stop and take a rest and you knew generally when you were recovered enough to go again.
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And you know, now we're kind of tied to the numbers and I'm, you know, constantly checking my heart right, go, okay, now I'm down to a certain threshold, it's time to go.
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So I completely hear you on that.
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So with the wearables, do they tend to consistently under or over estimate VO2 max?
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I think it goes both ways and, again, I haven't done a deep dive in this, but just my general sense is that it can over or under estimate, certainly depending on the device and maybe even in the given situation, right?
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So are you engaged in high intensity exercise or not?
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And you know my, the my.
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Let me bookend that statement with saying, you know I also involved in some collaborative research.
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This has not led from my group, this is led out of an individual, emmanuel Stammatakis, at the University of Sydney, where we recently published a paper where we were harnessing the power of wearables and it was data that was collected as part of the UK Biobank and in that study, in large numbers over 25,000 individuals who had worn wearable devices we were able to track mortality risk over a seven year period and show that engaging in brief, vigorous, intermittent lifestyle activity something we've termed VILPA, even three to four bouts of vigorous effort, three to four bouts totaling three to four minutes of vigorous intensity physical activity, not even structured exercise was associated with a marked reduction in all cause mortality.
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You know we're talking almost 40%, and even higher when it came to cardiovascular disease risk.
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So you know, I think that's an example of where wearables can really be harnessed in a research setting and from an applied or practical.
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One of the things that we called for, suggested, is maybe we can, you know, build in greater motivational tools, tracking your VILPA as part of your Fitbit or name your device to encourage people.
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And you know, it fits with our overarching theme where small amounts of physical activity can pay a lot of benefit.
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And, you know, if you don't have a half hour in your day, some people tend to blow off their exercise and people who are just starting out, compromised, as you say.
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I think that's an empowering or encouraging message for them that hey, even 30 seconds at a time can really pay benefits if it means a couple of minutes in a day.
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Yeah, and you.
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I know that in the book and it's been a while since I've read the book but if I remember correctly, you talk about the concept of exercise snacking.
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And before we get into that, can you define again VILPA?
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What does VILPA stand for?
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Yeah, sure.
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So VILPA stands for vigorous, intermittent, like-isle physical activity, and so the key things there are vigorous pace, intermittent in nature, lifestyle physical activity.
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So this is not structured exercise.
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We're talking about things, activities of daily living that you might already be engaged in.
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You know.
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You get off the bus or the subway and you're heading home and you have your groceries or a heavy backpack and you pick up the pace.
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You know these very simple cues and messages that we give to people.
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You know my favorites, of course get off the airplane, the plane.
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You've been sedentary for five, six, sometimes eight, 10, 12 hours and you have the choice between the escalator or the stairs.
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Obviously, the best thing is to grab your bag.
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You have, you know, weighted uphill stair climbing.
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There you go Is a classic example of VILPA, but many of us choose the escalator, of course.
00:23:42.757 --> 00:23:50.250
So it's taking advantage of those opportunities that are already part of our day, regardless of building and structured exercise.
00:23:50.846 --> 00:24:04.295
So let's I was just thinking let's delay the conversation about exercise snacking, because I do think that that's probably a great way to start somebody who is metabolically compromised on some type of interval training.
00:24:04.295 --> 00:24:16.991
And you know, I would imagine that for the most, most practitioners who are listening, we tend to shy away from asking people who are metabolically compromised to do things that are relatively intense.
00:24:16.991 --> 00:24:23.314
And so let's go back to kind of like, the basic science.
00:24:23.314 --> 00:24:25.378
What are some of them?
00:24:25.378 --> 00:24:33.997
The molecular adaptations, Like we understand that there's an increase in efficiency and oxygen uptake and delivery, right, and that's clinically, that's what we're looking for.
00:24:34.599 --> 00:24:54.656
But I know that you guys have studied, at least in some ways, the molecular adaptations as it relates to changes in heart, muscle and function, changes in muscle fiber when you do your tissue biopsies, and also changes in mitochondrial biogenesis, which for us, that's probably where the gold is.
00:24:54.656 --> 00:25:04.037
So can we talk a little bit about these molecular adaptations so that if a clinician says, hey, I'm going to start implementing this, what is it that they can expect clinically?
00:25:04.037 --> 00:25:10.269
And you know how do we communicate that or the importance of that to someone who's going to be doing that activity?
00:25:12.136 --> 00:25:12.638
Absolutely.
00:25:12.638 --> 00:25:24.997
And if you indulge me just before we get to that discussion, even taking this step back around, interval training and you'll see I continue to use that term as opposed to high intensity or hit.
00:25:24.997 --> 00:25:46.739
Hit, you know, is that sort of the buzzword and that captures a lot of the headlines and to me that's one specific type of interval training and I think you know an unfortunate reality of the field still is there's no universal terminology or accepted definition of hit.
00:25:46.739 --> 00:26:04.434
Many offer them, so for me I like this more encompassing term, interval exercise or interval training, which is just intermittent, go hard, take a break, however you define that, and I like to think of it in terms of green, yellow and red zones.
00:26:04.454 --> 00:26:08.314
You know, if you're an athlete you're often talking about three zone training or five zone training.
00:26:08.354 --> 00:26:33.537
But if we could just think of three zones, whereas green is intermittent, light to moderate exercise, and so that might just be interval walking for some people, yellow zone is vigorous but submaximal, so somewhere around about 80% of maximal heart rate, up to about VO2 max pace, and that's where classic high intensity interval training would fall.
00:26:34.239 --> 00:26:52.272
And then we have red zone, which is true supermaximal or above VO2 max pace, right up to sort of sprint from danger or sprint to save your life pace, and obviously we can perform at a workload that's well above VO2 max pace for very short periods of time.
00:26:52.272 --> 00:26:58.170
And so it goes back to this issue of can people perform interval training?
00:26:58.170 --> 00:27:00.859
In my opinion, almost anyone can.
00:27:00.859 --> 00:27:08.396
You know, clearly there's certain individuals who for whom exercise or interval training is absolutely contraindicated.
00:27:08.396 --> 00:27:31.873
But if we're talking green zone intermittent type exercise, there's great data on older individuals with type two diabetes who are overweight and clinically obese being able to perform that type of exercise and actually it might provide greater benefits in terms of blood sugar control compared to just steady state walking.
00:27:31.873 --> 00:27:45.198
You know, both options are great, but there are some data to suggest that the intermittent approach even what I call gentle hills and valleys, just varying up the pace may provide better returns for a given time investment.
00:27:45.664 --> 00:27:49.762
Yeah, and just for clarity, you mentioned you use the term interval walking.
00:27:49.762 --> 00:27:51.671
That doesn't mean walking sometimes.
00:27:51.671 --> 00:28:01.829
That means, while you're walking, varying the pace for a given time and then slowing down again, and you can accomplish that on a treadmill or just out walking in your community, right?
00:28:03.429 --> 00:28:03.891
Absolutely.
00:28:03.891 --> 00:28:12.288
Our classic example was always you know if you're walking your dog or with a partner you're supposed to, in the evening, pick up the pace for two light posts and then back it off.
00:28:12.288 --> 00:28:25.513
And as simple as that sounds, there's good data now from a small, well controlled, randomized clinical trials to support the point that I just made around fitness, even body composition and certainly blood sugar control.
00:28:25.884 --> 00:28:29.839
Yeah, so let's get back to the molecular adaptations and dude.
00:28:29.839 --> 00:28:34.250
Every word that comes out of your mouth makes five more questions pop into my head.
00:28:34.250 --> 00:28:40.798
So, yeah, let's go back to the metabolic adaptations and let's kind of talk about that briefly.
00:28:40.798 --> 00:28:49.169
We don't have to go into too much depth and detail unless you want to expound perhaps on the mitochondrial biogenesis aspect of that.
00:28:50.982 --> 00:28:51.202
Sure.
00:28:51.202 --> 00:29:06.744
So you know, I'm trained as a skeletal muscle physiologist and so much my basic science research looks at skeletal muscle remodeling and how exercise dose, volume, intensity, duration affect that process.
00:29:06.744 --> 00:29:29.675
And the process that we study the most is indeed mitochondrial remodeling, and so mitochondrial biogenesis, of course, is just the formation of new mitochondria, and of course, you know, many of us, we were trained to think that mitochondria are these bean shaped compounds, but really they're a reticular network much like a capillary.
00:29:29.675 --> 00:29:33.133
So imagine capillaries flowing through skeletal muscle.
00:29:33.133 --> 00:29:35.803
The mitochondrial reticulum is very much the same.
00:29:36.505 --> 00:29:59.404
But we can quantify changes in the mitochondria either acutely, so we can study this process of biogenesis, so the triggering process, by looking at certain molecular proteins, so we can study, for example, the phosphorylation of specific proteins using various blotting techniques.
00:29:59.404 --> 00:30:23.044
We can use, you know, rt-pcr to look at changes in mRNA levels, and so those studies would be very acute, where we give someone a dose of exercise, we take a biopsy from their skeletal muscle before and either right after exercise or a few hours into recovery, and we can literally quantify or measure the turning on of these various signals.
00:30:23.044 --> 00:30:32.912
And we know that these signaling cascades are then in turn linked to functional and other changes in mitochondria.
00:30:32.912 --> 00:30:37.569
So either structure or function of mitochondria, you know, and there's certain key ones that you'll look at.
00:30:37.569 --> 00:30:45.211
So PGC1-Alpha, for example, is a very important regulator Some people refer to as the master regulator of mitochondria biogenesis.
00:30:45.211 --> 00:30:49.233
If that's activated, you know you're going to get new mitochondria formed.
00:30:49.233 --> 00:31:17.681
So that's the way we generally study it, and you can sort of think of some of these other proteins as serving as molecular fuel gauges, and so as the fuel availability in the cell starts to drop, like in availability or things like that, the fuel gauges are starting to fall, and so you can imagine it's like the red light on your dashboard coming on, and intensity of the red light might signal the relative energetic crisis.
00:31:17.901 --> 00:31:35.150
And so, even though you know from elegant studies, most of it in animals, we know that activation of these molecular fuel gauges is important for triggering biogenesis, but we don't really know well, is it the rate that they're turned on?
00:31:35.150 --> 00:31:38.364
Is it the absolute amount that they're turned on?
00:31:38.364 --> 00:31:40.653
Is it a threshold that you have to get to?
00:31:40.653 --> 00:31:45.065
And so that's what a lot of the human research is now trying to tease out.
00:31:45.065 --> 00:31:59.770
You know how can you do these short, quick pulses, and so our sort of working hypothesis is you can imagine you could push on the gas pedal in your car and hold a given moderate speed for a long time and that's going to run out of fuel.
00:31:59.770 --> 00:32:24.644
Or you can reef down on the gas pedal really hard and drop the rate of fuel quickly, even though it's going to be a smaller magnitude of change absolutely, but the rate of change is very high and what it appears is that we can turn on the same molecular restructuring process or physiological remodeling process in different ways.
00:32:24.806 --> 00:32:31.029
So it's not like there's anything particularly unique about interval training in terms of the underlying physiological responses.
00:32:31.029 --> 00:32:41.653
It's just that you're triggering that same fundamental biological process in different ways, or at least that's how we think about it and have some evidence to support that.
00:32:42.420 --> 00:32:56.746
So are we at a place right now where we're questioning if I heard what you said correctly questioning whether or not improvements in function are due to increased number or increased function of the mitochondria?
00:32:56.746 --> 00:33:04.326
Do you ever see in your studies, do you ever see function improving, but mitochondria population doesn't change?
00:33:07.290 --> 00:33:08.071
Less so to that.
00:33:08.071 --> 00:33:12.547
So you can measure improvements in both content and function.
00:33:12.547 --> 00:33:24.453
But if you express the improvement in function relative to the increasing content, the intrinsic capacity of the mitochondria is not getting much better.
00:33:24.453 --> 00:33:35.282
If you will, the qualifier there would be in some compromised individuals or certain disease conditions.
00:33:35.282 --> 00:34:00.172
And again, I am not expert here but my colleague, for example, Dr Mark Tarnapulski, who's a clinician scientist, he's a neurologist who studies mitochondrial disorders, and Mark has done a lot of work looking at both nutritional as well as exercise interventions in these patients, many of whom these are very rare mitochondrial disorders, often affecting very young children.
00:34:00.172 --> 00:34:28.139
And so my sense there is you can see changes in intrinsic capacity sometimes, but generally speaking, I think in healthy humans or even compromised humans, the improvement that we see in functional capacity is mainly related to an increase in content and so overall function, as opposed to intrinsic mitochondrial function on a per unit basis.
00:34:28.199 --> 00:34:29.402
Yeah, understood, have you?
00:34:29.402 --> 00:34:48.731
And it's interesting that you brought up your colleague, because my next question was whether or not you guys had ever studied, as part of an intervention, using nutrients, natural compounds, that have been shown to improve either biogenesis or oxidative phosphorylation to cell respiration.
00:34:48.731 --> 00:35:01.500
So, whether that's antioxidants or membrane phospholipids like phosphotide or choline, anything like that, have you done different cohorts where training stimulus was the same and one took supplements and the other one didn't?
00:35:03.827 --> 00:35:04.811
Yeah, we have.
00:35:04.811 --> 00:35:24.998
We've done a number of studies using nutritional interventions to see if we might promote greater responses and generally we don't see much in that the nutrient doesn't markedly augment things and that's probably because exercise is such the big hammer.
00:35:24.998 --> 00:35:30.936
The nutrient, if it's eliciting responses, it's very subtle.
00:35:30.936 --> 00:35:44.860
If you talk about elite athletes, there's a pyramid right in the bases sleep and fundamental nutrition and fundamental training and then maybe at the top of the pyramid there's room for very specific nutritional supplements in specific situations.
00:35:44.860 --> 00:35:51.885
And if you're the elite athlete who's doing everything else perfectly, you can get improvements from that in certain situations.
00:35:51.885 --> 00:35:53.572
But for most of us we don't have the pyramid.
00:35:53.572 --> 00:36:06.498
Even if we're committed, we don't have the pyramid that great, and so the variability in the pyramid is just so great that changes in nutrients or that subtle nutrients don't have a major effect.
00:36:06.518 --> 00:36:11.878
But there is some work, for example, around low carbohydrate availability.
00:36:11.878 --> 00:36:26.293
I'm not talking necessarily ketogenic diets here or anything like that, and that could be a whole separate podcast because we're doing some work with exogenous ketone supplements, for example but just low-glycogen availability per se.
00:36:26.293 --> 00:36:30.168
There is some evidence that that can enhance mitochondrial biogenesis, probably because it makes exercise more stressful.
00:36:30.168 --> 00:36:35.650
If you don't have carbohydrate on board it's a more stressful situation, but it doesn't necessarily mean that performance is going to be better.
00:36:35.650 --> 00:36:40.092
So it's a bit like altitude.
00:36:40.092 --> 00:36:42.762
I can take you to altitude and it's going to hurt the heck when you're exercising.
00:36:42.762 --> 00:36:52.396
It's going to be more stressful, but it doesn't mean that that's going to lead to greater functional responses when you return to sea level.
00:36:52.416 --> 00:37:16.297
Again, the exception there would be in compromise really compromised patients or certain conditions, and so, for example, again, dr Tarnopolski has used something as simple as creatinine, which we know is involved in ATP transfer into the mitochondria and shuttling Creatinine supplementation in some of these individuals has actually enhanced mitochondrial function.
00:37:16.297 --> 00:37:21.550
So it's like anything in science it really depends on the context.
00:37:21.550 --> 00:37:25.119
There's a lot of gray and nuance is really important.
00:37:28.168 --> 00:37:29.092
Yeah, understood.
00:37:29.092 --> 00:37:36.592
So we've been talking about some of the studies and doing biopsies and looking at tissue-specific adaptations.
00:37:36.592 --> 00:37:43.949
It brings to mind the question as to how modality specific these adaptations are.
00:37:43.949 --> 00:37:59.257
I know that you're a big cyclist, so if I'm a clinician and I'm trying to get someone to get into some kind of an interval training that's appropriate for their physiology, do I need to worry about the modality that we use?
00:37:59.257 --> 00:38:14.702
If my goal is to improve my physical use, if my goal is to improve global and systemic mitochondrial population and function, should I have them bike on one day, row on another one, swim on another one or do some combination?
00:38:14.702 --> 00:38:26.163
Or can we pick one modality, because I know you're very big on maybe the most important variable is adherence and consistency, which means you've got to do something you enjoy that you'll stick to.
00:38:26.163 --> 00:38:27.769
So can you speak to that?
00:38:29.797 --> 00:38:35.757
Yes, and I don't mean to start every answer with it depends, but it does depend, and so I guess you know so.
00:38:35.757 --> 00:38:48.625
So point number one is, if we're talking cardiovascular conditioning, there's an old saying you know your heart doesn't know what your muscles are doing, and so from that standpoint it doesn't matter.
00:38:48.625 --> 00:39:01.025
So whether you row or swim or take the stairs or cycle or walk uphill, you know the cardiovascular stress for a given intensity is going to be about the same.
00:39:01.025 --> 00:39:05.666
So, however you elevate your heart rate, you're going to get cardiovascular remodeling.
00:39:05.666 --> 00:39:28.820
And so the delivery side of the equation, again, if we're comparing, a given dose of exercise at a given intensity is going to be the same or very, very similar, and given that cardiovascular spirit or fitness or go to max is primarily limited by delivery, so it's not oxygen utilization, it's more a delivery problem.
00:39:28.820 --> 00:39:33.764
You know so that that's one answer where it doesn't matter.
00:39:34.315 --> 00:39:56.521
Now if you're looking more at mitochondrial remodeling and skeletal muscle, which clearly is a contributor there, and it might be a more important contributor, arguably, in certain situations, or you know, for continued submaximal exercise or the ability to sustain any type of physical activity without fatiguing very, very quickly.
00:39:56.521 --> 00:40:01.108
There, the more specific training, the better, right.
00:40:01.108 --> 00:40:13.021
And so if you want to have the greatest approved mitochondrial content in your vastus lateralis and you're a cyclist, you want to cycle a lot and you want to do a lot of intermittent cycling exercise.
00:40:13.021 --> 00:40:19.905
And even you know, we have one of these in our lab now, even single leg cycling, where athletes are doing counterweighted single leg cycling.
00:40:19.905 --> 00:40:23.784
So it very much resembles and feels like natural two-legged cycling.
00:40:23.804 --> 00:40:32.061
Sure, well, what it allows you to do is increase the workload that one leg is able to do, because there's not a central delivery problem.
00:40:32.061 --> 00:40:34.782
So lots of really cool applied settings there.
00:40:34.782 --> 00:40:43.862
So again, it's an it depends answer, but it depends in part on are you targeting more the heart, the lungs, the blood vessels?
00:40:43.862 --> 00:40:45.561
Are you targeting more skeletal muscle?
00:40:45.561 --> 00:41:06.822
And then you know, from a applied perspective or a real life perspective, given that our biggest problem is people are just not moving generally, yes, then I would come back to do what you can get your patient to do, or what they like and enjoy, because they're probably more like to stick with it and if they're open to variety, variety is always better.
00:41:07.224 --> 00:41:07.423
Right.
00:41:07.423 --> 00:41:15.097
So and I was thinking, a couple of days ago, before this big ice storm came and hit us, I was in the gym.
00:41:15.097 --> 00:41:28.302
I did about 65 minutes where I did the first I think it was the first 20 minutes on an elliptical and you know I was kind of keeping it around the zone two stuff, and it was that particular day was a long, slow intensity day for me.
00:41:28.302 --> 00:41:33.085
And then so I get, I get bored very quickly with all this stuff.
00:41:33.085 --> 00:41:35.663
So I'm not usually listening to podcasts or something.
00:41:35.663 --> 00:41:48.141
So I'll spend 15 or 20 minutes on, say, an elliptical and then I'll pop on the rower and I might spend five or 10 minutes there and then I might go to like an echo bike, like a, like a Schwinn Erdine type thing.
00:41:48.181 --> 00:41:58.161
Because for me, you know I'm not, I don't play sports anymore, so I don't have the demand of specificity, I want global impacts.
00:41:58.161 --> 00:42:08.025
And so it brings to mind questions, because I've heard you say in other podcasts and I've seen this in the literature about modality, specific adaptations.
00:42:08.025 --> 00:42:14.219
But you know, most of our clients, at least the ones I work with, they're not athletes, unless you want to call life as a sport, right.
00:42:14.219 --> 00:42:16.483
So we're all athletes in the sport of life.
00:42:16.483 --> 00:42:20.043
I look at it that way, and so I want global adaptations.
00:42:20.043 --> 00:42:26.139
I mean, I don't want to go okay, your legs are really efficient at doing something, but the rest of your body is not.
00:42:26.735 --> 00:42:44.177
And I know that there is some carryover with things like even high intensity strength training into VO2 max, but it doesn't come anywhere near the specific adaptations in cardiorespiratory fitness as you would get with either steady state cardio or with intensity work like high intensity intervals.
00:42:44.177 --> 00:42:58.422
And so I wonder about things like I'm a huge kettlebell fan and if you, you know if anyone thinks that you can't get a good cardio workout with kettlebells, let me disabuse you of that notion.
00:42:58.422 --> 00:43:06.889
I mean, it can be incredibly, incredibly anaerobic or it can be very low, steady state sustained.
00:43:06.889 --> 00:43:29.507
So would something like either, you know, continuous two handed kettlebell swings or doing like a complex of movements where you're constantly moving, you're varying your speed and intensity, but you're still using the same weight to me that's that would be ideally suited to developing some kind of whole body, increased efficiency and cardiorespiratory fitness.
00:43:29.507 --> 00:43:30.809
Would you agree or disagree?
00:43:30.809 --> 00:43:32.460
And if I'm wrong, where am I wrong?
00:43:34.016 --> 00:43:40.505
No, I agree 100%, and you know I used to call them pre pandemic hotel room workouts, right.
00:43:40.534 --> 00:43:45.467
You get to the gym and especially if you're traveling in North America, it's impossible to find the stairs or it's.
00:43:45.467 --> 00:43:48.851
You know it's an emergency exit only and you can't get to the gym.
00:43:48.851 --> 00:43:51.943
So you have to do something in your hotel room and invariably it's.
00:43:51.943 --> 00:43:54.619
It's burpee sets or things like that.
00:43:54.619 --> 00:44:01.722
And so you know, I believe I'm a believer in kettlebells, some in my, you know, my home gym and my basement as well.
00:44:01.722 --> 00:44:02.503
Same thing.
00:44:03.255 --> 00:44:17.411
So absolutely resistive type exercise, especially when done at a vigorous pace with short recovery periods, absolutely can provide a cardiovascular conditioning stress.
00:44:17.411 --> 00:44:33.842
And that's where I think bodyweight style or simple equipment based resistance exercise, it's sort of opp or falls in that sort of great bill zone and, as you say, it's not going to provide the cardiovascular conditioning the traditional endurance aerobic training would.
00:44:33.842 --> 00:44:37.478
It's not going to provide the strength benefits traditional heavy weightlifting would.
00:44:37.478 --> 00:44:40.445
But for a lot of people it doesn't really matter.
00:44:40.445 --> 00:44:44.284
It's an extremely time efficient way to train.
00:44:44.284 --> 00:44:46.641
It's extremely functional.
00:44:46.641 --> 00:44:52.813
You know again, I'm talking to converted and you well know this, but you know it.
00:44:52.813 --> 00:44:56.786
Even it's fine to sit on a bike, but that's not providing a lot of fun strength for you.
00:44:56.786 --> 00:45:00.125
It's making your quad stronger and your heart, your heart's getting more aerobic.
00:45:00.335 --> 00:45:03.784
But you know, this was something that not to get off topic, but it really came home to me.
00:45:03.784 --> 00:45:20.344
I had a bike crash and I suffered a concussion and I was seen by an neurologist and as part of my recovery because you know, I know, okay, exercise is good for fitness and that can help recovery from concussion if you start slow and all of that.
00:45:20.344 --> 00:45:35.067
But the neurologist's first thing they said to me is actually I'd rather have you just out on the street throwing a Frisbee with someone you know and because of the sort of the three dimensional and or just go for a walk, ideally on some trails.
00:45:35.067 --> 00:45:43.159
You know, I was literally wearing a helmet, so there was the precautions there, but in my head was just like I'm going to get back on the bike at home and he's like that's great, that's going to help you.
00:45:43.159 --> 00:45:55.224
But it was a reminder that functional movement and three dimensional space is important for all of the adaptations that come along with that.
00:45:55.606 --> 00:45:55.806
Yeah.
00:45:55.806 --> 00:46:05.923
So we should get you and Tom and I on and just talk about the value of multimodal exercise and the impact on the brain and all that kind of stuff.
00:46:05.923 --> 00:46:08.342
That would be a fascinating conversation.
00:46:08.342 --> 00:46:21.322
Let me go back to something you said about the mitochondria, because the classic way that that's taught at least the way that I learned it is that you have these individual organelles that are floating around in the cytoplasm.
00:46:21.322 --> 00:46:24.864
But you said that it's really more of a reticular network.
00:46:24.864 --> 00:46:29.646
So inside any given cell you have X number of mitochondria.
00:46:29.646 --> 00:46:40.864
Are they connected in some contiguous fashion with physical structure or are they connected biochemically, where they're just talking to each other in a network fashion?
00:46:42.277 --> 00:46:45.646
Yeah, probably both, but certainly they're connected in a physical structure.
00:46:45.646 --> 00:47:03.344
And now there's these very elegant 3D imaging studies, including on human muscle, where they're basically able to stain just the mitochondrial network and then take the other stuff away and it very much looks like a capillary network.
00:47:03.344 --> 00:47:32.266
And so we still talk about subsarc Olemol and intermyofibrillar parts of mitochondria, and we've done electron microscopy analysis in our laboratory looking at trying to quantify subsarc in intermyofibrillar mitochondria but recognizing that they're still connected, even though they tend to occupy more the volume of certain parts of the muscle.
00:47:32.266 --> 00:47:40.659
Subsarc Olemol and literally squeezed between the actinomyosin filaments, is where they reside most inside skeletal muscle.
00:47:40.659 --> 00:48:03.067
But then there's also probably these very complex biological signals that are also talking, and there's again my colleague Dr Tarnopolski talks about exorcians, which are really just myokines that are released from skeletal muscle but from other places as well that we're just really learning about the interconnectivity of these molecules.
00:48:03.715 --> 00:48:13.918
And on that topic with the myokines, do you think that that is at least partly responsible for systemic improvements in health when you're doing modality-specific exercise?
00:48:14.235 --> 00:48:20.797
Thank you, yeah, I do and again, I'm biased by interactions with Mark and his thinking on this.
00:48:20.797 --> 00:48:23.887
But or I've been educated by Mark and his thinking on this.
00:48:23.887 --> 00:48:25.559
But you know, certainly, you know why.
00:48:25.559 --> 00:48:28.266
You know how do we explain that.
00:48:28.266 --> 00:48:33.963
You know skin is is often younger, if you will, in exercises.
00:48:33.963 --> 00:48:47.947
You know even you know name a physiological function and there's almost any part of the body that's enhanced by exercise and it can't just be because that local tissue or cell was engaged and so it's probably related to.
00:48:47.947 --> 00:48:55.353
You know something of these circulating system factors that are that are contributing some, some enhancement there.
00:48:55.559 --> 00:49:07.891
Yeah, all right, let's let's circle back around, because I realized that we didn't talk about in the scheme of measuring VO2 max and using that as a metric of cardiorespiratory fitness.
00:49:07.891 --> 00:49:13.695
Talk about good numbers and I can hear you say, well, it depends.
00:49:13.695 --> 00:49:15.400
It depends on where you're starting from.
00:49:15.400 --> 00:49:37.873
I'm sure you know any improvement is better, but do we have certain thresholds that if I'm a clinician and now I'm looking at VO2 max as one of the vital signs that I should be tracking or at least assessing initially in my client base, what numbers should I be looking at in terms of minimal, minimal capacity?
00:49:37.873 --> 00:49:42.869
And let's assume we're using the online calculator rather than doing formal testing?
00:49:44.380 --> 00:49:45.664
Yeah, no for sure.
00:49:45.664 --> 00:50:11.320
And in fact I teach a second year exercise theology course, and so our lecture yesterday was on VO2 max and I talk about what I call reasonable values and I tell my students you don't have to memorize an exact number, but you should have a second year kinesiology student, should have a reasonable idea of what's a good VO2 max or what's an elite level VO2 max, so that I knew the numbers, of course, but they're, they're particularly front of mind, and so you know.
00:50:11.320 --> 00:50:35.713
If you want an authoritative source, you could go to something, for example, like guidelines put out by the American College of Sports Medicine, the ACSM guidelines, that would have VO2 max expressed relative to age and various you know thresholds or classifications.
00:50:35.713 --> 00:50:46.925
But you know, on average, a typical healthy but otherwise sedentary middle aged individual might have a VO2 max of somewhere around 35.
00:50:46.925 --> 00:50:50.934
And that's milliliters per kilogram per minute.
00:50:50.934 --> 00:50:53.201
And so what we're expressing there?
00:50:53.201 --> 00:50:59.181
The rate of oxygen uptake in terms of mills of oxygen per minute relative to their body mass.
00:50:59.181 --> 00:51:03.831
And so it gets across this point that we can all talk about VO2 max in an absolute sense.
00:51:03.831 --> 00:51:08.992
So someone might have a two liter per minute VO2 max or four liter per minute VO2 max.
00:51:08.992 --> 00:51:12.887
Well, if you divide out their body mass there, that can impact things a lot.
00:51:12.887 --> 00:51:26.210
So normally we're talking about cardio respiratory fitness measures, we're talking about relative measures of VO2 max, and so that means you know numbers on a scale that typically range from about 10 to 100.
00:51:26.210 --> 00:51:31.688
You know, the highest VO2 max ever reported in humans is about 91.
00:51:31.688 --> 00:51:36.402
It was in an elite gold medal winning cross country skier.
00:51:36.402 --> 00:51:43.668
Cross country skiers of the elite endurance athlete community, cross country skiers tend to have the highest VO2 maxes, you know.
00:51:43.708 --> 00:51:54.900
At the other end of the spectrum would be a cardiac patient, highly deconditioned cardiac patient, who might have a VO2 max of 10, 12, 15 mils per kilogram per minute.
00:51:54.900 --> 00:52:01.922
You know, resting VO2, you may have heard of the concept of a met, which just refers to the auction required.
00:52:01.922 --> 00:52:07.175
You know, at rest one metabolic equivalent is 3.5.
00:52:07.175 --> 00:52:11.947
And that would be the average resting VO2 in humans.
00:52:11.947 --> 00:52:13.612
And so there you get a sense.
00:52:13.692 --> 00:52:33.307
Well, a cardiac patient might have a three met capacity, you know, whereas an average individual, sedentary maybe, as a 10 met, whereas the elite endurance athlete has, you know, 20, 25 met capacity, and that it sort of gives you a working operational range from rest to maximal capacity.
00:52:33.347 --> 00:52:36.193
You know, three is not very much Right.
00:52:36.193 --> 00:52:43.351
And so even you know, if you're a cardiac patient getting off the couch and walking a few steps, it's like you're at the top of Everest, right?
00:52:43.351 --> 00:52:50.978
It's just such a challenge because your peak capacity is three or you know, somewhere around 11, 12, 13 mils per kilogram per minute.
00:52:50.978 --> 00:53:02.436
So those are sort of the range of values and the ACSM and other authoritative sources would say well, this value would put you in the 20th percentile or the 50th or the 75th or the 90th.
00:53:02.436 --> 00:53:06.974
And so often in our research studies we'll say we just want people started in the middle.
00:53:06.974 --> 00:53:19.248
Or if we're doing more trained athletes, we'll say we're only going to recruit individuals who have 90th percentile for age level to try and to get that.
00:53:19.248 --> 00:53:23.704
But hopefully that's helpful in terms of ranges of values and things like that.
00:53:24.045 --> 00:53:25.512
Yeah, yeah it is, and you know.
00:53:25.512 --> 00:53:26.175
But you know.
00:53:26.175 --> 00:53:53.048
Several things come to mind because when you look at the units, that the O2 max are expressed in right Milliliters per kilogram per minute, and because body mass is part of that equation, you could take somebody with any given VO2 max and, if they're overweight, have them not exercise, do things to decrease their body mass and their VO2 max will automatically improve.
00:53:53.048 --> 00:53:54.934
So does that?
00:53:54.934 --> 00:54:11.548
Does that then map over to the concept that if you carry around excess nonfunctional weight right, not an extra 10 pounds of muscle, but, you know, an extra 30 pounds of body fat you think in terms of like, very simplistically, you know that's a strain on your heart.
00:54:11.548 --> 00:54:12.974
Is there?
00:54:12.974 --> 00:54:15.382
Is there metabolic truth to that concept?
00:54:17.829 --> 00:54:18.630
Yeah, I'd say there is.
00:54:18.630 --> 00:54:25.909
And so you know, to use that specific example, and you're right, you know, if you reduce the denominator the number is going to go up.
00:54:25.909 --> 00:54:39.849
And so if an individual loses 10 kilograms or, you know, 25 pounds of body mass, that can have a that will significantly improve their car respiratory fitness, measured numerically.
00:54:39.849 --> 00:54:48.782
Now, even though their heart function per se may not have changed, they're still going to have a markedly higher functional capacity, right?
00:54:48.782 --> 00:55:03.360
Because now if they go for a walk they're carrying, say, 20% less body to move and so, if you can think of what's happening, the demand to walk at, say, four miles an hour is here.
00:55:03.942 --> 00:55:15.614
They've sort of artificially, if you will, elevated the numerator and so when you express it now, maybe before walking took them 60% of VU2 max or 8%.
00:55:15.614 --> 00:55:37.690
Now you've reduced that it's only a 40% or 60% of maximal load, and that's both perceptually easier for them to achieve and physiologically, the way that they supply energy at 40% or 60%, they're going to be more aligned on lipid and so they can burn more lipid if they're engaged in exercise.
00:55:37.690 --> 00:55:44.434
So ideally you want to do both or you know, ideally you want to raise the numerator and reduce the denominator.
00:55:44.434 --> 00:55:45.538
You can.
00:55:45.538 --> 00:55:49.610
You can do either, and let me say I ideally do both.
00:55:49.610 --> 00:55:58.418
And it sort of gets back to the old adage where you know we engage physical activity for fitness and we use nutrition to regulate body mass.
00:55:58.418 --> 00:56:04.373
Right, yeah, they impact on each other, yes, but the two are the big drivers on either extreme.
00:56:05.021 --> 00:56:05.282
Yeah.
00:56:05.282 --> 00:56:31.769
So the way that I tend to think about this and this would be, I guess, a way that I would translate this into patient speak is that if we can decrease your body mass, your heart and your lungs no longer have to perfuse that extra body mass, and so now you have more resources available to go to your brain, to go to your gut tissue, to go to your liver to support normal function.
00:56:31.769 --> 00:56:49.530
I love that, and it was funny because, as I was thinking like, how do I translate this into a like a mental picture or an analogy, and I was thinking about you know, we have five kids and now they're all grown out of the house and supporting themselves, and so they're off the payroll, so to speak, and all of a sudden, now I've got more money to go to.
00:56:49.530 --> 00:56:58.840
You know the life and the lifestyle that my wife and I like to have, and I think that that's a pretty apt analogy to capture the core concept.
00:57:00.425 --> 00:57:01.568
So it absolutely is.
00:57:01.568 --> 00:57:06.282
Yeah, sorry, I was just gonna say you know, and it comes back to blood flow distribution.
00:57:06.282 --> 00:57:17.922
So if you can, if you need to partition out less to this tissue mass, you got more blood flow to divert it elsewhere and it can go to your little muscle to enhance your physiological function.
00:57:17.922 --> 00:57:19.967
So it's a very good analogy.
00:57:20.228 --> 00:57:28.902
Yeah, I'm watching my time here, marty, and I am in by no means close to being done with the questions that I have, so I don't know how much time you have.
00:57:28.902 --> 00:57:31.327
Do you want to keep going?
00:57:31.347 --> 00:57:32.411
I'm happy to keep rolling.
00:57:32.411 --> 00:57:35.389
You know again if your, if your audience hasn't tuned out by this time.
00:57:35.389 --> 00:57:37.840
But I mean, I'm happy to roll for a while yet.
00:57:37.920 --> 00:57:38.943
Okay, that's cool.
00:57:39.244 --> 00:57:40.427
And if it would be a benefit.
00:57:40.646 --> 00:57:46.951
Yeah, absolutely would, and I might split this up just into two different podcasts so people can digest it a little bit more.