 This is green, this is red, this is yellow. So they both reduce blood pressure, strength training increases arterial stiffening, whereas aerobics decreases it. The aerobics has a much smaller increase in base of dilation and it's only once the threshold of intensity is met, whereas we get a lot over here from the strength training and in pre-menopausal women, again, we don't get arterial stiffening. So it got me thinking. Laugh it up, fuzzballs, come on. Star Wars reference, anybody? Anyway, so maybe this is due to different hemodynamic effects that strength training experiences. It's kind of like there's a guy in the kind of primal community guy named Kurt Harris and he talks about how the blood markers you see for a paleo diet do not necessarily reflect health due to a paleo diet or in the context of a paleo primal ancestral diet that the blood markers we see as healthy might not be healthy, but we associate them with health because the only set of blood markers we've ever seen is in agrarian feeding unhealthy, quite inflamed individuals. Does that make sense? Does everybody understand what I just said there? Okay, okay. So it got me thinking there might be a study that's actually directly measuring what's going on during strength training on people who might be problematic. Hey, there is, what do you know? In this study, Patrick doesn't have chronic congestive heart failure here, but in this particular study, patients with chronic congestive heart failure, they found a decrease in systemic vascular resistance. So what they did was chronic congestive heart failure is the inability of your heart to supply your body with a sufficient amount of blood. And what happens is that they put these individuals on a leg press, they inserted a central catheter to measure exactly what's going on on a moment-by-moment basis. Most of the time you're getting these distal measures, not direct measures. And what they found was that at the highest intensities on a leg press, over 80% of their one rep max, these individuals, the higher the intensity went, up to, I don't think they went all the way to 90, but the higher they went, the more and more the vascular system opened up and allowed for this blood flow to occur. This in part is because in order for the heart, again it's a close hydraulic system, to pump, it has to be getting blood back. So the way this works is that your left ventricle, the largest, pumps it out and it comes back to the right aorta, right aorta, which then moves the blood into the right ventricle, which pumps it through your lungs, and then back into the left aorta, which moves into the left ventricle, back to move out to your body. That's why the left is larger. It's got to move the blood a larger distance, rather than just sort of front and back in your body. And so what happens is with these smooth, controlled contractions of a leg press, because if you're running it's chop, chop, chop, chop, you're getting the muscles actually constricting on the vascular system and shortening the amount of blood that's moved each repetition, because if you think about running, it's a series of repetitions. More smooth, heavy, heavy effort leg press is pumping huge amounts of blood back to the heart, so it's more efficient. And so if you don't have to pump very fast, if your rate of filling is smooth and consistent, you don't have to be constantly adjusting to these changes in pressure. That's why strength training shows a slight increase in arterial stiffening, but a reduction in, or an increase in vasodilation and reduction in blood pressure while working. On people with heart failure, you guys, you just need to work out hard leg press and your heart's going to be in great shape. But I have more, because when we talk about the heart and the health of cardiovascular system, blood glucose control matters a lot. It's the most important manifestation of that syndrome, metabolic syndrome. And if you can control glucose, you reduce the risk of any cardiovascular disease event by 42%. And strength training drains glucose like you wouldn't believe. Two sets of 10, if we're going to talk in set terminology, uses about five grams of intramuscular, of glucose. And they keep it simple, carbohydrate. So a workout might use 35 to 60 grams of carbohydrates, depending on how long it is, with weights. It's not nearly as aggressively draining those muscle tissues with a cardiorespiratory type training. And the thing is about your muscles is they do not like losing any glycogen. At all. So there's a process called supercompensation. When you drain them, they make room for more glycogen to be stored. So if you're constantly somewhat emptying the tank, you always create a headroom to take on any amount of glucose or not any. There's a limit. It's something the effect of 1200 grams for a 180-pound person is about the maximum amount of intramuscular glycogen and only for short periods of time and only after fully unloaded tissue. You're talking about endurance athletes, big time. Your average person, maybe it's about 500 grams. But if you're constantly pulling out of this bank and then reinvesting, pulling out and reinvesting, your body makes room for more of this. So you don't have to ever have abnormal blood glucose levels because it always has somewhere to go. And so here's an example of that. Isochloric amount of treadmill exercise did not match the amount of glycemic control of 10 weeks of resistance training. They controlled for calories. They did not get as good a result. And HBA1C is a measure of basically the last 120 days of blood sugar levels. Measure something called glycated hemoglobin. So it's a feasible treatment for the diabetic population at large because if you can reduce it to a clinically significant degree, you're as good as a drug at that point. So what happens here is that traditionally you have this increase in diabetes. You know, the supersize me of the world trying to blame McDonald's for their poor parenting decisions, making their kids diabetic. Youth type 2 diabetes levels enormously high. It used to be called adult onset diabetes or diabetes. Liberty Medical is not sponsoring this presentation. Has anyone watched cocoon recently? So but the point is that it only used to affect adults because they would get less muscle mass. They would have less room for the glucose. The cells would shut it off to protect themselves because your cells don't like having glycated proteins hanging out in the cytosol and that blood sugar would have nowhere to go. Now it's showing up in kids. Let's look at the Michelin boy here. It's showing up in kids because they're just being hammered with severe amounts of carbohydrates. Anyway, so in conclusion, I mean this sums it up so well here, this particular study. It is clinically and statistically significant effect on metabolic syndrome. Lowers all of these wonderful risk factors and it should be the measure or the marker in which all other treatments are measured when it comes to controlling type 2 diabetes and metabolic disorders. And in fact in Australia, they have started prescribing exercise for the treatment of type 2 diabetes, weight training specifically for the treatment of type 2 diabetes. And I wonder if there's just some sort of a medical legal truce there that understands that the doctor is trying to get the best results for their patient combined with the personal responsibility because here in America's Doug will tell you, Dr. Doug McGuff. When your balls are on the chopping block, you will prescribe walking because nobody is going to attempt to sue you. Well they might attempt to sue you for walking but we're bipedal. It'll be thrown out of court. So that suddenly becomes exercise rather than damn it, you're a human being. You should be able to stand on two feet, create locomotion, moving forward. So it's great. It's fantastic stuff in that regard. And so we talk about aerobic capacity. Lot of stuff I know. I'm trying to keep it fun. That's why Michelin Boy was there. Cardiorespiratory training, improvements in cardiovascular fitness. Some people, string training is a little controversial in this way. Typically it's assessed by a treadmill test. And it's an important risk factor in all cause mortality. Now should any of you be in a situation where you have to take a treadmill test for insurance? I have a suggestion. Practice the treadmill test then month prior to doing that. You will score so much better in spite of the fact that you have not gotten fitter because there's a skill component involved in constantly adapting to the increasing levels of the treadmill. When you do a treadmill test, every three minutes they're increasing the height of the treadmill, the grade and the speed typically. If you practice that, you're much better as a result. So mortality and comorbidity, they're associated with coronary heart disease in men and women in this particular treadmill test and all cause mortality. And high levels of physical fitness delay this mostly because of that lowered rate of cardiovascular disease. So you go on Google and you search heart attack. This guy showed up with some memes. Am I the only one who thinks that this isn't a heart attack but possibly an o-face? What's going on down here? What's going on down here? And I do like his old receipt machine here as well. That's always a good time. So that's what we're talking about. If we're talking about aerobic capacity to a certain extent, we're also talking about heart attack prevention, VO2 max, things of that nature. So in this particular study, treadmill walking endurance increases 30% and 80% of VO2 max in these elderly individuals, even though VO2 max has not changed. VO2 max is a monopoly money measure of how much oxygen you can consume and use at the muscle tissue level. The thing is is that you can increase your endurance without increasing your VO2 max. It's mostly set by genetics. And so people for a while there once they figured out, ah, VO2 max, let's drive this thing on the moon. You don't get much more than 20% training for it specifically above your genetic level. And that doesn't mean that you're going to suddenly be some sort of world champion athlete. You have marathon champions between 60 VO2 and 90 VO2. So it's an interesting measure that doesn't mean anything. But if you're going to argue with someone and their only term is VO2 max, now you've got something to say like, hey, buddy, I can argue with you on that and show you that strength training and on top of making you look better naked, made your ticker better as well, even in their arena of choice.