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James O'Keefe, MD — How to Train like a Hunter-Gatherer

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James O'Keefe, MD — How to Train like a Hunter-Gatherer

  1. 1. Organic Fitness: Achieving Hunter Gatherer Fitness in the 21 st Century James H O’Keefe, MD Professor Medicine, University of Missouri-Kansas City Director Preventive Cardiology, Mid America Heart & Vascular Institute
  2. 2. “ The Woodstock of Evolutionary Medicine” Loren Cordain
  3. 4. From the emergence of the human genus, Homo, about 2.4 million years ago, our ancestors, for approximately 84,000 generations, survived as hunter gatherers
  4. 5. Diabetes: < 1% Hunter Gatherer Native Americans Diabetes;1974: 23: 841-55
  5. 6. Native Americans 2011 50% Adults have Diabetes
  6. 7. Ancient Instincts Betray Us Moderns Move when you must. Rest whenever you can.
  7. 8. Genetic Complexity Roundworm=18,000 genes Human=27,000 genes
  8. 9. A Whole New You <ul><li>Exercise alters gene expression in 60% of the 20,000 genes </li></ul><ul><li>To thrive optimally, we need varied, vigorous daily </li></ul><ul><li>exercise </li></ul>
  9. 10. Exercise-induced Changes in Genetic Expression Improves: <ul><li> CV + Pulm Health </li></ul><ul><li> Musculoskeletal and General Fitness </li></ul><ul><li> Glucose, Lipids, Blood Pressure </li></ul><ul><li> Autonomic Balance, Mood </li></ul><ul><li> Sleep Quality, Immunity </li></ul>
  10. 11. Affluenza: (debilitating convenience)
  11. 12. RMR = Resting metabolic rate TEE = total energy expenditure EEPA=energy expenditure attributed to physical activity 1 Sedentary office worker 2 Runner running 12.1 km/h Energy Expenditure on Physical Activity Species Sex Ratio (TEE/RMR) EE PA kcal Day range miles Fossil hominids Homo habilis 1.70 983 Homo erectus 1.80 1,214 Homo sapiens (early) 1.80 1,284 Modern Hunters-Gatherers Kung 1.71 903 10 F 1.50 600 8 Ache M 2.15 1,778 16 Acculturated Modern Humans Homo sapiens (office worker) 1 M F 1.18 1.16 306 231 2.4 2.4 Homo sapiens (runner) 2 M 1.70 1,194 11
  12. 13. Sattelmair et al.  Circulation. 2011; 124:789-795 Exercise dose dependent CHD risk reduction
  13. 14. BP: Lower is Better Because Lower is Normal Age Group (Yrs.) mm Hg Males Females Age Group (Yrs.) Oliver et al. Circulation 1975;52:146-51. BPs in 506 Yanomamo Indians
  14. 15. Pygmy ≈100 San ≈ 120 Hazda ≈110 Mean Total Cholesterol (mg/dL) Inuit ≈140 !Kung ≈120
  15. 16. Baboon ≈ 110 Howler Monkey ≈ 110 Night Monkey ≈ 140 Wild Primates Mean Total Cholesterol (mg/dL)
  16. 17. Wild Mammals Mean Total Cholesterol (mg/dL) Horse ≈ 140 Pig ≈ 100 Rhino ≈ 90 Elephant ≈ 110 Boar ≈ 70
  17. 18. Mammals Mean Total Cholesterol (mg/dL) Adult American ~ 209 Horse ≈ 140 Rhino ≈ 90 Elephant ≈ 110 Boar ≈ 70
  18. 19. Calories Eaten = Calories Burned
  19. 20. Paleolithic Fast Food
  20. 21. Physical Activity and Survival* *Studies also show strong link: Between lifetime Physical Activity  Dementia risk
  21. 22. Fitness Improves Longevity Kokkinos P, et al, Circulation 2008; 117:614-22
  22. 23. Characteristics of a Hunter Gatherer Fitness Program <ul><li>A large amount background daily light-to-moderate activity such as walking was required. </li></ul><ul><li>Average daily distances covered were in the range of 4 to 10 miles. </li></ul>
  23. 24. Workout Hard/ Recover Easy <ul><li>Hard days were typically followed by easy day </li></ul><ul><li>Every day a variety of physical activities had to be accomplished to provide for the basic human needs </li></ul><ul><li>Hunter-gatherers’ daily at least 600 to 1,200 calories/d on physical activity </li></ul><ul><li>Moderns typically burn 300 calories/d </li></ul>
  24. 25. Rest and Recover <ul><li>Ample time for rest, relaxation, and sleep was generally available to ensure complete recovery after strenuous exertion. </li></ul>
  25. 26. High-intensity Exercise
  26. 27. + Deep Rest
  27. 28. = Peak Fitness
  28. 29. The Power of Napping <ul><li>Study of 23,000 Greek adults </li></ul><ul><li>Regular naps reduced Heart Deaths 30% </li></ul><ul><li>A 20 minute nap reduces Stress </li></ul>Archives of Internal Medicine; Jan 12, 2007
  29. 31. Walking Pace and Mortality Risk   Manson et al. N Engl J Med 1999; 341:650-658
  30. 32. Interval Training <ul><li>High-intensity interval training sessions 2 to 3 times weekly </li></ul><ul><li>Intermittent bursts of high level intensity exercise with intervening periods of rest and recovery </li></ul>
  31. 33. Subcutaneous & Abdominal Fat Loss after 15 wks of High-Intensity Intermittent Exercise J Obes. 2011; 2011: 868305. Published online 2010 November 24. doi:   10.1155/2011/868305
  32. 35. Get off the Streets <ul><li>Walking and running were done on natural surfaces such as grass and dirt, often over uneven ground. </li></ul><ul><li>Today we walk and run on unyielding concrete and asphalt </li></ul>
  33. 36. Expensive Running Shoes = More Injuries (plantar fascitis, hamstrings, Achilles’ tendonitis)
  34. 37. Pheidippides
  35. 38. Pheidippides
  36. 39. Marathoners  Increased Coronary Atherosclerosis
  37. 40. Myocardial Scarring 3x More Common in Chronic Marathoners 50 – 70 year olds n=102 marathoners n=102 controls
  38. 41. Chronic Marathoners Had Increased Risk of CV Events During Follow up <ul><li>Coronary event rate during 2-year follow up which was higher in the marathon runners than in controls (P < .0001). </li></ul><ul><li>Chronic marathoners: higher systolic blood pressures and increased aortic stiffness compared to controls </li></ul><ul><li>Marathons over age 50 might be candidates for close scrutiny of their cardiovascular health and future CV risks. </li></ul><ul><li>Breuckmann F et al. Radiology. 2009 Apr;251(1):50-7. </li></ul>
  39. 43. Go Outside and Play with your Friends* <ul><li>Virtually all of the exercise was done outdoors in the natural world. </li></ul><ul><li>Outdoor activities will help to maintain vitamin D levels, improve mood, and facilitate daily exercise. </li></ul>*Mantra of Leatrice O’Keefe to her 6 children for the second half of the last century
  40. 44. James H O’Keefe MD Vitamin D Deficiency: CV Risk Factor
  41. 45. Being active outdoors in nature induces instant relaxation in 84% of people
  42. 47. Strength Training <ul><li>Strength-building exercises are essential for optimizing musculoskeletal and general health and fitness. </li></ul><ul><li>Strength and Flexibility Promotes Resilience and Injury-proof </li></ul>
  43. 49. High Intensity Intervals
  44. 50. Functional Fitness
  45. 51. Sun Protection from the Inside Out
  46. 52. Just Dance <ul><li>Ceremonial and celebratory dancing, Multiple X’s weekly (1 to 3 hrs each) </li></ul><ul><li>Dancing is an ideal form of exercise: improves fitness, reduces stress, enjoyable/social </li></ul>
  47. 53. Exercise with a Friend <ul><li>Much of the physical activity was done in context of a social setting. </li></ul><ul><li>Some exercise benefits </li></ul><ul><li>due to social bonding. </li></ul>
  48. 54. Get a Dog <ul><li>Humans and dogs co-evolving for 135,000 yrs </li></ul><ul><li>Dog and human genomes adapted to </li></ul><ul><li>cooperate via outdoor exercise </li></ul><ul><li>Dog ownership improves exercise </li></ul><ul><li>compliance, fitness, and weight. </li></ul>
  49. 55. Prescription: 1 Dog, taken for a walk At least twice daily Refill: prn
  50. 56. If your dog is overweight, you aren't getting enough exercise.
  51. 57. Sexual Activity <ul><li>Prototypical Organic Exercise </li></ul><ul><li>Linked to health, well-being, longevity </li></ul><ul><li>Correlated with reduced risks CV disease, prostate cancer, improved immunity </li></ul>
  52. 58. Sex is Exercise: If Nothing Else <ul><li>30 minutes vigorous sex burns up to 200 calories—about 2 miles on a treadmill </li></ul><ul><li>@ Orgasm pulse = 120-150 BPM, Systolic up to 200 mmHg </li></ul><ul><li>Increases in Testosterone, Prolactin </li></ul>
  53. 59. High Intensity Interval Training (Tabatas)  8 to 10 Intervals  20 seconds of maximal effort  10 seconds rest  Total Workout Duration = 4 minutes
  54. 65. 5 Types of Exercise for a Balanced Routine <ul><li>Aerobic </li></ul><ul><li>Interval (Anaerobic) Training </li></ul><ul><li>Strength Training </li></ul><ul><li>Core Exercises </li></ul><ul><li>Stretching </li></ul>
  55. 66. Hunter-Gatherer Modern Equivalent Caloric Expenditure Activity Activity (kilocalories / hour) 176 lb Male 132 lb Female Carrying Logs Carrying groceries, luggage 893 670 Running (cross country) Running (cross country) 782 587 Carrying meat (20kg) Wearing backpack back to camp while walking 706 529 Carrying young child Carrying young child 672 504 Hunting, stalking animals Interval Training 619 464 Digging (tubers in field) Gardening 605 454
  56. 67. Hunter-Gatherer Modern Equivalent Caloric Expenditure Activity Activity (kilocalories / hour) 176 lb Male 132 lb Female Dancing (ceremonial) Dancing (aerobic) 494 371 Carrying, stacking rock Lifting weights 422 317 Butchering large animal Splitting wood with axe 408 306 Walking – normal pace Walking – normal pace 394 295 (fields & hills) (outside on trails, grass, etc) Gathering plant foods Weeding garden 346 259 Shelter construction Carpentry, general 250 187 Tool construction Vigorous housework 216 162
  57. 68. Train to Live <ul><li>Except for very young and the very old, all individuals were, by necessity, physically active </li></ul><ul><li>almost their entire lives. </li></ul><ul><li>Stay Fit or Die </li></ul><ul><li>Everybody dies, but not </li></ul><ul><li>everybody Lives: Train to “Live” </li></ul>
  58. 69. Thanks! <ul><li>cardionutrition.wordpress.com </li></ul><ul><li>DRJamesOKeefe (twitter) </li></ul><ul><li>Forever Young Diet and Exercise (Amazon.com) </li></ul><ul><li>[email_address] </li></ul>For More Info:
  59. 72. Native American Family Inuit Family Icelandic Family Mongolian Family Brazilian Family African Family S Peruvian Family Aboriginal Family
  60. 74. Lifestyle to Preserve Telomeres <ul><li>Sleep 7 to 8 hours each night </li></ul><ul><li>Exercise 45 to 60 minutes/day </li></ul><ul><li>Avoid tobacco </li></ul><ul><li>Maintain ideal weight, BMI (18.5 to 25) </li></ul><ul><ul><li>Waist size < half your height in inches </li></ul></ul><ul><ul><li>Body fat: < 22% for women, <16% for men </li></ul></ul><ul><li>Stress reduction </li></ul><ul><li>Bio-identical hormone replacement </li></ul>
  61. 75. Inflammatory Diet Increases Oxidative Stress, Shortens Telomeres Avoid! Do <ul><li>Excess calories </li></ul><ul><li>Refined carbs </li></ul><ul><li>Fast foods </li></ul><ul><li>Processed foods </li></ul><ul><li>Sodas </li></ul><ul><li>Trans fats </li></ul><ul><li>Saturated fats </li></ul>Follow Healthy Diet Drink Green Tea Supplements: Vitamin D and Omega 3 If alcohol used: 1 drink/d with eve meal
  62. 78. Copyright restrictions may apply. Autier, P. et al. Arch Intern Med 2007;167:1730-1737. Vit D Reduces Mortality
  63. 79. Rx: Sunshine, 10 to 15 mins daily Vit D 3, 2000 IU/d
  64. 80. From the emergence of the human genus, Homo, about 2.4 million years ago, our ancestors, for approximately 84,000 generations, survived as hunter gatherers
  65. 81. <ul><li>One analysis estimated the rate of sudden cardiac arrest among marathoners is approximately 1 per 100,000 participants. </li></ul><ul><li>The final 1-mile of the marathon course represents less than 5% of the total distance of 26.2 miles yet accounts for almost 50% of the sudden cardiac deaths. </li></ul><ul><li>Redelmeier et al. BMJ 2007; 335:1275-1277. </li></ul>
  66. 82. 3000 yr-old Egyptian Mummies: 50% have atherosclerosis
  67. 83. Agriculturists vs Foragers ↑ Sugar ↓ Essential Nutrients ↑ Grains ↓ Fiber ↑ Calories ↓ Potassium ↑ Saturated Fats ↓ Omega-3 Fats ↓ Monounsaturated Fats
  68. 84. Daily Intake Moderns Foragers Cholesterol 200-300 mg 500 mg Fats 30% 35% Saturated Fats 14% 7% Omega-3 110 mg 660 – 3000 mg
  69. 85. Daily Intake of Nutrients Moderns Foragers Vitamin C 90 mg > 500 mg Sodium 5 gms .5 to 1 gm Potassium 1 to 3 gms 6 to 10 gms Fiber Sugar 10 to 20 gms 25% of calories 40 to 100 gms 2% of calories
  70. 86. Life Expectancy in the U.S. 2-5 year decline in life expectancy
  71. 87. Diabetes and Reduction in Lifespan JAMA 2003;290:1884-1890 -11.6 yrs -14.3 yrs
  72. 88. Functional Fitness

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