Exercise Can Reverse Cardiac Secondary Aging Resulting from a Sedentary Lifestyle

It is never too late to exercise in order to obtain benefits to health - there are any number of studies showing beneficial outcomes to result from structured exercise, especially resistance exercise, even for people in very late life. That said, the study of exercise noted here suggests that at some point in middle age it does become too late to reverse consequences of secondary cardiac aging such as hypertrophy, stiffening of heart muscle leading to diastolic heart failure, and the like. Up until that point, however, even the earnestly idle among us can choose to undo some of the portion of overall loss of function that results from a sedentary lifestyle.

What is secondary aging? There is no bright dividing line between primary aging and secondary aging, but one possible definition is that primary aging results from the normal operation of cellular metabolism in a healthy individual in an optimal environment, while secondary aging results from detrimental environmental factors: long-term exposure to toxins or pathogens, lingering latent viral infections, poor diet leading to excess fat tissue, a smoking habit, lack of exercise, and so forth. The reason I say that there is no bright dividing line is that if you look under the hood at the types of damage and molecular mechanisms involved, there is considerable overlap between primary and secondary aging. Chronic inflammation and common ways in which cells can malfunction feature prominently on both sides, for example. Aging is damage, and for many forms of that damage it is a matter of origin and semantics as to whether we consider it a part of aging, the pathology of a disease, a self-inflicted injury, or something else.

Exercise can only take you so far. Given that it is essentially free, and reliably produces benefits, of course everyone should exercise if capable of doing so. But three quarters of the fittest, most diligent people nonetheless die from age-related disease, largely cardiovascular disease, before reaching 90 years of age, and those still alive at 90 are pale shadows of their former, youthful selves. The gains of exercise are small when considered against the bigger picture of what will become possible though near future medical technology. So exercise by all means, but also put some thought towards supporting the development of rejuvenation therapies capable of repairing and reversing the various forms of cell and tissue damage that cause aging. Success in that line of work is the only way forward to live in good health, and with a youthful physiology, for far longer than is presently possible.

Middle-aged couch potatoes may reverse heart effects of a sedentary life with exercise training

The researchers analyzed the hearts of 53 adults ages 45-64 who were healthy but sedentary at the start of the study - meaning they tended to sit most of the time. Study participants received either two years of training, including high- and moderate-intensity aerobic exercise four or more days a week (exercise group), or they were assigned to a control group, which engaged in regular yoga, balance training, and weight training three times a week for two years.

The exercise group committed to a progressive exercise program which monitored participants' recorded heart rates. People in this group worked up to doing exercises, such as four-by-fours - foue sets of four minutes of exercise at 95 percent of their maximum heart rate, followed by three minutes of active recovery at 60 percent to 75 percent peak heart rate. In this study, maximum heart rate was defined as the hardest a person could exercise and still complete the four-minute interval. Active recovery heart rate is the speed at which the heart beats after exercise.

They found that, overall, the committed exercise intervention made people fitter, increasing VO2max, the maximum amount of energy used during exercise, by 18 percent. There was no improvement in oxygen uptake in the control group. The committed exercise program also notably decreased cardiac stiffness. There was no change in cardiac stiffness among the controls. Sedentary behaviors - such as sitting or reclining for long periods of time - increase the risk of the heart muscle shrinking and stiffening in late-middle age and increases heart failure risk.

Previous studies have shown that elite athletes, who spent a lifetime doing high-intensity exercise, had significantly fewer effects of aging on the heart and blood vessels. However, the six to seven days a week of intense exercise training that many elite athletes perform throughout their life isn't a reality for many middle-aged adults, which led researchers to study different exercise doses, including casual exercise at two to three days a week and "committed exercise" at four to five days a week. "We found that exercising only two or three times a week didn't do much to protect the heart against aging. But committed exercise four to five times a week was almost as effective at preventing sedentary heart aging as the more extreme exercise of elite athletes. We've also found that the 'sweet spot' in life to get off the couch and start exercising is in late-middle age, when the heart still has plasticity."

Reversing the Cardiac Effects of Sedentary Aging in Middle Age - A Randomized Controlled Trial: Implications For Heart Failure Prevention

Sedentary aging is strongly associated with deleterious changes in cardiovascular function, including an increase in left ventricular (LV) stiffness. Sedentary seniors have small stiff LVs, which are comparable to patients with heart failure with a preserved ejection fraction (HFpEF). In contrast, competitive athletes have large, compliant LVs equivalent to much younger individuals, suggesting that exercise training, performed at a very high level over a lifetime, may counteract the detrimental effects of aging and inactivity on the LV.

Although competitive athletes are a useful model for characterizing the upper limits of cardiovascular protection from prolonged exercise training, the volume of training performed by these individuals (≥6 days/wk plus competitions) is not feasible for the general population. Although it appears that 4 to 5 days of committed exercise training over decades is adequate to achieve most of this benefit, it is unclear whether exercise training can restore or improve LV compliance in previously sedentary individuals, and if so, when is the optimal stage of life to intervene.

Epidemiological studies show that a measurement of fitness in middle age is the strongest predictor of future heart failure. Moreover, in observational studies, the dose of exercise associated with reduced heart failure incidence is much higher than that associated with reduced mortality. However, if exercise is started too late in life (i.e. after 65 years) in sedentary individuals, there is little effect on LV stiffness. Thus, a lifetime of sedentary aging is associated with a reduction of cardiac plasticity, which cannot be overcome with a year of moderate-intensity exercise training. We recently documented that this LV stiffening begins to be identifiable during middle age with a leftward shift in the LV end-diastolic pressure volume curve. We hypothesize that middle-aged hearts retain some degree of cardiac plasticity and may represent a more optimal time to intervene with aggressive lifestyle modification aimed at improving cardiac stiffness.

This study is the longest, prospective randomized controlled trial that has documented the physiological effects of supervised, structured exercise training in a group of sedentary but healthy middle-aged adults. The key finding is that 2 years of exercise training performed for at least 30 minutes, 4 to 5 days per week, and including at least 1 high-intensity interval session per week results in a significant reduction in LV chamber and myocardial stiffness. The use of high-resolution, invasively measured LV pressure-volume curves and comparison with an attention control group enhances the confidence in this conclusion. This study also demonstrated that exercise training can be adhered to by middle-aged adults over a prolonged period, suggesting that this may be an effective strategy to mitigate the deleterious effects of sedentary aging on the heart and forestall the development of HFpEF.


@Reason: Do you know if there exists any studies on how aggression, violence and war affects aging? I use an example: the turtles have developed the shell as defence and resources has been channeled to fix aging damage. When humans are met with death as result of aggression I speculate evolutions answer is to make humans more aggressive to counter the threat instead of more diplomatic. In war states invests in weapons instead of investing in the real threat inside of us - aging. I think human lifespan has suffered tremendously evolutionary because of this. If you take my point.

Posted by: Norse at January 8th, 2018 3:19 PM

@Norse: That falls under the effects of extrinsic mortality on evolution, and that more general topic is fairly widely studied.


I'm not immediately aware of evolutionary studies that break out human violence specifically, but I'm sure many discuss it in passing. It is more a topic for anthropology, at least looking as far back as paleolithic humanity.


At first glance, it doesn't appear to be as sizable a cause of mortality as disease or aging. We are only unusual by being near the top of the food chain, and thus less significantly shaped by the more usual forms of predation, unlike most other species.

Posted by: Reason at January 8th, 2018 4:13 PM

@Reason: I read that no 1 killer each year are if i not remember wrong malaria and no 2 our own species, which ment homicides/murder.

Posted by: Norse at January 8th, 2018 4:19 PM

and murder accounted for 0,5 million life pr year.

Posted by: Norse at January 8th, 2018 4:20 PM

If war has had an effect on human lifespan through cultural evolution it probably had one in the opposite direction of what you think.

Countries with the most experienced well trained soldiers had an objective advantage in the past.

Even if we go back to antiquity and look at, for instance, the Roman Legion - men were expected to serve for AT LEAST 25 years. It was not uncommon for men to remain in the service to train the recruits beyond that. Now 25 years doesn't sound like much for a career nowadays BUT the median life expectancy for a Roman in the same period was 25 years as well.
Wait what? Yes you heard it right.
Now this points to a very peculiar (not really) conclusion - soldiers outlived the average citizen significantly. Excluding death in war of course - but even in that case you have to consider that the general public was more at danger than the soldiers which were trained to survive in a battle, considering for most of history human rights were not in existence military service was actually a survival perk rather than the opposite.

Better education, better food supply, better clothing, more exercise , vibrant social life. The soldier was the epitome of healthy lifestyle for centuries.

Interesting fact - the median age of a military man has fallen significantly in the last 500 years. From 35 to 20 something nowadays. Granted war used to be a career back then, now it's just a sport.

Posted by: Anonymoose at January 8th, 2018 5:53 PM


Hi Norse ! Great question, many answered, Just my 2 cent..

I think I understand whatyou mean, in the sense that if we tally the total war casualties; they do have a sizeable impact and make it look as if war/violence is the ultimate cause of human death (wars over the centuries equal maybe a billion or more lost lives due to many wars). But in the grand scheme of things, especially today where war is relatively more quiet overall except in middle east areas; it is the aging that more Deadly and if you tally the number of world deaths, as others have said, it surpasses everything. And, In my pov even it did not surpass total tally it would still be one of most important one today because war is not what it was; that's not to say war has no casualties, it has a lot but life; overall on the planet, has become somewhat more peaceful with at least 40 year period of general peace (since Vietnam war).

I think the turtle analogy is interesting and it is indeed a protective response against predators (the turle not be eatean; this shell protects it) - it could have become violent and killed the predators attacking it - but instead it was 'defense' strategy evolution for this animal :

My 2 cent is that this animal's evolution was that it 'responded' to it being prey - by having shell formation. Turtle are ancient animals, small, docile, slow and the legs don't help - everything against it (an easy prey, and any large predator could lift and make a snack out of it). Fast animals generally don't developp shells/carapace/exoskeleton shield to protect their organs. Insects show that too with exoskeleton shell-like body that armor them (beetles for example), this armor is oftenly we weaker animals whom less predatorial and oftenly not carnivorous (herbivores); carnivores in dino times were oftenly Big, Strong or very fast - and killer. Slow animals such as turtles, porcupines, clams, beetles, stegaurus dino or armadillos (australia) have evolutionary delepped very specific like 'shields' that protect them because they themselves are no match against Deadly predators (stegausaurus was big but slow; if was turned around on its back; like a flipped turtle, a flipped stegaurus or flipped beetle - it's over this animal is dead and will be eatean alive 'from Under/no organ protection below the shell))'. While clams, if shell pryed open, is Goodbye they eat the content. Same thing for lobsters, full of exoskeleton like shell. Many of the shelled animals are pretty much 'defensive/'on the defense as prey'')' (the shell providint that defense) not offensive (like bigger 'teethed' predators whom make their meal prey).

In humans, it is different, humans have just replicated this shell effect (tanks, bullet proof armor, knight armor, samurai armor, knight shields, swat team shields, etc...),
this was mainly for war or population control/policing.

Why would war/violence not be the same for humans, I think because humans are driven, mostly, by emotions and can decide to use diplomay as you said...they have developped emotions over hundreds of thousand of years, this is direct correlation to brain development since h.erectus and migratory patterns (humans Evolved language/communication to make more cooperation (diplomacy/make it work), than competition (violence/war)). The main element before was hunting/catching game food and finding fruits/veggies. This means there was very much a life threat and this made humans powerful hunters whom understood how to kill game fowl and find food. This increased the humans capacity to violence and Killing; since you need those if you want to Fight a Deadly animal and make it your meal/feed the tribe. It is at that time that the Fight or Flight Response (Cannon, 1932) developped; a mechanism in the brain that triggers epinephrine/adrenaline boost/cortisol rise and makes you 'alert' to the danger to 'save yourself': you fight the threat or you flight/escape it. A caveage hominin hunt was met with Fight or Flight continuously; this increased the adreno/adrenal gland development in humans and made machines of Killing. The fear is important for humans, we fear what we don't know and fear deadl animals (we are scared when he animal screams or baby screams...that is our prehistory DNA that 'answers' - it's normal...ancient humans had to face countless dangers : poisonous snakes, Deadly spiders, huge smilodons, mammoth the size of bus, 8-feet tall terrorbirds...etcc...) They had to Watch their back continuously or else die the next day. It's why there are so many people afraid of 'Critters' it's because it's our natural ancestral 'primal' fears (fear of the dark, fear of predators, fear of dying etc....).
All this fear is 'fuel' for the cortisol/stress sysetm in humans and fuels the steroidal cascade (muscle/steroids are important for strenght and physical Killing power) : you become 'stressed' and then all best are of (your mind tells to slow down) but in acient times, I would not be surprised if tempers were short like short-wicks; they exploded and people killed each other any minute (plus they were cannibals). It was mean, savage, violent and far more Deadly then today. Today it is peaceful, and yes there is war, but humans choose to Behave in a good way and this affects the genetics.

This demonstrated in a study in the 1940s, where they bred silver fox in Russia, they tried to explain the violent behavioir of animals (primal instincts) and why certain animals of same specie can be more docile. They bred somethingl ike 5 générations and there was a clear 'genetic' transformation to these silver fox. They became 'docile' and were 'domesticated' just like domesticated dogs who become 'house dogs' and their long ago 'wild instincts' (which they descendants from wolves) are gone. Wolves are the ancestors and are 'wild'; they have more predatorial behaviors than many-generations-domestic animals who are not only genetically different they Behave different (they become docile and not violent anymore); there is specific hormonal changes in them :

They becomes more 'estrogenic' in apparance (this was visible in the silver fox) their paws and legs legths were smaller; (this the 'woman' effect due to estrogen exposure which reduces testosteron/Steroid exposure thus makes a smaller IGF GH impact (men have higher IGF/GH/steroid and testosterone levesl - they are direct reason why men can display more violent behaviors (testosterone makes Male baboons and Male Gorillas extremely more Dangerous; this was demonstrated where male apes did 'roudns' around a border just like a 'troop' that verifies its territory in a very 'offish' display of 'defending' their borders'. One time a female ape bonobo was lost in a male ape tribe; this female was adopted but a male from another bonobo tribe also lost himself and ended up there....this male was tortured/killed by the other Alpha males in the new tribe as an 'invader' (yet he only lost himself but was seen as intruder while the lost female 'intruder' was spared and was adopted))).

Thus, this an order o things, and such is the 'Alpha-MAle' which relies of strenght power and of course, in certain situations, violence/killing.

Anthropologic studies showed that ancient hominins were more hardy, stocky and much tougher than us 'thin' h.sapiens. We are not made for hunt life anymore we are made for peaceful life. Body builders are the exception but overal it's not the case of humans becoming more muscled or anything like that; they are becoming slender, taller.

As such war/violence has an effect on humans for sure (such as PTSD that war veteran most compose with); but humans now decide pretty much the whole thing; also we spend far more time indoor than in the ancient times; we are, in fact, just like domesticated dogs, become ourselves more 'domestical' which means harboring 'house/docile' features because of hormonal changes that affect body morphology/genetics in humans with said domestication.

If we are plpugged on the internet and doing computer all the time - it means evolution will aadpt us to that - meaning 'house life/bureau indoor life' - meaning no point for pointy fangs, huge muscles, angry testosterone fille behavior/violent/impulsive, but rather
to become more estrogenic, just like female features, more estrogen/opiace exposure (the hormone of Love and Peace), just more docile/domesticated.

Have you ever seen a Beta-Wolf vs a Alpha-Wolf..it's Something, there is 'order' in this pack of wolves. The beta- knows he's a beta and can get killed by an Alpha; thus whenever a beta is pissed by an alpha he immediately bows down and gets on this back belly up and the Alpha sort of says 'OK' you know...you are a beta and evetthing is alright/you're forgiven....
The beta does not try to challenge the alpha or die (he may have tried in the past and the beta order was established).

There is an old (pejorative) saying :

'beta bucks, alpha f..ks'.

Just a 2 cent.

Posted by: CANanonymity at January 8th, 2018 8:49 PM

PS: the effect of this domestication is that aging is slowed (as was seen in the subsequent silver fox raised in protection in a farm, they outlived their wild counterparts). This means there was estrogenic effect and the animals become docile behavior (domesticated/or subservient/subordinate...this is seen Beta-males vs Alpha-male wolves; the beta-male are subordinates and give up fighting the Alphas (or will be killed if they try))). Estrogen increases telomerase activation by estrogenic receptors in the brain; this increases lifespan by having more replicative lifespan in the cells (longe télomères). While in males, the testosterone is converted to estrogen by aromatase; amd thus get telomerase too but not as 'direct' as how females cells get it (and why females live longer than males/they are supportive/cooperative not combative/competitive; and that is due to estrogen/hormones)).

Posted by: CANanonymity at January 8th, 2018 9:13 PM

PPS: ''(as was seen in the subsequent silver fox raised in protection in a farm, they outlived their wild counterparts'' And I'm talking about 'biological age', not that a wild-silver fox would die precipitously in 'nature' by a predator. but rather it lived the maximum it could 'out there' without being killed Faster (by a predator) than how Total Long it can live 'in nature'. Its biological age is Faster in the wild than the silver fox raised in protection in the farm. That is because it avoids the predators/thus the stress activation. Mice it is the same, mice raised in perfect Lab environment Outlive their wild ones out there, and also these mice have same effect they become estrogenic-features and developpe more docile behaviors/because of endocrine changes of the generations of offspring (evolution understands taht you are 'protected' Inside a 'shell/shield/house..etc'; this in turn increases the lifespan of the animal/slowed aging and makes a protracted sexual/puberty (just like in humans whom are 'sexually late late' in reproduciton)). sexual hormones/endrocinal axis/IGF/GH are all at the nexus.

Posted by: CANanonymity at January 8th, 2018 9:18 PM

"If we are plpugged on the internet and doing computer all the time - it means evolution will aadpt us to that - meaning 'house life/bureau indoor life' - meaning no point for pointy fangs, huge muscles, angry testosterone fille behavior/violent/impulsive, but rather
to become more estrogenic, just like female features, more estrogen/opiace exposure (the hormone of Love and Peace), just more docile/domesticated...

There is an old (pejorative) saying :

'beta bucks, alpha f..ks'.2"

The thing is we are on the point of taking control of our biology (including aging) so we're not going to 'evolve' through natural selection into domiciled passive scrawny house cats.

What are the first two examples of bio-hacking in human/animal history that took place recently? Liz Parrish, a middle-aged woman, using gene editing to try to reverse time and turn herslef back into a peak fertility 20 year old. Josiah Zayner, a geeky beta male using CRISPR to give himself bigger muscles and turn himself into one of those alpha f..ks.

That's how evolution is going to play out over the next 100 years.

Posted by: alt-transhumanism at January 9th, 2018 4:27 AM

Hi alt-transhumanism !

Thanks for that, I am agreeing with you that, now, we are the ones controlling evolution to our liking rather than the other way around. These examples you provided are clear demonstrations that we have the power to change our bodies indeed (The only scary part about it, I believe, is what if things don't go as planned 'inside you', that is what scares me a bit; a bit like handing it to 'fate' when you are operated on the table - you hope that your eyes will open once the open-body surgery is done and not die while on the table. Genetic tinkering is all about that, somethnig happen in you and you hope it happens Correctly (hence why FDA bodies/trials exist but it's still freaky you have no control over it if it falters 'Inside of you'; that is why I am for rejuvenation/genetics tinkering but I'm weary/wary of just letting be invaded like a guinea pig and I would be down on luck (if you are about to die there is not much other choice; but if you are Young and healthy you have to weight the consequences/risk vs benefits; for old dying there is more benefit, it may not be the case for younger ones until there is sufficiet 'safety/trials' made about the safety of being genetically 'tinkered in').

Let's hope we are still there in the next 100 (because, technically, our chances are very small but not if things happen Sooner) to be able to profit from these new technology.

Posted by: CANanonymity at January 9th, 2018 1:50 PM

@Antonio: I know and agree upon that aging is the no 1 killer, even when its not "officially" so amongst ordinary peoples opinions. The article i "read" i didn't read it was a TV show i heard it (easier ti write I read), so i were sceptical. However my concern were that about homicide. I live in Norway where homicide are no 1 lowest in world ranged by countries i think. and what we read about in the US scares us over here. I think organ failure should be no 2 death reason if it were "accepted", tens of millions year. 1 every 30 seconds.

Posted by: Norse at January 9th, 2018 2:46 PM

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