So if you compare low muscle mass people to high muscle mass people as they age, the low muscle mass people have about 200% increase in all-cause mortality.

是以，如果將肌肉品質低的人與肌肉品質高的人進行比較，隨著年齡的增長，肌肉品質低的人的全因死亡率會增加約 200%。

If you look at cardiorespiratory fitness, it's even more profound.

如果再看心肺功能，情況就更嚴重了。

You're talking about 5x difference in all-cause mortality.

你說的是全因死亡率的 5 倍差異。

That's probably the single strongest association I've seen for any modifiable behavior.

這可能是我所見過的任何可改變行為的最強關聯。

So let's start with a couple of the things that you've already highlighted.

那我們就從你已經強調過的幾件事開始吧。

How much does smoking increase your risk of all-cause mortality?

吸菸會增加多少全因死亡風險？

Smoking is approximately a 40% increase in the risk of ACM.

吸菸會使患 ACM 的風險增加約 40%。

It doesn't mean your lifespan is going to be 40% less.

這並不意味著你的壽命會減少 40%。

It means at any point in time standing there, your risk of death is 40% higher.

這意味著在任何時候站在那裡，你的死亡風險都會增加 40%。

So now the question is like, how do you improve?

那麼現在的問題是，你該如何改進？

So what are the things that improve those?

那麼，有哪些東西可以改善這些情況呢？

So now here we do this by comparing low to high achievers and other metrics.

是以，現在我們通過比較成績差的學生和成績好的學生以及其他指標來做到這一點。

So if you look at low muscle mass versus high muscle mass, what is the improvement?

那麼，如果你看一下低肌肉品質和高肌肉品質的對比，有什麼不同？

And it's pretty significant.

而且意義重大。

It's about 3x.

大約是 3 倍。

So if you compare low muscle mass people to high muscle mass people as they age, the low muscle mass people have about a 3x hazard ratio or 200% increase in all-cause mortality.

是以，如果將肌肉品質低的人與肌肉品質高的人進行比較，那麼隨著年齡的增長，肌肉品質低的人的全因死亡率會增加約 3 倍的危險比或 200%。

Now, if you look at the data more carefully, you realize that it's probably less the muscle mass fully doing that.

現在，如果你更仔細地研究數據，你就會發現，這可能並不是肌肉品質在起作用。

And it's more the high association with strength.

更多的是與力量的高度關聯。

And when you start to tease out strength, you can realize that strength could be probably 3.5x as a hazard ratio, meaning about 250% greater risk.

當你開始研究強度時，你會發現強度可能是危險比的 3.5 倍，這意味著風險要高出 250%。

So they're usually using like grip strength, leg extensions, and like wall sits, squats, things like that.

是以，他們通常會使用握力、腿部伸展、壁坐、深蹲等方法。

So how long can you sit in a squatted position at 90 degrees without support would be a great demonstration of quad strength, a leg extension.

是以，在沒有支撐的情況下，你能以 90 度的蹲坐姿勢坐多久，將是四肢力量（即腿部伸展）的最佳體現。

How much weight can you hold for how long relative to body weight, things like that.

相對於體重，你能在多長時間內承受多少重量，諸如此類。

You know, we have a whole strength program that we do with our patients.

你知道，我們為病人制定了一整套力量訓練計劃。

We have something called the SMA.

我們有一種叫做 SMA 的東西。

So it's the Strength Metrics Assessment.

這就是強度指標評估。

And we put them through 11 tests that are really difficult.

我們讓他們通過 11 項非常困難的測試。

You know, like a dead hang is one of them.

你知道，死吊就是其中之一。

Like how long can you dead hang your body weight, stuff like that.

比如，你能用自己的體重懸垂多長時間，諸如此類。

So we're trying to be more granular in that insight, but tie it back to these principles.

是以，我們正試圖更細緻地洞察這些問題，並將其與這些原則聯繫起來。

If you look at cardiorespiratory fitness, it's even more profound.

如果再看心肺功能，情況就更嚴重了。

So if you look at people who are in the bottom 25% for their age and sex in terms of VO2 max, and you compare them to the people that are just at the 50th to 75th percentile, you're talking about a 2x difference roughly in the risk of ACM.

是以，如果將最大 VO2 值在同年齡、同性別中排在最後 25% 的人與排在第 50 到 75 百分位的人進行比較，那麼患 ACM 的風險大約相差 2 倍。

If you compare the bottom 25% to the top 2.5%, so you're talking about, you know, bottom quarter to the elite for a given age, you're talking about 5x, 400% difference in all-cause mortality.

如果將最低25%的人群與最高2.5%的人群進行比較，也就是說，在特定年齡段，最低25%的人群與最高2.5%的人群相比，全因死亡率相差5倍到400%。

That's probably the single strongest association I've seen for any modifiable behavior.

這可能是我所見過的任何可改變行為的最強關聯。

So maybe we could talk a little bit about the specifics around the training to get into that, you know, top two tiers there.

所以，也許我們可以談談培訓的具體細節，你知道，最高的兩層。

Because it seems that those are enormous positive effects of cardiovascular exercise, far greater than the sorts of numbers that I see around, let's just say supplement A or supplement B.

因為看起來這些都是心血管鍛鍊的巨大積極作用，遠遠大於我所看到的各種數字，比方說補充劑 A 或補充劑 B。

And that's, you know, like this is my whole pet peeve in life, right?

這就是，你知道，就像這是我生活中的一大忌諱，對嗎？

It's like, I just can't get enough of the machinating and arguing about this supplement versus that supplement.

就好像，我就是對這種補充劑和那種補充劑之間的爭論和爭論感到厭煩。

And I feel like you shouldn't be having those arguments until you have your exercise house in order.

我覺得，在你把自己的健身房打理得井井有條之前，不應該有這些爭論。

You know, you shouldn't be arguing about this nuance of your carnivore diet versus this nuance of your paleo diet versus this nuance of your vegan diet, like until you can deadlift your body weight for 10 reps.

你知道，你不應該爭論你的肉食動物飲食與你的素食主義者飲食的細微差別，比如直到你可以舉起你的體重10次。

Like then you can come and talk about those things or something.

比如，你可以來談談這些事情什麼的。

Like, let's just start with some metrics.

比如，我們先來看看一些指標。

Until your VO2 max is at least to the 75th percentile and you're able to dead hang for at least a minute and you're able to wall sit for at least two, like we could rattle off a bunch of relatively low hanging fruit.

直到你的最大氧飽和度至少達到第 75 百分位數，你能懸垂至少一分鐘，你能壁坐至少兩分鐘，就像我們可以嘮叨一堆相對低懸的水果一樣。

Dead hang for about a minute seems like a really good goal for a lot of people.

對很多人來說，死吊一分鐘似乎是一個非常好的目標。

At least that's our goal.

至少這是我們的目標。

I think we have a minute and a half is the goal for a 40 year old woman.

我認為，40 歲女性的目標是一分半鐘。

Two minutes is the goal for a 40 year old man.

兩分鐘是一個 40 歲男人的目標。

So we adjust them up and down based on age and gender.

是以，我們根據年齡和性別對它們進行了上下調整。

Great.

好極了

And then the wall sit, what are some?

然後是牆坐，有哪些？

We don't use a wall sit.

我們不使用牆坐。

We do as just a straight squat, air squat at 90 degrees.

我們只做直蹲，90 度空蹲。

And I believe two minutes is the standard for both men and women at 40.

我相信兩分鐘是 40 歲男女的標準。

Great.

好極了

And then because for some people thinking in terms of VO2 max is a little more complicated, they might not have access to the equipment or to measure it, etc.

然後，因為對有些人來說，用最大氧飽和度來思考問題要複雜一些，他們可能沒有設備或無法測量等。

What can we talk about, think about in terms of cardiovascular?

在心血管方面，我們可以談些什麼，想些什麼？

So run a mile at seven minutes or less, eight minutes or less?

那麼，跑一英里的時間是 7 分鐘或更短，還是 8 分鐘或更短？

That's a good question.

這個問題問得好。

So there are really good VO2 max estimators online and you can plug in your activity du jour.

是以，網上有很好的最大氧飽和度估算器，您可以輸入您當天的活動量。

So it would be at a bike run or rowing machine and it can give you a sense of that.

是以，在自行車跑步機或划船機上，它可以給你一種感覺。

And I don't remember, I used to know all of those.

我不記得了，這些我以前都知道。

But now that I just actually do the testing, I don't recall them.

但現在我真的做了測試，卻想不起來了。

But it's exactly that line of thinking.

但正是這種思路。

Like, can you run a mile in this time?

比如，你能在這個時間內跑完一英里嗎？

If you can, your VO2 max is approximately this.

如果可以，您的最大 VO2 值大約就是這個數值。

And then you mentioned deadlifting body weight 10 times.

然後你提到負重舉重 10 次。

I just made that one up.

這是我瞎編的。

That's not one that we include, but something like that.

這不是我們列入的內容，但類似於這樣的內容。

We use farmer carries.

我們使用農民搬運車。

So we'll say for a male, you should be able to farmer carry your body weight for, I think we have two minutes.

是以，我們可以說，對於男性來說，你應該能夠讓農民負重行走兩分鐘，我想我們有兩分鐘的時間。

So that's half your body weight in each hand.

是以，每隻手的重量是你體重的一半。

You should be able to walk with that for two minutes.

這樣你應該能走兩分鐘。

For women, I think we're doing 75% of body weight or something like that.

對於女性來說，我想我們要做的是體重的 75% 之類的事情。

Yeah, it's basically grip strength.

對，基本上就是握力。

It's mobility.

這是流動性。

I mean, again, walking with that much weight for some people initially is really hard.

我的意思是，再說一遍，對有些人來說，最初負重行走真的很難。

You know, we use different things like vertical jump, ground contact time, if you're jumping off a box, things like that.

你知道，我們使用不同的方法，比如垂直彈跳、地面接觸時間、從箱子上跳下等。

It's really trying to capture...

它真的試圖捕捉...

And it's an evolution, right?

這是一種進化，對嗎？

I think the test is going to get only more and more involved as we get involved.

我認為，隨著我們的參與，測試只會越來越多。

Because it took us about a year.

因為我們花了大約一年的時間。

Beth Lewis did the majority of the work to develop this.

貝絲-劉易斯（Beth Lewis）完成了大部分的開發工作。

Beth runs our strength and stability program in the practice.

貝絲負責管理我們的力量和穩定性訓練項目。

And basically, I just tasked her with like, hey, go out to the literature and come up with all of the best movements that we think are proxies for what you need to be like the most kick-ass, you know, what we call centenarian decathlete, which is the person living in their marginal decade at the best.

基本上，我給她的任務就是："嘿，去查閱文獻，找出所有我們認為能代表你成為最牛人所需的最佳動作，你知道的，我們稱之為百歲老人十項全能運動員，也就是活在最佳邊緣十年的人。