Understanding Heart Rate Variability: Improving Your Health & Performance | Joel Jamieson

Dr. Gabrielle Lyon: 00:00

I'm I'm Dr Gabrielle Lyon, and I work with elite performers, military operators and high achievers who want more than just inspiration. They want measurable results, and yet, I've never seen a tool more misunderstood than HRV, which is heart rate variability. That's why today's guest is Joel Jameson, a world class performance coach to combat athletes, Special Operations and pro sports teams. He's the creator of Morpheus, the first HRV guided training system built on over 20 years of data. We dive into what HRV really measures, how it changes with age, how stress impacts it, and even if you're sleeping fine, and why most people are training in the dark. You know, if you're waking up tired, it's not because you're lazy. It's because your body is already out of gas before the day even starts. People think it's just the training that makes them stronger, but the reality is, if you don't understand your nervous system, you're basically just guessing through health and fitness. Think you're recovering, think again. Think your fitness tracker is helping, maybe, maybe not. And if you're training hard every day without understanding this one signal, you might actually be getting worse, maybe everything you thought you knew about recovery, performance and stress is wrong. Joel Jameson, welcome to the show. This is actually a long time coming, and I'm really grateful to have you here. You have been a coach for two decades. Yeah, a little over that, a little over that, and you have coached world class athletes, Olympians, fighters, you name it. I know that you know our mutual friend Rob wolf right in the beginning of the CrossFit days long time ago, and you have some very innovative ways of thinking about training and recovery, which is, quite frankly, why I would love to have this conversation. And I'm grateful that you're here. So welcome.

Joel Jamieon: 01:59

Thanks for having me. I'm happy to talk to you and your audience, and like said, It's been two decades of coaching and learning and trying things out, and any opportunity to share what I've learned over the years is a really important one to me.

Dr. Gabrielle Lyon: 02:11

That's very valuable. There's a lot of discussion around evidence based medicine and evidence based practices, and part of evidence based practice is, yes, the science, but also it is the clinicians or the providers or the coaches experience.

Joel Jamieon: 02:27

Yeah, it's funny, because we live in an age of social media, obviously. And, you know, I post stuff that I've done with athletes that I'm working on, and you'll get people respond that doesn't work. There's no evidence support that the world champion I trained last year did that, it worked just fine for him, or, you know, her, or whatever the case may be. So yeah, we always have to keep in mind of what the science tells us, but I think we have to be aware of there are real limitations to the science a lot of areas, and there's a lot of things that science tells us now, work that we've been using for a long time, that we've known works in the komoche community. So there's always this combination of looking at the science and the data, but then also what works in real world. So I've always tried to bridge that gap and understand both sides of it,

Dr. Gabrielle Lyon: 03:07

and that's really valuable. One of the things that the athletic community seems to have a leg up on is you guys do a lot of things, and like you said, the science comes out a bit later, you'll see you know, you look at the bodybuilding type diets, or just the ways in which they have utilized certain behaviors, and over time, you'll say, Okay, well, that's why that worked. And I think that, you know, I think that the same is probably true for things like HRV and some of the recovery modalities that you have been using. And I'm curious Tell me a little bit about your coaching career, just a brief background,

Joel Jamieon: 03:44

yeah. So like a lot of coaches, I was a failed athlete at some level. Tried to play college football. Didn't last too long at that, but I'd always really loved the training side of things. So my senior year in college, I went down the weight room. There was a fantastic strength coach down there named Bill Gillespie, who people in the powerlifting world would probably know, but others may not. I I sense. He said, Hey, Bill, I would love to learn from you and to work with you and be part of the program here, if I can. And he said, Sure, come on down. And at the time, I had been just reading the Russian, old Russian manuals, the Soviet cell training, Yuri for shansky, kind of all these older powerlifting, weightlifting textbooks. And Bill was a, how to put it, the most focused power lifter I've ever seen. So he wanted to bench press more than anything in the world, and he focused purely on that. And so Bill now is, I don't want to over age bill, but I think Bill's 70 or late 60s. He's bench pressed, I think 1000 pounds. I mean, just some insane number. He's broken. Who knows how many world records. So anyway, we I went down there. We just started chatting all the time. And the biggest thing I learned from Bill is he was open to me at 21 or whatever. I was giving him ideas, and he'd been doing this for decades, but I would say, Hey, I read this in this manual. What do you think about this technique? And he's like, let's try it. And so we formed this partnership where I would dig. The science and look these old Russian manuals and build back. Yeah, let's try it and see what would happen. And so that was really the start of trying to bridge that gap between the scientific side of things and these old Russian manuals and Bill's power lifting and collegial strength conditioning. After about a year, he went to university or so, he went to the CLC Hawks. I followed him there as an intern. Worked for him, Kent Johnston, same thing, Kent had been in the field for four decades. At the time, three decades, whatever it was, worked at Green Bay, Tampa Bay, the Seahawks. And same thing, you know, these guys were just so open to ideas and trying things and discussion. And it really just sparked a love of this idea of performance and training to help athletes get better and help people reach their goals. But I decided I didn't want to be a collegiate or a professional strength coach, because you have no job security, you know, right? You're moving around the country all the time. It's like musical chairs every time the coach you're working for gets fired. Now you're looking for a job. I just didn't want to play that game. So, 23 years old, I decided to open a gym. And looking back and I was very naive about what that would take, but I did. I opened in place called Kirk and Washington, which was just outside of Seattle, and fortunately for me, I opened it next to a gym called AMC pen creation. I wish I could say this was planned, but I had no idea that AMC pen creation was really the best mixed martial arts gym in the world. And the coach there, Matt Hume, without question, the best mixed martial arts coach of all time. And so very quickly, I had these high level combat athletes coming over and saying, Hey, can you train me for a fight? And I was like, Yeah, sure. And I was like, what fight like? K1 I was like, what's k1 Google that right. I really had only worked primarily with football and strength and power and that side of things. And so my first approach was, let's treat them like I treat everybody else. I do an assessment. I'm like, these guys are weak, right? Like they could do, like, two pull ups. Some of them couldn't do couldn't even do a pull up. It's bogged my mind, you know, they couldn't squat their body weight compared to the athletes and the pro level. I was like, man, these guys are just really underpowered and under muscle. I'm just gonna make them really strong and they're gonna go kill everybody. I'm looking a genius. But it took about 30 seconds of training with myself and gassing out and getting destroyed despite being significantly stronger than them, to realize, Hmm, maybe I don't know what I thought I knew about conditioning. Maybe there's a whole other side to this that I've not dug into. And so that's where this fascination with conditioning and getting people in shape from a, you know, not just lift weights and call it good standpoint. And really, kind of around the same time, I started working at Seahawks. I was also introduced to Heart Rate Variability by an old Russian coach and sports science team. So as I was trying to understand, how do I help these fighters become better fighters? I was also looking at heart rate variability way before most people knew what it was. I was using this expensive Russian system where you had to put electrodes on people, and it was super invasive. But I was looking at real numbers. I was looking at the athletes performing, and in team sports, it's really hard to say, like, oh, I helped the team win. There's lots of variables, right? There's there's multiple players in the field, and there's all kinds of stuff going on, but combat sports like that, athlete gets in the cage of the ring. It's one on one. They gas out. And your job was, help them prevent that from happening by getting them in shape. You know, you gotta look yourself in the mirror. And so I took my job very seriously of making sure I learned everything I could about conditioning, making sure these guys were going into the fight, recovered and able to perform. And, you know, over time, I just kept learning and kept trying things and worked with Matt, who, again, had been in their field for a long, long time, and that really was where the whole conditioning HRV intersected, and really set my course on that career, and then keep a long story a little bit shorter. You know, as I've aged, as the people around me have aged, I've had a shift focus a bit towards, how do we now look at conditioning and fitness from a longevity standpoint, not just, you know, I want to knock somebody out or knock it knocked out myself, or how do I look at using the same types of tools like HRV and recovery and conditioning, but rather than again, performance to live a longer, healthier life. And have, you know, taken that path as well. So that's the shortest version. I think I can make 20 plus your career.

Dr. Gabrielle Lyon: 09:12

I think it's really it's really fascinating. It sounds like Russia had a leg up on us in terms of being very innovative, yeah,

Joel Jamieon: 09:21

the Russians. You know, I would never want to live in a communist regime, personally, but I will say what they had is massive structure and massive organization that United States never had that came from the top down. So, you know, they would have sports groups by type of sport, where they have a very clear hierarchy of coaches at top or coaches at the bottom. They would get together and have conferences. They were doing blood testing back in the 80s, and they were so the athletes I've talked to and the coaches said they would get blood tests every week based looking for different blood markers, having mineral panels. They would have customized supplementation, pharmaceuticals, all that stuff was literally customized. Organized as far back as the 80s, and they were using HRB back in the 80s to try to figure out how to use it, because they had actually created it. They created per se, but they took heart rate variability and use it with the space program and the cosmonauts to see what happens when you send someone to space. So they'd been using technology in a meaningful way for a long, long time. And so when you got to a communist regime where they could focus everything in a very organized, structured and quite frankly, maybe unfair way, using a lot of performance enhancing drugs. You saw a lot of it come out of it. And were they better? Stronger athletes? They were better, stronger athletes than us. But I will say, what's funny is, after one of them that started the HIV system. Came the US. Who was it? My name is valence edkin. So he was a decathlete himself, and he was a track coach, and then did some other stuff, and started to make way of the first HIV company. He went to Oregon, of all places, and he was telling me, like in Russia for a while, he'd been a selector, meaning he would go to the schools, and he would select which athletes were brought into the program to be trained. And that's the other thing they had, is like they would select athletes at youth and youth in like sixth grade or beyond, but below, and they would train them systematically all the way until they try to break world records. So that's the other thing they had, is this huge, organized Junior program that would train athletes always. China has it. Now I can tell you crazy stories about China. Do you think the US will ever have that? I don't think so. We have a different system that I think is broken in a lot of ways. I think we abuse kids because they just get thrown into I mean, I train a lot of you athlete youth athletes. They go from club sports to team sports and their school almost year round. They're just trained massive amounts with no real coordination. The one thing that the Russians did have is they had that coordinated system, right? It had a long system, right? It had a long term plan. And you have well meaning parents putting their kids in 12 months straight of training. So we had, you know, youth athletes, 1314, 15, with major ACL reconstructive surgeries in when I was coaching those athletes, and just low back problems and shoulder problems, because just massive overuse. You take these 1314, year old girls who can train them 12 months, year round. You know, it was crazy. The Russians, Soviets were much more cognizant of we need to keep these athletes healthy. Because, going back to the story when, when Val was selected, and he said he would go into an elementary school, or middle school, and he would select between, like, three and 10 athletes based on their athletic ability, which is crazy they're trying out, right? Very, also, very young, very young, yeah, and he would watch him move. He would look at mechanics or coordination skill set, and he would select the athletes that come into the program for giving sports, and they would actually, oh, you're gonna be this, you're gonna be that. They would select you and then put you in sport. He said, When he started coaching in Oregon, he went into elementary school, and he said, I would have selected 20% and the difference is, we have massive genetic diversity here. They only had Russians, right? So if you you know, not to play the big game, if you took out all of the races in the US except for Europeans, you'd have a whole lot less athletic performance in the real world. And they didn't have that genetic diversity in gene pool. So we have significantly better genetics and significantly bigger gene pool to draw from than I think that Soviets ever did. Wow, which is why he was like, Look, we had to take our athletes and be mindful of recovery and we couldn't burn them out. I think we have so many talented athletes that are just

Dr. Gabrielle Lyon: 13:12

more room for error, way more room for error. And you train young children, you train kids now,

Joel Jamieon: 13:19

not anymore. No, i So long story. When COVID hit my gym got taken over by Google the same time. So Google shut my building I trained. Oh,

Dr. Gabrielle Lyon: 13:28

yeah, not 15 years so long ago, 2003

Joel Jamieon: 13:31

until 2020 basically, I,

Dr. Gabrielle Lyon: 13:35

you know, I'm obviously a parent. I don't know if you knew this, but I have a four and five year old, and I have one child who is extraordinary, extraordinary, Lee athletic, tons of coordination, and just seems like a lot of capacity. And I think about genetically, if we train her up well, and she loves it. And then I think about exactly what you were saying. I have friends that their kids are in, you know, basketball track all year round, yeah, all year and I wonder for parents listening thinking about how they want to develop their children. Do you have a suggestion for how we can develop our children into lifelong athletes? Because now in your dare, I say 40s? Yeah, mid 40s. Mid 40s, you're beginning to think about what that looks like from a longevity perspective. Of course.

Joel Jamieon: 14:26

I mean, look, I think, first of all, it's taking a long term view. As you mentioned, the problem with, I think, our system is we have, some of the kids have so much pressure to make the varsity team in middle school, then they have to make a very good club team in high school, and then they have to get selected for college and try to get a scholarship. So there's a tremendous pressure from early on to make these teams. And in the short run, yeah, you spend more time playing your sport, you're more likely to develop the skill to make those teams. But you're also risking burnout and overuse injuries to you know, if you're in high school in your senior year and you blow out your shoulder or your back or something as an athlete. Like, you're not gonna get the college scholarship, or it's a lot, lot harder, so much harder. So I think the biggest thing is just maintaining that idea of like, we're not developing the athlete for your son or daughter short term, the short term, it's the long term. And going back to that, the most fascinating thing that the Russians told me, several of them, is they said, when we would select an athlete at some point in the career, we'd make a decision, is Is this an athlete that we think can make it to the national level? Or is this an athlete we think can make it to international or an Olympic level? And they would put them on different tracks, because they believe that peak performance for Olympic athletes need to be delayed, actually, because for most sports, and then other sports, was not the case. They thought that most sports, they would peak some of their mid 20s, late. You know, mid to late 20s is where their optimal window of performance was. And so they would actually slow down the trained Olympic athletes versus they thought were the international the national level athletes. They would peak them earlier, and they would intensify their training earlier because they thought they had a shorter window to perform. So if they said, Look, this is a special athlete, rather than accelerating their training, they would actually try to delay it and draw it out so that they had a longer career and they could get to that point. It's kind of the opposite of we do. It's opposite what you think now. I also had a chance to go to China several times. China takes almost a Russian approach, but without this mindfulness of we need to maintain these athletes right. They have a single population of Chinese. They want to get to the highest level possible. They do a lot of recruiting. I went to work for the judo School for the Chinese national games, and they train like I've never seen. So I get to this school and outside of Beijing one time, and they wanted me to help train their athletes for the upcoming competition. How did they find you? Word of mouth, yeah, word of mouth. There's a company that brings over us coaches over there. Okay? And so I show up in day one, and, you know, they're like, We want you to train our athletes. I'm like, Okay, I need to see what your athletes do, right first. And so they I watch about a two and a half hour, three hour Judo practice. It's, it's intense. I mean, these kids are going going hard from the start. How old were they anywhere from, like, I think 1211, 1112. Was the youngest, up to 18. These were youth athletes. And so I'm like, Okay, I watch them. And then they're like, Okay, they're gonna have lunch. And then we want you to do a program with a training program, like, I would like to do an evaluation first, maybe, like, understand, yeah. Like, see what's going on. Heads up, yeah. So they're like, no, we want you to train them. And so I'm like, okay, like, you know, let me see what you can do here. And so I just kind of put them through a standard strength training athlete type program for combat sports, just to kind of see where they're at, see what they were doing. Takes about 90 minutes. Like, we want to give you our best athletes first. These are most important. Takes 90 minutes, and they come back and they say, Well, what? What's going on? I'm like, Well, we're done. We're gonna do a cool down. They're like, Well, no, can you do that again? And I was like, do that again. We didn't do that again. Like, well, you have three hours. We have to train them for three hours. You can you just go through the workout again? Unbelievable. I was like, No, I can't go through workout again. The funny thing was, they had a second Julia practice session later in evening, the same day.

Dr. Gabrielle Lyon: 18:02

I mean, so they do. These athletes burn out faster. Oh, of course,

Joel Jamieon: 18:06

of course, we find it. Yeah, they it's just a meat grinder, unfortunately that, you know, we finally got, I finally got some access to, like, how many injuries they dealt with. We found that 70% of the youth athletes had at least one major reconstructive surgery. 70% 70% at least one major reconstruction while we were there, one that, girls blows your ACL out, like, four or five days before the competition, and we're like, are you gonna get an MRI and see what they're like, why would we do that? She's gotta compete in five days. Like, why? Why would we look at imaging? She's gotta compete? You

Dr. Gabrielle Lyon: 18:32

know, it makes me think about as you are building, you know, as we talk about heart rate variability and recovery, one of the things that I would was thinking about is that, is it the athletes? Let's say you select them young. Is it their innate capacity that you build upon, or are they better at recovering? I think

Joel Jamieon: 18:52

it's both right and so after working with a lot of pro athletes over the years, one of the big things, obviously, is their skill. Like they just they have a better kinesthetic awareness, they have better coordination, like they just have a gift that they turn to skill in their sport through lots of practice. The other is they are just recovery machines. And that was the first thing that struck me when I first started, they are, they're not. They are. They're just, they're just work capacity, recovery monsters, at least most of them. So when I first started measuring HIV, you know, I was mostly using it myself, and then I started working with the Seahawks and looking at their data, and I was like, That's why these guys are in the NFL, and I'm not because you would watch them, they'd go out to a practice, and they would come back and practice, we'd measure them, because they're doing two days in training camp, and you're like, these guys look like they just got out of bed, like they're perfectly fine, like that two hour training session that would have just obliterated most people, and myself included, it did nothing to them. They were they prepared for it. They had the work capacity. And so you see this tremendous difference between the elite athletes the world and everybody else regularly, they can just recover. Their HRV is always higher. They just have a capacity to recover faster than anybody else you know. Because part of it's because they've done their whole lives, and they just, you know, are used to that, but part of it's just, they genetically are superior human beings.

Dr. Gabrielle Lyon: 20:06

And they would argue, you know, it's kind of like the military operators. They would argue and say, No, we just are focused on training. But there has to be some baseline genetic variation.

Joel Jamieon: 20:17

There is. And I'll give you a little secret here. When I was the Seahawks, one of the running backs, Sean Alexander, won the NFL MVP for rushing touchdowns, or southern record, rushing touchdowns, and won, think, the NFL MVP that year. This

Dr. Gabrielle Lyon: 20:31

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Joel Jamieon: 22:21

I could be wrong. Anyway, Sean hated to lift weights. Hated train. Just didn't do it. Like I never saw that guy lift weights. Didn't do it, but he was, didn't matter. He was still able to set the NFL records rushing touchdowns. Just did not lift. Hated lifting. Would go run and had a running coach and did some running stuff, but like Dad, didn't want to touch a weight. You know, Ken Griffey, Jr, legendary baseball player like his, his joke was the recliner in the clubhouse was his gym, because you just lay back in the recliner room and worked out. You know, I hate to break it to people, but there's a lot, a lot more than people think of pro athletes who can succeed despite their training, not because of it or habits. You know, I they just are genetically gifted human beings that can do things that nobody else can do. Yes,

Dr. Gabrielle Lyon: 23:06

and even despite genetics, we're going to cover this heart rate variability, and I have a definition here I would love to hear, because you, again, have been looking at this for 20 years. And then I want to tell you a story about my sister, which she's going to be embarrassed, but I don't think she listened to the podcast. To the podcast. That's okay. Heart rate variability is so it's a non invasive marker of the autonomic nervous system, right? And it is measuring the balance between sympathetic and parasympathetic input into the heart. Is that, right? And it's the if there is 60 seconds in a minute. It's the space between beats.

Joel Jamieon: 23:44

Yeah, that's mostly right. So please correct Yeah. So correct me, yeah. It goes back to what you talked about. Is this balance between the sympathetic and the parasympathetic. So for people aren't familiar, you have these two branches of autonomic nervous system, right? You have, we call it sympathetic, the fight or flight, and then we have the parasympathetic, would think of as rest and digest and recovery. I don't necessarily love those definitions, because then people think it's like a switch that you turn on or off. Like you think like, Oh my I'm firefight, my sympathetic turns on and turns off. No, it's not quite that simple. Or we think that like the rest and digest turns on. It's these two systems are more like dials, I think is the best way to think of them, because they can turn down, and they can both be modified independently of one another. So when we're looking at heart rate variability, we're looking really at how the vagus, the parasympathetic, is impacting the heart itself. And the more that system is impacting the heart in a given time, the more variability there is in the heart. Meaning, if I was to measure your heart rate at 60 beats per minute, you might think, Oh, well, it's very evenly distributed, that every one second you're getting heartbeat, but you're not, and that's because the parasympathetic system is active, and it's pulsing in a way that's in rhythm with our respiratory respiration, and that input causes this variability. So the greater the input of that parasympathetic. System, the greater that level of variability into the heart. And so we see a different pattern of the heart rate when we see higher parasympathetic system input, then when we see lower parasympathetic input. We're not really measuring the sympathetic system itself directly through heart variability. We're measuring that resting level of the parasympathetic system. And so what like you mentioned? It does meant that does give us a picture of that balance of what is the body doing right now? How is the body regulating itself in response to the world around it? And to me, that's what it comes back to. It's understanding that we have a lot of stress in the world, mental stress, physical stress, environmental stress, and our body has to always cope with that and react to that. And the way that it does that is reflected in HRV,

Dr. Gabrielle Lyon: 25:39

and when someone is measuring their HRV, how? And there's a lot of you know, it's interesting. It seems, based on our research, it seems as if is that it is pretty well established as a marker. It's been around for 70 years, right? But it, but certainly not, establishes the only marker, right? There's HRV, there's respiratory rate, there's all of these other inputs that would maybe determine readiness, sure, but from an HRV standpoint, what are the things that, or I suppose, first of all, what is a healthy HRV look like? And what? What should our HRV do? We have a sense of, for example, what my HRV should be versus yours or mine? Yeah, sure.

Joel Jamieon: 26:26

So the tricky part with all of this is, if you think of blood pressure, for example, like we know how to measure that. We're gonna get very standardized measurements. We're not gonna use two different devices and get totally different numbers for blood pressure. We know, hey, here's a good blood pressure. Here's a not so good blood pressure. We measure resting heart rate. We know, okay, we're measuring beats per minute. It's it's better and more accurate to think about HRV as this framework to measure this variability. But there are many different ways to calculate the final number, and there are many different devices that can measure it differently. A chest strap, for example, measure it by using electrical activity number. That's the number one. Yeah, chest always most accurate, right? But the PPG, the risk based devices, can do it as well. They use a different technique, gives you slightly different numbers to some extent, and then you can end up, like said, with different calculations that are used. There's what's called time domain, there's what's called frequency domain, is what's you know, there's non linear dynamics. There's different calculations to give you heart rate variability. So it's really difficult to say, you should be this, and I should be this, and he should be that, because the number you're getting depends on what measurement you're using, what device you're using. When you're measuring right, there's measuring overnight, which a lot of devices are doing the background. There's the more standardized way to do it, which I believe in, which is measuring it first thing in the morning. And those are all going to give you different numbers. So it's really hard to say you should be this and you should be that, because there's just different ways of looking at this, and we have a ballpark. So yeah, I would say that the most common thing you're going to see is what's called RMS, SD that's the most common measurement technique that devices are using for most part nowadays. That helps. That does not apply to Apple Watch. The Apple Watch using what's called sdnn, you cannot compare the Apple Watch to aura or any other device. That's good to

Dr. Gabrielle Lyon: 28:07

know, yeah, friends, if you use the Apple Watch versus oura ring or whoop or something else, or Morpheus, you should know that they're different, yeah?

Joel Jamieon: 28:14

And Morpheus actually is a bit different too. We use rmssd. The problem with rmssd and what is our SSD? Yeah. So it's just a calculation method where we take the time between each beat, we do some math called the root, mean, successor, square differences, which is just a mathematical model, and that gives us a number in terms of milliseconds since the average variability in that heartbeat over time. So higher number means there's greater variability. Lower greater variability in general. So in general, over the long term, you want higher numbers. Higher numbers correlate with higher aerobic fitness and VO two, longevity, because this is an important thing to understand. Mostly what we're trying to achieve, in my mind, is resilience. How do you define resilience, the ability to cope with the stress the world around us and the world around us in a positive way? I would say because again, comes back to we're exposed to stress our whole lives, physical stress, mental stress, environment stress, nutrition, you name it. Stress is is acting upon us, and it's our autonomic nervous system's job to respond to that stress. So let's give an example. Let's say I'm gonna go do a workout. Okay, well, in a workout scenario, I need more energy than I do at rest, right? So what happens our fight or flight system dial turns up so we can create more energy, and at the same time, our parasympathetic system turns down a bit, because we don't need rest and digest when we're out training, we need energy. Now, a simple way to think about this is anabolic, catabolic, to some extent, the sympathetic, fight or flight is mobilized energy. It's more catabolic. The Rest Digest, parasympathetic is more on the anabolic side. So as I go work out, my sympathetic system turns on more, my parasympathetic system turns down more, and now I create a whole lot of energy so I can go out and train. Well, what happens after. Afterwards, this is where we get into resilience and recovery. First thing we have to do is say, Ooh, we don't need that energy anymore, right? We don't need this big influx, our big, big production of energy. Now the sympathetic system has to turn back down that dial. Has to come back down to where it was, and then simultaneously, or in conjunction, that parasympathetic system has to start to come back up so it can facilitate energy storage and recovery and the anabolic things that follow that right, the faster and the more efficiently we can do that, the better results and the more adaptable we are, because we have to be able to take that workout stress and turn it into something positive, be it better mitochondrial function or aerobically stronger muscles. From a strength standpoint, more efficient movement, all these things have to happen through those processes of recovering after the workout. So we don't get stronger in the middle of a workout, right? We get stronger by adapting to that workout afterwards. And that happens through that parasympathetic system driving energy into recovery and growth and repair, rather than that sympathetic system, driving energy into dealing with that workout right now and how that happens over time is what dictates a lot of how our body functions. Because the more stress we impose on ourselves, the more we have to be able to deal with that stress. If we can't deal with in a positive way, that's where we get negative adaptations and overtraining and overuse injuries. But from longevity standpoint, it's also where we get chronic inflammation, that's where we get all sorts of hormonal dysfunctions, where you get mitochondrial dysfunction, all these sorts of things happen if our body cannot cope with the stress the world is imposing on us. And part of this is just that inflammatory cascade, sympathetic system, more pro inflammatory, parasympathetic system, anti inflammatory. It turns off the inflammation that was created during that sympathetic process. When those two systems get out of balance, and we start to lose that ability to turn off inflammation, we start to lose the ability to cope with the world around us, this is where aging accelerates. And we know, if you look at mitochondrial dysfunction and all these sorts of things, you see how much it is related to all kinds of aging. That is a very big part of where we see this connection between HRV and longevity, because we know that HRV is closely related to mitochondrial function, aerobic function, this anti inflammatory reflex, all these sorts of things. So there's a really big connection between

Dr. Gabrielle Lyon: 32:15

all of it and HRV, from your perspective, is not a single unit measurement. For example, let's say I wake up. I again, I have two little kids. They keep me up. I'm sure that my HIV is pretty terrible, totally in the tank. And that might just be a season of life, right? Because I don't get good sleep. It's not that moment to moment or day to day. It's probably, and I suppose I should ask you, it's over a over seasons, over years, right?

Joel Jamieon: 32:46

Both, right? So as a so we look at from two standpoints. We look at where you are in a day to day basis, to understand how the world around us is having an impact. And what I mean by that is, if we see these big fluctuations in your HIV from day to day, that's the body reacting to a lot

Dr. Gabrielle Lyon: 33:02

of stress, right? Even though we it might be out of our conscious awareness, sure, 100%

Joel Jamieon: 33:07

like a lot of times, you feel the effects of stress after it's already had an impact on you. And sometimes you see much different results in HIV you expect. But on a daily basis, we're looking at, how much am I changing? And if it's again, if we're seeing big fluctuations from one day to the next, it means your body's coping with a lot of stress. If we see over time that number going up or going down, that indicates how your overall resilience and how your overall aerobic fitness is changing. So over time we want to, we'd like to see increases up to healthy levels, right through aerobic fitness training and all these things that can boost HIV from lifestyle standpoint, what's the biggest one? Aerobic fitness, by far. Aerobic fitness 100% so you have to understand the recovery system. It's driven by aerobic metabolism, right? When you say recovery system, well, I mean, with the parasympathetic system driving energy into our cells for growth and repair, we're functioning aerobically. In that case, it's driven by mitochondrial function, and it's driven by the mitochondria giving the right amount of energy to the cells that need it. So we have 30 plus trillion cells in our body, which is a lot of cells, and they all need energy. The question is, which cells get energy, or which cells get how much energy and when? That's what the autonomic nervous system is figuring out. It's saying, Hey, your muscles have to produce more energy. Your brain needs to function higher level. Your heart has to function, boom. Put energy into those cells so they can go do their job. Then it's saying, Oh, that workout was stressful. When you rebuild those muscle tissues that got damaged, we need to restock our glycogen storage. We need to do all these things promote growth. Put energy into those cells. And so the autonomic nervous system is communicating and using our mitochondria to derive energy into these different tissues need it when they need it. The more effectively we can do that, the more effectively you're going to live a healthier, longer life. And that comes down to the aerobic side of the equation, because the aerobic system is what's deriving the energy and 99% of. Our life, right? We're really only using anaerobic energy as necessary to do things are higher force and higher power, but the aerobic system turns on, or is there from when we're live, and as soon as we don't have oxygen to create energy, we're dead within a few minutes. So it's so fundamental, and we see this connection between heart rate variability, aerobic fitness across the board, it's just the way it is,

Dr. Gabrielle Lyon: 35:20

and the way to improve, and I want to say increase or decrease, because you pointed out that it's somewhat relative to the person it if we recognize HRV as a marker of readiness, is that fair to say, or longevity or

Joel Jamieon: 35:34

Yeah, I mean, I was fair again. I would say it's a marker of resilience in terms of your so I would say this, we see your average baseline HRV. That is a marker of how influential and how effective your parasympathetic system is, your recovery system, the more effective that system is, the higher that baseline level. That's what we're measuring, the baseline level of HRV, the more you're able to turn off the stresses that comes at you and adapt to it. So basically, if I have higher HRV on average, it just means, in general, I'm better at dealing with stress, and that has a lot of benefits. If it's lower on average, it has a lot of detriment, because I can't deal with stress as effectively. And that's also why she athletes at the highest level, they have very high HRV, because they're just machines,

Dr. Gabrielle Lyon: 36:15

and it makes me think of the individuals. Then I suppose that we're running a marathon, if we were to put the two together, those with greater aerobic fitness might be more resilient, of course, which, again, I think is fascinating. Is there a minimum dose response to improve HRV, for example, we have the recommendation for 150 minutes of moderate to vigorous activity. Sure. Do we know if that input is enough to improve HRV in any meaningful way? I mean,

Joel Jamieon: 36:44

yeah, it depends on where you're starting. It's like anything else. So if you, if you just substitute the word like aerobic fitness for HIV, you're probably going to get the answer, which is, yeah, of course, if someone is fairly unfit, they start training.

Dr. Gabrielle Lyon: 36:56

But what I'm but I also what I mean, starting to interrupt, but, but you've seen 1000s of people over time and so I mean, and also, to be fair, you're taking care of very highly trained individuals, but I'm sure not all of them were aerobically fit, because it just depends on what their sport of choice is, yeah. So I'm curious as to what you see as a and it's difficult, right? Because a global the idea of a global foundational program is probably impossible, because a specialization in someone doing jujitsu versus someone playing football versus someone who's like Justin Gatlin or a track star, but is there, say, a minimum input that you see just somewhat across the board for similarly to, I know that I would never recommend less than 100 grams of dietary

Joel Jamieon: 37:44

protein. Sure, I would say at a bare minimum, three days a week of some sort of physical, aerobically driven activity, probably 80% that in the lower end of the spectrum, the zone two type cardio, and you know, 20 ish percent on the higher intensity, if you get three days in, you're going to improve your HRV at a baseline level. That's that's been diminished as you get hired and hierobic fitness, but I would just say, starting out, you need three days a week of doing something physical. And again, someone who's just got the couch can still make progress with

Dr. Gabrielle Lyon: 38:12

like my producer. Yeah. Well, some people don't forget it

Joel Jamieon: 38:16

everything. The lower you're at, the bigger your room for improvement, the faster it's going to happen with less work. And that changes over time. Obviously, I like

Dr. Gabrielle Lyon: 38:23

that you're saying that it changes over time. And one of the things I think you're now very interested is in this idea of longevity, of how do we maintain a healthy HRV over time? Does that mean we need to continuously increase the stimulus to improve HRV over time? Yeah. I mean,

Joel Jamieon: 38:41

two things here. One is, there's a genetic component to HRV, which I want to point out. Is it 50% or, I mean, the papers you read are all over the map. It's hard to put that as a true number. I don't think we have a great answer in that. I would say it's, I don't know, 40% somewhere in that range. And I've seen this all the time. You'll all have people walking down the street. They're clearly not in good aerobic physical condition. They haven't worked out maybe in years. Maybe their metabolic health looks poor. And you'll test for HRV, like, what? And it's good, and it's very good. Same thing, you know, you see meta, you see people. You see people, yeah, but you see it, I'm sure you see people that come in. Maybe they don't look metabolically healthy. They're carrying more fat. They should be their diets terrible. And then you test them, like, oh, like, what they're like, they look great. Like, there's just that in the genetic spectrum. And then you see the opposite. And I even put myself in this category, which you,

Dr. Gabrielle Lyon: 39:30

I would love to hear you mention a little bit about this stuff that we were talking about, because it's just so important,

Joel Jamieon: 39:36

yeah, so genetically, I've always had lower HRV than I should. So what I mean by that is, if I look at some of the aerobic fitness or vo two max or resting heart rate, you know, other markers of actual aerobic performance, you can kind of assume roughly where you think they should be, or, you know, from an HRV standpoint, because there's a very broad correlation, like I said, between vo two and HRV, I've always been the much lower end of that. Maybe it's because early in my life, I did a lot. Molephant weights for a long time than I focus on the conditioning side. Maybe it's because it's genetically, you know, my family has lower HIV, which I've seen now, but there are multiple reasons for it. And so when I looked at my own HIV relative to where it should have been, it was always on the lower end. And I took that, you know, it's kind of ironic, right? Yeah, it's kind of ironic. It is, you know, and but, but it was just a reinforcement of like, this is a genetic thing. I've always been a strength and power athlete. I was, you know, I've squatted five and 500 bench in the 400 draw same, you know, perfect. You know, when I was younger, that's what I love to do, is lift weights. And you know, that's what I did. And it really wasn't until my 20s I started to take the conditioning side more seriously as I train these athletes. But regardless, you know, I've always seen that in my family, who has a very bad history of cardiac problems, I think we were talking about this. So my mom had a stroke when she was 61 she had severe cardiovascular disease, and he had three stents. She then had sarcoidosis in the lungs, that she had breast cancer. And so it was a series of things, obviously, and I got to see very clearly what happens when you lose your mobility? What happens when you lose your ability to get up and do things you want to do because it's so energetically demanding for you and so hard she was. She started 110 pounds, she ended up in like 90 pounds. So severe, sarcopenia, bone density was terrible, obviously, and it was just a very heartbreaking thing to watch. And her, you know, go through life for last 1012, years of life in such a miserable state, it's very difficult to see, very difficult to see. And you realize, I think at that point, your ability to do the things you love doing as you age, is so important.

Dr. Gabrielle Lyon: 41:32

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Joel Jamieon: 42:56

the retirement community with her, and I'd watch these people, and you'd see a mix. You'd see people who were just kind of resigned to their fate. They weren't trying that hard. They were just kind of waiting to die as to say and then you see people who are the opposite. She had this friend named Peggy. Peggy was 94 and she had a little Walker, and she would go to my mom's room, and she'd drag my mom to every field trip that they ever had, and she would just sit there and say, you have to do everything that you can, dear, you have to do everything that you can. And she had the most positive spirit I've seen. And Peggy made it to 95 like that, like she went on a field trip, and then the next day she was gone. But till the very end, I love that she was active and doing the thing that she loved. I think that's how we all want to live our lives. But I saw the opposite of that, and my mom's Spirit just slowly sucked away from her in that scene, certain things, but kind of back to the story, you know. So I was aware that genetically I had not cardiovascular, cardiovascular. My dad had a heart attack at 62 No, sorry. He had a heart attack in his late 50s, and then had quadruple, double bypass, early 60s, and died a year later. My brother, at my age now, 45 had three stents or two stents put in, and both Grandpas died early, heart attacks. I knew I had the bad end of the stick. As far as genetics, it was coming for me, and so, you know, and knowing the major he was lower was also a symptom, right? It was, it was, it was a clear indicator that there's probably something there. What about your

Dr. Gabrielle Lyon: 44:23

just out of curiosity, your resting heart rate, low 50s, you're Oh, god, okay, because some people, I think genetically, no matter how much,

Joel Jamieon: 44:30

but it's taken me a lot. So I would say it takes me a lot to get marriage and heart rate low 50s, takes me a lot more cardiovascular work, and I have to cut back my strength train. I hate to say it, but if it was up to me, I would lift weights five days a week and do as middle of card as necessary. It doesn't work. So

Dr. Gabrielle Lyon: 44:43

that's informing your decisions 100% Ah, that's bad news for me,

Joel Jamieon: 44:47

unfortunately. So I'll keep telling the story, and we can get there. But so again, I was aware of all this sort of thing, and my predisposition was towards lifting weights, being strong, looking heavy, you know, building muscle. I used to be 232, 35 really?

Dr. Gabrielle Lyon: 45:01

How much? You know? 2052, 10.

Joel Jamieon: 45:05

So as I got more and more aware of this, when I was taking my mom to the cardiologist, I would say, hey, what do I need to do to prevent being in this situation? Right? I'm in the health space like I want to do everything I can to prevent this. So in my 20s, late 20s, I started getting blood work every six months. Life Extension. I would do NMR, lipopro. I would do, you know, mix of things, depending on, like my hormones, testosterone, like everything, CRP was generally low. But something super fascinating is when I would lift weights and measure CRP next day, it'd be like six which is very high. What

Dr. Gabrielle Lyon: 45:39

about your liver enzymes, all normal, all perfect. They always stay normal. Yeah. What's fascinating

Joel Jamieon: 45:43

is, I took two different biological age tests, markers. They all said that was between 10 and 12 years younger. Both of them said I was between 10 and 12 Years Younger biologically than I am. Now, great, great, right? So I'm thinking, Oh, I'm good, and my cholesterol was, was never bad. So my cholesterol was like 100 110 like the worst ever saw was 120 doing whole 20 during holidays. You know, all my metabolic panel numbers look good, passing glucose. And

Dr. Gabrielle Lyon: 46:07

for those who are listening, you are a very trim, lean, you know, sometimes there's a creasing in the ear for cardiovascular disease. Have you seen that sign you don't have that? I mean, my skin does not show you. Like your Botox is looking great, perfect. So, yeah, all my metabolic numbers looked healthy, basically, like they did not signal, like, oh, this person's at risk for things.

Joel Jamieon: 46:29

My triglycerides are always in the 50s and 60s. Wow.

Dr. Gabrielle Lyon: 46:31

Like, and for people listening, we like to see it less than 100 Yeah.

Joel Jamieon: 46:35

I mean, all those numbers, basically every incidence, it was always the top of the chart. So as I was seeing this cardiologist, bringing my mom to him, he was like, Look, all your numbers are great. You clearly exercise like all signs are good, like, I'm not worried about you, you know, come back when you're 40, and we can do some more testing. So that was very heartening, right? Like, I'm thinking, Okay, I'm doing the right things. All my numbers look good, and I continue to test every six months. I have years of years of my blood work, and I wasn't testing little a back then, but I have since then. So regardless, 40 comes around and COVID hits, and I'm 40, so you know, the odds of me going back in there to get preventive screening were not high. I tried to actually call they wouldn't even, like, No, you can't get it because you had no abnormal markers, and it was not an emergency, right? So, long story short, you know, I'm just kind of resting the fact, like, hey, my vo two Max is in low 50s, not like marathon runner by any stretch, but for 45 that's not too bad. Where does someone want their vo two Max? I mean, higher for longevity seems to be better, but 50s at my age is in the top, probably 10 20% so all numbers again, look like I'm I'm on the right track. And so last year, I'm like, finally make the point. Get back to see the same cardiologist, and he does EKG. Listen to my heart like, look at my numbers again. He's like, Oh, you're doing great. The EKG

Dr. Gabrielle Lyon: 47:51

was normal, totally normal. But could you have looked at a heart rate variability with EKG? You could, but their system's not really designed to do it. It's interesting because I, as I was prepping for your podcast, nearly everyone gets an EKG, but you could tag it on as a biomarker, and then we would have a tremendous, oh, yeah, of course. So like additional data. The first

Joel Jamieon: 48:12

HIV system I use, like I mentioned, we actually had to do a full succeed. ECG, yeah, EKG, so we were doing that. So yeah, of course, in the hospital setting, they could get that they just aren't trained. It

Dr. Gabrielle Lyon: 48:21

would be interesting. So radiologists that are listening to this very fascinating, it would probably just be another algorithm in

Joel Jamieon: 48:29

which they would be another biomarker to pay attention to. Okay, so long story short, he's like, No, you're not. He does another blood panels, like, your numbers are great. Does EKG everything sounds great. Like you're on, you're in good track. Like, keep it up. And in the back of my mind, I'm thinking, like, let's do something more than this, because, you know, I want to make 100% sure that I'm doing the right things and things are heading the right direction. So I'm like, What about getting a CT angiogram? It's something Peter T had talked about it like, just been through his book, and he mentioned CT angiogram. And I'd heard about it before, you know, five years ago, but it wasn't super common. And he's like, he said, Yeah, you could do that. You could do a calcium score CTA, like, it wouldn't hurt, you know, like, everything looks great, but if you want to do it, you know, it's 1500 bucks out of pocket, by all means,

Dr. Gabrielle Lyon: 49:08

you do a CT angiogram. Or do you do a clearly hard and I did CT angiogram.

Joel Jamieon: 49:13

Well, CT angiogram gets soft and hard plaque clearly, is just the AI algorithm that tries to quantify that, right? So I found a radiologist who's great in my area. She does out of pocket CT angiograms. She reads soft plaque as well. Oh yeah, the full so just for your listeners, the if you get a calcium score, that's just the hard plaque, and that's like 200 bucks, right? Doesn't tell you anything. You expect it to be zero. You expect it to be zero. Or you can get the full CT angiogram, which is just the same process, but they put contrast dye to see the soft plaque right. And then the clearly is an algorithm that looks at the results of the CT angiogram and then tries to quantify the percentage of soft plaque. And this the cardiologist or the radiologist I worked with used to sign off on the clearly report, so that what they do is they have the CT angiogram, spits out the imaging, and then clearly does an algorithm, and then a radiology. Just reviews it and signs off on it, and she said that she was finding discrepancies 15, 20% of the time from what clarity would say versus what she saw radiographically. And so she stopped signing off on them, but she still thinks there's some value to it.

Dr. Gabrielle Lyon: 50:12

So just out of curiosity before we move on, because I do think hard and soft plaque, and you are an example of why measuring hard and soft plaque is important. How does she or how do you, how does one recommend making sure that you're getting, well,

Joel Jamieon: 50:25

that's the full TC angiogram, right? So the full CT angiogram is like, said, it's usually like, 1200 to $1,600 they pull you out, they do. They put you in the CT, they pull you back out, they put in contrast dye, and they put you back in. If you're doing that process, you know it because you're paying for it, right? It's a lot more expensive, and you feel like you're peeing down your leg. Yeah, exactly. It's a little weird, yeah. But if you're getting that done, you're getting hard and soft plaque, right? If you're going just to see, yeah, if you're getting, if you're paying 200 bucks, you're probably just getting a single calcium score, or maybe calcium scores of different coronary arteries, but you're not getting a contrast dye. That's the biggest difference. The biggest thing is the end state, is that hard plaque, right? But the soft plaque is what calcified into the hard plaque. And if you don't see the soft plaque, you could potentially have a zero calcium score, but still have a fair amount of soft plaque. That's right, hidden. And that's the problem, is that what happened to you? No, I have pulled unfortunately, so I get the CT angiogram, and again, there's 1500 bucks out of pocket. And I say this because it's for most people, that's not small amount of money, right? But it's your life is on the line here. How many times you spend 15 bucks on cars and far less important things? So I get the CT angiogram, and completely unbeknownst to me, my good friend from high schools, his wife, is his the lab tech, and I had no idea that she was working there was working. There was complete random coincidence. And so I get done. CT, she's running it, and I get done. Oh, I'm great, right? And she kind of, like, looks at me and, like, doesn't say much. I'm like, This can't be good. Can't be good. And so she's like, kind of like, you know, giving me the look, but she can't say anything because she's the lab tech. She's not the radiologist. And so, sure enough, I need the radiologist. And she's like, um, yeah, you've got some significant pocket blockages here. You know my calcium scores of 1300 and you want zero at my age, 1300s very high, very high. Now part of that could be because one of the things the the cardiologist did tell me to do is take red rice yeast, which has a naturally current level statin in it, and statins calcify soft plaque. So that could be why my score was much higher than it would have been if I hadn't taken one. That was one take on it. But regardless, I had a 50% blockage in the LED, which is Widowmaker, which is considerable.

Dr. Gabrielle Lyon: 52:33

And for the for listeners, a widow makers, typically when people, when you hear of someone having a massive heart attack and die, want to have video widow when you don't want to have them as black? Yeah? Well, you're a winner. What can I say? Yes.

Joel Jamieon: 52:47

So, you know, obviously I'm shocked. And I went into this thinking I was gonna get this thing done to validate I was doing all the right things, and I come out with a pretty, you know, shocking diagnosis of a blockage. So I go back cardiologist. And I'm kind of like, what you know, why did you like, kind of frustrated, because I really wish I had been told to do this earlier. It would have picked something up, and I was not. It's just a reminder, you have to look at your health for your own, be your own. Yeah, I mean, I did, in the sense that he didn't even tell me to go get the CT angiogram. Well, I had to ask, Hey, should I go do this? Well,

Dr. Gabrielle Lyon: 53:20

to be fair, all of your markers were normal. But the difference is, and I'm sure your radiologist friend would agree, is that you had a significant family history, yes, of cardio. I was there with my mom. Yeah, so that's unusual. And we, you know, we have a full medical practice still to this day, a shout out to you guys. You're the best Dr Lisa and team. We typically always recommend individuals get and listen at your age or a little bit younger, late 30s, early 40s. People are very resistant. They will say, Listen, all of my markers look good, just like you did. LP, little a, less than 25 APO, B, all of total cholesterol, triglycerides. And people will not want to do, yeah. I mean,

Joel Jamieon: 54:01

I have friends now. I'm so, I've been so ever since I had done I've been trying to convince my friends I have high risk to go get it done. Because why not? Right? And when you define high risk, you mean cardiovascular, cardiovascular disease history above all else at this point, and talking the radiologist genetics, right? So anyone that I know is most likely the fitness space, and they're in my mind's frame mindset of, oh, I'm fit like I probably find but if I you know talking to them, Hey, do you have cardiovascular family history? All the ones that have it, I'm like, You need to go get

Dr. Gabrielle Lyon: 54:27

this check. And friends all the ones that don't. If you do not know your family history, you, I would strongly encourage you to either get with our practice or get with a practice that is willing to order it, yep, you can get the cutting the calcium

Joel Jamieon: 54:41

score if you don't want to spend the 1500 bucks. I understand that the $200 calcium test, and sometimes insurance covers that for 200 bucks, you're getting at least something. You're getting a good marker. It's

Dr. Gabrielle Lyon: 54:52

not as or advanced cardiovascular lab markers, which is unusual. So the big question is, then you start on medication, right?

Joel Jamieon: 54:58

Yeah. So, yeah. Was, well, actually the first thing I do to stress echo. And so I think this is least somewhat reaffirming or reassuring. He does the stress echo miserable tests. I do the Bruce protocol test, which is inclined and speed. Everybody beats I

Dr. Gabrielle Lyon: 55:10

am surprised you say it's a miserable test. It's not considering how I max it out. I mean, I finished the test protocol talking about busting drops is you're on a incline. They're pushing you up to your max, max effort. Yeah,

Joel Jamieon: 55:24

I went, I finished the test 21 minutes, which they really see. It's terrible. Yeah, it's easy until you get to, like, I think it's like, 15% inclined at like, six miles an hour, or whatever. Break rule number one, and you had to have your hand on the treadmill, which is another problem. But again, it wasn't in the world. I finished it. He looks at everything. He's like, Look, you have no ischemia your heart. Like, your heart looks great. Everything's functioning really well. So that was reaffirming. And again, the fact that my brother, at my age, who didn't work out, who had much higher stress lifestyle than I did, he died of a motorcycle accident, unfortunately, where he would have been, it's terrible. But in his in his 40s, my age, he had to have stents put in. He had stunts. He had stents, and I did

Dr. Gabrielle Lyon: 56:02

not clear. So if you had not this is there's three things here. Number one, I'm sorry you lost your brother. Number two, had you not been doing the behaviors that you have been much worse, probably much worse. Number three, if you have a family history someone you know whether your blood markers are good, you should be evaluated 100% when you went through treatment. And for everyone listening, you were doing all the cardiovascular all the weight lifting, although you're telling me that less weightlifting, more cardio. Now, did it change your heart rate variability? So

Joel Jamieon: 56:38

here's a long story. No, no, it does, actually. So, but what's fascinating to me is that Statins have been packing HIV in a positive way, positive way, but interesting way, but going back to that. So when I did so, once I got diagnosed, I'm like, I need to understand this more. And so I did a bunch of genetic testing on everything, just sterile testing. And I'm basically did away sterols testing. Oh, yeah, I'm a hyper producer. Well done. Yeah, I'm a hyper cholesterol producer, which also tells me that, because my cholesterol was not super high, it tells me that my diet was poor, it probably would have been super high, which would have spiked things even more, right? So I think there's clear indications that things I was doing and still do was massively helpful. Then I looked at a bunch of genetic markers as well, and I have a they call the heart attack gene, quote, unquote, it's endothelial dysfunction. And basically the vascular smooth muscle cells tend to be hyper proliferative, and those smooth muscle cells can proliferate and become part of the plaque themselves, and it causes, basically, you know, and feel dysfunction, as I said, which makes you more prone to inflammation. So it's possible, you know, maybe years of heavy lifting exacerbated some of that.

Dr. Gabrielle Lyon: 57:47

I don't know about that. It's possible endothelial dysfunction. So if you, how are you measuring that Myeloperoxidase? And I didn't measure

Joel Jamieon: 57:54

direct test, I'm just looking at genetic, genetic likelihood, I'd

Dr. Gabrielle Lyon: 57:58

be hard pressed to believe your training, resistance training, if you're recovering. Well, would Yeah, you

Joel Jamieon: 58:04

wouldn't think so, but, but I would say the interesting thing to me is, like I said, I've now sent seven different people into the spirit garden in the Go get CT angiograms, and six of them have had blockages that were in high calcium scores their ages. And they're all lifelong athletes and lifters. Also, if you look at, there was two papers, the mark one and Mark 2m, A, R, C, which is measuring athletes risk of cardiovascular disease. They found that lifelong athletes often had higher calcium scores than general public

Dr. Gabrielle Lyon: 58:31

and interesting, we'll have to look at those so that could be, that would be interesting if you're producing more reactive oxygen species, yeah, and there's,

Joel Jamieon: 58:41

there's, I mean, I personally think most things have U shaped curves, right? Like more some is good. More is better, until it's not, and that's worse. If you look at some of the papers on longevity we discussed, or I sent over, and they looked at dose response to strength training, and you do see that about three sessions a week of strength trainings where we tend to be the most benefit associated with that. Can't prove causation, but you do see that the five, six days a week people seem to have risk of the wrong direction in these multiple studies and trials. Again, I'm not saying that strength training itself is inherently bad, but I will tell you, in my experience, what happens is, if we do lots of high pressure, high blood pressure work, those arterial walls become thicker. There's no question about that, and your HRV is lower. I can tell you that for decades of looking at HRV that chronic weightlifting, heavy weight lifting, power lifters, strength athletes, they have lower HRV because they have less cardiac output and they have much more thickened cardiovascular system in general, right? The vascular smooth muscle cells become thicker. The walls become more dense and more fibrous over time, your left ventricle thickens in the way that can handle high blood pressures. It's just a response to high blood pressure, right? The body gets better at dealing with high blood pressures. The way it does that is by the vascular system adapting by becoming thicker and more rigid. That's not great thing in the long run, and it's the opposite we see in the aerobic side, where we're training elasticity. In your lab vascular system, more or less. So I'm not blaming my condition by any stretch on lifting weights. I'm not saying that by anything, but I do think genetically, you know, you have to be aware of where your strengths and weaknesses are. And probably, for me, focusing on the aerobic system my entire life would probably have been, you know, a benefit versus focusing on not. I think

Dr. Gabrielle Lyon: 1:00:20

that's valuable in the way that HRV could direct and inform links or missing links, to what is potentially personalized training, right? There's this desire to be big and strong, but perhaps there's something else that can inform the direction. From a longevity sound. I

Joel Jamieon: 1:00:41

think the problem is we like to do what we're good at. I was always strong, and aerobic side was never my strong point, and so I like to revert back to what I'm good at. Most people do. I love lifting weights. I saw great better progress building aerobic system was always harder for me. It was not the easiest thing in the world, so I did less of it, just inherently right? So it's a good reminder. It's often more effective to be attacking your weak points and just reinforcing what you're already good at. And especially if it's on longevity side. We know how important the aerobic system is. We know how important vo two Max

Dr. Gabrielle Lyon: 1:01:11

is. And do you care how one gets to improve the VO two Max as a coach, for example, do you know Martin Gabala? Yeah, I know. Yes, yeah, out of McMaster University, he's been on the show. We'll be seeing him here shortly. Do you think that it matters how someone improves their vo two Max from a heart rate variability? For example, could you do high intensity intervals and improve your VO two Max and then thus have a positive influence on your heart rate variability? Or does one need to do slow, steady state, and then that also improves vo two Max, but the means to the end of the improvement in vo two Max is still the same metric, but the input to get there was different. Do? Does either, hopefully I'm making that clear, and does either input change the heart rate variability more or less well.

Joel Jamieon: 1:02:04

I think if we look at a long picture, long term picture, and just my own anecdotal experience, we build a foundation for a higher vo two ceiling through the lower intensity work.

Dr. Gabrielle Lyon: 1:02:14

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Joel Jamieon: 1:03:54

there's two reasons for that. One, we want to increase two things to build. Well, the biggest thing that drives vo two in the long run is heart size. And we see this in a bunch of research. A bigger heart can pump out more blood and more oxygen, and at the end of the day, that's what's going to limit. VO two is how big your heart is, and that's where a lot of genetics comes into it. If you have a bigger heart, you have higher capacity for cardiac output, you have more stroke volume. You can have a higher vo two. We know that lower intensity training causes the heart to dilate more. You get a bigger left ventricle, and you get more angiogenesis. You get more vascular development, and those things happen through lower intensity training. We also know you get more fat oxidation. We're doing slow type cardio because we're focusing on brain fat versus high intensity training. So I think it's pretty well understood, at least in the endurance world, and I think mostly now starting to populate down to the rest of the world. The lower intensity you do, more of that you do, the more you set the ceiling for higher vo two. So somebody could say, in the six week period, I did a bunch of high intensity, and I got better results for my vo two than if I just did lower intensity. Sure you probably did, because you just put your body into more load. So. I think your ceiling will be less high, will be will be lower than if you had spent the time doing the lower intensity work. So I think the answer depends on what's the ultimate goal. Is the ultimate goal to raise your VO two for next six weeks? Or is ultimate goal to raise your VO two to the highest levels over next 610, 20 years? And if all you do is high intensity training, you will ultimately limit your ceiling and where that vo two can get to. And that's just what we see in research. If you look at even, even the infamous Tabata study, right? They had seven people. Each of those groups, the high intensity group did the Tabata intervals, increased their vo two slightly more over the course of the study, but in the second half, the second three weeks, it basically stayed flat. Versus the endurance group that did the lower intensity, it increased fairly uniformly across the full six weeks. So that's fascinating. Yeah, I think that are we the problem with research in this context, specifically in looking at just looking at training research of like, okay, very challenging. It's very challenging if we say, Hey, is high intensity or lower intensity better if we have six weeks, which is what a lot of studies are, 10 weeks, eight weeks, whatever high intensity will win. It's just a it's a greater stimulus in the body. It's like saying if we had two people lifting weights, one did a bunch of three rep five rep maxes, and the other group did like, 10 to 12 reps, yeah, the three to five rep maxes, and get better at three to five rep maxes and be stronger. But does that mean every athlete should just do nothing to lift three to five reps every time? No, you need to build muscle. You need to build a same I would say it's the same exact concept actually. If you said, hey, I want to get as strong as possible, and I just did a bunch of heavy lifting, I would maximize my neurological component, and I would eventually hit a peak where I couldn't get any stronger unless I built more muscle. Right? It's the same thing. If I just do high intensity, I will maximize the cardiovascular adaptations I have to get to the highest vo two that I'm capable of with that physiology. But if I want to develop a higher vo two that increases over time, I have to build a physiological foundation. That's where the lower intensity work comes in. It builds that process of change within the body, within the vascular system, within the cardiac capacity itself, to raise the potential for how much vo two I can deliver down the road. It's a very similar process. That's

Dr. Gabrielle Lyon: 1:07:04

a really good point. I will say that I typically dismiss a slow, steady state. And I might have to reconsider that. Yeah,

Joel Jamieon: 1:07:14

I just think, but here's, here's a caveat to all of this. Yeah, there's a lot of genetics in that. So if you if a person has a high genetic vo two, they can probably get away with doing less of it, because they already have that higher genetic potential anyway. They already have a bigger heart to start with. They already have better cardiopulmonary potential because their lungs are bigger. They just have that innate capacity. Those people will build it faster. I would also say people that spent a youth doing team sport or doing endurance sports, they've built a foundation from a youth perspective, that probably will make it much easier them, for them to do it later in life. In my case, I can tell you that looking at athletes who are lifelong strength athletes, they have a much harder time building high vo two without that foundation. The worst part is, I hate it like they don't like doing I don't love doing low intensity cardio, but you do

Dr. Gabrielle Lyon: 1:08:00

it, do you do it minimum time. So you had said three days a week of doing three days a week of doing some kind of zone two training. Do you think that there it needs to be 45 minutes?

Joel Jamieon: 1:08:11

30 minutes is probably a starting point for most people. I mean, I hate to use this generic answer, but you need to however much it takes you to get better,

Dr. Gabrielle Lyon: 1:08:17

right? I mean, it's tough because training stimulus and the conversation around training and longevity is much more complicated from a biometric standpoint of heart rate variability, blood pressure, the inputs and the training inputs are so much more challenging than, say, as a physician who studies Nutritional Sciences, that's so much easier. Yeah,

Joel Jamieon: 1:08:39

I mean, I everything's modified by we did before. And I think, yeah, that's the other thing you realize with HIV, we can talk a lot about, is what you ate for breakfast, how your sleep was, what your workout was yesterday, where you're at and it's different cycles. All of those things will modify the response that work out to HRV, or HRV that work out, it'll change response that work out. And the biggest thing people fail to understand is HIV is this aggregate. It's the total picture of stress response, and that's the total picture of how your body is coping with the world around you. It's not just, Hey, you work out. HIV does this. Hey, you do you eat this food. HIV does that like it's just nowhere near that simple, because the body's not responding to just one thing. It's responding to literally everything. It's making choices based on the whole picture of your

Dr. Gabrielle Lyon: 1:09:23

life. But how can that inform that would be challenging then to have it informed decisions. Because if we know that, the biggest driver would be, say, aerobic fitness. Then if someone has a poor HRV, you add in aerobic activity. Now their HRV is improved, but not necessarily because maybe they're not sleeping, or they are having a high cognitive load, or it's cold outside, yeah. I mean, that's they sneeze, I don't know that's,

Joel Jamieon: 1:09:50

that's the difference between, I would say, daily changes in HRV, which reflect those things, and long term changes in your baseline HRV. So yeah, on a daily basis, if I get a point as. Sleep, or I have a bunch of alcohol or whatever, like, yeah, that's gonna probably tank my HIV for that day. But over the long term, if I'm building aerobic fitness and doing things it takes to build the aerobic side, that average will go up over time, and that's what we're looking for. I would say the single thing that you can do to stop overanalyze your HIV is just look at a weekly and a monthly basis. A weekly basis, oh, absolutely weekly basis. I'm looking at weekly basis more than looking at daily these days, because it's very informative of two things, am I trending a certain direction over that week? And how much variability is there in that I love that

Dr. Gabrielle Lyon: 1:10:32

most people will say, look at it daily, right? My a lot of my friends are wearing all these different devices, and they're like, Oh, my HRV is or I'll get calls from patients. My HRV is terrible, and I'm afraid I'm getting sick. And, yeah,

Joel Jamieon: 1:10:44

I mean, look, a daily basis can be informative, but it's just one data point from the greater picture, and it is dependent on you measuring accurately the same time of day, or, you know, using a device very consistently, and making sure that you're getting good, accurate data. But that single day is just one single day, right? It's just telling you what your what your body's doing right now. It's like a big example would be, if I woke up in the morning I was a pound heavier than was yesterday. Am I going to throw out my entire diet because I was maybe a pound heavier than I was going to be? Or am I going to, oh, maybe I ate a little bit too much yesterday, or my hydration is off, or

Dr. Gabrielle Lyon: 1:11:15

whatever? What else really impacts? HRV, you said something really interesting. You defined resilience as the ability to withstand stress around you. How much of HRV is and then you spoke about the woman, what's her name? Peggy. Yeah. Peggy. Peggy. Peggy, sound like she had a really positive outlook. How do we know the influence of mood on HRV?

Joel Jamieon: 1:11:39

It's huge. I mean, look, when we are stressed out about something, it is a physiological response. Our heart rate is higher, our resting HIV at that point is lower, because we are, by definition, turning I would say we have to kind of define stress. To me, stress is anything that turns that sympathetic dial up. And so stress is not like a on off switch or yes or no. It's a degree how much stress Are we under. It's how much is that Sympathetic System activating? So if we sit here and we look at social media and we look at politics and we watch the news, it's very easy for us to be sympathetically dominant or driven, because if we're stressed out right, there's stock markets going all over. This life around us is very stressful. And to me, that is, and after years looking this as as much, or probably more of a player in your HRV on a daily basis than your workout is the funny thing, because that's fascinating, when it comes down to is the workouts an hour a day, right? Maybe 90 minutes, maybe two hours most

Dr. Gabrielle Lyon: 1:12:36

the rest of your life in China, and you're in so there were seven hours, yeah? No,

Joel Jamieon: 1:12:41

it was more. It was at least that they would do five workouts. And they told me the recovery workout in the morning for injured athletes wasn't in their recovery session. I watched. It was a workout. They're in Plyometrics, yeah? But the big picture of your life is it's 24 hours a day. It doesn't stop when you, you know, end your workout. It's where the recovery process starts, right? So it's mental stress is a huge, huge component of this. And, you know, I can give you endless examples. I had this pretty early on. Actually, my using HRV, I had this guy from Microsoft. He was an executive. He was in his 40s, and he was Iraq or not racket so he was a volleyball player recreational. He's like, I want to get increased my vertical jump. Well, biggest problem he's missing one of his big toes, which is not the best recipe for vertical jump, totally fine, but he was like, I really want to increase my vertical jump, and I also keep rolling my ankle. And so I said, Okay, let's get to work. And he'd never done much training other than play volleyball. So I measure his HRV. He comes in twice a week. And back then, we didn't have mobile apps, like I had to put my whole system on him, and I could only measure we came in the evening, so I only saw him twice a week. First Four to six weeks is his vertical jump goes up, and everything's going great, and then it plateaus, and I start to increase load, and then it starts going back down. And it's, I'm like, why is this happening? Because when he's coming in, this twice a week, like he looks pretty good, like his recovery looks looks okay. And so I'm like, Okay, I'm clearly not seeing a big picture here. And so I said, Look, if you really want to get your up, which you clearly do, we're going to have to look at more broadly, you know, bigger picture, and look at your life style outside just two days a week. So first thing I do is have him do a dialog. He's drinking 20 to 25 cans a Diet Coke a day because he worked at Microsoft, and it's right next to the refrigerator. So that was problem number one. But problem

Dr. Gabrielle Lyon: 1:14:23

was it the caffeine or just the I think it's just stimulus. Yeah, I was just, it was caffeination all day long. Is there something wrong with that? Matt, we are in trouble. Caffeine, lower your HRV, a

Joel Jamieon: 1:14:33

lot of it, ah, but it also is genetically dependent on whether how you synthesize the OMT, right? If you have a if you're if you're fast metabolizer, it's much less of a fast metal it's interesting for me personally is I've always I'm a fast metabolizer, and I've always been able to have caffeine pretty late in the day and not affect my sleep. Until now it does in my 40s, some something changed, and now it affects me more. Same thing with working out. It didn't used to affect me at night. I could work out at night, no problem. Now impact my sleep greatly. So we change over time. Anyway, the second. Problem is when I had him start coming in and measuring HRV every day and early in a day, so I see his bigger picture. What I found out was he was playing video games until like four o'clock in the morning on three nights a week. Well, he does, did work at Microsoft, yeah, and he was up late, and so that was absolutely killing his recovery. I just couldn't see it. And looking at twice, he

Dr. Gabrielle Lyon: 1:15:18

was asleep or the stimulus both it was both, it was both. They're

Joel Jamieon: 1:15:21

linked, and so very quickly, I'm like, Oh, this is why you're not improving, right? Because three nights a week, your sleep is trash, and you're mentally stressed out of your mind playing this video game all night long. As soon as we fix that, his vertical jump went up two inches, just just by making a change in his lifestyle. Same thing. Another example, we had a college my old HIV system called Bio force. We had a college team that was a collegiate soccer team, and we had a year of data, and we started looking at all these different patterns. And I was like, What is that like? What is going on here? Because it was this period where the team was under just insane stress, and it was the highest point of stress I could find. It was when there was finally, yes, it was finals week. Finals Week is way more stressful than their tournament, than their any other tournaments where they're traveling, playing multiple games a weekend and coming back, that was less stressful than finals week to them. And you see this time and time again, it's it's the lifestyle is the single biggest driver of stress, not the workout, because of the time component. Workouts an hour, nine minutes, whatever it is, unless you're in China, the lifestyle is the whole rest of your day, right? It's how you eat, how you function within your social group, that stress of just being in the world.

Dr. Gabrielle Lyon: 1:16:31

Speaking of social group, I want to ask you about heart rate coherence. Heart Rate coherence is something that I found when I was in my first second and my second residency, because I could not regulate my nervous system when I was on call, we would be, you know, as an intern, you're on call, you're supposed to be running the codes your nervous system, at least for me, maybe not other people, but my nervous system was totally out of WoW, right? So I you have support, but you have to be able to run. If someone is you have to run a cardiac arrest code. I could not get my nervous system to calm down. I wasn't measuring heart rate variability, but I was just,

Joel Jamieon: 1:17:13

I bet you would have seen terrible, sympathetic shifted terrible.

Dr. Gabrielle Lyon: 1:17:16

So I found something called Heart Rate coherence. It was this Heart Math Institute. What been a long Yes, forever, and basically it was, and I started doing their meditations, had like an ear clip, and it was this idea of this harmonious interaction between the heart, brain and the nervous system, and it was supposed to balance this efficient state of physical and mental well being, and that it would smooth out again, this heart rate variability signal. So I was curious as to if something like that, sure, if you've seen that have impact. And they also talked a lot about breathing, one of the things to improve the heart coherence, heart rate coherence was now, when I think about it, somewhat of a tactical breath,

Joel Jamieon: 1:18:07

Yep, yeah, it's so there's what's called respiratory sinus arrhythmia, and that just means there's this influence on our breathing, both our rate and our inhale exhale pattern, on our heart rate variability. Because as we're exhaling, that's when the parasympathetic system is essentially turned on inputs amplified, and when we're inhaling, the opposite is happening, and that's happening for a whole lot of physiological reasons, but heart rate coherence is essentially this technique of trying to maximize the way that we're breathing, in a way that can influence heart rate variability to be at its highest point, and that's usually around six, eight breaths per minute, depends slightly on an individual, and it's all supposed to optimize what's called baroreflex and train the baroreflex to manage blood pressure effectively. I think there's something, there's a good amount of research showing that when you do breathe in this pattern, that you do maximize HRV in that moment. And I think there's a huge benefit to people learning how to turn that parasympathetic system off, or, sorry, that sympathetic system down. I mean, and taking time out of your day to breathe. I think, honestly, this is the foundation, to me, in yoga and meditation, any of these sort of breath work things, they're doing this in one form or another. They're developing a pattern breath that's focused more on the exhale and slowing your respiratory rate down, which just does increase the parasympathetic function. It's turning down the sympathetic system, and it's turning up the parasympathetic system, whether or not you need to have a clip on your ear and have a specific, exact ratio of inhale to exhale. I think it's less important than the fact that people are just doing it. So I've seen a ton of benefit. I think there's a lot of reasons why people do like meditation and these sorts of things, because they're calming their sympathetic system down. Whether it's following this exact pattern in the app or it's just taking time out of their day to relax and meditate, those things are hugely beneficial, because they break that cycle. They break that sympathetic, stress driven cycle, and doing that, I think, has a huge amount of benefit.

Dr. Gabrielle Lyon: 1:19:55

And you've seen individuals taking on breathing or meditation improve. Heart

Joel Jamieon: 1:20:00

rate, absolutely. Yeah, there's real research on it. There's research showing mindfulness and yoga and meditation, all these things that get you to stop that sympathetically driven cycle that you're in and take even five minutes out of your day can break that process and shift you back into more balanced state where that parasympathetic system is doing what needs to do. So,

Dr. Gabrielle Lyon: 1:20:17

yeah, absolutely. What about the influence of things that seem to increase your sympathetic nervous system that we think about for recovery, like cold plunge,

Joel Jamieon: 1:20:24

yeah, so the I would put recovery strategies in two buckets. One would, I would call them relaxation strategies, and that's where breath work, massage, deep water, floating like things like this, where we're just trying to actively turn that sympathetic system down. That's relaxation, a regenerative type recovery strategy. The other one is what I'd call stimulative, and it's under the same guise of training. It's a hermetic effect. So if we do a cold plunge, or we do contrast therapy, or we do some sort of load in training, we're turning the sympathetic system on briefly with a parasympathetic rebound afterwards. So a cold plunge is going to be sympathetic, because you hit the water, but after you get out, your body's gonna have to regulate temperature back, and everything's gonna have to be put back, and there's a recovery response. So we're trying to trigger that recovery response by a small stimulus. Now, the biggest thing I would say about all of those things is those sort of stimulative type methods, the body adapts to them, and that's what people don't understand. If you do the same stimulatory thing every day, cold plunge, or contrast, or million other things, your body adapts to, it doesn't have the same effect like anything else, the body gets better at dealing with it, and it's going to have less of an impact. And recovery, you can't expect the exact same workout to have the exact same effect, and you can't expect the exact same recovery modality to have the same effect over time. The other thing is cold plunges immediately after workouts can dampen the response of the workout because they're turning off inflammation as part of signaling process. But I would say in general, it's a very individualized thing, and it needs to be varied. You need to find something that you can do in cycles. You shouldn't do the same recovery modality every single time. And you really probably shouldn't have to rely on an overuse of recovery methods. Your programming, your lifestyle should be that's a really conducive to that to begin with. If you're having to constantly rely it's one thing if you're a team sport athlete and you're in season or you're doing particular particular stress or period, but if you have to try to recover every single workout, maybe your workout should be adjusted down.

Dr. Gabrielle Lyon: 1:22:21

Do you know Jordan challo? I don't think so. I think he's also good friends with our mutual friend Luca, but he always talks about, the best form of recoveries is better planning. Yeah, it's true. It's better programming. Yeah? And I

Joel Jamieon: 1:22:35

wouldn't say to the Yeah. The other thing here is, if you don't like the thing, so you're like, oh, I want to do cold plunges, but if you hate doing cold punches, just that mental I hate to say, of the mental stress and the mental load of doing that is actually more likely to have a negative impact, like when it's funny, going back to China, I had all these kids, and I could tell these kids were just beat down. And so something we did in combat sports was swimming a lot, because it's very low impact, we can work on breath hold, which has some capacity to different things. And so I was like, oh, let's take can we take the kids to a pool and do a recovery session? And she's the head coach, like, Hmm, and I don't know. And so they looked into it, like, yeah, we can do it. So the next day, they bring a bus and we drive, like, 30 Chinese kids, Julia kids, to this public pool. And I could see their eyes as wide, because they they just like, we're out, we're out of here. Like they live in the camp. These kids live in the school where they train. That's all they do. And so, okay, we're doing nice, easy recovery session. We're gonna do some some water, treading, some deep water, floating, some lap swimming. And so like, okay, get in the pool. This kids all jump in the pool, and it dawns me, in the first 10 seconds they can't swim. Oh, none of them could swim, so I'm looking like they're half drowning. The kids that jumped in the shallow end were fine. The kids on the deep end were literally drowning, and you got fired. No, I didn't get bite. So the funny, the funniest part is, I'm like, Oh, this is not gonna be so recovery driven, and I tried getting the shallow end. We go through a bunch of exercise, but they're just dying because they don't know how to swim. The funniest thing, if you get back and the coach was like, Oh, I heard it was very difficult. I was like, You didn't tell me the kids can't swim,

Dr. Gabrielle Lyon: 1:24:10

but how crazy they were willing to jump in? Oh, they were 100% No,

Joel Jamieon: 1:24:13

no questions asked. That's the mentality, wow. The funniest part was, head coach was like, I heard was very hard, yeah, because they can't swim. Yeah? Dude. She's like, we're doing it again tomorrow. I'm like, like, how incredible, though, because that was the mindset, right? Like, oh, it's hard. It must be effective. I'm like, No, it was supposed to recovery. I

Dr. Gabrielle Lyon: 1:24:29

don't know. I think that we're probably missing a lot of that here, not that kids should jump in pools that they can't swim in, but that is really,

Joel Jamieon: 1:24:36

oh, yeah, they did. They did whatever. They were told. No, no, no questions asked. No questions asked. There was no like, maybe they didn't think they could drown. I don't know, but I'm literally running like, throwing noodles and stuff in the pool to keep this kitchen drowning, because then I might have gotten

Dr. Gabrielle Lyon: 1:24:52

fired. What what populations are, or is Heart Rate Variability not good for would you expect a. So, you know, I've looked at some of the data, and it seems the older people get, the less robust. Or, you know, the heart rate variability is not as good. But then I've seen other data that really it's more about lifestyle.

Joel Jamieon: 1:25:12

Yeah, so we do naturally decline with HIV as we age. Women tend to be higher until they hit menopause, and after that, it tends to decline during menopause, then stabilize, but, yeah, it declines as we age. But there's no reason not to try to improve it. And we looked at the Morpheus data, which is, which is my HRV app, we found that, basically, the top 10% in each age group had the HRV of a 30 year younger group on average. So if you took someone in their 60s, it took the top 10% that was like the average of someone in 30s. So you can have, you know, some of that's genetics, like we talked about, there's no doubt to get to 10% you probably have some genetic

Dr. Gabrielle Lyon: 1:25:45

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Joel Jamieon: 1:26:54

But you can increase your aerobic fitness throughout your age. There's no point where you can't increase your aerobic fitness and where that's not gonna have a beneficial effect. So I wouldn't say for older population, you shouldn't do. You absolutely should. I'll see that. Challenging ones are people that have beta blockers, or people have arrhythmias. That interesting make it impossible if you get an accurate meeting, if you've got different types of a meal, sometimes you just can't

Dr. Gabrielle Lyon: 1:27:15

get, like, afib, yeah? Just some kind of abnormal, yeah, normal size. There's

Joel Jamieon: 1:27:19

so many different ones, some of them impact HIV, and some people and so what about pregnancy? So in general, pregnancy is an interesting one. You do see that number one, you're producing way more energy, right? Like your metabolism ripped up, and you have more blood volume because you're delivering nutrients to produce a baby. So you tend to see HIV decline across the pregnancy, and it seems to be the lowest in the third trimester, as you were just getting ready to give birth, but how that declines, and how much declines is so variable, and I think that's another really big takeaway here is you can't always say blanket statement HIV is going to do X, Y or Z at this time, because there's so much individual variation. Like, let's say somebody never works out and they have a bad lifestyle, and then this person gets pregnant and she thinks herself, oh, I really want to start improving my self care, because I want to make sure I'm doing the best for my baby. You know, she starts working out more. She gets focused on her sleep. She does always it could go up like it could go up just from making really important lifestyle changes and building fitness, even though, you know, you would say that it's going to decline over the course of pregnancy. For that individual person, it could go up during that period and because they improved their fitness. So it's it's really just never one thing, no matter how powerful that thing may be, even pregnancy, it's a very powerful thing. It still has multiple influences that can dictate what happens. You

Dr. Gabrielle Lyon: 1:28:34

know, looking back at your career, do you ever think man Heart Rate Variability was only one part of it. Or, I wish that I had thought about X, Y or Z again, because you've had a 20 year career, and do you have any thoughts like that, or any

Joel Jamieon: 1:28:53

insights? Yeah. I mean, I think we always, the more I've looked at this, the more it comes to I think the biggest thing is performance at the end of the day, in terms of what are the endpoint changes we're trying to move? Is it VO, two, Max? Is it strength? Is it muscle mass? To me, those the most important factors. And what we're trying to do is use HRV to get those things to where we want them to be. And so I think early on, when I started using HRV, it's really easy to over coach right by it, and become a set, you know, obsessed to some extent, with that one number moving the way you want to move, and trying to overlap. Why do this? Why is it doing

Dr. Gabrielle Lyon: 1:29:26

that like this? Is frustrating. How many years did you spend like that? Five with protein metabolism for us, the same thing, and then all of a sudden you're like, I got to get every single blood work, and every single this, and this is the input that it has to be. And then everything gets everyone needs this hormone, and then five years later, you're like, Nah,

Joel Jamieon: 1:29:43

yeah, it's a big I think we have to use as much information to make the best decisions we can. That's what HIV is hopefully doing, is informing us to make decisions about how to adjust training and lifestyle variables to get the outcome. So what happened after five years? You just kind of realize, like, Chase. Seeing that needle is not moving the needle right, like at the end of the day, you realize the big what I really want to stress to people is the big picture is what matters the most. And you look at people's lifestyles and you're like, wait a minute, I can make a much bigger change by improving their sleep a little bit or getting their diet a little bit more dialed in. That's gonna have a much bigger impact, and trying to micromanage three sets versus four sets, or 12 reps versus 15 reps, right? You can micromanage the workout all you want, but those things usually have very small changes relative to these bigger lifestyle variables and the bigger picture of their their workout. So the more you can look at the big picture and stop worrying about these little minute changes in details, like the body's just dynamic and you can't out guess it, you just have to look at the data and make your just your decisions. Was

Dr. Gabrielle Lyon: 1:30:44

there any point in your career where HRV just failed you, where you thought to yourself, Man, I totally did not see this coming, or this athlete completely tanked on X, Y or Z,

Joel Jamieon: 1:30:56

not necessarily. I think the biggest thing is, when you have athletes that are really competitive, it's really hard to get them to measure HIV accurately. Why is that? Some because they just don't want to do it. To be honest with you. Like, there, there was a big push for a while in the pro sport realm to get athletes to measure all these data points. Like there was we just work project the 40 Niners for a while. I just stuff at the Philadelphia Eagles, and we looked at a bunch of data. Athletes, in general, resist data at that level because they don't want the coaches to use against them. And so trying to get them to wake up the morning measure a data point. Share that data point their coaches. It's really, really difficult, and there was actually a lot of pushback in the NFL player Association across different sports leagues now about what athletes can or can't be required to use. And so a lot of athletes to psychologically also believe, like, Oh, if I see a number trending down or going down, it's going to, it's going to, you know, impact me physiologically. And so, yeah, I think in those scenarios, HIV is a really tough marker to use, and you work with the athletes that want to do it and use it, and athletes who don't, you can't force it upon them, because they're not going to measure it accurately anyway, like we had a we built a program with a friend of mine, the going to 40 Niners, when they were supposed to measure HRV every morning, and then it was supposed to be part of this big thing, or Chip Kelly, where you're gonna look at, like, readiness, self evaluation and hydration and body, like you're looking all these markers. And I went in there, and they were like, on their phones, measuring HRV, and they were like, talking to each other and sit there and drinking whatever they're drinking, like they they just didn't want to do it, and they didn't care about doing accurately. And so the data was ultimately totally worthless. And so you have to always be aware of data integrity matters. If the data is worthless, then chunk, you know, garbage in, garbage out. You don't want to use that.

Dr. Gabrielle Lyon: 1:32:37

And HRV algorithms, and those things are really challenging. Anyway. They

Joel Jamieon: 1:32:40

are. Yeah. So the one thing I'll say is the biggest challenge HRV is it's sensitive, which is also its attribute, because its sensitivity picks up a lot of things. But its sensitivity means if I'm sitting there in the morning taking a measurement, or if I'm measuring overnight, which we can talk about the differences, and I'm stressed out in the morning, for some reason, that measurement is going to be very reflective of that stress in the moment. That's not really reflective of where is my true resting HRV at. Because again, we can turn that sympathetic stress response on cognitively, functionally by thinking about something stressful. And to see this, look at your heart rate and think about something stressful, your heart rate goes it's because you've activated that sympathetic system. You've turned your HIV down. And

Dr. Gabrielle Lyon: 1:33:19

if you want to measure HRV accurately. What does that look like is that over a 24 hour period always, is it in the morning? Is it in the evening? And also, for example, some people have an increase in cortisol. If you are healthy and normal, cortisol increases in the morning. Also, blood sugar might increase

Joel Jamieon: 1:33:39

Absolutely So historically, there's been a few different use cases. But what has the most research is these shorter term measurements of like two to five minutes, generally in the morning, because that gives us a window into where you are as to each 24 hour period. There's also research they looked at 24 hours that usually uses CNN or different types of markers, because when a 24 hour basis, your average HRV is just gonna reflect your activity, right? Because as I get up and move around and work out, I do stuff like my tech systems higher, my HRV is lower. So if I'm really active, my HRV is gonna be lower than if I'm less active. It's not super informative, other than just like, oh, how mobile was this person throughout the day, the biggest thing now, we kind of seen two different divergent camps, and I would say my at Morpheus isn't one of the only ones down this one, but the two biggest camps are overnight measurements, where you wear a wearable overnight, and then it just gives you an average across that sleeping period. And then two is what I do now with mine, which is we wake up each morning and we take a morning measurement. The advantage to that, in my mind, it's a chest strap. We have a wristband. You can did you bring me on. No, but I can get you one the biggest advantage of that is we can see where you are at the end of that sleep recovery cycle. Because the way I approach this is, each day is its own stress recovery cycle, right? And we just repeat this process. I get up, I go about my day, I live my life. I do some workout already, don't to deal with stress. I go to sleep, my body. Tries to repair itself regenerate, and then I start that in over and over again. I want to see where I'm at in the morning and what that process looks like at the end of it, so I can make informed decisions and see where I'm at in a comparatively same context every day. And that's where, historically, most research has been done, from an HRV standpoint, the in the overnight measurements before these current, former wearables were done with EKG in hospitals and in sleep studies and things where they were using accurate EKG leads, and they were doing this, you know, in that sort of context, these overnight wearables, looking at average overnight is a very new thing, and most research been done on them has been done by the companies that are selling them, to be honest. Not that there's not utility in that but in my mind, and now, looking at a lot of data myself and other people, you're looking at something different, right? You're looking at an average cross a period is different than an instantaneous Where are you right now? And the biggest thing is, if I'm looking average over eight hours of sleep, the things I did close to that sleep period have a huge influence. If you work out in the evening, that's going to influence your average tremendously, because you're going to spend the first part of your hours of sleep in a different state than if you didn't work out if you had a couple glasses of wine before you went to bed. That's gonna have a massive impact on your average across the sleep period. It's the same thing in some respects, not exactly, but like, let's say I wanted to lose weight if I ever if I measure myself an average across multiple times a day, that's different than measuring myself each time the morning on a fasted state, the fastest states gave me more data and more accurate data, I'd say, to figure out, am I losing or am I gaining measurement average throughout the day is reflective of what I ate and when I ate it, and how much I drank, and all those sorts of things. So I think when we look at overnight, we're looking at the influence of sleep very specifically. We're looking at what you did in the hours leading up to your sleep, all those sorts of things will change your numbers pretty significantly. And I think just anecdotally, if you measure overnight, I would take those daily changes with much less of I won't say with a grain of salt, but I'd be putting much less weight in the daily changes. I would still look at long term trends. I think those are valuable, but if you measure it first thing in the morning, like I do with Morpheus, I do with Morpheus. I think that gives you just a better picture of where am. I am at right now, after that full 24 hour period, and I can use that information to make more informed decisions moving forward. And

Dr. Gabrielle Lyon: 1:37:11

it's really fascinating. I was thinking about, what are some things that would be surprising that affect HRV, and it looks like and you might not find this surprising. And maybe the listener is doesn't, or the viewer doesn't find this surprising, but exposure to natural sunlight is a way, it says, to promote this natural circadian rhythm and improve HRV. There's also an interesting paper here. It looks at the effects of post awakening light exposure on heart rate variability. This was just in healthy, healthy men, and it was talking about their the LED light of different spectrum compositions, and that red light decreased. So it's the LF, HF ratio. What is that? So,

Joel Jamieon: 1:37:57

going back to there's lots of ways to measure me. One of them is called spectral analysis, where they essentially take the heart rate and they break in this into frequencies, and they break into high frequency, low frequency, and some other frequencies. And that ratio tend, that ratio you just mentioned, tends to be the balance and the parasympathetic. So it's just a different way of quantifying HIV. Basically,

Dr. Gabrielle Lyon: 1:38:14

do you want it lower or higher? You want it higher frequency is more parasympathetic, okay? And it said the blue light, LF, HF ratio consistently increased across 40 minutes of light exposure. Yeah.

Joel Jamieon: 1:38:29

I mean, I think in general, anything that's gonna improve, either A, your mood, B, your circadian rhythm, is gonna have a beneficial impact on HIV, it's pretty much our certain things are always gonna have beneficial effects, and

Dr. Gabrielle Lyon: 1:38:41

that's one of them, but it, I think it also informs us to make better decisions in our life. The idea that light exposure, although we would think about light exposure as, yes, it would improve your mood, but we still live in highly industrialized worlds, and again, it's just fascinating to think that we could improve longevity, not even take out exercise and diet, just by our environment. Well,

Joel Jamieon: 1:39:08

of course, I think if you step out of the fitness realm for a second, and we look at the, you know, the octogenarians, the people, the centenarians, like most of them, are living in places where, like, they're not training their ass off every day like they just live in a very positive community. They have good genetics. They eat healthy, whole foods. Their stress is way lower their industrialized world, and they live longer. There was just a paper came out not too long ago, looking at a tribe in Amazon called the Toonami tribe. I'm probably butchering the name they say it, but they went in there and they measured calcium scores, and they had the lowest calcium scores. They had, I can't remember numbers off my head, but they had the lowest calcium scores, indicating the best cardiovascular health of any tribe or group that ever measured across the board period. And they're just living in the Amazon, and they're exposed to all kinds of pathogens, like they're not exactly living, you know, in clean, sanitary conditions. And despite having higher than. CRP than normal. They still had almost no atherosclerosis whatsoever, across the board, across all ages, and they eat like 70% carb and like 15% protein, 10% fat, whatever it was, but they're just living such a different lifestyle than we could ever possibly live. I'll also say it's fascinating. So I lived in Hawaii for four winters. What island? Oahu? North Shore. So I lived in the North Shore, which is where the surfing is beautiful. And I lived there a lot of the way. Reason because Washington is a very depressing state in the winter months, and Hawaii is the polar opposite, right? What was fascinating to me is just the pace of life is so much slower. But you see a lot of Hawaiians who are unhealthy looking, to be frank, but they have the highest life expectancy in the US.

Dr. Gabrielle Lyon: 1:40:43

They do, yes, which is super nice. You know that? I thought that? No, really, yeah.

Joel Jamieon: 1:40:47

Which is so look, if you want to, like, look at the picture of health, you don't look up Hawaiian food. No,

Dr. Gabrielle Lyon: 1:40:53

you don't, because it's not exactly, oh, it's not a spam and

Joel Jamieon: 1:40:57

subi and cutlets. And live on Kauai. Oh, yeah. So you get it. So, yeah, I lived in North Shore for, I said, four years, and you you just realize it's a different style of life. It's a more relaxed pace, which sometimes is frustrating when you want to get something done, but you just kind of realize, like, they have a very strong if you want to drive anywhere, yeah, as well. Yeah, exactly. And that's probably north shores. There's massive traffic and all sorts of other problems. But you realize, like, outwardly, like, their diet doesn't look awesome, like they don't look like they're metabolic and healthy, but looking at them, there's certainly some that work out, but a lot of them are surfing and doing things outside, but they're outside, and they have a very strong sense of community. And you know, that translates into something, I'm sure, genetic component to it. But you would not look at the Hawaiian population like, oh, that's the healthiest part of the US. But if you look at life expectancy, if you look at life expectancy, there it is, right? So I think if we look at again, I think lifestyle matters tremendously. Our fitness matters tremendously. The fitness, if we look at markers of these different papers you can talk about, you see people's fitness levels, like, reduce risk anywhere from like, I don't know, 10% in the low end, to like, 40% on the high end, mid 40% for in terms of all cause mortality, that's a huge percentage, right? But lifestyle matters more, right? It's the big picture of our genetic interaction with our environment and our lifestyle. All these things are tremendously important. So we can't forget you can be fit, but if you're in an unhealthy lifestyle, you know you're still gonna pay the price over time. Speaking

Dr. Gabrielle Lyon: 1:42:25

of that, was there anything surprising in over two decades of looking at this that didn't have an impact on HRV that you were sure was going to

Joel Jamieon: 1:42:36

Yeah, I think just in general, looking at like, different supplements, I think it's really hard to find supplements that move the needle. Like, I was a big supplement guy. I worked at something store when I was in college, and I had, you have this idea of, like, all these supplements are, like, gonna do all these things, and then you start testing different supplements and different dosages. And, like, it's really, really hard to use supplementation to move the needle. Not I'm not saying that they can't. They never do, but I think the dietary picture is so much bigger from nutritional standpoint with their eating. Then you take some set of supplements, it's really rare to find a supplement that really moves much of the needle in terms of HIV. So that was something I probably early on spent a lot of time trying to figure out, like these different supplement combinations, and you just don't see it that often, be honest with you, or like you mentioned earlier, like you have this idea that cold plunge, yeah, cold punch will do it right. And you see, for some people, like, yeah, it proves a little while and then doesn't do anything. I anything after that. Or some people like, it exacerbates their recovery, or slows it down, makes it worse. So you just kind of realize over time, there's no one size fits all approach. There's no magic bullet, there's no universal truth for most of these things that are always going to work for everybody.

Dr. Gabrielle Lyon: 1:43:38

That's fascinating. It really is fascinating. What about alcohol or drugs? Generally

Joel Jamieon: 1:43:43

speaking, alcohol is a sympathetic stimulant. You're going to see HIV go down. It's pretty rare you see benefit of that as well. It's the other thing, I would say, is there's always research, like, oh, maybe two glasses of wine and are really good for you. And maybe there's these things in the wine that are beneficial. But now they're, I think they're looking more and more research saying, like, probably not, right. Like, maybe it's not the best thing for you. So I would say it tends to lower sleep quality, from what I've seen in most people, and that, in itself, has a negative impact. I'm not saying it's the end of the world. I'm not saying everyone who drinks

Dr. Gabrielle Lyon: 1:44:13

is sedatives or sedatives don't move the needle.

Joel Jamieon: 1:44:17

No, not usually. I mean, I'd look the thing, the biggest thing moves needle is just getting good sleep quality, because your overall your overall day is less stressful and your workout is managed

Dr. Gabrielle Lyon: 1:44:25

more effectively. Do you think that that would be an early indication of, for example, sleep apnea? Sure, if someone is they have a poor HRV, but they don't snore, they're not overweight, their hemoglobin hematocrit is not Yeah, I think it's one more indicator that would suggest

Joel Jamieon: 1:44:37

they're more likely to it. And even see with like arthritis and rheumatoid arthritis, or rheumatoid arthritis, there are some research like you would see, or fibromyalgia, you would see that the sympathetic system would be more dominant, and those symptoms start to flare up more because they're connected. So you see any sort of inflammatory type thing, which I'm not saying. Sleep apnea is basically more inflammatory type conditions exacerbated by lower HRV, because it means that sympathetic system is. Is the heightened state, and the HRV is not turning it other parasympathetic systems, not turning it down the way that it should

Dr. Gabrielle Lyon: 1:45:06

be. Is there a way to measure it naturally? Do people always have to have a wear? No, unfortunately, not.

Joel Jamieon: 1:45:11

So you have to measure so in order to measure HRV, you have to get basically the time between one heartbeat to the next. So the way they're doing with chest wrap is measuring the peak of the the R wave, the RR interval, and you have to do that within plus or minus a couple milliseconds, which is very, very accurately. And it looks at the electrical signal, and it says, this is the this is the point. And it measures a distance between heartbeats, and that filters out what are called ectopic beats. Don't arise in the same area, and there's signal processing. So no, I mean, I would say, if you aren't going to measure HIV, rest and heart rate is not really a proxy in terms of like daily stress per se, but it's also an indicator of general aerobic fitness. So you could look at trends in resting heart rate and say, oh my, rest and heart rate's declining. Chances are if your rest and heart rate's decline significantly, chances are your HIV is probably going up at the same time, not always, but probably. And that's something you can measure a lot easier, without having to get, you know, without having to measure HIV. But no, you can't, just, like, put your finger on your pulse and measure it, unfortunately, unless you're super human, unless

Dr. Gabrielle Lyon: 1:46:09

you do jujitsu, yeah. Do you think that there is a way to or do you see in the future, for example, an individual will be able to predict a thyroid imbalance, or something that drives so, for example, thyroid hormone in from my perspective, probably drives sympathetic tone. Right stimulus.

Joel Jamieon: 1:46:33

Take thyroid you're going to see

Dr. Gabrielle Lyon: 1:46:35

decreasing. You won't feel it. Do you think that if we collect more data, or is there a world where we say, Okay, your space between beats is x, we see this group from, I don't know, just make up the number from 30 to 40 with a thyroid dysfunction. Or, again, that's really specific. Yeah, sure, but I mean, there's probably imprints, or, just like a, I don't know, some kind of tracking, sure that would indicate a pattern? Yeah, I would say

Joel Jamieon: 1:47:12

that again, because the stress response is generalized in nature. It's the sympathetic system reacts to so many things. It'd be really hard to say, Oh, your HIV is low, therefore you probably have X, Y or Z. But you can say, Oh, your HIV is low. This means you're probably more likely to have, you know, this set of things that you mentioned. I don't think we could ever necessarily say, oh, it's, it's your HIV is low. So this is probably the problem, and have to be in conjunction with other metrics and other monitors, other blood work. I bet you we could get there. You could definitely correlation, for sure. I was sure you could come up with a set of things and say, Oh, if HP is low, or it has this pattern, you also might be at serious risk for these other variables. You know, anything that inflammatory, like I mentioned, is probably gonna be at higher risk for it. Hormonally can be at higher risk for it, because that can influence things, you know, and that's also where there's all sorts of variants, right? People have very different hormone profiles. Women have different birth controls, like all these things influence your

Dr. Gabrielle Lyon: 1:48:02

HRV. It does, right? What is, what does oral contraceptives do? We know that. I mean, depends

Joel Jamieon: 1:48:07

on what you're taking, depends if you're taking the same dose of what, hyper progesterone. Progesterone generates more sympathetic it depends on which one you're taking. It depends on whether you want to, you want to change dose throughout the cycle, versus when it's steady. Depends on your own response to it. I mean, we have, that's the other thing I'll say, is that we have very different responses to drugs, right? So it shouldn't surprise us, we have very different responses to everything. We have different responses across the board, because we're different individuals. So I can't say you're on this birth control. It's gonna affect you the same as this person on the same birth control, like it can, you know, it's same thing with most drugs, like statins or, you know, none of my stat next I mentioned earlier. What's interesting is, it's seemed to have raised my baseline HRV, but also makes it more volatile.

Dr. Gabrielle Lyon: 1:48:46

And that would make sense, yeah, when the drug wears off, no, it makes more

Joel Jamieon: 1:48:50

I don't think so. I think it's got very long half life. I'm on resume with statin. I think it's because we see greater muscle damage in people with high levels of our high statin dose, because it exacerbates that somehow, and only mechanism

Dr. Gabrielle Lyon: 1:49:01

probably depend HMG Coase, yeah, it depends on if it's a fat soluble or, yeah,

Joel Jamieon: 1:49:07

exactly. So I'm so when I went and got diagnosed, the first thing that doctor gives me 40 milligrams of Crestor, which I didn't want, because I did not really want to maximize the dose of that, because you get a lot of the response from much lower doses. But the only way to get approved from insurance for pathway, which is the injectable that works differently those were listening, I had to do that and then see if it worked. And it did drive my HIV lower. That one actually did, but I started getting soft tissue injuries. I legitimately started getting weird injuries. Walking down the street. I pull a quad, I roll an ankle, I roll an ankle, I haven't rolled an ankle like in 20 years, like I just had all these weird soft tissue things. So it really, so I really, and I know what normal is for me. And so that 40 milligram dose did not sit well with me, did not work well, and I cut it down to 10 milligrams, and now I got the repath of prescription, and I haven't had any injuries. My HIV is actually. Be up as an average, back into more of a normal range where it should be, relative to my age and VO two. And you know, we'll find out when I do the CTA again, what it's doing to my actual plaque, and my cholesterol numbers are super low now. So hopefully that will have the impact I want. But you know, other people could have a different response on that, that statin versus another statin, right? Everyone responds differently, I think. So that's an interesting way to see that is, oh, like, a high dose of the statin had a lot of negative effects. For me, low dose seems to be pretty beneficial and raise HIV. So so it's

Dr. Gabrielle Lyon: 1:50:32

kind of like people may have kind of swung to over quantifying their life a bit. And it's really, there is an art to training, just an art to medicine. Where do you think the future is going with HRV or just in general, performance and recovery metrics?

Joel Jamieon: 1:50:48

Look, I think, at the highest levels of sport and performance, like they're getting really good at building these really complex models to take into account huge amount of variables. So they're looking at saliva for different things. They're looking at hormonal profiles in some sports. But again, some sports are also resisting that, and they're trying to build models. I think the question is, how do we build models? Are taking as many data points as possible to give us the best possible, you know, guidance, more or less. And I think those will continue to evolve and improve as we get more data from more different types of devices and more types of measurements. So we can use saliva to measure more stuff, and there's less there's less invasiveness involved in all this. So we'll get more and more data, and hopefully we'll be able to use, you know, AI is the talk of the town these days. I'm sure AI will do a good job at some point of sorting all this stuff out and giving us guidance. But I think the bigger challenge, honestly, is is influencing people do the right things. Because I don't care how good the data is, if the person doesn't change their behavior because of it. Like, does it doesn't matter, you know, like, I had had a guy named David Tenney, and he was the performance coach of the Seattle Sounders when I was first starting use HIV. Very progressive guy. And he said, Oh, I want to come in and have a certain number of players measure HIV to see if it's useful for our team. And this is back in, like, 2005 or 2006 really early on, somewhere around there. So he brings in a bunch of players. We spend like, six months measuring data. He's looking at on field metrics. He thinks it's really valuable. Long story short, they get their own HRV system, they get catapult GPS, they start getting a whole bunch of data metrics. And they bring a guy from Microsoft to build a big machine learning platform. And it's at this time, this again, this is, like 15 years ago was very advanced, probably the most advanced sport metric system at the time outside of Europe. And so he builds this big model. He predicts risk of injury. And it's like, takes all this data and says, Hey, this player, he does two things. He models game load by training. So he says, Hey, this practice was, you know, 102% of game load, or this practice was 80% of game load, which is super valuable for coach to know, like, how hard is that practice relative to a game? Anyway, he comes up this really advanced model, and he's able to predict injury risk, you know, within a certain percentage. So he would say, like, oh, this person has increased injury risk by 10% or this athlete is 20 increased risk of injury. And so he's working with all these people to develop this model. And the coach listening, listens to him and is making decisions. And then, you know, Dave says, Oh, this athlete is at a 25% increased risk, like this guy is really at high risk, which means he's 75% not right, still, right? So what happens is, the guy goes out and has a game of his life scores like three goals. So what's the coach say? Oh, your data model sucks. Oh, my God. And just kind of disregards it, because that's the problem, is, like, if the person making the decisions decides that data is not what they want to make the decision on, then the whole thing's kind of shot. And so Dave's models, again, it said, like, 20% risk or whatever. So I'm an 80% chance he wasn't gonna get injured. But in the coach's mind, because David said, Oh, this player is likely injured, he went out and performed really well. The coach was like, Oh, your data doesn't work. And it was, I mean, that's not the case, right? It's just, it comes back to, I think we can come up with all the data analysis in the world we want, all the tools you want. You can use Morpheus, all these things, but ultimately you have to figure out how to use that information to make better decisions, better choices. And that's the hard part, right? Like, I think the one good thing, I would say, not that one, but one of the things wearables have done is make people more aware of all these things. They make people more aware that sleep matters, that, you know, food choices matter, that training intensity and frequency matter, and that more is not always better. I think it's brought awareness to that, and I see that in the Morpheus data. And we see people email me all the time and saying, Hey, I didn't realize how much sleep was killing my progress, or I didn't realize how much I was doing, way too much, you know, then I should have been doing. So awareness, I think, is the first step. And then, you know, talking about it is a really important thing, because there wasn't that long ago where recovery was, like, What do you mean? You need recovery? Like, shut up and get back to work. That was, that was the mindset, right? There was this all intensity, all the time, kill yourself or you're not making progress. Like it was. That was that was the mindset of the fitness community. I think we've seen a pushback, because people got beat the hell doing that. Yeah, injuries. And, you know, CrossFit took a took a while to figure that out. But, you know, in general, the community has to say recovery is important. It matters. We need to focus on it. And I think that's ultimately what the data. Help can help drive. So I don't know that more tech is the solution. I think more, I think that's right, more discussion and more more discussion, more coaching, more reckons. Recognize, recognizing this paradigm shift into train and recover and lifestyle and training are intertwined. They're not separate entities. You know, all these things will hopefully help people make better decisions, but the data is there. You know, like, we have good data. HRV works. We have other markers. We

Dr. Gabrielle Lyon: 1:55:25

still have people measure HRV. Oh, yeah, absolutely.

Joel Jamieon: 1:55:28

Of course, when we've got 1000s of users on Morpheus, we look at all the data. So, I mean, one thing we're able to do that's really cool is we, we said, Okay, can we figure out how much volume intensity people use, on average they're using Morpheus that see their HRV increase over time, versus people that don't see their HRV increase over time. So we have 1000s of 1000s of data points, you know, millions of people doing workout or millions of workouts. And so we segmented people by their average resting heart rate and their average HRV into low, medium and high. So basically, people that were low fitness, people are moderate fitness, and people that are high fitness. And then we ran some computer machine learning stuff to look at over 12 week periods, how much time they spent at high intensity, moderate intensity and low intensity. So we're looking at volume intensity in these three groups, and we found particularly in the low and moderate groups, the people that did the higher amounts of volume intensity got worse or got no better. The people who did lower certain lower amounts of it got better. So it just, it just meant that, like the people in the low to moderate fitness categories were overestimating how much they could do, wow, they weren't recovering. And we found that people that were somewhere between 80 and 85% recovery in our system, at least across a week, were much more likely to see improvements in their HRV, rest and heart rate than people who are below 80% so we just showed a real world data analysis peak picture that showed us that, hey, people in lower to modest fitness categories that do more and more and more, they're not seeing the result for a reason. And I think that's the biggest thing. I would tell people that say, I need to train hard every day. I'm like, but are you improving? I love that. It's pretty, pretty straightforward. Are you getting better or not? And if you're not getting better, maybe better, maybe trying less would be an approach to start with.

Dr. Gabrielle Lyon: 1:57:06

Well, Joel Jameson, this has been a fascinating conversation. I learned a tremendous amount. And you know, the big takeaway for me is, and I'm curious as to what the listener or viewer sees, is that understanding where you are and you might not be able to feel your heart rate variability, you would think that you would, oh, I feel crappy. Maybe it's this, but there's a lot of influence that goes into it, whether it's sleep or external dynamics, but also over time, if you are not improving, then it can absolutely help direct your training, whether it's aerobic capacity versus strength, and that is a very meaningful data point or data points, especially if we want longevity. Yeah,

Joel Jamieon: 1:57:53

I think the biggest lesson I've learned over my whole career is that we're all unique. We're all individuals. And rather than spending your time looking on Tiktok or Twitter or Instagram or whatever X, whatever it is, to find what other people are doing, focus on what you were doing and what you can do better. And I think you can use other people's experiences to help give you ideas, but we're too fascinated with copying what other people are doing, and unless you are them, you're not going to choose results they are right? I don't really care what a pro athlete is doing, because I'm not a pro athlete. I don't want care what someone's doing on Instagram, because I'm not them, and I've got my own things to deal with. So I think that's where HIV can separate itself, is it can help you as an individual, make informed decisions about you as an individual, and over the long run, I think that's what creates sustainable fitness and sustainable change, finding what works for you and understanding how your body changed over time. That is the path of success. The path of failure is constantly trying things that you see online and just jumping from one thing to next and never really knowing what's working what's not, and never really finding that path. So I think if your goals longevity and sustainability, you know, HIV and that sort of data and learning about your own your own path, your own body, your own body, your own genetics, your own life. Think that's the most important

Dr. Gabrielle Lyon: 1:59:03

thing. Very well said. Thank you so much for coming on the show. No problem got to be here.

Joel Jamieon: 1:59:07

Thank You.