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June 10, 2024 • 1hr 51min
#305 ‒ Heart rate variability: how to measure, interpret, and utilize HRV for training and health optimization | Joel Jamieson
The Peter Attia Drive
In this episode, Peter Attia interviews Joel Jamieson, a conditioning expert and the founder of Morpheus, a system that uses heart rate variability (HRV) and other metrics to optimize training. They discuss the science behind HRV, how it's measured, what it tells us about health and fitness, and how it can be used to guide training decisions.
Joel explains his background in using HRV for over 20 years, starting with early Russian systems developed for Olympic athletes. He describes how he created Morpheus to make HRV data more accessible and actionable for coaches and athletes.
#305 ‒ Heart rate variability: how to measure, interpret, and utilize HRV for training and health optimization | Joel Jamieson
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Key Takeaways
- Heart rate variability (HRV) measures the balance between the sympathetic and parasympathetic nervous systems. It provides insight into the body's ability to adapt to stress and recover.
- HRV declines with age but can be improved through cardiovascular fitness and lifestyle factors. There is also a genetic component to HRV.
- Measuring HRV in the morning provides the best snapshot of recovery status and readiness for the day. Overnight measurements are less useful for gauging daily readiness.
- The Morpheus system uses HRV along with other metrics to provide personalized daily training recommendations. It aims to optimize fitness gains while avoiding overtraining.
- HRV is a useful metric but should be considered alongside other health markers like VO2 max. Output measures like VO2 max are generally more predictive of health outcomes.
- Lifestyle factors like stress, alcohol, and sleep quality have a significant impact on HRV. Managing these factors is key for maintaining a healthy HRV.
- Heart rate recovery after intense exercise is an important indicator of cardiovascular fitness. Elite athletes can drop 50-60 beats per minute in the first minute after maximal exertion.
- GLP-1 agonist drugs for weight loss appear to increase resting heart rate and decrease HRV. The long-term health implications of these changes are unknown.
Introduction
In this episode, Peter Attia interviews Joel Jamieson, a conditioning expert and the founder of Morpheus, a system that uses heart rate variability (HRV) and other metrics to optimize training. They discuss the science behind HRV, how it's measured, what it tells us about health and fitness, and how it can be used to guide training decisions.
Joel explains his background in using HRV for over 20 years, starting with early Russian systems developed for Olympic athletes. He describes how he created Morpheus to make HRV data more accessible and actionable for coaches and athletes.
Topics Discussed
The Science and Measurement of HRV (4:00)
Joel explains that HRV measures the variation in time between heartbeats, which reflects the balance between the sympathetic ("fight or flight") and parasympathetic ("rest and digest") branches of the autonomic nervous system. Higher HRV generally indicates better adaptability and recovery capacity.
Key points on HRV measurement:
- ECG (electrocardiogram) is the gold standard for measuring HRV
- Chest strap heart rate monitors are nearly as accurate as ECG
- Optical wrist sensors are less accurate, especially during movement
- Forearm optical sensors can be quite accurate if worn properly
"If you look at the data of RMSSD and you look at a normal bell curve, it's skewed, it's non-normal. It's all the way to the left." - Joel Jamieson on why Morpheus uses a log transformation of RMSSD
HRV Calculation and the Autonomic Nervous System (22:30)
Joel describes how HRV is typically calculated using the RMSSD (root mean square of successive differences) method. He explains that HRV reflects the interplay between the sympathetic and parasympathetic nervous systems, which are constantly adjusting to maintain homeostasis.
Key points on the autonomic nervous system and HRV:
- The sympathetic system increases heart rate and decreases HRV
- The parasympathetic system decreases heart rate and increases HRV
- HRV fluctuates with breathing (respiratory sinus arrhythmia)
- Higher HRV at rest generally indicates better parasympathetic tone
HRV Decline with Age and Modifying Factors (33:30)
Peter and Joel discuss how HRV tends to decline significantly with age. However, they note that this decline can be mitigated through lifestyle factors, particularly cardiovascular fitness.
Factors influencing HRV:
- Age: HRV declines steadily throughout adulthood
- Cardiovascular fitness: Higher VO2 max correlates with higher HRV
- Genetics: There is a significant genetic component to HRV
- Lifestyle factors: Stress, sleep, diet, and alcohol intake affect HRV
"As we age, if both those dials lose their range and they lose their coordination in some respect, then we have much less resilience, much less adaptability." - Joel Jamieson on the decline of autonomic function with age
The Morpheus System for Optimizing Training (51:30)
Joel explains how the Morpheus system works to provide personalized training recommendations based on HRV and other metrics. Peter shares his experience using Morpheus to guide his zone 2 training.
Key features of Morpheus:
- Daily morning HRV measurement
- Integration with sleep and activity data
- Personalized training zone recommendations
- Recovery score to gauge readiness
"I cannot put in words how impressed I am with that system and how remarkably accurate it is at predicting something that is very difficult to predict." - Peter Attia on using Morpheus for zone 2 training guidance
Morning vs. Overnight HRV Measurements (1:03:00)
Joel explains why Morpheus uses a morning HRV measurement rather than overnight tracking. He argues that the morning measurement provides a better snapshot of recovery status and readiness for the day ahead.
Advantages of morning HRV measurement:
- Reflects the body's response to the previous 24 hours
- Measured in standardized conditions
- Not affected by sleep stages or evening activities
- More actionable for daily training decisions
Impact of Lifestyle Factors on HRV (1:11:15)
Peter and Joel discuss how various lifestyle factors affect HRV. They emphasize that managing these factors is crucial for maintaining a healthy HRV and overall well-being.
Lifestyle factors impacting HRV:
- Exercise: Consistent training improves HRV over time
- Stress: Chronic stress lowers HRV
- Alcohol: Even moderate intake can significantly lower HRV
- Sleep: Poor sleep quality reduces HRV
- Diet: Healthy eating patterns support better HRV
Heart Rate Recovery as a Fitness Indicator (1:22:45)
Joel explains the importance of heart rate recovery (HRR) as an indicator of cardiovascular fitness. He shares his experience using HRR to assess the conditioning of combat athletes.
Key points on heart rate recovery:
- Measures how quickly heart rate drops after intense exercise
- Reflects the balance between aerobic and anaerobic systems
- Elite athletes can drop 50-60 bpm in the first minute after maximal exertion
- Faster HRR indicates better cardiovascular conditioning
"Heart rate recovery was such a great way to see that. And so, like I said, I would want to see in sparring at least...they should be able to get their heart rate back in the 130s between each round." - Joel Jamieson on using HRR to assess fighter conditioning
Effect of GLP-1 Agonists on Heart Rate and HRV (1:34:45)
Peter shares observations from his medical practice about the effects of GLP-1 agonist drugs (used for weight loss and diabetes) on heart rate and HRV. They discuss the potential implications of these changes.
Observed effects of GLP-1 agonists:
- Increase in resting heart rate by 8-12 bpm
- Decrease in HRV
- Effects reverse when drug is discontinued
"I cannot put in words how impressed I am with that system and how remarkably accurate it is at predicting something that is very difficult to predict." - Peter Attia on the potential risks of GLP-1 agonists for cosmetic weight loss
HRV in the Hierarchy of Health Metrics (1:42:00)
Joel and Peter discuss where HRV fits in the broader context of health metrics. They agree that while HRV is valuable, output measures like VO2 max are generally more predictive of health outcomes.
HRV's place among health metrics:
- Useful for daily monitoring and short-term trend analysis
- Less predictive than VO2 max for long-term health outcomes
- Should align with other health markers over time
- Very low HRV may indicate underlying health issues
Conclusion
Heart rate variability is a powerful tool for understanding the body's stress response and recovery capacity. While it shouldn't be viewed in isolation, HRV can provide valuable insights to guide training and lifestyle decisions. Systems like Morpheus that integrate HRV with other metrics offer a more comprehensive approach to optimizing fitness and health.
The discussion highlights the importance of understanding individual physiology and using data to inform personalized training and lifestyle choices. As Joel Jamieson concludes: "If you can spend the time to really dig into your own physiology, how you respond to training, how you respond to diet...you will reap the reward of that in the long run."