A Case Against Cardio, Part 27

marathon runner legs running on city streetI’m mostly joking with the title. Though, considering how much I’ve written on this topic since starting this blog way back in 2006, it’s probably not too far off. And it’s not just me. Endurance training has been getting the snot beaten out of it in recent years. A variety of media outlets, TED talks, other blogs, observational research and clinical trials have all sounded the alarm about the dangers of excessive chronic cardio.

A new string of studies has found evidence of higher arterial plaque levels in the most active endurance athletes. This is becoming a trend. While endurance athletes tend to have more of the calcified kind of plaque, which is more stable and theoretically less prone to dangerous ruptures than less-calcified plaque, it remains worrying. I’ve spoken in the past about the proclivity toward heart problems found in endurance athletes. I know many former peers with atherosclerosis, cardiac arrhythmias, and other heart troubles.

As disconcerting as that is, that’s not what today’s post is about.

Today, I’m asking, “What’s the point?”

The whole “this thing will kill you” tactic is helpful from time to time, but more effective is the utility argument: what works better? What gets you fitter, faster, stronger, and sexier?

In recent years, researchers have been running direct head-to-head comparisons between traditional endurance training and more intense forms of exercise, like strength training or sprint interval training. They almost always end badly for cardio. How badly?

Let’s find out:

A recent review asked an important question: what’s better for altering body composition—resistance training alone, endurance training alone, or endurance training with resistance training?

Resistance training won, leading to greater fat loss and retention of lean muscle mass. Furthermore, RT alone was better at reducing fasting insulin levels and improving blood lipids.

The only way the authors were able to find endurance training helpful was by including high intensity interval training in the endurance category. Their overall conclusion was that the “focus of treatment” for people interested in losing body fat should be on producing a large metabolic stress via intense strength training and/or interval training.

This jibes with other recent papers:

Endurance training burns more belly fat when you incorporate strength training.

In obese teens, strength training alone reduced body fat more than endurance training or combined endurance/strength training.

In women with PCOS, both strength training and interval training reduce body fat and improve insulin resistance without affecting body weight, which indicates gains in lean muscle mass. In another study, women with PCOS who engaged in standard moderate cardio improved endothelial function but lost no body fat.

It’s surprising, isn’t it? You’d assume that although strength training is definitely great for health, fitness, and body composition, adding in some endurance work could only improve those metrics even more. Sometimes, that’s true, but in the majority of studies, this just isn’t the case. Strength training or interval training alone are generally superior.

How about “unhealthy” people with conditions like heart failure or diabetes? Aren’t they too fragile to endure resistance training or high intensity intervals? Wouldn’t an hourlong jog be a better, safer use of their time?

In September, patients with heart failure (with preserved injection fraction) were placed on one of two exercise modalities: continuous medium-intensity cardio (30 minutes at 70% maxHR) or high-intensity interval training (4×4 minutes at 85-90% maxHR; 3 minutes rest). HIIT resulted in numerous improvements to arterial function and ventricular volume. The HIIT group even improved their cardiovascular fitness, with VO2max going up. The cardio group saw no improvements at all.

Other studies have found that endurance training can improve VO2max in heart failure patients but has little effect on markers of endothelial function or arterial stiffness.

Recently, researchers compared the effects of endurance training to either resistance training or HIIT on microvascular function in type 2 diabetes. Microvascular function refers to the system of tiny, precious little capillaries delivering blood and nutrients to individual cells and tissues. Poor microvascular function predicts future cardiovascular problems, so it’s really important. They found that the training modalities which employed the most amount of muscle tissue produced the biggest improvements. As most traditional endurance training localizes muscle recruitment, while HIIT and strength training tend to target the entire body, that’s a roundabout way of saying strength training and HIIT trounced endurance training.

Other diabetes researchers examining this exact issue are quick to say that “more exercise is not better” and that it’s all in how you exercise. You can’t just do something that gets you winded and hope you’re destroying your glucose intolerance, insulin resistance, and normalizing your glucose levels. You have to train the glucose sinks—the actual muscles that will be accepting (or rejecting) the glucose. And the absolute best way is to move those muscles, particularly vigorously. Jogging through your neighborhood or cycling for three hours just doesn’t cover all your bases like a full-body strength workout or a CrossFit WOD.

We’re not the fragile snowflakes we think we are. We can tolerate intense exercise. We cannot tolerate avoiding intense exercise. Dress for the job you want. Train for the intensity you want your body to endure and thrive in.

Plus, we’re all busy. Everyone’s working. Very few single income families exist these days. And if we want to be able to have it all—perform well at work, maintain relationships at home, procure and prepare good food, enjoy much-deserved leisure time—smart, efficient exercise has to be a part of our routine.

This might be even more relevant for my female readers. In many respects, you have it harder. You often take on more domestic responsibilities while still working, and yet the conventional wisdom is that you mustn’t lift too many weights or damage your delicate bodies with intense intervals. You’re warned about “getting all bulky.” You want “tone, not muscle.” And so you end up taking hour long pilates classes or doing 45-minute light aerobics sessions, when you could just as easily—and to greater effect—lift something heavy for 10-15 minutes or go sprint up a hill or do a quick bodyweight circuit.

What’s the point of hard-core endurance training? If you’re competing, professionally or on an amateur level, I get it. The drive to push your past its limits and beat the other guys is powerful and difficult to ignore. There’s something to be said for satisfying that part of human nature. There are probably benefits to seeing your enemies driven before you and hearing the lamentations of their women, particularly psychological ones.

If you’re getting paid to run marathons or compete in triathlons, keep doing it. You’ve got the justification you need to tax your body and perform what probably amounts to a suboptimal training regimen. Just be sure to get out while you can still walk and move well.

I don’t hate cardio (I might have loved it, in a manner of speaking, a bit too much, in fact). In the context of a movement-nutritious lifestyle—lots of walking, strength training, occasional sprinting, physical play—some cardio can be beneficial. It simply doesn’t work as well as we’ve been told it does. There are just better ways most of us can and should be spending our training time.

All that said, endurance training can enhance your health, and there are better ways to do it. Stay tuned for Primal Endurance, where I’ll lay out a whole new paradigm for endurance training.

Now let’s hear from you: have you experienced middling or nonexistent improvements from straight up endurance training? Does this gel with your experiences?

Thanks for reading, everyone.

Prefer listening to reading? Get an audio recording of this blog post, and subscribe to the Primal Blueprint Podcast on iTunes for instant access to all past, present and future episodes here.

About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

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69 thoughts on “A Case Against Cardio, Part 27”

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  1. I have to still write a success story but all I can say is I use to be the guy (still am a fitness director) who would workout every day for at least 90 minutes including lots of cardio; and believe me I was ripped. Now for about the last 3 years I walk like crazy (have two dogs helps a lot), lift weight 1-2X per week, and sprint 1-2X per week and just do not sit on my butt much and feel better and still am pretty ripped. It is so freeing to “exercise less” and be active more.

  2. Mark, how does this work with those of us who use Phil Maffetone’s methods for running?

    1. MAF recommends staying out of the ‘chronic cardio’ heart rate range. Long and slow, being sure to stay strictly aerobic according to the 180 formula, keeps you from damaging the system. This type of training isn’t ‘chronic’.

      1. How do you mean? I am not sure I am understanding you correctly. Do you want or do you NOT want to be in the cardio zone?

      2. This is the problem I have with these articles – what is “chronic”? What is “hardcore”? To me, “chronic” means something that you do all the time. So you’re saying that if I run 7 days a week but keep my HR in the MAF range, that’s fine? There seems to be a range of understandings in the comments here.

        I run because I like it – it reduces my stress and improves my health. I’ve never been one to push weights back and forth, but I do some bodyweight exercises a few times a week. Now I’m torn between wondering if running is killing me, or whether this is another blip on the science radar.

        1. I feel like MAF running is closer Mark’s “do lots of walking” category than it is chronic cardio. Case in point, when first starting MAF training a lot of people — even experienced runners — cannot actually run and keep their heart rate in the MAF zone. They end up having to walk or walk/jog, until they become more aerobically fit.

          I do think people who can run quite quickly at MAF may have to be careful not to overdo it. My MAF pace is around 7:30/mile, and while I still feel that lots of MAF running is healthy, at a certain point it can leave me feeling more tired afterwards than recharged. That’s a good sign that it’s time to rest more or substitute in more walking.

      3. Correct me if I am wrong here but ‘chronic cardio’ according to Mark is the (too) frequent execution of sustained activity in a too-high HR zone (say 75-85% max HR). Whereas chronically (daily say) performing MAF training is fine, even optimal simply because the intensity is more like 65-75%.

        All activity (from getting off the couch to sprinting up a hill) is cardio. The key is simply to find the right dosages of the various intensities based on an individual’s current level of fitness. There are cardio intensity levels that you want to do chronically and higher intensities less frequently but definitely periodically based on general fitness and recovery levels.

        1. I agree that it’s important to define our terms. I tried the “Body by science” approach of heavy RT to muscle failure 1x/week for 3 months and left me a mess! I was experimenting on myself before promoting it to my patients and was doing no aerobic/MAF type exercise.

          I gained 3 pounds and my clothes were tighter
          My Lumosity scores dropped
          My libedo took a nose dive!

          Most of the negative responses I attribute to a decrease in overall circulation.

          I went back to my MAF style workouts at around 70% MHR with good worm up and cool down for 30 min 3 times/week with moderate RT 2x/week. Everything is back to normal now and I’ve even lost a bit of weight from my original (before Body by Science) 175lb.

          I’m 66 years old which may be a factor in the kind of exercise that works for me. So far I’ve found that I can incorporate brief HIIT into my MAF sessions and it works OK. Haven’t seen it work better but no apparent downside for me.

          Again, It’s good to read that it’s just the excessive, high heart rate, endurance training that’s causing the negative effects. Of course, adequate recovery time is essential no matter what type of exercise we’re doing.

  3. So appreciate these posts, Mark. I work with so many people who are afraid to give up chronic cardio…even when it’s not getting them to where they want to be, so far as getting “fitter, faster, stronger and sexier.”

    It’s like there’s a belief–stronger than the reality–that it will work if they just keep at it.

    As a recovered chronic cardio addict myself, I soooo get this. In my 20s, I would run for an hour a day–impact on my health, energy and vitality be damned. My belief told me I “had” to do it–and that if I didn’t, I’d gain weight and would no longer have the freedom to eat whatever I wanted.

    Wow, how things have changed for me. But it took a health crisis in my late 20s (likely brought on by destructive movement and eating patterns) to force the issue…and force me to face where my beliefs around food and movement were far removed from reality.

    1. lol – the irony, even if you do the correct exercise, you never really have the freedom “to eat what you want”, at least without suffering the consequences. As we have learned, health is 80% diet, and you should stick the diet 80% of the time. A few people think though this means you can drop the exercise part – that’s like saying you can build a brick wall and just skip the mortar (cause its only 20% of the wall anyway, right ?)

  4. So appreciate these posts, Mark. I work with so many people who are afraid to give up chronic cardio…even when it’s not getting them to where they want to be, so far as getting “fitter, faster, stronger and sexier.”

    It’s like there’s a belief–stronger than the reality–that it will work if they just keep at it.

    As a recovered chronic cardio addict myself, I soooo get this. In my 20s, I would run for an hour a day–regardless of the impact on my health, energy and vitality. My belief told me I “had” to do it–and that if I didn’t, I’d gain weight and would no longer have the freedom to eat whatever I wanted.

    Wow, how things have changed for me. But it took a health crisis in my late 20s (likely brought on by destructive movement and eating patterns) to force the issue…and force me to face where my beliefs around food and movement were far removed from reality.

    1. Bruce Lee summed it up “the greatest enemy you face will be yourself”.

  5. “Just be sure to get out while you can still walk and move well.”

    I’ll be leaving long distance running in less than two years and deep down I am looking forward to turning a fork in the road and living like Anthony above. I’m burnt and I can no longer ignore the research and evidence that chronic cardio is less effective in most ways compared to other forms of activity and movement. I appreciate this website for educating me in this regard.

  6. Long walks with my dog, resistance training here and there, rebounding when I want a burst of energy, and rock climbing with my 16 year old daughter keep me very fit without making myself crazy. Glad to hear there is some science behind my instinctual avoidance of cardio!

  7. I was a distance runner for years. Now at age 57, twice a week I do 10 hill sprints followed by 20 minutes of intense circuit training at the gym. I feel younger and more energetic than ever.

    1. Completely agree! I feel younger and way more energetic now that I no longer feel compelled to do cardio! My energy level at 49 is even better than it was in college.

  8. Last year I started running at a moderate pace for 2-3 miles/day, 5 days a week, to help with my mental health. The physical health benefit is sort of secondary. I think any activity would do the trick, but what I love about running is that it’s only about 30 seconds from bed to business.

    From this, it sounds like there are activities that would be better for me; what, if anything, should I be doing instead?

    1. I step for 20-30 minutes, hopefully 3-5 days per week, also to relax and get a little reading in. I don’t think these examples qualify as chronic cardio. There may be more upside to doing something else, but a big draw from me is the relaxing. I like intervals and lifting but for me they require more concentration and aren’t as relaxing mentally.

    2. Try doing intervals instead of steady running. I do 30 seconds of sprinting, then 30 seconds of an easy jog to recover. About eight of those, preceded by a warm-up, followed by a warm-down. It may not be as relaxing, but it’s a good workout in half the time. I used to run 3 to 3.5 miles, frankly found it kind of boring. Intervals are not boring.

      At 55 I regularly play two hours of intense singles tennis. On days I’m not playing tennis I either do weights or run intervals. I’m also a believer intermittent fasting, which I do by making sure to have at least 12 hours between my last meal of one day and my first of the next. I feel great, and have taken off 10 lbs over the last 6 months.

  9. I love to bike and backcountry ski. I do it to gain the fitness needed to be able to cover demanding terrain wherever I want to go. I’ve never thought of my workouts as weight loss or health oriented(though they are), I consider them the key to adventure for me. A Century ride, a high alpine mountain bike ride, a ski trip to climb the volcanos in Japan, it’s what I live for.

  10. “How about “unhealthy” people with conditions like heart failure”. Is this the zombie apocalypse? I thought you’re dead if you have heart failure 🙂

    1. In the medical profession, “heart failure” is used to mean your heart’s pumping power isn’t as good as it should be. It’s definitely not reserved for only cases where the heart has ceased working altogether.

  11. Maybe, just maybe, someday these researchers might entertain the idea that it might be the diet of these athletes and not how they exercise that causes higher arterial plaque levels. No, never mind. Correlation must equals causation to these “researchers.”

    1. I’ve often wondered what the diets of these athletes looked like. I think it’s a combination of life-style, diet, genetics and exercise that contribute arteriosclerosis in endurance athletes. the human body is so vastly complicated that chronic cardio cannot be entirely blamed for arteriosclerosis in endurance athletes.

  12. I’ve run two marathons and several half marathons. I can’t see myself doing it again. My knees paid for it. I can play tennis and basketball for some cardio here and there. No need to run 13+ miles. I enjoy my knees and strength training a bit more!

  13. I run for fun….. usual training for me is=
    1 day I run sprints/intervals/hills/chase animals usually for about 10-30 minutes
    1 day I run a longer average pace run usually with a destination
    1 day I do whatever I want….usually involves chasing deer or playing with a dog

    I run because I think its fun, its a useful skill, I get to see as much ground as possible (lunch run adventures), I get outside! When you run outside with a dog, you get inspired to play and have fun. Run with the dog, try to keep up. Throw the ball and try to get it before the dog does (good luck)…….If you run outside and you see a deer or wild animal, trying to sprint after it certainly gives you some primal feelings…..specially when you realize that deer could kick your face and that would not feel good…

    How do you know if it is chronic cardio? I usually run with my sister’s dog. After the run I return the dog and I usually end up seeing my sisters kids. The kids don’t care how far you have just run and they expect you to run around and play with them. If you are too tired from your run to play – you ran too hard. If you can successfully play a game of football, more catch with the dog, swing on the swings and have jumping contests, AND do monkey bar challenges…….then obviously you are awesome and should keep doing that.

    some people go on treadmills and elliptical….
    some people live life…

    Ask yourself Why are your working out? = to get in better shape? Why? So you can do more things? Then do more things! If you want to be able to pick up your kid and play games with them then sure going to the gym will help you get stronger….but it also takes time away from playing with your kids (or whatever real life goal you have)…..Just make sure you actually do what you want. Don’t spend your whole life training for some event, just to die before ever using your body!

  14. I’m wondering if my mountain biking is considered chronic cardio. It’s typically 60-90 minutes with 10 or so all out max effort climbs interspersed with medium steady state efforts and 30 minutes of descending.

    1. I would consider mountain biking in my area (central Texas) much closer to interval training than chronic cardio, but I guess it depends on where you’re riding.

  15. I find it funny you put elite or sub-elite images of running athletes at the top of this article. You’re argument against “cardio” i.e. running, may be true for the guy that goes from couch to do something. If you are talking about wanting to just go to the gym and train and be efficient, great, got it. If you are talking about actually running and training for a running event, it’s a different story. You should educate yourself in the sport of running. There is a reason why people go run 10 miles at a moderate pace. Interval training is a huge, huge part of running for the reasons you outline above, VO2 max, etc. To be faster as a runner, you have to run more and run faster. But, you CANNOT do intervals every single day. You have to recover and that’s what the moderate days are for, let your body recover and build cardio endurance for the hard days. What you are talking about is the extreme ultra running athlete that puts crazy amounts of stress on their body. You aren’t doing a good job of actually educating people by promoting your own brand of what “people” should do to exercise.

    1. Ryan,

      I haven’t been reading the site that long, but if you read Mark’s bio, you’ll see that he had a running career and qualified for the Olympic trials.

    2. “You should educate yourself on the sport of running.”

      Are you kidding? I suggest you read a little about who Mark is.

    3. All I’ve got to say is…. Lololol
      Yes, mark! You should “educate yourself”

  16. I’ve been running miles upon miles for years now. I always wondered how someone can run so much and NOT LOSE WEIGHT! It’s my sincere hope to run less in the very near future (but I feel as if I can’t quit the half marathon circuit until I finally reach my PR goal!)

    1. Try interval training in your running. You won’t get faster just jogging every day…

      1. This is debatable – plenty of coaches will tell you that you will get faster as your body increasingly adapts to running slow.

    2. Current research is pointing out that you compensate for calories burned, no matter what you do. No one should expect to exercise themselves thin.

  17. Mark, I’ve taken to the once-a-week sprinting and staggered short body-weight lifting sessions. But curious how you suggest dealing with knee issues while maintaining the sprinting routine? I played lots of outdoor basketball in the past, and while my knees aren’t in awful shape, I do have some small cartilage tears in one knee. I try to sprint on soft track as much as I can, which seems to help a bit.

    1. I do my sprints on a stationary bike, no problem for the knees I find, and I’m a recovering IM triathlete who trashed herself for nearly a decade.

  18. I would call myself a mid of the pack endurance athlete. In order to compete, I have to include some strength, some hills (actually a lot of hills since I train for trails), tempo to sprint workouts. And that is for the running itself. I do strength training because I know as I get older I should work on that part. And I know to do real rest.

    Nothing makes me choose between the two ways of exercising. The headline suggests that anyone is working out in a particular way only to stay healthy. I don’t think this is sustainable, there needs to be a fun component included, too.

    And then, inevitably, there are different body types that need a different balance of intensity vs volume. I am the poster child of overtraining if I don’t watch the intensity. Volume? That takes a lot of miles to break me.

  19. I’ve always been at my most fit when strength training was involved, but my true love is hiking in the outdoors, and it is what keeps me most sane. Someone commented earlier about cardio for mental health, and for me, that cannot be state enough. I don’t need to be fit and ripped. I need to be calmed and contented. So if I hike for 1-2 hours a day, 5-6 days a week, instead of a 20 minute burst of cardio and a 20 minute HIIT, 4-5 days a week, and am 10 lbs heavier and less ripped, then so be it. I am 100% ok with that. I don’t think the research is wrong, on one hand. On the other hand, you have to do what you enjoy, otherwise, why bother? There are too many downsides and too many reasons to quit.

    1. I guess I’m a little saddened by the “A Case Against Cardio” title. I get it- I really do. But how about…. “A Case Against Feeling Obligated to Cardio”?

  20. Long distance sustained cardio causes lots of oxidation and repetitive stress syndrome. I’m sure there are a small percentage of people who have unusually strong joints and tendons and can do it for life and be fine, but not a good strategy for the vast majority of us. Cross training can help some I think for those that are passionate about it and determined to do so, i.e. alternate swimming, running and cycling.

    Not a problem for me, I’ve always hated distance training LOL. I enjoy weight lifting, different types of sports performance training, playing tennis and racquetball … as long as I’m chasing a ball around don’t mind the burn in my lungs ha.

    Best of health to everyone, peace out.

  21. I used to train excessively with up to 25 hours per week and the Standard Australian Diet (SAD). Luckily I listened to Mark’s Daily Apple podcast and was converted. I trained a lot less and ate properly. Even managed a personal best marathon of 3:28 after my 180km bike at Melbourne Ironman. I love Mark’s posts.

    Excess cardio also hurts your family in my article here that also links to Mark’s article:,https://primedforyourlife.com/2015/11/03/5-ways-your-excessive-sporting-activities-could-harm-your-family/

    Great job Mark. Always an inspiration.

  22. Very interesting article. Because over the last fifty two years here on Mother Earth, I can say that of all the types of exercise I have practiced, weight training always made me the happiest. And…I also noticed that I lose weight fastest during weight training. I have been a bicycle racer, mountain biker (non-competitive), white water kayaker, scuba diver and my favorite…rock climber. With a few other crazy things inserted in-between just for good measure.

    Anyway…I definitely prefer going into the gym and lifting weights. And I admit, I love a good trail run on a mountain trail in the Rockies, or out in the desert Southwest. Running the Hermit’s Crest Trail in the Grand Canyon (28 miles) is a favorite.

    Keep on celebrating life!


  23. Enjoyed the article and totally agree with it. One slight issue is the reference to Pilates as being a suboptimal method of exercise. Clinical and Reformer Pilates are both excellent forms of resistance training and are super ways to keep our bodies strong and flexible. This form of exercise was originally designed for injured ballet dancers and has progressed into a full body workout which is excellent for anyone recovering from injury.

    On the subject of knee injuries it is important to use bone broth and stews to build up the carilage. Also one legged squats on a bosu ball are great for strengthening the ligaments around the knee.

  24. Mark, I am new to your readership. As a life-long very active person listening to my body has led me naturally to your suggestions. Namely, I practice aikido. I love how it gives me intense short intervals of cardio with flexibility. Nothing better than falling down and getting up! I also hike in hilly places, which gives again short intervals of intensity. Then I also swim, which is great for toning and stretching. Thanks for your good work!

  25. Good well-balanced article. I;ve run, jogged, done marathons etc in my 56 years. More recently I;ve switched to High Intensity Interval type training, sprinting. I agreee these can produce dramatic effects on body composition and strength and fitness. That said, I still think it’s a case of ‘form follows function ‘ or ‘horses for courses’..i,e, you get good at what you do. For example, I went cycling up some hills with a Spanish visitor last week. I know I;m 11 years older than him and he’s the talent scout for a leading pro cycling team (and in good shape), but I really half expected (with all my sprint type training) to be able to show him who’s the boss (probably a MAN thing). I DID keep up with him..held my own…but I could sense he found the hills and long all-outs along the roads easier than me. Yes, i hear you say, he’s a cyclist. So, I guess that confirms my point: if you take part in endurance races or cycle up hills etc, then you need to have training that mimics those activities..3 burst or interval training sessions for 8 minutes a week isn’t going to do the job.

  26. Thanks, Mark for reminding me that cardio is not my friend! Up until three years ago I ran a half-marathon every year for seven years and ran regularly when I wasn’t training. In all those years (and many before when I was just running to “stay healthy” I never lost one stinkin’ ounce of fat! Then, three years ago, at the age of sixty-three, I started weight training and changed from a vegetarian diet to Paleo (thanks for that too!) and have never felt better!

    Because of a recent shoulder injury, I lost my senses and started running again which made me consider training for another half-marathon. What a timely wake-up call your blog was! This morning, I think I’ll just go walk!

  27. Hi Mark,

    First of all, thanks for great work! Me and my wife, have been following your blog, reading books and applying the lifestyle over last four years and without doubt it has improved our lives.
    This article is very interesting but has confused me a bit. How do I differentiate between slow moving and chronic cardio then? Your article above brings example of 30 mins exercise with 70% max HR, calling it medium intensity cardio. I would think that this duration and HR would qualify it rather as slow movement recommended daily by Primal Blueprint.
    I tend to have a very slow jog 30 minutes almost every day or quite moderate indoor rower 20 minutes exercise as an office work break. Do I do right thing? Thanks a lot for clarifying that…..

    All The Best,


  28. My long distance running destroyed a lumbar disc, caused me to eat what little of my own muscle I had, and gave me prediabetes. (Yeh, I know, n=1…)

  29. Mark,

    I have to disagree. I think longer term endurance training has its place for fit total athletic performance. When I wrestled, we did three mile runs on a regular basis often doing them in fartlek manner. I can say our team had great endurance. I won many matches in the third period when my opponents where too winded to keep going. I watch many high school wrestlers now and rarely see the endurance in the third period I saw when I was in school. Training methods have switched to favor more hit training.

    Personally, I still do longer term endurance work on the bike or rowing machine. I like to go long. I love to have the endurance to enjoy a long hike or walk. To do that I know I need to train to move for a long time. I also lift heavy things and move fast. Bottom line, I have learned to be totally healthy you need to do it all. You need to lift heavy weights, do intense sprint, and yes, do something for a long time. That plan along with changing my diet let regain my health.


  30. Love the anti-cardio articles, but don’t mess with my Pilates Mr. Sisson! To be fair you should note that the majority of people are very de-conditioned and do not have the pelvic, rib cage, or scapular stability for most heavy lifting right off the bat. Being a Pilates instructor myself I agree that one 45 minute Pilates session a week is not likely to get people the results they need but neither will one unsupervised 45 minute session of heavy lifting a week.
    Pilates on the reformer, 2 to 3 times a week (if you can afford it) with a great form focused instructor is a really great on ramp to heavy lifting- if that is your goal.

    1. Plates is awesome! Very challenging. Gives me good posture, balance and strength to do other workouts and cope with my physically active job. Definitely strengthens and builds the muscles.

  31. What if I just enjoy it? Is it really that big of a deal? Some people enjoy binge drinking, some enjoy binge eating, some enjoy watching movies, some enjoy playing video games…I legitimately like to run 8, 10, 15 miles. I have other friends who run who always groan “uggggh I have to do a long run today…” And I always say “If you’re so miserable why do it??” I never want to stop running!

  32. So I’m 51 and while I’ve spent time in the gym for the last 10 years or so, for the past 2 years, I’ve been lifting weights 3x a week consistently along with HIIT 1x a week and have never felt or looked better. That said, I’ve been a cyclist forever and enjoy a 2-3 hour ride once a week as a way to get away, decompress and think. I typically average 16-17 MPH and my heart rate averages around 125 with bursts up to 160 or so in the tougher climbs. Is this really a bad thing? Is this really putting my health at risk? I can certainly understand when I look at the people at the gym who spend all their time on the treadmill, just curious how much of a risk my behavior is. Thanks!

  33. The question “What gets you fitter, faster, stronger, and sexier?” is assuming rather a lot about my priorities. The primal community is a wide, and we’re here for many reasons. I run (2 or 3 marathons a year, probably topping off at 55 miles a week during peak training) and also do HIIT and lift and sprint a couple times a week. The latter probably have helped me get fitter, faster, stronger, and sexier. But these things, and appearance-focused goals associated with physical activity like “leanness,” are so, so much less important to me than feeling good and being happy. Running makes me feel good. It makes me happy. It doesn’t take me away from things I’d rather be doing; it is one of those things.

    “What’s the point?” The point of running — and I’m going to refer to it just as “running” because it’s only during miles 24-25 those two or three times a year that anything about running feels like something to “endure” — is joy. It’s feeling free. It’s feeling capable. It’s being out in the world, whether that’s a trail in the woods or along the river or on neighborhood streets. It’s being alone with my thoughts, or with music, or with great podcasts for about an hour a day or a couple hours on the weekend. But the point is also community: the friendships I’ve formed with fellow runners and the great people I’ve met at big races like Boston and New York. I’ve been running for more than 15 years, and I’m a faster and more joyful runner now in my mid-40s than I was at 30. I’ve never had a serious injury, and since I switched to a primarily paleo diet three years ago, I no longer need the anti-inflammatories I once took from time to time to combat muscle soreness. I am pain free. I have great energy and great knees. I never get sick (and this was the case even when I was eating the high-carb, whole-grain, low-fat way). When I started running all those years ago, the depression that hunted me throughout my teens and 20s went away, and it’s never been back. The point of running is that it enriches the life I’m living now.

  34. I do 20 minute runs every other day.
    I run at as fast a pace as I can, so am out of breath most of the run.

    Is this sprinting or endurance?
    Good for me or bad for me?

    Thanks for any suggestions…..

  35. Honestly, sometimes I wonder about the comments posted that seem to ignore the results of the research and continue to argue about causation v correlation. People have known for years that repetitive running/cardio is not going to cure heart/CVD issues, and in fact may make them worse. And Mark has a lot of experience in running. I used to run too, and in terms of conditioning moderate running (2-3 miles once or twice a week?) might make sense, as one part of some balanced fitness program. If you enjoy it. Why argue with that, unless you have equally valid research to the contrary?

    It looks to me like a lot of the posts relate to people defending what they have been doing and saying: Look, I’m still alive, so that’s proof its ok, or: I do it, and I’m ok, so the research is meaningless (and I don’t want to admit I was wrong…) The fact is that most people make mistakes about various things, from time to time. It’s ok to make mistakes if they don’t kill you and you have a chance to learn to do better. This is that chance.

    When I read things like this I try to compare my goals and my time involved and how the results are, in a reasonable time of following what I think the research says I should do. For now I do intervals with weights, going to momentary muscular failure with an initial set of weight where I can do six reps on the first try. Wait thirty seconds, so it again, probably two reps. I do that three days a week. On the other three days I play tennis, singles, and then doubles, for two hours. And one day off. HIIT works.

    Is exercise alone going to cure diabetes, make you lose weight, end disease of all types? Probably not. But combined with a proper diet and intermittent fasting, it may be quite a bit of help. IF works too, as does a low carb diet.

  36. I did plenty of aerobics classes in my time–can you say Jazzercise? I started running at age 40. The best decision I made was to stop running about three or four years ago. I was having terrible hip pain on the right side, and knee pain on the left (can you say connection?). Now I walk. A lot. No hip pain. I also dropped a few pounds, which has lead to really no hip pain, and no knee pain. And I enjoy walking much more. I get to see what is around me. I get to talk to my walking partner without gasping for air. I can focus on enjoying my exercise time instead of looking forward to when it will be done. And did I mention, no more terrible hip pain?

  37. For those new to exercise, HIIT can be intimidating, especially in group settings (which, paradoxically, are helpful if you’re newly active). Cardio (rowing, swimming, etc.) is a good gateway activity for more challenging HIIT sessions or sprints, so I don’t feel it should be demonized. Also, I doubt the author has ever taken a real Pilates class.

  38. Every time my friends or family discover that I am lifting weights i hear coments “oh, i don´t want bulky”, “do you want to be like those women on tv”. Like that would be easy…

  39. In the TED talk by James O’Keefe linked to in the post, he indicated that when exercising you need to do so at a moderate heart rate.
    So he runs at a relatively slow pace…

    The usualy excercise advice on MDA is replace distance running with sprinting etc…
    Surely this is not what James O’Keefe suggests, sprinting sessions are going to have your heart rate through the roof, if even for short periods your doing the vascular damage as would a distance runner after doing high miles…

  40. I endurance trained and ran long distances for about 10 years up until 2 years ago. I dropped about 25lbs in my initial ramp up phase but still had that “roll” of belly fat and never dropped it. Don’t get me wrong, I was “skinny” but I wasn’t lean. Prior to that I had lifted weights and strength trained quite a bit for years.

    The last few years of running, I was training pretty hardcore. I had friends tell me I looked “too skinny” and I thought they were jealous. After experiencing some injuries and burnout I looked back at some pictures and noticed myself that I did in fact look too skinny. It was an unhealthy look to where my arms and chest looked weak.

    I still run, but not like I used to. I have embraced some body weight routines like push ups and dips…but the diet has gone totally south. So I have gained weight back…even on the gut, That said I am trying to go more primal and pay attention to what I put in my mouth. With the strength training I want to keep the muscle I’ve put on, but have to drop about 10-15 lbs. My routine will consist of more sprints, and “bursts” in my runs…cutting way back on the long distance.

  41. About 20 years ago I used to jog around. Approximately 5-6 kilometers per session a few times each week. Did this for maybe 3 years. At the time I never questioned myself as to why. Today at the age of 55 I question everything I do when it comes to health and fitness. I can say the past five years have been amazing because of an interest in what works best. And it’s only getting better. Don’t “Just Do It”, think about it.

  42. I do hiit and endurance in the hoods. You haven’t take in account the mental benefits of running, for example 1 hour. Maybe from endorphines, but those feelings are very good for us.

  43. Absolutely Mark!
    Exercise is the best medicine. But in the correct dosage.
    Absence of it makes us very ill: diabetes,CAD, obesity, depression etc
    Too much exercise, Too often, or constant, not so beneficial

    Interval training/exercise (stress) bolsters the body. The HPA axis gets time to recover.
    Constant stress (think untreated anxiety, depression) & unrelenting exercise, activate a perpetual state of inflammation in the body. Interferes on big scale with immune system. Think atherosclerosis, diabetes.

    Two hours a day or slightly less, rest 1- 2 days a week?

    Thanks. Great post, Mark!