On Demand Webinar | Understanding & Fueling Your Cardio Workout + Q&A

Understanding & Fueling Your Cardio Workout + Q&A |Webinar with Dr. Harry Pino and Elli Kmiec

Recorded Live 6:30PM, February 11, 2021

Join us as PLC Exercise Physiologist, Dr. Harry Pino, and PLC Registered Dietitian, Elli Kmiec, take you through the ins and outs of getting the most from your heart health efforts – including a 10-minute HIIT workout you can do at home and pre & post workout nutrition suggestions for improved performance. Live Q&A with Dr. Pino and Ms. Kmiec to follow immediately after.


  • Types of Exercise for Heart Health
  • Understanding Heart Rate Zones
  • Using Heart Rate Zones for Maximum Results
  • How Nutrition Impacts Performance
  • What to Eat and Not Eat Pre and Post Workout 
  • Fueling Endurance vs. Strength-Based Training
  • And Much More!

Q&A Overview

Below please find the answers to the questions that were asked during the live webinar. Please note that we did group similar questions into one questions so the exact question as it was asked may not appear. Also note that any questions that could be construed as personal medical advice or business protocols were not able to be answered.

Fitness Q&A

Answered by Dr. Harry Pino, Exercise Physiology Manager at Princeton Longevity Center

Q: How do cardiac stents affect what is being discussed this evening? 

A: Patients generally do not need more than a few hours of bedrest following a stent procedure. It is advisable for patients to start low activity exercise such as walking the neighborhood on level ground for a few weeks following stent placement/angioplasty.  After clearance from your Cardiologist, gradually increase the intensity of exercise. One can expect to reach the pre-disease exercise status within 4-6 weeks of a stenting procedure. Heavy exercise such as lifting weights or walking up steep slopes should be avoided for 4-6 weeks as well and it may be recommended for a post-angioplasty treadmill stress test prior to starting.

Q: What is the formula for determining one’s optimal heart rate range during an aerobic cardio workout?

A: I like to use the formula: 208 – (% intensity x Age)

Q: What’s the most effective way to increase your VO2 max?   

A: One of my favorite ways to increase or improve my VO2max is by doing 300-400 meter sprint repeats at around 90-95% of your max heart rate with 1 minute recovery in between.

Q: I think I’m fairly healthy and am active April-October playing competitive senior softball. As an 80 year old, how would I know if I was “overdoing it?” 

A: There are many ways that might indicate you are overdoing it. Try checking your heart rate in the morning, if you notice that it’s higher than normal after exertion the day before, this could indicate your training is a bit harder than expected. It might also indicate that your nutrition “fueling” component was off the night before as well. Rest is key here. The older we get the more recovery we will need. Active recovery will definitely help your overall performance.

Q: My age is 59 and I routinely reach 185-190 bpm in my intense cycling workouts.  I don’t seem to be impacted the following day(s).  Should I be concerned at exercising at this level, given my age?         

A: First, great Heart Rate response! If you’re fit at this age and you can hold that heart rate, that’s great! If you’re worried about exercising at this level at your age – we do recommend after 40 adding a Coronary Artery Calcium Score or Cardiac CT Angiography to your healthcare regimen and getting clearance from your physician to ensure your heart is healthy enough to keep up with your intense workouts.

I also want to remind you that you will need to develop or train your aerobic base with Continuous Training. This type of training also greatly improves trainees’ aerobic fitness because it keeps the body at the oxygen threshold while exercising. It is good for the heart and for the respiratory system, and most exercises are simple to replicate and perform. Continuous Training can also help trainees lose weight or stay in shape after an injury or avoid injury.

Q: When you have a higher Heart Rate your Blood Pressure shoots through the roof, is BP based on HR?           

A: Blood pressure and heart rate are two different measurements. They are distinctly different factors in heart health. In some situations, such as periods of acute stress or danger, blood pressure and heart rate may both increase at the same time, but that’s not always the case. Your heart rate can increase without any change occurring in your blood pressure. This is often true during exercise, when your heart rate can increase substantially but your blood pressure may only change slightly. I can’t say anything about your specific pattern of changes in heart rate and blood pressure but I can say that if you are worried about the way your heart and blood pressure respond to exercise, ask your doctor if an exercise stress test is appropriate for you.

Q: Is there a particular type of exercise that is best for reducing visceral fat?    

A: I strongly recommend both resistance training and aerobic training, plus nutrition counseling to directly address reducing visceral fat specifically.

Q: As a runner, are heart rate monitors on GPS watches accurate enough, or should I be using a chest strap?    

A: I personally like to use a heart rate strap. It is more accurate. I notice every time I run with my GPS watch the heart rate tends to be off a bit. But if you are not hydrated or rested well, your heart rate will be effected too.

Q: Can you have HIIT days broken up with less intense cardio on interim days?               

A: Absolutely. HIIT can be very modifiable as discussed during the talk. You can work at a lower intensity but the rest period can be shorter as an example.

Q: Do smart watches accurately measure heart rate?    

A: Most wearables will give you a good feedback, however heart rate tends to change greatly with several factors like your temperature, heat , cold, etc.

Q: Sounds like a Tabata workout may possibly not provide enough recovery time.  Guess it depends on fitness level. Thoughts?

A: Absolutely, Tabata is a great way to get fit, however if you need extra time to recover, just cut back on the intensity. You will still get a great cardiovascular effect. So just slow down.

Q: Why do we sometimes hear about people having heart attacks during treadmill workouts? Are these people pushing too hard, or might they have some sort of predisposition that they are unaware of?     

A: Most heart attacks happen in arteries that are 50% blocked or less and are caused by a plaque rupture that quickly blocks off an artery. This process is demonstrated in this PLC YouTube Video. A plaque rupture in the arteries can be caused by many things including exertion while exercising. We always recommend for people over 30 to get clearance from a physician to ensure your heart is healthy enough to start a new workout regimen. After 40, adding a Coronary Artery Calcium Score or Cardiac CT Angiography to your healthcare regimen will give you added peace of mind that you can start, continue or increase intensity with your workout regimen safely.

Q: What is the typical recovery time from a heart rate perspective from 85% max to resting heart rate?              

A: Normally we look at total time to base. We recommend around or within 2-4 minutes. If this is not enough then it could mean you are still not ready to train at 85%, so decrease intensity.

Q: Question on maintaining 70% of my Max HR during the HIIT 1 min rest period.  As a 67 yr old runner with an Apple Watch – I notice my heart rate drops from 130 to 100 in the first min of recovery.  How can I train such that the HR stays above the 0.7 of Max? (During the 1 min rest period)

A: When your heart rate drops that quickly, it is a great sign that you are getting stronger. Your rest periods should be modified to a shorter period of rest.

Q: I am pushing 70 years of age.  I am strictly a fast walker up hills. A typical workout is a good 45 mins then slowdown. Is this good exercise for me?         

A: This is called interval work. If you can keep your heart rate even for the duration of your walk, you are doing great. Play around with the speed; Go 5 minutes faster then 2 minutes a bit slower. It’s a great way to be introduced to intervals. Congrats.

Nutrition Q&A

Answered by Elli Kmiec, Registered Dietitian at Princeton Longevity Center

Q: What is your opinion of the long term effects of a keto type or Low Carb/High Fat (LCHF) diet?         

A: First, I want to start with saying if you are following the keto diet as a medically prescribed diet (i.e. for neurological conditions like epilepsy) this response does not pertain to you, I would advise to continue the diet and continue working with your physician and registered dietitian. For everyone else, my “beef” with keto or any low carb high fat diet is that often it is done for quick (and often dramatic) weight loss results. For most this extreme and quick weight loss is hard to maintain and often results in muscle weight loss especially if followed without appropriate physical activity.

When wanting to follow a LCHF diet for weight loss purposes and not for medical purposes it is important to do so in a modified way to prevent extreme low carbs and subsequent beneficial complex carbohydrates. Complex carbohydrates help prevent visceral fat build up, may decrease risk of some cancers, contribute directly to maintaining a healthy gut microbiome (and subsequently neurological health as well), aid in energy metabolism and more. From a body composition standpoint as well, our muscles need adequate carb intake as muscle fullness actually is dependent largely on carbohydrates. I wouldn’t recommend dipping below 30% of your calories from *complex* carbohydrates while following a LCHF diet outside of medical need.

Q: Is the food in the Optavia diet healthy?

A: I have three health concerns with Optavia:

  1. I prefer diets that rely on intuitive eating (being mindful and in tune with what you’re eating, what it is doing for you, and how it makes you feel). It’s also best to gravitate towards a diet that takes into account social constructs and cultural roles food play and guides you on how to optimize and control “relaxed” food choices. Optavia, I find, removes the ability to learn how to intuitively eat by being too focused on a “yes or no” mentality and treats eating more as a means to an end.
  2. Optavia is heavily meal-replacement-product-based. This will make sustainability of a well-balanced diet and keeping off lost weight more difficult
  3. Optavia claims their products all have close to identical nutrient profiles. Every food at its primary purpose is in contributing to and fueling our health and performance and is meant to be unique. By offering a product portfolio where everything is alike takes the natural benefits from the whole food away and essentially means you are consuming man-altered nutrition.

I would recommend instead looking for a program that encourages whole food consumption, mindful or intuitive eating, nutritional skill and behavior change learning, and lets you be a little human. These companies are easy to spot because they aren’t pushing their own product (real or manufactured); they are pushing food in its most natural form.

Q: Can you make recommendations on hydration during endurance workouts.

A: Hydrations’ role in performance could be an entire webinar on its own! We should be hydrating to a base of 64 oz. per day and then more as needed depending on medication, activity level, environment etc. I only specifically mentioned hydration on the slide for strength-based exercise nutrient windows because for the duration window there is no need to utilize one of the macronutrients if the duration is a small time frame (<45 minutes). Just a friendly reminder that even though we aren’t focusing on a macro during that window for that duration we should still hydrate.

Q: I’ve heard that Omega 3 supplements have not been proven to supply good health, but fish yes.     

A: I always preach food first. Our useful forms of Omega-3 (DHA + EPA) are always going to be more efficiently used by our body when coming from fatty fish in comparison to plant sources (ALA), and supplements. There are also Omega-3 supplements that are not as beneficial due to low absorption rate, low concentration, or low dosage.

Researchers and authors have peer-reviewed the body of research on Omega 3 supplementation and have found sound reasoning for some of the inconclusive and mixed outcomes within the research. These findings include but are not limited to: insufficient blood levels, intake quantity, absorption aide (i.e. was it taken with fat containing meal as directed or not?), varying dosage, poor quality, inappropriate concentration of Omega-3 to 6, and comparing different measurements (i.e., plasma vs blood levels). Again, food sources are always the best and most useful form of DHA and EPA however there are reasons when our dietary consumption of DHA and EPA will not be adequate including environment, lifestyle, and dietary preferences. In this case, a supplement can be effective depending on the choice of supplement.

Some pitfalls to avoid with Omega 3 supplementation are taking a supplement that is more Omega-6 concentrated than Omega-3, buying from a company that does not have high quality and content standards, and supplementing with the ethyl-ester form. These do not promote adequate absorption and are thus less effectiveness. A triglyceride based (fish oil, omega-3 concentrated) and, although packed in small dosages, phospholipid based (krill oil) are the most highly absorbable and effective options.

Q: How do you get a high Potassium level in your blood?           

A: Our kidneys are responsible for the regulation of many vitamins and minerals in our blood, including potassium. If you have good kidney function, they are pretty good at removing extra potassium. If you have no other complications** it is recommended to consume 3,500-4,700mg of potassium per day. Unfortunately there is no set “toxic” level for healthy adults due to inconclusive research. However, there are many causes to why the kidneys are functioning at reduced capacity or are struggling to keep up with the excretion of potassium from your blood. **These factors or complications include but are not limited to: excessive intake beyond recommended daily mg, excessive supplementation, dehydration, medications, chronic kidney disease, acute kidney injury, Addison’s disease, Rhabdomyolosis, Type 1 Diabetes and more. Please reach out to your doctor if you are concerned about your blood potassium levels.