#305 ‒ 心率变异性：如何测量、解读并利用HRV优化训练与健康 | Joel Jamieson

这代表的是迷走神经、副交感神经系统对心脏窦房结的输入。

And what that represents is the input of the vagus nerve, the parasympathetic system and it's input into that sinoatrial node of the heart.

从根本上说，自主神经系统主导着心率，而在静息状态下，主要是通过迷走神经的副交感系统发挥作用。

Because fundamentally the autonomic nervous system is governing that heart rhythm and primarily what happens at rest is that parasympathetic system via the vagus nerve.

它的作用机制是通过神经支配心脏的窦房结，并与呼吸过程同步搏动。

And the way that it works is it's innervating that sinoatrial node in the heart and it's pulsing in beat with respiratory processes.

因此，当我们吸气时，迷走神经受到抑制，心率会相应加快。

So as we inhale, that vagus is inhibited and you get kind of this acceleration of heart rate.

实际上，我应该退一步说。

Actually, should back up.

如果你切断了自主神经系统，心脏的固有心率大约为每分钟100次，就在这个范围内。

If you were to cut out the autonomic nervous system, you'd have roughly an intrinsic heart rate of about 100 beats per minute, somewhere in that range.

我们再退一步说。

Let's back up even a

再远一点，乔尔。

little further, Joel.

我觉得你和我在这里有很多事情都会视为理所当然。

I think there's a lot that you and I would take for granted here.

所以，神经系统的入门知识，广义上来说，我们有两个神经系统。

So nervous system 101, we have two nervous systems broadly speaking.

一个是我们能控制的，另一个是我们无法控制的。

We have one that's under our control and one that is not.

你和我所做的大多数事情，比如人们能观察到的运动和说话，这些都属于我们自愿控制的范围。

Most of what you and I are doing that people can watch the movement speaking, all of these things, that's voluntarily under our control.

但大多数人看不到的是，当他们观察自己时，有多少事情是在没有任何意识参与的情况下发生的。

But what most people can't see when they're looking at themselves is how many things are happening without any input.

感谢上帝有这个系统。

And thank God for that system.

这个系统被称为自主神经系统。

That system happens to be called the autonomic nervous system.

如果没有它，我们会忘记呼吸，最终死亡。

Without it, we would forget to breathe and we would die.

我们的心脏会停止跳动。

Our heart would stop beating.

因此，所有这些至关重要的功能——从呼吸到心跳，到调节血压，到消化——都必须通过一个我们从不思考的神经系统来完成。

So all of these vital functions from respiration to heart beating, to regulating blood pressure to digesting have to happen via a nervous system that we never think about.

这个系统进一步细分为你已经提到的两个术语：交感神经系统和副交感神经系统。

That system is further subdivided into the two terms you've already brought up, a sympathetic system and a parasympathetic system.

你已经暗示了副交感神经系统中最重要的神经之一——迷走神经，它是一条脑神经，起源于大脑非常原始的部位。

And you've already alluded to one of the most important nerves in that parasympathetic system called the vagus nerve, which is a cranial nerve, so originates from a very primal part of the brain.

我们不一定深入讨论这些过程中涉及的所有神经递质，但你基本上是在说，心脏同时受到这两种系统的影响。

And we won't necessarily get into all the neurotransmitters involved in these things, but what you're basically describing is that the heart is under the influence of both of these.

没错。

Exactly.

一个能说明你观点的例子是：当患者接受了心脏移植后，作为极端案例，迷走神经会被切断。

An example that gets to your point is after a patient has undergone a heart transplant, as an extreme example, that vagus nerve is transected.

他们的心脏不再受这种控制，因此只会

Their heart is no longer under that control and therefore it's just going to have

在这种情况下，你会看到心率变异性基本为零。

And you would see a heart rate variability basically zero in that scenario.

它就会像节拍器一样。

And it would just be like a metronome.

是的。

Yep.

好的。

Okay.

抱歉打断一下，但我认为这可能对大家理解我们讨论的内容有帮助，那就是，尽管那个人的心率是每分钟60次，但交感神经系统和副交感神经系统之间仍然存在非常精细的相互作用。

So didn't mean to interrupt, but I think that might be just helpful context for people to sort of understand what we're talking about, which is you're talking about even though that person's heart is beating at 60 beats per minute, there's still a very fine interplay between what the sympathetic nervous system is doing and what the parasympathetic nervous system is doing.

对。

Yeah.

我们或许还应该再退后一步。

And we should probably even back up a little bit more.

我们之所以需要这种自主神经系统，是为了让我们的生理状态保持在正常范围内，这样才能产生能量并维持生命，对吧？

The whole reason that we need this autonomic nervous system is to keep us physiologically within these normal ranges that we have to be in to be able to produce energy and stay alive, right?

所以，如果我们的血压过高或过低，血糖过高或过低，体温异常——所有这些情况都必须在生理正常范围内维持，我们称之为稳态，即无论外部环境如何，内部环境都必须时刻受到调控。

So if our blood pressure goes too high or too low, if our blood glucose gets too high or too low, if our body temperature gets all of these things happen within physiological norms and we'd call that homeostasis that the internal environment has to be controlled at all times regardless of the external environment.

因此，无论我们处于何种温度、摄入何种食物、进行何种活动，我们都必须能够调节内部状态，保持在生存所必需的生理正常范围内。

So whatever temperatures we're in, whatever we're eating, whatever we're doing, we have to be able to regulate internally and stay within these physiological norms that are necessary for survival.

而这正是自主神经系统根本的职责。

And that fundamentally is what the autonomic nervous system is doing.

它维持着我们的生命，努力根据外部环境的变化，使内部需求与我们的行为相匹配。

It's keeping us alive and it's trying to match the internal demands with whatever we're trying to do given the external environment.

所以，正如你所说，人们可能听说过这两个分支：交感神经系统的‘战斗或逃跑’反应，以及副交感神经系统的‘休息与消化’状态。

So, like you said, people have heard of probably these two branches, the sympathetic, the fight or flight or the parasympathetic, which people call rest and digest.

这种说法有助于理解，但它让我们只想到……

Now, that's a good terminology to understand but it makes us only think of the

交感神经，这种说法不够细致。

sympathetic Yeah, it's not nuanced enough.

确实不够细致。

It's not nuanced enough.

它还让我们误以为交感神经只有在你压力大的时候才活动。

It also makes us think the sympathetic isn't doing anything less Unless you're under stress.

对吧？

Right?

其实并不是这样。

It's not really like that.

这些机制并不是非黑即白的。

These things aren't binary.

它们不是简单的开关，不会只是开启或关闭。

They're not switches that turn on or off.

更好的理解方式是，它们像是大脑不断调节的旋钮。

A better way to think about these is dials that the brain is constantly manipulating.

而听觉系统的作用，从根本上说有两个方面。

And fundamentally, what the auditory system is doing is twofold.

一是它的感知功能。

One is it's sensory.

大量信息必须传送到大脑，以处理体内环境的状态。

A lot of information has to go up to the brain to process what the internal environment status is.

然后大脑需要做出决策，并将运动指令下达到各个器官，以确保它们根据身体状态及其与外部世界的关系正常运作。

And then the brain has to make decisions and push motor action down to the different organs to make sure that they're doing what they need to do, given the state of the body, given its external relationship with the world.

因此，我们越能调节内部环境并匹配外部环境的需求，就越健康。

So fundamentally, the more we can regulate our internal environment and match the demands of our external environment, the healthier we're going to be.

我们会更具适应性。

We're going to be more adaptable.

我们的整体功能也会更好。

We're going to have better overall function.

我们大概会简单地说，这是更全面的健康。

We probably would just say it's broadly better health.

因此，交感神经和副交感神经之间的相互作用，以及确保它们能恰当地履行各自职能，是保障我们随着年龄增长身体仍保持健康的关键因素。

And so the interplay between that sympathetic and that parasympathetic and making sure they can do their jobs appropriately is a really big piece of making sure that our bodies are going to stay healthy as we age.

因为如果从整体来看衰老，我认为我们失去的是适应能力。

Because I would say fundamentally if we look at aging as a whole, we lose adaptability.

我们对锻炼的反应速度变慢了。

We lose the ability to respond to workouts as quickly.

我们更容易受伤。

We become more likely to become injured.

当我们生病时，康复所需的时间更长，这是因为身体自我调节的能力随年龄增长而下降。

When we get sick, it takes longer to get over that and that's just the body's ability to regulate itself, decline with age.

所以，话虽如此，在静息状态下，我们的交感神经活动应该非常低。

So anyway, with that said, at rest, we should have very little sympathetic activity going on.

我们可以从清醒和睡眠的角度来讨论这个问题，这是两种不同的状态。

And we can talk about this in terms of waking versus sleeping, those are different things.

是的，我想谈谈这个。

Yes, I wanna talk about that.

当我们坐着或躺着时，交感神经的活动水平本来就很低。

We have a pretty low level of sympathetic just sitting down or laying down.

而在静息状态下，副交感神经的活跃度会更高，因为我们不需要交感神经系统提供的额外能量。

And at rest, that parasympathetic dial is going to be higher because we don't need this additional energy that the sympathetic system can drive.

因此，在休息时，我们主要测量的是副交感神经对心脏的输入。

So at rest, we're primarily measuring that parasympathetic input into the heart.

正如我提到的，它会随着我们的呼吸而开启和关闭，这被称为呼吸性窦性心律不齐；当我们呼气时，这个调节器会略微上调，而当我们吸气时，它会略微下调。

And as I mentioned, it turns on and off with our respiration, it's called respiratory sinus arrhythmia, and as we exhale, that dial turns up just slightly, and as we exhale, it turns down just slightly.

但主要发生的情况是，我们在吸气时抑制了迷走神经的输入，而在呼气时则解除这种抑制，让迷走神经正常或不正常地发挥作用。

But mostly what's happening is we are inhibiting that vagal input as we breathe in, and we are letting it function correctly or not correctly, but we're disinhibiting it as we breathe out and as we exhale.

因此，你看到的是迷走神经对心率产生的脉冲式影响：心率加速、减慢、再加速、再减慢。

And so you're seeing just this pulsation type effect of that vagus nerve on the heart rate accelerating and then slowing down and then accelerating and then slowing down.

所以，你看到的是这种输入随着呼吸周期而波动。

So you're seeing that input pulsing with our respiratory cycles.

因此，当我们测量心率变异性时，无论采用何种方法，最终都是为了理解这种张力——我们称之为迷走神经张力，即迷走神经对心律的输入，而我们正是试图以此作为功能性指标，来评估我们的自主神经系统，特别是副交感神经系统的状态。

And so when we measure HRV, regardless of how we do it, we're ultimately trying to understand that tone, we call it vagal tone, that input of that vagus nerve into the heart rhythm and that's what we're trying to then gauge as a functional marker of what our autonomic nervous system, specifically the parasympathetic nervous system is doing.

它如何应对我们周围的环境？

How is it responding to the world around us?

它如何应对过去24到48小时内我们所做的事情？

How is it responding to what we've done in the last twenty four, forty eight hours?

它的静息张力是多少？

What is its resting tone?

它实际有多少输入？

How much input does it actually have?

基于此，我们试图获得其他所有我们可以讨论的洞察。

And from that, we then try to gain all the other insights we can talk about.

为了闭环讨论测量问题，大多数人使用的设备可能都是基于RMSSD算法来计算HRV的。

And then just to close the loop on the measurement thing, most people are using devices that are probably calculating the HRV on the RMSSD algorithm.

是的，大多数

Yeah, most of

商用设备都是这样。

the commercial ones.

是的。

Yeah.

是的，这是一种对数据进行的基本转换。

Yeah, it's a transformation that's basically run on the data.

如果我没记错的话，我们可以马上算出来。

And if my memory serves me correctly, mean we could figure it out right.

均方根，标准差。

Root mean square, the standard deviation.

连续平方。

Successive squared.

标准差的连续平方。

Successive squareds of standard deviation.

所以你基本上会说平均值或均值是x，标准差是这个，然后你可能要做平方和的平方根。

So you're basically gonna say average or mean value is x, standard deviation is this, and then you probably do a sum square square root of.

没错。

Exactly.

是的。

Yeah.

你就能得到你的数值。

You get your number.

现在，我认为唯一不同的是苹果手表。

Now, the only one I'd say that's different is Apple Watch actually.

他们使用一种叫做SDNN的方法，也就是R-R间期的标准差。

They use what's called SDNN, which is just the standard deviation of the B to B intervals.

他们为什么要这么做？

Why they do that?

我不确定。

I'm not sure.

这是一种在医学上长期使用的指标，通常会测量24小时，然后看看你是否有自主神经变化。

That's one that's historically been used medically and they'll usually measure it for twenty four hours and they'll just kinda look at like, do you have any autonomic variation?

副交感神经系统功能是否正常？

Does the parasympathetic system function well at all?

这是一种比较粗略的测量方式，远不如我们精确测量特定时刻的迷走神经输入来得细致，因为我们是跨较长时间段进行测量，也许这就是他们这样做的原因。

And it's kind of a gross measure, it's not nearly as nuanced because we're not measuring vagal input at a particular time, we're just measuring across longer periods of time and maybe that's why they did that.

在我看来，这也会引入一些噪音，因为你把静息状态和活动状态混在一起了。

It seems to me that that would also introduce a bit of noise because you're combining being at rest with being active.

是的，正是如此。

Yeah, exactly.

而且你会——我不知道这词是否准确——但你会因为人们更活跃而惩罚他们，因为运动越多，运动期间交感神经张力就越强，心率变异性就被压制得越厉害。

And you would I don't know if it's the right word, but you'd be penalizing people for being more active because the more you exercise, the more sympathetic tone you have during exercise, the more you're crushing the variability.

对。

Yeah.

有趣的是，苹果基本上是随机测量的。

What's interesting is Apple is just kind of measuring randomly for the most part.

它只是在你不知道的时候进行测量，你也可以手动测量，我们可以谈谈，这实际上是一种更好的方法。

It just kind of measures when you don't know and you can do a manual measurement, which we can talk about and you can actually check it, which is a better way to do it.

但不知为什么，他们用了这个别人从不使用的指标，然后在你不知道正在发生什么的时候定期测量。

But for whatever reason, they've just used this metric that nobody else uses and then they kind of measure it periodically when you don't know what's happening.

所以你得到的这个数字，如果你没有主动测量，就完全不知道它是从哪里来的。

And so the number you're just kind of getting in there, if you're not actively measuring it, is just kind of like I don't know where it comes from.

我记得几年前我在一个关于心率变异性（HRV）的AMA问答中提到过几件事，我们会在节目笔记中附上链接，以便有兴趣的人可以回去查看，作为HRV的入门资料。

So couple of things that I remember from a AMA that I did on heart rate variability a couple of years ago, and we'll link to it here in the show notes so that people can go back if they want a real primer on HRV.

我们之所以就这个问题做了一次AMA，是因为很多人对此提出了疑问。

The reason we did sort of an AMA on that was a lot of people had questions about it.

坦白说，我觉得我们当时并没有深入到这么详细的程度。

Frankly, I don't think we went into nearly this level of detail about it.

我们更多地讨论了死亡率数据之类的内容，但那是最早引起我注意的点之一。

We talked much more about the mortality data and things of that nature, but that was one of the first things that stood out.

乔尔，我印象最深的有两件事。

Two things I remember more than anything, Joel.

第一点是，在研究文献中，作为HRV测量的指标，与全因死亡率乃至特定疾病死亡率之间存在关联，我们应该谈谈HRV到底意味着什么。

The first is there was a relationship between in the research literature, what was measured as HRV, we should talk about what that means, and all cause mortality and even disease specific mortality.

第二点让我印象特别深刻的是一个图表，我永远都不会忘记，横轴是年龄，纵轴是HRV，曲线的走势是怎样的。

The second thing that really stands out is a graph that I'll never forget that shows on the x axis age, on the y axis HRV and what the curve looked like.

我简直不敢相信它的下降速度竟然如此陡峭，对吧？

I couldn't believe how steeply it declined, right?

而且我认为，如果我没记错的话，它绘制的是平均值或中位数HRV，并附带一个大约80%或四分位距的区间。

The And I think what it was plotting, if I'm not mistaken, was kind of mean or median HRV with a band of call it the 80% or interquartile range or something like that.

但这是一个非常明显趋势，50岁的人的HRV不到15岁人的一半。

But it was an unmistakable trend, which is like a 50 year old's HRV is less than half of a 15 year old's.

随着年龄增长，这种差距变得越来越悬殊。

It just keeps getting further and further crushed as we go down.

我想这印证了你之前说的，衰老的标志之一就是这种缺乏恢复力。

I suppose that speaks to what you said earlier, which is one of the hallmarks of aging is this sort of lack of resilience.

我们在各个层面都能看到这一点，但这是一个非常显著的例子——即使在自主神经系统层面，我们也丧失了从损伤中恢复的能力。

We see it on every level, but this is just a very notable example, which is even at the level of the autonomic nervous system, we lose the ability to recover from insult.

而生活本身就是一种损伤。

And life is an insult.

生活中的一切都是对我们的损伤。

Everything in life is an insult.

我们周围的世界无时无刻不在对我们造成伤害。

The world around us is insult to us all time.

只是当我们年轻时，能更好地应对这些伤害。

It's just we can respond much better to it as we're younger.

是的

Yeah.

顺便问一下，你知道随着年龄增长，HRV出现这种显著下降的细胞层面生理机制是什么吗？

Do you have a sense by the way of what it is physiologically at the cellular level that is resulting in this profound reduction in HRV as we age?

他们研究过

They've looked at

这个问题，但我不确定我们是否对确切的生理机制有很好的答案。

this and I don't know that we have a great answer for the exact physiological mechanism.

我们知道这与线粒体密度和线粒体功能有关。

We know it's tied to mitochondrial density, mitochondrial function.

我们知道这与免疫系统的某些成分有关。

We know it's tied to elements of the immune system.

我们知道这与荷尔蒙状态有关，显然随着年龄增长，这些方面都会下降。

We know it's tied to hormonal status and we obviously see decreases in all those things as we age.

你只是

You just have

去思考哪些是因果关系，哪些是结果。

to wonder which ones are causal and which ones are the response.

别以为

Don't think

我们不知道，但我们确实知道，可以通过心血管健康来延缓衰老，至少最有效地防止HRV的下降。

we know that but we definitely know that we can increase our age of year, we can at least prevent the decline most effectively through cardiovascular fitness.

我们看到VO2更高的人，线粒体功能更强，他们的VO2更高，这会导致或至少与更高的HRV相关。

We see people with higher VO2s, higher mitochondrial function, they have higher VO2 that leads to or at least correlates with greater HRV.

因此，我们了解到，总体而言，心血管健康与平均HRV的关系最为密切。

So we know that cardiovascular fitness in general seems to be the most closely tied to average HRV.

还有一个相当强的遗传因素，我们不能忽视，我们可以谈谈这个。

There's also a pretty strong genetic component which we can't ignore, we can talk about that.

但是的，如果你看一下衰老的标志论文，我相信你已经看过，它们会把这些因素归为几大类，对吧？

But yeah, if you look at the hallmarks of aging paper, which I'm sure you've seen, they kind of take these buckets of things, right?

它们说，随着年龄增长，你会出现菌群失调、营养感应失调、衰老细胞、干细胞耗竭、线粒体功能衰退。

They say, Oh, as you age, you get dysbiosis, you get deregulated nutrient sensing, you get senescent cells, you get stem cell exhaustion, you get mitochondria.

他们列出了我们衰老过程中发生的所有这些变化，并从这个视角审视什么是最终结果。

They list all these things that happen as we age, and they kind of look at this prism of what's the output.

如果你仔细阅读，他们会说：好的，主要的两个结果是对稳态的恢复力下降，以及无法对周围环境做出恰当的压力反应。

And if you read that, they say, Okay, the output, two of the major things are loss of resilience to homeostasis and lack of a stress response that's appropriate given the world around us.

所以，关于因果关系以及哪个是因、哪个是果，确实很难说清楚。

So yeah, where that cause and effect and which one's causing the other is tricky to say.

但我认为，衰老本质上是一种逐渐丧失适应能力的过程，这其中显然包含多个方面。

But I think fundamentally aging is this progressive loss of adaptability and there's multiple pieces to that obviously.

但正如你提到的，我们正在测量的正是我们想要评估的关键点之一：随着年龄增长，我们失去了多少这种恢复力和适应能力。

But we're measuring that, as you mentioned, is one of the things that we want to gauge of HIV is how much of that resilience of that adaptability are we losing as we age.

而这一点我们可以通过生活方式、训练以及其他我们正在尝试采取的措施来加以影响，以防止这种衰退。

And that's something we can influence through lifestyle and training and everything else that we're trying to do here to prevent that slowdown.

在那次AMA中，我没能得到一个很好的回答是：遗传在其中扮演了多大作用。

One of the things in that AMA that I didn't get a great answer to was how much genetics played a role on this.

但从我们的患者群体来看，尽管样本量并不大，但我们已经多年观察这些患者的数据，发现他们每个人都使用某种设备。

But from our patient population, because even though that's not a huge N, we've got years and years of seeing these data in patients where every single one of them is using some sort of device.

顺便说一下，还有一些我们没提到的设备。

By the way, it's even devices we haven't talked about.

比如一些高端产品，像床垫罩之类的，Eight Sleep现在能非常准确地测量这些数据。

Like if you look at really high end things like mattress covers and things like that, like the Eight Sleep will now measure that quite accurately.

所有类型的可穿戴设备都在不断产生海量数据，而且人与人之间的差异非常明显。

Every form of wearable and out, you've got endless streams of data and there's an unmistakable difference between people.

有些人——我们不妨以RMSSD为例，我们也应该谈谈其他指标，因为必须做到同类型对比。

There are some people who And let's just talk about this in RMSSD, we should talk about the other numbers because you have to do this apples to apples.

如果我们只谈RMSSD，我有一些患者，正常情况下他们的数值是100，状态好的时候能达到120，状态差的时候则降到85。

If we just talk RMSSD, I've got patients who live at 100 and a good day for them, a good day for them, they're at 120 and a bad day for them, they're at 85.

但如果你跟踪他们五年，他们的平均HRV会稳定在100毫秒左右。

But if you follow them for five years, their average HRV is going be a hundred milliseconds.

而我还有另一些患者，他们的平均HRV只有15毫秒，状态好的时候是25到30，状态差的时候则降到10。

I've got other patients whose average HRV is fifteen milliseconds and a good day for them is 25 to 30 and a bad day for them is 10.

这种情况还能用什么来解释，除了基因因素？

How could that be explained by something other than genes?

不是的。

It isn't.

我的意思是，我查阅了很多研究，只是为了理解。

Mean, I've looked at a bunch of research just to understand.

根据你参考的论文和他们计算的指标，结果差异很大。

It's all over the map depending on what paper you're looking at, depending on which metrics they calculated.

他们说遗传因素对HRV的影响大约在15%到70%之间。

They say genetics is somewhere between like fifteen and seventy something percent of HRV.

研究中看到的数据范围实在太广了。

There's just such a wide range in the research of what you see.

具体数值是多少，我不确定，但你确实能明显看出遗传成分的影响很强。

Where the exact number falls, I'm not sure, but you definitely see a very strong genetic component to it.

为什么？

Why?

我认为我们还没有真正理解这一点。

I don't think we truly understand that.

但正如你提到的，我见过一些根本不锻炼的人，他们走进健身房或其他地方，你看看他们的数据，会发现他们的HRV非常高，这与你预期的、他们明显缺乏心血管健康水平的情况不符。

But as you mentioned, I see people who don't work out at all and they come into the gym or they whatever and you look at their numbers and you're like, you have a very high HRV that you would not expect because you clearly don't have a very high level of cardiovascular fitness.

但总的来说，如果你去和这些人聊聊，他们往往

But I'll say kind of as a whole, if you start talking to those people, they tend to

有着更健康的家族病史，健康指标也更好。

have a healthier family history, they tend to have better health markers.

我觉得这背后确实有原因，这种较高的HRV可能仍然与健康益处相关，即使它并非来自运动带来的影响，而只是他们天生的遗传特质，这种特质可能带来了保护性优势。

I think there's something to that and that higher HRV probably still correlates to a health benefit even if it doesn't necessarily come from exercise derived means, it's just a genetic thing that they have that probably had conversion benefit.

你会不会把HRV和VO2 max放在同一个类别里来比较？

Would you put HRV in a comparable bucket to VO2 max in terms of the following?

在遗传决定的比例、可调节的比例，以及它在理解整体健康状况中的作用方面？

Amount of it that is genetically determined, amount of it that is modifiable and the role it might play in understanding overall health status.

对于VO2 max，我知道这些问题的答案，对吧？

For VO2 max, I know the answers to all those questions, right?

它确实有遗传成分，但并不大。

There is a genetic component, it's not huge.

它可能更接近百分之十五，而不是百分之七十。

It's probably closer to that fifteen percent than seventy percent.

它高度可改变，但很难改变。

It's highly modifiable but difficult.

正因为它是高度可改变但难以改变的，所以我相信——你可能听过我说过——它是目前我们拥有的最强的死亡率预测指标。

And the fact that it's highly modifiable but difficult to modify is why I believe it is, and you've probably heard me say this, the single greatest predictor we have of mortality.

如果还有更好的指标，我很想听听，但我还没见过。

If there's a better one out there, I'd like to hear it, but I haven't seen one.

我认为这是因为我一直把VO2 max看作是大量努力的综合体现。

I think that's because I always talk about VO2 max as like the integrator of so much hard work.

你无法临时抱佛脚。

You can't cram for the test.

如果你的VO2 max处于前1%，那你不是天生如此，而是通过流血、流汗和泪水才达到的，而所有这些努力都为你带来了巨大的益处。

If your VO2 max is in the top 1%, you weren't born there, you blood, sweat and tears your way to that and all that work does so much good for you.

好的。

Okay.

那么，让我们用这个框架来评估心率变异性。

So let's use that framework to evaluate HRV.

它有多大的遗传性？

How genetic is it?

它有多大的可塑性？

How modifiable is it?

而你为改善它所付出的努力，是否真正指向了关键问题——即，如果一个人的心率变异性提高了50%，我们有多大把握认为这真正影响了他们生活的实际结果，而不是那个无意义的数字？

And are the modifications you have to put into it then speak to, hey, if somebody improves their HRV by 50%, how confident are we that that moves the needle in terms of what actually matters, which is not the silly number, but actually the outcome of their life.

不。

No.

我认为它更偏向遗传，根据我所见，可塑性可能也较低。

I think it's more genetically based just from what I've seen and probably a bit less modifiable.

我认为它的预测价值较低，比如，如果我遇到一个心率变异性为110的人，而另一个人的VO2 max我知道是70。

I would say it's less predictive in the sense that if I have somebody who's got an HRV of a 110 to use your example or whatever, then and I have someone who's got a v o two max I know is, I don't know, 70.

我几乎可以确定，那个VO2 max为70的人体能非常出色，他们过着相当健康的生活方式，并付出了大量的努力和训练才达到这个水平。

I can pretty well know that person with a v o two max of 70 is pretty robotically fit and they've lived a pretty solid lifestyle and had to done the the work and the training to get that level.

我更确信，那个有锻炼习惯的人的寿命会因此受益，而不是那些只是HRV高但没有锻炼史的人。

I'm more confident that that person's longevity would be fitted and and affected from that, then I'm confident than somebody who has no workout history that just has a high HRV.

我不敢说，仅仅因为某人的HRV较高，就认为他们在全因死亡率上具有相同的预后价值。

I don't know that I could say the same comments at all just because they have a higher HRV that they would have the same prognostic value in all cause mortality.

所以，这是一个我们并不用来衡量产出的指标。

So it's a metric that we aren't gauging output from.

我们只是在测量这种内在的生理状态，我认为高HRV会给人们带来益处。

We're just measuring this internal physiological state, and I think that confers benefits to someone who has higher HRV.

但我不能单凭这个数字就断定这个人非常健康或非常健壮，因为你确实能看到更强的遗传成分。

But I can't necessarily just look in that number and say, Oh, this person is really healthy or this person is really fit necessarily because you do see that much stronger genetic component.

如果我看到一个人VO2max高，同时HRV也高，那很可能反映了我们刚才讨论的所有因素——健康的生活方式、大量的心脏训练，以及由此带来的生理变化，我们更有信心这些数值与全因死亡率相关。

Now if I see a coupling, if I see some with a high VO two and I see higher HRV, chances are that's reflective of all the things we just talked about, a healthy lifestyle and a lot of heart training and physiological changes that come as a result of that and we're more confident that those numbers are going to line up with all cause mortality.

Joel，对这一点的一个很好的解读方式如下。

A nice way to interpret that Joel would be the following.

尽管很多人在担心自己的HRV，而且确实很在意，但你更应该关注自己的VO2max，因为你对它有更大的控制权，而且它对全因死亡率的预测能力更强。

As much as people are worrying about their HRV and people really do worry about it, you should worry more about your VO2 max because you have more control over it and it's a better predictor of all cause mortality.

我认为，被测量的东西才能被管理，对吧？

I think that what gets measured gets managed, right?

因为HRV太普遍了，它被大量输出，现在你甚至去星巴克，他们都能通过你嘴唇压在杯子上的压力推算出你的HRV——我这是在开玩笑。

Because HRV is so ubiquitous and it's so spit out and basically you're at the point now where if you go get a Starbucks, they'll tell you your HRV, that they've somehow inferred from the pressure your lips put on the cup, I'm being facetious.

每个人都被这些数据淹没，这造成了很多压力。

Everybody is inundated with these data and it is creating a lot of stress.

是的。

Yeah.

我认为我们应该关注输出指标。

I think we want to look at output measures.

VO2 max是最好的输出指标。

VO2 max is the best output measure.

我们可以关注心率和二区心率。

We can look at something like heart rate and zone two.

心率恢复。

Heart rate recovery.

心率恢复。

Heart rate recovery.

我们可以关注实际的输出指标，因为归根结底，我认为这才是真正重要的。

We can look at actual output measures because at end of day, I fundamentally think that's what matters.

随着年龄增长，我们需要能够持续活动，并继续对周围环境做出反应。

As we age, we need to be able to continue to move and we need to be able to continue to be able to respond to our environment around us.

而输出指标正是我们能够观察这些数据的地方。

And output is where we can see those metrics.

我们活动所需的代谢成本是多少？

What's the metabolic cost for us to move around?

如果我们能在衰老过程中保持活动能力，就能保持高度活跃。

If we can maintain movement as we age, we can be highly active.

如果你观察你身边健康的老年人，很多人都是非常活跃的。

If you look at people that you know around you that are healthy and older, a lot of them they're very active.

他们四处走动，有爱好，有朋友，社交活跃，做自己热爱的事情，这些对于保持他们的健康和韧性至关重要。

They move around, they have hobbies, they have friends, they're social, they do things they love and that's a big part of keeping them healthy and resilient.

如果我们没有足够的代谢能力来活动，我们的衰退速度就会快得多。

If we don't have the metabolic capacity to move, we've declined a lot faster.

因此，VO2最大值和不同速度下的心率，能够反映我们活动能力以及随着年龄增长维持这种能力的水平。

And so again, VO2 max and heart rate at different speeds, that correlates the ability to move and maintain that as we age.

我认为，这比那些虽然重要但预测力不如它的内部指标更具预测价值。

That's far more predictive I think than just an internal metric that you know, is important but isn't does not have the same predictive power.

你有孩子吗？

Do you have kids?

我没有。

I don't.

所以任何有孩子的人，尤其是有年幼孩子的，都会理解我接下来要说的：我变得更加关注一个我想推广给全世界的指标，它与你描述的内容相关，叫做自发性活动。

So anybody who's got kids, especially young kids will appreciate this comment, but I've become so much more cognizant of a metric I would love to introduce to the world that ties into what you're describing called spontaneous movement.

我是个老头了，尽管我的体能符合我的年龄，但我并不浪费太多活动。

I'm an old guy and even though I'm fit for my age, I don't waste a lot of movement.

所以我已经到了人生中的这个阶段，实际上觉得自己挺懒的。

So I'm already at that stage in my life where I actually think of myself as quite lazy.

我喜欢锻炼，显然在锻炼的时候我并不懒。

So I love to exercise and obviously I'm not lazy when I'm doing that.

但当我穿过机场时，我只是在走路。

But if I'm walking through the airport, I'm just walking.

我会选择走楼梯而不是乘自动扶梯，这些我都懂。

I will use the stairs and not the escalator and all that stuff, I get it all.

但如果你和我的孩子在一起，我两个儿子分别是六岁和九岁，他们那种自发的、爆发式的活动量，是我小时候不记得自己做过的，尽管我相信我小时候也做过。

But like if you're with my kids and my two boys are six and nine, the amount of spontaneous explosive movement is something I don't remember doing as a kid, although I'm sure I did it too.

但这真的是一件了不起的事。

But it's really a remarkable thing.

我们还养了一只小狗。

We also have a puppy.

这只小狗也到处蹦蹦跳跳，撞墙。

So we have this puppy that also is bouncing off walls.

但当你看到老狗时，这种行为就没了。

But when you see older dogs, that's done.

一只14岁的狗，即使健康状况良好，也不会再到处乱蹦乱跳。

A 14 year old dog is not even if it's in good health for its age, it's not bouncing off the walls.

而那只小狗却停不下来。

Whereas that puppy can't stop moving.

当我看着我的两个儿子时，也是这样，无论去哪儿，他们都要比赛跑步。

And the same thing like when I look at my boys like everywhere we go, have to race.

每件事都变成了一场竞赛。

Everything is a race.

他们到处冲刺跑动。

They're sprinting there and about.

所以当我们走路时，他们一路上不停地来回冲刺。

So if we're walking somewhere, they're doing sprints to and from us the whole time.

我只是觉得，这种状态很美好，而且我认为这体现了青春的本质。

I just think a, there's something beautiful about that and it's But I think it speaks to this idea of youth.

青春就是关于活力与运动。

Youth is about movement.

它将我们食物中的化学能转化为驱动肌肉和自发运动的电能，这种自发运动似乎正是如此。

It is converting the chemical energy of our food into the electrical energy that powers muscles and spontaneous locomotion seems to be this.

我不知道，但有朝一日我真想知道，是否能将这种自发运动作为另一个输出指标。

I don't know at some point like I would love to know like is there a way to take that as another output metric which is

就像给某人装个GPS一样。

Like a GPS on somebody.

是的，正是如此。

Yeah, exactly.

那种毫无明显原因却依然想要自发运动的驱动力究竟是什么？

Like what is the drive to spontaneously move for no apparent good reason?

我们常说会失去心率变异性，对吧？

We talk about we lose HRV, right?

但我们也失去了交感神经的驱动力。

But we also lose sympathetic drive too.

我们失去了一些

We lose some of

随着年龄增长，这种提高交感神经水平的能力也会下降。

that ability to turn that sympathetic dial up as we get older too.

很可能是因为我们失去了这两种能力：无法再提高交感神经水平、无法产生更多能量以及分泌肾上腺素和皮质醇。

Probably it's as we've lost both of those capabilities, the ability to turn that sympathetic dial up and crank out more energy and produce adrenaline and cortisol.

你认为这能解释最大心率的下降吗？

Is that what you think explains the fall in maximum heart rate?

其中一部分原因是心脏收缩力下降、肌肉系统收缩力下降，以及交感神经导致的激素释放减少。

Part of it is loss of contractility of the heart, loss of contractility of the muscular system, loss of hormonal release as a result of the sympathetics.

我的意思是，你正在失去这种适应性——无法根据身体所承受的需求灵活调节这两个旋钮。

I mean, you're just losing, again, this adaptability, this ability to turn those two dials as necessary to meet whatever demand you're placing the body.

如果我们无法充分提高交感神经水平，就失去了你刚才描述的那种自发能量，无法起身冲刺，因为那种能力变慢了，而且可能也无法达到那么高的水平。

If we can't turn that sympathetic dial up as much, we don't have that spontaneous energy that you just described to get up and sprint because that's that that was way slower and it probably can't go up as high.

是的。

Yeah.

所以我们出生时，这两者都像是一个从0到10的可调电阻或旋钮。

So it's like we were born with a zero to 10 rheostat or dial on both of them.

随着年龄增长，这个10会变成9、8、7、6、5，你仍然能调节它们，但幅度变小了。

And as you age, that 10 goes to a nine, eight, seven, six, five, and you can still move them but you just can't move them as much.

100%。

A 100%.

这就是我所说的自主神经范围，它真正代表了我们的身体在能量层面所能达到的能力。

That's what would call like autonomic range and that really kind of represents what is our body capable of from an energetic standpoint.

我们能多快地调高这个旋钮，反过来，又能在多快的时间内将其调低，激活副交感神经系统，以恢复稳态，让身体回归正常？

How quickly can we turn that dial up and then conversely, how quickly can we turn that dial back down and crank up that parasympathetic side to restore homeostasis and get our bodies back to normal?

最后，我研究过一篇关于海军潜水员参加资格培训的论文，这相当于他们的海豹突击队训练，包括所谓的‘地狱周’等等。

And finishing, if you look at I've looked at the paper where they looked at different, Navy divers who were going through this qualification school, which is kind of their equivalent of SEAL training and, you know, Hell Week and all that.

他们试图找出哪些变量能区分那些表现优异、成功通过训练的人和那些未能通过的人。

And they tried to pick out what are the variables that separate the people that are really good at this and succeed and make it through versus the ones that don't.

他们在整个过程中测量了心率变异性。

And they measured HRV throughout the process.

他们发现的正是我刚才提到的自主神经范围：在需要时能大幅激活交感神经系统，并在压力源结束后立即关闭它，同时以更强的副交感反应做出回应。

And essentially, they find what I just talked about is this autonomic range where they could really crank up the sympathetic system when they needed to and then turn it off as soon as the stressor is over and respond in the other direction with a much higher parasympathetic response.

这种快速且恰当地使用这些调节旋钮的能力，似乎是实现适应性的关键。

That ability to use those dials quickly and in the right combination seems to be a really key thing to get adaptability.

正如我们所说，随着年龄增长，如果这两个旋钮的调节范围都缩小了，并且在某种程度上失去了协调性，我们的韧性与适应性就会大大降低。

And as we said, if you age, if both of those dials lose their range and they lose their coordination to some respect, then we have much less resilience, much less adaptability.

我们还应该提到，正如你指出的，迷走神经和交感神经在许多方面都会影响行为。

And we should mention too, as you pointed out, the vagus and the sympathetics, they do influence behavior in lot of ways.

在心理社会层面，还有许多相关内容超出了我的专业范围，你可以参考史蒂芬·波吉斯的多迷走神经理论。

There's a there's a whole thing that's be outside my lane in the psycho social aspect of this, and you can look at the polyvagal theory by Steven Porges.

但从根本上说，大脑在某种程度上是通过自主神经系统来调节情绪的。

But fundamentally, the brain regulates emotions through autonomic function in some capacity.

迷走神经与社交行为有关，也与不同情境下的认知控制有关，还涉及各种其他方面。

And the vagus is related to social behaviors, it's related to cognitive control in different scenarios, it's related to all sorts of stuff.

他们称之为战斗、逃跑、冻结，所有这些都与自主神经系统如何影响我们的情绪有关。

They call it fight, flight, freeze, all these things related to how our autonomic nervous system is influencing our emotions.

如果我们缺乏这种自主调节范围，那么由于自主神经系统功能的变化，我们可能就更缺乏起身活动的动力。

If we don't have that autonomic range, we probably have less drive to get up and move around as a result of that as those nerves in the autonomic system changes what it can and can't do.

我认为这一点永远不应被低估或弱化。

I don't think that should ever be underestimated or understated.

我认为，即使仅从我们患者群体这样小的样本来看，我们也经常能看到这一点。

I think again, just even looking at a sample size as small as our patient population, I think we see that a lot.

我认为，从运动和锻炼的角度来看，那些很难放松的人之间存在非常明确的关联。

I think there's a very clear association between an individual that if you just look at them from a movement and exercise perspective has a very difficult time relaxing.

‘放松’这个词听起来似乎很荒谬，但我在这里是用临床意义上的含义。

Relaxing sounds like such a silly word, but I mean that in a sort of a clinical sense.

如果他们无法让肋骨下沉，无法正确产生腹内压，无法完成一系列能产生一定运动控制和代偿性放松与收缩的动作，那么这些表现与情绪压力和心理压力之间似乎存在很强的关联。

If they can't let their rib cage down, if they can't properly generate intra abdominal pressure, if they can't go through a sequence of movements that generate some amount of motor control and compensatory relaxation contraction, I think there seems to be very high association between that and emotional stress and psychological stress.

百分之百。

A 100%.

实际上，疼痛也是如此。

Actually pain as well.

我认为我们经常看到慢性疼痛。

I think we see chronic pain.

而且，你可能会问，那到底是鸡先出现还是蛋先出现？

And again, you could argue, well, where's the chicken?

到底是鸡先出现还是蛋先出现？

Where's the egg?

如果一个人感到疼痛，这会导致更多的情绪压力吗？

If you're in pain, does that lead to more emotional stress?

这会导致身体无法调节放松，从而进一步加剧疼痛吗？

Does that lead to an inability to regulate relaxation within the body, which further exacerbates pain?

这是一个非常恶性循环。

It's a very vicious cycle.

你还会看到睡眠不足。

And you see lack of sleep.

老年人同样需要

Older people need just as

和年轻人一样多的睡眠，但他们更难获得足够的睡眠，而睡眠与迷走神经和副交感神经系统密切相关。

much sleep but they have a harder time getting as much sleep and sleep is very much tied to that vagus nerve and the parasympathetic nervous system.

所以，我们再次面临睡眠质量下降、适应能力减弱，这又是鸡生蛋还是蛋生鸡的问题。

So it's again, we get worse quality sleep, we get less adaptability, it's it is chicken and egg.

但从根本上说，这正是我们希望正确调节自己的原因，我认为运动最重要的作用就是提升身体自我调节的能力。

But fundamentally, that's why we want to regulate ourselves correctly, that's where exercise I think the biggest thing exercise does is improves our body's ability to regulate itself.

它改善了这些调节旋钮的使用，因为我们让身体接受了有氧训练，而我们知道这种训练与之有广泛的关联，并且如果我们以适当的量进行，身体就能以积极的方式适应这种压力。

It improves the use of those dials because we are exposing the body to the aerobic training that we know has some broad correlation to that and we're giving the body a stress it can adapt to in a positive way if we do it in the right amounts.

而这

And that's

就是其中的注意事项。

the caveat there.

在我们离开测量这个话题之前，想再聊一两个其他的测量指标。

Before we leave the measurement thing, wanna go on to another one or two of those measurement.

在Morpheus，你们用什么来测量？

At Morpheus, what do you guys use to measure?

所以我们使用RMSSD，然后进行自然对数变换和乘数调整。

So we use RMSSD and then we use log natural transform and a multiplier.

这听起来像是很多数学运算，但本质上，如果你查看RMSSD的数据，会发现它呈偏态分布，像一个正常的钟形曲线，但整体向左偏移。

That sounds like a lot of math, but essentially, if you look at the data of RMSSD and you look at like a normal bell curve, it's skewed.

它不是正态分布，而是完全偏向左侧。

It's non normal, it's all the way to the left.

你可能会看到正常的范围是20到80或100，就像你所说的，但精英运动员的数据可能达到180、200，而大量数据却聚集在最左侧。

You get these normal ranges of 20 to 80 or a 100 like you said, but then you can get elite athletes a 180, 200, and see this big bunch of data on the far left hand side.

这很难解读。

It's kinda hard to interpret.

所以，我不是统计学家。

So, again, I'm not a statistician.

这个公式也不是我发明的。

I didn't create the formula.

但为了使这些数据标准化，让它们看起来更接近自然分布，更像一个正常的钟形曲线，我们会进行自然对数变换并乘以一个系数，这样Morpheus最终会呈现一个类似100分的量表。

But essentially to normalize this data and make it look more naturally distributed, more like a normal bell curve, you do this log natural transform, use a multiplier, and Morpheus ends up on a scale that looks more like a 100 scale.

因此，HRV较低的人通常在50到60之间，中等水平的在60到70之间，较高的在70到80之间，而精英运动员则在90到100之间。

So people with lower HRV are going be more like the fifty-sixty, people with more moderate sixty-seventy, higher seventy-eighty, elite athletes are going be ninety-one 100.

这更像一个我们更熟悉的尺度，从钟形曲线的角度来看，数据也更标准化。

It's more of a scale that we have a more familiar relationship with I would say and the data is more normalized from a standpoint of a bell curve.

所以它更容易解读，但这就是这么做的原因。

So it's just an easier to interpret, but that's the reason for it.

所以当大多数人刚开始使用Morpheus，同时也在使用其他仅基于RMSSD的设备时，他们通常会看到多大的差异呢？

So do most people when they start using Morpheus and they're also using whatever other device they're using that's just a purely RMSSD device, how much discordance are they typically seeing between them?

这完全取决于他们使用的是什么设备。

It really depends on what are they using.

不同设备之间、它们给出的数值可能存在很大差异，但趋势通常应该是一致的。

It can be a big difference between the devices they're using, the numbers they're getting, but the trends should generally line up.

如果你发现Morpheus的整体数值在上升，你也应该看到其他设备的整体数值在上升。

If you're seeing Morpheus increase as a whole, you should see the other one increase as a whole.

你应该看到方向性的变化是一致的，但具体数值会因你在该谱系中的位置不同而略有差异。

You should see the directional change matching, but the actual numbers will be somewhat different depending on where you're at in that spectrum.

现在我们来聊聊Morpheus吧。

Let's now talk a little bit about Morpheus.

我之前已经提过几次了。

I've alluded to it a couple of times.

所以我已经使用这个产品大约一年半了，快两年了。

So it's a product I've been using for about a year and a half, maybe close to two years.

但在谈论我使用它的体验和原因之前，我做每件事都有我的理由。

But before I talk about my experience with it and why I use it, everything I do, I do for a reason.

我是一个非常谨慎的人。

I'm a very deliberate human being.

因此，我使用它的用途非常特定，范围也很窄。

So there's a very particular use case that is pretty narrow for how I use it.

我知道我没有充分发挥它的全部潜力，但还是跟大家介绍一下这是什么，你在这方面的参与情况，这自然也是我们相识的由来。

I know that I'm not using it to its full potential, but tell folks what this is about, your involvement in this and that's obviously how we got to know each other.

是的，当我刚开始使用旧系统时，我得等人来健身房才能给他们测量。

Yeah, mean, when I started using the old system, I had to wait for people to come in the gym to measure them.

所以我意识到，我所获得的只是他们生活状况的一个非常小的片段，因为我可能每周只测量他们两到三次。

And so I realized I was getting a pretty small snapshot of what their life story was because I might measure them two or three times a week.

他们有时早上来，有时下午来。

Sometimes they come in the morning, sometimes they come in the afternoon.

我意识到了这种方法的局限性。

And I realized the limitations of that.

那是2007年或2008年的事了。

This is back in 2007 or '8.

所以我想要开发一个能让人们用手机操作的系统，这样我们就能获取更多的数据。

And so I wanted to create something that people could use their phones and that we could get way more data from.

那就是我的第一个系统，BioForce HRV 2011年版。

And that was my first system, BioForce HRV '20 11.

那是最早期的HRV应用程序之一，用户可以用手机进行记录并自行获取HRV数据。

And that was really one of the earliest HRV apps out there where we could take your phone, you could do a recording and you could get your HRV on your own.

他们不需要再来健身房。

You didn't need to come into the gym.

但那个系统的局限性在于，我只能查看他们的HRV数据。

And one of the limitations of that was all I could look at was your HRV.

我并不一定知道还有什么其他因素与之相关。

I didn't necessarily have any idea what else was being tied to that.

所以我可以观察变化，向你提出很多问题，试着弄清楚这些变化的来源，但我希望创建一个能整合训练、睡眠、主观指标和其他数据的系统，这样作为教练，我能更全面地了解发生了什么。

And so I could look at the change and ask you a bunch of questions and maybe try to figure out what those changes were coming from, but I wanted to create something that also tied in training and sleep and subjective markers and other metrics so that as a coach, just had a more complete story of what was happening.

因此，这正是Morpheus的起源，我从2016年到2017年开始开发它，已经很多年了。

And so that was really the genesis of Morpheus, and I started that in 2016, 2017, so quite a few years ago.

我们基本上是在测量HRV，同时追踪活动、睡眠、锻炼等所有这类数据。

And basically what we're doing is we're measuring HRV and then we're tracking activity, sleep, workouts, all that sort of stuff.

你可以使用Morpheus设备来完成大部分这些功能，也可以使用其他设备。

You can use the Morpheus device for a lot of that or you can use other devices.

如果你使用Apple Watch来追踪活动或睡眠，或者使用Garmin，我们会把这些数据导入进来。

So if you're using an Apple Watch to track your activity, your sleep, or Garmin, we'll pull that data in.

但我们真正想做的是结合这些HRV数据。

But what we're trying to do is take that HRV.

这确实是我们应该深入讨论的话题。

This is something we should definitely talk about.

有很多应用都会提供HRV数据。

There's a lot of apps that give you HRV.

然后你可以选择自己解读这些数据，尝试弄清楚这些变化意味着什么。

And then you can either say, okay, I'm gonna interpret what this means myself and I can try to figure out what these changes are.

这是一个生理指标。

It's a physiological metric.

或者你可以认为，这些应用正在根据HRV给你提供恢复度或准备度之类的评估。

Or you can say the apps are giving me a recovery or a readiness or some gauge that's based on that.

现在问题在于，每个应用的做法都完全不同。

Now this comes back to every app is doing this completely differently.

我们不仅在HRV测量上缺乏标准化，而且在如何解读这些数据以生成恢复度、准备度或其他数值方面也缺乏统一标准——这些数值只是我们为了尝试解释数据而创造出来的。

Where we have a lack of standardization across not just the HIV measurement, but then how that information is interpreted to generate recovery or readiness or some sort of number that the person in the app is saying, oh, my recovery is 80% or my readiness is these are just numbers that we are creating as a way to try to interpret the data.

我认为，有些应用在这方面做得还不错。

And then some of those apps, I think, do a reasonable job with it.

但有些应用则做得不好。

Some of them don't.

但我创造了Morpheus，以及基于我过去二十年（或当时可能是十五年）使用HRV的经验所形成的恢复评分理念。

But I created Morpheus and this idea of the recovery score based on what I had seen using HRV for twenty years or maybe fifteen years at that point.

它只是一个衡量你某一天适合什么的指标。

It's just a metric of what's appropriate for you on a given day.

你的身体更有可能从什么中受益？

What is your body more likely to benefit from?

所以我们或许应该再谈谈，什么是恢复？

And so we should probably talk about, again, what is recovery?

什么是准备度？

What is readiness?

因为这些正是Morpheus、Oura、WHOOP和Garmin（比如体能电池）提供给你的指标，每个应用都有自己的衡量标准。

Because those are metrics that Morpheus gives you and Oura gives you and WHOOP gives you and Garmin gives you like a body battery or every kind of app has their own gauge of that.

但问题是，它的准确度如何？

But then the question is, how accurate is it?

它到底意味着什么？

What does it really mean?

我认为这也是很多困惑的来源，因为我们试图将这些指标转化为一种非生理性的衡量标准，而是一种我们试图构建的东西。

And I think that's where a lot of confusion also comes in because we're trying to take metrics and turn them into something that's not a physiological measure, but something we try to create.

是的。

Yeah.

我的意思是，我曾经用了好几年的Oura戒指，但可能有一年半都没再用过了。

I mean, look, I used an Oura Ring for many years, probably haven't used it in a year, year and a half.

现在有更先进的设备可以追踪我的睡眠了。

There's better devices I can use to track my sleep now.

正如你所说，恢复分数，即使你相信这个分数是准确的——也没有理由一定相信它——更重要的是，你无法根据它采取行动。

The recovery score, as you said, even if you believe the score is accurate and there's no reason to believe it necessarily is, more importantly, it's not something you can act on.

假设你相信这个数字，然后你说：好吧，我今天的恢复分数是80。

Let's just say you believe the number and you say, Okay, my recovery score is 80 today.

我确实相信，如果它显示90而不是70，你的WHOOP或Oura设备之间可能存在某种差异。

I certainly believe that if it spits out a 90 versus a 70, your WOOP or Aura, there's probably a difference there.

在恢复分数为90的那天，你可能比在60的那天状态更好。

You're probably better off on the day you're 90 than the day you're 60.

但你如何将这些信息付诸实践？

But how do you operationalize that information?

当我第一次接触Morpheus时，其实是我的临床团队中有人告诉我：我们很难给人们提供关于二区训练的切实指导，因为大多数人并不想做你所做的事，彼得。

And so when I was introduced to Morpheus, it was actually someone on my clinical team that said, We're having a hard time giving people real instruction around zone two because most people don't want to do what you do, Peter.

没人愿意检测自己的乳酸水平并经历这一过程。

Nobody wants to check their lactate levels and go through this.

我理解。

And I get it.

我绝不会因为有人不想每次锻炼时都做指尖采血而责怪他们。

I'd never fault somebody for not wanting to do a finger stick every time they do a workout.

说实话，对一些人来说，仅依靠主观疲劳评分也可能很有挑战性。

Truthfully for some people, just relying on RPE can be challenging.

所以这个人说：嘿，你看，Morpheus应用，我们会谈谈它是如何运作的。

So this person said, hey, look, the Morpheus app, and we'll talk about how it works.

我也很欣赏这种测量方式。

I also appreciate how the measurement is taken.

Morpheus应用程序每天都会为你提供心率目标区间。

The Morpheus app gives you target zones for heart rate every day.

如果你使用它所划分的一区和二区之间的分界点，这可以很好地反映你当天的二区心率范围。

And if you use the cutoff between what it's calling zone one and zone two, that's a pretty good proxy for what your zone two is on that day.

于是我购买了这套系统并开始使用，我应该给你看看数据，因为我过去一年半里记录了每一次锻炼，记录的内容包括：

So I bought the system and started using it and I should show you the data because I have recorded every single workout I have ever done for the last year and a half and I record the following.

我记录Morpheus预测的我的二区心率。

I record the heart rate predicted by Morpheus for what my zone two is.

我主要根据主观疲劳度（RPE）达到的心率，有时两者接近。

The heart rate I largely end up at by RPE and sometimes they're close.

通常它们很接近，但有时差距也很大。

Usually they're quite close, sometimes they're quite far.

所以有时候Morpheus告诉我应该保持在138，但我已经累得只能维持在131，有时情况正好相反。

So sometimes Morpheus tells me to be at 138, but I'm kind of gassed out at 131 and sometimes it's the reverse.

有时候Morpheus说你应该保持在133，但我感觉状态极佳，于是直接冲到了140。

Sometimes Morpheus says, You should be at 133, but I feel fantastic and I go to 140.

间歇训练的功率和乳酸水平。

What the power was for the interval and what the lactate is.

我必须告诉你，乔尔，我对这个系统印象深刻到无法用言语形容，它预测如此难以预测的指标竟然如此精准。

And I have to tell you Joel, 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.

为此，我要向你致敬。

So kudos to you for doing that.

我觉得神奇的是那些日子，就在一周前我就经历了这样的一天。

What I find amazing are the days when and I had one of these days a week ago.

Morpheus告诉我，那天我的二区心率应该是140或139。

Morpheus said I should have been at 140 or 139 for Zone 2.

我骑上自行车，感觉并不好，于是心想，Morpheus可能搞错了，我就按这个功率骑吧，结果心率大约是132，我测了乳酸，结果是1.1毫摩尔。

I got on the bike and I did not feel great and I sort of said, I think Morpheus got it wrong, I'm going to ride to this wattage and my heart rate was about 132 and I checked my lactate and it was 1.1 millimole.

那天我根本没接近自己的极限。

I was nowhere near my limit of where I could have been that day.

不过，我们也可以深入探讨一下，也许这样也没关系，也许那天我确实只需要这样，也许我本该完全听从自己的感觉。

Now, again, we could get in the weeds on maybe that's fine, maybe that's all I needed that day and maybe I should have just been following how I felt.

但如果我真的想获得正确的训练效果，那天我的训练量其实是有点不足的。

But if I'm really trying to get the right training effect, I was under training a little bit on that day.

所以我会先停一下，想让你好好理解我说的话，以及为什么这一点很重要。

So I'll kind of pause there because I want to kind of let you sort of interpret what I'm saying and why is it about that?

因为你输出了三个区间：区间一、区间二、区间三，我想你称之为恢复区和调节区。

Because you spit out three zones, zone one, zone two, zone three and I think you call them recovery and conditioning.

是的，这只是一个术语问题，对吧？

Yeah, it's just terminology, right?

这只不过是一种大致衡量低、中、高强度的方式。

It's just a way to gauge low, moderate, high intensity more or less.

这让你感到惊讶吗？

Does it surprise you?

因为在此之前，我们所有的交流中我都没跟你说过这个故事。

Because I haven't told you this story before in all of our communications.

我们从未讨论过这个具体的问题。

Don't We've never talked about this particular issue.

你有没有觉得惊讶，你第一和第二训练区之间的临界心率，恰好对应着乳酸值为2的黄金区间？

Does it surprise you that the heart rate that is on the cusp between your first and second training zones happens to correspond to this lactate of two sweet spot?

我的本意就是如此，设计的时候就是这么想的。

I mean, that was really the intent when I designed it.

那就是我

That's I

我认为这可能是Morpheus的不同之处，我设计它时，是基于我多年作为教练积累的经验，包括乳酸测试、VO2最大值测试和HRV测试。

think probably that's difference in Morpheus I would say is when I designed it, it was as my experience as a coach for many years of testing lactate, v o two max testing, of HRV testing.

我综合了大量从这些测试中获得的信息、知识和洞察，创建了这套低、中、高强度的结构化体系。

I took a synthesized a lot of information that I gained and knowledge and insight I gained to create this structured system of low, moderate, and high intensity.

你可以随意命名它们，但本质上这些区域就是这么回事。

You can call them whatever you wanna call them, that's basically what the zones are.

我意识到最重要的一点是，随着人们自主神经系统的变化，强度和心率也会随之改变。

The biggest thing I realized is as people's autonomic nervous system changes, intensity and heart put, our heart rate changes.

当你长期观察时就会明白，今天1:40时是这样，明天同一时间却可能完全不同，这取决于自主神经系统的波动。

And you learn this over time when you see today at 01:40 is doing this, and tomorrow at 01:40 might be doing that based on changes in the autonomic nervous system.

因此，当我创建这个算法时，它完全基于多年来在健身房观察、测量并回溯分析的大量数据。

And so, when I created the algorithm, it just based on a lot of data collected over a number of years of what I'd seen in the gym, what I'd measured, what I didn't look back at the data.

因此，Morpheus 的最终成果就是试图将体内的变化转化为更智能、更准确、更精准的训练方式，而这正是你所看到的 Morpheus 的作用。

And so, that was the end result of Morpheus, trying to translate changes internally with how we can then turn that into smarter, more accurate, precise training and that's what you're seeing with Morpheus.

听到它对你来说如此准确，真是太棒了，不过对有些人来说，它的准确性可能始终会更高一些。

So it's awesome to hear that it's that accurate for you and some people it's always gonna be much more accurate than others.

但总体而言，Morpheus 无疑是将体内变化转化为健身房中应做调整的最佳方式。

But as a whole, Morpheus is by far the best way to translate again changes internally with changes that we should be doing in the gym.

是的。

Yeah.

对我们现在的患者来说，我们几乎不再让他们检测乳酸了。

Mean basically for our patients now, we almost never bother with them checking lactate.

基本上就是靠主观疲劳度（RPE），如果你能清楚感受到二区训练的感觉，那就再好不过了。

It's basically RPE, if you can manage it, if you really have a sense of what zone two feels like, great.

但如果你需要一些指导，可以试试马费通公式：180减去你的年龄，这是个不错的起点。

But if you want some guidance, look, take the Maffetone formula one hundred eighty minuteus your age, great place to start.

当你需要更精细的指导时，可以使用Morpheus并参考那个心率。

Once you're getting a little more nuanced, if you want more guidance, use Morpheus and go to that heart rate.

再跟大家说说我是怎么每天早上得到这个数字的。

Again, tell folks how I get that number every morning.

它是怎么为我输出这个数字的？

How is it spitting out that number for me?

必须得做个测量，对吧？

Have to do a measurement, right?

是的。

Yeah.

意思是，你

Mean, you

必须测量你的心率变异性，同时我们会查看你过去24小时内记录的其他活动。

have to measure your HRV and then we're looking at other things that you've done in the past twenty four hours if you're recording it.

然后根据你的体能水平，我们通过你的静息心率、平均HRV以及训练时的心率趋势来评估你的体能水平，比如，彼得的体能大致处于这个水平。

And then based on your fitness level, so we ascertain your fitness level by looking at your resting heart rates, by looking at your average HRGB, by looking at some of your heart rate trends when you're training, and we say, okay, Peter's roughly at this level of fitness.

彼得的自主神经系统以这种方式做出反应，而这再次与它今天的表现相关。

Peter's autonomic nervous system is responding in this way, which again correlates to how it's gonna react today.

如果我感到疲劳，那么产生相同的功率输出就需要消耗更多的能量。

If I'm fatigued, then it's gonna take more energy to produce the same level of power output.

然后我们像你所说的那样，估算出对你而言低强度、中等强度和高强度之间的分界点。

And then we estimate, like you said, what for you is this cutoff between low intensity, moderate intensity, and high intensity.

人们可以这样理解这一点：肌肉纤维的募集。

And a way that people can think about this, would say, is muscle fiber recruitment.

因此，低强度主要由慢肌纤维承担大部分工作。

So low intensity is primarily slow twitch muscle fibers doing the majority of the work.

具体来说，在二区，我们讨论的是身体尽可能多地氧化脂肪；而在这种中等强度下，我们开始募集一些中等阈值的纤维，我们可以谈谈这意味着什么。

And specifically, if zone two, we're talking about where they're mostly oxidizing fat as much as possible, Kind of this moderate intensity, we're starting to recruit some of those moderate threshold fibers, and we can talk about what that means.

但我们开始募集一些更快的、更高阈值的肌纤维，而在高强度下，我们会大量募集所有肌纤维以及最高阈值的肌纤维。

But we're starting to recruit some of those faster twitch, higher threshold muscle fibers, and then higher intensity, we're starting to really recruit all the muscle fibers and the highest intensity muscle fibers.

因此，当Morpheus分析这些数据时，它基本上是在说：大约在这个心率下，我们认为这对应着低、中、高三种强度水平。

And so as Morpheus is looking at this, it's basically saying, roughly this heart rate, we think this is the level of intensity that is gonna correspond to these low, medium, and high.

然后它让你能够直接接入Morpheus，并说：我想进行二区训练。

And then it's giving the ability to just plug in Morpheus and say, I wanna do zone two.

Morpheus会说：好的，根据我们之前的观察，这是我们今天认为适合你的二区心率范围。

Morpheus says, Okay, based on what we've seen, this is where we think your zone two is for you today.

同样的道理也适用于其他情况。

And so on the same thing.

是的。

Yeah.

而且我想再强调一次，这正是它如此有价值的原因。

And again, I just want to reiterate, this is why it's very valuable.

它每天都在为我提供具体的训练方案。

It's actually giving me the prescription every single day.

当我刚拿到它时，我有点惊讶。

When I got it, I was a little surprised.

我有点不假思索就入手了。

I sort of bite at sight unseen.

我只是被告诉说它很有价值，但我不理解其中的细微差别。

I was just kind of told it's valuable, but I didn't understand the nuance.

这个设备出现后，我才意识到，每天早上起床前，我需要在床上平躺两分半钟，继续测量我的心率。

The thing shows up and I realized, oh, every morning I need to do a two and a half minute lay down in bed before I get up, still test measuring my heart rate.

我想你可以这么做。

I guess you can do that.

当时Morpheus附带了一个胸带和一个臂带。

Morpheus at the time came with a chest strap and an armband.

我想现在只剩胸带了。

I think now it's just a chest strap.

所以你要在床上戴上胸带，平躺下来，回答几个问题。

So you put the chest strap on in bed, you lay there, you answer a couple of questions.

它想知道我昨晚睡了几个小时？

So it wants wants to know how many hours did I sleep the night before?

于是我从我的睡眠追踪器——Eight Sleep——上提取这些数据。

So I pull that data off my sleep tracker, my eight sleep.

我的睡眠质量如何？

What's the quality of my sleep?

我也会提取这些数据。

I'm pulling off that as well.

然后它似乎在问，我主观上有多酸痛？感觉有多好？

And then I think it's saying how sore am I subjectively and how good do I feel?

是的。

Yep.

这些主观指标。

Those subjective markers.

这些实际上是经过合理验证的训练表现指标。

Those are actually reasonably validated markers for training performance.

没错。

They are.

然后我会躺下，什么都不做，通常只是冥想，它会测量我的心率变异性与心率。

Then I measure, I lay there and just kind of do nothing, meditate usually, and it measures my HRV and heart rate.

然后它会输出你的HRV、你的心率、你的恢复分数百分比，以及你的目标训练区间，这些数据会在你当天训练时自动加载到应用中。

And then it spits out, here's your HRV, here's your heart rate, here's your basically your recovery score as a percent, and then here are your target training zones, which then come up again when you train that day, it's already loaded into the app.

没错。

Exactly.

你的训练区间每天都会变化。

Your training zones change every day.

所以有一件事让我很惊讶，乔尔，我想：等等。

So one of the things that surprised me, Joel, was like, wait a minute.

我以前习惯于整晚测量HRV。

I'm used to having to measure HRV over the course of a night.

我以前用Aura戒指在八小时睡眠期间测量的数据，和这个设备在早晨起床前两分半钟内告诉我的数据，两者之间有什么区别？

What is the difference between what my aura ring used to tell me by measuring over eight hours of sleep versus this thing that's telling me in two and a

这难道不是在早晨起床前的两分半钟内完成的吗？

half minutes in the morning before I've gotten up?

这可能是HIV中最关键的部分，因为这方面存在太多混淆。

This is probably the most important part of HIV because there is so much confusion in this.

我们回溯历史，所有使用过的数据、这些导致死亡率的研究以及各种文献，其中95%都是基于瞬时HRV测量，即我们在特定时间点进行测量，并尽可能在标准化条件下获取基线数据。

We look back historically, all the data that's been used, these all cause mortality studies and all the different pieces of literature out there, ninety five percent of them are from spot HIV measurements that we are measuring at a specific time and you're doing this in standardized conditions as much as you can to get a baseline.

因为我们想知道你的副交感神经系统在每次测量时是否处于相同的时间点。

Because we wanna know where is your odd numbered nervous system Same time every time.

每天都在相同的时间、相同的条件下测量。

Same time every day in the same conditions.

因为我想知道的是，在过去24小时里，你昨天做了一些事情，我猜你做了很多事。

Because what I wanna know is, last twenty four hours, you did something yesterday, did lots of things I assume.

你吃了东西，可能锻炼了，可能喝了酒，也可能没喝，经历了精神压力，也可能没有。

You ate food, you maybe worked out, you maybe had alcohol or maybe you didn't, you did mental stress or maybe didn't.

你让身体在一天中的大部分时间里应对各种状况，然后才去睡觉。

You put your body in a situation where it had to respond for the majority of the day to do something, and then you went to bed.

我们想看到这些行为带来的结果。

And we want to see the result of that.

我们想看到你昨天经历的压力与恢复周期，因为这能告诉我们你当前的身体状态，它是如何反应的，因为我们还会观察随时间的变化，理解你的身体是如何适应周围环境的。

We want to see this stress and recovery cycle that you went through yesterday because that tells us where your body is at right now, how is it responding, because we'll look at changes over time and understand how your body is adapting to the world around you.

大多数心率变异性指标的建立基础就是：我们在标准条件下进行测量，了解你今天的状况，从而推断过去24小时甚至稍长时间内发生了什么。

And that's what most HRV has been built on is we measure in standard conditions, we see where you're at today, and that informs us about what happened over the last twenty four hours and maybe slightly beyond.

这就像我要称体重，我会希望在早晨起床后、标准条件下称重。

And the analogy is if I was gonna weigh myself, I'd wanna weigh myself first thing in the morning in standard conditions.

我不会吃完饭后再去称体重。

I wouldn't wanna have a meal and then go weigh myself.

我会采用非常标准化的测量方式，以便观察变化。

I'd wanna have very standard ways of measuring so I can see the changes.

因为最终，最有价值的是你与自己之前的对比。

Because ultimately it's you changing against yourself that's the most informative.

所以我们醒来后测量心率变异性，了解你当前的状态，同时回顾你的平均值和波动情况，从而判断你今天的状态，并帮助我们决定你现在最适合做什么。

So we wake up, we measure HIV, we see where you are and we see where you were, what your averages have been, what your variations have been and that tells us where you are today and that helps us make a decision about what are you ready to do right now or what's the most appropriate for you to do right now.

我要说的是，如果你的心率变异性偏高或偏低，我们可以讨论这些数值的含义。

And one thing I'll say is if your HRV is high or low, we can talk about what those mean.

这并不意味着你不能进行高强度训练，只是可能这不是对你最有益的选择，而且可能会带来一些代价。

It doesn't mean that you can't train hard, it just might mean that like that might not be the most beneficial thing for you and there might be a cost associated with that.

如果我早上醒来发现我的HRV远低于正常水平，你不能说：‘今天不能锻炼了。’

If I wake up and my HRV is way outside of normal, You can't say, oh, I can't work out today.

你可以锻炼，关键在于这是否是你身体真正需要的？

You can, it's just a question of is that what your body needs?

是的。

Yeah.

澄清一下，我不认为我曾经——我的意思是，我不觉得。

To be clear, I don't think I've I mean, I don't think.

我从未因为HRV数据而停止过锻炼，有些日子我的分数非常差，但数据告诉我，我的心率范围从未超过141。

I have never once not exercised as a result And of what I've there have been days when I've had abysmal scores and it's told me Like my heart rate range on what it has told me is never above about 141.

有些日子它低至121，这对我来说意味着我的恢复率只有35%到40%。

There have been days it's been as low as 121, which for me means like my recovery was 35 or 40%.

那是我彻夜未眠、身体出现明显异常的一晚。

That's a night when I didn't sleep and something was dramatically off.

你还是会去锻炼。

You'd still do the workout.

你还是会去锻炼。

You still do workout.

对吧？

Right?

你只是清楚这次锻炼会付出什么代价。

You just are aware of what the cost of that workout would be.

你可能会在明天或你的计划中做出调整。

You might make adjustments tomorrow or to your plan.

这就是我们在睡眠结束后测量时所得到的信息。

That's what we're getting when we're measuring at the end of sleep.

早晨我们看到的是睡眠的结果、锻炼的结果。

The morning time we're seeing what was the result of our sleep, what was the result of our workout.

所以昨天你做的其他所有事情。

So yesterday everything else we did.

如果我们夜间测量HRV，HRV数值在夜间总是更高，因为副交感神经系统在你睡觉时已经被调高了很多，此时数值最高。

If we're measuring HRV overnight, HRV number one is always higher at night because the parasympathetic system is that dial's already turned up quite a bit because you're sleeping where it's the highest.