Vit D + Calcium: Too Much Of A Good Thing?

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Vit D + Calcium: Too Much Of A Good Thing?

  • Myth: you can’t get too much calcium!
  • Myth: you must get as much vitamin D as possible!

Let’s tackle calcium first:

❝Calcium is good for you! You need more calcium for your bones! Be careful you don’t get calcium-deficient!❞

Contingently, those comments seem reasonable. Contingently on you not already having the right amount of calcium. Most people know what happens in the case of too little calcium: brittle bones, osteoporosis, and so forth.

But what about too much?

Hypercalcemia

Having too much calcium—or “hypercalcemia”— can lead to problems with…

  • Groans: gastrointestinal pain, nausea, and vomiting. Peptic ulcer disease and pancreatitis.
  • Bones: bone-related pains. Osteoporosis, osteomalacia, arthritis and pathological fractures.
  • Stones: kidney stones causing pain.
  • Moans: refers to fatigue and malaise.
  • Thrones: polyuria, polydipsia, and constipation
  • Psychic overtones: lethargy, confusion, depression, and memory loss.

(mnemonic courtesy of Sadiq et al, 2022)

What causes this, and how do we avoid it? Is it just dietary?

It’s mostly not dietary!

Overconsumption of calcium is certainly possible, but not common unless one has an extreme diet and/or over-supplementation. However…

Too much vitamin D

Again with “too much of a good thing”! While keeping good levels of vitamin D is, obviously, good, overdoing it (including commonly prescribed super-therapeutic doses of vitamin D) can lead to hypercalcemia.

This happens because vitamin D triggers calcium absorption into the gut, and acts as gatekeeper to the bloodstream.

Normally, the body only absorbs 10–20% of the calcium we consume, and that’s all well and good. But with overly high vitamin D levels, the other 80–90% can be waved on through, and that is very much Not Good™.

See for yourself:

How much is too much?

The United States’ Office of Dietary Supplements defines 4000 IU (100μg) as a high daily dose of vitamin D, and recommends 600 IU (15μg) as a daily dose, or 800 IU (20μg) if aged over 70.

See for yourself: Vitamin D Fact Sheet for Health Professionals ← there’s quite a bit of extra info there too

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  • Wakefulness, Cognitive Enhancement, AND Improved Mood?

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    Old Drug, New Tricks?

    Modafinil (also known by brand names including Modalert and Provigil) is a dopamine uptake inhibitor.

    What does that mean? It means it won’t put any extra dopamine in your brain, but it will slow down the rate at which your brain removes naturally-occuring dopamine.

    The result is that your brain will get to make more use of the dopamine it does have.

    (dopamine is a neutrotransmitter that allows you to feel wakeful and happy, and perform complex cognitive tasks)

    Modafinil is prescribed for treatment of excessive daytime sleepiness. Often that’s caused by shift work sleep disorder, sleep apnea, restless leg syndrome, or narcolepsy.

    Read: Overview of the Clinical Uses, Pharmacology, and Safety of Modafinil

    Many studies done on humans (rather than rats) have been military experiments to reduce the effects of sleep deprivation:

    Click Here To See A Military Study On Modafinil!

    They’ve found modafinil to be helpful, and more effective and more long-lasting than caffeine, without the same “crash” later. This is for two reasons:

    1) while caffeine works by blocking adenosine (so you don’t feel how tired you are) and by constricting blood vessels (so you feel more ready-for-action), modafinil works by allowing your brain to accumulate more dopamine (so you’re genuinely more wakeful, and you get to keep the dopamine)

    2) the biological half-life of modafinil is 12–15 hours, as opposed to 4–8 hours* for caffeine.

    *Note: a lot of sources quote 5–6 hours for caffeine, but this average is misleading. In reality, we are each genetically predetermined to be either a fast caffeine metabolizer (nearer 4 hours) or a slow caffeine metabolizer (nearer 8 hours).

    What’s a biological half-life (also called: elimination half-life)?

    A substance’s biological half-life is the time it takes for the amount in the body to be reduced by exactly half.

    For example: Let’s say you’re a fast caffeine metabolizer and you have a double-espresso (containing 100mg caffeine) at 8am.

    By midday, you’ll have 50mg of caffeine left in your body. So far, so simple.

    By 4pm you might expect it to be gone, but instead you have 25mg remaining (because the amount halves every four hours).

    By 8pm, you have 12.5mg remaining.

    When midnight comes and you’re tucking yourself into bed, you still have 6.25mg of caffeine remaining from your morning coffee!

    Use as a nootropic

    Many healthy people who are not sleep-deprived use modafinil “off-label” as a nootropic (i.e., a cognitive enhancer).

    Read: Modafinil for cognitive neuroenhancement in healthy non-sleep-deprived subjects: A systematic review

    Important Note: modafinil is prescription-controlled, and only FDA-approved for sleep disorders.

    To get around this, a lot of perfectly healthy biohackers describe the symptoms of sleep pattern disorder to their doctor, to get a prescription.

    We do not recommend lying to your healthcare provider, and nor do we recommend turning to the online “grey market”.

    Such websites often use anonymized private doctors to prescribe on an “informed consent” basis, rather than making a full examination. Those websites then dispense the prescribed medicines directly to the patient with no further questions asked (i.e. very questionable practices).

    Caveat emptor!

    A new mood-brightener?

    Modafinil was recently tested head-to-head against Citalapram for the treatment of depression, and scored well:

    See its head-to-head scores here!

    How does it work? Modafinil does for dopamine what a lot of anti-depressants do for serotonin. Both dopamine and serotonin promote happiness and wakefulness.

    This is very promising, especially as modafinil (in most people, at least) has fewer unwanted side-effects than a lot of common anti-depressant medications.

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  • An Unexpected Extra Threat Of Alcohol

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    If You Could Use Some Exotic Booze…

    …then for health reasons, we’re going to have to say “nay”.

    We’ve written about alcohol before, and needless to say, it’s not good:

    Can We Drink To Good Health?

    (the answer is “no, we cannot”)

    In fact, the WHO (which unlike government regulatory bodies setting “safe” limits on drinking, makes no profit from taxes on alcohol sales) has declared that “the only safe amount of alcohol is zero”:

    WHO: No level of alcohol consumption is safe for our health

    Up there, where the air is rarefied…

    If you’re flying somewhere this summer (Sinatra-style flying honeymoon or otherwise), you might want to skip the alcohol even if you normally do imbibe, because:

    ❝…even in young and healthy individuals, the combination of alcohol intake with sleeping under hypobaric conditions poses a considerable strain on the cardiac system and might lead to exacerbation of symptoms in patients with cardiac or pulmonary diseases.

    These effects might be even greater in older people; cardiovascular symptoms have a prevalence of 7% of inflight medical emergencies, with cardiac arrest causing 58% of aircraft diversions.❞

    Source: Alcohol plus cabin pressure at higher altitude may threaten sleeping plane passengers’ heart health

    The experiment divided subjects into a control group and a study group; the study group were placed in simulated cabin pressure as though at altitude, which found, when giving some of them two small(we’re talking the kind given on flights) alcoholic drinks:

    ❝The combination of alcohol and simulated cabin pressure at cruising altitude prompted a fall in SpO2 to an average of just over 85% and a compensatory increase in heart rate to an average of nearly 88 beats/minute during sleep.

    In contrast, that was 77 beats/minute for those who had alcohol but weren’t at altitude pressure, or 64 beats/minute for those who neither drank nor were at altitude pressure.

    Lots more metrics were recorded and the study is interesting to read; if you’ve ever slept on a plane and thought “that sleep was not restful at all”, then know: it wasn’t just the seat’s fault, nor the engine, nor the recycled nature of the air—it was the reduced pressure causing hypoxia (defined as having oxygen levels lower than the healthy clinical norm of 90%) and almost halving your sleep’s effectiveness for a less than 10% drop in available oxygen in the blood (the sleepers not at altitude pressure averaged 96% SpO2, compared to the 85% at altitude).

    We say “almost halving” because the deep sleep phase of sleep was reduced from 84 minutes (control) to 67.5 minutes at altitude without alcohol, or 46.5 minutes at altitude with alcohol.

    Again, this was a pressure cabin in a lab—so this wasn’t about the other conditions of an airplane (seats, engine hundreds of other people, etc).

    Which means: in an actual airplane it’s probably even worse.

    Oh, and the study participants? All healthy individuals aged 18–40, so again probably worse for those older (or younger) than that range, or with existing health conditions!

    Want to know more?

    You can read the study in full here:

    Effects of moderate alcohol consumption and hypobaric hypoxia: implications for passengers’ sleep, oxygen saturation and heart rate on long-haul flights

    Want to drop the drink at any altitude? Check out:

    How To Reduce Or Quit Alcohol

    Want to get that vacation feel without alcohol? You’re going to love:

    Mocktails – by Moira Clark (book)

    Enjoy!

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  • How To Leverage Attachment Theory In Your Relationship

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    How To Leverage Attachment Theory In Your Relationship

    Attachment theory has come to be seen in “kids nowadays”’ TikTok circles as almost a sort of astrology, but that’s not what it was intended for, and there’s really nothing esoteric about it.

    What it can be, is a (fairly simple, but) powerful tool to understand about our relationships with each other.

    To demystify it, let’s start with a little history…

    Attachment theory was conceived by developmental psychologist Mary Ainsworth, and popularized as a theory bypsychiatrist John Bowlby. The two would later become research partners.

    • Dr. Ainsworth’s initial work focused on children having different attachment styles when it came to their caregivers: secure, avoidant, or anxious.
    • Later, she would add a fourth attachment style: disorganized, and then subdivisions, such as anxious-avoidant and dismissive-avoidant.
    • Much later, the theory would be extended to attachments in (and between) adults.

    What does it all mean?

    To understand this, we must first talk about “The Strange Situation”.

    “The Strange Situation” was an experiment conducted by Dr. Ainsworth, in which a child would be observed playing, while caregivers and strangers would periodically arrive and leave, recreating a natural environment of most children’s lives. Each child’s different reactions were recorded, especially noting:

    • The child’s reaction (if any) to their caregiver’s departure
    • The child’s reaction (if any) to the stranger’s presence
    • The child’s reaction (if any) to their caregiver’s return
    • The child’s behavior on play, specifically, how much or little the child explored and played with new toys

    She observed different attachment styles, including:

    1. Secure: a securely attached child would play freely, using the caregiver as a secure base from which to explore. Will engage with the stranger when the caregiver is also present. May become upset when the caregiver leaves, and happy when they return.
    2. Avoidant: an avoidantly attached child will not explore much regardless of who is there; will not care much when the caregiver departs or returns.
    3. Anxious: an anxiously attached child may be clingy before separation, helplessly passive when the caregiver is absent, and difficult to comfort upon the caregiver’s return.
    4. Disorganized: a disorganizedly attached child may flit between the above types

    These attachment styles were generally reflective of the parenting styles of the respective caregivers:

    1. If a caregiver was reliably present (physically and emotionally), the child would learn to expect that and feel secure about it.
    2. If a caregiver was absent a lot (physically and/or emotionally), the child would learn to give up on expecting a caregiver to give care.
    3. If a caregiver was unpredictable a lot in presence (physical and/or emotional), the child would become anxious and/or confused about whether the caregiver would give care.

    What does this mean for us as adults?

    As we learn when we are children, tends to go for us in life. We can change, but we usually don’t. And while we (usually) no longer rely on caregivers per se as adults, we do rely (or not!) on our partners, friends, and so forth. Let’s look at it in terms of partners:

    1. A securely attached adult will trust that their partner loves them and will be there for them if necessary. They may miss their partner when absent, but won’t be anxious about it and will look forward to their return.
    2. An avoidantly attached adult will not assume their partner’s love, and will feel their partner might let them down at any time. To protect themself, they may try to manage their own expectations, and strive always to keep their independence, to make sure that if the worst happens, they’ll still be ok by themself.
    3. An anxiously attached adult will tend towards clinginess, and try to keep their partner’s attention and commitment by any means necessary.

    Which means…

    • When both partners have secure attachment styles, most things go swimmingly, and indeed, securely attached partners most often end up with each other.
    • A very common pairing, however, is one anxious partner dating one avoidant partner. This happens because the avoidant partner looks like a tower of strength, which the anxious partner needs. The anxious partner’s clinginess can also help the avoidant partner feel better about themself (bearing in mind, the avoidant partner almost certainly grew up feeling deeply unwanted).
    • Anxious-anxious pairings happen less because anxiously attached people don’t tend to be attracted to people who are in the same boat.
    • Avoidant-avoidant pairings happen least of all, because avoidantly attached people having nothing to bind them together. Iff they even get together in the first place, then later when trouble hits, one will propose breaking up, and the other will say “ok, bye”.

    This is fascinating, but is there a practical use for this knowledge?

    Yes! Understanding our own attachment styles, and those around us, helps us understand why we/they act a certain way, and realize what relational need is or isn’t being met, and react accordingly.

    That sometimes, an anxiously attached person just needs some reassurance:

    • “I love you”
    • “I miss you”
    • “I look forward to seeing you later”

    That sometimes, an avoidantly attached person needs exactly the right amount of space:

    • Give them too little space, and they will feel their independence slipping, and yearn to break free
    • Give them too much space, and oops, they’re gone now

    Maybe you’re reading that and thinking “won’t that make their anxious partner anxious?” and yes, yes it will. That’s why the avoidant partner needs to skip back up and remember to do the reassurance.

    It helps also when either partner is going to be away (physically or emotionally! This counts the same for if a partner will just be preoccupied for a while), that they parameter that, for example:

    • Not: “Don’t worry, I just need some space for now, that’s all” (à la “I am just going outside and may be some time“)
    • But: “I need to be undisturbed for a bit, but let’s schedule some me-and-you-time for [specific scheduled time]”.

    Want to learn more about addressing attachment issues?

    Psychology Today: Ten Ways to Heal Your Attachment Issues

    You also might enjoy such articles such as:

    Lastly, to end on a light note…

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  • Dr. Greger’s Anti-Aging Eight

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Dr. Greger’s Anti-Aging Eight

    This is Dr. Michael Greger. We’ve featured him before: Brain Food? The Eyes Have It!

    This time, we’re working from his latest book, the excellent “How Not To Age”, which we reviewed all so recently. It is very information-dense, but we’re going to be focussing on one part, his “anti-aging eight”, that is to say, eight interventions he rates the most highly to slow aging in general (other parts of the book pertained to slowing eleven specific pathways of aging, or preserving specific bodily functions against aging, for example).

    Without further ado, his “anti-aging eight” are…

    1. Nuts
    2. Greens
    3. Berries
    4. Xenohormesis & microRNA manipulation
    5. Prebiotics & postbiotics
    6. Caloric restriction / IF
    7. Protein restriction
    8. NAD+

    As you may have noticed, some of these are things might appear already on your grocery shopping list; others don’t seem so “household”. Let’s break them down:

    Nuts, greens, berries

    These are amongst the most nutrient-dense and phytochemical-useful parts of the diet that Dr. Greger advocates for in his already-famous “Dr. Greger’s Daily Dozen”.

    For brevity, we’ll not go into the science of these here, but will advise you: eat a daily portion of nuts, a daily portion of berries, and a couple of daily portions of greens.

    Xenohormesis & microRNA manipulation

    You might, actually, have these on your grocery shopping list too!

    Hormesis, you may recall from previous editions of 10almonds, is about engaging in a small amount of eustress to trigger the body’s self-strengthening response, for example:

    Xenohormesis is about getting similar benefits, second-hand.

    For example, plants that have been grown to “organic” standards (i.e. without artificial pesticides, herbicides, fertilizers) have had to adapt to their relatively harsher environment by upping their levels of protective polyphenols and other phytochemicals that, as it turns out, are as beneficial to us as they are to the plants:

    Hormetic Effects of Phytochemicals on Health and Longevity

    Additionally, the flip side of xenohormesis is that some plant compounds can themselves act as a source of hormetic stress that end up bolstering us. For example:

    Redox-linked effects of green tea on DNA damage and repair, and influence of microsatellite polymorphism in HMOX-1: results of a human intervention trial

    In essence, it’s not just that it has anti-oxidant effect; it also provides a tiny oxidative-stress immunization against serious sources of oxidative stress—and thus, aging.

    MicroRNA manipulation is, alas, too complex to truly summarize an entire chapter in a line or two, but it has to do with genetic information from the food that we eat having a beneficial or deleterious effect to our own health:

    Diet-derived microRNAs: unicorn or silver bullet?

    A couple of quick takeaways (out of very many) from Dr. Greger’s chapter on this is to spring for the better quality olive oil, and skip the cow’s milk:

    Prebiotics & Postbiotics

    We’re short on space, so we’ll link you to a previous article, and tell you that it’s important against aging too:

    Making Friends With Your Gut (You Can Thank Us Later)

    An example of how one of Dr. Greger’s most-recommended postbiotics helps against aging, by the way:

    (Urolithin can be found in many plants, and especially those containing tannins)

    See also: How to Make Urolithin Postbiotics from Tannins

    Caloric restriction / Intermittent fasting

    This is about lowering metabolic load and promoting cellular apoptosis (programmed cell death; sounds bad; is good) and autophagy (self-consumption; again, sounds bad; is good).

    For example, he cites the intermittent fasters’ 46% lower risk of dying in the subsequent years of follow-up in this longitudinal study:

    Association of periodic fasting lifestyles with survival and incident major adverse cardiovascular events in patients undergoing cardiac catheterization

    For brevity we’ll link to our previous IF article, but we’ll revisit caloric restriction in a main feature on of these days:

    Fasting Without Crashing? We sort the science from the hype!

    Dr. Greger favours caloric restriction over intermittent fasting, arguing that it is easier to adhere to and harder to get wrong if one has some confounding factor (e.g. diabetes, or a medication that requires food at certain times, etc). If adhered to healthily, the benefits appear to be comparable for each, though.

    Protein restriction

    In contrast to our recent main feature Protein vs Sarcopenia, in which that week’s featured expert argued for high protein consumption levels, protein restriction can, on the other hand, have anti-aging effects. A reminder that our body is a complex organism, and sometimes what’s good for one thing is bad for another!

    Dr. Greger offers protein restriction as a way to get many of the benefits of caloric restriction, without caloric restriction. He further notes that caloric restriction without protein restriction doesn’t decrease IGF-1 levels (a marker of aging).

    However, for FGF21 levels (these are good and we want them higher to stay younger), what matters more than lowering proteins in general is lowering levels of the amino acid methionine—found mostly in animal products, not plants—so the source of the protein matters:

    Regulation of longevity and oxidative stress by nutritional interventions: role of methionine restriction

    For example, legumes deliver only 5–10% of the methionine that meat does, for the same amount of protein, so that’s a factor to bear in mind.

    NAD+

    This is about nicotinamide adenine dinucleotide, or NAD+ to its friends.

    NAD+ levels decline with age, and that decline is a causal factor in aging, and boosting the levels can slow aging:

    Therapeutic Potential of NAD-Boosting Molecules: The In Vivo Evidence

    Can we get NAD+ from food? We can, but not in useful quantities or with sufficient bioavailability.

    Supplements, then? Dr. Greger finds the evidence for their usefulness lacking, in interventional trials.

    How to boost NAD+, then? Dr. Greger prescribes…

    Exercise! It boosts levels by 127% (i.e., it more than doubles the levels), based on a modest three-week exercise bike regimen:

    Skeletal muscle NAMPT is induced by exercise in humans

    Another study on resistance training found the same 127% boost:

    Resistance training increases muscle NAD+ and NADH concentrations as well as NAMPT protein levels and global sirtuin activity in middle-aged, overweight, untrained individuals

    Take care!

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  • Team’s Personal Health Practices Disagreements?

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    You’ve Got Questions? We’ve Got Answers!

    Q: I’m curious how much of these things you actually use yourselves, and are there any disagreements in the team? In a lot of places things can get pretty heated when it’s paleo vs vegan / health benefits of tea/coffee vs caffeine-abstainers / you need this much sleep vs rise and grinders, etc?

    A: We are indeed genuinely enthusiastic about health and productivity, and that definitely includes our own! We may or may not all do everything, but between us, we probably have it all covered. As for disagreements, we’ve not done a survey, but if you take an evidence-based approach, any conflict will tend to be minimized. Plus, sometimes you can have the best of both!

    • You could have a vegan paleo diet (you’d better love coconut if you do, though!
    • There is decaffeinated coffee and tea (your taste may vary)
    • You can get plenty of sleep and rise early (so long as an “early to bed, early to rise” schedule suits you!)

    Interesting note: humans are social creatures on an evolutionary level. Evolution has resulted in half of us being “night owls” and the other half “morning larks”, the better to keep each other safe while sleeping. Alas, modern life doesn’t always allow us to have the sleep schedule that’d suit each of us best individually!

    Have a question you’d like answered? Reply to this email, or use the feedback widget at the bottom! We always love to hear from you

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  • How To Do HIIT (Without Wrecking Your Body)

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    How To Do HIIT (Without Wrecking Your Body)

    High-Intensity Interval Training, henceforth “HIIT”, is a well-researched and well-evidenced approach to exercise that gives powerful health benefits.

    Specifically, health benefits that we don’t get from moderate exercise (as important as that is too) or endurance training.

    Super-quick overview of the benefits first:

    *remember that most forms of exercise aren’t very good for fat loss, because our metabolism will slow afterwards to compensate. So HIIT flipping this one is quite a big deal.

    What actually is it?

    HIIT means exercise sessions in which one alternates between high intensity “maximum effort” bursts, and short recovery periods during which more moderate exercise is performed.

    An example for runners could be switching between sprinting or jogging, changing mode each time one passes a street light.

    ❝A total of only two minutes of sprint interval exercise was sufficient to elicit similar responses as 30 minutes of continuous moderate intensity aerobic exercise❞

    ~ Trewin et al. (2018)

    Read more: Acute HIIT elicits similar changes in human skeletal muscle mitochondrial H₂O₂ release, respiration, and cell signaling as endurance exercise even with less work

    What did you mean about not wrecking your body? Is that… Likely?

    Hopefully not, but it’s a barrier to some! We are not all twenty-something college athletes, after all, and our bodies aren’t always as durable as they used to be.

    HIIT relies on intense exercise and short recovery periods, but what if our bodies are not accustomed to intense exercise, and need longer recovery periods? Can we still get the same benefits?

    The trick is not to change the intensity or the recovery periods, but the exercise itself.

    For HIIT to work the “intense” part has to be best-effort or approaching such. That part’s not negotiable. The recovery periods can be stretched a bit if you need to, but with the right tweaks, you ideally won’t have to do that.

    Great! How?

    First, note that you can do resistance interval training without impact. For example, if you crank up the resistance on an exercise bike or similar machine, you will be doing resistance training along with your cardio, and you’ll be doing it without the impact on your joints that you would if out pounding the pavement on foot.

    (Running is fine if your body is used to it, but please don’t make HIIT your first running exercise in a decade)

    Second, consider your environment. That exercise bike? You can get off it any time and you’re already at home (or perhaps your gym, with your car outside). Not so if you took up mountain biking or road racing.

    Third, go for what is gentle in motion, even if it’s not resistance work per se. Swimming is a fabulous option for most people, and can absolutely be done with HIIT principles. Since vision is often obscured while swimming, counting strokes can be a good way to do HIIT. For example, ten strokes max effort, ten strokes normal, repeat. Do make sure you are aware of where the end of the pool is, though!

    Fourth, make it fun! Ok, this one’s not about the safety quite so much, but it is about sustainability, and that’s critical for practical purposes too. You will only continue an exercise routine that you enjoy, after all.

    • Could you curate a musical playlist that shifts tempo to cue your exercise mode intervals?
    • Could you train with an exercise partner? Extra fun if this has a “relay race” feel to it, i.e. when one person completes a high intensity interval, the other person must now begin theirs.

    Need some pointers getting started?

    There are a lot of HIIT apps out there, so you can just search for that on your device of choice.

    But!

    We at 10almonds have recommended 7-Minute Workout before, which is available for iOS and for Android, and we stand by that as a great starting choice.

    Enjoy!

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