Dr. Rhonda Patrick is a leading expert in fitness and health, regularly using scientific-backed research to offer exercise guidance. In her latest venture, she shared a groundbreaking Vo2 ‘four-by-four’ Norwegian exercise protocol that reverses cardiac aging structures by up to 20 years.
With appearances on the Joe Rogan Experience, to conversations with the esteemed Dr. Andrew Huberman and Dr. Peter Attia, Dr. Rhonda Patrick’s grasp of health, nutrition, and exercise makes her a standout within the fitness community.
She completed her graduate studies at the St. Jude’s Children’s Research Hospital on mitochondrial metabolism, where she quickly expanded her knowledge of biomechanics. Dr. Patrick boasts over 500,000 subscribers on her growing FoundMyFitness YouTube channel. A major proponent of high-intensity interval training, Patrick continues to offer her fans useful advice for bettering their bodies.
Cardiorespiratory fitness (measured by VO2 max) is one of the best indicators of improved healthspan and lifespan.
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One of the best protocols for improving VO2 max is the Norwegian 4×4 protocol – a 4-minute interval at the maximum intensity you can maintain the entire interval… https://t.co/25WIyi54dt
— Dr. Rhonda Patrick (@foundmyfitness) December 8, 2023
Dr. Rhonda Patrick Outliness ‘Vo2 Max-Based Norwegian 4×4’ Protocol for Preserving Heart Health
Dr. Rhonda Patrick believes the four-by-four Norwegian protocol holds weight because the workout is based on a participant’s Vo2 max, which many believe to be a marker for longevity.
“I think Vo2 max is one of the single — the thing I love about it is it’s something you can measure. It’s a biomarker, I think it’s one of the most important things, absolutely. There’s some evidence that doing this vigorous exercise is important but it has to be like a longer interval type of exercise. At least one minute, that would be sort of the minimum but better if you can get to four minutes.”
According to Dr. Patrick, the protocol is made up of four minutes at ‘the highest intensity you can maintain’ followed by a three-minute recovery period of light exercise. This process is repeated four times.
“There’s something called the Norwegian four-by-four protocol. And that is four minutes at the highest intensity that you can maintain for that entire four minutes followed by a three-minute recovery of like light light exercise. I mean you want your heart rate to come down so you can do it again, four times, right?”
Studies on the Norwegian four-by-four took a sample of 50-year-olds who utilized this routine for two years. The results were astounding: they discovered that the participant’s cardiac aging structure was reduced by 20 years, effectively giving them the hearts of 30-year-olds.
“The Norwegian four-by-four, this is one of the studies that inspired me, this was a study out of South West in Dallas. The study took 50-year-olds that were healthy but they were not physically active, so they didn’t have like Type 2 diabetes and all that but they weren’t active.”
“After that two years of doing this pretty vigorous intensity exercise protocol, the 50-year-olds reversed their cardiac structure aging by 20 years. Their hearts were looking more like 30-year-old hearts versus 50-year-old hearts after two years of doing this.”
In total, the subjects were exposed to ‘maximal intensity exercise’ for four hours per week.
“They put them on a pretty intensive training protocol for two years. It was a two-year intervention. It was a progressive protocol so obviously if you have an untrained person, you don’t just right off the bat, Norwegian four by four, no that’s not going to happen. It took them six months to work up their training, their endurance, by the time they got to their six-month mark, they were doing about four hours a week of what is called maximal intensity exercise.”
“This is vigorous. They were basically doing as high as you can maintain vigorous intensity workouts for 30 minutes,” said Dr. Patrick. “You’re doing 75-80% of max heart rate for 30 minutes.”
Given that exercise performance often decreases as we age, Dr. Patrick found this protocol to have a profound impact on longevity.
“After two years, these people, the cardiac structure, so as we age our heart gets smaller and stiffer and this happens it’s like part of aging that results in a lot of things so cardiovascular risk goes up but also like your exercise performance and capacity goes down.”
During the routine, Dr. Patrick stated that your heart rate should be between 75-80% of your max capacity.
“You don’t want to go all-out like 95% of your max heart rate because then you can only last for like a minute. So, then, you’re going to go down. You’re going to slow down right? So what it means is, you wanna go it might for some people be like 75% max heart rate, for some people it might be 80% but you want to go as hard as you can for the four minutes.”
“You should not be able to talk for sure when you’re doing it. It’s hard enough to where you absolutely can’t talk but it’s not all out. Four minutes and then three minutes of totally light. You know, back to like Zone 1 if you want to call it something.”
If increasing your Vo2 max is a priority, Dr. Patrick believes this protocol is one of the best.
“That’s one of the best protocols to improve Vo2 max now,” said Dr. Rhonda Patrick. “I’m trying to incorporate the four by four into my routine which coaches help with that.”
Dr. Patrick’s cohort, Dr. Peter Attia, has also made longevity-inspired workouts a primary concern. He recently shared the supplement stack and training protocol he implements for preserving his youthfulness and strength as he gets older.
With new data and studies flooding the fitness world, Dr. Rhonda Patrick’s breakdowns and insight serve anyone seeking physical or mental enhancements from day to day. Try out the four-by-four Norwegian protocol to see how it influences your results.
RELATED: Arnold Schwarzenegger Shares Time-Efficient Norwegian-Inspired Workout of the Week
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This is a good work out. I have incorporated into my fitness routine. How many times a week should this be done? Is it once a week, every other day, or something in between?
At four hours a week does this mean that they were then actually doing two sets of four by four a day?
Hi Haley, thanks for the question. The Norwegian 4×4 protocol involves the following steps:
Warm-up: Start with a light warm-up of about 5 minutes.
High-intensity Interval: Run/Exercise for 4 minutes at 75%-80% of your maximum heart rate, or at the fastest pace you can maintain for this duration.
Recovery: Follow with 3 minutes of very light walking or another gentle activity to let your heart rate decrease.
Repetition: Repeat the high-intensity interval and recovery cycle four times, excluding the initial warm-up.
The total workout duration is approximately 30 minutes. This is shorter than traditional aerobic exercise (which takes 40-60 minutes) but longer than typical HIIT sessions (around 12 minutes).
It is recommended to perform the Norwegian 4×4 protocol 2-4 times a week for the best results. Hope this helps!