Professional athletes don't train for cardiometabolic health. They train to perform at competitions. The study is perfectly fine for the people it is intended to serve in the context of their lives. Normal people neither want nor need to train like athletes. They certainly don't need to follow a training program to compete at the Olympics. But they would still be well served to train in some form because of their increasingly sedentary lifestyles. Optimizing that form for efficiency is a key to population health. This paper is just the latest in a stream of evidence that suggests shorter but higher intensity bursts of exercise might be the more efficient way of training if you want to min-max your workout time and health as a normal person who has a real job and possibly a family and other hobbies.

Isn't it likely that blended exercise is best for longevity anyway? i.e. per week 1-2h Zone 2 and 20 minutes HIIT (nordic 4x4?) and then as much strength training as you can fit in, say 3 x 1h PPL per week, and maybe some sauna too.

This is likely around what is best for most people and probably cutting the strength training time to 1h before cutting the rest if you "don't have time".

But athletes don't have health as their main goal.

Good and best is doing a lot of heavy lifting in your comment.

What are you talking about when you speak of good/best outcomes? I think especially when it comes to talking about fitness it is important to be explicit about outcomes because only with outcomes in mind can you talk about what “good” actually means.

In that context I’m a bit confused by your focus on (endurance) athletes. Their overriding goal is obviously increasing their athletic performance in a way that keeps them injury free. Their main focus aren’t health outcomes. That’s not the same. So if you focus on them you are in danger of talking past each other.

To that point: sure, those studies often have unrealistic protocols but the way (performance) athletes train is also unrealistic for most people!

If those studies are about population health they should have realistic protocols (in terms of: realistically achievable and adhered to by non-athletes, in the best case also empirically grounded in the sense of: this is a realistic range of activities non-athletes might actually engage in on a regular basis) for non-athletes.

This is about comparing different exercise intensities ?

Yeah. The formula isn't terribly complicated: don't eat crap and move your body in different ways.

Despite doing exercise (including high intensity stuff like spin class) I was overweight and had a HOMA-IR of 3.8 (Moderate Insulin Resistance) and insulin 13.2 (Early Insulin Resistance).

This was because I was addicted to sugary stuff.

I cut my refined sugar intake to almost zero and in two months HOMA-IR went to 1.02 (Normal Range) and insulin to 4.9 (Optimal / Longevity Range). My triglycerides had peaked at 228 (Moderate Risk) and dropped to 96 (Normal/Good). Glucose went from 116 (Prediabetes) to 85 (Healthy).

My assistant in cutting all that sugar was Claude. I used Claude as my buddy: I'd chat with Claude when I had cravings and it gave me alternatives and support. And it worked.