Patrick Dempsey  ·  PE, MBA  ·  Certificate in Nutrition Science, Stanford University

Spring 2026  ·  7 min read  ·  Biological Reserve Series, Final Video Companion

📺  This article companions the series finale: The Reserve Architecture — Watch on YouTube →

Biological Reserve Series — All Four Pillars Pillar 1: The Cognitive Reserve →
Pillar 2: The Cardiovascular Reserve →
Pillar 3: The Musculoskeletal Reserve →
Pillar 4: The Metabolic Reserve →

Over the past several months I've put together what I think is one of the more important things this newsletter has ever covered.

The biological reserve series had a direct message underneath it: the way most of us train — as cyclists, as endurance athletes — is not enough. Not for the version of ourselves we want to be at seventy-five or eighty.

The final video pulls all four pillars into one place and asks a harder question: what are the findings that actually changed things? Not the most interesting — the ones I personally cannot un-know, and that seemed to land hardest with viewers and readers throughout the series.

That's what this article is. Four findings. What they mean. And the one insight that only appears when you see all four together.

Finding One — Every Hard Ride Was Also Working on Your Brain

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Jon Slade1 month ago

You asked for a followup so here it is: Nuclear stress test fine, echocardiogram with ejection fracture of 58 percent also fine. They did a cardiac cath yesterday and found NO blockages in the main or ancillary arteries. They did find calcium buildup outside the vessel walls. That was the cause for the high CT score. Done with cardiologists for a while. Final words were "keep doing what you're doing". Thanks!

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Jon Slade3 months ago

Hey Patrick; I'm new to your newsletter but in the same boat. I'm a 63 year old male 6'2" 205 lbs physically fit with excellent vitals and labs. Because of "slightly" elevated LDL Cholesterol I submitted to a CT CAC test. My score was 631! significant calcium buildup in the LAD artery. I'm freaked out about it and seeing a cardiologist in a couple of days. I'm on a low dose statin to harden the plaque so it does not break free and help calcify it. What did you end up doing? I know it's psychosomatic but now I think I'm having an ischemic event every time I train (usually two a days five days a week). I have a feeling a stress test and angiogram are next. Thanks for all you do. Jon

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Patrick Dempsey3 months ago

Hi Jon. Your story is the same as mine but my score was mid 500’s, still very high. Several people following the newsletter have reported the same thing with even much higher scores. After seeing a doctor, doing a stress test (passing with flying colors), and seeing a cardiologist this is what he told me to do. “Keep doing what you’re doing, you are in excellent health”. Long story short, the test is not a great indicator of a problem, many other factors that are more important. This is what the cardiologist told me. Don’t get me wrong, everyone has different history and biomarkers etc. and I did go on statins to get my LDL way down, but you are not alone. I am convinced it was cycling (and cycling to near physical failure) for far too long that did this. Good luck and let me know how it goes - but hopefully worry a little less in the meantime.

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Jeff Boatman 19783 months ago

Makes sense. Thanks, Jeff Amelia Island, Florida

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Kent Starling5 months ago

I think this series was very important. As I’ve gotten older it’s become more important. One thing that I have noticed, and a friend and I were discussing, is that we feel like our balance has gotten worse. I think that a lack of balance may lead to falls in the future. I do think that riding helps us but off the bike it’s a different balance. I’ve added some exercises specifically directed towards improving balance to my strength training.

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Santi Samorano5 months ago

The cognitive reserve section probably landed hardest for me. I've noticed that some of my best ideas and solutions to problems seem to come while riding, typically at the 20-minute mark, and I never really connected that to a biological process before. The idea that a training session can be working on multiple systems at once is a perspective I'll be thinking about for a while. It certainly changes how I think about the value of a training session.

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Patrick Dempsey5 months ago

Exactly my feeling. I can pinpoint the precise section of trail it happens on my regular ride!

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