Endurance sports can be bad for your heart...

[Louis]

Link to NYT article (http://well.blogs.nytimes.com/2011/03/09/when-exercise-is-too-much-of-a-good-thing/?hp)

Unfortunately, I don't think they know how much is too much. Somehow, I doubt I ride too much.

Recently, researchers in Britain set out to study the heart health of a group of dauntingly fit older athletes. Uninterested in sluggards, the scientists recruited only men who had been part of a British national or Olympic team in distance running or rowing, as well as members of the extremely selective 100 Marathon club, which admits runners who, as you might have guessed, have completed at least a hundred marathons.

All of the men had trained and competed throughout their adult lives and continued to work out strenuously. Twelve were age 50 or older, with the oldest age 67; another 17 were relative striplings, ages 26 to 40. The scientists also gathered a group of 20 healthy men over 50, none of them endurance athletes, for comparison. The different groups underwent a new type of magnetic resonance imaging of their hearts that identifies very early signs of fibrosis, or scarring, within the heart muscle. Fibrosis, if it becomes severe, can lead to stiffening or thickening of portions of the heart, which can contribute to irregular heart function and, eventually, heart failure.

The results, published online a few weeks ago in The Journal of Applied Physiology, were rather disquieting. None of the younger athletes or the older nonathletes had fibrosis in their hearts. But half of the older lifelong athletes showed some heart muscle scarring. The affected men were, in each case, those who’d trained the longest and hardest. Spending more years exercising strenuously or completing more marathon or ultramarathon races was, in this study, associated with a greater likelihood of heart damage.

The question of whether years of intense endurance training might, just possibly, be harmful to the heart is hardly new. It arises whenever a seemingly healthy distance runner, cyclist or other endurance athlete suffers a heart attack. It’s also sometimes invoked by those looking for an excuse not to exercise.

But, to date, science has been hard pressed to establish a clear cause-and-effect link between strenuous exercise and heart damage. A much-discussed 2008 German study of experienced, older marathon runners, for instance, found signs of fibrosis in their hearts more frequently than in a group of less active older men. But some of the racers had taken up regular exercise only late in life, after decades of smoking and other bad health habits. It was impossible to say whether their current heart damage predated their marathon training.

The new study of elite lifelong athletes avoids that pitfall. None of the athletes were new to exercise. Only one had ever smoked. But even so, the study can’t directly prove that the older athletes’ excruciatingly heavy training loads and decades of elite-level racing caused heart scarring, only that the two were associated with each another.

But another new study, this time in laboratory rats, provides the first solid evidence of a direct link between certain kinds of prolonged exercise and subtle heart damage. For the study, published in the journal Circulation, Canadian and Spanish scientists prodded young, healthy male rats to run at an intense pace, day after day, for three months, which is the equivalent of about 10 years in human terms. The training was deliberately designed to mimic many years of serious marathon training in people, said Dr. Stanley Nattel, a cardiologist who is director of the electrophysiology research program at the Montreal Heart Institute Research Center and a senior author of the study.

The rats had begun their regimens with perfectly normal hearts. At the end of the training period, heart scans showed that most of the rodents had developed diffuse scarring and some structural changes, similar to the changes seen in the human endurance athletes. A control group of unexercised rats had developed no such remodeling of their hearts. The researchers also could manually induce arrhythmias, or disruptions of the heart’s natural electrical rhythm, much more readily in the running rats than in the unexercised animals. Interestingly, when the animals stopped running, their hearts returned to normal within eight weeks. Most of the fibrosis and other apparent damage disappeared.

What does all of this mean for those of us who dutifully run or otherwise make ourselves sweat several times a week? Probably not much, realistically, said Dr. Paul Thompson, the chief of cardiology at Hartford Hospital in Connecticut and an expert on sports cardiology. He was one of the peer reviewers for the British athlete study.

“How many people are going to join the 100 Marathon club” or undertake a comparable amount of training? he asked. “Not many. Too much exercise has not been a big problem in America. Most people just run to stay in shape, and for them, the evidence is quite strong that endurance exercise is good” for the heart, he said.

Dr. Nattel agrees. “There is no doubt that exercise in general is very good for heart health,” he said. But the emerging science does suggest that there may be a threshold of distance, intensity or duration beyond which exercise can have undesirable effects.

Unfortunately, it remains impossible, at the moment, to predict just what that threshold is for any given person, and which athletes might be most vulnerable to heart problems as a result of excessive exercise, said Dr. Paul Volders, a cardiologist at the University of Maastricht in the Netherlands, who wrote an editorial accompanying the recent rat study.

“Let’s say we ask 100 people, all same age, all same gender, to start a marathon training program at the age of 20 years,” Dr. Volders wrote in an e-mail. If the runners continued their training uninterrupted for 30 years and scientists then scanned their hearts, “it is very likely (one may say: for sure) that there will be major differences in the tissue of the chambers of the heart between these people,” he wrote. For some, the changes will be beneficial; for others, probably not.

Similarly, because most of the research has been done in men and male animals, it is unclear whether the hearts of long-term female athletes are affected in the same fashion. But Dr. Nattel said it seems likely that the latest finding would also apply to women.

So for now, the best response to the emerging science of excessive exercise is to just keep exercising, but with a low-level buzz of caution. If your heart occasionally races, which could indicate arrhythmia, or otherwise draws attention to itself, Dr. Nattel said, consult a doctor.

But if you exercise regularly and currently have no symptoms, “I think it’s safe to say that you should keep it up,” Dr. Thompson said.

[AngryScientist]

fortunately i wont be admitted to the 100 marathon club anytime soon.

[old_fat_and_slow]

Aw C'mon AS. What's with tha pessimistic attitude. You still got time.

Lace up yer runnin' shoes and get crackin'.

(BTW, I'm well on my way to gaining admission to the exclusive ranks. I only need to complete 99 more and I am in. Schweet ! ! )

[false_Aest]

Some fat slob is going to get wind of a basterdized version of this report via CNN or the (absolutely abysmal) LA Times, search for a reinforced soap box, get on it and start talking about how being fat and lazy is a good thing.


Then NPR will get a hold of it and air an über liberal-conspiracy story about it twisting everything around.

The net result will be that the Govt will stop funding public broadcasting, NPR will get less funding, CNN (or FOX or LA Times) will distribute more basterdized stories and it will once again be hella SHEEEEEEK to be fat and pasty....

someone apply loctite to this thread.

[dekindy]

Do the athletes studied have a higher or lower incidence of actual heart problems like attacks, etc? That is all that I would care about, not what the heart looks like.

Maybe scarring and structural changes are caused by the exercise that resulted in the heart getting stronger?

[mpetry]

Mark Sisson (www.marksdailyapple.com) has been saying the same thing for years. All that high intensity training builds up cortisol in the heart.

Bottom line, if you believe this stuff, as you pass 50 you change your riding tempo.

Mark Petry
Bainbridge Island, WA

[RPS]

Bottom line, if you believe this stuff, as you pass 50 you change your riding tempo.

Yeah -- and often not by choice. ;)

[Fixed]

[QUOTE=mpetry]

(Bottom line, if you believe this stuff, as you pass 50 you change your riding tempo. )



you got no choice if you listen to your body, you can try and jump with the 25 year olds but your body will scream when i hit 50 a few years back it was an eye opener( i was still a messenger ) then i got sick now an hour on the bike or a little more and i ride my workout not somebody else's . i'm happy
push the envelope too much and i not so happy body and mind are connected ..
cheers

[Ralph]

I believe that. I have some Doc friends who believe moderate to more than moderate exercise is good for you....assuming you are healthy. They also believe running marathons or training for them, is beyond healthy exercise. It may or may not shorten your life. I'm convinced the ability to run 26 miles is not necessary for good heart health.

As a 69 year old cyclist, I enjoy getting in my 100 or so miles each week. But see no health benefit to stepping those miles to 200....even if it would make me a stronger rider.

[gregblow]

I have sat with a doctor more than a number of times and debated my exercise schedule. he is convinced that exercise is bad for the heart and also believes that no carb diet is the best. there is a ton of evidence he says

[biker72]

I believe that. I have some Doc friends who believe moderate to more than moderate exercise is good for you....assuming you are healthy. They also believe running marathons or training for them, is beyond healthy exercise. It may or may not shorten your life. I'm convinced the ability to run 26 miles is not necessary for good heart health.

As a 69 year old cyclist, I enjoy getting in my 100 or so miles each week. But see no health benefit to stepping those miles to 200....even if it would make me a stronger rider.

I'm with you Ralph. At 72 I'm really not interested in running a marathon or winning the Tour de France. The 100 mile weeks I complete are enough to keep me fit and out of the hospital.

[Frankwurst]

Mark Sisson (www.marksdailyapple.com) has been saying the same thing for years. All that high intensity training builds up cortisol in the heart.

Bottom line, if you believe this stuff, as you pass 50 you change your riding tempo.

Mark Petry
Bainbridge Island, WA

I didn't change my riding style because I believe this stuff. I changed my riding style because I'm past 50. :beer:
And Kudos to Ralph and biker72. I want to be like you guys when I grow up. :beer:

[1centaur]

If the body is viewed as a machine, I don't see why pushing it towards its limits regularly would not tend to wear things out faster. Doctors who say that the problem is not exercising enough are looking at the forest and ignoring the trees, just like when they tell people not to consume salt or eat eggs. The patient in front of them is not an aggregate but an individual, and too many doctors are too comfortable spouting advice that is societaly true but not individually true. That's because they don't know what athletes require.

I have seen enough studies at this point that I think where there's smoke there's fire. Driving up Mt. Washington with a 96 hp motor can put a strain on the engine, even if you're willing to keep the pedal down. I was happy to see the part in this study about the body's engine healing itself with enough rest. When I see these studies I always think of the folks on the Boston Common gathering for the marathon each year. So many toned 40+ bodies, so many unhealthy looking faces.

[wasfast]

The problem is making this an all or nothing at the high level. In true Type A fashion, endurance athletes quickly apply the "more is better" approach and(using running as an example) go from 5K to 10K to half marathon to full marathon to multiple marathons per year to Ultra marathons to more difficult ultra marathons. Beyond some reasonable point, extreme exercise (good luck defining that) isn't "better" for you.

Sitting on your a$$ isn't healthy either and the developed world is FAR from worrying about issues from overexercising in general.

I've thought about this multiple times in recent years. I started serious training and racing 4 years ago (I'm 52 now) doing TT's which put you at your very limit for what seem like eternal periods of time. Running at redline wouldn't seem the smartest thing for older folks (again, define "older:-)).

The flip side is I'm in the best shape I've ever been, now weigh what I did in college and look 10 yrs younger. Not to sound like an informercial.........

[bobswire]

I'm with you Ralph. At 72 I'm really not interested in running a marathon or winning the Tour de France. The 100 mile weeks I complete are enough to keep me fit and out of the hospital.

Ditto! 66 here.

[Fixed]

The problem is making this an all or nothing at the high level. In true Type A fashion, endurance athletes quickly apply the "more is better" approach and(using running as an example) go from 5K to 10K to half marathon to full marathon to multiple marathons per year to Ultra marathons to more difficult ultra marathons. Beyond some reasonable point, extreme exercise (good luck defining that) isn't "better" for you.

Sitting on your a$$ isn't healthy either and the developed world is FAR from worrying about issues from overexercising in general.

I've thought about this multiple times in recent years. I started serious training and racing 4 years ago (I'm 52 now) doing TT's which put you at your very limit for what seem like eternal periods of time. Running at redline wouldn't seem the smartest thing for older folks (again, define "older:-)).

The flip side is I'm in the best shape I've ever been, now weigh what I did in college and look 10 yrs younger. Not to sound like an informercial.........
good point
how you feel is the main thing
cheers

[gdw]

I wonder how long Johny Kelly would have lived if he had just exercised moderately?
http://en.wikipedia.org/wiki/Johnny_Kelley

There's probably some truth to the report but I'm willing to trade a few years of doltage for some adventure now.

[benb]

I think even this article is twisting this study around heavily and sensationalizing it...

After all.. only 50% of the athletes had this "scarring" in their hearts. The article does not say what the scarring level was in the control group. And as always, I'm sure the guys doing the science understand the following, but the media always fails to report it.

"Correlation is not Causation"

Heh.. but yah, no risk of me ever being in that group either I fear. But we all have to die at some point.

[biker72]

The flip side is I'm in the best shape I've ever been, now weigh what I did in college and look 10 yrs younger. Not to sound like an informercial.........

Wait, there's more... :banana:

Seriously, having extensive personal experience with cardiologists, they've all said that endurance athletes tend to develop "strange" EKG results. I've heard of numbers as high as 80%.

[Fixed]

doctors i love them but a lot want us all to be patients


i think diet has some bearing on the argument also
cheers

[Dekonick]

Wait, there's more... :banana:

Seriously, having extensive personal experience with cardiologists, they've all said that endurance athletes tend to develop "strange" EKG results. I've heard of numbers as high as 80%.

Interesting... My 12 lead shows an inverted T wave in several of my lateral leads. I have had it for years... I doubt it is going to go away. My doc isn't worried... I am not worried... the only thing I do is carry a copy of my EKG in my wallet.

Get a good physical once a year... go about your business as usual. Floss your teeth! :beer:

Oh, and we should all lift weights... I know it isn't good for your cycling... but it will help you out later in life.

[BumbleBeeDave]

I believe that. I have some Doc friends who believe moderate to more than moderate exercise is good for you....assuming you are healthy. They also believe running marathons or training for them, is beyond healthy exercise. It may or may not shorten your life. I'm convinced the ability to run 26 miles is not necessary for good heart health.

As a 69 year old cyclist, I enjoy getting in my 100 or so miles each week. But see no health benefit to stepping those miles to 200....even if it would make me a stronger rider.

. . . and I'm only(!) 52. I enjoy a hundred mile week up to about 150. But ratchet that up any more and it stops being fun and that's why I ride--to have fun.

BBD

[BCS]

I think even this article is twisting this study around heavily and sensationalizing it...

After all.. only 50% of the athletes had this "scarring" in their hearts. The article does not say what the scarring level was in the control group. And as always, I'm sure the guys doing the science understand the following, but the media always fails to report it.

"Correlation is not Causation"

Heh.. but yah, no risk of me ever being in that group either I fear. But we all have to die at some point.

There is a lot more evidence but here is an interesting link.
http://heart.bmj.com/content/94/7/860.abstract?ijkey=cafc8a9868930f671b251b6127addf0 967b723eb&keytype2=tf_ipsecsha

However, this won't keep me from doing a 400K ride on saturday

[biker72]

. . . and I'm only(!) 52. I enjoy a hundred mile week up to about 150. But ratchet that up any more and it stops being fun and that's why I ride--to have fun.

BBD

When I retired, the first time, I had almost a month that I rode 200+miles/week. That became not fun.

[Seramount]

bfd.

Olympic-caliber and extreme endurance athletes have training regimens that have no resemblance to recreational and weekend warrior types.

you run a machine at redline long enough and bad things usually happen.

duh.

[bobswire]

Reading this thread brings back thoughts I had on two local riders who were serious riders.
Tom Milton.
http://www.bicycleretailer.com/news/newsDetail/4003.html

And Clay Mankin

http://www.veen.com/jeff/archives/000818.html

[Ray]

Our grandmothers and mothers had a point when they kept telling us "everything in moderation". There's nothing that's been invented yet that couldn't be overdone.

And to the earlier mention of Mark Sisson - I agree completely. Since I adopted his basic philosophy (but not 100% - remember, all things in moderation), I'm less fit and a bit fatter but generally healthier and I feel a lot better almost always. Eat and exercise like our caveman ancestors - its what we've evolved for. I'm not even afraid of winter time couch potato-hood, again in moderation. I walk a lot in the winter because I walk to get around as much as possible and I have a dog that needs to walk a couple of times a day even when I don't. And that seems to work too. I almost never do any hard exercise in the winter anymore - my daughter showed me something from some eastern religion that posited that one should never raise their metabolism to the point of sweating in the winter - some connection to hibernation I think. I sweat easily, so some of my winter time walks will create a bit of a sweat, but not an extreme one.

Do whatever feels right. Do too much and it doesn't feel right. Do too little and it doesn't feel right either. Trust your body and listen to it.

-Ray

[fiamme red]

And to the earlier mention of Mark Sisson - I agree completely. Since I adopted his basic philosophy (but not 100% - remember, all things in moderation), I'm less fit and a bit fatter but generally healthier and I feel a lot better almost always. Eat and exercise like our caveman ancestors - its what we've evolved for.Did our cavemen ancestors ride bikes? If they did, did they post on bike forums?

I've read some of Sisson's stuff and he seems to be a paleo-cultist.

Now I'm off to poison myself by eating a whole grain roll and some cottage cheese.

[Ray]

Did our cavemen ancestors ride bikes? If they did, did they post on bike forums?

I've read some of Sisson's stuff and he seems to be a paleo-cultist.

He is. He might not be wrong. It makes at least as much sense to me as anything else nutritional science has come up with. They didn't ride bikes, but if they'd had a Pugsley it would have made their jobs somewhat easier. But I think they'd have still spent long parts of the day going easy and very short bursts going very very hard in their ongoing quest for plants and animals to eat (and not be eaten by).

[fiamme red]

He is. He might not be wrong. It makes at least as much sense to me as anything else nutritional science has come up with. They didn't ride bikes, but if they'd had a Pugsley it would have made their jobs somewhat easier. But I think they'd have still spent long parts of the day going easy and very short bursts going very very hard in their ongoing quest for plants and animals to eat (and not be eaten by).I think Sisson used to be an endurance athlete, but now he prefers less time-consuming and more intense exercise. He has simply rationalized his biases about training (and diet, of course) with dubious inferences about caveman life.

Primitive man often ran animals for long durations to exhaustion in order to kill them. We evolved to run, not sprint. Most animal predators are faster than we are, and we've learned to escape them with cunning, not speed. The fastest man (Bolt) tops out at 27 mph, a cheetah at 70 mph.

[benb]

Yep the Persistence hunting stuff I think has totally killed the notion we were not intended for endurance exercise.. I think Sisson has some neat ideas but he's just a guy who is ripped, he has no authority other then that. :)

Maybe there is a point that is too much. I just hate how in a country where the vast majority of people are getting 0 exercise and we have a major epidemic of health problems that is hitting us a result of poor exercise habits, stories like this one get so much play in the media.

It kind of reminds me how small amounts of wine may be healthy.. it gets talked about in the media like crazy because there is no sacrifice in drinking wine, and meanwhile a bunch of people likely use it as an excuse to drink too much wine.

[Fixed]

ok i am dumb but you don't have to be a genius to know that...
obesity is killing america not exercise
cheers

[Ray]

ok i am dumb but you don't have to be a genius to know that...
obesity is killing america not exercise
cheers
True, but nobody is claiming exercise is bad. Its really really really good and I don't think anyone would argue. Its just a matter of how much and how intense. Most recreational cyclists probably aren't getting too much or going too hard too much of the time (although I'm sure plenty of amateur racers are). And while obesity is killing Americans, its not about lack of exercise as much as massive carb intake. In the 1950s and 1960s people weren't getting as much exercise as now (at least structured - probably a fair amount of informal exercise - walking and stuff) and were a whole lot thinner. Still a lot of heart disease and cancer but it was driven more by smoking than weight. The obesity thing is only in the last, what, 10-15 years or so, maybe 20? Exercise is probably up relative to when people were thin, but carb intake is through the roof. When I was riding a lot more than I am now and a lot harder, I was also eating loads of carbs. I couldn't keep the weight off even with 5000-6000 mile years. Now its no problem and I'm probably only riding a couple thousand miles per year, maybe 2500.

-Ray

[rugbysecondrow]

Interesting... My 12 lead shows an inverted T wave in several of my lateral leads. I have had it for years... I doubt it is going to go away. My doc isn't worried... I am not worried... the only thing I do is carry a copy of my EKG in my wallet.

Get a good physical once a year... go about your business as usual. Floss your teeth! :beer:

Oh, and we should all lift weights... I know it isn't good for your cycling... but it will help you out later in life.


Mike, why would you carry an EKG in your wallet?

[wc1934]

that does it - trading in my running shoes for ding dongs and devil dogs.

[soulspinner]

Yeah -- and often not by choice. ;)

Aint it the truth...................

[Alan]

I emailed Dr Mirkin who basically told me not to worry about it. I don't want to copy and paste his reply. He follows his own advice as he rides over 200 mi at a pretty good clip (faster than me and he is 20 years older than me).

I let him know that this issue had raised concerns in the cycling community so hopefully he will comment about it in his email/web site which you can find at:

http://www.drmirkin.com/

I get his email and it is very well done.

Alan

[Samster]

i read somewhere that the average heart has about 2.5 billion beats in it. you exercise and you use up beats, but get it back (and hopefully then some) in a lower resting pulse for a big chunk of the day. but elevate it for 100+ marathons and training that goes with it... i guess you're cashing in more chips than you get back.

bottom line, all capital depreciates. have a good time while your at it, imo.

[Samster]

i also read that hearts are about the same size. if you're overweight, your heart basically has to pump at a faster rate to service the entire vascular system. i guess this basically burns more beats day-to-day. you're better off thin and overtrained.

btw... i am _not_ a doctor, and perhaps it shows through these simple minded conjectures.

[Samster]

i am going for a bike ride. bye.

[bobswire]

I emailed Dr Mirkin who basically told me not to worry about it. I don't want to copy and paste his reply. He follows his own advice as he rides over 200 mi at a pretty good clip (faster than me and he is 20 years older than me).

I let him know that this issue had raised concerns in the cycling community so hopefully he will comment about it in his email/web site which you can find at:

http://www.drmirkin.com/

I get his email and it is very well done.

Alan


Good site and well worth getting his news letter.

[biker72]

Interesting... My 12 lead shows an inverted T wave in several of my lateral leads. I have had it for years... I doubt it is going to go away. My doc isn't worried... I am not worried... the only thing I do is carry a copy of my EKG in my wallet.

Get a good physical once a year... go about your business as usual. Floss your teeth! :beer:

Oh, and we should all lift weights... I know it isn't good for your cycling... but it will help you out later in life.

I didn't mean to imply that you should quit exercising if your EKG is a little abnormal. I've had a "strange EKG" since 1986. Every year when I get a stress test the cardiologist compares all of my EKG's on record. As long as nothing new shows up I'm encouraged to get back out there on that bike and keep riding.

[akelman]

Wait, did someone say that Usain Bolt is going to race a cheetah? Because I'd totally pay-per-view that.

[eweg]

I really think it is a combination of genetic predisposition, other life choices which can be stressful and too much intense work load on the heart. I say once you have seen what your maximum althetic abilities are and no longer improving - stop pushing yourself to be what you were as a 20 year old. Enjoy the ride and you will probably avoid cardiovascular injury (unless your Jim Fixx or Arthur Ashe and your genes just have it in for you)

[Louis]

Wait, did someone say that Usain Bolt is going to race a cheetah? Because I'd totally pay-per-view that.

"Ave, Caesar, morituri te salutant"

[rugbysecondrow]

i read somewhere that the average heart has about 2.5 billion beats in it. you exercise and you use up beats, but get it back (and hopefully then some) in a lower resting pulse for a big chunk of the day. but elevate it for 100+ marathons and training that goes with it... i guess you're cashing in more chips than you get back.

bottom line, all capital depreciates. have a good time while your at it, imo.

I want my heart to quit about the same time the rest of my body stops working. If I have the capacity to understand, I will be pissed if my heart pumps into my 90's while my bladder, legs, back, mind etc. have already shut down. If my heart uses up my beats in my 70's and I get to avoid all the other BS, fine by me.

[Samster]

I want my heart to quit about the same time the rest of my body stops working. If I have the capacity to understand, I will be pissed if my heart pumps into my 90's while my bladder, legs, back, mind etc. have already shut down. If my heart uses up my beats in my 70's and I get to avoid all the other BS, fine by me.

i wish the same thing myself. but good luck with that.