UPDATED: A death blow to excessive exercise believers?

I like most exercise scientists believe whole-heartedly that exercise is indeed medicine. I’ll debate anyone that it is the overall best medicine, in fact. When we look across populations and research two things, that is two lifestyle choices impact our health more than any other thing, except where genetic anomalies exist. On the negative side is smoking, because no other choice you make has such a broad range of negative effects as smoking does. On the positive side, though, is exercise. So powerful is exercise that it can actually reverse diseases like diabetes and heart damage, as well as reduce your risk for cancer. So when I first read that too much endurance exercise, actually ultra levels, caused significant damage, I waded in and looked at some of the data. James O’Keefe kept at raising alarm bells with a companion TedTalk. I admit it, I was hooked by this fishing line, because he was a good talker and raised some interesting points. I even did a podcast on sudden death in athletes. Yet, I was unconvinced for a lot of reasons. So it came as no real surprise, but a bit of relief, to see that maybe those alarm bells were a bit premature. In a very good review of broader research, Sweat Science guy, Alex Hutchison reviewed a series of new studies that deflate the hyperbolic suggestions that endurance exercise is a killer. I’m not going to rehash that article, because it summarizes everything nicely. However, if you’re short on time here are the highlights:

  • one study indicated that extreme ultra endurance athletes show indications of wear and tear on the heart, but we don’t know if those signs are actually pathological. This is very similar to back pain and degeneration. Up to 80% of Americans have the latter, but only a small percentage have actual back problems. Many people with back pain have some type of anomaly. However, neither one of these cases helps us ascertain if degeneration is the rot cause of back pain.
  • Another study “over-controlled” by statistically adjusting for factors like BMI (related to body fat) or blood pressure among runners, but these factors are actually improved by running, so minimizing their effect on health in a sense minimizes potential health improvements from running.
  • Commonsense tell us that too much of anything is not good, but we just don’t know what that threshold is for exercise.
  • A recent publication indicates no relationship between arterial stiffness and ultra endurance events.

I don’t need an opinion or data on this matter to tell you the facts. The leading fact here is that inactivity contributes to obesity, heart disease, and diabetes, among other diseases. Heart disease alone accounts for 600,000 deaths each year in the U.S., and is also the leading cause worldwide. I also know that 1.5 triathletes per 100,000 competitors die each year, a number that has remained stable for more than a decade. Finally, for any person who does die during exercise, it is impossible to know if exercise was the underlying cause, because sudden death really is the first symptom of sudden cardiac-related death. It garners headlines BECAUSE it is so uncommon. In non-politically correct terms, American is fat, lazy country. We drive all day in cars and complain about skinny people who may or may not exercise. I don’t exercise because I’m special or gifted, I exercise because I enjoy it and for as many aches and pains as I have, I feel worse if I do nothing. In the end, it actually is your choice!

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