4 ms·

Extreme exercise such as distance running damages the heart. https://youtu.be/Y6U728AZnV0 https://youtu.be/Y6U728AZnV0

scott_w 2y ago
This is simply not true. Even research that suggests damage also suggests endurance athletes have better outcomes anyway: https://www.heart.org/en/news/2019/03/01/is-long-distance-running-good-for-the-heart https://www.heart.org/en/news/2019/03/01/is-long-distance-ru...
- gregwebs 2y ago
  The article you linked doesn’t support the statement made about it. The evidence is mixed but shows worse overall outcomes for those overdoing it. Here’s a scientific publication that’s clearer that recommends 1-2 days off per week, and no more than 5 hours running per week. https://journals.lww.com/acsm-csmr/fulltext/2015/03000/exercise_and_the_heart___the_harm_of_too_little.12.aspx https://journals.lww.com/acsm-csmr/fulltext/2015/03000/exerc...
  - scott_w 2y ago
    Quote from the article: > Recent research has raised alarms about the potential for plaque buildup and scarring in the heart in some long-distance runners. Yet other studies have suggested that when marathoners get heart disease, they may be able to weather it better than non-runners. All articles discuss scarring and physical signs but no clear link between exercise and worse life outcomes. The article you cited noted most issues resolve themselves within a few weeks after a race. There are literally 0 people exercising at “race intensity” day after day, which is completely different kettle of fish to your regular training run. Kato here certainly isn’t doing that. Given many professionals and amateurs run over 5 hours per week and easily break 5/6 miles at a time. A quick search will show strong runners regularly hit 6-8 hours per week. Cyclists will cover greater distances and times and, apart from Pantani (who was doped to the gills), you don’t see them dropping dead of heart attacks despite regularly covering 10-20 hours a week. Similar for triathletes. So no, the evidence really isn’t there that distance running causes heart disease.
    - gregwebs 2y ago
      That's another incorrect summary. From the journal article there are multiple studies that have shown worse long-term outcomes from large amounts of exercise: > Other studies also have confirmed the long-term adverse effects on myocardial structure (18,27–30,32), including one study suggesting that the CAD event rate during 2-year follow-up was significantly higher in the athletes than that in controls > Recent studies have suggested that long distance runners may have increased levels of atherosclerosis and CAD (18,37). In a study 6 years ago, male marathon runners had paradoxically increased coronary artery calcification (CAC) as measured by computed tomography (CT) CAC scoring (21). A very recent study of men who completed at least one marathon yearly for 25 consecutive years (n = 50) compared with 23 sedentary controls demonstrated increased total plaque volume (P < 0.01), calcified plaque volume (P < 0.0001), and noncalcified plaque volume (P = 0.04) compared with those with EEE (Fig. 3) (37). Despite the fact that runners have better overall CAD risk profiles, these results underscore the potential for very heavy EEE to increase the severity of CAD through mechanisms largely independent of the traditional CAD risk factors. > Very high doses of running, however, were associated with trends of worse survival compared with either nonrunners or groups of low- and moderate-dose runners. > However, when dividing runners into quintiles of doses (miles·wk−1, running days per week, min·wk−1, and running speed), with the exception of speed (faster running always had a trend for better survival), quintile 1 (<6 miles·wk−1, 1 to 2 times per week, <51 min·wk−1) had similar mortality reductions as those in quintiles 2 to 4 and a trend to slightly greater benefit than those in quintile 5 (Fig. 4). There are other studies that have not shown long-term adverse events. The evidence isn't conclusive and most people need more exercise, not less. But it's prudent to caution committed runners about overdoing it with this information so they can make their own informed decision.
      - scott_w 2y ago
        > There are other studies that have not shown long-term adverse events. The evidence isn't conclusive So after all that, you end up agreeing with me.
      - throwway120385 2y ago
        It's entirely possible that the CAC response is evolved to have some protective factor for endurance running.
dudeinjapan 2y ago
Only love can break your heart. https://www.youtube.com/watch?v=364qY0Oz-xs https://www.youtube.com/watch?v=364qY0Oz-xs
dahart 2y ago
Important quotes from that video: “You can exercise all day, it seems, if you keep it down.” And “let me be clear about this: there is no single step you can take in your life to ensure robust health and remarkable longevity than a habit of daily exercise.” FWIW, there are some more recent studies that flatly contradict this claim [1] [2], so YMMV with a TED talk. My father has been a long-distance runner for 50 years, and he thinks that it is possible to do heart damage in very extreme cases, but these cases including being more committed than most Olympic athletes. The problem is when doing competitive racing type running without ever taking a break for recovery. He does know a couple of people who ran too fast and too much and had to quit due to what he calls “overtraining syndrome”. He specifically said he thinks Deo Kato isn’t likely running fast enough to cause overtraining syndrome. In the video, you might notice the data he shows depends on running pace; In the TED video, James didn’t separate miles per week from pace (at for example ~6:50). This means that distance alone - miles per week - doesn’t necessarily prove anything, miles might not be associated with risks until it’s enough miles that there’s no time left to rest. There is a real danger here of scaring people who should exercise more, of giving the wrong impression or a backwards summary to the vast majority of people who will never ever run the risk of over-exercising so much they could cause heart damage. Your summary left out the part where James pointed to the absolute consensus that an hour a day of “vigorous” exercise is known without a doubt to be very beneficial. There’s also a danger of giving a misleading impression about the risks of not exercising compared to the risks of extreme exercise. The data in the video at ~5:10 shows not exercising leading to dying many years earlier, while there is no data here that shows extreme exercise leading to higher mortality; all it shows is that the benefits plateau. There’s some data and discussion on incidence of heart problems, but not outcomes. Essentially the summary should be: exercise all you want, and if you are wondering if you’re exercising too much, then you’re nowhere near the threshold - the very few people exercising enough to do heart damage are extreme and already know they exercise too much, because they’re compromising on work, hobbies, friends, and family in order to exercise. ;) [1] https://www.outsideonline.com/health/training-performance/extreme-exercise-heart-health-study/?scope=initial https://www.outsideonline.com/health/training-performance/ex... [2] https://www.utsouthwestern.edu/newsroom/articles/year-2019/extreme-exercise.html https://www.utsouthwestern.edu/newsroom/articles/year-2019/e... PS you’re not the Andrew Stuart of Sudoku/puzzle fame are you?

This is simply not true. Even research that suggests damage also suggests endurance athletes have better outcomes anyway: https://www.heart.org/en/news/2019/03/01/is-long-distance-running-good-for-the-heart https://www.heart.org/en/news/2019/03/01/is-long-distance-ru...

gregwebs 2y ago
The article you linked doesn’t support the statement made about it. The evidence is mixed but shows worse overall outcomes for those overdoing it. Here’s a scientific publication that’s clearer that recommends 1-2 days off per week, and no more than 5 hours running per week. https://journals.lww.com/acsm-csmr/fulltext/2015/03000/exercise_and_the_heart___the_harm_of_too_little.12.aspx https://journals.lww.com/acsm-csmr/fulltext/2015/03000/exerc...
- scott_w 2y ago
  Quote from the article: > Recent research has raised alarms about the potential for plaque buildup and scarring in the heart in some long-distance runners. Yet other studies have suggested that when marathoners get heart disease, they may be able to weather it better than non-runners. All articles discuss scarring and physical signs but no clear link between exercise and worse life outcomes. The article you cited noted most issues resolve themselves within a few weeks after a race. There are literally 0 people exercising at “race intensity” day after day, which is completely different kettle of fish to your regular training run. Kato here certainly isn’t doing that. Given many professionals and amateurs run over 5 hours per week and easily break 5/6 miles at a time. A quick search will show strong runners regularly hit 6-8 hours per week. Cyclists will cover greater distances and times and, apart from Pantani (who was doped to the gills), you don’t see them dropping dead of heart attacks despite regularly covering 10-20 hours a week. Similar for triathletes. So no, the evidence really isn’t there that distance running causes heart disease.
  - gregwebs 2y ago
    That's another incorrect summary. From the journal article there are multiple studies that have shown worse long-term outcomes from large amounts of exercise: > Other studies also have confirmed the long-term adverse effects on myocardial structure (18,27–30,32), including one study suggesting that the CAD event rate during 2-year follow-up was significantly higher in the athletes than that in controls > Recent studies have suggested that long distance runners may have increased levels of atherosclerosis and CAD (18,37). In a study 6 years ago, male marathon runners had paradoxically increased coronary artery calcification (CAC) as measured by computed tomography (CT) CAC scoring (21). A very recent study of men who completed at least one marathon yearly for 25 consecutive years (n = 50) compared with 23 sedentary controls demonstrated increased total plaque volume (P < 0.01), calcified plaque volume (P < 0.0001), and noncalcified plaque volume (P = 0.04) compared with those with EEE (Fig. 3) (37). Despite the fact that runners have better overall CAD risk profiles, these results underscore the potential for very heavy EEE to increase the severity of CAD through mechanisms largely independent of the traditional CAD risk factors. > Very high doses of running, however, were associated with trends of worse survival compared with either nonrunners or groups of low- and moderate-dose runners. > However, when dividing runners into quintiles of doses (miles·wk−1, running days per week, min·wk−1, and running speed), with the exception of speed (faster running always had a trend for better survival), quintile 1 (<6 miles·wk−1, 1 to 2 times per week, <51 min·wk−1) had similar mortality reductions as those in quintiles 2 to 4 and a trend to slightly greater benefit than those in quintile 5 (Fig. 4). There are other studies that have not shown long-term adverse events. The evidence isn't conclusive and most people need more exercise, not less. But it's prudent to caution committed runners about overdoing it with this information so they can make their own informed decision.
    - scott_w 2y ago
      > There are other studies that have not shown long-term adverse events. The evidence isn't conclusive So after all that, you end up agreeing with me.
    - throwway120385 2y ago
      It's entirely possible that the CAC response is evolved to have some protective factor for endurance running.

dudeinjapan 2y ago

Only love can break your heart. https://www.youtube.com/watch?v=364qY0Oz-xs https://www.youtube.com/watch?v=364qY0Oz-xs

dahart 2y ago

Important quotes from that video: “You can exercise all day, it seems, if you keep it down.” And “let me be clear about this: there is no single step you can take in your life to ensure robust health and remarkable longevity than a habit of daily exercise.” FWIW, there are some more recent studies that flatly contradict this claim [1] [2], so YMMV with a TED talk. My father has been a long-distance runner for 50 years, and he thinks that it is possible to do heart damage in very extreme cases, but these cases including being more committed than most Olympic athletes. The problem is when doing competitive racing type running without ever taking a break for recovery. He does know a couple of people who ran too fast and too much and had to quit due to what he calls “overtraining syndrome”. He specifically said he thinks Deo Kato isn’t likely running fast enough to cause overtraining syndrome. In the video, you might notice the data he shows depends on running pace; In the TED video, James didn’t separate miles per week from pace (at for example ~6:50). This means that distance alone - miles per week - doesn’t necessarily prove anything, miles might not be associated with risks until it’s enough miles that there’s no time left to rest. There is a real danger here of scaring people who should exercise more, of giving the wrong impression or a backwards summary to the vast majority of people who will never ever run the risk of over-exercising so much they could cause heart damage. Your summary left out the part where James pointed to the absolute consensus that an hour a day of “vigorous” exercise is known without a doubt to be very beneficial. There’s also a danger of giving a misleading impression about the risks of not exercising compared to the risks of extreme exercise. The data in the video at ~5:10 shows not exercising leading to dying many years earlier, while there is no data here that shows extreme exercise leading to higher mortality; all it shows is that the benefits plateau. There’s some data and discussion on incidence of heart problems, but not outcomes. Essentially the summary should be: exercise all you want, and if you are wondering if you’re exercising too much, then you’re nowhere near the threshold - the very few people exercising enough to do heart damage are extreme and already know they exercise too much, because they’re compromising on work, hobbies, friends, and family in order to exercise. ;) [1] https://www.outsideonline.com/health/training-performance/extreme-exercise-heart-health-study/?scope=initial https://www.outsideonline.com/health/training-performance/ex... [2] https://www.utsouthwestern.edu/newsroom/articles/year-2019/extreme-exercise.html https://www.utsouthwestern.edu/newsroom/articles/year-2019/e... PS you’re not the Andrew Stuart of Sudoku/puzzle fame are you?