EXERCISE: Avoiding Death by Exercise

Memento Mori*With the Tour de France winding down, it is hard not to notice what a strong place in popular culture the endurance sports hold.

Photo by: henning

*Cycling is still second in the campaign for most popular endurance sport.  Long distance running remains the undisputed champ.  Forrest Gump ran for 3 years, 2 months, 14 days, and 16 hours.  The previous three U.S. President’s have used jogging photo ops to depict themselves as health conscious.  Now, the Nike + Ipod sport kit has united two of the most recognizable commercial brands in the world and is touting a new ability to monitor the healthful effects of running (or is this just another gimmick to sell running shoes and iTunes).

*Given limited resources of time and money, you have to make important decisions about how and when you will exercise.  Here are three questions to ask yourself:

(1) Can you afford a sport that requires $100+ running shoes every three to six months (how about a bike and bike maintenance), an iPod, sporty outfits, energy drinks, power bars, race entrance fees and travel costs?

(2) Do you have the time to properly train for: a marathon, a half-marathon, or a 100 mile day on your bike?

(3) Will this type of training actually improve your health?

*The last question is the most important one.  Evidence shows that training for and participating in endurance sports are dangerous to your long term health.  To save time and money and avoid permanent damage to your body, skip training for endurance sports.  Instead, improve the effectiveness of your training and safeguard your health with sprints and focused 20m periods of steady exercise.

*The number one reason to avoid endurance sports is their tendency to result in death.  High profile running related deaths include, Pheidippides, who dropped dead after running from Marathon to Athens to announce the victory over the Persians.  Jim Fixx, one of the top promoters of running in the modern era, became famous in the 1970s for touting the health benefits of regular jogging.  On July 24, 1982, after finishing his daily run, he suffered a heart attack and died.  More recently, on November 3, 2007, Ryan Shay an amazingly successful distance runner, died during the US Olympic marathon trials in New York City.  Five and a half miles into the race, he suffered a massive heart attack.  High profile cycling death, November 2002, Edmund R. Burke, Ph.D., author of The Complete Book of Long-Distance Cycling: Build the Strength, Skills, and Confidence to Ride as Far as You Want suffered a heart attack and died while riding.

*Men’s Health cites a  1982 New England Journal of Medicine study showing that the chance for sudden death during exercise is not highest in couch potatoes, individuals that only exercise vigorously 1 to 19 minutes per week.  Rather, the highest risk group is men who exercise vigorously for 140 or more minutes per week.  It is pretty easy to crank out 2h and 20m (140m) of exercise over a week, when training for a marathon or long distance bicycle event.  The sweet spot, with the lowest risk for sudden death while exercising, is the range between 20 to 139 minutes per week.

*Risk of serious bodily injury is the number two reason to avoid endurance sports.  Stress fractures and damage to joints are obvious potential if not inevitable side effects from long distance running.   But, recent studies of competitive cyclists show that they have significantly less bone density than active, but not competitive athletes.  Putting cyclists at greater risk for fractures.  Not a good thing when sitting well above ground level and traveling at high speeds.

*The real benefit of endurance sports is supposed to be improved cardiovascular health.  However, one has to wonder about this claim, when the great marathoner Alberto Salazar, suffers two heart attacks, leaving his heart permanently damaged.  At some point, the benefits to your heart from exercise level off and go negative.

*MSNBC and Men’s Health report that as measured by enzymes leaking through the heart membrane of marathoners, significant stress on the heart appears to be a side effect from running a marathon.  Ultrasound and blood tests of 60 marathon finishers revealed that some runners’ hearts had difficulty refilling their chambers.  Also, abnormalities were noted in the way that blood was pumped from the right side of the heart to the lungs.  By the end of a marathon, there is a significant probability that your heart has been so taxed that it fails to function properly.

*This happens, because, as you pile up miles, muscles become damaged.  Continuing to run causes your muscles to release enzymes which signal to the body that a significant injury exists.  The body reacts to this information with an emergency response team.  Your adrenal glands and brain release vasopressin and cortisol.

NOTE: Health risks associated with chronic stress and high levels of cortisol are well-known.  The continuous release of cortisol, without a counter-balance of relaxation, causes damage to the body, including impaired cognitive performance, suppressed thyroid function, blood sugar imbalances such as hyperglycemia, decreased bone density, decrease in muscle tissue, higher blood pressure, lowered immunity and inflammatory responses in the body, slowed wound healing, and increased abdominal fat.  Increased abdominal fat has its own set of associated health problems like heart attacks and strokes.

*Meanwhile, cytokines from your muscles signal your liver to start producing C-reactive protein, an acute phase reactant, levels of which rise significantly during inflammatory processes.  The body is reacting to these muscle injuries, as it would to extreme stress due to a substantial traumatic injury.  The result is significant inflammation and an increase in coagulation agents.

*These emergency systems are meant to be engaged rarely.  They are not meant to be turned on repeatedly.  The body may be willing to risk slight damage to the heart if it means averting death from a serious injury.  But, imposing these types of systemic crises over and over again can create cumulative negative effects.

*Training for and running a marathon, as a personal challenge to be met and conquered, is an individual choice.  But, like many other personal challenges, it is a behavior fraught with risks including death and serious injury.  Contrary to pop culture marketing campaigns, habitual long distance running is not a good health practice.

*Now, let me give you three reasons to experiment with sprinting.

(1) Who would you rather look like?

Osaka07_D5A_Usain_Bolt

Photo by: Eckhard Pecher

London Marathon 2005Photo by: Nickt

(2) Who do you think is having more fun?

Paris half marathon

Photo by: Frederic de Villamil

usain bolt world recordPhoto by: rich115

(3) How much time do you have?

watch face*From an efficiency standpoint, with sprinting, you get better cardio benefits in a shorter period of time.  Try running a 440 all out and see what happens.

Photo by: waynemah

Don’t like the track, then try the pool.  Slice through your top 100 freestyle.  Don’t have access to a pool, then try nailing ten double-unders with your speed rope.  Now, tell me if you ever breathe like that while out for a jog.  Rest.  Now do it again.  These are short bursts of maximum effort, which is what your body was designed for, rather than the constant stress from perpetual exercise.

* With 20m of steady training, you can get a solid total body workout.  Throw in some Tabata work and you are getting plenty of cardio.

*Try a split between sprinting and days in the gym.  Three days in the gym with a couple of days on the track, on a field, or on the court. Now switch three days on the track, with a couple of days in the gym.  This sort of training lends itself to creative tinkering.  It is not a grinding battle to endure a long workout.

*Stop wasting time damaging your body.  Avoid endurance sports, work on sprints, and experiment with 20m workouts.  Help yourself get fit and stay healthy.  You will look good and feel good too.

*Resources/Further Reading:

—Are you running yourself to death?  http://www.msnbc.msn.com/id/27460551/

—Is Bicycling Bad for Your Bones?  http://well.blogs.nytimes.com/2009/07/01/is-bicycling-bad-for-your-bones/

—Exercise and death:  Am I safer on the couch?  http://www.cbc.ca/news/background/exercise_fitness/exercise_death.html

—Death by Exercise  http://www.menshealth.com/cda/article.do?category=heart.disease&channel=health&conitem=6fe999edbbbd201099edbbbd2010cfe793cd____&site=MensHealth

—Art Devany’s Archive for the Death by Exercise Category  http://www.arthurdevany.com/?cat=23

—Sprinting: The Purest Most Powerful Physique Shaper in an Athlete’s Arsenal!  http://www.bodybuilding.com/fun/par46.htm

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13 responses to “EXERCISE: Avoiding Death by Exercise

  1. I have not had time to draft up a full response, but I found this piece to be very misleading. As a lifelong long distance runner I would dispute the vast majority of these claims. Many of the so called scientific studies I have seen before and were based on samples too small to reach a scientific conclusion.

    I have run 18 marathons. I believe I am more healthy than most people. There is risk with any sport. A person that has never exercised before could easily have a heart attack while trying to do a short sprint. Marathon running is about conditioning. It is not for the once in a while runner. It is an event that you have to train for.

    Any given year there will be a handful out of the millions that run marathons that die. Most of the time these people had congenital defects that would have cut their lives short without the running.

    There are many reasons to not participate in endurance events, but fear of killing yourself is not one of them.

    • stoffainkorea

      Darren:

      *Don’t get me wrong, I am impressed with your 18 marathons. I am impressed in a way similar to hearing about someone who has survived climbs on 18 peaks of 14k feet or higher. I just don’t think that by undertaking the activity, you have improved your health. Rather, you have taken risks with it.

      *I am not sure that your short sprint leading to a heart attack argument is well founded. One, I would think that someone just coming off of the couch would be more likely to pull a hamstring, thus preventing a heart attack. Two, sprinting does not place the heart under constant strain for extended periods of time. This is the part that leads to long term damage.

      *With regard to the mortality statistics for marathoners, see Art Devany’s post. The numbers are actually worse, because runners are likely to compete in more than one marathon. How many times have you run the Marine Corps marathon? If you are counted as a separate person each time, then the statistics look better than they actually are, because the pool is artificially increased, rather than decreased to account for repeat runners.

      *The last point, about congenital defects is an attempt to shift the burden from the environment to heredity. Not sure that this can be done anymore, with what is being discovered in the science of how genes work. That is, long distance running from an early age, as in Shay’s case, may actually be activating genes that result in the heart defects. There is no doubt that environment impacts gene expression. And training for and participating in long distance runs is exposing yourself to an extreme environment.

      -Adam

  2. Alaskan Ninja

    I’m going to have to agree with Darren on this one. Anecdotally, having been someone who spent most of college lifting weights (and bulking up 60-70 pounds — but still playing full court basketball 3-5 times/wk) and then giving way to distance running (trained for 2 ultas until knee surgery hit) after law school, my overall health (cholesterol and BP) were significantly better during my running days versus my lifting days (despite being older and thus subject to more of the health realted issues).

    Over the last 6-9 mos, I’ve been experimenting back and forth with different work-outs to get “healthier” — ie, leaner and stronger — and ultimately avoid having to go back onto cholesterol and BP meds (which give me really bad side effects) and have come down on the side of adopting a distance regimen. Ultimately for me, this was an issue of what works with my body type, metabolism, and genetics. I can bulk up with weights very easily (and maintain a healthy body fat percentage), but it doesn’t fix anything else for me (cholersterol and BP remain or increase to problematic levels). Note: I acknowledge a genetic predisposition towards higher cholesterol and BP which form necessary data point for my evaluation of the best program for me, but will not necessarily translate to someone else. But distance running has made my overall fitness significantly better (I’ve dropped 29 unnecessary pounds since April) and has become my primary focus. The genetic bias towards higher cholesterol and BP are also controlled by my distance running which I cannot achieve with shorter cardio and weight programs.

    So while I can’t predict the time and manner of my demise, I can look at certain health markers as increasing or decreasing the liklihood of it happening sooner. And if a particular activity helps those markers refelct a healthier body/life, then I would be foolish not to support and continue in that activity.

    I note that the articles identify two relevant points for consideration: (1) data on older weight lifters (ie, those approaching the age of the dying marathoners) is sparse given that only in recent years has there been movement towards weight lifting by older individuals, therefore, a direct comparison is probably premature (particularly since shovelling snow seems to the most deadly of all activities according to a look at the numbers in the article); and (2) that the utlimate conclusion in the Men’s Health article is that to avoid exercise death, the best remedy is exercise.

    Yet another anecdote I would add is that my father had to have a stent put in his heart in recent years and his cariologist recommends against bulk inducing weight training (low weight/high rep got the OK). The interesting reason for this being that with the bulk comes the risk that as people age and cannot maintain the weight training program, it typically does not merely disipate, but remains as unhealthy weight. A leaner body type as one ages, provides a greater liklihood that the body will not have to reshape (or at least attempt to) itself in the 60s/70s.

    Finally, in defense of poor Pheidippides, let’s get his full running program out there for evaluation. It was August/Septepmber 490 BC in Greece — not exactly a cool and refeshing climate for a run. He was initially dispatched from Athens to Sparta to seek assistance in defending against the recently landed Persions — a run of 147 miles (commemorated at http://www.spartathlon.gr/). The Spartans (King Leonidas of Thermopylae fame) agreed to assist . . . after the next full moon . So Pheidippides immediately turned around and ran back to Athens to provide the bad news. After delivering the news he ran to Marathon, participated in the battle, and then made his famous run back to Athens to declare victory and die. He was approximately 40 years old (a rather aged soldier by that day’s accounting — if he were in Sparta, he would have been “retired.”). And all of this transpired in about 6 days — almost 350 miles and a military engagement. All of a sudden 26+ miles seems a rather insignificant.

    • stoffainkorea

      *The Alaskan Ninja strikes back!

      *First and most important glad to hear that you are experimenting with ways to help your blood pressure and other health issues. This site is all about self-experimentation and sharing findings with each other.

      *Taking the weight off is a good first step. So, congratulations for that accomplishment. Keep up the good work…obviously we will want to hear more about your progress.

      *If you want to try a very interesting experiment in weight loss, read up on the Shangri-la diet. Could be a fun way to self-experiment in this area.

      *Whether starting a long distance running program was the safest way to drop weight remains unanswered. Note, I can imagine any number of stressful ways to drop weight…controlled starvation comes to mind. In fact, I have seen athletes starve, dehydrate, and run extreme distances to cut weight. Never once did it make them more healthy. Rather, they immediately, literally within days, become more susceptible to colds, flus, and other opportunistic infections. It also makes them really grouchy.

      *I know, it’s not just the running that makes them grouchy. But, maybe it is the exposure to extended periods of added stress that allows endurance running to initially create the weight loss.

      *As far as the gym and bulking up, you can use sprinting to cut up that bulk (wish I had that problem). Also, note that the example workouts I provided will have you smoked with only one exercise requiring a bar and two 45s. (obviously work up to these, they are scalable). The key is steady work for the full 20m.

      Q: Have you tried Tabata workouts? Note to self, we need a post on these.

      *Anyway, these are some ideas for you to experiment with.

      Q: With previous knee surgery, why not consider a long distance swimming program as an alternative to endurance running, because swimming can help limit the pounding that joint will take?

      *Which brings me back to the main point, more is not always better. From a health perspective, with endurance training, there are diminishing returns, that eventually go negative. Meanwhile, the trend from a pop culture standpoint is to do more marathons or triathlons or try for an ultra-marathon. More rounds of punishment is not better, just ask Pheidippides.

      *Imagine a day, when a bunch of medical results surface from experiments commissioned by Nike demonstrating that endurance running is unhealthy and the more you ran the higher the probability of heart failure and other health risks. Even with this information in hand, the execs at Nike continued urging people to “Just Do It”.

      Cheers,

      -Adam

  3. I think the problem here is that Stoffainkorea has over stated his case a wee bit. Long distance running can be harmful if one’s approach is to grind out meaningless mile after mile. All the while ignoring signs of over training.

    It seems to me that the current trend in long distance running is to de-emphasize pure distance (you still have to log some miles though) and to incorporate sprints, tempo runs, weights, etc. Simply put cross training is good.

    I believe that the benefits of training for marathons and halfs outweight the potential dangers.

    And climbing is even cooler.

    • stoffainkorea

      Tex 66:

      *Climbing is cool! So is riding a motorcycle. At least climbers and their insurance companies do not kid themselves about the risks.

      *Even if your training for an endurance event de-emphasizes distance, you are still faced with the event itself, 26+ or 13+ miles. This is a lot of time under stress.

      *If anything, I may have underestimated the case.

      *Let’s hike Bukhansan before we head to the Formula 1 race next year. Can’t wait to see you in Austin next month!

      -Adam

  4. Miller’s Fixed Opinion: Life is far too short to waste more than 30 minutes a day running. Caveat: running while chasing a soccer ball, frisbee, basketball, or similar endeavor is of course ok.

    • stoffainkorea

      Matt:

      *Yeah. the time hack aspect of this is important. It takes a lot of time to properly train for an endurance event.

      *Lots of starting and stopping when chasing a soccer ball or frisbee, which allows for some recovery before sprinting off again.

      -Adam

  5. I think your post speaks with a bit too much certainty on this topic. I personally believe that the science is highly conflicting and has gone back and forth a good deal. I will not disagree that during a marathon (or other extreme endurance event), the body is under a great degree of stress which does put you at higher risk. However, I’ve read several articles that lead me to believe that the long term health implications are positive. The human body responds well to stress and rebuilds stronger (assuming we train appropriately and do not introduce it to too much stress too soon).

    In the end, I think we will all make decisions based upon the form of exercise we enjoy and will participate in on a regular basis (all of which is better than sitting on the couch eating your face off). For instance, I have minimal interest in weight training and sprinting. I only incorporate them into my training because I know they will make me a better and healthier distance runner. If I was told tomorrow that I couldnt run marathons – I’d probably revert back to my couch potato days and put 30lbs back on.

    By the way, I have a 50 miler scheduled for November – I’ll be sure to let you know if I survive. :)

    • stoffainkorea

      Tom G:

      *There is a lot in your comment that I agree with. Regular exercise is better than eating your face off. Exuberance / Enthusiasm is a key component for maintaining regular exercise.

      *I will also agree with you that up to a point, the human body responds well to physical stress from training. You can push the threshold back with proper training, but at some point you cross that line and the benefits go negative. This is not even questioned in areas outside of exercise where we stress ourselves. For example, no matter how hard you train yourself to go without sleep, less than a certain amount per 24 hour period has negative consequences on performance. More awake time does not lead to greater productivity gains, rather prolonged sleep deprivation leads to permanent damage. Same for work related stress. More stress at work means decreased performance and risk of burnout, not to mention all of the stress related diseases. My point, it is worth considering the possibility that similar consequences follow from training and competing in endurance events.

      *Let us know how your 50 miler turns out in November. That is a massive undertaking and an impressive feat!

      -Adam

  6. Courtesy of my friend Tom:

    In the end – I think the science is conflicting and we will all make decisions based on what makes us happy. Anyway, I’ve run 13 marathons, a 50k, and have 2 marathons and a 50 miler scheduled for 2009 – I don’t plan on stopping any time soon. If I die, do me a favor and don’t read into it.

    http://health.msn.com/fitness/running/articlepage.aspx?cp-documentid=100236549

    Marathoners Go the Distance on Heart Health
    Even walking half an hour a day can boost longevity, study finds

    — Robert Preidt

    Even walking half an hour a day can improve quality of life, boost longevity, study finds.

    FRIDAY, April 10 (HealthDay News) — Long-distance runners are less likely than other people to develop metabolic syndrome, a group of health problems that include high blood pressure and high cholesterol and can lead to diabetes and cardiovascular disease.

    U.S. researchers analyzed data from the National Runners’ Health Study of more than 62,000 men and 45,000 women. They found that men who ran two or more marathons per year were 41 percent less likely to suffer from high blood pressure, 32 percent less likely to have high cholesterol, and 87 percent less likely to have diabetes than non-marathoners.

    Men who ran only one marathon every two to five years were also significantly less likely to have these conditions than non-marathoners.

    Study author Paul Williams found that the benefits of running marathons were largely independent of total number of miles run per year by participants. This indicates that isolated distance running bouts in preparation for marathons may have helped decrease the risk of disease. Even runners who didn’t enter marathons, but did include longer runs as part of their usual exercise routines, were less likely to have high blood pressure, high cholesterol or diabetes.

    The findings were published in the March issue of Medicine & Science in Sports & Exercise.

    “All forms of regular exercise provide important health benefits. But these data suggest there may be heightened benefits for those who make the exceptional effort and commitment,” Williams said in an American College of Sports Medicine (ACSM) news release.

    However, he noted that people who regularly run marathons may be genetically predisposed to running long distances.

    “Not everyone is going to run marathons, but most can probably exercise a lot more than they are currently. Those with heart conditions should consult their physician,” Williams said.

    Research shows that even modest sessions of regular exercise, such as walking half an hour a day, can improve health, sustain quality of life and boost longevity, according to the ACSM.

  7. Another commentator in your favor:

    OK, I’m going to play devil’s advocate for all of you. I kind of, if not in a technical way, agree with a lot of the article. I’ve run a few marathons, although whether or not I trained correctly is up for debate. By and large, I felt miserable during the training. Yes, I got the runner’s high, but something always hurt (foot, knee, back, etc.). For the last six months, I’ve been doing this workout called crossfit, which is an intensity based, constantly varying workout. The workouts are very intense (often sprint level heart rates), usually use nothing more than your own body weight, and never last more than 1 hour. I definitely feel an overall fitness increase, and have been injury free.

    So, that’s my two cents.

    Rick Kaufman, P.E.

  8. Here is an article worth a read. An Ironman with some else’s heart.
    http://www.cnn.com/2009/HEALTH/08/13/heart.transplants.ironman/index.html

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