This is something I have suspected for a while now. Hopefully 8 Ironman races wasn’t too many.
Those 4 chocolate chip cookies I ate at lunch could clog my arteries. I guess something has to get me. I’d rather die skinny.
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This is something I have suspected for a while now. Hopefully 8 Ironman races wasn’t too many.
This guy’s claims have been talked about a few times here. I read through his papers. He makes a pretty good case that there’s no extra health benefit for doing more than moderate daily exercise, e.g. more than the daily moderate 3-5 mile jog. But I really didn’t find anything convincing that it causes damage as a general rule. His mortality graphs flatten out with increasing exercise. They don’t drop. He lays out some mechanisms on how it could in theory cause damage, but those theories are not (yet) supported by data, and he admits that in his papers.
In any case the original generation of marathoners from the boom in the 70’s and the original long-course triathletes from the 80’s are now getting older (sorry, Fleck), and we should see if they start dropping more quickly than we expect. But, so far, there’s no anecdotal evidence that they’re struggling more than usual. There’s a decent list here of pro triathletes with heart problems, but, in my lay reading, exactly none of those are likely directly caused by triathlon. Exercise may sometimes trigger a lethal event (e.g. Larsen), but he had blocked coronary arteries. We know that exercise isn’t the cause of blockage. Reading through all those, it’s very difficult to conclude it’s the result of “extreme excercise.”
In short, I’ll watch O’Keefe’s research with interest, but I’ve yet to modify my behavior based on anything he’s said.
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No worries here. I put his concerns on my TIDGAFA List. Ah, I feel so much better now.
I agree with this but don’t have any medial proof. I’m sure the science will be there in the next few years. I know that when I was in full IM mode in my late 30s/early 40s, I would have episodes of very rapid and irregular heart beats. Typically it would last for a few seconds and go away. When I quit the long stuff, those symptoms went away completely. Ten years later I ramped up for a half IM and the symptoms returned again. Just my personal experience. I have had heart scans and been told everything was fine that it was something called “athletic heart syndrome”. I would not be surprised if we find out in the next several years that the extreme stuff is damaging. It would be really good to know what the safe limits are.
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This is something I have suspected for a while now. Hopefully 8 Ironman races wasn’t too many.
https://www.youtube.com/watch?v=dvTp9FunaLA
Forget that…I thought you’re coming to St. Croix so only half the damage!!!
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I agree with this but don’t have any medial proof. I’m sure the science will be there in the next few years. I know that when I was in full IM mode in my late 30s/early 40s, I would have episodes of very rapid and irregular heart beats. Typically it would last for a few seconds and go away. When I quit the long stuff, those symptoms went away completely. Ten years later I ramped up for a half IM and the symptoms returned again. Just my personal experience. I have had heart scans and been told everything was fine that it was something called “athletic heart syndrome”. I would not be surprised if we find out in the next several years that the extreme stuff is damaging. It would be really good to know what the safe limits are.
I think they already have proved it can be ‘damaging’. BUT only to a certain percentage of people and why is that?? That’s the question I hope the research can explain over the next several years. The good doc talks about half of marathoners with post-race indicators of heart damage but what of the other 50%.???
It must be genetic. I mean why can one guy smoke 3 packs a day throughout his lifetime and die in his sleep at 90 while the other guy gets cancer or coronary disease and dies at 50. ? Genetics baby!!
Someday you will go to your cardiologist and he will do a genetic test and you will either get the Green light or Red light for extreme endurance events. Green lighters can do 8 IM’S and RAAM every year and die in their sleep at 90. Red lighters will be instructed to take up lawnbowling ::))
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Might be there as a spectator Dev. A good buddy is doing it. Are you racing Croix? Still my favorite race after Hawaii.
We know that exercise isn’t the cause of blockage. Reading through all those, it’s very difficult to conclude it’s the result of “extreme excercise.”
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Watch the video again. His research has shown that the marathoners studied did in fact have increased coronary plaque DESPITE having DECREASED risk factors from controls. As a doctor I found his evidence quite compelling and alarming.
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Watch the video again.
I refuse to watch videos. 
I’ll read the paper. I might have missed a recent paper because I don’t recall seeing that data.
We know that exercise isn’t the cause of blockage. Reading through all those, it’s very difficult to conclude it’s the result of “extreme excercise.”
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Watch the video again. His research has shown that the marathoners studied did in fact have increased coronary plaque DESPITE having DECREASED risk factors from controls. As a doctor I found his evidence quite compelling and alarming.
You have to have the mortality data; you could point to a lot of correlative factors otherwise that ‘might’ be problematic, but if mortality/morbidity is the same between marathoners and nonmarathoners, it’s all noise.
As a doctor I found his evidence quite compelling and alarming.
For your reference, here’s O’Keefe’s paper: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3538475/#bib52
I do remember the plaque reference now.
But he kind of cherry picks his research.
O’Keefe kind of picked the most alarming studies, picked the most alarming claims by those studies (leaving out that many of those papers pointed to benefits), then crafted them into an overall alarming narrative. Which the media picked up and ran with, so to speak. He also neglected to point out the many of the studies he referenced pointed to temporary (post race) increases in risk factor. (although plaque obviously doesn’t fall into that category).
He left out this 1997 study which looked at over 8000 runners (vs. the ~40-80 of most studies). The abstract:
"Compared with runners who ran less than 16 km (10 miles) per week, long-distance runners (≥80 km/wk) showed an 85% reduced prevalence of high-density lipoprotein cholesterol levels that were clinically low (<0.9 mmol/L ), a 2.5-fold increased prevalence of clinically defined high levels of high-density lipoprotein cholesterol (ie, ≥1.55 mmol/L , the level thought to be protective against CHD), a nearly 50% reduction in hypertension, and more than a 50% reduction in the use of medications to lower blood pressure and plasma cholesterol levels. Estimated age-adjusted 10-year CHD risk was 30% lower in runners who averaged more than 64 km/wk than in those who averaged less than 16 km/wk (42 vs 61 events per 1000 men). Each 16-km incremental increase in weekly distance run up to 64 to 79 km/wk was associated with significant increases in high-density lipoprotein cholesterol levels and significant decreases in adiposity, triglyceride levels, the ratio of total cholesterol to high-density lipoprotein cholesterol level, and estimated CHD risk."
There’s a new paper this year which found that marathon runners had an overall improved risk profile: “Habitual endurance exercise improves the cardiovascular risk profile, but does not reduce the magnitude of carotid atherosclerosis associated with age and cardiovascular risk factors.”
Reading the O’Keefe paper alarmed me as well. But when I read all the papers he referred to. Then read the rest of “the literature,” I came to the conclusion that the issue is very far from settled. I’ll continue to monitor O’Keefe, but I view him as a bit of evangelist more than the ideal unbiased scientist (if such a thing exists).
In short: read O’Keefe. But don’t stop there. Make your own informed decision before giving up on marathon and long-course triathlon.
Me? I’ll ask my Dr. to monitor my heart health, and even pay out-of-pocket if the tests aren’t deemed necessary. And if they find a risk factor, I’ll modify my behavior. Until then I’ll just keep reading the research with interest after I get back from my long run.
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We know that exercise isn’t the cause of blockage. Reading through all those, it’s very difficult to conclude it’s the result of “extreme excercise.”
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Watch the video again. His research has shown that the marathoners studied did in fact have increased coronary plaque DESPITE having DECREASED risk factors from controls. As a doctor I found his evidence quite compelling and alarming.
I can agree with the coronary plaque buildup because if is built up whenever the human body is under stress be it work, family or even Ironman type training…it is all stress and our livers will over produce cholesterol…now the question is its correlation to plaque build up. I personally feel that Ironman training is excessive and the trap that people fall into is doing that type of stressful IM type training for too many weeks all year. We all also have different genetic tolerance for high stress loads (each of us is individual) but I can see where this can get us to in a bad way. That’s partially why I don’t do any really long training anymore other than for around 4 weeks per year. Most of the training I do is short. Most of the year, long run is 80 min, long ride/ski is 2.5-3.5 hours. Not that this is that short either, but I find my health is much better on shorter training. The day of the Ironman is 1-2x per year, and I count it in the “traumatic event” category and I assume my body will recover from these 1 time hits. It is the day in and day out grind/stress load that cumulatively hammer all the organs etc.
I hear what you are saying and you make good points.
I do believe there is truth to what O’Keefe saying (although just my opinion which is worthless scientifically). As he says it is controversial and there needs to be further studies.
But I have seen several of the fittest people I know have heart arrhythmia issues, usually in there late forties, early 50s, but some younger. Coincidence? Maybe, but not likely. The mechanism of injury makes sense physiologically.
Ironman training is highly stressful and not natural. It just makes sense that there may be some untoward effects.
I for one would rather err on the safe side of moderation.
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When anything is taken as a singularity and not compared to either the status quo or other activities, you can generally find “something” detrimental about it.
Having said that, for what I’ve read in this thread, the report seems to find a correlation between intensive Triathlon training and Heart Plaque. I suspect I’m over simplifying and I didn’t read the article as I’m too busy, in ST fashion, of posting my opinion.
Having returned to training over the past few years, from many years if not training (long stories), my cardiologist tells me that my heart health has improved. Prior tests showed some issues with CAD (plaque in arteries). More recent tests do NOT show this. Although he thinks it is because my heart has built additional arterial flow to compensate. I can’t give a ton of details as once he said I was “normal”, I was too happy to listen to the rest. I did catch him telling me I should not get my HR too high (he didn’t want me over the old 220-age range and in fact was happier when I was closer to 100-age).
Now, I don’t often train 6 days a week, if I do 4 I’m happy with sessions around 1 to 2 hours. Better weather will see me with a 45 minute run at noon and then one to two hours in the evening.
Hello slick and All,
Note: Keeping in mind that I am biased because I like to exercise and feel healthy … and hence tend to give weight to those studies that feed my beliefs and desires …
http://med.stanford.edu/.../august/running.html
Excerpt:
STANFORD, Calif. - Regular running slows the effects of aging, according to a new study from the Stanford University School of Medicine that has tracked 500 older runners for more than 20 years. Elderly runners have fewer disabilities, a longer span of active life and are half as likely as aging nonrunners to die early deaths, the research found.
“The study has a very pro-exercise message,” said James Fries, MD, an emeritus professor of medicine at the medical school and the study’s senior author. “If you had to pick one thing to make people healthier as they age, it would be aerobic exercise.” The new findings appear in the Aug. 11 issue of the Archives of Internal Medicine. - See more at: http://med.stanford.edu/...sthash.9EOtfEvj.dpuf
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http://med.stanford.edu/...4/january/ultra.html
Excerpt:
Not unexpectedly, baseline statistics indicate that ultrarunners are healthier than the overall U.S. population. During the previous year, study participants missed an average of just two days of work or school because of illness or injury, compared with four days for the general population. Most of their visits to health-care professionals, about 64 percent, were for exercise-related injuries, not for diseases that would indicate chronic deterioration.
More than three-quarters of the ultrarunners reported an exercise-related injury in the prior year, while 65 percent had lost at least one training day to injury. Comparing the profiles of injured runners with those who had avoided injury revealed an interesting trend: Injuries appeared to be more common in younger, less experienced runners.
“It’s a bit like drivers. Young drivers are at higher risk of car crashes than older people. So similarly, people who have recently started running are much more likely to suffer injuries than veteran ultramarathoners,” Krishnan said.
- See more at: http://med.stanford.edu/...sthash.n3dcWZX0.dpuf
Cheers,
Neal
+1 mph Faster
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Why not!
It’s damaged dam near everything else (including my wallet)
Excerpt:
STANFORD, Calif. - Regular running slows the effects of aging, according to a new study from the Stanford University School of Medicine that has tracked 500 older runners for more than 20 years. Elderly runners have fewer disabilities, a longer span of active life and are half as likely as aging nonrunners to die early deaths, the research found.
Interesting…though I’m curious about the longterm comparison between* casual running* and*** racing*** - where the body is put under extreme stress on a regular basis.
I guess Ryan Sandes & Ryno Griesel will be dead by the end of the month then…
2014 Drak Traverse
Later!
Brian
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I’m also a doc and was also troubled by O’Keefe’s opinions. When I pulled the original data it seems to fall into two camps, anecdotal data showing healthy “fit” runners with some cardiac problems. Then population data showing great benefits to exercise, but maybe with a ceiling effect. i.e. at some point running more does not further improve mortality. I found an article on olympic medalists lived longer than their comparative populations (http://www.bmj.com/press-releases/2012/12/13/olympians-live-longer-general-population-cyclists-have-no-survival-advanta)
At the end of the day, I run, bike, swim, etc b/c I like it. If I choose to run, bike, and swim more than 7 hours/week its b/c I want to. Training and racing Ironman distances is not likely to improve my lifespan over training for Olympic distances and Ironman might actually reduce it some but it’s worth it to me.