Can Triathlon Kill?

Triathlon Forum
1

Yesterday the Wall Street Journal had an article called “Can Excercise Kill.” Here are a few excerpts:

Evidence is mounting that extreme exercise – marathons, triathlons and the like – may be detrimental to the immune system and long-term health. “Exercising to excess can harm our health,” cautions Kenneth Cooper, the physician credited with founding the aerobics movement back in the 1960s.

An increasingly popular theory has it that death from extreme exercise may not come until years afterward. This theory first occurred to Dr. Cooper, founder of the Cooper Institute in Dallas, when he noticed what seemed like a higher-than-average rate of cancer and other disease among the fitness fanatics he knew.

‘More Harm Than Good’?

Having now studied the matter for more than 20 years, he has concluded that especially long and intense bouts of exercise may be damaging to the immune system. It is only a theory, but it is at least partly based on medical studies such as one showing that marathoners suffer a high rate of cold and flu just before and after races.

“If you’re exercising more than five hours a week , there’s a possibility that you may be doing more harm than good,” Dr. Cooper says.

2

Somebody better tell Joe Bonness. Or, show me the data.

Frank

3

Well, I would have to agree that once you get over 10 hous per week, it is more harm than good. 5 seems low, but I have no scientific evidence for 10. That being said, I would rather do tris and marathons and die early, then sit on my ass and not do these great things and miss out on life.

If you look at old pro cyclists, many seem to die at a young age. Triathlon is not old enough for us to say what happen to us when we turn 60 from 20 hour weeks in our 20’s. Just look at other endruance sports for the evidence though. It is actually pretty scary !

4

“Better to live one day as a lion than a hundred years as a lamb.”

-Arab proverb.

That says it all for me. I don’t care if it does kill me. So far it’s killed my best friend. Some days I envy him.

5

It could be where you do the exercise, also. Did they control for environmental factors such as poor air in a region. The presence of oxidative damage caused by free-radicals can literally make you “rust out”.

That’s another reason I moved back out here to Hawaii. Clean air.

6

I want to see data. And didn’t get sick this past Fall, winter, or spring at all and was training 6 days per week, twice a day. total weekly hours averaged around 22-28 hours per week. Felt pretty good actually.

7

Dev P wrote: I would rather do tris and marathons and die early, then sit on my ass and not do these great things and miss out on life.

I agree.

However, I’ve seen lots of people’s hearts, some were athletes on the operating room table with thick, sluggish hearts ravaged by heart disease. But, it’s been a rare case compared to the thin people with cholesterol levels in the low 100’s (they picked the wrong parents), the obese, the diabetics, and the smokers. The currently active athlete getting heart surgery is about as common as the unlucky (accident victims). Then again, one of the reasons we don’t see currently active athletes in the OR, is that their heart disease often curtails their activities for quite a while before they become sick enough to need surgery.

From a strictly physical point of view, thick ventricular walls can cause a bit of a problem for adequate blood flow (more-so in the ventricular septum). It’s harder to get blood deeper and deeper into thick squeezing muscle, for a couple of reasons. Then, if the small vessels that reach deeper into these thicker walls get plugged with platelets, bits of clot, or other debris, the newly irritated muscle cells can send out electrical impulses that can cause an arrhythmia. If you develop an arrhythmia that results in a significantly inadequate pumping action of the heart, you lose consciousness. Depending upon when you lose consciousness (not a good thing to do while driving a car, for example), or depending upon how long an arrhythmia lasts (especially if it is not allowing the heart to move blood adequately): you can quickly become worm-food. More normal ventricular walls and septae don’t have some of the physical characteristics that predispose the person to the decreased blood flow in these wall, and are therefore not as likely to have the small vessel obstruction problem to the same degree.

I make a living stopping the electrical and physical action of the heart, so that a surgeon can operate on an unmoving heart for periods of time (up to a few hours). The thicker-walled hearts are much harder to adequately perfuse in order to sufficiently cool the muscle and deliver the high-potassium solution throughout the entire muscle wall. If the heart begins to “wake up” prematurely, it’s often in these thick-walled areas that were harder to perfuse.

Athletes, like people with certain valvular and/or shunt disease, usually have thicker hearts. A little thicker is OK. A lot thicker isn’t. The more stress the heart is working against, the thicker the ventricles become. If, as an athlete, just as in someone with certain heart disorders, one’s heart is required to work too hard for too long, it can get too thick to be healthy…at least compared to an athlete’s heart that isn’t so thick.

I don’t know where that line in the sand is drawn. I don’t know if it is at 10 hours, or 20 hours, or 40 hours a week at 60%, or 75%, or 85% of Max HR. Probably, the imaginary line is dependent upon the peak and diastolic blood pressures found during exercise in the individual, as well as the duration of exercise. So, if you are hypertensive in spite of your exercise, don’t think you shouldn’t worry about your hypertension. It wouldn’t be a bad idea to check your blood pressure during exercise to make sure it is within normal exercise blood pressure limits.

That’s just the physical heart changes due to exercise…the pollutants one is exposed to by breathing all the fossil-fuel-burning exhaust (hear that SUV owners? ;)) when exercising, as well as all those extra pollutants from the extra food athletes consume, may stress the body, too. The fight or flight response does depress the immune system some. Simple over-use injuries (defined as tearing tissue down faster than it can be rebuilt) can contribute to mal-health, as well as free radical damage from all that increased oxidative chemical reactions.

HOWEVER, if exercise were a drug, it should be the MOST prescribed drug for what ails the human being. Exercise, done in the right way, benefits probably every aspect of the human organism…mentally as well as physically.

I plan to always be exercising to some degree, but, after my first Iron distance race this coming weekend, I’m cutting back to more sane and sustainable exercise workloads. Some of you are suited for longer endurance athletic better than I am. I’m a natural sprinter-type that has moved too far the endurance direction…I think I should let the pendulum swing back a little more toward my natural tendencies, I might even live a little longer, who knows?

8

Death surrounds life. Not doing excessive extreme exercise kills more than doing it will ever claim.

I’d rather die having fun or doing something I enjoy than die watching tv.

9

Yup.

10

“If you’re exercising more than five hours a week , there’s a possibility that you may be doing more harm than good,” Dr. Cooper says.

I think that the critical point here is “at high intensity” where I interpret high intensity as hard anaerobic lactic-acid producing training.

In this definition the statement may have a clue to it as it´s a proven fact that lactic-acid effects our muscles in a negative way and as the heart is a muscle it´s in no way immune against the damaging effects of it.

As IM- and longdistance triathletes it seems unlikely that anyone should spend an inordinate amount of time in this trainingzone. I for one can spend months and months training without ever hitting that intensity.

However, I think our sport is suffering in some way from a “more is better-” or a “what doesn´t kills me only makes me stronger”-syndrome. I don´t believe in crap like that, that´s the kind of attitude that puts athletes in the hospital (or grave) with acute cardiac disease from training with a cold or generally pushing something that didn´t want to get pushed.

10 years ago, Swedens at the time best IMer (8.32 PR) died while swimming at th age of 32. His heart had multiple scars on it from making very unwise choices in training and always “going for it”. I think the biggest challenge in this sport is to keep a healthy perspective. Just because most of us can produce training that would hospitalize a “normal” person doesn´t mean that we´re more immortal in any way. Just beacuse we felt good about training 30 hours this week, doesn´t mean 40 hours next will make us feel even better.

There´s a great book about training and the need for balancing health and fitness and it´s called “In fitness and in health-everyone is an athlete” by Phil Maffetone. Good reading

11

Do you watch a good movie because it’s healthy?

I don’t, and I don’t do triathlons because it’s healthy - I do it because it’s fun.

Look at these 2 statements - which of them describes the most dangerous way of living?

“Overweight & passive lifestyle related diseases is next to smoking the most serious health treath in the industrialized world” (Statement from former WHO leader G. H. Brundtland).

versus

“If you’re exercising more than five hours a week , there’s a possibility that you may be doing more harm than good,”

12

No, I don´t watch a good movie beacuse it´s healthy but I do know to choose the “good” movies and stay clear of the "bad " ones just like I choose good training over bad. I just don´t think your parallell is relevant

Of course, triathlons and training for them and the lifestyle associated with it is fun - and healthy - and fulfilling and that´s the reasons I do them.

But I wouldn´t train and race if I knew I was harming myself, whether injured or sick or forwhatever reason. What´s the fun in that? Would you? Should Greg Welch keep doing triathlons because they´re fun even though they surely would kill him?

I´m the first to preach the effects of training over sedentary lifestyle but in our little subculture, I don´t think obesity and smoking is a real problem. Much more of a problem is the stupid macho-kind of thinking that sometimes drive people to do stupid things in training and racing. Unhealthy training and racing sucks, no way around it.

13

The question was “Can triathlon kill?” Life style choices is a different subject.

For some people eating too much and smoking is fun. They may want to sacrifice fun for shorter life. But that does not answer the question, that is, the link between a life style (smoking, eating, triathlon etc.,) and premature death. Personally, I prefer to live longer if it means no triathlon.

I work with a few people who have invested lots of time, money and effort in developing an executive belly. They are also very stressed out and tend to run around the office like headless chickens. None of them seem to have heart problems. In my Sunday morning group ride some riders are in the same age group as these office managers (mid 50s) and have had bypass operations and other procedures despite their high level of fitness and excellent diet. These samples are too small, but it shows me that nobody knows if one life style or another will make a difference to their health.

My granddad is a WWII concentration camp survivor. For a few years he suffered harder life than any ironman has ever went through (physically and mentally). And he did not get power bars or bananas in feed stations. But he is still around age 91 and walk everyday for a few miles.

14

There could be a happy medium.

15

“Evidence is mounting that extreme exercise --…may be detrimental to the immune system and long-term health”

Why would anybody doubt this? I don’t doubt this one single bit. Everything should be in moderation, and that would also include exercise if you are looking at long term benefits or hoping for life extension. The recreational athlete is more likely to live a longer life than the the extremist just as much as the moderate drinker is likely to live longer than a heavy drinker.

16

What I got from the article was that people with an increased risk of heart disease are more likely to suffer a potentially fatal episode during exercise than those who do not exercise. However, the article also said that the reason for this is that a large number of people who get into fitness to avoid heart disease(like myself) end up gravitating toward marathons and triathlon(again, guilty), and that this type of extreme exertion is more likely to cause problems than not.

I find that I agree with certain aspects of the article, and disagree with some of its conclusions. I definitely believe that hig levels of exertion depress the immune system. Every time I work really hard in a race or compete in a swim meet, I get sick. Further, needing almost three months to recover from IM tells me that it definitely takes a toll on my enitre body.

However, I believe that as a person whose strategy includes both a sensible nutrition plan(which I do not believe the article addresses) and a lot of exercise, I am far better off than I would be otherwise. coming from a family where my father had his first heart attack at 41 and died at 65, and my oldest brother had a heart attack at 43, I can’t help but think that I am in far better shape than either of them was at 37(my current age.)

Finally, as in most studies, I think that the explanations are vague enough to draw whatever conclusions you like. What, exactly, do we mean by “high intensity”? I may work out for 10 hours per week in Zone 1, whereas they may be referring to people who do Zone 5 workouts all the time. I can see where running at 175 bpm for an hour 5-6 times a week might not be good for me, but I don’t think that is the same as working out at more reasonable levels.

I guess my gripe with the article is that instead of showing that exercise in general is good for you, they are drawing a picture, based on extreme cases, that indicates that exercise is bad for you. Invariably, this will be used by some people to justify continuing to take truly dreadful care of themselves.

17

I read that article and it makes perfect sense to me. The two main points were that 1) if you are predisposed to have a heart attack, it is much more likely to happen during a period of high stress, like a marathon or intense excercise and 2) there is a developing theory, yet unproven, that very intense prolonged excercise puts stress on the body generally and its immune system in particular and this can, over the long term, result in adverse affects and possibly earlier death from those effects. The heart attack point is proven and the second point seem self evident to me.

Factor this statstical increase in risk with the statistical increased risk of accidental death from riding a bike in traffic and I’m sure it would be a piece of cake to show statistically that training for and particiapating in triathlons is a life shortening activity.

Of course, this says nothing about how being a triathlete affects any given individual triathlete. On an individual basis, you may actually be saving yourself from early death.

You won’t know until the end so stop worrying and just enjoy the ride.

18

Well I gotta disagree here - most heart attacks happen in the morning when people are just sitting around and doing nothing. I’ve seen quite a few people during/after their heart attacks - and not one of them was exercising. How do heart attacks happen? A relatively new/unstable plaque (generally small/asymptomatic one) - fissures - clot forms - blocks blood flow = heart attack. Exercise/stress has nothing to do with it. Now if you have an old/stable 90% blockage - and exercise or get stressed - then you get angina/chest pain - but this should not lead to a heart attack. A lot of “athlete heart attacks” are not heart attacks - they are arrhythmias (irregular heart beats) that occur for a bunch of different reasons (congenital problems (ex) Hank Gathers/electrolytes…).

Exercise is generally good for you - I think we can all agree on that. Now if you run slowly an hour a day - thats probably as good for your health as it gets. Probably walking for a couple hours is even better. I’d bet that the best exercise we can do is walk a lot - better than running (mile for mile) - better than swimming/biking or anything else. I also think “LSD” or low zone stuff is way better health wise than any higher intensity stuff. LT work does not help your health at all - likely more harm than good. Only reason to work-out faster than easy is so you can race faster (thats as close to 100% in my book as anything). Now can you harm yourself by doing some high intensity stuff? I doubt it if its in moderation and you do a much higher percent of LSD stuff (like 90%/10%…) and you are in good health.

Running a marathon close to as fast as you can = bad for your health. Racing a triathlon as fast as you can = bad for your health. Running/walking a 5 hour marathon (if you could run a 3 -3:30) with a couple stops for burgers and beers = good for your health.

When I do all LSD training - I never (knock on wood) get sick. I start adding high intensity and wham I get colds…

Dave

19

daveinmammoth wrote: most heart attacks happen in the morning when people are just sitting around and doing nothing.

Yep…your platelets are “stickier” early in the am, and more likely to grab onto a roughened spot, like a plaque that’s being “explored” by a neutrophil, and the clotting cascade is initiated a little more readily in such a case. WHAM. Clot formed with resulting ischemia with or without arrhythmia…forecast: possibly muscle cell death, otherwise called a myocardial infarction. Add stressors on top of this (such as shovelling snow), and you’ve got a statistically significant increase in MI in the early am. Like dave said, having an athlete present with an MI that occured during exercise is much more uncommon.

Doing more exercise than is optimal isn’t as dangerous as eating more than is optimal, or smoking more than you used to, or drinking more alcohol than is optimal, etc. But, it is probably incorrect to think that if you keep exercising more and more that you’d continually get healthier. Not only are there diminishing health benefits to more exercise after some point, there is probably harm…and I wouldn’t be surprised if benefits/harmful effects had an intensity/duration component relationship.

Again, if exercise were a pill, it should be the most prescribed pill for what ails the human organism. But, with exercise, like medicine, just because some is good for you, it doesn’t mean a whole lot is better for you. Someone summed the effect of excercise on health pretty well when they said: optimal health is passed somewhere on the road between getting up and walking, and achieving maximal cardiovascular fitness.

20

We had a guest speaker come in and talk to our triathlon club last year and he pretty contradicted what you say about endurance athletes having thicker heart muscles.

He’s a researcher at Hopkins looking into this very thing. He’s currently funded by the NFL of all places. Not your traditional grant agency.

At any rate, Dr. Tandri had a nice presentation in which he showed us how an endurance athlete’s heart differes from an athlete who does resistance training. Showing examples of how thick the walls become in a resistance trained athlete and how they stay thin in an endurance athlete. Perhaps you cast too wide a net when you mention that “athletes” have thicker heart walls.

At that time his study revolved around how to identify a diseased enlarged heart from an enlarged athlete’s heart. Not usually a problem, however what if the person is an endiurance athlete? Are the size changes and rhythm changes the regular changes we expect in an endurance athlete ro are those same changes the result of not only the training but also the disease. The changes are very similar and can complicate the issue.

Perusionist eh? I always thought that a perfusionist is one of the best jobs no one has ever heard about.