Heart problems in old endurance athletes

[jacob]

http://espn.go.com/sports/endurance/sto ... eir-hearts

Perhaps it makes sense to be strategic about this (rhetorical). Fortunately, I'm not mentally inclined towards extended "suffering". I've never experienced "runner's high", and I only get a slight endorphin rush from mild exercise.

I think the heart risks of endurance sports have been known for a while, as has, obviously, the heart risks of being sedentary, but what about power sports like kettlebells or strength sports?

[IlliniDave]

I wonder if the underlying nutrition isn't a big part of it. Endurance athletes tend to lean towards the high carb/low fat style of nutrition, which despite the prevailing scientific/medical opinions of the 1970s and 1980s and beyond has proven to be a grave disservice to many. I don't know that there's much data yet for the activity regimens that weight the shoter-term metabolic pathways at least equal to endurance and how they affect long-term cardiovascular health. I do know that Crossfit plus a reduced carb variant of the Zone diet worked wonders on my "numbers". But a sample of 1 over a short time span is not significant to anyone but me.

[henrik]

member of the U.S. national cycling team

It was nonstop. /.../ "I was burning the candles at both ends,"

etc

Goes to show it's not wise to overdo things? Probably applies to pretty much anything?

[DSKla]

I believe the nutrition (and possibly other gactors like stress and sleep) play a role, but these heart conditions really only happen in older athletes (usually starting in the 50's) who do a ridiculous amount of aerobic work week in and week out for years. Constantly running marathons or ultras, cycling hundreds of miles a week, etc. while the heart isn't working very hard in terms of its max output, it is in an elevated output for hours upon hours, almost every day. There is no way that isn't damaging over a period of years. Human beings are adapted to walk 30 miles a day, not run 100 miles in 16 hours. Some of these ultrarunners are using 30 mile training runs on a weekly or biweekly basis, in addition to shorter runs. You may only be at 120-130 bpm, but the human heart doesn't appear cut out to do that for 20-30 hours a week, every week.

I have never heard of similar heart conditions in power sports, because the nature of power is that it is unsustainable at that high output. You simply can't keep your heartbeat at 175-200 for very long, but the overload stimulus of briefly hitting 200 then recovering back to 50-60 for the rest of the day seems to be a lot healthier than sustaining 130 for a long time. My thought is that it boils down to 1) time under stress, and 2) recovery. While we can handle a lot of stress, a chronic stressor from which we do not allow sufficient recovery is very destructive.

[Dragline]

This is a known risk factor for older people who do intensive cardio/endurance sports. The research is not without controversy:

See generally https://www.google.com/webhp?sourceid=c ... ge&es_th=1

Participate to excess at your own risk. I would guess that the risks vary widely from individual to individual, though.

I am not aware of any similar findings with respect to weight training, but I doubt you would find a significant sample size for the reasons DSKla mentions.

[Ego]

I get a great deal of pleasure from running, cycling and swimming, and often experience the runners high that people talk about, so I am very much biased against believing these studies.

But I do believe them. Heart thickening most certainly happens to lifelong endurance athletes and is probably the cause of these electrical disturbances that seem to increase in correlation with years of endurance training. Joint damage and repetitive stress injuries are also very common.

I've shortened and intensified my workouts while leaving a rest day between runs or long rides. When I have a choice between shorter or longer races, I always choose the shorter. For instance, next month I'm doing the 5k "fun run" at a half-marathon and the following month I'm doing the sprint triathlon rather than the longer olympic distance.

I've got to admit, this is hard for me. I know I can do well in the longer races but I also want to be able to run, ride and swim when I'm eighty, so I'm throttling down the endurance and up the intensity.

[J_]

"but what about power sports like kettlebells or strength sports?"

I do experience that working with kettlebells, doing pulls up at a bar keeps my figure in shape. I walk more upright, sit better, breath better. And in winter when I do endurence sport (freestyle cross country) in a though but moderate way I watch my heart rate and have a good rate in rest. Even a very good rate in relation to age.
FWIW I experience good results in moderate excercise in strength and endurence, have never had 'heights', only benefits.
(but I am neither old nor an athlete

PS: Jacob made me aware of the Kettle bell, Ego about the joy of a bar, and Jennypenny let me see the danger of too much endurance sport. What a inspiring bunch in this forum.

[Gilberto de Piento]

I know two athletes, both in their 50s, who recently had surgery for atrial fibrillation. Apparently it results from a muscle in the heart becoming too strong due to cardio training for many years. Its not really a problem for pro athletes because they typically train for a number of years but then stop. Amateurs train their entire life and this causes the problem. Its a serious concern for people who are otherwise very fit.

[stand@desk]

This ex-Lawyer seems to have no trouble running very heavily into his 70s. An outlier?

http://www.runnersworld.com/newswire/69 ... -in-a-year

http://www.ksat.com/content/pns/ksat/ne ... athon.html

[tommytebco]

I am an old amateur endurance athlete. I am 74. I ran for exercise my whole life. I ran high mileage (50 plus miles per week) through my 40's and into my mid 50's. At that point I was bothered by back aches, so I cut way down on running and switched to bicycling, pedaling 50 to 80 miles a week. There is nothing wrong with my heart. I also took up hiking on the Appalachian Trail 8 years ago. I walk or bicycle and I hike for a month each year and train for about 4 months prior. I have lost 20 pounds of flab during the last two hikes. After my hike this year, I started swimming laps to try to stop the flab from regrowing.(Boy!! Is that hard for me!!)

Why in the heck do people try to generalize from a few cases?? I believe some people have a predilection for heart trouble. I also believe in the diet contribution to heart problems.

I recall Jim Fixx, a popular running proponent in the 80's who ate a shitty fat heavy diet and died from a heart attack,on the road side, while running from a heart attack.
There was another crackpot doctor at that time who used to write in Runner Magazine, who claimed that if you completed one marathon, you were immune from heart attack. Then folks started to "call in" about those who died. He was full of S***. (Tom Bassler: http://www.marathonandbeyond.com/choices/emmett.htm)

Heart health is an amalgam of heredity, nutrition, life style and health care. You can't hang the health hat on any one peg.

[Ego]

Why in the heck do people try to generalize from a few cases?? I believe some people have a predilection for heart trouble. I also believe in the diet contribution to heart problems.

Tommy, that's a good question. The study that really got my attention was this one...

http://circ.ahajournals.org/content/114/22/2306.full

In this issue of Circulation, Neilan and colleagues provide evidence for cardiac damage during marathon running. These authors measured the serum biomarkers troponin T (cTnT) and N-terminal probrain naturetic peptide (NT-proBNP) and performed echocardiographic measurements of cardiac function in 60 recreational runners before and 20 minutes after the 2004 and 2005 Boston Marathon, a 42-km (26.2-mile) foot race. None of the runners had increased cTnT concentrations before the race, but 60% had cTnT concentrations greater than the 99th percentile of normal (≥0.01 ng/mL) after the run, and 40% had cTnT values concentrations at or above the concentration used by Neilan and colleagues to diagnose myocardial necrosis (>0.03 ng/mL). NT-proBNP concentrations roughly doubled from a median of 106 before to 182 pg/mL after the race.

The markers they measured before and after the race are those used to determine the extent of damage to a heart after a heart attack.

The hypothesis is that heart cell death causes scarring which in turn creates electrical problems which causes synchronization problems. Like Gilberto, I personally know older endurance athletes with this problem.

[7Wannabe5]

The endorphin high people often experience from running is a masochistic response. If you want to experience the same physiological state without risk of damage to heart muscle, you might try some other activities such as boxing, bungee or bondage. I mean, think about the type of survival situation a person would have to be in to exhibit the behavior of "running hard and compelled to continue to run hard "naturally. Basically, you are tricking your body into thinking that you are in danger, so that natural opiates are released to aid you. That's why it is often correct to describe a person as being addicted to running. More moderate exercise will also lift overall mood, but in a more slow-release type manner.

[Chad]

Some interesting things happening in the ultra distance world.

http://www.outsideonline.com/1986361/running-empty

The schedule these people keep (only one rest day after a hundred miler?) is crazy.

[Gilberto de Piento]

Why in the heck do people try to generalize from a few cases??

We shouldn't but observing the prevalence of this problem in people who are just like me but a little older brought it to my attention. Here's a meta-analysis that suggests that atrial fibrillation is more likely for athletes: http://europace.oxfordjournals.org/cont ... 1156.short

Does this show causality? No. For example, maybe people who are likely to have heart problems tend to participate athletics and one does not cause the other.

There are a number of other studies. Search for "atrial fibrillation athletes" or similar in Google Scholar.

[black_son_of_gray]

I mean, think about the type of survival situation a person would have to be in to exhibit the behavior of "running hard and compelled to continue to run hard "naturally.

I think it's less about outrunning danger (we could easily be caught quickly by many predators - we are slow). One of the popular theories for why humans can run for hours on end is persisence hunting. Considering that this type of hunting was probably a group thing, and therefore allowed people to rest intermittently, it was probably more like a fartlek style than a consistent pace.
Just because we might have evolved to be able to perform long endurance running, that still doesn't mean that a few decades of it won't damage the heart - that damage accumulates long after childbearing years. It could be that we have a biological pull towards distance running (at least some of us), AND that distance running will ultimately be bad for us.

[tommytebco]

Also,
A casual reader will take away the impression that running as exercise is bad for you.

a generation of "Mr Jellybellies" will not run and will sucumb to heart attack from clogged arteries. One of my favorite themes is Balance in everything.

The sensation seeking authors omit the footnotes.

TBT I started out to be a fast runner, but couldn't cut it. I was a "Half fast Runner" Half assed!! Get it?? 5 marathons 3:28 best. You need to run around 3 hours to qualify for Boston. That's elite runner territory in local running circles.

[Ego]

One of my favorite themes is Balance in everything.

I couldn't disagree more. Respectfully.

Living a life where everything is kept in balance is a self-imposed tyranny. A tyranny of average. Blah.

The moments that make up an extraordinary life are by definition out of balance, above average and immoderate.

There are situations in life where losing balance is far more sane than keeping it. Excess isn't always bad. In fact, excess is a necessary element in doing anything beyond ordinary. Falling can be the best thing to happen

Interestingly, running itself is the act of purposely putting oneself out of balance - falling forward - then catching oneself just before the fall. The faster you go, the more out of balance you put yourself.

[tommytebco]

That is an interesting take on "balance" that I hadn't envisioned.

Maybe "moderation" comes closer to my meaning. I undertake new experiences on a regular basis.
I guess I intended Balance to mean avoiding the addiction end of the spectrum.

A mantra when I was in my 20's was "excess is the root of all evil. moderation is the key to happiness". This written in lipstick on my dresser mirror. I don't remember whose lipstick. I've never owned any.

[enigmaT120]

We had a thread not too long ago that included some charts that Jacob and I found relating life-span to weekly hours of moderate to vigorous exercise, and now I can't find it. From memory, the benefits in the form of increased life expectancy leveled off at about two hours per day of exercise, though I didn't find any charts to demonstrate where increasing exercise actually started to diminish life expectancy.

I think the main draw backs to training like the people in the OP do is they don't have time for anything else in life.

[tommytebco]

The info I read recently said moderate (one hour-ish) aerobic exercise three times a week was the break point, more didn't help extend life span.
It almost sounds too easy.