Going to Extremes

Could there be such thing as getting too much exercise? According to a new study presented at the annual meeting of the American College of Sports Medicine this month, the answer is “yes.”

Scientists at the Mid America Heart Institute of St. Luke’s Hospital in Kansas City studied research on people who exercised at extreme levels, those participating in marathons, triathalons, ultramarathons or long bike races. They found that people who exercised regularly saw significant benefits overall, tending to live seven years longer than their inactive counterparts. However, when they focused solely on extreme athletes, the researchers found that the healthy effect of all their activity not only declined, but actually reversed itself and became toxic. The scientists found that levels of troponin, which is the same enzyme that shoots up when someone is having a heart attack, are elevated by up to 50 percent in runners during and immediately following a marathon. This enzyme increases when the heart is under distress and signals damage to the heart.  The researchers said that it may start to climb as heart muscle fibers start to tear from the intense burden of pumping continuously at a high level during a lengthy and extreme exercise session. Over time, this can cause scar tissue to the heart.  The damage doesn’t happen overnight, but builds up over years of training.

The key take-away from the study is not that exercise is bad for the heart, or that it’s better to watch TV on the couch than go for a run. Rather, it’s that the heart and health benefits of exercise don’t require extreme efforts. When it comes to exercise, the phrase ‘everything in moderation’ is fitting. Based on the data, the researchers suggested that the optimal level of running for increasing life expectancy is about 10 to 15 miles per week and that 15 to 60 minutes of activity several days per week is best.

Dr. Sunil Bhoyrul, expert bariatric surgeon in San Diego, spoke with us about the study, explaining that “exercise has been influenced for too long by a Spartan philosophy of “do or die; more is better”.  As modern day Athenians, we need to get science behind the way we exercise.  Patients and even the healthy benefit from metabolic and fitness testing and a prescribed and monitored exercise plan.  The use of mobile health devices such as heart rate monitors, combined with mobile Apps (that track the distances, calories burned, duration, and intensity of exercise), can be tailored by a specialist to prescribe a sensible routine that often exceeds expectations without causing injury,” Dr. Bhoyrul concluded.

Exercise is not the only area in which people tend to go to extremes; fad diets often are very extreme and the new K-E or “feeding tube” Diet, is a prime example.  The diet involves using a nasogastric feeding tube (through the nose) for a period of 10 days. A high-fat, high-protein, very low-carbohydrate formula is taken in 24 hours a day using a pump and is intended to invoke rapid weight loss.  While feeding tubes do have a place in medical treatment, nutrition groups such as the Academy of Nutrition and Dietetics do not endorse the K-E Diet in any way. The Academy states that the diet carries both short-term and long-term health risks, such as kidney damage and gallstones from rapid weight loss. In addition, weight loss is often unsustainable after the tubes are removed since treatment does not address underlying emotional and psychological eating behavior.  Rather, the Academy encourages a moderate approach to weight loss, requiring lifestyle changes that include healthful eating paired with regular exercise.

You can learn more about eating right on the Academy of Nutrition and Dietetics website here.

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