When is too much of a good thing bad?

November 15, 2018

There is increasing academic interest in whether too much exercise can be detrimental to your health. Not a popular topic to discuss amongst athletes but we are exercising harder as we get ever older and there are some signals to be mindful of. In the medical world this is referred to as the “J-curve” – where reduction in something confers health benefits until it passes a threshold, and then starts causing harm. Blood pressure would be a good example of this. Or perhaps weight loss?

The most extreme example is Pheidippides heart – where extreme endurance sports can lead to myocardial fibrosis and heart failure or death – named after the well known Greek legend who originated the beginning of the modern marathon. A link here if you want to read an interesting perspective on the accurate historical context of this. https://www.runnersworld.com/runners-stories/a20836761/the-real-pheidippides-story/

But a more common trend I am watching is the statistic that you are 5 times more likely to develop atrial fibrillation (AF) if you are a middle aged endurance athlete than your sedentary peers! Which doesn’t sound fair. Although thankfully the risk of developing the arrhythmia is still low, as 5 times a low number is still a low number, it is a marker of abnormal cardiac physiology that merits watching.

So my advice as always is to exercise freely and as hard as you wish, but always get checked if you develop any worrying symptoms.

Robin van Lingen

Robin is a Cardiologist living and working in Cornwall, England.

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