Does endurance sport harm your heart?

[Cowsham]

Over reaching yourself regularly must be a red line. Anecdotal evidence suggests that performance athletes live no longer or better than others. TDF winner Jacques Anquetil died aged only 53 and Runner James Fixx only managed 52 years, dying from a heart attack whilst running!
Competition drives people beyond their capacity and vanity often drives competitiveness.

And yet, Raymond Poulidor lived until he was 83. He had a long career as a racer, retiring at the age of 41. Eddy Merckx is 78. Anquetil died of cancer, not heart problems.

And as for Fixx I seem to remember when I quoted that he'd died at the tender age of 52 someone told me at the cycle club his father only lived 43 years, after his second heart attack. So you could say Jim added nearly 10 years onto his by keeping fit.

[Cowsham]

As for Jim Fixx, his arteries were probably in a horrible condition after the two packs a day that he dropped: plaque doesn't go away.

What's packs ?

[Carlton green]

As for Jim Fixx, his arteries were probably in a horrible condition after the two packs a day that he dropped: plaque doesn't go away.

What's packs ?

https://en.wikipedia.org/wiki/Jim_Fixx

Packs of cigarettes.

. Fixx died on July 20, 1984, at age 52 of a heart attack, during his daily run on Vermont Route 15 in Hardwick.[1] The autopsy, conducted by Vermont's chief medical examiner, Dr. Eleanor McQuillen, revealed that atherosclerosis had blocked one coronary artery 95%, a second 85%, and a third 70%.

Over reaching yourself regularly must be a red line. Anecdotal evidence suggests that performance athletes live no longer or better than others. TDF winner Jacques Anquetil died aged only 53 and Runner James Fixx only managed 52 years, dying from a heart attack whilst running!
Competition drives people beyond their capacity and vanity often drives competitiveness.

And yet, Raymond Poulidor lived until he was 83. He had a long career as a racer, retiring at the age of 41. Eddy Merckx is 78. Anquetil died of cancer, not heart problems.

We’re all individuals and what one can do or recover from another person cannot. ie. The ‘red line’ is in different places for us all and likewise the consequences of stepping over it vary between individuals and over lifecycles.

Medical opinion continues to uphold the link between moderate exercise and longevity.[9]

[re_cycler]

It seems to me that endurance exercise as such is probably good for ones health.
One aspect of long distance cycling (audax) is that for most participants at distances over 400k there is inevitably some sleep loss.
Some keen "audaxers" participate in such events ( and longer) on a weekly basis and some complete "permanents" as well as "calendar" events even more frequently - I'm not sure if the inevitable sleep deprivation is not harmful - similarly to shift work.
I can remember a desultory conversation on this at a control in the early morning hours when riding a 400k - basically "is what we are doing good for us ?" - the answer being "no" - not that it made any difference - I saw the same faces often in the following years.

I bought a book called "Why We Sleep" --- I only had to read the first few pages to understand the premise of the title.
In essence -- all animals including us sleep. We, along with all the animals are at our most vulnerable when we sleep. If this is so then why hasn't sleep been evolved out over all these millions of years ?

There -- now you know -- you'll not have to buy the book -- apologies to Matthew Walker.

Why We Sleep: Unlocking the Power of Sleep and Dreams https://amzn.eu/d/3sNrzRA

Matt also presents most of the material in his free podcasts
https://www.sleepdiplomat.com/podcast

[Cowsham]

As for Jim Fixx, his arteries were probably in a horrible condition after the two packs a day that he dropped: plaque doesn't go away.

What's packs ?

https://en.wikipedia.org/wiki/Jim_Fixx

Packs of cigarettes.

Ah -- didn't know he was a smoker.

[axel_knutt]

My thoughts on the risk of arrhythmia.

non-competitive endurance sport is beneficial, unless you go at it like a pretend boy racer winning an imaginary Tour de Ballymaccaret.

It doesn't take that.

At the time I was busting a gut chasing better fitness the consensus on this forum was that my poor fitness was due to lack of effort and poor attitude of mind on my part, nobody suggested it was due to overtraining except for me. The view was also expressed that I'd had a very poor service from the NHS. How times change, don't they.

Some things don't change though, whenever anyone comes on here complaining of what look like they might be overtraining symptoms, there's only me who warns them.

In my mid 20s the fastest ride of my life, flat-out over a distance of just 9 miles, was 17mph. At 50 I had a regular 39.22 mile training route, and had target time for it of 3 hours, but I never managed that, the closest I ever got was 3h02m57s (just 12.86mph) on 20.7.09. My HR for that ride was only 119bpm. Two days later my time for the same ride had shot up by over 16 minutes, and then two days after that was the first time I arrived home with the HRM data all garbled by AF. I put it down to a faulty monitor until I learnt better three years later.

If my speed had been more typical of other cyclists my cycling hours wouldn't have been much more than two thirds of what they actually were.

On tour, my average speed excluding stops was 8.6 mph, and 6.3mph including rest stops. My AF seems to have started following a concerted effort to increase it to 8.9mph after it had declined from 9.5 to 8.1. That effort consisted of shorter faster training rides of about 20minutes at 140bpm (83%MHR). Does that sound like a lot to most riders? It didn't on the 2009 thread.

Having noticed the improvement in fitness from the different training I decided to repeat it again the following winter, and that was when things went seriously wrong, because the AF was making my HRM useless, and I was working blind.

Isn’t it simply something like this?

IMG_3133.jpeg

My guess would be that this general curve is calibrated differently each individual, and given that it could be scaled by intensity (fixed duration, increasing intensity) or duration (fixed intensity, increasing duration), it needs to be thought of in both dimensions.

The metric that's the most powerful predictor of developing AF is lifetime hours of exercise, 2000 hours being the magic number.

My understanding is that rather than a plateau as shown on your graph, the sweetspot for maximum benefit from exercise is a sharper peak, equivalent to about 120 minutes of moderate exercise per week.

That's a schedule for developing AF in 20 years.

Are there any cardiologists on this forum?

Most cardiologists have a very different idea of what exercise is, coloured largely by their customers, who can't do any.
John Mandrola is an Electrophysiologist (that's a cardiologist who specialises in treating arrhythmia), he's also an amateur racing cyclist with AF.

[Nearholmer]

Doubtless knowledge has moved-on since 2018, but this is an interesting read: https://www.ncbi.nlm.nih.gov/pmc/articl ... %20%5B2%5D.

[Cowsham]

I know at least one amateur competition cyclist now in his 60's with AF. -- but then again many people that have it, haven't been competition anythings. My view is that your heart is there to do a job and like an old engine if you push it too hard for long periods too often it can develop problems. Moderation and rest.

[Cowsham]

Also if your training the largest muscle groups ie leg muscles your heart is working hard pumping blood around them. The weightlifting was less demanding on the heart I recon unless you go to the extremes like one of my friends who ate a pile of Smarties to get massive muscles on his muscles and ended up with a heart problem ( same age as me but he's bucked ! ) I didn't bother with the Smarties.

[arnsider]

Heart Rates and safe maximums must figure in any discussion here.
I remember reaching the top of the Bwlch y gros from Bala with three mates. We'd flogged around from Dinas Mawddwy via Dolgellau and the Arrenigs, so we'd climbed a lot of hills.No one had a heart monitor and we'd obviously banged away hard up Cwm Cynllwyd.
None of us could be described as athletes,indeed the beer consumption and paunches told a far differet story.
One of us was a medic and came up with the 240 minus your age for a safe maximum BPM.
Now I can count my BPM against my sweep second and was quite alarmed.
That would have been back in 2001 and we are all still alive and cycling, though three of us have succumbed to E bikes.

[Nearholmer]

True.

As I related in the AF thread, when I was investigated for fleeting AF, the specialist, himself a very keen cyclist, and pretty much the same age as myself, advised that “thrashing away above 80%HR for long periods isn’t healthy for your heart; OK for short periods, but not good for long periods”. He was himself in the process of “gearing down” from a quite punishing road riding style, to a gentler touring and “light gravel” style, to ensure that as he aged, he kept out of that >80% zone for the vast majority of the time.

[Carlton green]

As I related in the AF thread, when I was investigated for fleeting AF, the specialist, himself a very keen cyclist, and pretty much the same age as myself, advised that “thrashing away above 80%HR for long periods isn’t healthy for your heart; OK for short periods, but not good for long periods”. He was himself in the process of “gearing down” from a quite punishing road riding style, to a gentler touring and “light gravel” style, to ensure that as he aged, he kept out of that >80% zone for the vast majority of the time.

^^ This should actually speak volumes to us all.

The (only) part of the bathtub curve you drew that we should seek to use is the left hand side ramp up. Yes, folk can ride harder and seemingly with no immediately obvious effect but I believe that sometimes it can take a while (years) for damage to appear.

Interestingly quite a few here - and in my local cycling club too - use an e-bike to continue cycling into older age. I wonder whether some of those riders unwittingly overdid things earlier in life and now have to use electric assistance.

More by accident and self observation than anything else I’m following that consultant’s example. The bike that I use most often has a low top gear which ensures that I can’t end up pushing out my peak power for long periods on the level (‘cause I’d spin out). I previously noticed that I was holding onto a higher top gear, pushing it, and ending up tired for the rest of the day - daft. As far as I know my heart and health are sound but erring on the side of caution doesn’t seem to have too much of a down side.

Life has taught me - mostly the hard way too - that just because you can do something doesn’t mean that you should. That applies to a very broad range of stuff too .

[Psamathe]

...
The metric that's the most powerful predictor of developing AF is lifetime hours of exercise, 2000 hours being the magic number.

My understanding is that rather than a plateau as shown on your graph, the sweetspot for maximum benefit from exercise is a sharper peak, equivalent to about 120 minutes of moderate exercise per week.

That's a schedule for developing AF in 20 years.
...

How does that fit with the NHS 150 mins and the WHO have now increased their guidance to 300 (or 150-300). Of course it must depend on "exercise" as used here vs "moderate intensity activity" but noting the even under NHS includes a "a mix of moderate, vigorous and very vigorous intensity activity".

Ian

[ossie]

I'm 58 and Zwift has my max heart rate at 170 bpm.

In a typical 90 minute turbo ride my max heart rate is around 150 bpm, I'm 35 minutes in Zone 4(134-150), 20 minutes zone 3 (120-138), 12 mins in zone 2 (104-120bpm) and the rest in Zone 1 (60-104)

This would indicate I'm spending 31% of my time at 80% of my max heart rate or above, so 30 minutes three to four times a week doing something that's allegedly bad for me. It certainly doesn't feel like I'm thrashing away.

Having been a long distance runner and cyclist since the age of 16 I'd argue the advice might be slightly skewed and any cycling GP's are probably erring on the side of caution without any knowledge of a patients history. For sure a 40 something suddenly finding cycling or the gym might choose to be careful. I also accept that age and other factors can also bring an unrelated heart issue into the equation but your body will probably let you know before you fall off the bike into a pool of your own sweat.

[Carlton green]

...
The metric that's the most powerful predictor of developing AF is lifetime hours of exercise, 2000 hours being the magic number.

My understanding is that rather than a plateau as shown on your graph, the sweetspot for maximum benefit from exercise is a sharper peak, equivalent to about 120 minutes of moderate exercise per week.

That's a schedule for developing AF in 20 years.
...

How does that fit with the NHS 150 mins and the WHO have now increased their guidance to 300 (or 150-300). Of course it must depend on "exercise" as used here vs "moderate intensity activity" but noting the even under NHS includes a "a mix of moderate, vigorous and very vigorous intensity activity".

Ian

That’s an interesting question. Doubtless the advice is broadly targeted and generally issued in good faith; it’ll be in-line with current wisdom and (normally) best practice too. However one size does not quite fit all and, in pretty much all professions, what’s believed to be best practice get’s updated over time. The NHS, I believe, tends to work in terms of benefits in the immediate and near future. Stuff that’s many years away is likely not on its radar as that is more something relating to public and population health.

I also accept that age and other factors can also bring an unrelated heart issue into the equation but your body will probably let you know before you fall off the bike into a pool of your own sweat.

Don’t bank on it. Locally a lifelong and very fit older guy died of heart issues whilst out cycling. You can’t cater for every case but in general I avoid placing bets that I wouldn’t be comfortable about loosing.