Is More Exercise Always Better?

Is More Exercise Always Better?

An article published in The Washington Post in May titled “When Too Much Exercise Is Bad For Your Heart,” by Gretchen Reynolds, piqued my interest. It cited research on longtime endurance athletes, suggesting their strenuous training regimen might contribute to an increased chance of atrial fibrillation—which is an irregular and often a rapid heart rhythm that can lead to blood clots. 

Having authored many articles and books about the health value of exercise, my immediate response was “Don’t panic!” A comparable statement in the article made by Dr. Meagan Wasfy, a sports cardiologist at Massachusetts General Hospital in Boston, also confirmed my perspective when she said, “By all means, keep exercising.”  

The basis for Reynolds’ article was a widely discussed 2019 study from Sweden. The researchers gathered medical records for 208,654 Swedish finishers of the Vasaloppet, a draining series of cross-country ski races with distances of up to 90 kilometers (56 miles) and compared them to 527,448 Swedish men and women who did not enter the race. Overall, the skiers showed no greater risk of atrial fibrillation (AFib) than the other Swedes. But the male skiers who entered the most races or finished with the fastest times—suggesting that they had trained the hardest or more than anyone else, skiers or not—were more likely to develop AFib in the following years. (Female skiers had the lowest risk of AFib of any group in the study.) Reynolds states that some emerging research, including this study, shows that years of repeated, strenuous workouts and races may take a toll on the heart. 

Before drawing any final conclusions, let me tell you more about AFib. It is the most common heart irregularity, or arrhythmia, in the United States, with an estimated 2.7 to 6.1 million people having that diagnosis. AFib is also responsible for one in seven strokes. Risk factors include advanced age, high blood pressure, obesity, diabetes and heart problems, including coronary artery disease and heart valve abnormalities. An overactive thyroid is a common cause as are excess alcohol consumption and smoking. AFib is typically treated with oral medication, although the most successful treatment is an ablation procedure requiring hospitalization. 

Now, on the idea of too much exercise, remember excessive endurance exercise activities are not necessary for the average person to achieve great health benefits, as I have discussed since publication of my first book, Aerobics, in 1968. When looking at exercise for performance versus longevity, the weekly recommendation for achieving health and longevity for the average person could translate into walking two miles in less than 30 minutes just three times per week, or two miles in less than 40 minutes five times a week. Furthermore, a 2011 study published in the Journal of the American Medical Association (JAMA), “Gait Speed and Survival in Older Adults,” showed that how fast a person walks is a good predictor of longevity. If at age 80 a man can walk at 3.5 mph (a 17-minute mile), there is an 84% chance he will live to age 90. For a woman walking at the same pace, the probability is 86%. It comes down to lacing up your shoes and walking a few times per week!

 In my first book, I, too, felt that “more was better” in terms of exercise—until we learned what we know today through our research. Whether you run ultra distances or exercise for longevity, my message is still: “Listen to your body.” If you are a regular runner or perform vigorous exercise, and immediately notice the onset of extreme shortness of breath while exercising, on many occasions that could be the onset of AFib. As we have continued our research over these 53 years, I have revised my recommendations on many occasions because of undeniable new medical research. The first change I made to the early recommendations was if you are running not to compete but primarily for good health, then there is no need to run more than 15 miles per week. Above that level, there is an increase in musculoskeletal problems, not cardiovascular events.

Another revision stemmed from our 1989 landmark study from The Cooper Institute published in JAMA as “Physical Fitness and All-Cause Mortality.” This showed if you can get only 30 minutes of aerobic exercise, collective or sustained, most days of the week (a total of 150 minutes per week—which is also the recommendation of the American College of Sports Medicine), it could decrease deaths from all causes—particularly heart disease, strokes and cancer—by 58% and increase longevity by up to six years. Exercising above this threshold only decreased deaths from all causes by 65% and increased longevity by nine years. Above all, avoid inactivity; $29 billion dollars annually is spent treating medical problems associated with physical inactivity.  

Bottom line: We have proven that exercise is good for you, and it doesn’t take much—150 minutes sustained or collective per week—to reap the benefits and improve the quality and quantity of your life. At 92 years of age, I am blessed to still be exercising daily and enjoying the benefits of a long, healthy, active life—and I wish the same for you. Remember, your health is your responsibility, not the responsibility of the government, the insurance company or even your personal physician. No drug can replicate the benefits of an active lifestyle. 

And in all of your endeavors, remember to trust in the One who designed you. Isaiah 40:31 says, “But those who trust in the Lord will find new strength. They will soar high on wings like eagles. They will run and not grow weary. They will walk and not faint” (NLT). ©2023 Kenneth H. Cooper

Kenneth H. Cooper, M.D., MPH, known worldwide as “the father of aerobics,” is the founder and chairman of Cooper Aerobics in Dallas and chairman emeritus of The Cooper Institute.

The Scripture quotation is taken from the Holy Bible, New Living Translation, ©1996, 2004, 2015, by Tyndale House Foundation. Used by permission of Tyndale House Publishers, Carol Stream, Illinois. All rights reserved.

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