No Such Thing as Too Much Exercise, Study Finds

Alvin

Alvin

Senior Member (Voting Rights)
Didn't bother to read more than the excerpt you posted, but the general premise is flawed the way it is depicted because a) More exercise than you can handle will decrease fitness transiently because you will be forced to take a break (higher susceptibility to just the common cold etc is a topic among populations that try to get in very high workloads in their training) and, more importantly, b) of course someone with a higher level of cardiovascular fitness will be alive longer because they are a lot less likely to be severely sick. If this is addressed in the article then my points may not apply, but if you're taking clickbaity shortcuts in your headlines then forgive me if I just assume you will not have done your due diligence throughout the entire piece.
 
I thought someone had shown that if you exercise you might just about live longer by the amount of time you wasted making yourself feel ill exercising. And who wants to live longer? As if that was equal to 'health'.

And of course the non sequitur is that these data relate to whole populations not ill people. If you have aortic stenosis or obstructive cardiomyopathy then exercise is a good way to make you drop dead.
 
And meanwhile - that belife, that there is no such thing as to much exercise, has caused an increase in people landing themselfs in hospital with exercise induced rhabdomyolysis:

Rhabdomyolysis is a syndrome involving muscle breakdown and damage. When muscles are injured, they release their contents, including a muscle enzyme, into the bloodstream. The enzyme can harm the kidneys and can cause kidney failure in up to 40% of cases. It also can harm the kidneys’ ability to remove urine and other waste.
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https://www.webmd.com/fitness-exercise/news/20180222/exercising-yourself-to-death-the-risk-of-rhabdo

I know they are actually talking about fitness level here, but most people will remember the message from the headline. So, ironically, the way this research is presented could lead to more people injuring themselfs from exercise...
 
TigerLilea said:
This article wasn't about ME, though. For a person in reasonably good health it probably is very true.
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I think the point was that they were making sweeping generalisations. No caveat for ME for eg.
Not to mention the fact that among most healthy people above a certain level of economic means this info is unnecessary. When I was less ill and raising my children ALL the people I knew (mostly through school) were driven to achieve and live life fully. Because-They-Could.

This sort of science is in fact mostly aimed at people who have challenges that mean getting the kind of physical exercise that is perceived to be 'correct' is rather difficult.

These days (and some will beg to differ I'm sure) but there is a trend that you need to dress the part. So you don't go to Yoga (for eg) without your (very expensive) Lulu Lemons. It costs money to stay fit for anything but jogging and even then you need the right clothes or at the very least the right shoes.

Just my opinion on where these studies are coming from in terms of ideology.
 
Snowdrop said:
I think the point was that they were making sweeping generalisations. No caveat for ME for eg.
Not to mention the fact that among most healthy people above a certain level of economic means this info is unnecessary. When I was less ill and raising my children ALL the people I knew (mostly through school) were driven to achieve and live life fully. Because-They-Could.

This sort of science is in fact mostly aimed at people who have challenges that mean getting the kind of physical exercise that is perceived to be 'correct' is rather difficult.

These days (and some will beg to differ I'm sure) but there is a trend that you need to dress the part. So you don't go to Yoga (for eg) without your (very expensive) Lulu Lemons. It costs money to stay fit for anything but jogging and even then you need the right clothes or at the very least the right shoes.

Just my opinion on where these studies are coming from in terms of ideology.
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I don't disagree with your points, but I don't think that is the case with this particular study. There seems to be an ongoing discussion of could to much exercice actually be bad for your health:

That exercise is universally great for our health sounds like a no-brainer, sure. But in recent years, there’s actually been evidence that elite athletes and other heavy exercisers might paradoxically be at greater risk of some heart conditions than the average person, such as an irregular heartbeat, clogged arteries, and thickened heart valves. And these conditions might then raise an athlete’s risk of sudden cardiac death or other heart problems.
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This is all about behavior change. If patient follows healthy behavior A, they get health benefit B.

The problem comes in assuming that increased exercise is always the healthy behavior. Doctors may automatically prescribe exercise, thinking it is the healthy behavior for all patients. Patients could even be monitored for behavioral compliance, and rewarded (with, for example, lower insurance rates) for following healthy behaviors.

The problem is that, for ME/CFS, increased aerobic exercise is not generally a healthy behavior. Fortunately, many doctors are already familiar with exercise intolerance in other conditions, such as chronic pulmonary disease. Also, at least in the US, there seems to be growing awareness that graded exercise is not appropriate for ME/CFS patients.

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https://pages.questexweb.com/rs/294-MQF-056/images/8386.pdf?aliId=5084751842
 
The study, free access.


Association of Cardiorespiratory Fitness With Long-term Mortality Among Adults Undergoing Exercise Treadmill Testing
Kyle Mandsager, MD1; Serge Harb, MD1; Paul Cremer, MD1

Abstract
Importance Adverse cardiovascular findings associated with habitual vigorous exercise have raised new questions regarding the benefits of exercise and fitness.

Objective To assess the association of all-cause mortality and cardiorespiratory fitness in patients undergoing exercise treadmill testing.

Design, Setting, and Participants This retrospective cohort study enrolled patients at a tertiary care academic medical center from January 1, 1991, to December 31, 2014, with a median follow-up of 8.4 years. Data analysis was performed from April 19 to July 17, 2018. Consecutive adult patients referred for symptom-limited exercise treadmill testing were stratified by age- and sex-matched cardiorespiratory fitness into performance groups: low (<25th percentile), below average (25th-49th percentile), above average (50th-74th percentile), high (75th-97.6th percentile), and elite (≥97.7th percentile).

Exposures Cardiorespiratory fitness, as quantified by peak estimated metabolic equivalents on treadmill testing.

Main Outcomes and Measures All-cause mortality.

Results The study population included 122 007 patients (mean [SD] age, 53.4 [12.6] years; 72 173 [59.2%] male). Death occurred in 13 637 patients during 1.1 million person-years of observation. Risk-adjusted all-cause mortality was inversely proportional to cardiorespiratory fitness and was lowest in elite performers (elite vs low: adjusted hazard ratio
, 0.20; 95% CI, 0.16-0.24; P < .001; elite vs high: adjusted HR, 0.77; 95% CI, 0.63-0.95; P = .02). The increase in all-cause mortality associated with reduced cardiorespiratory fitness (low vs elite: adjusted HR, 5.04; 95% CI, 4.10-6.20; P < .001; below average vs above average: adjusted HR, 1.41; 95% CI, 1.34-1.49; P < .001) was comparable to or greater than traditional clinical risk factors (coronary artery disease: adjusted HR, 1.29; 95% CI, 1.24-1.35; P < .001; smoking: adjusted HR, 1.41; 95% CI, 1.36-1.46; P < .001; diabetes: adjusted HR, 1.40; 95% CI, 1.34-1.46; P < .001). In subgroup analysis, the benefit of elite over high performance was present in patients 70 years or older (adjusted HR, 0.71; 95% CI, 0.52-0.98; P = .04) and patients with hypertension (adjusted HR, 0.70; 95% CI, 0.50-0.99; P = .05). Extreme cardiorespiratory fitness (≥2 SDs above the mean for age and sex) was associated with the lowest risk-adjusted all-cause mortality compared with all other performance groups.

Conclusions and Relevance Cardiorespiratory fitness is inversely associated with long-term mortality with no observed upper limit of benefit. Extremely high aerobic fitness was associated with the greatest survival and was associated with benefit in older patients and those with hypertension. Cardiorespiratory fitness is a modifiable indicator of long-term mortality, and health care professionals should encourage patients to achieve and maintain high levels of fitness.
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https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2707428
 
Webdog said:
This is all about behavior change. If patient follows healthy behavior A, they get health benefit B.
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That's not really what this study was about though? The thesis they tested was:

Adverse cardiovascular findings associated with habitual vigorous exercise have raised new questions regarding the benefits of exercise and fitness.
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That seems relevant and fair to research to me?
 
Kaiser Permanente/University of Illinois study suggesting that "White men who exercise at high levels are 86 percent more likely than people who exercise at low levels to experience a buildup of plaque in the heart arteries by middle age". This is a subgroup of patients who need further study to determine the risk of high exercise levels on coronary artery disease.

Press release:
https://today.uic.edu/physically-active-white-men-at-high-risk-for-plaque-buildup-in-arteries

Study:
25-Year Physical Activity Trajectories and Development of Subclinical Coronary Artery Disease as Measured by Coronary Artery Calcium: The Coronary Artery Risk Development in Young Adults (CARDIA) Study
Laddu et al 2017
https://www.mayoclinicproceedings.org/article/S0025-6196(17)30577-3/fulltext
Abstract said:
Abstract
Objective
To evaluate 25-year physical activity (PA) trajectories from young to middle age and assess associations with the prevalence of coronary artery calcification (CAC).

Patients and Methods
This study includes 3175 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study who self-reported PA by questionnaire at 8 follow-up examinations over 25 years (from March 1985-June 1986 through June 2010-May 2011). The presence of CAC (CAC>0) at year 25 was measured using computed tomography. Group-based trajectory modeling was used to identify PA trajectories with increasing age.

Results
We identified 3 distinct PA trajectories: trajectory 1, below PA guidelines (n=1813; 57.1%); trajectory 2, meeting PA guidelines (n=1094; 34.5%); and trajectory 3, 3 times PA guidelines (n=268; 8.4%). Trajectory 3 participants had higher adjusted odds of CAC>0 (adjusted odds ratio [OR], 1.27; 95% CI, 0.95-1.70) vs those in trajectory 1. Stratification by race showed that white participants who engaged in PA 3 times the guidelines had higher odds of developing CAC>0 (OR, 1.80; 95% CI, 1.21-2.67). Further stratification by sex showed higher odds for white males (OR, 1.86; 95% CI, 1.16-2.98), and similar but nonsignificant trends were noted for white females (OR, 1.71; 95% CI, 0.79-3.71). However, no such higher odds of CAC>0 for trajectory 3 were observed for black participants.

Conclusion
White individuals who participated in 3 times the recommended PA guidelines over 25 years had higher odds of developing coronary subclinical atherosclerosis by middle age. These findings warrant further exploration, especially by race, into possible biological mechanisms for CAC risk at very high levels of PA.
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inox said:
That's not really what this study was about though? The thesis they tested was:

"Adverse cardiovascular findings associated with habitual vigorous exercise have raised new questions regarding the benefits of exercise and fitness."

That seems relevant and fair to research to me?
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But if I'm reading it correctly, the study finds that the benefits of high cardiorespiratory fitness (CRF) outweigh any previous adverse findings, concluding (bolding mine):
Conclusion said:
Increased CRF was associated with reduced long-term mortality with no observed upper limit of benefit. The adjusted mortality risk of reduced CRF was greater than or equal to traditional clinical risk factors, such as cardiovascular disease, diabetes, and smoking. Extreme aerobic fitness (CRF ≥2 SDs above the mean for age and sex) was associated with the greatest survival and was notably beneficial in older patients and those with hypertension. Cardiorespiratory fitness is a modifiable indicator of long-term mortality, and health care professionals should encourage patients to achieve and maintain high levels of fitness.
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This seems a blanket recommendation for doctors to encourage high levels of fitness for all patients.
 
Maybe the people who exercised more sweated more and this caused all of their negative energy and evil spirits to be sucked out? The more exercise, the more this happened. Possibly exactly the same effect could be seen by redoing the experiments in a sauna with no exercise, or seeing if pouring cold water over people in a freezer has a negative effect on life expectancy?

Who knows, we need more research, to determine how much we don't know.

All I keep thinking is, if excessive exercise, with no sensible limits, is so good at increasing life expectancy, where are all the guys who built the pyramids now, that was a fair amount of exercise, surely it should have been enough to keep them ticking over until now.

But then I'm fried with a tendency towards barking.
 
Wonko said:
Maybe the people who exercised more sweated more and this caused all of their negative energy and evil spirits to be sucked out?
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This sounds likely! :D

I heard a report on the radio last night that obese people who exercised excessively could damage their heart.
 
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