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  1. #1
    Senior Member astompa's Avatar
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    Can Exercise Kill? Yes

    An article in today's Wall Stree Journal titled "Can Exercise Kill?" states that "Present research reveals that vigorous exercise is responsible for triggering up to 17% of sudden cardiac deaths in the U.S., says a recent article in the Ameican Medical Athletic Association Journal. ... Evidence is mounting that extreme exercise--marathons, triathalons and the like--may be detrimental to the immune system and long term health." If you have access to the article, please read and discuss.

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    Virtulized geek MsMittens's Avatar
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    It'd be nice if the rest of us could see the article (I can't find any alternative sites that have it online). That said, I wonder if it's the exercise that is actually doing the killing or a previous health condition that wasn't looked at. Additionally, how many of those up to 17% "over did it" as it were in an attempt to get "thin". I personally find stats rather misleading at times.

    And "up to 17%" of how many? How many others had a cardiac event but recovered? How many others died of other events? etc....

    edit

    While I was looking for the article in question I did find the following that might be of insight:

    Will Cardio Kill Seniors: note the section on Warming Up. This would make me question as to whether those "up to 17%" did a warm up?

    Abstract from 1989: When exercise can kill: how to spot IHSS.

  3. #3
    Senior Member astompa's Avatar
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    Yeah sorry, the WSJ is not available online for free. I don't see the information you
    ask about in the article. The article says that blood is more "clottable" for some people during long distance runs, and also mentions "water intoxication with acute brain swelling" something that has to do with drinking too much water during a marathon, which I had never heard of. The research isn't accepted by everyone, but of course we have all heard of people dropping dead during or after intense exercise. The point as I see it isn't whether this is due to previous health condition but if strenuous exercise exacerbates that condition, to the point that you were better off doing moderate exercise instead of running the marathon or doing the century.

  4. #4
    Stegosaurus Crunkologist's Avatar
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    Extreme cardio is detrimental to the immune system, even among trained athletes. This is well documented in the literature, although BCAAs and Glutamine seemed to help when taken post exercise, in the few studies on this that I've seen.

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    Virtulized geek MsMittens's Avatar
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    The point as I see it isn't whether this is due to previous health condition but if strenuous exercise exacerbates that condition, to the point that you were better off doing moderate exercise instead of running the marathon or doing the century.
    This of course assumes that you know it exists. And if individuals know it exists, then we'd hope they'd exercise accordingly....

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    2-Cyl, 1/2 HP @ 90 RPM slvoid's Avatar
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    Quote Originally Posted by Crunkologist
    Extreme cardio is detrimental to the immune system, even among trained athletes. This is well documented in the literature, although BCAAs and Glutamine seemed to help when taken post exercise, in the few studies on this that I've seen.
    Damn... maybe that's why I get sick more when I exercise when it's cold out. I always thought being in shape helped the immune system.

  7. #7
    Stegosaurus Crunkologist's Avatar
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    It does. But when you go extreme, there is a temporary lull.

  8. #8
    H23
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    Quote Originally Posted by astompa
    An article in today's Wall Stree Journal titled "Can Exercise Kill?" states that "Present research reveals that vigorous exercise is responsible for triggering up to 17% of sudden cardiac deaths in the U.S., ....

    "Triggering" is different from "causing". Exercise does NOT kill. Inactivity, a lifetime of poor diet choices, and genetics kill by causing heart disease in the first place.

    It sort of makes sense that if someone has heart disease that stressing the cardio sytem could cause bad things to happen. In fact, one of the tests given to determine whether a heart problem is present is called a "stress test" (running on a treadmill).

    These epidemiological stories get the public all mixed up and primes them for reaching irrational conclusions.

    I wish the medical community would just keep the story straight and simple-- Exercise 3-5 times a week and eat a sane, healthy, balanced diet.

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    Pat
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    Well an out of shape sedentary person with a heart condition can often expire if they go out and do something energetic.

    A friend of mine organizes various atheletic events including some well attended marathons. A guy expired at one of these and it caused a certain amount of coverage in the local press. The thing was that apparantly deaths at marathons are surprisingly common.

    I have participated in quite a few centuries and I have never heard of such a thing happening at an organized century. I am not saying that it does not happen or has never happened, just that I have not heard about it.

    Seems that I read something else also, that if you exercise regularly (cardiovascular) that you have an elevated risk of death during the exercise but that the exercise reduces your risk if engaged in regularly.

    As for anecdotes, I have a couple. I went to see an orthopedic surgeon after a particularly nasty crash. He is an older guy and knows how to use a stethascope (apparantly the skill is no longer taught effectively). He listened to my heart and wanted to get me put down as an organ donor but then he found out how old I was and I have too many miles on it.

    A friend of mine who rides quite a bit turned out to need triple bypass surgery. It wasn't anything he was doing, he just had the wrong genes. His cardiologist told him that if he had not built up his cardiovascular system cycling, he would not have survived long enough for the symptoms to manifest themselves before he dropped dead.

  10. #10
    starving for knowledge
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    thats it im sitting on the couch eating chips from now on.
    rather be forgoten than remembered for not trying

  11. #11
    HJR
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    There is a history here. Remember, according to Greek legend, Phidippides ran from the battlefield of Marathon to Athens after a heavily outnumbered Greek force defeated the invading Persians, then dropped dead after proclaiming, "Nike!" (victory) over the Persians.

  12. #12
    Every lane is a bike lane Chris L's Avatar
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    Quote Originally Posted by MsMittens
    It'd be nice if the rest of us could see the article (I can't find any alternative sites that have it online). That said, I wonder if it's the exercise that is actually doing the killing or a previous health condition that wasn't looked at. Additionally, how many of those up to 17% "over did it" as it were in an attempt to get "thin". I personally find stats rather misleading at times.

    And "up to 17%" of how many? How many others had a cardiac event but recovered? How many others died of other events? etc....
    Much like what I was about to say. We need to question just who makes up the 17% that supposedly died during exercise. What about those who decided to run a marathon on no training (and probably a poor fitness base before that)? Yes, it does happen. The whole 17% figure when taken in isolation really tells us nothing.
    "I am never going to flirt with idleness again" - Roy Keane
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    SAB
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    The medical community does keep things straight! It's the media and unqualified lay "experts" that get it wrong - putting out an inaccurate, poorly-researched message and confusing everyone!

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    H23
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    Quote Originally Posted by SAB
    The medical community does keep things straight! It's the media and unqualified lay "experts" that get it wrong - putting out an inaccurate, poorly-researched message and confusing everyone!
    You're right. Its not the medical community. It is medical news as reported by media outlets that is the problem.

  15. #15
    Virtulized geek MsMittens's Avatar
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    For those interested, someone on one of the other forums posted the article. I've copied it here for us "poor" folks. On a side note, I've started reading The Obesity Myth, which seems to suggest that being "overweight" may not be as bad as we think (granted I'm only in the first chapter but seems interesting, albeit controversal).

    Personally though, I'd rather die exercising and enjoying life than be found in front of the "boob tube".

    Can Exercise Kill?
    The answer: Yes, and probably more often than you think
    By KEVIN HELLIKER
    Staff Reporter of THE WALL STREET JOURNAL
    October 11, 2004; Page R7

    In the space of seven months in 2002, three physicians at Johns Hopkins Hospital in Baltimore suffered sudden cardiac death while exercising. Two were running, the other working out in the hospital's fitness center. All three had paid close attention to diet and exercised regularly. The oldest was 51.

    This unlikely string of deaths brought tremendous local attention to a topic that medicine typically doesn't emphasize -- for good reason.

    Exercise, after all, prolongs more lives than it cuts short. And in a nation that is largely sedentary, people need no extra excuse not to exercise.

    Yet a growing number of physicians believe that publicizing the risks of exercise could potentially save a significant number of lives. Johns Hopkins cardiologist Nancy Strahan, for one, is now advising her middle-aged patients to stay away from jogging until they've undergone an exam to determine their risks.

    "Present research reveals that vigorous exercise is responsible for triggering up to 17%" of sudden cardiac deaths in the U.S., says a recent article in the American Medical Athletic Association Journal. This means that vigorous exercise is triggering tens of thousands of U.S. deaths a year.

    Impact on Immune System

    What's more, sudden death isn't the only risk. Evidence is mounting that extreme exercise -- marathons, triathlons and the like -- may be detrimental to the immune system and long-term health. "Exercising to excess can harm our health," cautions Kenneth Cooper, the physician credited with founding the aerobics movement back in the 1960s.

    All of this, of course, runs counter to conventional wisdom, which says that exercise is a virtue, and that you can't get too much of a virtue.

    Indeed, pretty much as soon as a thirtysomething slips on his first pair of running shoes he is challenged by an acquaintance or athletic-store poster to run a marathon. But exercise more accurately may be perceived as a medical therapy, and doctors are generally very cautious about the dosages they prescribe for medical therapies. Nobody would recommend quadrupling the dose of a drug that had proved to be effective.

    So, how much is too much? It depends, of course, on the person.

    The risk of sudden cardiac death during exercise would be reduced if people -- especially those older than 40 -- underwent various tests before starting a workout program. These tests include: an electrocardiogram, an electrical recording of the heart that can detect various abnormalities; an exercise stress test, during which physicians monitor the cardiovascular system's response during a treadmill workout; and an echocardiogram, an ultrasound scan that can spot a wide range of defects.
    Whether your insurance will pay for these tests depends on your age, health plan and how strongly your doctor recommends them.

    Although these tests aren't guaranteed to find every cardiovascular booby trap that exercise can trip, they can identify a significant percentage of the conditions that cause sudden cardiac death-artery blockages, cardiac arrhythmias, aneurysms and more.

    The risk of sudden death during exercise appears to rise as the duration of the workout grows. For instance, the risk of death during a marathon is about one in 50,000 finishers -- significantly higher than during shorter races or inactivity. One reason is that during long-distance runs the body sustains muscle injury, and it can react to this injury as if it were bleeding, by rendering blood more clottable, says Arthur Siegel, a Harvard University professor and chief of internal medicine at McLean Hospital in Belmont, Mass. In people with hidden blockage in their coronary arteries, this thickened blood can result in sudden cardiac death.

    But that's not the only danger. Muscular injury can also set off a hormonal response that in turn triggers water intoxication, with acute brain swelling, says Dr. Siegel. This can be deadly for marathon runners who take too seriously the recommendation to drink lots of fluid. In recent years, young and healthy runners have died of hyponatremia -- essentially drinking too much fluid -- in several marathons, including those in Chicago and Boston.

    "A half-million Americans a year are going out to run marathons," says Dr. Siegel. "They incur a dose of exercise that is enough to cause muscle injury that could, under certain circumstances, have grave consequences."

    Having run 20 marathons himself, Dr. Siegel calls himself an advocate for safe participation. Avoiding hyponatremia is mostly a matter of drinking only when thirsty, and this caution is especially important for slower runners.

    As for sudden cardiac death, Dr. Siegel suggests that people at risk for cardiac disease perhaps should be cautious about pushing their heart rates too high. People with high risk factors "ought to be careful about keeping the intensity moderate," says Dr. Siegel. "Exercise at a level where they can be conversational." Should such people run marathons? Dr. Siegel advises: "Do the marathon training but skip the race."

    An increasingly popular theory has it that death from extreme exercise may not come until years afterward. This theory first occurred to Dr. Cooper, founder of the Cooper Institute in Dallas, when he noticed what seemed like a higher-than-average rate of cancer and other disease among the fitness fanatics he knew.

    'More Harm Than Good'?

    Having now studied the matter for more than 20 years, he has concluded that especially long and intense bouts of exercise may be damaging to the immune system. It is only a theory, but it is at least partly based on medical studies such as one showing that marathoners suffer a high rate of cold and flu just before and after races.

    "If you're exercising more than five hours a week [at a high intensity], there's a possibility that you may be doing more harm than good," Dr. Cooper says.

    Nobody should feel compelled for health reasons to run marathons, do triathlons or otherwise aspire to become a fitness fanatic, says Dr. Cooper, adding that 30 minutes a day of moderate exercise such as walking is sufficient.

    Of course, there are benefits to extreme exercise -- it provides enormous relief from stress and consumes a spectacular number of calories. For people committed to exercising fanatically, Dr. Cooper and others recommend diets heavy in antioxidants such as green vegetables, as well as supplements such as vitamins C and E. Such diets are believed to bolster the immune system.

    Devotees of extreme exercise express confidence that any risks, including a possible increased vulnerability to cancer, are outweighed by benefits ranging from lowered blood pressure to heightened confidence. This explains why Frank Webbe, a professor of psychology at Florida Institute of Technology, has run 14 marathons.

    "You run them because you can," says Dr. Webbe, a veteran officer of a group called Running Psychologists. Marathons, he says, are "part of my identity. It's a self definition. I'm one of the elite few. It's important to me."
    Exercising to excess can harm our health: maybe it's just me but anything in excess can be harmful. Why would we think anything different about exercising?

  16. #16
    Around now and then DnvrFox's Avatar
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    Having run 20 marathons himself, Dr. Siegel calls himself an advocate for safe participation. Avoiding hyponatremia is mostly a matter of drinking only when thirsty, and this caution is especially important for slower runners.

    And slower bicyclers?
    DnvrFox - still bicycling, swimming, walking and weight lifting at 74yo is participating a bit in BFN 50+.

  17. #17
    winter is comming BenyBen's Avatar
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    DNvrFox: I would think that if you're able to hold a conversation for a couple seconds you'd be fine. If you're concerned just do as he says and drink only when thirsty.

  18. #18
    Bike Happy DanFromDetroit's Avatar
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    There are safe and unsafe ways to do anything. If you are completely sendentary, I wouldn't suggest an intense cardio workout as a good way to begin an exercise program.

    Saying "Exercise Kills" is just overly broad and the WSJ should know better than to try to back this nonsense up with invented percentages (like that makes it anymore credible).

    Standards have really slipped when a formerly respectable publication endorses crap like this.

    There is nothing "extreme" about marathons either; thousands of folks every year complete one without being killed, which is more than you can say for driving your car.

    I wonder if I can convice my wife that "Yard Work Kills" or "Snow Shoveling Kills". I can quote the WSJ. On second thought, she probably won't buy it either.

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  19. #19
    Senior Member Tom Pedale's Avatar
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    Being a financial advisor, I subscribe to WSJ and saw the article yesterday. The old proverb of "moderation in all things" comes to mind. The article seems to focus on the number of marathon runners that croak. I've cycled for over 30 years and although I've done some running in that time, it's always been apparent to me how significantly more painful running is than cycling which is probably why I no longer run. Cycling on the other hand almost always leaves me with an after ride glow save for an occasional sore butt or muscle now and again. I try and listen to my body and pace my riding accordingly.
    With respect to the immune system, many studies have concluded that moderate exercise strengthens the immune system. Overtraining can lead to a weaker immune system (and slower times). Pro athletes are generally treading the thin line between not enough & too much training.
    "Learn how to handle hot things. Keep your knives sharp. And above all, have a good time" - Julia Child

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    Quote Originally Posted by Tom Pedale
    I've cycled for over 30 years and although I've done some running in that time, it's always been apparent to me how significantly more painful running is than cycling which is probably why I no longer run. Cycling on the other hand almost always leaves me with an after ride glow save for an occasional sore butt or muscle now and again. .
    Agreed. Running raises my heart rate sky high while cycling enables me to coast thus lowering my pulse.

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    i did the 10k cooper river bridge run last year in charelston, SC with my gf. She saw an older(like 55 to 60) guy collapse and die from cardiac arrest right in front of her. He was on the bridge too, with thousands of other runners, so they couldn't get an ambulance up to him. The family also said he had no history of heart disease and neither did their family. Just thought i'd share some personal experience

  22. #22
    H23
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    Quote Originally Posted by pearcem
    i did the 10k cooper river bridge run last year in charelston, SC with my gf. She saw an older(like 55 to 60) guy collapse and die from cardiac arrest right in front of her. He was on the bridge too, with thousands of other runners, so they couldn't get an ambulance up to him. The family also said he had no history of heart disease and neither did their family. Just thought i'd share some personal experience

    A disturbing percentage of people find out they have heart disease by simply dropping dead. I met an avid cyclist in his 60's who later died of a heart attack shortly after completing a century.

    On the other hand, perhaps it is better to die that way than to die after years of reduced mobility, or worse, senility or Alzheimers.

  23. #23
    2-Cyl, 1/2 HP @ 90 RPM slvoid's Avatar
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    Quote Originally Posted by H23
    A disturbing percentage of people find out they have heart disease by simply dropping dead. I met an avid cyclist in his 60's who later died of a heart attack shortly after completing a century.

    On the other hand, perhaps it is better to die that way than to die after years of reduced mobility, or worse, senility or Alzheimers.
    I wouldn't mind drifting off into a state where I'm totally unaware that I'm going to die. It's less scary that way.

  24. #24
    Don't Believe the Hype RiPHRaPH's Avatar
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    i am rereading the book 'how to lie with statistics'

    exercise is a part of your lifestyle. those 3 physicians at johns hopkins died from exercise and not from the frenetic pace and long hours that all dr's are bound to? please. stress in any form kills. physical and mental stress. we release stress hormones that is virtually impossible to override.
    everyone has stress in their lives. its how you deal with it.

    i try to stay out of the RAT RACE....not the foot or bike race. I exercise for overall health and to better myself, not to prove anything that i am not genetically predisposed to do. you can't pick your parents you know.


    how many people who exercise do it out of competitiveness and vitrol rather than pure enjoyment. how many wishes that you didn't have to exercise to stay slim instead of embracing it. ABOUT 17%????? umh.

    its like people who steal $$. they don't love $$. They hate it. They hate that that is how people keep score and crave it because of competitiveness. People who are willing to work for it love $$. same with exercise. some embrace it and some hate it but know that they have to compete or do it for motives that aren't healthy.

    i've got to step off my soapbox and repair it now....sorry.

    maybe it's as simple as an underlying condition ignored or worked through. or maybe it was due to improper training. how many of the 17% worked under the care of a trainer or professional to ensure success?
    I have enough words to get me into trouble, but not enough to get me out of trouble.

  25. #25
    Who said turtles are slow
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    Quote Originally Posted by BenyBen
    DNvrFox: I would think that if you're able to hold a conversation for a couple seconds you'd be fine. If you're concerned just do as he says and drink only when thirsty.
    I had read that once you were actually thirsty, de-hydration was already setting in

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