Can You Actually Be Too Athletic? Long-Term Mortality Study

The recent study in the Journal of the American Medical Association reports that the more fit one is, the longer one is likely to live. To some, this may come as no surprise, but to many athletes who have reviewed the extant research (Oxford Academic EP Europace’s 2009 Article, American Heart Association’s 2017 Article, JACC’s 2017 Article, e.g.), they know it comes with a caveat.

Too Much Fitness ≠ Long Life

It turns out that there exists an increased risk of some cardiovascular irregularities such as atrial fibrillation and coronary artery disease in athletes who strive toward elite fitness levels. In his book, The Haywire Heart, How Too Much Exercise Can Kill You, and What You Can Do to Protect Your Heart, cardiologist and athlete John Mandrola, MD reveals and explains the research showing that pushing the limits required to become an elite athlete often comes with negative consequences. However, as this study affirms, despite the known increased incidence of these cardiovascular morbidities, these “elite” athletic endeavors pay off in terms of longevity.

“Pushing the Limits Can Lead to Negative Consequences”

So How Much is Too Much?

The question begged by these facts is: at what level of fitness can one expect maximum longevity, but minimize or eliminate risk of the cardiovascular morbidities that can affect qualityof life, while including that increased life span obtained from fitness. We do not have the answer to that question at this point, and may never have more than a generalized statement / recommendation, because, as Dr. Mandrola points out, there are different causes of these various morbidities as we understand them today and they are very individualized in nature.

Dr. Rand’s Recommendation

Unless you still have an opportunity to win Olympic Gold, tailor your workouts to achieve maximum fitness while minimizing the risk of morbidities (duh). How does one do this? All we can really say for sure is that this tailoring will be different for each person. For example, my heart may be closer to my pulmonary vasculature than yours and the mild “healthy” enlargement of the right atrium that often typically occurs with elite cardiovascular fitness may be enough to elicit atrial fibrillation. Therefore, I might have to tailor my cardiovascular workouts so that I ultimately achieve a lower level of cardiovascular fitness than you. Keep in mind, however, that if you or I were prone to one of these morbidities, we are typically referring to their developing, not from achieving average levels of fitness, but rather, some level approaching well above average or elite fitness levels.

General Guidelines

I recommend training between 30 and 120 minutes per day, being careful to fit your training stress in with your total stress (day to day “life” stressors) so that, while one can still push limits, one is careful not to push too far at one time or too quickly. We know there is a correlation between excess inflammation and various morbidities, thus it is believed that while we do need to engender some inflammation to achieve better fitness, the key is to find the “sweet spot” in which we engender only that and not more. We also know that there is a direct correlation between alcohol consumption and risk of atrial fibrillation, so it may be prudent in individual circumstances to limit or eliminate alcohol consumption (please don’t shoot the messenger). Meanwhile, the good news is that, in many cases, once one of these morbidities presents itself, in the early stages, one can reduce the training load and/or other instigating factors, and, either eliminate or reduce the frequency of the morbidity (such as atrial fibrillation). In this case, and once again, the old saying, “no pain, no gain” must be supplanted with a more useful saying, “no brain no gain”