Exercise: How much is too much?

Many afibbers have histories that include years of various types of strenuous exercise-- especially, running. It’s acknowledged by leading cardiologists that while it’s important to exercise and be fit, there is also room for potential damage from prolonged, endurance exercise... like running.

What often isn’t emphasized along with an exercise or fitness program is consideration of preventive measures that help blunt the effects or damage that comes from ROS… reactive oxygen species or free radical damage....a consequence of the exercise process. Along with exercise, it’s critically important to have in place a daily regimen of antioxidant supplements to help offset that damage. It's rare to see emphasis by cardiologists on this topic (or emphasizing the importance of magnesium, potassium, etc) so we must look to functional or holistic practitioners who understand the importance of daily nutritional support no matter how much exercise you do. You can't exercise for a couple hours on a hot day, sweat until your clothes need to be wrung out, and still maintain your body's nutrient requirements without an optimal plan for replacement.... including optimal hydration with pure water.

I was gathering info on this topic for a friend who is addicted to running for the ‘runner’s high’ but also sustained some heart issues that were a mix between arrhythmia and a pacing. I found this well-done and highly informative video clip and published study by cardiologist, James O’Keefe, MD that is worth viewing… only 12 minutes... that highlights a balanced approach to exercise in light of the long-term effects that heavy, endurance exercise has on the cardiovascular system... including the tendency to develop arrhythmia.

This report is a reminder that while exercise is important, too much can also be damaging. Understand the difference by starting with this introduction:

James O'Keefe, M.D., Potential Adverse Cardiovascular Effects From Excessive Endurance Exercise.
Most doctors would agree that exercise is beneficial for your health. But is it possible to exercise too much? According to James O'Keefe, M.D., preventive cardiologist at Saint Luke's Mid America Heart Institute, long-term, excessive endurance exercise may do more harm than good in some. His findings are published in the June 4 issue of the Mayo Clinic Proceedings. Published on Jul 26, 2012
[www.youtube.com] – 12 minutes

Mayo Clin Proc. 2012 Jun; 87(6): 587–595.
PMCID: PMC3538475
Potential Adverse Cardiovascular Effects From Excessive Endurance Exercise
James H. O'Keefe,a,⁎ Harshal R. Patil,a Carl J. Lavie,b Anthony Magalski,a Robert A. Vogel,c and Peter A. McCulloughd

Abstract
A routine of regular exercise is highly effective for prevention and treatment of many common chronic diseases and improves cardiovascular (CV) health and longevity. However, long-term excessive endurance exercise may induce pathologic structural remodeling of the heart and large arteries. Emerging data suggest that chronic training for and competing in extreme endurance events such as marathons, ultramarathons, ironman distance triathlons, and very long distance bicycle races, can cause transient acute volume overload of the atria and right ventricle, with transient reductions in right ventricular ejection fraction and elevations of cardiac biomarkers, all of which return to normal within 1 week. Over months to years of repetitive injury, this process, in some individuals, may lead to patchy myocardial fibrosis, particularly in the atria, interventricular septum, and right ventricle, creating a substrate for atrial and ventricular arrhythmias. Additionally, long-term excessive sustained exercise may be associated with coronary artery calcification, diastolic dysfunction, and large-artery wall stiffening. However, this concept is still hypothetical and there is some inconsistency in the reported findings. Furthermore, lifelong vigorous exercisers generally have low mortality rates and excellent functional capacity. Notwithstanding, the hypothesis that long-term excessive endurance exercise may induce adverse CV remodeling warrants further investigation to identify at-risk individuals and formulate physical fitness regimens for conferring optimal CV health and longevity.


Related discussions:
How much running is bad for your heart? [running.competitor.com]

Extreme Exercise [fitness.mercola.com]

Antioxidants
Antioxidants are electron donors. They can break the free radical chain reaction by sacrificing their own electrons to feed free radicals, but without turning into free radicals themselves.

Antioxidants are nature's way of providing your cells with adequate defense against attack by reactive oxygen species (ROS). As long as you have these important micronutrients, your body will be able to resist aging caused by your everyday exposure to pollutants. If you don't have an adequate supply of antioxidants to help squelch free radicals, then you can be at risk of oxidative stress, which leads to accelerated tissue and organ damage.

Antioxidants also help slow down the aging process.
Other important benefits of antioxidants include:
• Repairing damaged molecules – Some unique types of antioxidants can repair damaged molecules by donating a hydrogen atom. This is very important when the molecule is a critical one, like your DNA.
• Blocking metal radical production – Some antioxidants have a chelating effect – they can grab toxic metals like mercury and arsenic, which can cause free radical formation, and "hug" them so strongly to prevent any chemical reaction from taking place. Water-soluble chelating agents can also escort toxic metals out of your body through your urine.
• Stimulating gene expression and endogenous antioxidant production – Some antioxidants can stimulate your body's genes and increase your natural defenses.
• Providing a "shield effect" – Antioxidants, such as flavonoids, can act as a virtual shield by attaching to your DNA to protect it from free radicals attacks.
• Promoting cancer cells to "commit suicide" – Some antioxidants can provide anti-cancer chemicals that halt cancer growth and force some cancer cells to self-destruct (apoptosis). Continue: [articles.mercola.com]

In his book, The Antioxidants, Richard A. Passwater, PhD, says

Many people think that taking just a few antioxidants – just one or two megadoses – is sufficient to maintain optimal health. But I strongly disagree. Instead, you must get a wide variety of antioxidants to maintain your well-being.

[www.drpasswater.com]
[www.pycnogenol.com]

There is much more to this topic. This short report serves as incentive to assess both your exercise program and also evaluate your intake of antioxidants and essential minerals/electrolytes as both restorative and preventive.

Reminder of past posts on running and magnesium depletion causing cardiac fibrosis as researched by William J. Rowe, MD verified in these links:
[www.femsinspace.com]
[femsinspace.com]
[link.springer.com]
[www.dailyprogress.com]

Jackie

Great post. I shared this with my wife who is training for her first marathon. I worry about how much she trains.

Thanks for this. While I was never an long distance endurance athlete, I did my more than my share of biking, running and full court basketball. I still trail run and bike but nothing excessive along with weight training.

I'm coming off my first cadioversion (exercise/coffee induced) after 20 hours in the hospital last week, my second afib event in 16 years. My afib attacks seem to be fairly intense relative to what I hear is more of a "background" event, for lack of a better term. Unfortunately, despite the infrequency of my events, I don't seem to convert on my own.

Naturally, getting back into exercise mode I feel like I'm being hyper vigilant as to what my ticker is doing! To that end, I'm curious what products people recommend for electrolyte replacement that doesn't contain sugar.

Daniel