Extreme exercise has never been more fashionable, but cardiologists are worried that we may be causing problems for our hearts
Go into any fashionable gym class and it’s not always easy to distinguish between the instructor and the students. The clients are likely to be as hard-bodied and professionally dressed as the instructor. As for the workouts, the modern workout is more “training” than “exercise”. Forget gentle aerobics and “legs, bums and tums”, fitness counts these days only if it’s boxing, extreme Spinning or fast and furious bootcamp-style circuits.
Not long ago, if someone had told you they exercised three times a week, you would think they were superfit. Now it’s not unusual for metropolitan midlifers to work out every day – sometimes more than once. It seems that everyone is a wannabe athlete now – in the lunch hour, before work and after the school run – and we are priming our bodies for performance and perfection.
Of course, it is for the good of all that being fit has become a fashionable life goal – but many experts believe that the cult of the fitness junkie has gone too far. Far from doing us good, they warn that extreme exercise regimes are bad for our bodies. Research is showing that too much exercise can harm your heart and is linked to a range of conditions, from arrhythmia (irregular heartbeat) to coronary heart disease. It can also lower your immunity and put you at increased risk of injury.
Runners, swimmers and cyclists with decades-long workout histories have been shown to be more prone to cardiac problems
In the long term, warn the American authors of a new book, extreme exercisers could be setting themselves up for serious consequences. In The Haywire Heart: How too much exercise can kill you, and what you can do to protect your heart, Dr John Mandrola, a leading US cardiac specialist, reveals the science behind what he calls a paradoxical truth. Namely, “that too much exercise, especially at a high and sustained level, can damage your heart irreparably, and sometimes fatally”. Mandrola outlines published research that links long-term aerobic exercise among the over-thirties to a range of heart conditions, including arrhythmia, atrial fibrillation and heart “flutter”, and coronary artery disease. He establishes that there are higher levels of cardiac troponin – a protein that can indicate damage to the heart muscle – among those who work out too long and too hard. He describes himself as “anything but alarmist”.
Mandrola is concerned that a growing number of people take the adage that “exercise is good for you” to an unhealthy extreme. “They believe that if 30 minutes a day is good for you, two hours a day is four times better,” he says. “That’s not the case, and there’s a link between exercise dosage – how long and how hard someone has trained – age and risk of heart disease.” Runners, swimmers and cyclists with decades-long workout histories have been shown to be more prone to cardiac problems. “But middle-aged people who take up marathons and triathlons in their forties or fifties, having previously been sedentary or possibly smokers, are also at risk,” Mandrola says. “Basically, the older you get, and the longer and harder you have been exercising, the higher the risk of heart disease.”
Sudden cardiac arrest is one of the leading causes of death in the United States. In fact, studies reveal that more than 350,000 people suffer cardiac arrest in a year. Presently, the only way to restore a regular heart rhythm during cardiac arrest is to use an AED. An automated External Defibrillator or AED is used to support those experiencing sudden cardiac arrest. Because it is sophisticated, yet easy-to-use, medical device that can analyze the heart’s rhythm, it can help the heart re-establish an effective rhythm. However, while comparing AED laws by state, one can notice that New York has some of the strictest requirements in the nation. Since many health experts believe that New York’s AED laws are very strict, those who run a business or a public facility there are required to maintain an automated external defibrillator.
That being said, some of London’s top trainers are increasingly concerned about the new approach to fitness. “There’s this sense that people think harder, faster and longer workouts are the way to go,” says the celebrity trainer Dalton Wong. “You see people who train morning, lunch and evening, on top of a demanding job and maybe with a young family. When you exercise to extremes, it’s as bad as doing nothing at all.”
Part of the problem, says the personal trainer Matt Roberts, is that too many people expect too much from their bodies, assuming they can emulate the training feats of top sports stars. “It’s fine to aim high with your fitness, but the reality is that, when you add work, home life, stress and other commitments into the mix, your body will struggle to tolerate the demands that come with high levels of training,” he says. At the very least, persistent excessive exercise can raise the risk of repetitive strain injuries, weakened immune systems and heightened susceptibility to infections. “It results in an overload that can make the process of physical development incredibly difficult and can even mean that the body’s cells start to break down,” says Roberts. “Unlike elite athletes and some fit celebrities, the average person does not have the advantage of a support team who can help them adopt a wide variety of carefully managed recovery approaches – a great deal of rest and soft-tissue management, for example – all planned to allow their body to grow and develop in the best way.”
The obsessive nature of our appetite for fitness is getting out of control
It’s true that in many ways this mass move towards serious fitness is a good thing – at least we can’t be accused of being couch potatoes. Sales of fashionable fitness wear – high-end yoga pants and designer Lycra – have soared by 40 per cent worldwide over the past seven years and represent a 7 billion market in the UK alone. It’s not unusual to own two or three pairs of trainers, each specific to a form of exercise. Figures from Mintel, the retail analyst, show that 37 per cent of women who bought any type of shoe in the year to May 2016 purchased trainers, compared with 33 per cent who chose heels. Almost half of women aged 35 to 44 prefer to spend their money on sports footwear than regular shoes.
The trouble is, the obsessive nature of our appetite for fitness is getting out of control. Laura Turner-Alleyne, a former Olympic sprinter who is a personal trainer at the Centre for Health and Human Performance in Harley Street in London, says that she sees extreme exercisers with alarming frequency. “I saw a client on Friday who had already done three classes before coming to us for a session,” she says. “And despite us stressing that it’s inadvisable, she is far from an unusual case.”
With fashionable gyms such as Barry’s Bootcamp, CrossFit and the many other boutique classes offering a rotation of tough workouts, the temptation for class-cramming is reportedly on the rise, despite most expert trainers warning against it.
In his own research, Greg Whyte, the professor of sport science at Liverpool John Moores University, has seen how unremitting hardcore training over many years can cause changes in blood markers that “make someone more susceptible to unusual heart rhythms”. A review he co-authored for the British Journal of Sports Medicine in 2012 reported that half of long-term endurance and ultra-endurance runners showed signs of heart damage. He did have some words of comfort, though. “We are talking lifelong runners here – some had been training for 43 years,” Whyte says. “There was not the same risk in intermittent athletes who maybe did a marathon every couple of years. And we did stress that for most people the benefits of regular exercise far outweigh the risks.”
Numerous other studies are showing exercise beyond a certain level to be counterproductive to improving health. In 2015 researchers from the Copenhagen City Heart Study published findings in the Journal of the American College of Cardiology saying that, while joggers lived longer than non-exercisers, it was the slow plodders who had a longer lifespan than faster runners. The optimal amount of slow jogging a week was only between 1 and 2.4 hours. Data from other studies shows that people who increase the volume of their exercise by as much as 140 per cent, from 50 to 140 minutes daily, see only a 5 per cent drop in their risk of dying young.
Adding too much training to the demands of a career can put your body under stress
So exactly how much is too much? Mandrola’s message is simple: if health is your goal, you need not exercise more than 30 to 60 minutes each day. “That amount is more than enough to achieve the cardiovascular and health benefits of exercise,” he says, with the caveat that “periodically exercising harder and longer to achieve a one-off goal like a marathon is fine, but if you are looking to be as healthy in your sixties and seventies as you are in your forties, then 30 to 60 minutes is your goal, although even less is sometimes acceptable.”
If you exercise consistently for more than 60 minutes a day over many years, your risk of heart problems will rise with your age, Mandrola says, explaining that it’s the accumulation of hard exercise over time that is problematic. “An occasional two-hour session is not going to present problems,” he says. “It’s the people who do 60 minutes or more, day in, day out, who are storing up potential problems.”
It’s a hard message to hammer home to those hooked on extreme training, a large number of whom are 40. Turner says she has seen a marked rise in the number of women who are pushing themselves to new limits – whereas “it used to be more men” – and many of them are approaching middle age.
Wong says: “For a lot of people the drive to exercise hard comes out of fear – of getting old, or of gaining weight. However, you shouldn’t be doing in your thirties, forties and fifties what you did in your twenties to stay in shape – you need more recovery time if you are going to carry on enjoying your body.”
Yet it seems the ethos of “work hard, play hard” now has the added element of “be seen to work-out hard”.
It can take days for the body to recover fully from a hard 5km or 10km run
Many of Turner’s clients are City workers who try to combine their jobs with preparing for anything from a 30-day fitness challenge to a triathlon. “Their lives simply aren’t conducive to the level of exercise required,” she says. “By attempting to add too many training sessions on top of the demands of their career, they are placing their bodies in a constant state of stress and they are bound to crumble.”
Wong says that he increasingly spends his time convincing “workout adrenaline junkies” to give their bodies a break. “A huge number are successful in the business world and like the rush that comes with hard exercise,” he says. “But they are the ones at risk of chronic fatigue, injuries and burnout if they don’t cut down, so I advise a bit of gentle yoga to help them cut back.”
Mandrola agrees that allowing the body recovery time is key. Depending on your age and fitness level, it can take days for the body to recover fully from a hard 5km or 10km run, and weeks or even months to recover from an extreme endurance challenge, such as a marathon or triathlon. Bouncing from one event to another without a break is inadvisable. “It can’t all be relentless,” he says. “If you are in training for something specific, factor in frequent total rest days and then take weeks or months to recover with light activity after something like a marathon. We are not elite athletes. We don’t need to push on.”
A runner, cyclist and triathlete until his forties, he has slashed his activity levels to preserve his health. “At 53, I still ride my bike to work, but I moderate my exercise,” Mandrola says. “I still absolutely love exercising and being fit, but there is a benefit to having more balance. My advice would be to resist the urge to train more and train harder to get fitter for years on end. Think about your future health. Keep things in perspective. Remember, there can be too much of a good thing.”
How to exercise after 40
By Matt Roberts
You need to lift weights in middle age
Your body needs extra work from the age of 40 to help replace the muscle mass which declines with age. From about the age of 25, men lose an average of a fifth of a pound of muscle a year. By the age of 50, this accelerates to a loss of a pound of muscle every 12 months. A loss of muscle means that your body fat ratio will increase. Lifting weights also improves bone strength. This is particularly important for women, whose bones weaken in the lead-up to the menopause.
Do cardio twice a week
A couple of sessions of running, cycling or swimming are essential for healthy heart and lung tissue. Cardio is also good for mental wellbeing, and improves your circulation which can get worse with age.
Interval training once a week
Interval training is the most effective form of exercise for weight loss. Essentially, this means going as fast as you can for short bursts intermittently during your run/cycle/swim. This has been proven to be the best way to boost your metabolism and burn fat.
Your core matters more in midlife
At this stage, strong abdominals are the key to protecting your spine. You would do well to find a workout that focuses on your core. Pilates is good for this.
Include lunges and squats in your workout
Lunges and squats work the larger muscle groups in the buttocks and thighs. Muscles themselves are calorie-burning machines, so strengthening the glutes and quads will help to keep the fat off.
Stretching is important
Every day, stretch the limbs out properly. This will help to alleviate stiffness and aches and improve overall flexibility.
Yes, it’s time to take up yoga
Flexibility naturally decreases with age but it also works on a “use it or lose it” principle. Exercise that stretches and bends your body can help you not only hang on to your flexibility but you can even improve it – at any age. Stretching (ideally you should do some every day) is also very important for injury prevention.
Don’t exercise every day
If you are exercising for general health, working out too much will do more harm than good. Never train for more than an hour a day on a regular basis. As you get older, your risk of injury gets higher as muscles take longer to recover. They also lose elasticity as you get older, which increases the likelihood of injury. If you work out too much, your body will overproduce the stress hormone cortisol. You must have two rest days per week.
How much exercise is too much?
Weights are essential after the age of 40 – but do follow this rule: lift weights three times a week in your forties, twice a week in your fifties, and once a week in your sixties. Any more than that, and the muscles won’t have enough time to recover between sessions.