“If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health”
Hippocrates circa 400BCE
We have heard the terms food is medicine, and exercise is medicine.
We know that the RIGHT kind of food in the RIGHT amount is a critical aspect of wellness- although there is a range of acceptance of what the right food really is. However , we have been a bit slower to acknowledge Hippocrates' statement regarding exercise.
Exercise for sports performance and peak cardiorespiratory fitness is not necessarily equated with health. As Phil Maffetone and Paul Laursen state in their 2016 article: "fitness describes the ability to perform a given exercise task, and health explains a person’s state of well-being, where physiological systems work in harmony" (1).
Numerous studies have shown that there is actually a j curve of exercise intensity and duration when related to health. In particular to cardiovascular health: specifically atrial fibrillation and coronary artery disease (2).
Worldwide there is an epidemic of poor health related to insufficient incidental exercise ;the curse of modern sedentary societies. However , for many years more was also thought to equate with better. If you could run a marathon then you were deemed really healthy. So many people go all out at every training session, they train for taxing marathons with huge mileage. They perform regular high intensity workouts for durations well in excess of the described benefit. But is fit really healthy?
We now know that high training volumes of intense exercise are precursors to atrial fibrillation and increased risk of coronary artery disease when compared to moderate exercise. The risk is less than doing NO exercise but a risk nonetheless. In addition such training programs have the potential for physical overuse injury and mental fatigue in the form of overtraining syndrome.
The advice of 150min of moderate exercise per week "or 75 min intense exercise per week "is not necessarily a formula for health. We need to rethink the intense exercise.
Again we need to go back 2000 years and learn from Hippocrates:
"everything in excess is opposed to nature"
These excesses in exercise result in what has been simplified as a "chronic inflammatory state". It is more complex than this, and the science is still not fully clear. For example, in the case of atrial fibrillation in athletes, there is alteration in the autonomic nervous system, triggered by prolonged high sympathetic activity (3). Then during times of vagal stimulation: recovery from exercise, large meals, sleep, oesophageal reflux- there is a potential to trigger the abnormal rhythm. The biochemistry of the conduction cells in the heart changes, there are often structural changes to the the heart chambers and muscles and fibrosis at a microscopic level. Intense exercise is not the only precursor to atrial fibrillation, and like many things it is likely multifactorial. However, a combination of high intensity lifestyle with inadequate rest/sleep/recovery is a key underlying feature.
This information is not only important for athletes but also when it comes to exercise prescription for those with medical problems such as metabolic syndrome or diabetes. It's important to stress the more is not better message and the understanding that walking ( or equivalent low intensity movement) is an excellent form of exercise for the human body.
After all, our body is designed for long periods of moving at slow pace interspersed with infrequent bursts of running and occasional efforts of strength.
So when approaching your exercise regime ask yourself a few questions. What really are your goals? Is it for peak performance in a competitive sport? Is it to lose weight? Is it to have a more satisfying body image? Is it for overall health?
If the goal is anything but peak sports performance, then the ideal approach to exercising is a moderate one. Busy type A professionals have a tendency to exercise consistently in the red zone. Every workout squeezed in amid busy life demands. Every workout a competition to go harder, faster. All supported by a massive health industry marketing machine.
However, with the appropriate diet, appropriate heart rate guided exercise intensity, strength training, and attention to a number of other lifestyle factors you can find yourself getting healthier.
If you need help achieving these goals and overcoming barriers to change, having a health coach work with you is a real advantage.
RECLAIM THE OUTDOORS
Maffetone and Laursen Sports Medicine - Open (2016) 2:24 DOI 10.1186/s40798-016-0048-x
Mayo Clin Proc. n September 2014;89(9):1171-1175 n http://dx.doi.org/10.1016/j.mayocp.2014.07.007 www.mayoclinicproceedings.org
Matthias Wilhelm, MD et al Remodeling, Autonomic Tone, and Lifetime Training Hours in Nonelite Athletes
