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Endurance Training: The Best Heart Health Drug There Is?

Endurance training and its importance in improving heart health

The phrase ‘my heart is beating out my chest’ is given new meaning to you as you come to a stop. You don’t just understand it, you are currently living it. Words you once saw as hyperbole are now a reality, with each LUB-DUB of your heart seemingly threatening the solidity of your rib cage. You’re entirely drenched in sweat that drips, nay streams, down from your hair all through your sports tee, giving it a colour gradient that wasn’t there before. ‘This gradient is the attire of winners’ you think to yourself between laboured breaths and large chugs of water. And you’re right, because you’ve pushed yourself harder and further than ever before, and that’s what winners do. Whether you’re a runner, a swimmer, or a biker, you have shared in this beautiful feeling that comes post endurance training. A well deserved sense of pride washes over you as you watch yourself put in the work required to achieve your goals. You’re feeling stronger and more physically able, the endorphins in your brain have you on cloud nine, and you know your mirror is going to start showing you what you want to see.

But better than all of this is the invisible improvement you’re making. Heart disease is the leading cause of death worldwide, and you are out there improving your heart health every time you lace your shoes up or don your swimsuit. It is reported that people who engage in endurance training regularly show lower rates of disability and an average life expectancy that is 7 years greater than their physically inactive counterparts[i] [ii].

With all this considered, it makes complete sense that those of us who get into endurance training want to keep pushing ourselves. We compete with ourselves, trying to better our fastest time or our greatest distance. We compete with friends and family, using social media or certain training based platforms (who can forget the part of the pandemic that had everyone uploading their daily runs). We compete and push ourselves because that is what training is at its core. I challenge you to find a gym that doesn’t have a quote like “The pain you feel today will be the strength you feel tomorrow” printed across its walls. As cheesy as it sounds, it makes sense, right? The more effort you put in, the greater the reward you reap.

But that’s not particularly scientific, is it? Certainly, this innate sense of positive impact is good enough for most of us, but the medical community needs something more empirical.

 And so, we’re going to look at a medical article[iii] published by the Mayo Clinic that addresses exactly this question, empirically.

IS ENDURANCE TRAINING ACTUALLY GOOD FOR YOUR HEART?

The short answer. Yes.

No surprises there.

The paper states that “physical exercise, though not a drug, possesses many traits of a powerful pharmacological agent”.

The concept is simple – there is a reason doctor’s have always prescribed regular Endurance Training to patients with a variety of conditions. Engaging in daily physical activity allows the body to go through certain physiological changes that prime it for effective prevention or treatment of some of the most prevalent heart issues known to the world. Some chronic conditions that are significantly improved through Endurance Training are hypertension, heart failure, obesity, depression, diabetes, and coronary heart disease. The paper actually lists 13 different physiological changes brought about by endurance training that each directly reduce one’s risk of Coronary Heart Disease.

So, do we leave it there?

Certainly not. The paper continues with the Endurance Training as a drug analogy to explain a simple caveat. You CAN OVERDO it. When it comes to actual medication, this is quite obvious to us, isn’t it. You’re not going to empty a bottle of Ibuprofen into your throat just because you have a particularly bad headache, will you?

Endurance Training works the same way.

In the words of the Doctors themselves ‘As with any pharmacological agent, a safe upper-dose limit potentially exists, beyond which the adverse effects of physical ET may outweigh its benefits.’

Let’s find out what the safe upper and lower limits are then.

HOW MUCH ENDURANCE TRAINING IS GOOD FOR YOUR HEART

Over 415,000 participants were observed across 12 years in a prospective cohort study[iv] to see whether less than the recommended amount (150 min/week) of exercise can have life expectancy benefits. Participants were placed into 5 groups depending on time spent training per week, with mortality risks and life expectancy calculated for each. 

The Results. In comparison with the ‘Inactive’ group the ‘Lowest Activity’ group showed 14% reduced risk of all-cause mortality, and a 3 year longer life expectancy. This group exercised for approximately 15 minutes a day. Each addition of 15 min/day of training reduced all-cause mortality by 4%.

In some sense this proved that, up to an hour, increased time spent training did increase the health benefits accrued. What it also showed is that the most significant jump was found between the inactive and lowest activity groups, highlighting that even 15 minutes of training a day can significantly improve your heart and general health.

Another similar observational study[v] looked at 52,000 adults and found that runners had a 19% lower risk of all-cause mortality compared with nonrunners. The trend they found was that the mortality curves were always U shaped when charted against distance, speed, or frequency. In simple terms, when a study reports a U-shaped curve it means that there is the lowest incidence of disease in the middle ranges, with peaks in both the lower (Inactive) and upper (Over exertion) ranges. Running distances of about 1 to 20 miles per week, speeds of 6 to 7 miles per hour, and frequencies of 2 to 5 days per week were associated with lower all-cause mortality, whereas higher mileage, faster paces, and more frequent runs were not associated with better survival.

So, there we have it, empirical data on the ideal training ranges.

ENDURANCE TRAINING WHEN YOU ALREADY HAVE A HEART CONDITION

The human body is very complicated, and that means that any ranges offered (as above) are guidelines created based on expected averages. Everybody works differently, and so everyone will see moderately different results even when training exactly the same. So, is all the information provided accurate for those with pre-existing heart conditions, given the ideal range of training is most important to this community of Endurance Trainers.

One study assigned 60 male patients who had Coronary Heart Disease to two groups – either they engaged in Endurance Training for 30-minute sessions, or they did it for 60.

The results. The 30-minute exercise sessions produced less oxidant stress and improved arterial elasticity, whereas 60-minute sessions worsened oxidant stress and increased vascular stiffness. While you do not need to know the specifics, this effectively showed that the lower activity duration (different from inactivity) actually provided greater benefits specifically in relation to heart health.

So, though a lot of people in such situations assume they need to go above and beyond to correct their heart issues, the evidence points to the contrary. Endurance Training for those with Coronary Heart Disease is most effective if they can calculate the ideal duration and exertion, and pushing their limits in this regard may actually be counter-productive.

WHAT NOW?

All of the information provided essentially boils down to one thing – Endurance Training is a fantastic way to treat or prevent heart health issues, but it is only effective when used in the correct amounts. 

Fortunately for us we live in the age of modern technology, and with it almost anything is possible. There are a number of devices that provide you with a range of information that helps calculate and set these correct amounts of training, while also making sure you do not go above it.

Here is a link to ‘The 5 Best Devices That Help You Keep Your Heart Healthy’.

[i] Sarna S., Sahi T., Koskenvuo M., Kaprio J. Increased life expectancy of world class male athletes. Med Sci Sports Exerc. 1993;25(2):237–244.

[ii] Chakravarty E.F., Hubert H.B., Lingala V.B., Fries J.F. Reduced disability and mortality among aging runners: a 21-year longitudinal study. Arch Intern Med. 2008;168(15):1638–1646.

[iii] O'Keefe, J. H., Patil, H. R., Lavie, C. J., Magalski, A., Vogel, R. A., & McCullough, P. A. (2012, June). Potential adverse cardiovascular effects from excessive endurance exercise. In Mayo Clinic Proceedings (Vol. 87, No. 6, pp. 587-595). Elsevier.

[iv] Wen C.P., Wai J.P., Tsai M.K. Minimum amount of physical activity for reduced mortality and extended life expectancy: a prospective cohort study. Lancet. 2011;378(9798):1244–1253.

[v] Lee J., Patte R., Lavie C.J., Blair S.N. Running and all-cause mortality risk: is more better? Med Sci Sports Exerc. 2012;44(6):990–994.