Dr. Phil Maffetone is back for this instant classic episode talking about heart health and athletes with everything you need to know, what information out there that you can ignore, and proactive tips to stay healthy for a lifetime.

* We often see articles and hear unfortunate stories of athletes with heart health complications, sometimes resulting in death. It understandably would make anyone a bit nervous to think their exercise routine might be deadly. But is it as simple as assuming that exercise puts one’s heart at risk? Or are there underlying issues that would make one more prone to developing a heart condition or experiencing a cardiovascular event.

* What are legit vs. inaccurate concerns about types of damage to the heart muscle that may be associated with running and endurance sports?

* The basic physiological adaptations that occur in the heart and CV system when one trains for endurance – these adaptations all boost performance but could put more “stress” on the heart.

* Phil outlines the real reasons athletes get heart issues—from diet to stress—and why you can rest easy that exercise is ok and that a lot of the news media you hear is hyped up or not telling the whole story.

* Even if someone appears healthy and eats clean, could there still be an underlying risk?

Easy ways to monitor and assess your health and risk:

* Things we can do to be proactive:

* Clean diet low in “junk” foods and rich in nutrient dense whole foods

* Mostly avoid refined sugars/carbs and vegetables oils; avoid carb intolerance

* Tailor carbs to your needs

* Interview with Dr. Cate Shanahan

* MAF test

* HRV measuring

* Recovery focus

* Frequent blood work

* Triglycerides (fasted)

* Cholesterol

* TG HDL Ratio

* Fasting blood glucose—monitor this often

* Measure your waist circumference—waist to height ratio;

* Health history and physical from doctor; with you asking the right questions – record your office visits or appointments!

* Blood pressure monitoring

* Risk factors:

* Pre-diabetes or diabetes

* Pre hypertension or hypertension—sympathetic system revved up, will perform well at expense of health.

* Waist-to-height ratio—if waist circumference is half your height or more, that’s not good. More info here.

* Only then go to: EKG, ECG, treadmill stress test (don’t go to this first).

Studies mentioned:

* Potential Adverse Cardiovascular Effects From Excessive Endurance Exercise

* Long-term excessive endurance exercise may induce pathologic structural remodeling of the heart and large arteries. What are issues with the heart that can happen over years?

* Acute effects:

* Volume overload of the atria and right ventricle, with transient reductions in right ventricular ejection fraction and elevations of cardiac biomarkers.

* Returns to normal within 1 week.

* Months to years of repetitive injury may lead to:

* Adverse CV remodeling

* Patchy myocardial fibrosis, particularly in the atria, interventricular septum, and right ventricle, creating a substrate for atrial and ventricular arrhythmias.

* Coronary artery calcification

* Diastolic dysfunction

* Large-artery wall stiffening.