Performance isn't as much as a priority as longevity is now, but I still love to compete. This dilemma, so well stated by one of our clients, got us thinking. It's well documented that exercise extends both lifespan and healthspan, and the people we work with typically have no trouble meeting the widely recommended 150 minutes per week of moderate physical activity. But what happens when you're a competitive athlete training significantly more than that?

For this podcast, I met up with Dr. Tommy Wood, MD, PhD and Performance Psychologist Simon Marshall, PhD to talk about the benefits and risks of intense exercise with regard to longevity and healthspan. The science points to a U-shaped curve with dangers at both ends of the spectrum - not enough activity and also too much - and we discuss the point at which an athlete's long-term health might suffer. We also talk about the kinds of exercise that will keep you strong and resilient as you age.

Here's the outline of this discussion with Drs Tommy Wood and Simon Marshall:

[00:00:37] Lesley Paterson 2018 ITU World Champion; Podcast: Off Road Triathlon World Champion Lesley Paterson on FMT and Solving Mental Conundrums, with Lesley Paterson.

[00:03:08] Performance, longevity, healthspan.

[00:05:21] Atrial fibrillation.

[00:05:51] Braveheart Coaching.

[00:08:01] Up to 6-7 hours/week of exercise, moderate to vigorous intensity, correlates with increased lifespan.

[00:08:29] 100 steps per minute; Study: Marshall, Simon J., et al. "Translating physical activity recommendations into a pedometer-based step goal: 3000 steps in 30 minutes." American journal of preventive medicine 36.5 (2009): 410-415.

[00:09:08] Intense exercise associated with cardiac diseases; Study: Merghani, Ahmed, Aneil Malhotra, and Sanjay Sharma. "The U-shaped relationship between exercise and cardiac morbidity." Trends in cardiovascular medicine 26.3 (2016): 232-240.

[00:09:17] Above 25-30 miles/week, some increase in mortality; Study: Lee, Duck-chul, et al. "Leisure-time running reduces all-cause and cardiovascular mortality risk." Journal of the American College of Cardiology 64.5 (2014): 472-481.

[00:09:37] Diminishing returns vs. harm.

[00:10:32] 2/3 of people not getting enough exercise.

[00:10:47] Risks with high levels of exercise.

[00:11:37] Podcast: Arrhythmias in Endurance Athletes, with Peter Backx.

[00:11:49] Higher coronary artery calcium (CAC) in marathon runners; Study: Kröger, Knut, et al. "Carotid and peripheral atherosclerosis in male marathon runners." Medicine and science in sports and exercise 43.7 (2011): 1142-1147.

[00:12:12] Elevated troponin in marathon completers; Study: Regwan, Steven, et al. "Marathon running as a cause of troponin elevation: a systematic review and meta‐analysis." Journal of interventional cardiology 23.5 (2010): 443-450.

[00:13:08] Extreme exercise unveiling congenital vulnerabilities.

[00:14:26] Required ECGs, cardiac stress test.

[00:16:15] Half of marathoners as former smokers; Study: Möhlenkamp, Stefan, et al. "Running: the risk of coronary events: prevalence and prognostic relevance of coronary atherosclerosis in marathon runners." European heart journal 29.15 (2008): 1903-1910.

[00:17:30] Gut permeability, endotoxemia.

[00:18:18] Hunter gatherer populations. Studies: 1. Raichlen, David A., et al. "Physical activity patterns and biomarkers of cardiovascular disease risk in hunter‐gatherers." American Journal of Human Biology 29.2 (2017): e22919; 2. Pontzer, Herman, et al. "Energy expenditure and activity among Hadza hunter‐gatherers." American Journal of Human Biology 27.5 (2015): 628-637.

[00:19:49] Periods of rest.

[00:21:48] Why do people "over"-exercise?

[00:21:50] Personal goals, exercise dependency, training goals.

[00:23:24] Liking the gear, competition.

[00:24:41] Self-referenced challenge, especially for long events.

[00:26:19] Managing performance anxiety.

[00:27:10] Competitor vs participant mindset; Podcast: Why We Self-Sabotage (And What to Do Instead), with Dr. Simon Marshall.

[00:32:01] Short term vs. prolonged exposure to extreme exercise.

[00:37:15] Building good exercise habits.

[00:40:24] Tommy's exercise regimen.

[00:40:41] Zach Moore: NBT Head of Strength and Conditioning.

[00:41:57] Standing, walking, playing with dogs.

[00:45:25] Strength and power in endurance sports.

[00:48:01] Wingate test.

[00:49:27] Simon's exercise regimen.

[00:52:17] Aim for aerobic fitness and strength in top 25% of peer group.