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Mike41

"Extreme" Exercise - Good or Bad?

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[This is a new thread to discuss the topic of "Extreme" amounts of exercise. The first 15 posts have been moved from the Blood Pressure thread where the discussion started - DP]

On 8/29/2020 at 4:26 AM, Dean Pomerleau said:

No. 

Two miles per day plus light resistance training for ~40min/day, and about 20 miles of walking per day. 

--Dean 

Dean is that a misprint? 20 miles! And on top of 2 miles of running. I cannot help but quote Kenneth Cooper. I paraphrase: jogging more than 15 miles a week will not improve health. 

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1 minute ago, Mike41 said:

Dean is that a misprint?

No. 

2 minutes ago, Mike41 said:

I paraphrase: jogging more than 15 miles a week will not improve health

Notice I don't? 

--Dean 

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Dean, your exercise regimen sounds amazing and I surmise you've optimised it as well as can be done given your circumstances. One of the issues is time - ideally, one should be able to combine exercise with other activities, otherwise the time sink is simply not sustainable (for most people). I can see your 20 miles of walking insofar as health benefits, but the time is where it becomes an issue. I imagine you must somehow be doing something else at the same time - perhaps you have access to google glasses or apple glasses or something where you are maintaining productivity during your walking time. If you feel comfortable, could you reveal how you use that time? TIA!

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15 minutes ago, TomBAvoider said:

I imagine you must somehow be doing something else at the same time - perhaps you have access to google glasses or apple glasses or something where you are maintaining productivity during your walking time. If you feel comfortable, could you reveal how you use that time?

About 1/2 the 20 miles is done on my treadmill, during which I read, catch up on the news, compose correspondences and sometimes post to this forum (like right now!). For long posts I have a Bluetooth keyboard on my DIY treadmill desk that links to my tablet. Here is a post from 2015 with a picture of my treadmill desk setup. 

The other 10 miles of walking I do outdoors listening to podcasts, dharma talks and doing walking meditation

Here is a post from 2016 describing my exercise routine (which hasn't changed much except swapping my stationary bike for more walking) and my motivations for the volume of exercise I do. 

--Dean 

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Brilliant! Thank you Dean. I remember the bike, as I bought one as well. Unfortunately, my bad luck with home gym equipment continued and the bike broke after a few months of use and I never bothered with another one. The treadmill seems a much more interesting solution. 

If I can prevail upon your generosity - do you mind sharing which podcasts you listen to? I'm always looking for medical oriented ones, but with the exception of Peter Attia's Drive I have not found good quality medical podcasts (and Attia frequently has podcasts on other subjects which don't interest me). 

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5 minutes ago, TomBAvoider said:

do you mind sharing which podcasts you listen to?

Not at all. I do most of my listening via YouTube videos downloaded to my phone. Here is a smattering of people I like, in no particularly order except what is in my YouTube history from the last few days:

Lex Fridman - Technology, AI

Isaac Arthur - futurism

Bob Wright - Politics, philosophy, psychology, Buddhism

Sean Carroll - Science, psychology, cosmology

Sam Harris - Current events, culture, meditation

Nikola Danylov (aka Socrates) - Futurism, technology, ethics

Mike Osterholm - Covid-19 epidemiologist from CIDRAP

Talks at Google - various smart people

Shields & Brooks on PBS - Politics

Ajahn Amaro / Ajahn Chah - Buddhism

--Dean

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19 hours ago, Dean Pomerleau said:

About 1/2 the 20 miles is done on my treadmill ...

Dean, at what speed (and possibly incline) do you walk on the treadmill?

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1 minute ago, Iporuru said:

Dean, at what speed (and possibly incline) do you walk on the treadmill

2.5 miles at 3.7 mph

3.5 miles at 3.5 mph

4.0 miles at 3.0 mph

All at 15% grade (treadmill max).

--Dean 

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It's quite a high level of exertion. Can you maintain your concentration level on what you're reading? I guess with time and your level of fitness it's not a big deal...

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12 minutes ago, Iporuru said:

you maintain your concentration level on what you're reading?

During the first two higher-intensity stints I'm mostly reading the news so it doesn't require a very high level of concentration. I do more cerebral reading at 3 mph, which seems pretty easy to manage. 

--Dean 

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Interestingly enough, I too found, before reading the above, that fast walk at 15% inclination appears to be an optimum combination with regard to maximizing the effects of exercise and minimizing the damage on joints. I devote to the treadmill far less time than Dean does, though, and probably at a lesser speed on average.

 

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On 8/30/2020 at 12:02 PM, Dean Pomerleau said:

No. 

Notice I don't? 

--Dean 

Pfeiffer: You have taken a position that too much exercise may actually be detrimental to immune function and expose chronic exercisers to life-threatening health conditions such as cancer. On what facts do you base this premise, and what do you believe to be a safe dosage?
Cooper: Four people come to mind who have been instrumental in the fit- ness movement over the last 30 years — George Sheehan, Jim Fixx, Fred Lebow and myself. Unfortunately, I am the only one still alive in that group: Jim Fixx, age 52, heart attack; Fred Lebow, age 60, cancer of the brain; George Sheehan, in his early 70s, prostate cancer.
And it’s not just those three. I have in my reference files more than 250 cases of high-level exercisers who thought they were achieving optimum health, but who have succumbed to or been diagnosed with severe medical problems, including heart disease and cancer. So that prompted me to start a research study in which we looked at elite athletes vs. regular runners. We looked at their DNA damage and saw clearly that DNA damage does occur with high levels of physical activity. The most dramatic study on this came from Mutation Research, published in 1995 from Ulm, Germany. It showed the same thing that we saw here — extensive DNA damage in the person exercising at high levels. I define high level as running over 30 miles per week, or over 300 minutes per week of intense activity that’s above 85 percent of your predicted maximum heart rate, or more than 100 Aerobics Points per w e e k.

So Dean yes your not running over 30 miles a week but your aerobic points come out to according to the cooper chart 39 points for walking between 3-4 mph x 7 is 273 points so your easily more than triple what Kenneth Cooper considers a high and unhealthy level of exercise. I hope you know what you are doing cause it sounds like EXTREMISM to me.
 

Edited by Mike41

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1 hour ago, Mike41 said:

I hope you know what you are doing cause it sounds like EXTREMISM to me. 

Mike, 

As I've said many times before, I'm not one to shy away from informed and informative extremism for the reasons I listed in that 2016 post, but which can be summarized as "it is better to live a life less ordinary than a lifeless ordinary."

Only time will tell if my lifestyle should be considered a shining example or a dire warning. Sadly, I know all too well that cancer is a crapshoot and can strike anyone at any age. But so far so good. All my health indicators seem good, including BP which is supposed to be the topic of [the original] thread. And for what it is worth, I haven't had an illness or injury (besides a bout of Lyme disease) in well over a decade, not even a cold. So it would seem I've been doing something right. Your mileage may vary. 

--Dean 

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This probably should move to its own thread, as it's an important topic and only tangentially related to BP. [Done! - DP] 

Exercise at the Extremes

Journal of the American College of Cardiology

Volume 67, Issue 3, January 2016DOI: 10.1016/j.jacc.2015.11.034

 PDF Article

COUNCIL PERSPECTIVES

Exercise at the Extremes

The Amount of Exercise to Reduce Cardiovascular Events

Thijs M.H. Eijsvogels, Silvana Molossi, Duck-chul Lee, Michael S. Emery and Paul D. Thompson

Author + information

Abstract

Habitual physical activity and regular exercise training improve cardiovascular health and longevity. A physically active lifestyle is, therefore, a key aspect of primary and secondary prevention strategies. An appropriate volume and intensity are essential to maximally benefit from exercise interventions. This document summarizes available evidence on the relationship between the exercise volume and risk reductions in cardiovascular morbidity and mortality. Furthermore, the risks and benefits of moderate- versus high-intensity exercise interventions are compared. Findings are presented for the general population and cardiac patients eligible for cardiac rehabilitation. Finally, the controversy of excessive volumes of exercise in the athletic population is discussed.

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Thanks Tom,

I quote the most-relevant two sentences from the exercise study you posted:

Finally, there is no evidence for an upper limit of exercise-induced health benefits. Every volume of moderate- and vigorous-intensity aerobic exercise results in a reduction of all-cause and CVD mortality compared with physical inactivity.

Regarding the "sweet spot" for the amount of walking exercise - there is this 2020 study [1] in JAMA (which I posted before on the Walking and All Cause Mortality thread). It found that walking 8000 steps per day was associated with a ~50% reduction in all-cause mortality relative to 4000 steps per day. Boosting steps to 12,000 per day appeared to be even better. It was associated with a 65% reduction in all-cause mortality even after adjusting for the following potential confounders: sex, age, diet quality, race/ethnicity, body mass index, education, alcohol consumption, smoking status, diabetes, stroke, coronary heart disease, heart failure, cancer, chronic bronchitis, emphysema, mobility limitation, and self-reported general health. Interestingly, walking intensity (i.e. steps per minute) didn't seem to matter much at all.

Obviously 12K steps (~5 miles) is a lot less than the ~45K steps (~20 miles) walking per day that I do. And despite adjusting for potential confounders, there is always the possibility of reverses causality in this kind of observational study - i.e. people less likely to die (for reasons other than walking) may tend to walk more. But at least there doesn't seem to be evidence for a ceiling on the benefits of walking, especially (presumably) if coupled with other healthy habits of diet, sleep, stress management, not smoking, etc.

-Dean

-----------

[1] JAMA. 2020;323(12):1151–1160. doi:10.1001/jama.2020.1382

Association of Daily Step Count and Step Intensity With Mortality Among US Adults. 

Saint-Maurice PF, Troiano RP, Bassett DR, et al.

Abstract
Importance  It is unclear whether the number of steps per day and the intensity of stepping are associated with lower mortality.

Objective  Describe the dose-response relationship between step count and intensity and mortality.

Design, Setting, and Participants  Representative sample of US adults aged at least 40 years in the National Health and Nutrition Examination Survey who wore an accelerometer for up to 7 days ( from 2003-2006). Mortality was ascertained through December 2015.

Exposures  Accelerometer-measured number of steps per day and 3 step intensity measures (extended bout cadence, peak 30-minute cadence, and peak 1-minute cadence [steps/min]). Accelerometer data were based on measurements obtained during a 7-day period at baseline.

Main Outcomes and Measures  The primary outcome was all-cause mortality. Secondary outcomes were cardiovascular disease (CVD) and cancer mortality. Hazard ratios (HRs), mortality rates, and 95% CIs were estimated using cubic splines and quartile classifications adjusting for age; sex; race/ethnicity; education; diet; smoking status; body mass index; self-reported health; mobility limitations; and diagnoses of diabetes, stroke, heart disease, heart failure, cancer, chronic bronchitis, and emphysema.

Results  A total of 4840 participants (mean age, 56.8 years; 2435 [54%] women; 1732 [36%] individuals with obesity) wore accelerometers for a mean of 5.7 days for a mean of 14.4 hours per day. The mean number of steps per day was 9124. There were 1165 deaths over a mean 10.1 years of follow-up, including 406 CVD and 283 cancer deaths. The unadjusted incidence density for all-cause mortality was 76.7 per 1000 person-years (419 deaths) for the 655 individuals who took less than 4000 steps per day; 21.4 per 1000 person-years (488 deaths) for the 1727 individuals who took 4000 to 7999 steps per day; 6.9 per 1000 person-years (176 deaths) for the 1539 individuals who took 8000 to 11 999 steps per day; and 4.8 per 1000 person-years (82 deaths) for the 919 individuals who took at least 12 000 steps per day. Compared with taking 4000 steps per day, taking 8000 steps per day was associated with significantly lower all-cause mortality (HR, 0.49 [95% CI, 0.44-0.55]), as was taking 12 000 steps per day (HR, 0.35 [95% CI, 0.28-0.45]). Unadjusted incidence density for all-cause mortality by peak 30 cadence was 32.9 per 1000 person-years (406 deaths) for the 1080 individuals who took 18.5 to 56.0 steps per minute; 12.6 per 1000 person-years (207 deaths) for the 1153 individuals who took 56.1 to 69.2 steps per minute; 6.8 per 1000 person-years (124 deaths) for the 1074 individuals who took 69.3 to 82.8 steps per minute; and 5.3 per 1000 person-years (108 deaths) for the 1037 individuals who took 82.9 to 149.5 steps per minute. Greater step intensity was not significantly associated with lower mortality after adjustment for total steps per day (eg, highest vs lowest quartile of peak 30 cadence: HR, 0.90 [95% CI, 0.65-1.27]; P value for trend = .34).

Conclusions and Relevance  Based on a representative sample of US adults, a greater number of daily steps was significantly associated with lower all-cause mortality. There was no significant association between step intensity and mortality after adjusting for total steps per day.

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I sympathize with Dean, because I find some aspects of exercise addictive - not so much the exercise per se, but in my case, the tendency to extremism in all practices. Somehow whenever I embark on something I tend to go too far. The latest example are squats. I started with just doing them while on the WBV platform, but now it's escalated to my just doing them in one fell swoop. Currently, I'm doing squats for 31 minutes - about 1090 squats per session, and I do this four times a week, so that's 2 hours and 4 minutes of squats, or some 4360 squats a week. The same days I squat, I also jog for anywhere between 40-50 minutes per session, so 160-200 minutes jogging and 124 minutes of squatting. The way it happens is that I find I adjust to the exercise very quickly and the level of difficulty drops dramatically. I went from 100 squats, to 300 squats, to 600 squats, to 900 squats to now 1090, and really while squatting I feel I can go pretty much forever - the subjective sensation of exertion is pretty minimal (although I do sweat!).

I think if I felt I was really breathing hard, or feeling stressed, I'd cut back, but unfortunately my body seems to signal that it's all *easy*. I think the key is to monitor what's happening to the body. For example, in the beginning, I felt the squats in my knees, muscles and tendons the following day. Recently, the recovery days seem about enough - I exercise Mon, Tue, Thur, Fri - so the recovery days are Wed and Sat&Sun. Recently I've noticed that my knees and muscles don't have any discomfort at all after the recovery days. Of course, this is a moving target, so it's possible that as I age, this will be too much and I'll have to cut back.

My point: probably the best way to judge of you're doing too much is if you feel worn out, low energy, sore joints, muscles and tendons or otherwise feeling subpar and recovery days don't take you to 100% again. At that point you'll probably start accumulating damage. Of course, this may not tell you if you're doing damage to your DNA, so YMMV. 

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Inflammatory Effects of High and Moderate Intensity Exercise—A Systematic Review

Conclusion: In summary, intense long exercise can lead, in general, to higher levels of inflammatory mediators, and thus might increase the risk of injury and chronic inflammation. In contrast, moderate exercise or vigorous exercise with appropriate resting periods can achieve maximum benefit.

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7 hours ago, Dean Pomerleau said:

I haven't had an illness or injury

Nit picking, but you injured one of your leg muscles a while back causing you to dial down for a while.

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9 hours ago, AlPater said:

Nit picking, but you injured one of your leg muscles a while back causing you to dial down for a while.

Thanks Al,

Pick away! You are probably thinking of the episode described in this post from fall 2017 where I reported dialing back my exercise to 1 mile of running, 30 min of resistance training, 60 min of stationary biking and 3 miles of walking due to pain in my knees. As I mentioned in this post, I thought at the time I was just getting older and my many years of copious exercise had finally caught up with me.

But the pain only got worse, until I thought to get tested for the above-mentioned Lyme disease. (I'd spent much of the summer of 2017 living in the forest, so I should have realized the possibility of Lyme disease sooner). Thankfully, after a month-long course of antibiotics and another month or two of taking it easy by my usual exercise standards the  joint pain went away and I was good as new and back to my usual exercise routine.

The best thing to come out of that painful episode was the "arm pocket" mattress idea (described here) to take the pressure off my shoulders which were also quite sore from the Lyme disease. To this day I sleep more comfortably than I ever have before using that method.

--Dean

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I must say that while I don't think I personally can stick to Dean's regimen, I also don't find it "extreme" in the sense that it overtaxes one's body to the threshold of endurance.  Walking 20 miles a day is a lot, but I don't see the harm in it, while I can see benefits and Dean's measurements seem to support this.

The one thing I am puzzled about is why Dean, and apparently most others here, do not wear trackers?  While not medical grade, the data from these can very useful, in my experience. In the same way as checking BP, or blood sugar, etc..  Does anyone here know their estimated VO2 Max?

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Well, Ron, I keep meaning to, but for a variety of reasons don't persist and give up. Mostly I find it hard to trust the accuracy, it's fiddly and generally sporting some kind of deal-breaker. I'm not against them - quite the contrary - but I'm waiting until something comes along that has the requisite characteristics that would push me to get one again. I guess you could call me a late adopter. I waited until the iPhone 6S before getting one, until the Air 3 iPad before getting an iPad and so on for most of my equipment - it has to reach a minimum treshold of a combination of features. The Apple Watch is miles and miles away from that, and others are not enticing, although the Garmin Venu looks interesting. I still feel a few product generations need to pass before I sign up. YMMV.

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8 hours ago, Ron Put said:

The one thing I am puzzled about is why Dean, and apparently most others here, do not wear trackers?

I wore a Fitbit Charge 2 for a couple of years (see my review here). Since my lifestyle is so regular, I found that I stopped learning anything useful from all the repetitive data. Also I found that I can become obsessed with the numbers and milestones, which I find not psychologically healthy or pleasant. It is the same reason that I don't weigh my food or meticulously count calories anymore. 

--Dean 

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Had to think of Dean's set-up when I saw this:

The Rube Goldberg Exercise Bike will fan you and feed you a cookie while you work out
Seth Goldstein's latest 'kinetic sculpture' started as a back scratcher, but became so much more
CBC Radio · Posted: Aug 31, 2020
https://www.cbc.ca/radio/asithappens/as-it-happens-monday-edition-1.5706308/the-rube-goldberg-exercise-bike-will-fan-you-and-feed-you-a-cookie-while-you-work-out-1.5706434 

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https://www.sciencedaily.com/releases/2016/11/161128151241.htm
 

The above article gives us an Evolutionary perspective on what may be extreme. These modern day hunter gathers wore monitors. They averaged a whopping 75 minutes a day of MVPA.

and this From an article in psychology today:

Since the !Kung and Ache are so much lighter than Americans, it is important to take body weight into account. I did this by converting their energy consumption into number of miles walked (at a standard 3 mph) the point being that energy used in walking increases the more weight a person is carrying. Energy used for daily physical activity was equivalent to 10 miles walked for the Ache, 6.8 miles for the !Kung, and 3 miles for the Americans.

If Americans wanted to be as active as the !Kung, they would need to add the equivalent of 3.8 miles of walking to their daily activity. If they wanted to be as active as the Ache, they would need to hike 7 miles a day. Taking the average, if we wanted to be as active as foragers, we would add 5.4 miles.

 

Walking at 3 mph, this would take 1.8 hours. This is 3.6 times the half-hour the Surgeon General and other medical experts recommend

So we see that 2 miles of running and 20 miles of walking is certainly an outlier when compared to these three examples; however not quite the outlier we have when compared to the average American!

 

Edited by Mike41

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