Health lessons from Winston Churchill

Winston Churchill said, never run when you can walk, walk when you can sit, or sit when you can lie down. And he lived to a ripe old age, while smoking his cigars and having his two drinks per day. He even sported a moderately overweight paunch.

And he was apparently onto something–like common sense and moderation.

A growing body of research underscores the dangers of extreme exercise. And the latest study, published in the European Heart Journal, found that extreme athletes experience serious heart problems later in life. And the more extreme, the greater the risk.

For the study, Swedish researchers followed more than 52,000 cross-country skiers for decades. These were no ordinary weekend athletes. The group included finishers of the Vasaloppet, a grueling 55-mile cross-country ski race. It is a Nordic equivalent of an Ironman or double marathon, roughly.

Not only is the race itself grueling, the training is just as difficult. Nearly 80 percent of Vasaloppet finishers participate in intense training all year round. In fact, athletes MUST train year-round to achieve the extreme aerobic capacity required to finish such an event.

At the study’s outset, the athletes were 38 years old on average. And just about any doctor would have said these athletes were in top physical condition.

The researchers followed these top specimens over the next 10 years. And many of them–an astounding number, actually–began to experience painful heart symptoms. Of the 52,000 athletes studied, there were nearly 1,000 hospital visits for arrhythmia during an average 10-year follow-up. The first arrhythmias occurred, on average, when the athletes were only 57 years-old.

Remember, these results occurred after just 10 years of following relatively young and middle-aged men.

The athletes most commonly experienced atrial fibrillation, which is a fluttering or irregular heartbeat. Bradyarrhythmia was the second most common heart issue the athletes experienced. This is an abnormally slow heartbeat. Thirty-four athletes even experienced complete atrioventricular (AV) heart block.

Of course, extreme athletes also compete about who can achieve the lowest heart rate. Apparently, if you can get it low enough, you can get dead. (The study did not include heart abnormalities that can lead to sudden death, without warning.)

In addition, doctors did not find these serious heart changes by chance during a routine EKG. Rather, all the patients had painful, disabling symptoms that brought them to the hospital.

Overall, researchers found that these extreme athletes had more than double the rate of arrhythmias one would expect in an age-matched group.

Plus, the more extreme the athlete, the higher the risk.

In fact, athletes who completed the most races had the greatest risks. For example, athletes who completed five races had a 30 percent higher risk of developing an arrhythmia. And the increase in risk went up in a straight line, with a 10 percent increase for each additional race completed.

Exercise intensity also mattered.

So, athletes who had the fastest finishing times had higher risks. Whereas, “strollers,” who took more than twice as long as the fastest finishers, had the lowest risk for arrhythmia. (They also probably had a chance to actually enjoy the experience, instead of enjoying bragging about it later.)

Clearly, this kind of extreme exercise appears to damage the heart, or at least the electrical conduction system of the heart. And it has long-term consequences.

The study’s authors said that their findings are “counter-intuitive,” because exercise is “good” for health. So it baffled them that their study found extreme exercise is “bad” for the heart.

Here’s the problem…

They took the idea that exercise is good for you too far. Beyond the boundaries of common sense.

Just because moderate exercise is good for you doesn’t mean that “extreme” exercise will be even better for you. Our culture is brainwashed to believe that “extreme” is better, but clearly the science doesn’t add up.

It’s also interesting to note that previous studies showed that Vasaloppet finishers smoke less, carry less body fat, and report better eating habits.

But  these “healthy” factors are not enough to offset the damage to your heart when you just keep over-doing it. In the United States, we seem to be experiencing epidemics of both over- and under-exercise. What we need is an epidemic of moderation and common sense.

My long-lived ancestors, who enjoyed good food, good wine, and even an occasional cigar, always said,

Qui va piano, va sano. Qui va sano, va lontano

That means: He who goes slowly, goes safely/sanely. He who goes safely, goes far/ goes for a long time.

So, the next time your day is disrupted by zealot endurance runners or bike-riders, blocking the public roads, let them pass. We all have the same final destination. Turns out, the endurance zealots are just getting there a lot sooner–apparently, like they always intended


1. “Risk of arrhythmias in 52,755 long-distance cross-country skiers: a cohort study,” Eur Heart J. 2013 June 11. [Epub ahead of print]