Ultra-Endurance Sports Are Unhealthy

People are often surprised when they hear me say that ultra-endurance activities — including marathons, ultra runs, double centuries, and Ironman triathlons — are Not Very Healthy for you.

After all, haven’t I been participating in these types events (including some ridiculously tough ones) for the last, oh, 10-12 years?

Ah, I will get to that. But first let me explain why exercising too much can be unhealthy. Then in a subsequent post, I will explain how I mitigate the risks, and why I continue to do the Crazy Things I Do.

Evidence

To me, being “physically healthy” is defined as the following:

• Not being sick.
• Not being injured.
• Looking younger than he is (or, at the very least, not older than he is) and not being overweight.
• Having high energy levels
• Likely to live a long time.

(Mental health is out of the scope of this article.)

How does high-endurance training and racing affect the above?

Illness

Research has shown that moderate activity boosts the immune system. On the other hand, too much exercise actually suppresses it. As marathonandbeyond.com explains,

Overtraining and taking part in long-distance races can lower resistance to disease, especially to colds and other upper respiratory tract infections. “Running a marathon and beyond is a huge stressor,�?? says David Nieman, professor of health and exercise science at Appalachian State University. “What you put your body through is beyond what’s good for it,�?? notes Nieman, who has run 58 marathons and ultras. After about 90 minutes of running, blood glucose levels begin to drop (assuming the runner hasn’t been taking in adequate amounts of carbohydrates), triggering the release of stress hormones, particularly cortisol.

These hormones, in turn, suppress and stress many components of the immune system, especially the innate system. Phagocytes and NK cells become less efficient at killing microbial invaders; macrophages don’t communicate as well with lymphocytes. The levels of one of the most important antibodies in saliva and the mucous membranes, IgA, drop dramatically. These are just a few stress hormone-induced changes to the immune system.

Fortunately, this reduced immunity only persists for three hours to three days. But with the chronic amount of over-exercising many ultra-endurance athletes do, the consequences are grim. A paragraph of the book Bike for Life: How to Ride to 100 (a pretty good book with a lot of interesting information) claims on Page 78,

The normal population in Australia expects to get between three and four upper respiratory infections each year. But if you look at groups of elite athletes, about 15 percent of those athletes can have six or seven or more, up to even eleven or twelve. They seem to get more vulnerable as they train harder.

Six or seven illnesses per year? Definitely not healthy.

Injuries

When I ran in the Boulder 100 last month, an alarming number of participants seemed to be wearing braces on one or two knees or limping — before the race even began. While this is purely anecdotal, the athletes I know who have the most injuries are runners.

Iliotibial (IT) bands, knee problems, foot fractures, shin splints, plantar fasciitis, groin problems, back problems… these are the problems my own friends (usually not much older than I) have been complaining about the last two years.

The statistics back this up. Supposedly, up to 70% of all runners will get injured. It seems reasonable that the more one runs, the greater the risk. Hence, those most at risk are ultra-runners.

Unfortunately, injuries among runners are so common that many runners seem to think this is “normal.” Some act wisely and actually stop running until healed, but plenty of stubborn ones train through injury while racking up the bills with doctors, massage therapists and chiropractors.

Never mind that if an athlete is in and out of a hospital more times than an obese person, I think the obese person has an excellent case that he is in fact healthier.

But ultra-runners have lower blood pressure and high amounts of flexibility and muscle strength, right? Actually,

The Cooper Clinic in Dallas says that regularly extending your cardio past 45 to 60 minutes can reduce flexibility and muscle strength. It can also boost blood pressure.

If it sounds like I’m picking on ultra-runners, let me note that ultra-cycling has its own problems. There was the impotency scare of the late 90s. The link between long-distance cycling and osteoporosis has also been well-documented.

Of course, Ironman triathletes have to worry about ALL risks listed above.

Appearance

This is one area that most endurance athletes usually do well — at least when they are not limping. Endurance athletes tend to be thin, and thinness is associated with youth (since most young people are not fat). But even with in regards to aesthetics, exercising too much can have adverse effects.

Please see Exhibit A: photos of the most successful Tour de France racers from the United States.

Greg Lemond (Photo by Graham Watson)	Lance Armstrong (Photo by MSN)

Greg Lemond may have retained his wonderfully boyish smile, but he already had deep wrinkles by the time he had won his second and third Tour de France in his late 20s.

The photo of Lance Armstrong was taken above just after the 2007 New York Marathon. He may look 46 years old, but he’s actually 36.

I used to think that this “Fred Flintstone phenomenon” (I dubbed it that because elite cyclists have deep creases in their faces just like the characters on The Flintstones) was due to over-exposure to the sun, but it turns out their accelerated aging may be more than skin deep. It has long been known that endurance events can increase the levels of free radicals — molecules that oxidize and cause damage to cells.

Compounding the endurance athletes’ aging problem is their diet. In general, these hardcore athletes consume gels, “powerbars,” sports drinks, simple sugars, white flour, and other processed foods with high glycemic indexes not just for races, but on a daily basis. I know MANY athletes who even say, “I exercise so that I can eat anything I want.” This is counter-productive. The demands of endurance sports are so great that if anything, the athletes should be more strict about eating nutrient-dense foods and not empty calories.

As Dr. Joseph Mercola says on his website,

The effects of a bad diet are not compensated for by exercise and may actually be worsened as exercise places certain demands on the body for detoxification. And if one does not have those nutrients to perform detox, certain cancers can develop and/or the aging process can actually be accelerated.

So how to eat well? I have studied and practiced this for the last four years and will post something about it soon, but in a nutshell, I advocate consuming 1) primarily all-natural, unprocessed foods, 2) lean meats and lots of vegetables, 3) nothing with simple sugars (whole fruits excepted — and NOT juice!), 4) healthy fats from olives (including olive oil), avocados, and nuts (including nut butters) and 5) fish oil. Note that I did not include grains (even whole grains) here, although I do eat oatmeal and sprouted whole grain bread sometimes during high-training periods (my weakness and trying to cut back especially now that it’s the off-season). One should consume gels, sports drinks, cola, and manufactured foods only during races. If he could do without them during races, using more natural foods like fruit instead, even better.

Energy Levels

During a race, ultra-endurance athletes usually look energetic — especially the fast ones at the beginning. But during training and after races is a different story.

Most people I know who had just finished a half-hour workout in the gym, tennis court, or trail come back looking invigorated and more relaxed. In contrast, people who had just come back from a 15+ mile run or a 100+ mile bike ride usually come back looking like they just want to go to bed.

To me, a healthy person is one who has energy during most of his waking hours — not just during a sports activity.

Longevity (lifespan)

When I was a teenager and developing my interest in cycling, I had read in Bicycling Magazine that at one time, doctors had speculated that each year a cyclist rode in the Tour de France, he shortened his lifespan by about a year. Unfortunately, I cannot find an actual study demonstrating this, so it’s just speculation. Considering the toll this 3000+ kilometer race surely had on the body, however, this was not hard to imagine.

The only methods that have consistently increased maximum lifespan in mammals are calorie restriction and intermittent fasting. Ultra-endurance athletes consuming 5000 calories a day are obviously doing neither. And unfortunately, research has shown that calories burned as exercise do not increase lifespan as calorie restriction does.

Conclusion

Endurance sports — when done to the extreme — fail at virtually all markers that define what it is to be healthy . More of a good thing does not necessarily equal a great thing; in fact, very often, less is more.

Fortunately, there are ways to participate in ultra-endurance sporting events while mitigating the risks. I will write a subsequent article on what I do (as a person who has never been injured, almost never gets sick, is consistently mistaken for someone still in his 20s, and still improves athletically each year), but in a nutshell, it all comes down to training less, training smart, and eating well (and much differently from most other people who do the events I do).

If you still are skeptical, below are some articles I recommend reading, especially this one entitled, “Training is No Guarantee of Health.” It gives some examples of super-athletes that you might think are the epitome of health, but actually have struggled with many of the problems described above.

Recommended Reading

• SlowTwitch.com: “Training is No Guarantee of Health” by Mark Sisson (July 24, 2007)
• (July 9, 2005)

Related Articles

• Running, Injuries & Health '07
• Putting Health Back into Endurance Sports '07
• Assessing the Damage: Part 2 '08