Are triathletes healthy?

September 18th, 2009  |  Published in Stumpblog  |  10 Comments

Puzzling as it is for many people unaccustomed to this logic (typically, those people prone to assume that if 1 drink is fun, 20 must be fucking hilarious), biology has a sweet spot for everything.

Biology is all about the just-right of Goldilocks’ porridge. This doesn’t mean the oft-quoted “everything in moderation” is true, especially since one often hears this from people whose bodies bear witness to the fallacy that Cheetos, Jack Daniels and cigarettes “in moderation” produce optimal physiological function. I am also not aware that, say, asbestos or PCBs “in moderation” are beneficial.

It means that there is a right amount — usually a range — for everything. It may indeed be moderate. It may be large. Or it could be a tiny microgram.

In this case, endurance exercise. How much is too much? There is accumulating evidence that while some is good — say, a nice half-hour’s run outside on a sunny day — running marathons may not be the brightest idea for the average person.

The frequency of cardiac incidents (i.e. keeling over as the ticker goes on strike) decreases with some exercise, but increases with a lot of endurance exercise, as many unfortunate (and late) middle-aged marathoners who are myocardially infarcting all over the finish line can attest.

As one study notes:

Conventional cardiovascular risk stratification underestimates the CAC burden in presumably healthy marathon runners. As CAC burden and frequent marathon running seem to correlate with subclinical myocardial damage, an increased awareness of a potentially higher than anticipated coronary risk is warranted.

Möhlenkamp S, Lehmann N, Breuckmann F, et al. Running: the risk of coronary events : Prevalence and prognostic relevance of coronary atherosclerosis in marathon runners. Eur Heart J. 2008 Aug;29(15):1903-10.

On the other hand, as another study points out, “Vigorous exercise (running) at middle and older ages is associated with reduced disability in later life and a notable survival advantage.”

Again, sweet spot. Some is good. A fair bit is good. A lot, not so much.

A recent study examines one mechanism by which this problem may occur.

This study collected blood from sedentary volunteers and triathletes at rest and after a short-duration triathlon (SDT) and after a long-duration triathlon (LDT-half Ironman) competitions.

It found that the triathletes had depressed immune systems and more cellular damage, both at rest and after events.

In addition, when cell death occurred, in SDT it was more likely be from apoptosis (a kind of pre-programmed cell suicide that is often part of a natural process of healing). In LDT it was more likely to be from necrosis (aka cell murder).

The post-event triathletes also had very high reactive oxygen species (ROS), akin to “rusting” in the body. ROS can induce damage to cellular DNA and other structures.

[There was] “lowered lymphocyte proliferation capacity compared with sedentary volunteers either at rest or after the competitions…. Lymphocytes from triathletes after SDT competition showed an increase in DNA fragmentation, phosphatidylserine externalization, and mitochondrial transmembrane depolarization and did not alter membrane integrity when compared with cells from athletes at rest. In contrast, the LDT competition raised the proportion of lymphocytes with loss of membrane integrity when compared with cells from athletes at rest and did not change the apoptotic parameters. The LDT competition induced an increase of reactive oxygen species (ROS) production by lymphocytes compared with triathletes at rest. The SDT competition did not alter ROS production by lymphocytes when compared with cells from triathletes at rest. ROS production by lymphocytes after LDT competition was 60% higher than in SDT.”

Levada-Pries, Adriana, et al. Induction of Lymphocyte Death by Short- and Long-Duration Triathlon Competitions. Medicine & Science in Sports & Exercise. 41(10):1896-1901, October 2009.

Temporary immunosuppression is normal following nearly all exercise, and is likely part of the normal process of supercompensation (getting stronger/better/more functional after an exercise stimulus). But again, sweet spot.

It’s like a little life challenge is good — obstacle is presented, you struggle through, learn life lessons, become tougher and more resilient. But a huge, traumatic life challenge = years of therapy and PTSD.

Are triathlons bad? Am I a big meanyhead to endurance athletes? No. Each person finds their own exercise path.

However, if you experience symptoms of significant immunosuppression and tissue damage following extensive bouts of endurance exercise, and you’re feeling like a rusty old car, perhaps consider scaling back.


  1. Geoff says:

    September 18th, 2009at 11:24 am(#)

    As someone who has people try to choke him for fun (submission grappling, not BDSM, thanks), I am not in any particular position to poo-poo what hobbies people pursue. However, here’s what I do try to make clear:

    If your objective is fat-loss, increased cardiovascular health or diminished risk factors, then endurance sports are not your best choice.

    Once that’s been established, we can discuss what’s fun — an entirely different subject.

  2. Varsha says:

    September 19th, 2009at 1:05 am(#)

    I endorse this fully for I have lived through this.Having gained 15kgs after my second baby ,I embarked on a mammoth (and mindless)plan of walking,running,swimming and cycling for upto three hours everyday and soon ended up with achy joints and a permanently rundown feeling.Till I discovered weight training and HIIT (and this site)I would probably have been an middleaged,overweight mom with PTSD!

  3. Braidwood says:

    September 19th, 2009at 2:50 pm(#)

    I too can say Amen! to this article.

    I ran a marathon when I was 30. I trained well, didn’t overdo it, had a good run, was proud of my time. Afterwards, I became depressed for no discernible reason. I had heard people say that you can get depressed after a marathon because its a big let down after going for a goal- they say its psychological.

    I didn’t think it was psychological.

    I read a book called The Mood Cure, it recommends supplements including a lot of amino acids for depression. I followed the suggestions and felt better right away. SO, I really think that I became depressed because my body just broke down and used up too much of my own resources, so I didn’t have enough of the feel good chemicals that amino acids help create.

    I really loved running as long as I did- especially when we ran 16 miles along the southern california coast during training. I felt strong, and good. But I do think, for me at least, marathon training was a luxury that cost my body rather than helping my body.

    I could see myself doing a half marathon again, but a full marathon took too big a toll on my system.

    On the other hand, my mom has run several ultra-marathons (50 miles) with seemingly no dire consequences except for black toe-nails.

  4. Chris says:

    September 21st, 2009at 8:12 am(#)

    I am just happy to have my aversion to senseless ammounts of running justified :-)

  5. Sharon from Penn State says:

    September 21st, 2009at 1:48 pm(#)

    I second Chris!

  6. Kat says:

    September 23rd, 2009at 9:20 am(#)

    I’m one of those freaks who actually loves endurance sports. I was given the opportunity couple weekends ago to skip my 10-mile run and go to the spa instead at a conference for work. Predictably, terrified onlookers saw a disheveled, sweaty woman running through the golf course that afternoon, dodging motorized carts on the path. Anyway, the research is clear — doing crazy amounts of endurance training is clearly not good for your body! Everyone does have to find their sweet spot — for me, biweekly strength training and the less-demanding swim/bike/run training schedule required for sprint/Oly tri’s is the key (not so much weight lifting that I get bored and angry, and enough s/b/r that I can have fun without overtraining myself to the point of illness).

    There is one thing I want to point out, though — MI rates have increased during marathons and triathlons in recent years, as the popularity of these sports has increased. I don’t know if anyone has done the analysis to see if the MI rates have gone up in direct proportion to the number of entrants, but I have a hunch that the rates have risen DISproportionately. I’m on a bunch of triathlon and running-related sites, and there are a lot of people with a fairly low level of fitness who want to go from the couch to the marathon or Ironman. A lot of them happen to be middle-aged guys. Whether these are the same middle-aged guys who are dying all over the finish line at races (or in the swim at a tri) is not known by me, but it seems possible that going from a sedentary lifestyle straight into marathon training is even harder on the body than training for a marathon when you already have a good endurance base built up.

  7. Mistress Krista says:

    September 23rd, 2009at 10:08 am(#)

    Great point Kat! I definitely think we need to examine the multiple factors involved, if only to prevent unnecessary and premature shuffling off this mortal coil after shuffling over the finish line. I also notice that “do a triathlon” or “do a marathon” has become a kind of collective goal for people who might be better off just getting outside for a nice trundle for a few years in preparation. It’s like we have to go from 0 to 26.2, with nothing in between. Perhaps some attention to how we might work towards bigger and better goals without sacrificing wellness is in order.

    I love running and cycling, although I’m a bit of a failure at swimming — I wonder how much the focus on “Must Do X Comp” sucks the joy out these activities?

  8. Alex says:

    November 18th, 2009at 8:16 am(#)

    Hummm … this is interesting.

    My mother, now in her fifties, has run marathons for the last twelve years or more: sometimes, two a year.

    However, as a family, we started to question the whole ‘marathon running = peak fitness = long life’ idea when she discovered last year that she has now developed a heart problem seemingly exacerbated by her endurance exercise (a valve in her heart has hardened). After years of careful eating and exercise, this development seems somewhat unjust really.

    Not only that, but a long time friend of the family died from a MI earlier this year in his mid 40s while out cycling: he too had been an endurance buff for twenty years and a marathon obsessive.

    Another interesting thing is that my mother’s problems with depression and anxiety began around the time she started running marathons — I do wonder whether there would be some merit in someone pursuing this line and researching whether some types of endurance exercise take too much out of non-professional athletes, causing physical and mental imbalances.

  9. Stumptuous asks: Are triathletes healthy? | Authentic Threads says:

    March 28th, 2010at 1:04 am(#)

    […] Stumptuous asks: Are triathletes healthy? …endurance exercise. How much is too much? There is accumulating evidence that while some is good — say, a nice half-hour’s run outside on a sunny day — running marathons may not be the brightest idea for the average person. […]

  10. Pedro says:

    April 8th, 2010at 4:21 pm(#)

    I was a top age grouper at the half-ironman level. Actually qualified for worlds a few years back. I totally agree that anything over an Olympic Distance triathlon or a half marathon is simply not healthy. I am convinced my immune system was wrecked because of the non-stop training. I was depressed and I looked like hell. I have since ditched the traditional
    Triathlon Training for my own triathlon training (weight lifting, cycling less than 60 miles and sprinting (100-400 meters). I look and feel better and I have more time than before to spend with my family and to travel. I am convinced that most endurance athletes are in essence self-medicating their obsessive compulsive personalities by exercising at extreme levels. They aren’t even “FIT” take a world class decathlete vs. a world class triathlete…no contest. The decathlete is faster, stronger and quite frankly just looks healthier. Not only are long distance triathlons physically unhealthy…they are mentally unhealthy and dehumanize those “taking up the challenge” by leaving them void of any other activity to partake in except training. Forget the wife, kids, job and friends. Everything will take a back seat to the training….I wish I had the divorce rates on chronic Ironman Triathletes. I venture to bet it is not good. For all those triathletes reading this…it is not meant as a put down. Just a wake-up call…Sit down and really ask yourself what and why you are doing this…Don’t buy the hype that it is making you healthier because it isn’t.

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