No excessive deaths among serious exercisers in Harvard study with 30-yr follow up

July 25. Any runners concerned that their favorite activity could increase risk of death (the “excessive exercise” hypothesis) received a big dose of good news this week from a big, impressive dive into the question. Harvard researchers performed a 30-yr follow up (that’s a long time) of more than 100,000 nurses and health professionals (a lot of people). During the 30-yr period, more than 47,000 of the subjects died (that’s a lot of deaths).

The paper looked for links between total exercise minutes per week and all-cause mortality. It found that those who exercised moderately for up to 4x the recommended 150 mins/week had a 26 to 31% lower mortality rate than those who didn’t meet the recommendation. Those who did 4x the recommended amount of vigorous activity (75 mins/week) had a 21 to 23% lower risk of mortality. All running, even very slow running, qualifies as vigorous activity.

There was no increased gain from doing more than 4x recommended amounts. However, there was also no increased risk. “This finding may reduce the concerns around the potential harmful effect of engaging in high levels of physical activity observed in several previous studies,” said first author Dong Hoon Lee of Harvard’s T.H. Chan School of Public Health. More at Circulation.


JULY 21: NEW THIS WEEK: Skip the sex, & run faster. How to deal with pain. Can you outrun a bad diet? No more blisters, cramps, or nausea. Here’s what will happen if you change your stride. Should you try PT or surgery for meniscus problems. Clean up your breathing. 20 great squat variations. More

No sex = faster running (in soccer)

For as long as I can remember, we’ve been told that having sex the night before a race would not hinder performance. Some even said you’d run more relaxed, therefore better. Any advice to avoid sex, we were assured, was based on a complete lack of evidence, or even moral strictures. Of course, no one actually performed a decent study with objective data. Everything was based on self reports. Until now.

A team of soccer researchers measured players’ speed during matches. Afterwards, the players were asked if they had sex the night before. Eventually the researchers had speed data relating to both Yes (I had sex) and No (I didn’t have sex) from the same players. Result? After No Sex the players ran significantly faster during games than after Sex. “This study is the first to show that sexual intercourse the night before a football match may have a negative influence on players' performance.” I’m no moralist; follow your pleasure. I’m just reporting the outcomes. More at J of Sports Medicine & Physical Fitness.

“Pain only hurts”

That’s a simple but powerful mantra if I ever heard one. I’m not sure that ultramarathon legend Scott Jurek ever said this, as Google credits someone else. But I think runners should definitely embrace the thought behind the words. Author Matt Fitzgerald believes you can learn to accept discomfort through bracing and detachment. Bracing means planning and practicing for the tough moments to come. Detachment is learning to move your thoughts away from the immediate hurt. 

Sports psychologist Noel Brick says that runners should ask: “Given how I’m feeling right now, what is the best thought I can think or action I can take to maximize my performance.” Also, always remember that other immortal quote: “Pain is temporary, pride is forever.” More at Trail Runner.

Can you outrun a bad diet?

This was one of the big stories last week, often below the headline, “You can’t outrun a bad diet.” The report came from a top international team of experts who analyzed mortality data from the important UK Biobank database. The study followed more than 300,000 subjects for 11 years. Here’s what the NYTimes had to say.

It wasn’t a running study per se, but one that delved into various levels of exercise from sedentary to highly active, and also diet levels, from low quality to very healthy. Conclusion: “High levels of physical activity did not counteract the detrimental effects of poor diet.” Similarly, you couldn’t eat yourself fully healthy without moderate exercise.

Some previous studies like this one had hinted that you could outrun a lazy diet. However, those studies were small and did not cover a decade-plus of followup. The new paper appears much stronger and more convincing. It tells us, with data, what we already believed and are hopefully following. “That exercise does not fully compensate for a poor diet, and we should recommend and advocate for both an active lifestyle and a healthy diet.” More at Brit J of Sports Medicine.

No more blisters, cramps, or nausea

Every runner worries about blisters, cramps, and nausea. This article offers terrific advice on all three, with physical therapist Joe Uhan explaining why he takes a “first principles” approach to many running problems vs “evidence based.” I’d never before heard his take on how to continue running with blisters, and think it’s brilliant: “Pretend you’re running through four inches of snow.” Uhan doesn’t claim to have all the answers, but his approach to cramps and nausea is equally convincing. More at I Run Far.

What happens when you change your stride?

I know few runners, myself included, who don’t occasionally think about tinkering with their running form. Maybe I could be faster? Maybe I could reduce injuries? After all, hope springs eternal. 

But research doesn’t. A new systematic review and meta-analysis of changes in running form showed that the changes did alter things like stride frequency and impact loading, but did not change running economy or performance. The outlook was better for injuries. “Two trials demonstrated reduced 1-year injury incidence following gait retraining.” More at J of Orthopaedic & Sports Physical Therapy.

Make every minute count: Weekend warriors are fine

Thirty years ago we were warned against being “weekend warriors.” The phrase conjured up an image of guys who drank beer all week, then played full tilt flag football Saturday morning. Not a healthy combo. Now we have an evolved, less negative view. Any exercise is better than no exercise, and many people don’t have a lot of time during the workweek. If they double down a bit on weekends, hey, that should be a good thing vs their sedentary Mon-Fri behavior.

In fact, according to a new study that attracted lots of attention last week, 150 minutes of exercise/week crammed into Saturday and/or Sunday is just as effective at lowering risk of death as when spread more evenly across the week. It’s the minutes that count, not the days.

The underlying data followed 350,000 American adults for 10 years, noting mortality rates for various exerciser habits. It concluded: “Individuals who engage in the recommended levels of physical activity may experience the same benefit whether the sessions are performed throughout the week or concentrated into fewer days.” More at JAMA Internal Medicine.

What’s better for meniscus problems: PT or arthroscopic surgery?

As a runner, if you develop some knee pain, you could get an MRI to assist your doctor’s diagnosis. The image might show meniscus damage, which can often be repaired with simple arthroscopic surgery. At that point, you might think, as I did a dozen years ago, “Let’s just do the surgery, and move past this knee pain.”

That could be a too-hasty mistake. In a recent study, young patients with partial meniscus tears were randomized into a group that received physical therapy and one that had arthroscopic surgery. The results indicated that “physical therapy with optional delayed arthroscopic partial meniscectomy is a reasonable alternative to early arthroscopic partial meniscectomy.” More at Brit J of Sports Medicine.

Another report reached a similar conclusion. It came from a 5-years-later followup to a randomized trial of physical therapy vs surgery for patients with a “degenerative meniscal tear.” The key finding here? “Exercise-based physical therapy should be the preferred treatment over surgery for degenerative meniscal tears.”  More at JAMA Network Open. (Personal endnote: My surgery worked fine. I’ve had no knee problems in the last decade.)

Low energy availability (under fueling) featured in two important new studies.

The area of low energy availability (LEA) is one of the most active research topics for distance runners, dancers, gymnasts, or athletes in any sport where low weight might offer a competitive advantage. LEA results from not eating enough, or purging after meals. The biggest concern is dangerous health repercussions like hormone disruption, weak bones, and mental health. Serious stuff.

LEA is often associated with overtraining, now termed “overreaching” in scientific circles. But an important new study shows that LEA is not a precondition for overtraining. It can also occur in athletes who are fueling enough. “Overreaching is also observed in the absence of LEA.” So you have to monitor more than just calories. You have to monitor everything, particularly mental state. More at Sports Medicine.

Female athletes have drawn most of the attention in LEA studies, though several recent ones have pointed out that males are also susceptible to the same syndrome. Now a new randomized trial has looked into males--when and how they suffer from LEA. One major conclusion: Male LEA “starts at significantly lower values than in female athletes.” This means that males can restrict calories more than females before suffering the consequences. A second conclusion: “Mental state and performance are affected before health.” More at J of the Int Society of Sports Nutrition.

Every breath you take

I pay a lot of attention to articles about breathing and air pollution, because, What could be more important to endurance exercise than breathing? While running, we pull 6-7 times more air through our lungs than while sitting. Here’s a deeply cautionary tale, just published. The researchers knew that regular exercise lowers dementia rates, but wondered if exercising in polluted air might erase part of this benefit. It did. Conclusion: “Exposure to even moderate levels of air pollution attenuates [lowers] the benefits of PA on risk of dementia.” 

Several months ago the NYTimes did an excellent review of an early version of the report, including some good advice. Most importantly: Exercising indoors won’t necessarily help; wearing a Covid-type mask might help; and don’t stop exercising, as the overall positive effects remain strong. More at New York Times.

SHORT STUFF you won’t want to miss

>>> Warming the legs, as with a hot water soak, might  improve muscle force production

>>> A new type of mile--A2 milk--could help you avoid those digestive issues.

>>> 20 great squat variations for runners (with simple-but-terrific gifs to illustrate each)

GREAT QUOTES make great training partners

“Run often. Run long. But never outrun your love of running.”

--Julie Isphording, 1984 Olympic marathoner

That’s it for now. Thanks for reading. Stay well, and see you next week. Amby