Jogging is Paleo, Deal with It

A couple new papers and stories in the media have me thinking more about running lately. I don’t make a big habit out of it, but I do occasionally do some hill sprints and 5k races just for fun, and to mix up my exercise routine. Sometimes I think there is a bit too much naysaying of running and moderate-intensity endurance exercise in general within the Paleo community, and in light of this new research, I wanted to reexamine running within a Paleo framework.

Jogging has gotten a rather cold reception within the Paleo community, but I’m not sure that’s entirely fair. First of all, it’s a really easy activity to do. You don’t need a home gym or thousand dollar bike to do it. A decent pair of shoes (I prefer minimilist shoes) and a bit of sidewalk or trail will do. Second, by stepping up the intensity occasionally, it’s an easy way to reach those peaks of exertion required for the cascade of positive metabolic effects to occur if one is pursuing a weight-loss/metabolic conditioning program. Brief bursts of high-intensity training can increase insulin sensitivity, leptin sensitivity, reduce blood pressure, and increase one’s resting metabolism, among other benefits.[1,2]

Photo by Mike Baird

There is also no doubt that some amount of running was routinely practiced by the Paleolithic people whose’s genetic heritage we carry. It’s very difficult to imagine living in the wild without occasionally running after prey, running from predators, running from/after competing groups, etc. And let’s not forget about persistence hunting.[3,4]

Now, don’t get me wrong. It’s very easy to overdo it. Running marathons, for example, has been shown to cause subclinical heart damage.[5-7] Running for long periods can also expose the runner to an excess of the stress hormone cortisol and oxidative damage.[8] We just need to know what’s healthy and what probably isn’t.

Jogging, or running at a moderate pace for an extended period, is really what get’s the ire of a lot of people, and mostly for good reasons. This is probably exactly what most people picture when reading Mark Sission’s famous “Chronic Cardio” post. But what about joggers that don’t aspire to run marathons and just go out for a few miles every couple of days?

A new, unpublished study found a U-shaped correlation between jogging time and life expectancy.[9]

Undertaking regular jogging increases the life expectancy of men by 6.2 years and women by 5.6 years, reveals the latest data from the Copenhagen City Heart study presented at the EuroPRevent2012 meeting. Reviewing the evidence of whether jogging is healthy or hazardous, Peter Schnohr told delegates that the study’s most recent analysis (unpublished) shows that between one and two-and-a-half hours of jogging per week at a “slow or average” pace delivers optimum benefits for longevity.

Further analysis exploring the amounts of exercise undertaken by joggers in the study has revealed a U-shaped curve for the relationship between the time spent exercising and mortality. The investigators found that between one hour and two and a half hours a week, undertaken over two to three sessions, delivered the optimum benefits, especially when performed at a slow or average pace. “The relationship appears much like alcohol intakes. Mortality is lower in people reporting moderate jogging, than in non-joggers or those undertaking extreme levels of exercise,” said Schnohr.

Two and half hours of jogging per week is a lot more jogging than a lot of Paleo enthusiast are comfortable with (15 miles at a nice-and-easy 10 minutes/mile), but it appears to be safe.

Now, of course, this type of study cannot show causal relationships–there could be other factors at work. For instance, joggers are less likely to smoke, drink excessively, and probably try to eat a healthier diet than most non-joggers. All of these things affect the difference in life expectancy between joggers and non-joggers, but that doesn’t explain why jogging more than 2.5 hours a week ends up having a negative effect, as one would assume joggers that go out even longer are even more committed to leading a healthy lifestyle.

Another study looked at the neurological effects of running (aka the “runner’s high”). They found that a runner’s body produces cannabinoids, the same type of chemicals found in marijuana.* The researchers wondered if this was an evolutionary adaption for species that enage in distance running, and loe and behold, found the same effect in dogs (distance runners) but not in ferrets (not distance runners). While too much running is clearly damaging, there is still evidence that we were “Born to Run” as it’s been put.[10]

So there you have it. Jogging is a perfectly healthy part of a Paleo lifestyle. Just skip the sugared-up exercise drinks, run as close to barefoot as possible, run on uneven terrain to reduce repetitive stresses on the joints, and keep your overall time low. If you want to be out all day, go for a long hike or low-intensity bike ride instead.

* Tangent: The press has presented this as if running is as addictive as hard drugs, which makes about as much sense as claiming marijuana is as addictive as hard drugs. Why everything that activates the reward centers of the brain is considered addictive, I will never understand. Pleasurable experiences, including the use of hard drugs, do active the brain’s reward centers (big surprise), but clearly there is more to the story than blobs on an fMRI. Some rewards we can manage, some we can’t. Just looking at fMRI’s and ignoring the behavioral aspects of addiction because we now have “hard evidence” is foolish.

References

1. Babraj JA, Vollaard NB, Keast C, Guppy FM, Cottrell G, Timmons JA. Extremely short duration high intensity interval training substantially improves insulin action in young healthy males. BMC Endocr Disord. 2009 Jan 28;9:3. PubMed PMID: 19175906; PubMed Central PMCID: PMC2640399.

2. Irving BA, Davis CK, Brock DW, Weltman JY, Swift D, Barrett EJ, Gaesser GA, Weltman A. Effect of exercise training intensity on abdominal visceral fat and body composition. Med Sci Sports Exerc. 2008 Nov;40(11):1863-72. PubMed PMID: 18845966; PubMed Central PMCID: PMC2730190.

3. Bramble DM, Lieberman DE. Endurance running and the evolution of Homo. Nature. 2004 Nov 18;432(7015):345-52. PubMed PMID: 15549097.

4. Liebenberg L. The relevance of persistence hunting to human evolution. J Hum Evol. 2008 Dec;55(6):1156-9. Epub 2008 Aug 29. PubMed PMID: 18760825.

5. Möhlenkamp S, Lehmann N, Breuckmann F, Bröcker-Preuss M, Nassenstein K, Halle M, Budde T, Mann K, Barkhausen J, Heusch G, Jöckel KH, Erbel R; Marathon Study Investigators; Heinz Nixdorf Recall Study Investigators. 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. Epub 2008 Apr 21. PubMed PMID: 18426850.

6. Wilson M, O’Hanlon R, Prasad S, Deighan A, Macmillan P, Oxborough D, Godfrey R, Smith G, Maceira A, Sharma S, George K, Whyte G. Diverse patterns of myocardial fibrosis in lifelong, veteran endurance athletes. J Appl Physiol. 2011 Jun;110(6):1622-6. Epub 2011 Feb 17. PubMed PMID: 21330616; PubMed Central PMCID: PMC3119133.

7. Neilan TG, Januzzi JL, Lee-Lewandrowski E, Ton-Nu TT, Yoerger DM, Jassal DS, Lewandrowski KB, Siegel AJ, Marshall JE, Douglas PS, Lawlor D, Picard MH, Wood MJ. Myocardial injury and ventricular dysfunction related to training levels among nonelite participants in the Boston marathon. Circulation. 2006 Nov 28;114(22):2325-33. Epub 2006 Nov 13. PubMed PMID: 17101848.

8. Witt EH, Reznick AZ, Viguie CA, Starke-Reed P, Packer L. Exercise, oxidative damage and effects of antioxidant manipulation. J Nutr. 1992 Mar;122(3 Suppl):766-73. Review. PubMed PMID: 1514950.

9. “Assessing prognosis: a glimpse of the future.” Symposium: Saturday May 5, 9.15 am to 10.15 am. Liffey B Lecture Room. P. Schnohr, Jogging-healthy or hazard?

10. Raichlen DA, Foster AD, Gerdeman GL, Seillier A, Giuffrida A. Wired to run: exercise-induced endocannabinoid signaling in humans and cursorial mammals with implications for the ‘runner’s high’. J Exp Biol. 2012 Apr 15;215(Pt 8):1331-6. PubMed PMID: 22442371.

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Why We’re Sick in One Picture

Want to see everything that is wrong with conventional diet and exercise regimens and the causes of ever-increasing chronic disease in one photo? Here it is. (Hat tip: Reddit)

It goes like this:

Eat a processed, high carbohydrate, grain-based diet that makes you fat and hungry,[1] and results in chronic disease.[2] Try to remedy the situation by doing “cardio” exercise like jogging which over-stresses your heart[3] and saturates your body with the stress hormone cortisol. Finally, double down on this failed strategy by blaming meat for your declining health and adopt an extremely high carbohydrate, unnatural[4] Vegan diet that requires endless pill-popping and results in malnutrition and heart disease.[5,6]

Thumbs up!

Why do we do this to ourselves? There are much better paths to optimal health.

References

1. Ludwig DS, Majzoub JA, Al-Zahrani A, Dallal GE, Blanco I, Roberts SB. High glycemic index foods, overeating, and obesity. Pediatrics. 1999 Mar;103(3):E26. PubMed PMID: 10049982.

2. Cordain L, Eaton SB, Sebastian A, Mann N, Lindeberg S, Watkins BA, O’Keefe JH, Brand-Miller J. Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr. 2005 Feb;81(2):341-54. Review. PubMed PMID: 15699220.

3. Möhlenkamp S, Lehmann N, Breuckmann F, Bröcker-Preuss M, Nassenstein K, Halle M, Budde T, Mann K, Barkhausen J, Heusch G, Jöckel KH, Erbel R; Marathon Study Investigators; Heinz Nixdorf Recall Study Investigators. 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. Epub 2008 Apr 21. PubMed PMID: 18426850.

4. Milton K. The critical role played by animal source foods in human (Homo) evolution. J Nutr. 2003 Nov;133(11 Suppl 2):3886S-3892S. Review. PubMed PMID: 14672286.

5. Shinwell ED, Gorodischer R. Totally vegetarian diets and infant nutrition. Pediatrics. 1982 Oct;70(4):582-6. PubMed PMID: 6812012.

6. Ingenbleek Y, McCully KS. Vegetarianism produces subclinical malnutrition, hyperhomocysteinemia and atherogenesis. Nutrition. 2011 Aug 26. [Epub ahead of print] PubMed PMID: 21872435.

Cycling Intensity is Important for Longevity, Not Duration

A new study from Denmark shows that cycling intensity has a strong relationship with life expectancy and cycling duration appears to have little, if any.[1]

Here’s study’s data on intensity and duration’s association with life expectancy:

And the data for each group showing the stronger association intensity has with reducing risk of death:

The high intensity cycling group had the lowest risk of all-cause mortality and an increase of 4-5 years of life expectancy compared to the low intensity group, and the difference was highest in risk of CHD related death.

The difference in all-cause mortality from increasing cycling duration was small or non-existant among all groups.

The authors were careful to state that, although intensity has a stronger relationship, we don’t really know what is the optimal duration, if it exists at all. But it appears that less than 30 minutes of cycling was enough to drop the high intensity group’s risk of death from coronary heart disease to less than a fifth of the low intensity group (the largest difference in the study). Interestingly, risk of death from CHD among the high intensity group crept upwards among those cycling more than an hour per day, but stil remained lower than the low and average intensity groups. The average intensity group saw a smaller difference of less than half the risk of death from CHD while also cycling less than 30 minutes a day when compared to the low intensity group.

Thoughts

I want to say “I told you so,” but let’s remember this is an observational study that isn’t powerful enough to show cause (however, it appears that they did do their best to adjust for differences between the groups). This does provides evidence that high intensity cycling longer than an hour per day may not be as dangerous as we thought, although not optimal. I doubt they were anywhere near the amount of training that professionals engage in though. Still, it certainly does add to the growing body of evidence that short, intense cycling is best way to train for health and longevity. Remember this study the next time you’re thinking about heading out for a fast 50!

References

1. Schnohr P, Marott JL, Jensen JS, Jensen GB. Intensity versus duration of cycling, impact on all-cause and coronary heart disease mortality: the Copenhagen City Heart Study. Eur J Cardiovasc Prev Rehabil. 2011 Feb 21. [Epub ahead of print] PubMed PMID: 21450618.

Life Expectancy of Endurance Athletes

A new study claims that Tour de France cyclists add an average 8 years to their life span through extreme endurance training, and that people engaged in such activity should have no fear that they could be doing damage to their health.[1] Hmm. Pretty big statements for an epidemiological study. Let’s dig in.

Here’s the abstract:

Increased Average Longevity among the “Tour de France” Cyclists.

It is widely held among the general population and even among health professionals that moderate exercise is a healthy practice but long term high intensity exercise is not. The specific amount of physical activity necessary for good health remains unclear. To date, longevity studies of elite athletes have been relatively sparse and the results are somewhat conflicting. The Tour de France is among the most gruelling sport events in the world, during which highly trained professional cyclists undertake high intensity exercise for a full 3 weeks. Consequently we set out to determine the longevity of the participants in the Tour de France, compared with that of the general population. We studied the longevity of 834 cyclists from France (n=465), Italy (n=196) and Belgium (n=173) who rode the Tour de France between the years 1930 and 1964. Dates of birth and death of the cyclists were obtained on December 31 (st) 2007. We calculated the percentage of survivors for each age and compared them with the values for the pooled general population of France, Italy and Belgium for the appropriate age cohorts. We found a very significant increase in average longevity (17%) of the cyclists when compared with the general population. The age at which 50% of the general population died was 73.5 vs. 81.5 years in Tour de France participants. Our major finding is that repeated very intense exercise prolongs life span in well trained practitioners. Our findings underpin the importance of exercising without the fear that becoming exhausted might be bad for one’s health.

And here’s why it’s wrong:

The study compared professional cyclists to the general population, only controlling for country of origin and age. So the pro’s were compared to a group in which some members suffered from known causes of reduced life span like: genetic disease, poverty, smoking, obesity, sedentary lifestyles, and oh yeah, WORLD WAR II, without controlling for any of them.

Were the pro cyclists conscripted at the same rate as the general population? Given the popularity of competitive cycling in France, Belgium, and Italy, I would suspect that even if they were, these men were kept from the front lines. Their data did not include cause of death.

Did they come from similar socio-economic backgrounds? Today’s pro’s usually come from fairly well-off families rather the poor families. You can’t say the same thing about the general population, and poverty is known to reduce life span.[2]

I could go on, but you get the idea: The study was so poorly-controlled that its breathtakingly over-reaching conclusions are totally unsupported. Even if we assume their data is sound, they simply cannot conclude that pro cycling caused the increase in life span. Doing so is the cardinal sin of epidemiology. Correlation does not imply causation. It’s only a clue to look closer with more powerful studies that most often find no causal link, only a coincidence and one or more confounding variables.

They acknowledged some of these factors as limitations of their study (but not the deadliest war in human history). Yet, despite already published studies that clearly show heart damage in marathon runners they confidently concluded:

In our opinion, physicians, health professionals and general population should not hold the impression that strenuous exercise and/or high-level aerobic competitive sports have deleterious effects, are bad for one’s health, and shorten life.

I’d add that using poorly-controlled, observational data to recommend extreme endurance exercise–even beyond the point of exhaustion–is not only unsupported by the data, it’s irresponsible.

Other Longevity Studies

Several observational studies have looked at similar data and reached a wide range of conclusions. They have suggested several factors as possible causes of the increase in life span, including: the sports themselves, genetic selection of elite athletes, active and healthy lifestyles of athletes, lower rates of smoking, less alcohol consumption, lower body weight, lower overall blood pressure, and lower risk of ischemic heart disease caused by any of the previously listed factors.[3-7]

So which is it? Did the sports cause longer life span or was it another factor or combination of factors? Observational studies are simply incapable of determining this. They can only show association. That’s why a well done observational study concludes only that a correlation exists and modestly offers several possible causes, if any.

Evidence Against Endurance Sports

Endurance athletes, especially marathon runners, have been the subject of recent studies designed to observe the effects of endurance sports on the heart. Nearly all of them have shown acute damage, and some have shown long-term damage correlated to degree of participation in endurance sports.

Several studies have shown damage to the heart in lifelong endurance athletes, including myocardial fibrosis (thickening of the heart values) that can lead to heart failure.[8,9] An enlarged heart was once thought to be a temporary adaptation to endurance athletics, but at least one study has found the syndrome can persist decades after retirement from professional cycling.[10] Marathon running is now well-correlated with an increased risk of heart attack caused by atherosclerosis.[11] Even completing a single marathon can result in temporary heart damage.[12] The evidence is steadily mounting that too much endurance exercise pushes the heart too far beyond it’s evolved capability and leads to disease.[13]

Another thing to consider is the low bone mineral density most endurance athletes suffer from.[14-16] A frail skeleton in advancing age is a precursor to breaking bones from a fall, and that can lead to death among the elderly.[17]

There is an interesting line of research, still in early stages, that shows that glucose may speed up the aging process in worms and yeasts. In one study, lifespan was reduced by 20%. This metabolic pathway may have been conserved through evolution in humans. The diet of a typical endurance athlete is loaded with sugar in order to sustain enormous efforts hour after hour. It’s too early to say, but it’s possible that this diet has a negative effect on life span. An author of one of the studies was convinced enough to have removed all sugar and starch from her diet.[18,19]

Evolutionary Perspectives

The prevailing notion in the Paleo community is that humans rarely pushed their cardiovascular systems to the extremes that professional cycling and other endurance sports demand. Hunting was a matter of stalking prey (mostly walking quietly), then sprinting in for the kill. Since these extreme endurance events are evolutionarily novel, human genes are likely poorly adapted to them, making them detrimental to human health. This consistent with the new clinical evidence that lifelong marathon running and competitive cycling results in heart damage.[20]

On the the other hand, proponents of endurance running claim that persistence hunting observed in hunter gatherer populations and several anatomical features unique to humans suggest that we are well adapted to endurance exercise. Humans are the only mammals that sweat in the heat, are relatively hairless, and are bipedal. These factors allow us run more efficiently in hot weather than other species. Using these advantages, we can pursue prey over long distances during the hottest part of the day until it suffers from heat exhaustion and is killed. This idea is known as the Endurance Running Hypothesis, and is advocated by biologists Daniel E. Lieberman and Dennis M. Bramble.[21,22]

I think this point of view has some problems. It’s likely that hairlessness and sweating were adaptations to hot climates, but to claim they were adaptions to a specific behavior in such climates seems a bit overreaching. These traits gave the humans that had them an advantage in nearly every activity carried out in the heat, not just in persistence hunting. Also, running for miles in hot weather seems like a pretty inefficient way of hunting. The hunter(s) would have to expend an enormous amount of energy for each hunt, including those that were unsuccessful. Ambush hunting or scavenging would have been more calorically efficient, producing selection pressure against persistence hunting. Many anthropologists have challenged the Endurance Running Hypothesis, stating that archaeological and ethnographic data do not support it.[23] Still, one cannot ignore the fact that no species has nearly the same capacity for endurance running as humans and that some hunter gatherer groups traditionally practiced persistence hunting in Africa and North America.[24]

Below, David Attenborough narrates a modern day persistence hunt by the San, a hunter gatherer group in Southern Africa that carries the oldest existing human DNA.

http://www.youtube-nocookie.com/embed/826HMLoiE_o?rel=0

An Evolutionarily Consistent Theory

On one hand we have some rather problematic observational studies that show higher life span among professional cyclists and endurance athletes. On the other hand, we have observational studies showing clear evidence of heart damage in lifelong marathon runners and professional cyclists. Evolutionary arguments seem to support the notion that extreme endurance exercise is novel to humans, but how can we explain the epidemiology? We can simply ignore them for being poorly-controlled studies, or we can suggest a confounding variable: genetics.

A study published March 2011 in PLos ONE suggests that genetics may be a factor in increased lifespans among endurance athletes.[25] Here’s the abstract. The complete paper is available at PLoS ONE and it’s worth reading in its entirety.

Are ‘Endurance’ Alleles ‘Survival’ Alleles? Insights from theACTN3 R577X Polymorphism

Exercise phenotypes have played a key role for ensuring survival over human evolution. We speculated that some genetic variants that influence exercise phenotypes could be associated with exceptional survival (i.e. reaching ≥100 years of age). Owing to its effects on muscle structure/function, a potential candidate is the Arg(R)577Ter(X) polymorphism (rs1815739) in ACTN3, the structural gene encoding the skeletal muscle protein α-actinin-3. We compared the ACTN3 R577X genotype/allele frequencies between the following groups of ethnically-matched (Spanish) individuals: centenarians (cases, n = 64; 57 female; age range: 100-108 years), young healthy controls (n = 283, 67 females, 216 males; 21±2 years), and humans who are at the two end-points of exercise capacity phenotypes, i.e. muscle endurance (50 male professional road cyclists) and muscle power (63 male jumpers/sprinters). Although there were no differences in genotype/allele frequencies between centenarians (RR:28.8%; RX:47.5%; XX:23.7%), and controls (RR:31.8%; RX:49.8%; XX:18.4%) or endurance athletes (RR:28.0%; RX:46%; XX:26.0%), we observed a significantly higher frequency of the X allele (P = 0.019) and XX genotype (P = 0.011) in centenarians compared with power athletes (RR:47.6%; RX:36.5%;XX:15.9%). Notably, the frequency of the null XX (α-actinin-3 deficient) genotype in centenarians was the highest ever reported in non-athletic Caucasian populations. In conclusion, despite there were no significant differences with the younger, control population, overall the ACTN3 genotype of centenarians resembles that of world-class elite endurance athletes and differs from that of elite power athletes. Our preliminary data would suggest a certain ‘survival’ advantage brought about by α-actinin-3 deficiency and the ‘endurance’/oxidative muscle phenotype that is commonly associated with this condition.

In other words, elite endurance athletes may be endowed with genes that predispose them to incredible feats of endurance and also exceptionally high life span. Their genes are the primary factor in determining their life span. This unique genetic profile is also common in centenarians, so perhaps we should be wondering why endurance athletes rarely live past 80 years of life, and not decades longer. If that is the case, it would appear that endurance sports do in fact negatively impact life expectancy. This theory is consistent with the longevity studies, the evidence showing negative health outcomes, and the evolutionary perspective that humans may not be well-adapted to endurance exercise. A lot more study is needed before the theory is confirmed, but it does tie everything together nicely.

Conclusions

What should we do with all this conflicting data and theory? Observational studies show higher life span among endurance athletes, but it could be due to genetic or other factors, and new clinical studies show detrimental cardiovascular effects from endurance exercise. Still, we can’t wait for better studies or new insights to guide us, we live in the world now and must decide on a course of action now. I suggest we exercise a little epistemic modesty and admit that we can’t say for sure what the effect of extreme endurance sports are on human life expectancy. In this case, I think we should follow the examples we can observe in nature that hint at the evolutionary appropriateness of endurance exercise. While some hunter gatherers engage in persistence hunting, most do not, and evidence that it occurred in the past is has been contended.

The honest answer right now is that we don’t know how extreme endurance exercise affects life span, but there are not-yet-established scientific and evolutionary reasons to believe humans aren’t optimally adapted to it, and the observed increase in endurance athlete life span is due to genetic differences, not the effect of endurance exercise. Therefore, I think the best course of action is to avoid extreme endurance exercise, and if you do engage in it, limit it’s frequency to protect your heart. Also be aware that it may cause still unknown health problems due to its evolutionary discordance (a hint of unwelcome unknown unknowns).

Postscript on Cycling Folklore

You may have heard the claim that professional cyclists life spans are shortened on average by 15 years. Tim Moore made this claim in his book French Revolutions: Cycling the Tour de France.[26] (Read the excerpt on Google Books) I could not find his source for that claim, he did not respond to my tweet (his only contact method) asking for evidence, nor could I find a study that supports it, which leads me to believe that this claim might be a bit of cycling folklore. It’s been repeated in The New Statesman and other media outlets. He might counter that new doping methods and drugs caused a more recent decline in pro cyclist life span that would not appear in studies with subjects from previous generations. Maybe it’s true, but studies available at the time didn’t support it.

References

1. Sanchis-Gomar F, Olaso-Gonzalez G, Corella D, Gomez-Cabrera MC, Vina J. Increased Average Longevity among the “Tour de France” Cyclists. Int J Sports Med. 2011 Aug;32(8):644-7. Epub 2011 May 26. PubMed PMID: 21618162.

2. Fiscella K, Franks P. Individual income, income inequality, health, and mortality: what are the relationships? Health Serv Res. 2000 Apr;35(1 Pt 2):307-18. PubMed PMID: 10778817; PubMed Central PMCID: PMC1089103.

3. Teramoto M, Bungum TJ. Mortality and longevity of elite athletes. J Sci Med Sport. 2010 Jul;13(4):410-6. Epub 2009 Jul 1. Review. PubMed PMID: 19574095.

4. Karvonen MJ, Klemola H, Virkajärvi J, Kekkonen A. Longevity of endurance skiers. Med Sci Sports. 1974 Spring;6(1):49-51. PubMed PMID: 4826692.

5. Sarna S, Kaprio J, Kujala UM, Koskenvuo M. Health status of former elite athletes. The Finnish experience. Aging (Milano). 1997 Feb-Apr;9(1-2):35-41. PubMed PMID: 9177584.

6. Sarna S, Sahi T, Koskenvuo M, Kaprio J. Increased life expectancy of world class male athletes. Med Sci Sports Exerc. 1993 Feb;25(2):237-44. PubMed PMID: 8450727.

7. Kujala UM, Tikkanen HO, Sarna S, Pukkala E, Kaprio J, Koskenvuo M. Disease-specific mortality among elite athletes. JAMA. 2001 Jan 3;285(1):44-5. PubMed PMID: 11150106.

8. Wilson M, O’Hanlon R, Prasad S, Deighan A, Macmillan P, Oxborough D, Godfrey R, Smith G, Maceira A, Sharma S, George K, Whyte G. Diverse patterns of myocardial fibrosis in lifelong, veteran endurance athletes. J Appl Physiol. 2011 Jun;110(6):1622-6. Epub 2011 Feb 17. PubMed PMID: 21330616; PubMed Central PMCID: PMC3119133.

9. Breuckmann F, Möhlenkamp S, Nassenstein K, Lehmann N, Ladd S, Schmermund A, Sievers B, Schlosser T, Jöckel KH, Heusch G, Erbel R, Barkhausen J. Myocardial late gadolinium enhancement: prevalence, pattern, and prognostic relevance in marathon runners. Radiology. 2009 Apr;251(1):50-7. PubMed PMID: 19332846.

10. Luthi P, Zuber M, Ritter M, Oechslin EN, Jenni R, Seifert B, Baldesberger S, Attenhofer Jost CH. Echocardiographic findings in former professional cyclists after long-term deconditioning of more than 30 years. Eur J Echocardiogr. 2008 Mar;9(2):261-7. PubMed PMID: 17470417.

11. Möhlenkamp S, Lehmann N, Breuckmann F, Bröcker-Preuss M, Nassenstein K, Halle M, Budde T, Mann K, Barkhausen J, Heusch G, Jöckel KH, Erbel R; Marathon Study Investigators; Heinz Nixdorf Recall Study Investigators. 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. Epub 2008 Apr 21. PubMed PMID: 18426850.

12. Neilan TG, Januzzi JL, Lee-Lewandrowski E, Ton-Nu TT, Yoerger DM, Jassal DS, Lewandrowski KB, Siegel AJ, Marshall JE, Douglas PS, Lawlor D, Picard MH, Wood MJ. Myocardial injury and ventricular dysfunction related to training levels among nonelite participants in the Boston marathon.Circulation. 2006 Nov 28;114(22):2325-33. Epub 2006 Nov 13. PubMed PMID: 17101848.

13. La Gerche A, Prior DL, Heidbüchel H. Strenuous endurance exercise: is more better for everyone? Our genes won’t tell us. Br J Sports Med. 2011 Mar;45(3):162-4. Epub 2010 Dec 27. PubMed PMID: 21187292.

14. Smathers AM, Bemben MG, Bemben DA. Bone density comparisons in male competitive road cyclists and untrained controls. Med Sci Sports Exerc. 2009 Feb;41(2):290-6. PubMed PMID: 19127198.

15. Medelli J, Lounana J, Menuet JJ, Shabani M, Cordero-MacIntyre Z. Is osteopenia a health risk in professional cyclists? J Clin Densitom. 2009 Jan-Mar;12(1):28-34. Epub 2008 Oct 1. PubMed PMID: 18835799.

16. Campion F, Nevill AM, Karlsson MK, Lounana J, Shabani M, Fardellone P, Medelli J. Bone status in professional cyclists. Int J Sports Med. 2010 Jul;31(7):511-5. Epub 2010 Apr 29. PubMed PMID: 20432201.

17. Topinková E. Aging, disability and frailty. Ann Nutr Metab. 2008;52 Suppl 1:6-11. Epub 2008 Mar 7. Review. PubMed PMID: 18382070.

18. Lee SJ, Murphy CT, Kenyon C. Glucose shortens the life span of C. elegans by downregulating DAF-16/FOXO activity and aquaporin gene expression. Cell Metab. 2009 Nov;10(5):379-91. PubMed PMID: 19883616; PubMed Central PMCID: PMC2887095.

19. Ruckenstuhl C, Carmona-Gutierrez D, Madeo F. The sweet taste of death: glucose triggers apoptosis during yeast chronological aging. Aging (Albany NY). 2010 Oct;2(10):643-9. Review. PubMed PMID: 21076182; PubMed Central PMCID: PMC2993794.

20. O’Keefe JH, Vogel R, Lavie CJ, Cordain L. Achieving hunter-gatherer fitness in the 21(st) century: back to the future. Am J Med. 2010 Dec;123(12):1082-6. Epub 2010 Sep 16. Review. PubMed PMID: 20843503.

21. Bramble DM, Lieberman DE. Endurance running and the evolution of Homo. Nature. 2004 Nov 18;432(7015):345-52. PubMed PMID: 15549097.

22. Liebenberg L. The relevance of persistence hunting to human evolution. J Hum Evol. 2008 Dec;55(6):1156-9. Epub 2008 Aug 29. PubMed PMID: 18760825.

23. Pickering TR, Bunn HT. The endurance running hypothesis and hunting and scavenging in savanna-woodlands. J Hum Evol. 2007 Oct;53(4):434-8. Epub 2007 Aug 27. PubMed PMID: 17720224.

24. Liebenberg L. Persistence Hunting by Modern Hunter-Gatherers. Current Anthropology. 2006; 47:6.

25. Fiuza-Luces C, Ruiz JR, Rodríguez-Romo G, Santiago C, Gómez-Gallego F, Yvert T, Cano-Nieto A, Garatachea N, Morán M, Lucia A. Are ‘endurance’ alleles ‘survival’ alleles? Insights from the ACTN3 R577X polymorphism. PLoS One. 2011 Mar 3;6(3):e17558. PubMed PMID: 21407828; PubMed Central PMCID: PMC3048287.

26. Moore T. French Revolutions, Cycling The Tour De France. Griffin, 2003. Web.

Why Do You Ride? Health and Longevity or Maximum Cycling Fitness

My main problem with cycling is the major emphasis on cycling fitness rather than health and longevity. Let’s face it, the large majority of cyclists aren’t competitive professionals. Nor do we want to be. We ride for fun and to improve and maintain our health. But the emphasis on improving speed, distance, power output, and other measures of fitness create this disconnect. These things are important to winning races. They are not especially important to improving health and living a long time. In fact, they may actually be working against it.

Do you care about your VO2 max or lactic threshold? Me either. What I do care about is reducing my likelihood of suffering from the diseases of civilization (cancer, heart disease, diabetes, i.e. diseases that were extremely rare in our pre-agricultural past), keeping body fat low while retaining muscle mass, and having fun. Will endless, Puritanical struggling to improving your cycling fitness help achieve these goals? I doubt it, but before we get to that, let’s talk about the Paleo lifestyle.

Paleo is a lifestyle that improves health and compresses the morbidity of the end of life through approximating the environment in which human genes evolved. This is accomplished through modifying diet and exercise to better match the diet and exercise of our ancient ancestors from the Paleolithic Period, where the overwhelming majority of human evolution occurred. Present your genes with the environment (including the food and exercise) they expect, and they will reward you with optimal health. Think of a wild animal in captivity in a zoo. It will get sick, get fat, get depressed, fail to reproduce or it’s off-spring won’t survive infancy, but all of the effects of captivity are reversed when it’s returned to the wild. We are animals and modern life is the “zoo” deterring us from the environment to which we are adapted. We can approximate a return to the wild to achieve optimal health, leaving behind modern food and physical stresses to which human genes are poorly adapted. That’s Paleo in a nutshell.

Does cycling fit into this perspective? Like most questions, the answer is “it depends,” but assuming we’re considering the type of cycling that cycling culture encourages, the answer is definitely “no.”

The end result of training for cycling fitness instead of health.

I’m talking about cycling long distances, at consistently high heart rates, while consuming a steady stream of high-sugar drinks and foods. There is nothing in our ancestral past that would suggest that our genes are adapted to exercising this way. This type of exercise goes by the pejorative “chronic cardio” within the Paleo community, and for good reason.

Beyond the evolutionary argument, there is emerging science that suggests that lifelong endurance cycling is bad for your heart,[1,2] your bones,[3-5] your muscles,[6] and potentially increases your risk of cancer.[7] Abusing sugary “sports drinks” and foods might lead to metabolic derangement (then diabetes), and there are some scientific clues that sugar consumption might be one of the causes of aging.[8,9] Beyond that, a fragile skeleton and low muscle mass are well-established harbingers of an early grave.[10-12]

Is that worth shaving 30 seconds off your 40k time trial time? It is for some, and to each his own. The point I want to make is that the perception that endurance athletes are a model for optimal human health is flat wrong. Just ask this one. Some love cycling enough to make this sacrifice. Some are competitive professionals who’ve dedicated their lives to it. For them, this trade-off in health is OK. But most of us don’t want to go down that road. We want to maximize health and longevity, and we want to include cycling to do it. To do this we must recognize that cycling fitness and health are not always directly related.

That’s why I created this blog. To explore evolutionarily-informed cycling and health, and to challenge the dominant fitness-maximizing paradigm in cycling that, I believe, comes at the expense of health.

References

1. Wilson M, O’Hanlon R, Prasad S, Deighan A, Macmillan P, Oxborough D, Godfrey R, Smith G, Maceira A, Sharma S, George K, Whyte G. Diverse patterns of myocardial fibrosis in lifelong, veteran endurance athletes. J Appl Physiol. 2011 Jun;110(6):1622-6. Epub 2011 Feb 17. PubMed PMID: 21330616; PubMed Central PMCID: PMC3119133.

2. Luthi P, Zuber M, Ritter M, Oechslin EN, Jenni R, Seifert B, Baldesberger S, Attenhofer Jost CH. Echocardiographic findings in former professional cyclists after long-term deconditioning of more than 30 years. Eur J Echocardiogr. 2008 Mar;9(2):261-7. PubMed PMID: 17470417.

3. Smathers AM, Bemben MG, Bemben DA. Bone density comparisons in male competitive road cyclists and untrained controls. Med Sci Sports Exerc. 2009 Feb;41(2):290-6. PubMed PMID: 19127198.

4. Medelli J, Lounana J, Menuet JJ, Shabani M, Cordero-MacIntyre Z. Is osteopenia a health risk in professional cyclists? J Clin Densitom. 2009 Jan-Mar;12(1):28-34. Epub 2008 Oct 1. PubMed PMID: 18835799.

5. Campion F, Nevill AM, Karlsson MK, Lounana J, Shabani M, Fardellone P, Medelli J. Bone status in professional cyclists. Int J Sports Med. 2010 Jul;31(7):511-5. Epub 2010 Apr 29. PubMed PMID: 20432201.

6. Knechtle B, Baumann B, Wirth A, Knechtle P, Rosemann T. Male ironman triathletes lose skeletal muscle mass. Asia Pac J Clin Nutr. 2010;19(1):91-7. PubMed PMID: 20199992.

7. Reichhold S, Neubauer O, Bulmer AC, Knasmüller S, Wagner KH. Endurance exercise and DNA stability: is there a link to duration and intensity? Mutat Res. 2009 Jul-Aug;682(1):28-38. Epub 2009 Feb 20. Review. PubMed PMID: 19699460.

8. Lee SJ, Murphy CT, Kenyon C. Glucose shortens the life span of C. elegans by downregulating DAF-16/FOXO activity and aquaporin gene expression. Cell Metab. 2009 Nov;10(5):379-91. PubMed PMID: 19883616; PubMed Central PMCID: PMC2887095.

9. Ruckenstuhl C, Carmona-Gutierrez D, Madeo F. The sweet taste of death: glucose triggers apoptosis during yeast chronological aging. Aging (Albany NY). 2010 Oct;2(10):643-9. Review. PubMed PMID: 21076182; PubMed Central PMCID: PMC2993794.

10. Topinková E. Aging, disability and frailty. Ann Nutr Metab. 2008;52 Suppl 1:6-11. Epub 2008 Mar 7. Review. PubMed PMID: 18382070.

11. Sirola J, Kröger H. Similarities in acquired factors related to postmenopausal osteoporosis and sarcopenia. J Osteoporos. 2011;2011:536735. Epub 2011 Aug 28. PubMed PMID: 21904688.

12. Ensrud KE, Ewing SK, Taylor BC, Fink HA, Stone KL, Cauley JA, Tracy JK, Hochberg MC, Rodondi N, Cawthon PM; for the Study of Osteoporotic Fractures Research Group. Frailty and risk of falls, fracture, and mortality in older women: the study of osteoporotic fractures. J Gerontol A Biol Sci Med Sci. 2007 Jul;62(7):744-51. PubMed PMID: 17634322.