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Relationship Between Lifelong Exercise Volume and Coronary Atherosclerosis in Athletes

Legal disclaimer: since we are not doctors, do NOT follow anything based on health-related topics on this or related sites without first consulting with your doctor or other trusted health professional.This is NOT medical advice and we are not qualified in any way to offer medical advice.

See also: Mayo Clinic: Extreme Physical Activity May Increase Coronary Calcification, But Fitness Still Prevails (“Hearts of Stone”)

This article below bears directly on previous discussions on coronary atherosclerosis including my recent post Can an Extreme Endurance Athlete Have an Early Heart Attack?.

METs are a measure of oxygen consumption, with one MET corresponding to about 70 KCal. My caloric burn per hour when training intensively is about 740 calories per here, let»s round that down to 10 METs when rounded. During a double century, that typically drops to 650 to 680 KCal/hour depending on the course and how good I am feeling.

The last 4 days alone I have expended 8200 KCal* ~= 117 MET-hours. If I have that correct, than that is 117 * 60 = ~7000 MET-min, which far exceeds the study’s cutoff of 2000 MET-min/week—and the week has 3 days left. Having done this for years, it would surely explain my CT coronary calcium score.

* According to my highly accurate SRM power meter. Right now I am having problems with my SRM PC8 connecting to the computer and it may need to be fixed, but I plan to show an entire week’s overload-cycle spring training.

Relationship Between Lifelong Exercise Volume and Coronary Atherosclerosis in Athletes

Participants in the >2000 MET-min/wk group had a higher prevalence of CAC and atherosclerotic plaques. The most active group, however, had a more benign composition of plaques, with fewer mixed plaques and more often only calcified plaques. These observations may explain the increased longevity typical of endurance athletes despite the presence of more coronary atherosclerotic plaque in the most active participants.

The key take-aways from the article are:

  • Physically highly active individuals may have substantial, asymptomatic coronary atherosclerosis.
  • The plaque types of the most active group are more benign calcified plaques and need more study to understand the implications.
  • The relationship between high exercise volume and coronary artery calcification and plaque is as yet poorly understood.
  • The more calcified plaques in high volume athletes may offset calcification scores and contribute to superior life expectancy of athletes.
  • ...possible that it is not the duration of exercise that is most important in the development of coronary atherosclerosis but the intensity of exercise.
  • Underlying mechanisms for higher prevalence of CAC/plaque and increased calcification in athletes with the highest exercise volume and intensity are unknown.

This adds yet more context to the relatively context-free paint-by-numbers evaluation of heart disease favored in doctor’”s offices. Also, the data does not seem to have distinguished runners from cyclists, and runners take much more of a beating/pounding, which could affect the health of arteries.

See also

Various Interesting Health Findings in Science Daily: Exercise and Hidden Fat, Extreme Exercise and Heart Disease, Fasting, Brain and Fasting, Peripheral Neuropathy

MESA 10-Year CHD Risk With Coronary Artery Calcification

ACCEL: Detecting CAD in Older Athletes and What to Recommend When You Find

Expert Opinion: "Crazy for Ketones" – The Ketogenic Diet in Athletes: Variable Effects on Athletic Performance with Potential for Cardiovascular Harm

Expert Opinion: Fat for Thought – Any Role for the Ketogenic Diet in Athletic Training?

Coronary Atherosclerosis in Masters Athletes: Mechanisms and Implications for Cardiovascular Disease Risk

Association of All-Cause and Cardiovascular Mortality With High Levels of Physical Activity and Concurrent Coronary Artery Calcification


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