Should We Exercise Less as we Age?

An article in the Wall Street Journal can be misinterpreted to mean that old people shouldn't exercise, and that they should keep their heart rate below a certain number of beats. But let me disect this article to make sure you understand it. The author isn't lying, and he isn't being deceitful, but it can be easily misunderstood.

Sudden cardiac death (SCD) is natural death from cardiac cause within a short time period less than one hour after onset of symptoms. It's the most common fatal manifestation of cardiac disease. Almost 2/3s of deaths attributed to cardiac death are SCD. When SCD is exercise-related, it is associated with obstruction of two or more coronary arteries, or ruptured atheroslcerotic plaque and extensive blood cotting. Fatty depsoits break away from the artery wall and block the artery. During exercise, these ruptures can occur in the center of the artery. When this happens, you die.

Exercise can also cause an imbalance between oxygen delivery and oxygen demand, which can result in ventricular arrhythmias, or irregular heartbeats. When the symphatiec nervous system turns on the flight-or-fight mode, the coronary artries expand, but not in those with coronary heart disease. The chambers of the heart don't fill and this reduces cardiac output. So exercise really only increases SCD for those who already have risk factors for coronary heart disease. Risk factors include gender, age , smoking, family history, and hypertension. Low levels of physical activity are also associated with myocardial infarction and SCD. The US Physicians Health Study showed that people who exercised four times per week were at a much lower risk than those who exercised once a week or less.

So there are many risk factors associated with SCD, intense exercise among them. However, if you make sure you adhere to a diet of clean food, you don't smoke, you consider your family history, and you have no contraindications (unlike Mr. Helliker), intense exercise is unlikely going to kill you.

Back to the article. Kevin Helliker, the author, has been told not to cross 120 BPM at any time, even during the triathlons he competes in. He writes, "unquenched competitiveness can become a threat to their stiffening joints, ridgid muscles, hardening arteries and high-mileage hearts." First of all, none of those ailments are inevitable. A good routine of stretching, a healthy diet, and proper recovery will drastically reduce the risk of those ailments. Mark Allen, an avid proponent of heart rate monitor training, is quoted: "If you have to go as fast at 50 as you did at 20, you will grind yourself into the ground and become stressed out."



I think this is obvious. Does anyone really believe they can go as fast at 50 as they did at 20? It's possible, assuming you were totally deconditioned at 20 and now you're an avid athlete later in life. But really the article comes down to this: you can't exercise as much or as intensely in your middle ages as you did when you were a young adult. Is this really anything new?



The article continues: "exercise can provide substantial protection against chronic ailments ranging from heart disease and diabetes to dementia and depression, all the while helping weight control. But like any medical treatment, exercise can also cause damage." There's still nothing new here. Exercise (or movement as I like to call it) is essential at any age. By more is not always better. More is not better for any athlete. You should do as much exercise as you can absorb.



"Older athletes struggling against declining performance are prone to excess training, which can hurt the immune system and raise levels of the stress hormone, cortisol." All athletes are prone to excess training, especially type-A triathletes.



As you age, you have to accept that you're going to slow down, and you're not going to be as strong as you were when you were in your 20s. This should seem obvious, and we need to adjust intensity and volume as we age. But this doesn't mean we can't win our age group, be extremely fit, and test our body's limits. You just have to know how to rest and recover properly.



Don't forget, this author has an aneurysm in his aortic root, which is a major contraindication for high-intensity exercise. I don't know how common aneurysms are, but they're probably very rare, and most people don't have them. While exercise increases the risk of sudden heart attacks, there are too many proven benefits of exercise to not perform it because of a fear of sudden cardiac death during your bike ride. Keep moving, and stay happy healthy and strong.



Kevin