Dr. Carl Lavie is the Medical Director of Cardiac Rehabilitation and Preventive Cardiology and Director of the Exercise Laboratory at Ocshner. He also serves as a consultant, working two days a month for preventative medicine at the Pennington Medical Research Center in Baton Rouge. As if he wasn’t busy enough, Lavie has recently been receiving attention for his research into the benefits, or lack thereof, of extreme exercise.
Lavie published a study in early June based on 52,000 non-runners compared to 14,000 runners. The study showed that the non-runners had a 19 percent lower mortality. The study also showed that the runners who ran less than 20 miles per week at slower paces had significant mortality reductions.
As people ran longer and faster, or they ran more times per week, the runners actually lost the survival benefit that they had with low amounts of running.
“We were trying to look and see if more is better, and what we expected would have been that running would have been associated with mortality benefit and then level off. But we actually found that it didn’t level off, it went the opposite way. So not only was more not better, it seemed like more was worse.”
Lavie explained that if you look at people right after they run a marathon, a large number of people have the same enzymes that are released during a heart attack, or the same enzymes that are released in bad heart failure. When scans were done on marathon runners’ hearts after a race, a large number have abnormal heart function. Most of these problems resolve within a week, but some runners end up having chronic problems.
Lavie says his toughest cases involve dealing with the triathletes and runners who are his patients. “I take care of a lot of people who are heavy runners. I take care of one man who’s in his 70s who has run a marathon in every state and every continent. So now we have to deal with all of these runners who want to do triathlons who either are worried about it or patients who are dealing with the fact that they’re not going to stop running. I know they’re not going to stop.
“The hard part is, how do you counsel them? How do you handle the fact that we know that it would be healthier for them if they just did a 30-minute or 40-minute run? So it’s handling the data we know in my own research and publications that is so difficult.” He continues, “You have to keep in mind that people who are doing these kinds of extreme events – they’re not doing it for health. People who do triathlons are doing it for the sport or they’re doing it for the ego or they’re doing it for the camaraderie or they become semi-addicted to exercise. Dealing with what to tell them is the hardest thing at the moment.”
Since the study came out, Lavie has been trying to get the serious runners to cut back some, but he realizes that it’s not as simple as that. “You’re not gonna get someone who wants to be doing triathlons to just stop doing them. So, they have to either be checked out more, or they have to think about if they have to run, if they should think about doing so at less intensity.”
Lavie says that the study has caused him to think more about how this will affect his patients, whether for good or bad. “It’s a dual issue – with most of my patients, the problem is that they’re not exercising enough. Most of the world isn’t doing enough exercise, so you don’t want to give the idea that exercise is bad. There are far more problems with people who are under-exercising as opposed to over-exercising. But then you have a problem with some people who are going overboard.”