#87 - Exercise and sports cardiology with Professor Paul D. Thompson
Aug 15, 2024
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Professor Paul D. Thompson, Chief of Cardiology Emeritus at Hartford Hospital, shares his extensive knowledge on exercise and heart health. He discusses the surprising prevalence of atrial fibrillation in athletes and the implications of coronary artery calcification. Recommendations include 8000 vigorous steps a day and the role of genetics in athletic performance. Thompson also emphasizes the balance between exercise intensity and enjoyment, alongside the importance of mentorship in advancing sports cardiology.
Accurate exercise guidance should come from qualified experts rather than social media influencers for effective heart health management.
Excessive endurance training can lead to negative cardiovascular outcomes like atrial fibrillation, highlighting the importance of moderation in exercise.
Personal anecdotes from renowned figures underscore the value of mentorship and collaborative experiences in understanding exercise's impact on health.
Genetics play a significant role in determining individual responses to exercise, influencing both performance and cardiovascular health outcomes.
Deep dives
The Importance of Exercise Information from Experts
Accurate exercise information is best sourced from qualified experts rather than social media influencers. The podcast highlights the need for individuals to rely on studies and research conducted by professionals in exercise physiology and cardiology. This approach ensures more reliable guidance on exercise-related health topics, particularly concerning the heart. The discussions aim to bridge the gap between scientific knowledge and public understanding of exercise benefits and risks.
Potential Negative Effects of High Intensity Exercise
There is evidence that excessive exercise can lead to negative cardiovascular outcomes, such as increased atrial fibrillation and coronary artery calcification. The podcast discusses how excessive endurance training may lead to changes in heart size that could predispose individuals to heart rhythm disturbances. This section emphasizes the importance of moderation in exercise routines, suggesting that more is not always better. Understanding personal limits and responding to body signals can help mitigate potential risks.
Personal Experiences and Insights on Training
The speaker shares personal anecdotes from their medical career, including experiences with renowned figures in exercise science. These stories highlight the value of mentorship and collaboration in advancing one's knowledge and expertise in the field. The importance of integrating practical experiences, such as training alongside experts, is also highlighted as a means of gaining valuable insights. This narrative exemplifies how one's journey can greatly shape their perspective on the relationship between exercise and overall health.
Research on Exercise and Atrial Fibrillation
The discussion touches upon the correlation between exercise and the increased likelihood of atrial fibrillation, particularly in male athletes. Several studies are referenced, indicating that lifelong endurance training may be associated with a heightened risk of developing this condition. It is postulated that increased heart size and structural changes may contribute to the vulnerability of athletes to heart rhythm abnormalities. The conversation encourages listeners to be aware of these risks while still promoting the overall benefits of exercise.
Coronary Artery Calcium and Its Relation to Exercise
The podcast explains that coronary artery calcification is a potential indicator of heart disease, often more prevalent among endurance athletes. However, a higher calcium score may not necessarily convey a higher risk of heart attack, particularly in active individuals. The notion that exercise can lead to calcium buildup is discussed, with an emphasis on the need for clarification in the public’s understanding of this relationship. It stresses the importance of regular check-ups and discussions about heart health in the context of an active lifestyle.
The Role of Genetics in Exercise Outcomes
The speaker addresses the influence of genetics on an individual's response to exercise and overall health outcomes. It's suggested that some people may be genetically predisposed to excel in endurance sports, impacting their cardiovascular health. The speaker highlights the complexity of attributing exercise benefits solely to physical activity due to genetic factors. Understanding one's unique genetic makeup can aid in personalizing exercise routines for optimal health benefits.
Practical Advice for Exercising Safely
Participants are reminded to listen to their bodies and be mindful of exercise intensity and duration, especially if they have existing health conditions. Prioritizing safety by examining symptoms during exercise is emphasized, with a recommendation to seek medical advice as necessary. The speaker encourages a balanced approach to fitness where enjoyment and sustainability are key components of an exercise regimen. This segment serves as a reminder that physical fitness should not come at the expense of personal health and safety.
Understanding the Benefits of Different Exercise Types
The podcast discusses how various types of exercise—moderate vs. high intensity—offer distinct benefits for heart health. Moderate activity, like brisk walking, can significantly improve health, while high-intensity training may enhance cardiovascular performance. It suggests that individuals should tailor their exercise programs based on personal goals, whether for health maintenance or competitive training. This differentiation encourages listeners to find the right balance between intensity and enjoyment in their fitness journeys.
Dr Glenn McConell chats with Professor Paul D. Thompson who is Chief of Cardiology, Emeritus at Hartford Hospital, Hartford, CT and Professor of Medicine, Emeritus at the University of Connecticut. He has published over 500 peer reviewed journal articles, was a past President of the American College of sports medicine (ACSM) and was a impressively fast marathon runner. This is the third of a series of podcast episodes on sport cardiology (See Professor Benjamin Levine and Associate Professor Andre La Gerche’s episodes). We covered a lot of ground. There is a greater prevalence of atrial fibrillation in athletes (is it due to larger hearts?). We discussed possible reasons why coronary artery calcium/calcification is higher in athletes. He recommends 8000 steps done vigorously per day. Exercise is very important for your health. What exercise to do depends on your goals and health status. See time stamps further much more. We discuss his free substack called 500 rules of cardiology. 0:00. Introduction 2:40. Previous IE podcast episodes on sports cardiology 5:30. Worked with ex physiol legend David Costill 8:00. Ex physiol legend Bengt Saltin 9:00. More than 500 publications, importance of collaboration 10:45. Can exercise have negative effects on the heart? 13:00. More atrial fibrillation in athletes (due to larger hearts?) 20:30. Genetics and exercise 25:15. Was excellent marathoner 27:30. Exercise and right ventricle “fatigue” 32:00. Genetics, exercise and longevity 34:10. Cut off points/prevalence of increased risk of atrial fibrillation 36:26. Atrial fibrillation, blood thinners and strokes 39:30. Daily aspirin and heart risk 42:42. Why coronary artery calcium/calcification (CAC) higher in athletes? 48:40. Sex differences 51:03. Less heart beats per day in endurance athletes 53:40. Athletes, higher CAC and cardiovascular events 56:15. Exercise reduces cardiovascular events 58:30. Almost never restricts exercise in patients 1:00:20. Rationale to train hard 1:02:30. Most bang for your buck if less fit to start with 1:05:30. Cadence and turbulence in artery 1:09:30. Better athletes have more heart issues 1:11:40. Exercise intensity and coronary calcification 1:13:55. Walking and the heart 1:18:00. Fit handle operations/illnesses better 1:20:17. Statins and muscle pain /cholesterol 1:24:15. Medications vs lifestyle in diabetes 1:26:32. Metformin and exercise adaptations 1:27:15. Sudden death during exercise 1:29:25. Coronary narrowing and heart attacks 1:31:45. Best athletes have larger aortas 1:35:20. Intermittent fasting /ketosis 1:38:45. Exercise intensity and heart adaptations 1:39:40. Pay attention to symptoms 1:41:55. Broke his hip in a bike accident, cycles now 1:43:25. Exercise training early in life /epigenetics 1:47:05. Drugs and exercise performance 1:49:20. Environmental factors: eg walking to school 1:51:52. Cardiac sex differences re exercise 1:54:05. Wise advice 1:58:45. Be mindful of the media’s take on exercise 2:00:25. Takeaway messages 2:02:12. His free substack 500 rules of cardiology 2:02:59. Outro
Inside Exercise brings to you the who's who of research in exercise metabolism, exercise physiology and exercise’s effects on health. With scientific rigor, these researchers discuss popular exercise topics while providing practical strategies for all. The interviewer, Emeritus Professor Glenn McConell, has an international research profile following 30 years of Exercise Metabolism research experience while at The University of Melbourne, Ball State University, Monash University, the University of Copenhagen and Victoria University. He has published over 120 peer reviewed journal articles and recently edited an Exercise Metabolism eBook written by world experts on 17 different topics (https://link.springer.com/book/10.1007/978-3-030-94305-9). Connect with Inside Exercise and Glenn McConell at: Twitter: @Inside_exercise and @GlennMcConell1 Instagram: insideexercise Facebook: Glenn McConell LinkedIn: Glenn McConell https://www.linkedin.com/in/glenn-mcconell-83475460 ResearchGate: Glenn McConell Email: glenn.mcconell@gmail.com Subscribe to Inside exercise: Spotify: shorturl.at/tyGHL Apple Podcasts: shorturl.at/oFQRU YouTube: https://www.youtube.com/@insideexercise Anchor: https://anchor.fm/insideexercise Google Podcasts: shorturl.at/bfhHI Anchor: https://anchor.fm/insideexercise Podcast Addict: https://podcastaddict.com/podcast/4025218 Not medical advice
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