The topic of fitness has always been controversial. Some claim that a healthy heart is made in the kitchen while others argue, the gym. Even Coca-Cola has recently shifted the dialogue from whether or not its sugary drinks are unhealthy and instead insists that consumers should simply exercise more. General knowledge dictates that a healthy diet and physical activity go hand in hand when improving one’s overall mental and physical well-being. Most people are asking two not-so-simple questions: which should be given more consideration? And is it possible to simply “overdo” it?

Evidence strongly suggests that a sedentary lifestyle ultimately leads to higher risk for heart attacks, strokes, heart failure, and diabetes. Because of this, doctors recommend at least three days of high-intensity physical activity a week. And yet, some perpetuate the myth that excessive cardiovascular activity can over-exert the heart muscle, leading to an unfortunate and untimely death. It’s unclear what constitutes as “too much exercise” or “running too much” as it differs from person to person, but we do know that bad practices like lifting weights that are entirely too heavy and neglecting rest days can contribute to injury over time. But besides best practice, is it fair to say that runners are at an even greater risk for heart failure?

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Triathletes spend a lot of time training to prepare for ultra-competitive races. Exercise can improve heart health by reducing body fat, improving blood pressure and glucose, lessening stress and increasing production of HDL cholesterol while also lowering LDL levels. Concerned parties often cite isolated stories about consistent runners who randomly collapse in over exertion-related situations. On the contrary, it appears that studies have been unable to successfully link a higher mortality rate to excessive exercise (correlation does not equal causation). Moreover, even though some have suggested in the past that endurance events such as half and full marathons and triathlons pose a threat to runners, this simply hasn’t been proven. Endurance races are taxing, both physically and mentally, however, no concrete evidence exists that runners are at a great risk for heart failure simply because they run. According to the New England Journal of Medicine, cardiac arrests occur in less than 1 percent of every 100,000 runners. Family history of heart disease must always be taken into consideration when assessing these numbers.

Not everyone is equipped to handle endurance training. Those with a family history of premature heart disease, current symptoms of heart disease, or high blood pressure should consult a doctor before engaging in strenuous activity. As science and technology continue to evolve, perhaps we will find more information linking premature heart issues with endurance training. But for now, we just can’t say it’s there.