Jogging does NOT cause heart disease


Periodically, I'll come across a knuckleheaded report like this one from Minneapolis:

Marathon Man’s Heart Damaged by Running?


Of course, the obligatory story about how a cardiologist came to the rescue and "saved his life" with a stent follows. In other words, a stent purportedly saved the life of this vigorous man with no symptoms and high capacity for exercise.

Does vigorous exercise, whether it's marathon running, long-distance biking, or triathlons, cause coronary disease? Should all vigorous athletes run to their doctor to see if they, too, need their lives to be "saved."

Let me tell you what's really going on here. People with the genetic pattern lipoprotein(a), or Lp(a), tend to be slender, intelligent and athletic. For genetic reasons, these people gravitate towards endurance sports like long-distance running. Lp(a) is a high-risk factor for coronary disease. It is the abnormality present in the majority of slender, healthy people who are shocked when they receive a high heart scan score or have a heart attack or receive a stent. (I call Lp(a) "the most aggressive known coronary risk factor that nobody's heard about.")

The association between endurance exercise and heart disease is just that: an association. It does not mean that exercise is causal. Having seen coronary plaque detected with heart scans in many runners, virtually all of whom demonstrated increased Lp(a), I believe that Lp(a) is causal.

Unfortunately, the man in the Minneapolis story, now that his life is "saved," will likely be advised to take a statin drug and follow a low-fat diet . . . you know, the diet that increases Lp(a).

Comments (20) -

  • Anna

    6/13/2009 2:55:22 PM |

    I get the point about the Lp(a).  

    But I wonder about the hormonal effect of a *lot* of running.  Does all that running that raise cortisol levels?

    Does the carb-loading that many athletes practice (increased insulin production) contribute to increased disease risk?

  • David

    6/13/2009 5:33:13 PM |

    I totally disagree. While, exercise at moderate amounts is obviously very beneficial, extreme amounts of exercise are counterproductive. Too much exercise causes a person's body to age much quicker.

    Why? It is a fact that extreme amounts of exercise causes one's body to utilize massive amounts of oxygen. Too much oxygen has been proven to cause massive free radical production. This is seen in hyperbaric chambers.

    The same thing happens when a person eats too much. The food we eat turns into energy ("oxidizes") and in turn produces massive amounts of oxygen. That's why caloric limitation is the only thing that has been absolutely proven to extend life and slow aging.

    High free radical production equals aging (damage to cells). While eating in moderate amounts is healthy and necessary, too much is bad. The same thing applies to exercise.

  • pmpctek

    6/14/2009 6:31:07 PM |

    So what you're basically saying is that everyone should have a Lp(a) test, even if we are of healthy weight, athletic, and  even if we follow the TYP program?  My GP already thinks I'm a hypochondriac, lol.

    "Exercise at moderate amounts..." now that phrase will conjure up as many definitions as there are people who exercise.   No one would think that a daily 30 minute walk would yield nearly the same level of health benefits as a daily 30 minute intense weight training session.  But then it's amazing how many mainstream "fitness gurus" designate the former activity as all that anyone needs.

    Okay, after we have a couple blood tests, and if they show elevated Lp(a), then what?  The only accepted treatment is 1 to 2 grams/daily of nicotinic acid, and maybe antioxidant supplements like C, E, and N-acetyl-cysteine, which I already take.

  • Kismet

    6/14/2009 8:33:28 PM |

    David, any references to back this theory up? We all know there must be a balance between enough (eliciting a hormetic response) and too much (damaging the body) exercise, but I'm not sure there's any evidence actually showing where the *exact* border lies, i.e. proving that X amount of exericse accelerates intrinsic and/or extrinisic aging while Y helps.

  • Dr. William Davis

    6/14/2009 10:08:07 PM |

    There are a world of treatments for Lp(a) reduction.

    They are fully discussed in detail on the Track Your Plaque website, the website that this blog is mean to supplement.

  • Anonymous

    6/14/2009 11:03:58 PM |

    "Extreme exercise" - whatever that is - causes accelerated aging?  And the evidence for this is...?

    And I am also to believe that "over-exercising" is akin to over-eating?

    I have heard such nonsense before. It just surprises me to read it here.

  • Anonymous

    6/14/2009 11:52:48 PM |

    I am a big follower of your findings and think they can really make a difference in our lives.  But hope you share this information and not require we pay for it.

  • Dr. William Davis

    6/15/2009 3:40:52 PM |

    Anonymous--

    I have personally put over $100,000 of my personal money to put this website up. Programmers need to be paid, though none of my staff are paid. There are also the costs of doing business, e.g, attorney fees, etc. This is a fairly costly operation, though nobody gets a salary.

    So I am personally shocked by attitudes that "I'll only do it if it's free." Free is what you get at WebMD, where the information is paid for by the drug industry. We do not take any money from the drug industry nor supplement industry. We pride ourselves on providing unbiased information. But somebody's got to pay the bills. I personaly got sick and tired of it. Putting in many hours a week for no financial return is my contribution.

  • Anonymous

    6/15/2009 5:29:54 PM |

    Kismet,

    Yes, its quite simple. Oxidative stress=aging/cell damage


    1. Overeating causes massive oxidative stress/premature aging. http://content.nejm.org/cgi/content/extract/337/14/986

    2. Extensive exercise such as Marathon running drastically increases oxidative stress/aging:

    http://www.ncbi.nlm.nih.gov/pubmed/16923247

    http://oregonstate.edu/dept/ncs/newsarch/2002/Feb02/stress.htm

  • Ricardo

    6/15/2009 8:35:54 PM |

    A few oxidative stress & exercise related articles:

    http://www.ebmonline.org/cgi/reprint/222/3/283.pdf
    http://www.anakarder.com/sayilar/29/2006-141-142.pdf
    http://www.ajcn.org/cgi/reprint/72/2/670S.pdf
    http://www.academicjournals.org/ajb/PDF/pdf2009/4Feb/George%20and%20Osharechiren.pdf
    http://driade.es/comunicacion/uploads/CSIC/SGFR/FPallardo/Sastreetal2003.pdf
    http://plaza.ufl.edu/cleeuwen/CMC8.PDF

  • David

    6/16/2009 3:19:13 AM |

    Sorry, my previous comment was intended for anonymous.

    As far as how much is too much in relation to exercise before it becomes counterproductive, that is yet to be deciphered.

  • Ross

    6/16/2009 4:46:07 AM |

    Distance runners tend to be huge on "healthy" low-fat (high-carb) diets, usually involving lots of high-fiber whole wheat products.

    Nuff said.

  • Anonymous

    6/16/2009 9:06:53 AM |

    The Oregon study referenced above studied ultramarathoners.  (I could not retrieve the other pubmed reference).


    Is there evidence  that immediate post-exercise "damage" is predictive of long-term adverse outcomes?

  • David

    6/16/2009 1:29:12 PM |

    Anonymous,

    There are actually many other studies that have well proved that the more exercise one does, the more free radical pathology (cell damage/oxidation) occurs. Just how much is enough, no one knows exactly, but we do know it dramatically increases once our antioxidant enzymes (eg. glutathione, superoxide dismutase, etc.)are overtaxed.

    Now, how does does oxidative stress and cell damage correlate with degenerative diseases? Well, two reasons, which are somewhat based on logical assumptions:

    1. Cell damage to the artery wall is the essence of atherosclerosis. (Many actually suggest that oxidation is a chief player in inflammation).

    2. It is generally agreed by all that caloric restriction dramatically increases lifespan. The 'Caloric restriction,' principle is not necessarily related to being overweight or obese. Neither is it related to healthy or non-healthy food consumption. Neither is it an overeating/under-eating issue. Caloric restriction is simply limiting the amount of energy producing foods (especially carbohydrates) for anybody, thin or heavy, which in turn, drastically impacts the health of that person.

    The question we have to ask ourselves is this: Why? Why does caloric restriction play a part in prevention of degenerative disease? One of the main answers scientists have suggested is oxidative stress.

  • Kismet

    6/17/2009 8:28:04 AM |

    David, what you do is commonly called "mechanistic speculation" -- I'm not saying you are wrong, but strictly speaking your guess is as good as mine: the point still stands, there is certainly a line whereafter exercise becomes damaging, but none of the provided references helps to us draw that line when it comes to *long term* health.
    Damage per se is not a good marker of anything due to hormesis. Aging would be defined as a build-up of *long-lived* damage that cannot be fixed by the cellular machinery; it's a tricky definition of a tricky problem after all.

  • Trinkwasser

    6/17/2009 1:34:01 PM |

    Damn! This exactly describes certain members of my family. I suspect one of the danger factors in excessive cardio level exercise is that they then fuel it with massive carb intakes, thus undoing all the benefits.

    I'm with Mark Sisson

    http://www.marksdailyapple.com/primal-blueprint-101/

  • David

    6/17/2009 1:36:22 PM |

    Kismet,

    I think it's safe to say that marathon running would be an example of too much exercise.

  • Treatment for heart disease

    9/27/2010 12:47:32 PM |

    Heart  disease is one of the most  dangerous disease which takes thousands of life every years all over the world. If we know its symptoms and Treatment for heart disease. We can prevent is to large extent.

  • buy jeans

    11/3/2010 8:40:22 PM |

    There are actually many other studies that have well proved that the more exercise one does, the more free radical pathology (cell damage/oxidation) occurs. Just how much is enough, no one knows exactly, but we do know it dramatically increases once our antioxidant enzymes (eg. glutathione, superoxide dismutase, etc.)are overtaxed.

  • pammi

    11/9/2010 9:22:29 AM |

    Heart  disease is one of the most  dangerous disease which takes thousands of life every years all over the world. If we know its symptoms and Treatment for heart disease. We can prevent is to large extent.

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Track Your Plaque in the news

Track Your Plaque in the news

The NPR Health Blog contacted me, as they were interested in learning more about health strategies and tools that are being used by individuals without their doctors. The Track Your Plaque website and program came up in their quest, as it is the only program available for self-empowerment in heart disease.

Several Track Your Plaque Members spoke up to add their insights. The full text of the article can be viewed here.

How's Your Cholesterol? The Crowd Wants To Know
Mainstream medicine isn't in favor of self-analysis, or seeking advice from non-professionals, of course. And anyone who does so is running a risk.

But there are folks who want to change the course of their heart health with a combination of professional and peer support. Some are bent on tackling the plaque that forms in arteries that can lead to heart disease. They gather online at Track Your Plaque, or "TYP" to the initiates.

"We test, test, test ... and basically experiment on ourselves and have through trial and error came up with the TYP program, which is tailored to the individual," Patrick Theut, a veteran of the site who tells Shots he has watched his plaque slow, stop and regress.

The site was created in 2004 by Bill Davis, a preventive cardiologist in Milwaukee, Wisc. Davis is also the author of Wheat Belly: Lose the Wheat, Lose the Weight and Find Your Path Back to Health, which argues that wheat is addictive and bad for most people's health. Davis recommends eliminating wheat from the diet to most new members of Track Your Plaque.

"The heart is one of the hardest things to self-manage but when you let people take the reins of control, you get far better results and far fewer catastrophes like heart attacks," Davis tells Shots.

Doctors typically give patients diagnosed with heart disease two options: take cholesterol-lowering statin drugs, or make lifestyle changes, like diet. It's usually far easier for both parties — the doctor and the patient — to go with the drugs than manage the much more difficult lifestyle changes, Davis says.

"Doctors say take the Lipitor, cut the fat and call me if you have chest pain," he explains. "But that's an awful way to manage care."

TYP has members submit their scores from heart CT scans, cholesterol values, lipoproteins and other heart health factors to a panel of doctors, nutritionists and exercise specialists. Then they receive advice in the form of an individualized plaque-control program. But the online forum, where users share their results with other members and exchange tips, is where most of the TYP action happens.

The community currently has about 2,400 members who pay $39.95 for a quarterly membership, or $89.75 for a yearly membership. Davis says all proceeds go towards maintaining the website.

Ilaine Upton is a 60-year-old bankruptcy lawyer from Fairfax, Va., and a TYP member. At a friend's suggestion, Upton decided to get a heart CT scan in July. Her score was higher than it should have been (22 instead of 0), so she decided to get her blood lipids and cholesterol tested, too, and sent a sample off to MyMedLabs.com.

She learned that her LDL particle count was over 2,000 ("crazy high," she says), and she posted her results on TYP. Davis advised her that a low-carb diet would reduce it, so she decided to try it.

Since July, she says she has had "excellent results" with the program, and her LDL counts are coming down.

"It would be nice to have a [personal] physician involved in this, but [my insurer] Blue Cross won't pay if you are not symptomatic, and I am trying to prevent becoming symptomatic," says Upton. "I feel very empowered by this knowledge and the ability to take better control of my health by getting feedback on the decisions I make."

Comments (6) -

  • Ali

    9/24/2012 8:24:33 PM |

    Dear Dr. William Davis,

    You have been a tremendous force in helping me recapturing my life. I called your office today. Let them know that I live in Baltimore Maryland and would like to see if it is possible for you to review some details of my cardiovascular disease status. I can send you my history and blood test information through email. You can interview me over the phone if you feel it is necessary. I can pay the bill related to the “virtual” visits using check, money order, visa, etc and in advance; however the preference is.

    Please advise. Thanks again for having made TrackYourPlaque possible. It is truly a practical tool for shifting the paradigm in health management.

    Ali Khorramshahi
    ............................................................................................................
    DigitaLogic, Inc.
    711 West 40th Street.  Suite 315 Baltimore, MD 21211
    t: 410.662.9500 Ext. 2545 o I o f: 410.662.9400 o I o e: ali@DigitaLogic.com
    c: 443.845.6033
    h: 410-669-3266

  • Dr. Davis

    10/3/2012 1:41:56 AM |

    Thank you, Ali.

    But I would urge you to use the resources here and in the Track Your Plaque program, as well as the information in the Wheat Belly book and blog.

    Given the pressures on my time, I am no longer able to see new patients and am barely able to provide any more teleconferences, as I am traveling to speak and consult for the development of new, alternative, wheat-free foods.

  • Gene K

    10/10/2012 2:43:39 PM |

    Dr Davis,

    It would be nice if your 2nd edition of the Track Your Plaque book were actually published. I've been using it in PDF, but your TYP followers need it as a real book, on par with Wheat Belly. Do you have plans to do it?

    Thank you so much for everything you are doing!

  • Jim Stewart

    11/21/2012 5:41:48 PM |

    I have been scouring your website and have not found what I am looking for.

    I want to lay out for my cardiologist a clear and detailed request as to why he should support the required testing in TYP.  They do not have respect for any course of action other than the current generally  accepted, woefully inadequate, standard of care. I recently had 3 stents to correct 2 100% blockages (RCA and Circumflex).  Kaiser will not pay for scans nor any lipid testing other than total cholesteral since they say the results will not alter their proscribed treatment.  I want to undestand why I have the CAD and take steps to measure and reverse it.  I do not wish to wait till the widowmaker clots too.

  • Dr. Davis

    11/22/2012 1:40:35 AM |

    Then, I fear, Jim, that the answers will not come from your doctor. Your best bet is to get out of the system and/or find someone within the system willing to work with you.

    In effect, your doctor is saying, "I have chosen to ignore the thousands of studies that demonstrate why simple cholesterol testing fails to fully characterize coronary risk in a substantial number of people. I therefore place the burden of proof on YOU."

    Imagine you take your car to the mechanic and ask why the engine isn't running. Instead of providing an answer, the mechanic says, "Hey, if you want your car fixed, then you tell me what you want done!" We would walk out in disgust. You should do the same with your doctor.

    YOU are not the problem. Your doctor is the problem.

  • Susan Brauer

    2/17/2013 3:25:45 AM |

    Can you supply a list of doctors who agree with your approach to heart disease.  I am trying to get my doctor to authorize a VAP test and they will not do it because they have never heard of it before.  It is so aggravating that I can't just get one done.  I live in Springfield, Illinois.

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