Exercise is now recognised as having a positive impact on nearly all types of physical and mental health outcomes and its effect on Cardiovascular Disease is particularly impressive. Mortality and morbidity directly due to exercise remain minimal even up to very intense levels and for the overwhelming majority, the benefits outweigh the risks.
The guidelines all state that any form of exercise provides Cardiovascular Disease risk reduction, with those newly starting exercise achieving greatest benefit and any subsequent increases providing significant but diminishing returns.
British and American guidelines recommend 150 minutes of moderate-intensity aerobic activity per week or 75 minutes of vigorous aerobic activity. Moderate-intensity exercise is considered to be any activity causing a raised heart rate and increased breathing but being able to speak comfortably and includes a brisk walk at 4 mph or cycling at 10–12 mph. So, you don’t need to be an Ironman Triathlete to gain benefit from exercise.
So, what is the rationale for really intense exercise? Can one have “too much of a good thing?”
There is emerging data that suggest a U-shaped relationship between exercise intensity and adverse cardiovascular events; moderate exercise is better than no exercise, but vigorous exercise may be harmful in some individuals particularly those predisposed to inherited cardiac conditions. Screening for this through a history, examination and blood tests as well as an ECG and echo can identify some individuals at risk.
Symptoms of dizziness, chest discomfort or unexplained shortness of breath during or following physical activity should always be reported and palpitations during exercise should always be considered abnormal.
Dr Lawrence Lear
Specialist Family Medicine
Medical Director – DIFC