#218 - AMA #38: Can you exercise too much?

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In this “Ask Me Anything” (AMA) episode, Peter dives deep into the question of whether there is such a thing as “too much exercise.” He explores the theoretical “J-curve” relationship between exercise and longevity, whereby mortality risk declines with increasing activity levels only to see an uptick above a certain exercise volume threshold. While Peter maintains that exercise is perhaps the single most important tool we have to live longer and live better, he explains the challenges involved in identifying an optimal dose. He takes a hard look at studies—many of which have contradictory results—to highlight major limitations in methodology and how readers could be misled. Additionally, he discusses the rare, but real, risks associated with extreme levels of physical activity and concludes by weighing the benefits against the risks of exercise.

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We discuss:

• How exercise reduces risk for all-cause mortality [2:40];
• Defining the metric called “MET” and how it’s useful for evaluating different exercises [8:00];
• The challenge in determining the optimal exercise doses and the limitations of methods used to study the effect of exercise [13:45];  
• Using VO2 max as a proxy for fitness to better predict mortality risk [19:30];
• Reviewing data which support the theory of a “J-curve” relationship between exercise and longevity [25:00];
• Importance of understanding p-values and statistical significance [33:45];
• Deconstructing the studies that show a J-curve: major limitations and how one could be misled [37:00];
• Peter’s takeaways on the theoretical “J-curve” relationship between exercise and longevity [51:30];
• Risk of sudden cardiac death from vigorous physical exertion [54:00];
• Atrial fibrillation associated with extreme levels of exercise [1:00:15];
• Parting thoughts: benefits of exercise far outweigh the risks [1:04:15]; and
• More.

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