Intense Exercise & Potential Heart Damage (aka Athlete's Heart)

**Andy Galpin** (0:00)
The science and practice of enhancing human performance for sport, play, and life. Welcome to Perform. I'm Dr. Andy Galpin. I'm a professor and scientist and the executive director of the Human Performance Center at Parker University. Today, we're going to start with a story. In fact, it's a ghost story with a character by the name of Caballo Blanco. For those Spanish-speaking friends out there, that of course means the white horse. Caballo, as he was referred to, terrorized and mystified the Copper Canyon Range of the Sierra Madres in Northern Mexico for the better part of 20 years. Many years later, of course, the story would be unraveled as an individual by the name of Micah True, which was also in fact not his real name. But as the lore goes, Micah or Caballo lived most of his life in this desolate canyon region. He would live running between 30 and 60 miles from village to village, gathering up resources and then running back to his hut. And no one really knew what the heck he was doing. Micah himself was running somewhere between 160 to 170 miles per week for nearly two decades. And again, keep in mind, he was doing this in an area where he had no access to running shoes, medical care or really any advanced technology, nutrition, hydration strategies to simply surviving by running large amounts every day for decades on end. Micah's story was made famous by the best selling book Born to Run. You can read more about it there. But really, he became one of the most central and legendary figures in the ultra marathon circles. This launched, of course, an entire generation of ultra runners. But where the story is of use today is the fact that Micah himself, while running those 150 to 170 miles per week for decades, eventually end up dying at age 58 during a very routine 12-mile jog.
And if you're from the running community or world at all, you probably know this exact story. If you don't know of Micah himself, you know the bigger plot here. And that is this juxtaposition or paradox between really incredibly highly cardiovascularly fit individuals, oftentimes runners, who then end up paradoxically dying in mid to early age of cardiovascular disease.
And so if you looked at the title of this show and were kind of wondering what it meant, this is really exactly what I'm talking about. It's this phenomenon of trying to understand, well, how are these people who are elite in this physiological area also at extremely high risk?
The story itself is really as old as we've understood cardiovascular physiology.
And so when we actually get into what's happening here, we don't know Caballo's story itself. It took them several days to actually find him. He was lost in the middle of a canyon somewhere. And by the time they got to him, it was too difficult to perform a proper autopsy. But the prevailing wisdom here is he likely died of something called left ventricular cardiac myopathy. I'll get into what all that means here very momentarily. Where this has gotten more difficult is then cardiologists and other medical professionals have tried to inspire and help the world. And in the sense of preventative care here, we've also led to confusion and concern about really what is this relationship between exercise, extreme exercise and cardiovascular health. And so I think the best way to think about this is to split it into two broad categories. The first is the classic case of cabio, what I just described. These are the folks who are typically between 30 to 50 or so years old. It's generally men, though it can occasionally happen women, who have this paradoxical extreme cardiovascular fitness, and then they suddenly die in the middle of a race or an activity from cardiovascular disease. You also then have what people are probably potentially more familiar with, and that is the young athlete. So this is your, again, typically 12 to 20 year old, who has no apparent signs and symptoms, and then unfortunately passes away during physical activity. I'm bringing this up today for the unfortunate news, the fact that I have personal experience with this. A friend of mine, Mike Osuna, recently lost his 15 year old son, Lucas, to a similar event.
So I think it's really important to me to cover this topic, because some of this is preventative. We can do something about this. At the same time, we're causing unnecessary confusion in it. And so what I really wanted to cover today with this athlete heart idea, is what do we really know about this situation? Why does it happen? What's causing it? How do we prevent it? What do we look for? And so we can separate the fact from the fiction as much as we know the information. I'll skip to the end here. We don't know everything right now. We certainly know plenty of things that I think are very actionable and helpful, but we have way more to learn. And so I believe it's personally important for all of us to understand, what do we look for again? What is preventable? How do we do that? And that we can hedge people against the two major pitfalls, one being unnecessary risk. So when are we putting ourselves in a situation where we probably should be considered, or at least understand the true risk that we're in, and not be overconfident? The other side of that equation is the opposite, where we're inducing unnecessary fear of exercise or running on people when it is completely unnecessary. I think once people have that information, they can make whatever choice they would like. That's not up to me to decide. That is entirely up to you. But I believe it would be helpful for us to truly understand what do we know scientifically? What do we know clinically right now about this really interesting paradox of the athlete's heart? The presenting sponsor of this podcast is Momentous. Momentous makes the highest quality supplements on the market, period. I literally spent years vetting their products, company and leadership team before officially partnering with them in 2023 Every single one of Momentous' products is third-party tested to ensure quality. And many are even NSF certified for sport. Now, while I love all their products, I'm incredibly excited about their new Fiber Plus prebiotic. Almost everyone is seeking more energy, improved recovery and better performance. But most people are missing a key foundation to their overall health, and that's getting enough good fiber. In fact, 95% of Americans are failing to hit the recommended daily amount of fiber. Fiber powers gut health, which we know drives long-term performance. Proper gut health allows for better nutrient absorption, energy stability, recovery, inflammation control, and much more. I personally simply mix a scoop with their cinnamon flavor and some water every night. And by doing so, I make sure I'm covering any gaps I might have in my daily fiber intake that I try to get through eating a balanced whole food diet. If you'd like to try Fiber Plus or any of Momentus' best-in-class supplements, just go to livemomentus.com/galpin and use the code Galpin for up to 35% off your first order. Again, that's livemomentus.com/galpin and use the code Galpin for up to 35% off your first order. In 1899, we see this term athlete heart officially coined by a Swedish physician. What we started noticing was cross-country skiers had these enlarged or larger than normal hearts. Did not know if this was something they were born with. That's what allowed them to be good skiers or endurance athletes or something that they accrued as a result of their exercise. Well, about a decade or so later, since people were noticing this was happening mostly in runners, not because of anything special to running, but just because these were the events people were doing. And so athletes heart got turned into runners heart. You'll still hear this today. If you ever hear those phrases, athlete's heart or runner's heart, you can think of them as basically interchangeable. I will in short moment just tell you what the true scientific term for this phenomenon is. But in pop culture, runners heart, athlete's heart, it's basically the same thing here.