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The middle path

The middle path
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First Published: Mon, Mar 21 2011. 08 40 PM IST

Sweat it out: Regular moderate exercise boosts immunity.
Sweat it out: Regular moderate exercise boosts immunity.
Updated: Mon, Mar 21 2011. 08 40 PM IST
It was almost 2,500 years ago that Gautam Buddha spoke about the “middle path” in the very first teaching that he delivered after enlightenment. Roughly 200 years later, Aristotle spoke of the “golden mean” as the desirable middle between two extremes, one of excess and the other of deficiency.
Sweat it out: Regular moderate exercise boosts immunity.
This is applicable to everything in life, even the intensity and duration of exercise or physical activity. Too much of even a good thing can’t be right. How many of you know that drinking excessive amounts of water during a marathon can actually kill you? This happens simply because  hyponatraemic (low serum sodium concentration, i.e. less than 135 mmol per litre) encephalopathy develops in people who ingest excessive volumes of fluid during exercise and gain weight due to “water intoxication”.  
On the other hand, consuming the right amount of wine every day is beneficial for your heart. No, I am not suggesting you drink wine while you exercise.
So why is it an “aha” moment for us when a study, Diverse Patterns of Myocardial Fibrosis in Lifelong, Veteran Endurance Athletes, published online in February in The Journal of Applied Physiology, showed that lifelong, competitive endurance veteran athletes have some heart muscle scarring. To me that’s a moot point. It only works as ammunition for the super-lazy modernized human race to become even more sedentary.
I personally know a few members of the 100 Marathon Club, the same group from which some of the subjects were taken for the above-mentioned study done by M.G. Wilson, et al. These runners don’t run for health. They run because they love it. At times, it could be a vice, as it probably is in my case too.
If there is a takeaway from that study, it is “not to indulge in physical activity to extreme levels”, but then there aren’t enough people globally (and even fewer in India) indulging in sports and physical activity in the first place. On the other hand, there are way too many people with sedentary lifestyles out there, and that is far more dangerous.
During a 2006 panel discussion on “Exercise in the Age of Evidence-Based Medicine: A Clinical Update”, on the Medscape website, one of the panellists, Tim Church, professor, Pennington Biomedical Research Centre, Louisiana, US, made a very good point. The marathon runner who increases his mileage doesn’t get that much benefit, but the person who goes from couch potato to regular walker gets huge benefits.
Another panellist, Paul Thompson, professor of medicine, University of Connecticut, and director, division of cardiology, Hartford Hospital, Connecticut, US, didn’t mince his words. “I don’t want any comments about the risks of exercise to be an impediment to physicians recommending exercise for their patients because exercise has overwhelming benefits.”
This was in spite of Dr Thompson pointing out that when you’re actually engaged in exercise, the risk of sudden cardiac death and myocardial infarctions (commonly known as heart attack) increases. But he added that exercise reduces the overall risk of chronic diseases. The benefits of exercise very easily outweigh the disadvantages. The conclusion from this panel discussion was that all adults need 30 minutes of at least moderate intensity physical activity each day. This is equivalent to walking 2.5-3.25km at a speed of 5-6.5 kmph. Doing more exercise and perhaps more strenuous exercises may produce additional health benefits.
It’s also important to remember that a duration and intensity which has beneficial effects for one person could be harmful or not effective at all for another. The best way is to gradually increase the duration and intensity, one at a time. Soon enough, you’ll know your body better than doctors or personal trainers.
Rajat Chauhan is a practitioner of sports and exercise medicine and musculoskeletal medicine, CEO of Back 2 Fitness, and an ultra runner. Write to Rajat at treadmill@livemint.com
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First Published: Mon, Mar 21 2011. 08 40 PM IST