title: Part 1: potential dangers of extreme endurance exercise: how much is too much? Part 2: screening of school-age athletes.
abstract: The question is not whether exercise is or isn't one of the very best strategies for improving quality of life, cardiovascular (CV) health and longevity-it is. And there is no debate as to whether or not strenuous high-intensity endurance training produces an amazingly efficient, compliant, and powerful pump-it does. The essence of the controversy centers on what exactly is the ideal pattern of long-term physical activity (PA) for conferring robust and enduring CV health, while also optimizing life expectancy. With that goal in mind, this review will focus on the question: "Is more always better when it comes to exercise?" And if a dose-response curve exists for the therapeutic effects of PA, where is the upper threshold at which point further training begins to detract from the health and longevity benefits noted with moderate exercise? The emerging picture from the cumulative data on this hotly debated topic is that moderate exercise appears to be the sweet spot for bestowing lasting CV health and longevity. However, the specific definition of moderate in this context is not clear yet.
authors.affiliation: Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, MO. Electronic address: jokeefe@saint-lukes.org.
authors.forename: James H
authors.initials: JH
authors.lastname: O'Keefe
authors.affiliation: Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, LA; Department of Preventive Medicine, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA.
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Lavie
authors.affiliation: Heart Failure Unit, IRCCS Policlinico San Donato, University of Milano, Milan, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Guazzi
mesh_terms: D056352:Athletes / Q000706:statistics & numerical data; D001265:Athletic Injuries / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000517:prevention & control; D002423:Cause of Death; D015444:Exercise / Q000502:physiology*; D040261:Harm Reduction; D006801:Humans; D010807:Physical Endurance; D011153:Population; D012306:Risk; D013177:Sports; D013995:Time
keywords: Atrial fibrillation; Cardiovascular; Exercise; Longevity; Physical activity; Running