FoundMyFitness · 2024-05-29 · Rhonda Patrick (host), Benjamin Levine
Dr. Benjamin Levine: How Exercise Prevents & Reverses Heart Aging
72 research-tied claims examined: 5 contradicted 2 overstated 7 context 50 supported 8 unverified
2 Overstated
Collegiate athletes who had abnormalities on initial COVID triad screening but no cardiopulmonary symptoms had normal cardiac MRI scans.
"We then went on to do cardiac MRIs in a lot of people, a lot of athletes who had abnormalities in this triad, and if they didn't have cardiopulmonary symptoms, they didn't have anything wrong with their heart." (said at 0:10:14)
Large prospective registry data from collegiate athletics cohorts (such as the Outcomes Registry for Cardiac Conditions in Athletes, ORCCA) showed that routine 'cardiac triad' screening (ECG, troponin, echocardiography) had very low yield and high false-positive rates among athletes without cardiopulmonary symptoms. In ORCCA, among 3,018 athletes evaluated after COVID-19 infection, true cardiac involvement was rare (0.7%), and isolated triad abnormalities without symptoms rarely represented true myocarditis on cardiac MRI (CMR). However, stating definitively that none of these athletes 'had anything wrong with their heart' is an overstatement: isolated abnormalities did occasionally correlate with cardiac involvement, and multicenter registries (including the Big Ten COVID-19 Registry) identified subclinical myocardial involvement on CMR even in some asymptomatic athletes.
- context: SARS-CoV-2 Cardiac Involvement in Young Competitive Athletes. (Circulation 2021) · cited 265x in the literature
"A total of 2820 athletes underwent at least 1 element of cardiac triad testing (12-lead ECG, troponin, transthoracic echocardiography) followed by cardiac magnetic resonance imaging (CMR) if clinically indicated... Definite, probable, or possible SARS-CoV-2 cardiac involvement was identified in 21 of 3018 (0.7%) athletes... After adjustment for race and sex, predictors of SARS-CoV-2 cardiac involvement included cardiopulmonary symptoms (odds ratio, 3.1 [95% CI, 1.2, 7.7]) or at least 1 abnormal triad test result (odds ratio, 37.4 [95% CI, 13.3, 105.3])." (abstract, results, passage verified)
pubmedfull study (doi) - supports: Cardiac Troponin Testing as a Component of Return to Play Cardiac Screening in Young Compe… (Journal of the American Heart Association 2022) · cited 6x in the literature
"Of the 32 athletes with abnormal cTn testing, 19/32 (59%) underwent cardiac magnetic resonance imaging, 30/32 (94%) underwent transthoracic echocardiography, and 1/32 (3%) did not have cardiac imaging. One athlete with abnormal troponin met the criteria for definite or probable SARS-CoV-2 myocardial involvement. In the total cohort, 21/3184 (0.7%) had SARS-CoV-2 myocardial involvement, among whom 20/21 (95%) had normal troponin testing. Conclusions Abnormal cTn during routine return to play cardiac screening among competitive athletes following SARS-CoV-2 infection appears to have limited diagnostic utility." (abstract, results, passage verified)
pubmedfull study (doi)
Smartwatches that rely solely on photoplethysmography (PPG) are accurate for measuring heart rate at rest but are inaccurate during exercise.
"If you've got a watch, at rest it's pretty accurate. During exercise, the watches that just use the PPG, the plethysmogram, are not accurate." (said at 1:42:08)
While motion artifacts during exercise increase measurement error compared to resting conditions, stating that photoplethysmography (PPG) smartwatches are simply 'not accurate' during exercise is an overstatement. Systematic reviews and validation studies show that while performance varies across device models and activity types, many commercial PPG smartwatches maintain acceptable to high heart rate accuracy during exercise (often with an overall mean bias within ±3% to 5% relative to electrocardiography or telemetry standards).
- partial: Accuracy in Wrist-Worn, Sensor-Based Measurements of Heart Rate and Energy Expenditure in … (Journal of Personalized Medicine 2017) · cited 651x in the literature
"Six of the devices achieved a median error for HR below 5% during cycling... In conclusion, most wrist-worn devices adequately measure HR in laboratory-based activities, but poorly estimate EE, suggesting caution in the use of EE measurements as part of health improvement programs." (abstract, results)
openalexfull study (doi) - partial: Investigating sources of inaccuracy in wearable optical heart rate sensors (npj Digital Medicine 2020) · cited 670x in the literature
"We saw no statistically significant difference in accuracy across skin tones, but we saw significant differences between devices, and between activity types, notably, that absolute error during activity was, on average, 30% higher than during rest. Our conclusions indicate that different wearables are all reasonably accurate at resting and prolonged elevated heart rate, but that differences exist between devices in responding to changes in activity." (abstract, results, passage verified)
openalexfull study (doi) - contradicts: Keeping Pace with Wearables: A Living Umbrella Review of Systematic Reviews Evaluating the… (Sports Medicine 2024) · cited 88x in the literature
"Of 904 identified studies through the initial search, 24 systematic reviews met our inclusion criteria; these systematic reviews included 249 non-duplicate validation studies of consumer wearable devices involving 430,465 participants (43% female)... For heart rate, wearables showed a mean bias of ± 3%." (abstract, results, passage verified)
openalexfull study (doi)
Unverified means no publication matching the claim was located; it does not prove the claim false. Spotted an error? See the corrections policy - disputes from the people quoted are prioritized.