A new paper published on May 26 in the scientific journal Sports Medicine takes a look at the topic of how athletes can be both fit and unhealthy. The paper, published by sports scientists Phil Maffetone and Paul Laursen, starts by noting that fitness and health are two different things: fitness describes the ability to perform a given exercise task, and health explains a person’s state of well-being, where physiological systems work in harmony. It also suggests that many athletes are fit but unhealthy, most often because of excess high training intensity or training volume and/or excess consumption of processed/refined dietary carbohydrates.

Maffetone and Laursen look at diet, athletic origins, training trauma and inflammamation before offering possible solutions and conclusions. Here is a look at the abstract of the paper (published with permission) and their conclusions, as well as a link to the published paper.

Abstract
While the words “fit” and “healthy” are often used synonymously in everyday language, the terms have entirely separate meanings. Fitness describes the ability to perform a given exercise task, and health explains a person’s state of well-being, where physiological systems work in harmony. Although we typically view athletes as fit and healthy, they often are not. The global term we place on unhealthy athletes is the overtraining syndrome. In this current opinion, we propose that two primary drivers may contribute to the development of the overtraining syndrome, namely high training intensity and the modern-day highly processed, high glycemic diet. Both factors elicit a sympathetic response through the hypothalamic-pituitary-adrenal axis, in turn driving systemic reactive oxygen species production, inflammation, and a metabolic substrate imbalance towards carbohydrate and away from fat oxidation, manifesting in an array of symptoms often labeled as the overtraining syndrome. Ultimately, these symptoms reveal an unhealthy athlete. We argue that practitioners, scientists, and athletes may work towards health and alleviate overtraining syndrome by lowering training intensity and removing processed and/or high glycemic foods from the diet, which together enhance fat oxidation rates. Athletes should be fit and healthy.

Conclusions
Physical, biochemical, and mental-emotional injuries are not expected/normal outcomes from endurance sport participation, yet the incidence of these in athletes is alarmingly high. Practitioners, coaches, and athletes should be cognizant of impending health abnormalities during training and consider periods of reduced training intensity and recovery, while emphasizing a natural, unprocessed diet to improve health and cultivate sustainable fitness. For optimal performance, athletes must be fit and healthy.

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