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Exercise should keep your heart safe but professional bodybuilders are dying at fivefold higher rates

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Exercise should keep your heart safe but professional bodybuilders are dying at fivefold higher rates

Professional bodybuilders often strain their hearts through extreme training, rapid weight loss, and dehydration. Bulking-cutting cycles, harsh diets, and intense regimens can cause heart rhythm issues and long-term cardiovascular damage

Published Jun 09, 2025 | 7:00 AMUpdated Jun 09, 2025 | 7:00 AM

Exercise should keep your heart safe but professional bodybuilders are dying at fivefold higher rates

Synopsis: The sudden death of Mr. India Senthil Kumaran Selvarajan highlights a disturbing trend in Indian bodybuilding: young, peak-condition athletes dying from heart attacks and organ failure, often linked to suspected steroid abuse. Similar fates befell Akash from Tamil Nadu and champion Dheeraj Dahiya. Even fitness icon Puneeth Rajkumar’s cardiac arrest in 2021 underscores hidden health risks in extreme fitness pursuits.

The promising career of Senthil Kumaran Selvarajan, India’s Mr. India titleholder, ended abruptly with a fatal heart attack. He was young, seemingly at peak physical condition, and represented the pinnacle of bodybuilding achievement in the country. His death wasn’t an isolated tragedy.

Akash, a 25-year-old bodybuilder and gym trainer from Avadi, Tamil Nadu, collapsed while preparing for competition. Doctors discovered multiple organ failure—his heart, kidneys, and liver had all shut down, likely from what they suspected was excessive steroid and supplement abuse. Another champion, Dheeraj Dahiya, who held multiple prestigious titles including Mr. India and Mr. North India, died suddenly from a reported heart attack, joining a growing list of elite athletes whose pursuit of physical perfection ended in premature death.

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Even beyond competitive bodybuilding, the fitness world was shaken when Kannada superstar Puneeth Rajkumar, renowned for his fitness regimen, died of sudden cardiac arrest in 2021. Though not a competitive bodybuilder, his case drew national attention to cardiovascular risks among seemingly healthy, fit individuals.

These Indian cases reflect a troubling global pattern that has now been quantified by groundbreaking research. A comprehensive 16-year study published in the European Heart Journal has exposed alarming mortality rates among competitive bodybuilders worldwide, with sudden cardiac death claiming 38 percent of fatalities in a sport increasingly scrutinized for its hidden health risks.

The global study that confirms the crisis

Dr. Marco Vecchiato from the University of Padova, Italy, who led the groundbreaking study, was motivated by observing exactly these kinds of tragic cases worldwide. “I’ve seen a growing number of reports of premature deaths among people involved in bodybuilding and fitness,” he said in a statement. “These tragic events, often affecting young and apparently healthy athletes, highlight a gap in our understanding of the long-term health risks associated with competitive bodybuilding.”

The research team examined 20,286 male bodybuilders who participated in International Federation of Bodybuilding and Fitness (IFBB) events between 2005 and 2020. Through meticulous cross-referencing of media reports, social media, bodybuilding forums, and official sources across five languages, researchers identified 121 deaths among these athletes, with an average age at death of just 45 years.

Most alarmingly, professional bodybuilders faced a more than fivefold increase in sudden cardiac death risk compared to amateur competitors, suggesting that the intensity and methods of elite-level competition—the very practices that likely contributed to deaths like those of Senthil, Akash, and Dheeraj—significantly amplify health dangers.

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Also Read: Privileged veganism vs othering of the marginalised

But why?

The study identified several interconnected factors that create a perfect storm for cardiovascular catastrophe in competitive bodybuilding.

Dr.Vecchiato explained that “bodybuilding involves several practices that could have an impact on health, such as extreme strength training, rapid weight loss strategies including severe dietary restrictions and dehydration, as well as the widespread use of different performance-enhancing substances.”

While only 16 percent of deceased athletes had documented histories or toxicology reports confirming performance-enhancing drug (PED) use, researchers believe this figure dramatically underrepresents reality due to underreporting and limited autopsy access.

The available autopsy reports revealed telling patterns: heart muscle thickening or enlargement, coronary artery disease, and in some cases, clear evidence of anabolic substance abuse.

The study’s data becomes even more concerning when considering anti-doping statistics. Despite organizing over 6,000 events annually, the IFBB submitted only 80 doping samples to the World Anti-Doping Agency (WADA) in the most recent reporting year—with a shocking 13 percent positivity rate, far exceeding most other sports. This discrepancy raises serious questions about the adequacy of current anti-doping measures and suggests widespread PED use remains largely undetected.

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Extreme training and competition practices

Professional bodybuilders engage in practices that place extraordinary strain on the cardiovascular system. Extreme strength training combined with rapid weight loss strategies—including severe dietary restrictions and dangerous dehydration techniques—can trigger irregular heart rhythms and structural heart changes over time. The pursuit of competition-ready physiques often involves cycling between bulking and cutting phases that shock the body’s systems.

“The risk may be greater for professional bodybuilders because they are more likely to engage intensively in these practices over prolonged periods and may experience higher competitive pressure to achieve extreme physiques,” Dr. Vecchiato noted.

Beyond physical risks, the study uncovered a disturbing mental health component. Approximately 15 percent of deaths were categorised as “sudden traumatic deaths,” including car crashes, suicides, murders, and overdoses. Researchers linked these to psychological pressures surrounding body image, performance expectations, and the relentless pursuit of extreme physiques.

“These findings underline the need to address the psychological impact of bodybuilding culture,” Dr. Vecchiato emphasized. “These mental health challenges, sometimes worsen with substance abuse and can elevate the risk of impulsive or self-destructive behaviours.” The toxic combination of body dysmorphia, depression, and performance pressure creates a dangerous psychological environment, particularly for younger athletes.

The regulatory gap

Unlike established professional sports, bodybuilding often operates without adequate medical oversight, especially in countries where it isn’t formally recognized as a sport. This regulatory vacuum means athletes rarely undergo pre-participation cardiovascular screenings, and there are virtually no safeguards to monitor or mitigate health risks.

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The contrast is stark: while professional football, basketball, or tennis players undergo regular medical evaluations and operate under strict anti-doping protocols, bodybuilders frequently compete without comparable protections despite facing potentially greater health risks.

Also Read: India’s packaged food labels under fire

A broader message about health and fitness

Even the Indian cardiologists support the findings of the study. “Was seeing many videos of the Mentzer brothers’ strength training. Then read how they both died at 49! What’s the point,” Cardiologist based out of Bengaluru Dr Deepak Krishnamurthy said on X.

However, the researchers emphasised that their findings shouldn’t discourage general strength training or fitness culture. “Regular physical activity and strength training can be extremely beneficial for health, quality of life and mortality risk,” Dr. Vecchiato clarified. Instead, the study challenges the dangerous notion that physical appearance alone indicates health and exposes the hidden risks behind even the most sculpted physiques.

The path forward: urgent reforms needed

Dr. Vecchiato’s research doesn’t aim to vilify bodybuilding but rather catalyze essential reforms. “For bodybuilders, the message is clear: while striving for physical excellence is admirable, the pursuit of extreme body transformation at any cost can carry significant health risks, particularly for the heart,” he stated.

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The study’s authors recommend several critical interventions:

  • Medical Oversight: Implementing mandatory cardiovascular screening and regular medical supervision for competitive bodybuilders, similar to other professional sports.
  • Anti-Doping Enhancement: Strengthening drug testing protocols and enforcement, given the current system’s apparent inadequacy.
  • Cultural Transformation: Promoting safer training practices and firmly rejecting performance-enhancing substance use through education campaigns.
  • Mental Health Support: Addressing the psychological pressures and providing mental health resources for athletes struggling with body image and performance anxiety.
  • Policy Development: Creating specific health surveillance programs and collaborating between medical associations, federations, and policymakers.

(Edited by Ananya Rao)

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Six ways your smartwatch is lying to you, according to science

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Six ways your smartwatch is lying to you, according to science

You check your smartwatch after a run. Your fitness score has dropped. You’ve burnt hardly any calories. Your recovery score is really low. It’s telling you to take the next 72 hours off exercise.

The worst bit? The whole run felt amazing.

So why is your watch telling you the opposite?

Ultimately, it’s because smartwatches and other fitness trackers aren’t always accurate.

Smartwatches can shape how you exercise

Using wearable fitness technology, such as smartwatches, has been one of the top fitness trends for close to a decade. Millions of people around the world use them daily.

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These devices shape how people think about health and exercise. For example, they provide data about how many calories you’ve burnt, how fit you are, how recovered you are after exercise, and whether you’re ready to exercise again.

But your smartwatch doesn’t measure most of these metrics directly. Instead, many common metrics are estimates. In other words, they’re not as accurate as you might think.

1. Calories burned

Calorie tracking is one of the most popular features on smartwatches. However, the accuracy leaves a lot to be desired.

Wearable devices can under- or overestimate energy expenditure (often expressed as calories burned) by more than 20 per cent. These errors also vary between activities. For example, strength training, cycling and high-intensity interval training can lead to even larger errors.

This matters because people often use these numbers to guide how much they eat.

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For example, if your watch overestimates calories burned, you might think you need to eat more food than you really need, which could result in weight gain. Conversely, if your watch underestimates calories burned, it could lead you to under-eat, negatively impacting your exercise performance.

2. Step counts

Step counts are a great way to measure general physical activity, but wearables don’t capture them perfectly.

Smartwatches can under-count steps by about 10 per cent under normal exercise conditions. Activities such as pushing a pram, carrying weights, or walking with limited arm swing likely make step counts less accurate, as smartwatches rely on arm movement to register steps.

For most people, this isn’t a major problem, and step counts are still useful for tracking general activity levels. But view them as a guide, rather than a precise measure.

3. Heart rate

Smartwatches estimate your heart rate using sensors that measure changes in blood flow through the veins in your wrist.

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This method is accurate at rest or low intensities, but gets less accurate as you increase exercise intensity.

Arm movement, sweat, skin tone and how tightly you wear the watch can also impact the heart rate measure it spits out. This means the accuracy can vary between people.

This can be problematic for people who use heart rate zones to guide their training, as small errors can lead to training at the wrong intensity.

4. Sleep tracking

Almost every smartwatch on the market gives you a “sleep score” and breaks your night into stages of light, deep and REM sleep.

The gold standard for measuring sleep is polysomnography. This is a lab-based test that records brain activity. But smartwatches estimate sleep using movement and heart rate.

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This means they can detect when you’re asleep or awake reasonably well. But they are much less accurate at identifying sleep stages.

So even if your watch says you had “poor deep sleep”, this may not be the case.

5. Recovery scores

Most smartwatches track heart rate variability and use this, with your sleep score, to create a “readiness” or “recovery” score.

Heart rate variability reflects how your body responds to stress. In the lab it is measured using an electrocardiogram. But smartwatches estimate it using wrist-based sensors, which are much more prone to measurement errors.

This means most recovery metrics are based on two inaccurate measures (heart rate variability and sleep quality). This results in a metric that may not meaningfully reflect your recovery.

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As a result, if your watch says you’re not recovered, you might skip training — even if you feel good (and are actually good to go).

6. VO₂max

Most devices estimate your VO₂max — which indicates your maximal fitness. It’s the maximum amount of oxygen your body can use during exercise.

The best way to measure VO₂max involves wearing a mask to analyse the amount of oxygen you breathe in and out, to determine how much oxygen you’re using to create energy.

But your watch cannot measure oxygen use. It estimates it based on your heart rate and movement.

But smartwatches tend to overestimate VO₂max in less active people and underestimate VO₂max in fitter ones.

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This means the number on your watch may not reflect your true fitness.

What should you do?

While the data from your smartwatch is prone to errors, that doesn’t mean it is completely worthless. 

These devices still offer a way to help you track general trends over time, but you should not pay attention to daily fluctuations or specific numbers.

It’s also important you pay attention to how you feel, how you perform and how you recover. This is likely to give you even more insight than what your smartwatch says.

Hunter Bennett is a lecturer in exercise science at Adelaide University. This piece first appeared on The Conversation.

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How the 3-3-3 Rule Helped Me Stick to an Exercise Routine

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How the 3-3-3 Rule Helped Me Stick to an Exercise Routine

If you’ve ever started a new workout routine with the best intentions only to find yourself skipping sessions by week two, you’re not alone. I’m the type to get trapped in the same cycle of burnout, where I go hard for a couple of weeks, feel exhausted, feel guilty, and repeat. For me, what finally broke that cycle wasn’t a new gym membership or a fancy fitness app, but a simple scheduling hack: the “3-3-3 rule.” I’d seen this rule applied it to general productivity, and all the same principles can apply to your fitness habits, too. Here’s how you can use the 3-3-3 rules to structure your workouts and create a habit that sticks.

What is the 3-3-3 rule?

The 3-3-3 “rule” (or “method,” or “gentle suggestion”) is essentially a weekly workout framework built around three types of movement, each done three times per week:

  • Three strength training sessions. This includes lifting weights, bodyweight circuits, resistance bands, whatever builds muscle and challenges your body.

  • Three cardio sessions. This includes running, cycling, swimming, jump rope, a dance class—what counts as “cardio” is up for debate, but here, I think of it as anything that gets your heart pumping.

  • Three active recovery days. This includes light walking, yoga, stretching, foam rolling, and so on.

And yes, I realize this math adds up to nine intentional days of movement across a seven-day week. Here’s the thing: You do double duty some days, or skip workouts here and there, or adjust to a nine-day cycle, because the point isn’t rigid scheduling. The point is rhythm over a strict structure. For me, the 3-3-3 rule provides a sense of momentum that’s flexible enough to fit into real life, but consistent enough to actually stick to.

Why the 3-3-3 rule works for me

Before I get into how the 3-3-3 rule helped me specifically, let’s talk about why so many workout plans fall apart in the first place. I believe most of them make two classic mistakes. The first is doing too much, too soon. You go from zero to six days a week at the gym, you get burnt out, and the whole thing unravels. The second mistake is having no real structure at all—just vague intentions, like “I’ll work out when I can,” which never materializes into anything real for a lot of people.

For me, the 3-3-3 rule solves both of those problems. It gives me enough structure to build habit and momentum, but not so much intensity that my body and brain feel overwhelmed. I personally adore running, but I struggle to motivate myself to lift weights; the 3-3-3 rhythm here helped me find a middle ground between those two workouts. When I know I have three strength sessions to hit in a week (or nine-ish day cycle), I can look at my calendar and find three slots without too much drama or dread.

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There’s also plenty of breathing room built into the plan, which was the biggest game changer for me. I used to have the (toxic) thought that my rest days were wasted days, which is a mentality that led to either overtraining or complete inactivity with pretty much no middle ground.

Plus, there’s something psychologically satisfying about the number three. I know and love the rule of threes in photography, comedy, survival tips, and all over the place.

How to make a 3-3-3 workout schedule work for you

The 3-3-3 rule has a ton of wiggle room for customization. Here are some ideas for how you can approach it:


What do you think so far?

For strength days, pick a format you actually enjoy. That might be a full-body circuit, a push/pull/legs split, or a class at your gym. (Boxing, anyone?) Your focus on these days should be a progressive challenge—push yourself, yes, but don’t obliterate yourself.

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For cardio days, variety helps. Mix a longer, easier effort with a shorter, more intense session (like a 20-minute interval run). I know I’m biased, but cardio really shouldn’t feel like punishment.

For recovery days, resist the urge to “make them count” by sneaking in extra work. The whole point is to let your body consolidate the gains from your harder days. Walk, stretch, breathe, and trust the process.

Another practical tip: Pick a night to map out your 3-3-3 week ahead of time. You’ll probably find that the week arranges itself pretty naturally once you’re looking for those nine windows.

The bottom line

As always, consistency should always be your priority in fitness. If you’ve been struggling to find a rhythm, if your past workout plans have always fizzled out around week three, give the 3-3-3 rule an honest four-week try. Maybe start with a 1-1-1 month! After all, the 3-3-3 rule isn’t a hack to totally transform your physique, but I do think it can provide something way more valuable. Finding a routine that works for you—like the 3-3-3 rule works for me—is the first step to make exercise a reliable, sustainable part of your life.

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I’m a running coach — I’ve just tested shoes actually designed for women’s feet, and they’re a total game changer

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I’m a running coach — I’ve just tested shoes actually designed for women’s feet, and they’re a total game changer

Why you can trust TechRadar


We spend hours testing every product or service we review, so you can be sure you’re buying the best. Find out more about how we test.

QLVR ENDVR: Two minute review

Most running shoes feel familiar for a reason: the formula has barely changed in millennia. We have archaeological evidence of shoes being fastened with “shoelaces” as far back as around 3,500 BC, yet the basic lace-up running trainer remains the default.

QLVR (pronounced “clever”) set out to challenge that. Its debut shoe, the ENDVR, is a laceless “running slipper” built around a women-specific mechanical structure, with a slip-on Wing Fit system inspired by the way a bird’s wing opens and closes around movement.

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