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I thank Mr Berestka for his comments and for citing evidence that the risk of fatal heart attacks in skiers is extremely low. I also thank him for convincing me that downhill skiing is not an entirely anaerobic activity. Provided a downhill skier actually spends all of the 5 or 6 hours skiing rather than standing (at vantage points, in lift cabins, in lines, or at bars) or sitting (in lift chairs, at tables, on bar stools, or in snowdrifts), he or she will have had a pleasant workout and will have impressed Mr Berestka.Meanwhile, in the same 5 or 6 hours at high altitude, the cross-country skier, the marathon runner, the high-altitude trekker, and the mountain climber with his huge pack all will have impressed me.
Rennie D. Downhill Skiing: Impressive to the Impressionable-Reply. JAMA. 1989;262(10):1328. doi:10.1001/jama.1989.03430100062021
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