Wednesday, October 16, 2013

Why you shouldn't consider running a marathon unless you're in great shape by Jerry Brainum

Back in the early 70s, America was enthralled with a running craze. Or more specifically, a jogging craze. Just about everywhere you looked, people had laced up their Adidas or Rebok running shoes, and were hitting the roads. Numerous books extolled the many benefits associated with jogging, such as fat loss and improved cardiovascular health. Some even hinted that regular jogging held the key to an extended lifespan. Even the regulars at Gold's Gym got pulled in. I recall running in a park near the gym in the late 70s. I often ran with the famous Mentzer brothers, Mike and Ray. On one occasion, after a late night workout, I ran with my friend and training partner, Bill Grant, a Mr.America and Mr.World winner. We were stopped by the police who couldn't understand why a white guy and a black guy would be running down the street at 2 a.m. 
   At the height of the running craze, a pathologist from Inglewood, California named Thomas Bassler declared that anyone who followed the "running lifestyle" that included no smoking and no junk food eating, and who could complete a marathon in under four hours was immune from having a heart attack. This statement by a physician caused even more people to get involved in the running craze. Perhaps the most popular book related to running at the time was aptly titled The Complete Book of Running. It was written by Jim Fixx, whose enthusiasm for running was clearly infectious. Fixx had led an unhealthy lifestyle, being overweight, sedentary, and an avowed junk food water until age 35, when he began running. His father had died of cardiovascular disease at 42, so Fixx had some clear motivation to start exercising. But what he didn't know was that he also possessed an enlarged heart that put him at greater risk of having a heart attack. He also felt that exercise was more important than diet. Fixx, the champion of running, died of a heart attack at 52 while engaged in his favorite activity. An autopsy revealed that one of his coronary arteries was 95% blocked, while two others were 85% and 70% blocked respectively. His death made many people question the "heart attack immunity theory" suggested by Dr.Bassler.
    While the jogging craze eventually abated, the zeal for long distance running seems to have increased over the years. For many, the ability to complete the 26 mile, 385 yard course of a marathon race represents a personal victory. It makes them feel that they can do anything if they persevere and set their mind to it.  But the truth is that many people are not fully prepared to undergo the rigors of a marathon race, and the stress it imposes on the body, particularly the heart.
    Even experienced marathon runners could be at risk if they are unaware of certain underlying cardiovascular conditions. A good example of this is the case of U.S Congressman, Goodloe Byron. Byron died of a heart attack while jogging in 1978. He was only 49 at the time. Prior to that unfortunate event, Byron had completed running six Boston Marathons with a best time of 3:28:40, and hadn't smoked for over 25 years. This, of course, met Dr.Bassler's criteria for heart attack immunity. But a series of prior treadmill stress tests on Byron had revealed that he likely suffered from atherosclerosis. His last test revealed outright cardiovascular disease, and he was advised not to run, which he ignored.
    In a new study of amateur marathon runners who had competed in a Canadian marathon, tests done before and after the race revealed that half the runners showed potentially severe heart defects related to heart muscle injury incurred from running the race. The subjects were 20 runners, with an age range of 18 to 60, none of whom showed any prior cardiovascular disease, or were on any drugs used to treat cardiovascular disease. The runners were tested and observed for six to eight weeks prior to the race, and also on the day of the race. They were again tested 48 hours after competing the marathon. These tests revealed that half the runners showed a decrease in the function of the left and right ventricles of their hearts. Some of them also showed edema or swelling of the heart muscle, as well as reduced blood flow. Those with lower fitness and less training were more prone to show these disturbances in heart function.
   The good news is that the effects are transient. All the runners showed that the changes induced in heart function returned to normal within three months. But this study does also suggest that if you contemplate running a marathon, follow the Boy Scout creed and be prepared. Training for just a few weeks isn't enough. It takes at least 6-8 months or more to properly prepare for running a marathon. In addition, the damage imposed on joints and heart function can take at least three months to recuperate after a marathon. Competing in another long distance race within that time is not just foolish, but could be life threatening for some. Perhaps those seeking to prove something to themselves would be well advised to seek a safer pursuit to boost their self-esteem.
    In reality, however, emerging research is showing that long-term participation in long distance running events can reverse the benefits of exercise on heart function. This, of course, is the converse of what Dr.Bassler proposed in the 1970s. The new studies suggest that those who regularly engage in long distance running have a higher incidence of heart rhythm defects. In some cases, these disturbances in heart rhythm can result in sudden death. Studies show that participation in long distance running raises the risk of atrial fibrillation, a common heart rhythm disturbance, 5-10-fold. In addition, veteran marathon runners show increased calcium deposits in their coronary arteries, a harbinger of atherosclerosis.Jogging at a rapid pace  more than 4 hours a week causes the loss of all exercise-related heart benefits.
   The increase in heart rhythm disturbances seen in long distance runners may result from an increase of scar tissue (fibrosis) in the heart, which sets the state for aberrant heart rhythms, especially atrial fibrillation. Ultramarathon runners (50 mile or more runs) show levels of the adrenal hormone, aldosterone, that are 5-times higher than normal. This is significant because elevated chronic aldosterone levels are associated with cardiac fibrosis. Running long distances also boosts levels of inflammatory cytokines, immune system chemicals that can damage the heart. While endurance athletes show a heightened parasympathetic response, which results in their typically very low resting heartbeats, it also sets them up for possible heart rhythm problems later on.
   It is perhaps important to consider what happened to Pheidippides (portrayed by Steve Reeves in the 1959 film, The Giant of Marathon),  the Athenian man said to be the inspiration for the marathon race. He ran 25 miles, then promptly dropped dead. Enough said.

Larose, E, et al. Transient myocardial tissue and function changes during a marathon in less fit marathon runners. Can J Cardiol 2013;1269-73.

©,2013 Jerry Brainum. Any reprinting in any type of media, including electronic and foreign is expressly prohibited.

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