Apparently running marathons isn't such a good idea

March 16, 2010 1:46 PM

Excessive cardio is linked with heart disease, according to some recent studies examining marathon runners and markers for coronary risk

Here's the summary:

"they recruited 102 active marathon runners. To be a marathon runner ... required at least 5 marathons in the past 3 years. Many had run dozens or more in their lifetime. Anyone with a known history of heart disease or diabetes was excluded ... There were 102 totally asymptomatic age-matched controls, also with no history of diabetes, who had no significant history of vigorous exercise."

"12% of asymptomatic marathon runners had evidence of myocardial damage on LGE ... [4% of sedentary controls had abnormal LGE]" This metric was not technically significant, p < .08, but it certainly trends in the right direction and is probably worth investigating.

"The more marathons run, the higher the likelihood of heart disease. The number of marathons run was an independent and significant predictor of the likelihood of myocardial damage."

posted by scrutiny (74 comments total)

AHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH
posted by kmz at 1:47 PM on March 16, 2010 [1 favorite]

I'll be over here not exercising, I'm trying to be more health conscious.
posted by mullingitover at 1:49 PM on March 16, 2010 [10 favorites]

Is it because if you'll damage yourself if you stress out your body too much? "Oh but I think of myself as being healthy, and you can't have too much health, therefore I can do whatever I want in the name of health".
posted by amethysts at 1:50 PM on March 16, 2010 [1 favorite]

*chokes on bran muffin*
posted by The Card Cheat at 1:51 PM on March 16, 2010 [2 favorites]

Wait, let me get this straight. So we can't sit down without causing heart disease, but we can't run marathons without causing heart disease either?

Guys, guys, stop a second -- I think we're all gonna die!
posted by vorfeed at 1:51 PM on March 16, 2010 [32 favorites]

So that's what happened to Jim Fixx.
posted by Iridic at 1:51 PM on March 16, 2010 [1 favorite]

Life: It's sexually transmitted. And terminal.
posted by entropicamericana at 1:55 PM on March 16, 2010 [23 favorites]

I would be surprised if excessive cardio does not genereally induce problems in parts of the human circulatory system.
posted by polymodus at 1:59 PM on March 16, 2010 [1 favorite]

Again, with the morbid scientists and their death fixation. Who are these people? Do they wear black labcoats and listen to Sisters of Mercy all day? I know I'm gonna die. Quit rubbing it in my face.
posted by dortmunder at 2:00 PM on March 16, 2010 [9 favorites]

There's quite a bit of research coming out that long, slow distance (LSD) activities - like running a marathon - are just a bit too much cardio and cause more damage than they prevent. There is such a thing as too much of a good thing. Hence the new fad is short, intense workouts such as Crossfit and interval training.

Another example might be Steve Larson, professional bike racer, triathlete, and dead of a heart attack at 39.
posted by meowzilla at 2:00 PM on March 16, 2010

Can't sit down, can't exercise too much, can't hang upside down like a sleepy fruit bat for more than half an hour without getting a splitting headache...what the fuck, human biology? Were predators, parasites, viruses, meteor showers and tsunamis not dangerous enough? Was it really necessary to build so much planned obsolescence into the hardware?
posted by infinitywaltz at 2:01 PM on March 16, 2010 [3 favorites]

Good to know. I'll adjust my lifestyle accordingly.
posted by rocket88 at 2:01 PM on March 16, 2010

That's NOT what happened to Jim Fixx, who had a family history of heart disease. This study was controlled for risk factors. There are several studies out there showing that marathon running is an extreme activity that stresses body systems across the board and it generally an unhealthy activity (all you have to do is look at runners collapsing at the finish line to know that this is probably not a health-promoting activity). This study shouldn't be taken as a reason to forgo or not take up sensible fitness running. Regular fitness running is one of the great life-enhancers out there, and everyone of sound body should give it a try.
posted by Faze at 2:01 PM on March 16, 2010 [9 favorites]

but it may generally induce spelling problems
posted by polymodus at 2:01 PM on March 16, 2010

I had a heart attack last August and now I'm up to 5 days a week on the elliptical. I'm feeling great, but I'll let you know if I don't make it.

Errr, wait....
posted by sporb at 2:03 PM on March 16, 2010

I know that my LSD activities occasionally caused too much of a good thing.
posted by Babblesort at 2:03 PM on March 16, 2010 [2 favorites]

I recall seeing this a few months ago. It's really just for Elite runners. 26 miles puts a real strain on your body and the more runners (including one physician) I talk to the more I get told that it is nice to complete one or two, but you should stick to half-marathons at the max. It's a better distance.

I've been running more and more and sometimes it is frustrating not being marathon-ready. And then I saw that 3 people died during the Detroit Half-Marathon.

So I'm firmly on the super-slow path to longer distances.
posted by cashman at 2:05 PM on March 16, 2010

I'm not going to make a separate FPP from this, but here's the other shoe dropping - resistance training is also bad for the heart:

"Unfavorable Effects of Resistance Training on Central Arterial Compliance"

"Conclusions— In marked contrast to the beneficial effect of regular aerobic exercise, several months of resistance training "reduces" central arterial compliance in healthy men."

"Reductions in the compliance of central arteries exert a number of adverse effects on cardiovascular function and disease risk."

Don't sit too much - walk. Run in moderation. Do some resistance training, but emphasis on some. Don't overdo anything, including exercise.

And just to emphasize that endurance exercise (if not overdone - marathons is overdoing this, IMHO) is not harmful, I serve up this [warning - pdf]:

Endurance exercise as a countermeasure for aging.

CONCLUSIONS: The results demonstrate that reduced insulin sensitivity is likely related to changes in adiposity and to physical inactivity rather than being an inevitable consequence of aging. The results also show that regular endurance exercise partly normalizes age-related mitochondrial dysfunction, although there are persisting effects of age on mtDNA abundance and expression of nuclear transcription factors and mitochondrial protein. Furthermore, exercise may promote longevity through pathways common to effects of caloric restriction.

[emph. mine]
posted by VikingSword at 2:05 PM on March 16, 2010 [8 favorites]

Not to direct the thread much, but Faze is right. This only pertains to running extremely long distances. I recommend running fast every now and then for the health benefits and sheer joy of the activity.
posted by scrutiny at 2:06 PM on March 16, 2010 [3 favorites]

I'm not going to make a separate FPP from this, but here's the other shoe dropping - resistance training is also bad for the heart:

Is that all strength training, or just resistance training specifically? I'd like to see a comparison between resistance machines and free weights, for example.
posted by infinitywaltz at 2:10 PM on March 16, 2010

I recommend running fast every now and then for the health benefits and sheer joy of the activity.

Also; because I'm chasing you.

And you really don't want to be caught.
posted by quin at 2:12 PM on March 16, 2010 [7 favorites]

Is that all strength training, or just resistance training specifically? I'd like to see a comparison between resistance machines and free weights, for example.

This is what they have on the nature of the resistance training:


Resistance Training Intervention
In the first 4 months of the study period, subjects in the intervention group underwent 3 supervised resistance-training sessions per week. During each training session, subjects completed 3 sets of 8 to 12 exercises at 80% of 1RM in the following order: leg extension, seated chest press, leg curls, lateral row, squat, and sit-ups. Subjects performed 12 repetitions in sets 1 and 2 and as many repetitions as possible to concentric failure in set 3. Resistance was increased for the following exercise sessions when subjects were able to complete at least 10 repetitions in the final set. Recovery time between exercises was controlled at 2-minute intervals. Each training session lasted 45 minutes. Trained assistants verbally encouraged the subjects and ensured proper form and technique. Subjects were instructed to refrain from any other regular exercise workouts during the entire study period. Subjects in the control group were instructed not to alter their normal activity levels throughout the study period.
posted by VikingSword at 2:15 PM on March 16, 2010 [1 favorite]

OK, that's really interesting. Thanks for that, VikingSword. Of course, possible negative effects on the hart need to be balanced against all the benefits of resistance training, but it's yet another point emphasizing the importance of changing up one's exercise routine on a pretty regular basis.
posted by infinitywaltz at 2:18 PM on March 16, 2010

And again, I want to re-emphasize what I wrote in the first post - this result pertains to heavy workouts, not the kind of moderate resistance training recommended by most physicians. From the study:

"It may be feared that our present findings may discourage the practice of resistance training. We should emphasize, however, the important difference between the training protocol used in the present study and those recommended by the major health organizations.9,10 The intensity, volume, and frequency of the resistance training used in the present study were much greater than those recommended for the comprehensive health programs.9,10 In light of the role of resistance training on the maintenance of functional ability and the prevention of osteoporosis, the "properly prescribed" resistance training should still be highly encouraged, particularly for older adults. Our present study raises a caution when heavy and strenuous weight training is to be prescribed especially to high-risk populations."
posted by VikingSword at 2:19 PM on March 16, 2010

In other words - not to beat a dead horse - again: moderation in all things.

Moderate endurance aerobic exercise - good. Marathons, Iron Man etc. - bad. Moderate resistance training - good. Muscle Beach - bad.
posted by VikingSword at 2:21 PM on March 16, 2010 [4 favorites]

I wonder if you can balance the negative effects of resistance training by doing (non-marathon-level) cardio a few times a week too.
posted by serazin at 2:24 PM on March 16, 2010

I recall seeing this a few months ago. It's really just for Elite runners.

No, it's most definitely not the elite in this study:

The average age was 57 with age 50-72. The median number of marathons was 20. Weekly mileage was 35 (55km). Mean work was 4700 METs per week.

35 miles/week isn't elite in any sense of the word. In fact, I'd think that running a marathon on 35 miles/week would indeed be incredibly detrimental to one's health. Trying to run almost your entire week's mileage in one go would be incredibly difficult and would put a phenomenal strain on your body. This doesn't read like good science to me at all - where are the studies on all the elite guys from the 70s who were running more than 100 mile weeks week after week after week? They're all in their 50s-60s now. I don't hear about any of them having heart attacks, with the exception of Alberto Salazar - pictured in that article. He had a heart attack a while back, and everyone was shocked - but:

- he also nearly ran himself to death several times in his career, received last rites after collapsing at the finish of the 1978 Falmouth Road Race,

- he claimed that his 'Duel in the Sun' with Dick Beardsley at the 1982 Boston Marathon ended his career

- he was on Prozac for a long period of time for depression,

- he had a long self-diagnosed episode of Chronic Fatigue syndrome,

- he returned to ultramarathoning after a spell of inactivity. This is hardly a model of healthy living.

- he's only one guy. Anything can happen to one guy.

Every once in a while someone will bring up either Jim Fixx (most definitely not elite either) or Salazar as proof that runners have heart attacks. I call bullshit. The high mileage guys aren't dropping like flies. You'd think that if it were so bad for you, guys who were the high mileage guys back in the day would all be suffering - after all, if 30mpw does damage then 200mpw must have been a killer. Not so, as far as I can see.

This is all alarmist bullshit. I'll continue to run my 10+ miles a day and see how long I last. I'm betting I fare better than my sedentary counterparts.
posted by jimmythefish at 2:27 PM on March 16, 2010 [8 favorites]

I wouldn't run a marathon even if I could.
posted by zzazazz at 2:27 PM on March 16, 2010

I wonder if you can balance the negative effects of resistance training by doing (non-marathon-level) cardio a few times a week too.

Well moderate resistance training is not deleterious. Of course, the question is what is moderate, and here there may be a few surprises. The kind of training usually recommended by gym rats and gym trainers (3 sets to failure 3 times a week etc.) - is exactly what is considered heavy, and according to this study, bad. I suspect that quite a few people are doing the "heavy" by this definition, thinking it's moderate. The actual moderate is considerably less strenuous.
posted by VikingSword at 2:29 PM on March 16, 2010

On the other hand, a meta-analysis found that resistance training lowers resting blood pressure slightly.
posted by knave at 2:32 PM on March 16, 2010

Uh, maybe this is big news, or maybe it's just a blip. But right now all we see is one blog post making the connection, apparently the paper itself is written in a way that you need to know the subject to get. Now, this guy might know the subject, but his interpretation might bet way off

It's bad enough when irresponsible newspapers print "X causes cancer" by over interpreting scientific research but one blog post!?!

Come on. Besides the study only looked at one group of people who run at least four miles a day. I doubt that most people's cardio regimes are nearly that intensive.
posted by delmoi at 2:33 PM on March 16, 2010

I am really struggling to figure out whether the massive spray of jargon in the original post is meant to obfuscate bad writing or that he just conforms gleefully to the stereotype of the opaque MD. That said, the crazy list of "I think" statements toward the end of the post--especially the part where he says

That is, could the wheat, carbohydrate and linoleic acid found in low fat “healthy” diets be more prevalent in marathon runners by virtue of their greater caloric intake of this noxious garbage?

That’s a possibility. I think it may apply to cyclists, most of whom seem to eat horribly and who seem to be prone to osteoporosis.

seems incredibly wrong and unprofessional. I mean...he touts CrossFit as a great alternative, and that workout is incredibly hard on your knees.
posted by kittyprecious at 2:35 PM on March 16, 2010

Jim Fixx loved his steak. All the running in the world could not undue the damage those steaks did to his arteries. This part at least is not news. As for the rest of it, I think they may need a bigger study.
posted by caddis at 2:37 PM on March 16, 2010

This is all alarmist bullshit

All famous runners dying or not dying aside, this study examines older people who run marathons and tests whether or not that seems to be a generally good idea for their heart health. The answer seems to be no, but you're right in that the study didn't test elderly people who run ~200mpw, or even people who had been running 200mpw for all of their lives. That is a study that should be done, no doubt about it, especially given the results of the current study. It shouldn't even be too hard to get a population sample either. I'm sure there are plenty marathoners are eager to demonstrate that their exercise of choice is not detrimental.
posted by scrutiny at 2:37 PM on March 16, 2010 [1 favorite]

Frankly, the study cited in the OP is not ideal for the purposes of discussion. I think this is better:

"Eur Heart J. 2008 Aug;29(15):1903-10. Epub 2008 Apr 21.

Running: the risk of coronary events : Prevalence and prognostic relevance of coronary atherosclerosis in marathon runners.

Möhlenkamp S, Lehmann N, Breuckmann F, Bröcker-Preuss M, Nassenstein K, Halle M, Budde T, Mann K, Barkhausen J, Heusch G, Jöckel KH, Erbel R; Marathon Study Investigators; Heinz Nixdorf Recall Study Investigators.

Clinic of Cardiology, West-German Heart Center Essen, University Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany. [e-mail]
Comment in:

Eur Heart J. 2008 Aug;29(15):1800-2.
AIMS: To quantify the prevalence of coronary artery calcification (CAC) in relation to cardiovascular risk factors in marathon runners, and to study its role for myocardial damage and coronary events. METHODS AND RESULTS: In 108 apparently healthy male marathon runners aged >or=50 years, with >or=5 marathon competitions during the previous three years, the running history, Framingham risk score (FRS), CAC, and presence of myocardial late gadolinium enhancement (LGE) were measured. Control groups were matched by age (8:1) and FRS (2:1) from the Heinz Nixdorf Recall Study. The FRS in marathon runners was lower than in age-matched controls (7 vs. 11%, P <>or= 100 experienced coronary events. Event-free survival was inversely related to CAC burden (P = 0.018). CONCLUSION: Conventional cardiovascular risk stratification underestimates the CAC burden in presumably healthy marathon runners. As CAC burden and frequent marathon running seem to correlate with subclinical myocardial damage, an increased awareness of a potentially higher than anticipated coronary risk is warranted.

PMID: 18426850 [PubMed - indexed for MEDLINE]"

[emph. mine]
posted by VikingSword at 2:42 PM on March 16, 2010

no time to read link. what was the control group in the study, people who read link?
posted by shmegegge at 2:42 PM on March 16, 2010

jimmythefish, I pretty much agree with you. First of all, when endurance athletes die of heart attacks, it makes waves because it's surprising. The story stands out, unlike all the 40- and 50-something guys that drop dead every day in their office chairs. Second, it's anecdotal and not really useful evidence of any generally applicable causal relationship.

The other thing I feel when I see extremely specific physiological effects measured in studies is that we don't understand the entire system of the body well enough to draw conclusions about how we should behave as a result. For example, in Pollan's famous "eat food" article, he describes how foods such as fruits and vegetables are known to be good for you, yet supplements containing similar nutrients have almost zero effect. Reductionist approaches to nutrition have not yet yielded a meal in pill form, and probably won't for some time. The interrelated systems of the body and the foods we eat are extremely complex. (Is a glass of wine a day good for you or isn't it?)

In a similar sense, I think a study like the one VikingSword linked is potentially misleading. It's possible that arterial stiffness is increased by resistance training, and arterial stiffness is linked with hypertension and heart disease. However, the meta-analysis I linked found that blood pressure is not increased and actually slightly decreases as a result of resistance training. So it's possible that the benefits of resistance training outweigh the possible negative of increased arterial stiffness. Just like it's possible that distance running is, in general, a very healthy activity to participate in, especially considering that running for long distances is the one evolutionary claim to fame humans have.

TL;DR: I wouldn't alter my lifestyle as a result of one or two extremely specific studies. Eat food, mostly plants. Exercise a reasonable amount every day.
posted by knave at 2:44 PM on March 16, 2010 [1 favorite]

Caddis: Jim Fixx loved his steak. All the running in the world could not undue the damage those steaks did to his arteries. This part at least is not news. As for the rest of it, I think they may need a bigger study.

Yes, as well as the family history of heart problems. Arguably, one could make the case that if he hadn't begun running at 36, when he weighed 240 and smoked two packs a day, he might've passed away in his early 40's like his father at 42.

Thing I don't get is, that the severe blockages in his arteries from arteriosclerosis could not be diagnosed beforehand.

I wonder if that is still the case.
posted by Skygazer at 2:49 PM on March 16, 2010

Considering that the dude that made the marathon famous died after running a marathon, I think this research can safely be summarized thusly: no duh.
posted by Civil_Disobedient at 2:51 PM on March 16, 2010 [1 favorite]

In a similar sense, I think a study like the one VikingSword linked is potentially misleading. It's possible that arterial stiffness is increased by resistance training, and arterial stiffness is linked with hypertension and heart disease. However, the meta-analysis I linked found that blood pressure is not increased and actually slightly decreases as a result of resistance training.

The variable that you are missing is "intensity". The link you provided is unable to specify global mean for the intensity of the exercise. It states so plainly in the link you gave:

"Because most studies reported the range versus the mean for the number of repetitions performed as well as the rest period between exercises, we were unable to calculate an overall mean, SD, and between-group range of means for these data."

Whereas in the study I linked to, intensity is well defined.

So, the more likely conclusion is that moderate intensity resistance training is beneficial - indeed in the study I linked to, the authors state so, and I cited that statement in my post. Whereas intense workouts are deleterious.

It's the dose that makes the poison. The only possibly surprising thing is just what is considered "heavy" in the study - and I suspect most would think it as "normal".
posted by VikingSword at 2:52 PM on March 16, 2010

Next up: Scientist discover that anything fun, interesting, or engaging makes you die, and the cure for mortality is a brutal case of ennui.
posted by BrotherCaine at 2:56 PM on March 16, 2010 [3 favorites]

Has anyone boiled these studies down to how much resistance and cardio training is optimal, and what % of max heart rate we should be working out at? I'm a big fan of heart rate training, because it's the only way for me to make sure I'm not overdoing it on days I'm dehydrated or stressed.
posted by BrotherCaine at 3:02 PM on March 16, 2010

They should have a study to see if scientists bruise if hit with punishing blows about the head and shoulders.
posted by digsrus at 3:02 PM on March 16, 2010 [4 favorites]

and the cure for mortality is a brutal case of ennui

Sorry, boredom is strongly associated with dementia. The more a person is bored in life, the more likely they'll get dementia when older... I have a study about that rattling around somewhere on my hard drive... except I forgot where I put it- TA DA DA DAM! And I'm never bored... ouch!
posted by VikingSword at 3:03 PM on March 16, 2010 [2 favorites]

Man, we're all going to be sheepish as hell if we find out it really is just God with His finger on the Smite button.
posted by Pragmatica at 3:04 PM on March 16, 2010

Well, there's this:

"Med Hypotheses. 1996 May;46(5):463-6.

The physiology of boredom, depression and senile dementia.
Saunders MN.

Green Gables, South Humberside, UK.
Mental stimulation ensures the flow of blood, oxygen and nutrients to the brain. The stimulation can be either generated internally from thought and rumination or externally from our environment via the senses. Without this stimulation, neuron shrinkage and atrophy eventually may lead to depression and senile dementia. This paper explains why mental stimulation may be prevented from realizing its beneficial effects of increasing the blood flow to the brain. The hypothesis is based on feedback biological mechanisms that prevent overload of the neural circuitry due to excessive mental stimulation. However, if overstimulation is maintained over a long period and, with it, the overload protection process, it may eventually lead to permanent depletion of neuron connections and also neural communications.

PMID: 8735885 [PubMed - indexed for MEDLINE]"

I got a much better study somewhere, but can't find it at the moment.
posted by VikingSword at 3:07 PM on March 16, 2010

Dammit, you just can't win.
posted by chillmost at 3:17 PM on March 16, 2010

Mental stimulation ensures the flow of blood, oxygen and nutrients to the brain.

That makes definite sense. My motto is "Better busy than bored," and the worst period of depression and anxiety I ever went through was while I was working 8:00-5:00 at an extremely boring job.
posted by infinitywaltz at 3:20 PM on March 16, 2010

Sample size of 102. Results not "technically significant" (Is this the same as statistically significant?). Not a lot to base conclusions on, it seems to me.

Also, "completing" a marathon means different things to different people. To some people, it means running the entire 26.2 miles; to others, all that matters is that you finish by some combination of walking/running, even if it takes 5 or 6 hours.

So I question marathon completion as a marker of "excessive cardio," especially when it's not considered in the context of training. Lots of people finish marathons after averaging 20-30 miles a week; lots of others run much more. And then there are plenty of people (like me) who run 25-30 miles a week but *don't* run marathons. I suppose I'm just wondering if these and other related variables were considered.
posted by young_simba at 3:22 PM on March 16, 2010

Well moderate resistance training is not deleterious. Of course, the question is what is moderate, and here there may be a few surprises. The kind of training usually recommended by gym rats and gym trainers (3 sets to failure 3 times a week etc.) - is exactly what is considered heavy, and according to this study, bad.

I'd question whether "bad" accurately describes the finding. The artery returned to the baseline shortly after detraining, which would seem to suggest that this is a case of adaption, not damage. And arterial stiffness was correlated with increased left ventricular mass in this study, which has been shown to enhance diastolic function in weightlifters. Thigh size is also positively associated with heart health, and resistance training is the most reliable way to increase that (other than lots of ice cream, of course).

In short: this study found that heavy resistance training stiffens one particular artery. That's it. That may be bad, or it may not -- it may be that other cardiovascular changes (such as the one above) make up for this in some way, or it may be that stiffening of this artery is not, in and of itself, a significant risk to otherwise-healthy subjects. As the study itself says, "the underlying physiological mechanisms and clinical implications of these findings warrant further investigation"... and until that investigation demonstrates a significant negative link between resistance training and overall cardiovascular health, I personally feel pretty comfortable with shrugging and getting on with my workout.
posted by vorfeed at 3:26 PM on March 16, 2010 [2 favorites]

Thigh size is also positively associated with heart health, and resistance training is the most reliable way to increase that (other than lots of ice cream, of course).

I'll see your thigh, and raise you a calf:

"Calf Circumference Is Inversely Associated With Carotid Plaques

Conclusion— The present study shows, for the first time, an inverse relationship between carotid plaques and CC. Although this needs to be confirmed in other populations, it may suggest an antiatherogenic effect of large CC."
posted by VikingSword at 3:39 PM on March 16, 2010 [1 favorite]

This is why we need bigger wolf population again, so running ability has a satisfactory positive correlation with lifespan.
posted by Wolfdog at 3:40 PM on March 16, 2010 [1 favorite]

We're surprised that running a distance which caused the first guy to do it to drop dead is harmful?
posted by stevis23 at 3:53 PM on March 16, 2010 [3 favorites]

I think that the Greeks were likely aware of this association in 490 BC, after the original (battle of) Marathon:

Enter Pheidippides, covered in dust:

Νενικήκαμεν! *dies*

I know that the journey of 140 miles in two days, delivering word of Greek victory and promptly dying of exhaustion is all likely mythical, but amuses me that they named an event after it.
posted by Bora Horza Gobuchul at 4:00 PM on March 16, 2010

In other words, don't be a gerbil.
posted by filthy light thief at 4:43 PM on March 16, 2010

"I usually do two hours of cardio and then four - more of cardio and then two more of cardio."

I smoke two joints before I smoke two joints, and then I smoke two more.
posted by knave at 5:02 PM on March 16, 2010

Timely.

32-year-old Mark Austry of Lantana, Texas, died at a local hospital Sunday.

Austry collapsed Sunday morning after finishing the 13.1-mile run benefiting the Susan G. Komen Breast Cancer Foundation. About 13,000 runners registered for the race. ESPN

posted by Decimask at 5:07 PM on March 16, 2010

Med Hypotheses. 1996 May;46(5):463-6.

It's important not to treat Medical Hypotheses as a journal or anything resembling a journal or as any other kind of vehicle in which a 'scientific study' would appear. It would be the best joke ever foisted on the scientific community if it weren't not actually a joke.

(Sorry about the sciencedirect link but I hope it's possible to at least read the abstract if you're not at a university)
posted by monocyte at 5:21 PM on March 16, 2010

Interested that this guy's stated bias hasn't been mentioned -- he favors a "paleo" diet, with high consumption of animal fat and limited intake of carbohydrates. Somehow this doesn't have the ring of credibility.
posted by texorama at 7:54 PM on March 16, 2010

I'm not going to make a separate FPP from this, but here's the other shoe dropping - resistance training is also bad for the heart

I think that study is interesting, but it's quite a leap from what it says to "resistance training is bad for the heart."

A few things come to mind. What they found is that their training program caused a reduction in central arterial compliance, which apparently means the artery became stiffer. I'm not a doctor and so I'm unsure of the precise implications of this result. They say that "higher arterial stiffness is associated with a greater rate of mortality in patients with end-stage renal failure and essential hypertension." And the conclusion says "Our present study raises a caution when heavy and strenuous weight training is to be prescribed especially to high-risk populations." So it's not totally clear to me what, if any, implications this has for healthy people.

On to their methodology:

During each training session, subjects completed 3 sets of 8 to 12 exercises at 80% of 1RM in the following order: leg extension, seated chest press, leg curls, lateral row, squat, and sit-ups. Subjects performed 12 repetitions in sets 1 and 2 and as many repetitions as possible to concentric failure in set 3. Resistance was increased for the following exercise sessions when subjects were able to complete at least 10 repetitions in the final set. Recovery time between exercises was controlled at 2-minute intervals.

First of all, this is a shitty strength program, which isn't surprising. Talking about percentage of 1RM for novices is meaningless -- a novice doesn't have the experience necessary to attempt a true 1RM, and a novice's rate of adaptation is such that simply testing a max will alter it.

And representing it as heavy or strenuous strength training is goofy. This isn't a lot of volume or intensity. I don't see anything indicating the loads used, but they weren't heavy if untrained people were completing three sets of 10 with them. This looks like the routine any random Joe with no experience could make up if you threw him into a gym and asked him to do "resistance training."

I'd be curious what the results would be with a legitimate barbell program. I'm not sure if there's any reason to think that the cardiovascular effects would be much different -- although it seems that they would be if the exercises involved using the valsalva maneuver to keep the spine rigid against a load, e.g. in a squat, press, or deadlift.

The strangest part to me is that they limited rest between sets to 2 minutes. That obviously changes the cardiovascular element and moves away from strength training and towards circuit training or CrossFit's metcons. A strength routine would allow for rest as needed between sets in order to minimize fatigue buildup and allow the most quality reps to be completed. CrossFit-type workouts intentionally minimize or eliminate recovery between sets in order to provide a conditioning effect and elevate VO2 max.

So I don't think people ought to be scared away from getting strong by these particular findings.
posted by ludwig_van at 8:03 PM on March 16, 2010

I just realized I misread the exercise methodology part slightly, but the way it's written doesn't really make sense.

subjects completed 3 sets of 8 to 12 exercises at 80% of 1RM in the following order: leg extension, seated chest press, leg curls, lateral row, squat, and sit-ups. Subjects performed 12 repetitions in sets 1 and 2 and as many repetitions as possible to concentric failure in set 3.

I read the bold part as "3 sets of 8 to 12 reps." It actually says "8 to 12 exercises," but then it lists 6 exercises. So I'm not sure what that means.

But anyhow, this only underscores my previous point -- they were actually doing 2 sets of 12 followed by a set to failure. Any load you can move for 2 sets of 12 doesn't qualify as heavy. It also seems odd to me that the trainees would be able to complete 2 sets of 12 but then wouldn't be able to get 10 reps on a third set with the same load.
posted by ludwig_van at 8:09 PM on March 16, 2010

26 miles puts a real strain on your body and the more runners (including one physician) I talk to the more I get told that it is nice to complete one or two, but you should stick to half-marathons at the max.

Eddie Izzard is fucked.
posted by kirkaracha at 8:45 PM on March 16, 2010

I recall seeing this a few months ago. It's really just for Elite runners.
No, it's most definitely not the elite in this study:
The average age was 57 with age 50-72. The median number of marathons was 20. Weekly mileage was 35 (55km). Mean work was 4700 METs per week.

35 miles/week isn't elite in any sense of the word.-- jimmythefish

Speak for yourself!

The typical person wondering whether to exercise or not is probably sittting in his chair all day, and in the couch at home until he goes to bed. If he decides to exercise at all, it is probably a walk around the block a few days a week. This is as far from running a marathon as lighting a bottle rocket is from the Space Shuttle. This report is completely irrelevant to these people, that probably includes 99.99% of all people.

I do a lot of exercise but I'm certainly not running any marathons. If I did I'd consider myself elite among the masses.

Maybe you aren't considering the masses in your definition.
posted by eye of newt at 10:04 PM on March 16, 2010

This metric was not technically significant, p <>
It's not significant. It might possibly be worth investigating further. Relax.
posted by internet fraud detective squad, station number 9 at 10:21 PM on March 16, 2010

RIP Jim Fixx..the Father of running culture in the US (keeled over of a heart attack) .. now back to more non-cardio Metafilter
posted by celerystick at 10:42 PM on March 16, 2010

Sorry but there is reason to be very skeptical of this.
Most runners run because they like it. Not because it will make them live longer.
If the option is to sit around your entire life and do nothing but be bored with a chance that you'll live to 90 - or go out and run or exercise or keep active which may lead to death by age 70 - then I have to say most would choose the latter. Life is for living. And for a good many that includes quality exercise.
That said, I know a lot of marathoners and people who do and have done excessive cardio most of their lives. They all are fit, thin and living a very healthy [and fulfilled] life.
For those with heart disease running and such may extend one's life. More importantly it adds to the quality of life. But it alone will not prevent heart disease.

Also to the guy who mentioned that 'marathon runners collapsing at the finish line' should one day go watch a marathon [or run one]. The number of runners collapsing at the finish is very very low. And if they do it is often simply because they are tired - not because they are dying.

Anyway, I suppose any crackpot scientist can 'prove' that just about everything is bad for us in one way or another.
posted by Rashomon at 11:20 PM on March 16, 2010

Dammit, you just can't win.

Not only that, you can only break even on a very, very cold day. And it never gets that cold.
posted by moonbiter at 3:26 AM on March 17, 2010

Anyway, I suppose any crackpot scientist can 'prove' that just about everything is bad for us in one way or another.

The science is good even if you find the conclusions suspect. Perhaps this study means that elderly people who don't exercise enough are the ones who get heart problems when they run marathons? Who knows? It requires deeper study and deserves more than a "this is not valid because I have all this anecdotal evidence x."

I don't have any problem with people running marathons if that's what they want to do. Running marathons is hard and I respect and acknowledge that. However running, like most other sports, can be very taxing on the body when you push yourself to the limits. I'm a big fan of exercising regularly, and I think it's healthy, but I'm not convinced that running marathons is a good thing to do health-wise, especially for older folks. My interpretation of these studies is that running marathons may not be a good idea to improve heart health when you're over the age of 50. Of course this is all correlational, and of course there are plenty other confounds not accounted for (e.g. diet, happiness, general constitution), but I don't think dismissing the entire study as irrelevant is sound reasoning.
posted by scrutiny at 8:30 AM on March 17, 2010 [2 favorites]

Extremely long distances? "Elite" runners? There are a lot of people who run marathons. It's interesting to learn that it's not a problematic distance because of the inexperience/insufficient training of some runners, but may be detrimental for all. That would be news to me, if this research is solid. But running a marathon is not an activity of some extreme fringe. Multiple marathons a year, ultramarathons, etc., ok.

That being said, I'm completely down with the idea that a half is a much more healthy goal for most people, myself included. But I'd hate to cut full marathons out completely unless there was solid evidence that, even with adequate fitness and training, the harms outweigh the benefits.
posted by Durn Bronzefist at 9:23 AM on March 17, 2010

Let's say (reasonably, I think) that 2 million people in the US ran full marathons last year - 40,000 marathoners per state, if you like, although not likely distributed so uniformly. That's about 0.6% of the US population that do, leaving 99.4% that don't. Pretty fringey, if you ask me (though I'm quite willing to have my estimate corrected).
posted by Wolfdog at 3:00 PM on March 17, 2010

*drops dead*
posted by stagewhisper at 3:46 PM on March 17, 2010

There's more than one person in this thread that doesn't know how to read a study and/or doesn't know how one is properly set-up.
posted by P.o.B. at 7:07 PM on March 17, 2010

This was a great comment on a previous thread about marathon running. Unfortunately Runner's World has since revamped their website and the linked articles are nowhere to be found.
posted by hindmost at 7:26 PM on March 18, 2010

Here's a followup to the original post on the PaNu blog.
posted by ludwig_van at 6:59 AM on March 23, 2010