Halfway through the Mitchell report on steroids in basball
December 13, 2007 05:07 PM
So far the report is a bore. No science save the usual references to the harm associated with steroids and protecting "our kids" the mantra of the new social engineer/prudes/and semi-fascists who want to make us do things their way.
It is a sleazy document so far, and thus gets much press coverage for the naming of names and locker room gossip. One section actually is devoted to sports writer comments on baseball and steroids, just about the least credible group on anything. All they want to do is to be noticed and to sell their story, an admission made by the sports writer who castigated Ted Williams, one of the greatest and most ethical of baseball players.
If I find some statistics that purport to document the surge in hitting, I will take a good look at them. So far there is nothing but an allegation that hitting surged in 1996 with no specifics.
Mitchell was not my favorite senator when he was senate majority leader and he is not winning any more admiration with this, so-far, sleazy report. Some of the usual antagonists to steroids also appear in the report, as they do in the Senate hearings. The same crew of witnesses keeps recycling, making the same statements.
Steroids are not that dangerous. They don't kill people. The people who overuse them already have significant problems. Most of the effects are reverseable, though not always for women. Steroids, as the research I have discussed, are only moderately effective.
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Death by Exercise
December 8, 2007 11:25 AM
Thanks to an alert reader of the blog in Toronto we have a well-researched article on exercise-related deaths from Men's Heatlh.
It adds new statistics and explanations for the benefits and risks of exercise. As with nearly everything in human physiology, there is an increasing, but concave, benefits curve; the benefits of exercise rise, reach a peak, and then decline. There is an optimum or a range of optima; to be below or above the optimum range is harmful. Exercise beyond the optimal region is destructive and dangerous. 6 METS is a good upper limit for continuing activity. One can hit 8 or even 12 METS briefly in weight training. The hormesis concept tells us that these very brief stresses make us more able to tolerate the real stresses that life brings.
Weight lifting shines for its benefits and low risk. Running can be truly dangeous. Other aerobic endurance activities share the risks of excessive running.
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Marathon Kids
November 11, 2007 06:56 PM
If you ever have doubts that the marathon life style is presented as a model of health and well-being, have a look at what the movement is starting to do with our kids. Getting children to move and love fitness is wonderful, but there are so many more healthful and rewarding ways to do this that I can't support it. Then again, children's football has little in its favor and is just as apt to kill a child with a heart condition as marathoning. All competitive sports really ought to cut back on the age and degree of competition in children's sports. Few of them are truly healthy exercises or activities for children below the age of 14 and the old saw that "life is competitive and competitive sports teach lessons for life" is refuted day after day as pro athletes strike plea bargains on various charges and fall into drugs and wife beating.
A more balanced discussion of marathoning and running for kids is Marathons for Kids.
To enter a child in marathoning, even on a modest scale, a parent ought to do rather expensive screening for heart conditions, least they lose the child. The continuous exertion close to the limits of the cardiovascular system promotes ischemia of the heart. Play is far different from the monotonous, chronic exertion of marathoning. Children need to play.
My thanks to a reader for pointing out to me the growing intrusion of marathoning and organizations that promote it into the lives of our children.
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Over Training and sudden death
November 7, 2007 02:34 PM
I have searched for a good source on sudden death in athletes for some time now. Finally, I found an excellent one put up by the Minneapolis Heart Institute Foundation Sudden Death in Athletes.
The most common cause is Hypertrophic Cardiomyopathy (HCM). That large, slow-beating "athletic" heart may kill you. So can alcohol, energy drinks, and steroids. Which activity is most dangerous? You may see why I play tennis now. Weight lifting didn't make the grade, but competitive lifting is such a small sport. In part, the sports with the most participation rank highest. The incidence per athlete in the sport is not really known.
According to the Institute:
"Systemic training in endurance (dynamic, aerobic) or isometric sports (static, power) has been known to increase cardiac mass and dimensions, and trigger structural remodeling in many athletes (18-22). This form of hypertrophy is physiologic and is regarded as an adaptation to systematic athletic training, and therefore was termed "athlete’s heart." The changes include enlargement of left and right ventricles and left atrium; however the function of the heart remains preserved. Physiologic increases in cardiac mass vary in magnitude according to sporting discipline. For example, the most extreme cavity dimensions and/or wall thickness have been reported with rowing, cross-country skiing, cycling and swimming. Weight lifting and wrestling have been associated with abnormal increases in left ventricular wall thickness disproportionate to cavity size."
I noted the disruption of contraction pulses, ischemia or blood loss and consequent damage to heart muscle in an earlier post. That damage is then infiltrated by scar tissue and, as a result, the contraction waves become disorganized and arrhythmia may follow.
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Running to Death
November 5, 2007 09:16 AM
Several people sent links to the running death of Ryan Shay. Mark Sisson sent it and so did PaleoGal. Mark also sent a link on Alberto Salazar, a premiere runner who has run himself close to death several times. He had at one time been described as "a man who once heard testers declare his cardio output to be the greatest they had ever measured." Note also the severe loss of muscle mass associated with marathon training, one that Salazar tries to avoid in his trainees. No wonder they look like ghosts. When I saw some of the participants of our recent Huntsman Senior Games Marathon in St. George, they looked like the walking injured and near dead. If I can be a bit whimsical about it all, remember my Top 10 Reasons Not to Run Marathons. One of my most important (and criticized) posts. It may be sinking in. The evidence is close to overwhelming.
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Glutathione, Aging and Cancer
August 4, 2007 10:18 AM
Here is a bit more on why I think supplementing with glutathione (GSH) is a good practice as we get older. The mechanisms through which GSH reduces aging and prevents cancer are described (to the extent they are known, there may be others such as preventing cell senescence of cells by reducing oxidation of telomeres so that the Hayflick limit is not hit).
I have only quoted part of the article; those of you who have access can read it all. GSH detoxifies numerous metabolic products that promote aging and cancer, particularly toxins and carcinogens. I think it may be true that the aging we see in excessive runners is due to the depletion of GSH. Almost surely, depleted GSH is a factor in inflammation. A high carb diet supplies little GSH or other natural antioxidants and promotes a burst of free radicals that deplete GSH and other endogenous antioxidants. It also damages the HPA axis (the hypothalmic, adrenal, pituitary network) which is ruinous. Perhaps the only reason slightly better longevity is found in runners is that the rest of the subjects (the controls) live so poorly; with almost as bad a diet and too little exercise. Do recall that the mortalilty curve is J-shaped; it declines with exercise, hits a bottom and then rises. The over-exercised fare no better than the underexercised.
For those of you trying to gain muscle mass, be reasonable in your goals: wanting too much mass and too quickly is a prescription for getting fat and is unhealthy in so many ways. But, do note that GSH is important to muscle synthesis. I can put on muscle, even at my "advanced" age, just by looking at a barbell. I think GSH is one of several reasons for my response to exercise.
The text from the article is below...
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Sudden Death in Athletes
August 3, 2007 01:58 PM
Coming on the heels of the death of a 51 year old marathoner is the news that PaleoGal sent regarding a young man trying to become the World's Strongest Man. See also Jesse Marunde's Workouts and Diet.
While the media looks for reasons in Jesse Marunde's training and diet (and even speculate about what it means to be a man), they say nothing like that in the death of Brian Maxwell, the marathoner. It seems few journalists question the health benefits of marathoning, when it kills far more people than the bizarre lifting and eating that Jesse Marunde did. Of course, neither are worth the cost or the risk.
In Jesse's case, it is likely hypertrophic cardiomyopathy that killed him. It is the most common cause of death in young athletes, accounting for 34% of such deaths. A heavy blow to the chest is the next most common cause, accounting for about 20% of deaths in young persons engaged in athletics. Coronary artery malformations are found in about 14% of such deaths. Barring a blow to the chest then, congenital heart problems account for the greatest number of deaths.
Mocarditis, inflammation of heart tissue, is the cause of just over 5% of athlete deaths. Viral infections are the leading cause. So, it is unwise to run or train when you have a cold or the flu. Another cause of heart inflammation is overuse as might occur in a chronic runner. Perhaps that was a factor in Brian Maxwell's death as myocarditis kills cardiac muscle and induces arrhythmia and sudden death.
Heat stroke and possible drug use also cause sudden cardiac death, but I don't think anyone has the numbers to say how many. For a small fraction of sudden deaths the cause is not known. It is also well known that heavy muscle contraction raises blood pressure and that competitive lifters tend to develop enlarged heart muscles and thickened arteries. While you may be tempted to think this makes for a strong heart, an imbalanced musculature in the heart may alter the cascade of impulses across the heart tissue and alter the contraction pattern. I don't know if this contributes to arrhythmia, but it may.
Jesse Marunde's eating patterns can only be described as bizarre. They are probably not very dissimilar to some other strength athletes, who are not likely to have good longevity. The old adage that to be big you have to eat big or be in positive nitrogen balance has never really been tested. Eating excess calories puts on fat, not muscle. The heightened muscle gene expression caused by a work out is dampened in a high carbohydrate environment. Thus, the "window of gene expression" is closed if you ingest gainer drinks during the "window for replenishment."
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He Died Rich
July 29, 2007 09:16 AM
Brian Maxwell, a top marathoner, died of a heart attack at the age of 51. He "invented" the Power Bar. Thanks to Mark Sisson for the link.
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Training and Aging
Mark Sisson has an excellent post Training and Health summarizing well all the arguments we have come to know about over doing endurance training. He really ties it all together. Though his article is addressed to an audience of over-trainers, it has lessons for all of us. As we also have come to know, his article received a lot of negative comments from the committed over-trainers.
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Soccer Brain
July 24, 2007 04:03 PM
From the New York Post comes this brief article on brain injury among soccer players. This is not new news; other studies have shown slight cognitive deficiencies among professional soccer players. I remember telling a colleague that his son ought not to head the ball too aggressively.
Football is a candidate sport for the same sort of injury, much like boxing. In fact, many athletes develop a sort of punch drunk-like mentality even if they are not often struck in the head. In the case of soccer, repeated heading of the ball eventually kills brain cells.
Professional and highly organized amatuer sports do take their toll on brains and other body parts. I was beaned quite severely playing minor league baseball and also fell so hard in a motorcycle race that it "rang my bell". If only I hadn't hit my head so often. "I coud'a bin a contenda" to quote Marlon Brando.
HEADING FOR TROUBLE
Reuters
July 24, 2007 -- Playing soccer, where the ball is often hit with the head, may be linked to long-term brain injury and memory problems later in life, says a new study.
Researchers found evidence of reduced gray matter in the brains of 10 male college soccer players, compared with 10 young men who had never played.
Among players in the study, reduced gray matter was seen in the anterior temporal cortex - which is consistent with effects from repeated knocks to the front of the head, John Adams and colleagues at the University of Cincinnati College of Medicine in Ohio report in the Clinical Journal of Sports Medicine.
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A "Healthy" Doctor Runner with Heart Disease
July 2, 2007 01:45 PM
Following on the Salazar post on marathoners is another less dramatic story, but with the same plot: Excessive Running. The doctor who looked the picture of health and was a runner was expected to ace his treadmill stress test. Yet, he flunked and was found to have calcified arteries Hidden Heart Disease.
Note that by using vitamins C and E, natural antioxidants, the doctors treating the patient were able to partially reverse the disease. Don't run excessively (or only when you sprint briefly in my opinion) and do take antioxidants, especially if you do run excessively.
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An Elite Marathoner's Heart Problem
July 1, 2007 10:14 AM
Mark Sisson sent in this report about a 3 time NYC marathon winner Salazar.
We wish him well. I hope the marathoners are listening. It is injurious to your health and not at all helpful to your heart. How is it that such a dangerous activity has been promoted as healthful? Does it send up alarms about the soundness of health advice and research? I think so. But, the best research has already documented the many problems of over-training among runners (see my Top Ten Reasons Not To Run Marathons). If you love to run, then do so playfully, not obsessively. That medal on your chest may signal something deeper inside that is not right with your heart or your psyche.
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Asthma
June 30, 2007 05:30 PM
I was reading a review on the status of asthma through out the world and was struck by the strong correlation between obesity and the incidence and severity of asthma.
The bulk of the rise in asthma around the world seems to be diagnosis; that is, subjects see doctors more and are diagnosed. The criteria have also changed a bit. So, overall, more cases are diagnosed (this is true of almost any diseased these days and is a good sign that more people are gaining access to medical care).
The "clean environment" hypothesis, which says you need some exposure to pathogens to develop immunity, is only weakly confirmed. Generally, the diagnosis is hyperactivity of the constriction of the airways.
Asthma is a general condition of inflammation of the airways and lungs. Triggering events may be many, but the general condition of inflammation is the underlying and unifying trigger of asthma events.
I do think that inflammation is the broadest and most prevalent cause or symptom of disease in our time. From heart disease, atherosclerosis, Alzheimer's, lupus, MS, and so on the common issue is inflammed tissue. I would speculate that aging falls in that grouping too.
The most powerful sources of inflammation are obesity, excess production of free radicals, and lack of antioxidants in the diet. Obesity triggers many free radical pathways and the resistance to insulin that accompanies it accelerates the damage through the poor metabolism of fats and excess glucose in the blood (it oxydizes every tissue it reaches). Excess production of free radicals comes from drinking soft drinks and alcohol and consuming excess fats. It also comes from excessive aerobic exercise (many distance runners have asthma). The lack of anitioxidants comes from a poor diet, lacking in protein (a consitituent of antioxidant enzymes), too high in simple sugars and starches (they deplete antioxidants and contain few), and a lack of co-factors that stimulate enzyme action.
In the review I read, there were few conclusions to savor or try to use. It failed to look at the generalized inflammation hypothesis which I suspect is the most promising. When diet, activity, environment and obesity promote inflammation, then it is just a matter of which tissues are most susceptable and how weak the person's defences are to the latest stress. Chronic free radical stress from all the sources I listed push the most vulnerable tissues into a chronic state of inflammation. Specific therapies aimed at those tissues are not sufficient. A more general approach to attacking inflammatory producing processes at all sources seems more promising to me.
I do live this way. I always have in mind the inflammatory load associated with anything I do, eat, or drink. It is working, at least for now. I am looking forward to my 70th birthday with relish. I will celebrate with my new wife (WW) and new home in Mexico.
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Cardio Life
June 21, 2007 09:50 AM
You may know of Mark Sisson by now. I have posted some of his comments, coming as they do from a recovering cardio suffer. He has a nice post summarizing his experience and the evolutionary reasoning that under pin the Evolutionary Fitness Way. Have a look around his web site too. Go to Mark's Daily Apple.
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Fatigue
January 31, 2007 11:49 AM
A reader, T. J., was kind enough to send me this summary of an article on fatigue, see below.
The tired, fatigued, exhausted continuum seems to me to be a useful one. They also have an emotional component, noted by Dr. Olson; when I am tired I am usually happy because I have done something challenging and fun and enjoyed the process, even if the result didn't turn out as I had intended (there is no failure, only feedback). If I am fatigued, a rare event, I known that I am probably fighting off a "bug" or doing something I do not enjoy (and probably do not have to do). So, I stop right there.
Exhaustion must be a terrible thing to deal with; it is a total loss of adaptive capacity and dangerous.
The idea that there is just so much energy in the body is certainly wrong; an exhausted person may have thousands of calories of energy stored in body fat and muscle. I don't like these mystical appeals to energy sources, energy pathways, and floating fields that the quacks and gurus of self help nonsense promote.
These states are not physical states, they are states of the nervous system in the advanced stages of fatigue and exhaustion. The nervous system is increasingly isolating the person from the external world.
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Muscle Breakdown in an Elite Runner
November 30, 2006 09:27 AM
From Tom, a reader in New Jersey, this story.
This is one of the mechanisms that diminishes muscle mass in runners. This case was more severe. The breakdown is a continuous process during a long exertion in any sport. But, it takes a large effort to go this far. There may also have been other elements, as noted in the story.
Of course, elite runners ask too much of themselves. But, so do many of us in other endeavors. I have learned to play and enjoy what I do, not push limits.
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Marathoners and Skin Cancer
November 21, 2006 12:59 PM
From a reader named Scott comes this interesting article about marathoning and skin cancer. The remarkable thing is the dose-responsiveness of skin cancer to training time; those who trained more showed more cancerous and pre-cancerous skin cells.
It may not be only sun exposure. More likely it is the combination of chronic exposure with suppressed immunity. Free radicals are behind the skin cancer --- a half hour in the sun depletes the Vitamin C content of the epidermis. Marathoners generate a lot of free radicals from their aerobic activity and their glucose-heavy diet. The loss of peripheral circulation (caused by rerouting blood flow to the muscles) would also be a contributing factor because this denies antioxidants to the skin during training.
The list grows...
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Should My Daughter Run 10Ks?
November 19, 2006 04:48 PM
Mark Christensen (author of Supercar) asked if his daughter should continue to run 10Ks. She finished high among 1500 runners in her first race with only light training.
You might be able to guess my answer. I would say No, she should not continue to run them. Some reasons:
1. She did not collapse and, so, may not have a heart issue that will kill her. But, you may not know for sure. She ought to be screened.
2. Light training is OK, but her next step will be to increase training to do better. If it works, she will do better and then come back and train harder. This positive feedback loop is a non-linear path to ill health and much wasted time.
3. Why would she drop tennis, a beautiful and more healthful sport, for the drudgery and risk of long distance running? I don't get it at all. Any bragging rights she might earn are worthless.
4. It is a highly destructive activity. Ankles, knees, hips, and lower back all take a pounding. She will develop poor posture and progressively grow shorter as her spinal disks compress. Her vascular system will become inflamed and she may develop asthma from the LA basin air and high volume breathing. She will age more rapidly and compromise her immune system. Her stress hormones will elevate and her good hormones will decline.
5. She will become slower unless she adds sprinting into her mix. And she is likely to develop a higher level of body fat, particularly if she begins eating the pitiful foods runners eat.
6. The free radicals produced by running and the glucose heavy foods runners eat will expose her to high oxidative stress. Her mitochondria will take a beating and may eventually go into premature decline (though years later).
7. Her muscle mass will decline as the cells go into their suicide program from the heavy inflammation induced by excessive running.
8. The pretty, happy, and athletic young woman that is your daughter will become a fat, skinny, compulsive, overtrained and prematurely aged woman with a slight scowl on her face in place of that smile if she becomes a chronic runner.
9. Her risks of brain cancer will rise as will the likelihood she may be injured in traffic. Or accosted out on a run.
10. It takes too much time and is no fun.
What ever possessed people to do this? As I said in my Charles Staley interview, I believe jogging and running were encouraged by lab research that was seriously incomplete. Researchers were able only to do the lab testing on runners and cyclists because the methods were available for this and the models are far simpler than what is required to do anarobic research. Running is steady state work, power activities are non-steady state and far harder to model. Only now are tools for non-linear modeling of human activity becoming available.
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Sudden Cardiac Death in Athletes
September 21, 2006 02:32 PM
This has become a more serious discussion and a worthy one I think i view of the favor with which the press and the public tend to look at athletes as a model of health. One of my readers was kind enough to point me to a review for physicians of sudden cardiac death in athletes. I can't put up the whole text but a few portions and some summarization are enough to put this discussion on a foundation of data and physiological consequences of athletic training for competitive sports. The document is Sudden Cardiac Death in Athletes: A Clinical Perspective by Michael Gold, MD, PhD and is published on the Medscape web site.
From our perspective the study is limited because it is focussed on underlying heart disease and how athletic training affects it. On the other hand, many people have undiagnosed heart disease.
The introduction begins by describing adaptations in the heart from athletic training and offers a definition of "athlete".
Athletes are generally thought to be very healthy, so when sudden cardiac death (SCD) occurs in this population, it is a particularly unexpected and high-profile event. But just as in the general population, athletes can harbor undiagnosed cardiac disease and congenital abnormalities that unknowingly put them at high risk for SCD. Moreover, intensive athletic activities may trigger life-threatening arrhythmias in susceptible subjects. It is noteworthy that athletic training can result in physiologic adaptations in the heart (including atrial dilatation and hypertrophy) and autonomic changes in heart rate control (such as sinus bradycardia, atrioventricular [AV] nodal conduction disturbances, and atrial fibrillation [AF]) that can be difficult at times to distinguish from more serious structural or arrhythmia problems.Although the word "athlete" can be defined in various ways, the 36th Bethesda Conference on sports eligibility recommendations for athletes with cardiovascular abnormalities defines a competitive athlete as "one who participates in an organized team or sport that requires regular competition against others as a central component, places a high premium on excellence and achievement, and requires some form of systematic (and usually intense) training."[1]
A large 21 year study in Italy quantified the risks of physical activity in adolescents and young adults and found the incidence of SCD to be 2.62 per 100,000 among athlete males, 1.07 among athlete females versus 1.00 for the entire cohort (athletes and non-athletes). 89% of deaths were exercise related versus 22% for the cohort. Still the number of deaths is low and the risk is low; just 300 SCD in the 21 year study period involving 1.4 million people. Nonetheless, the low risk was doubled for athletes relative to their cohort peers.
Contributing risk factors for SCD are summarized as:
There are a number of underlying cardiac conditions that increase the risk of SCD in athletes (Table 2).[6] Congenital heart disorders are the most common associated disorders found in those under age 35 and are estimated to account for at least 40% of sudden deaths in young athletes in the United States.[7] Chief among these is hypertrophic cardiomyopathy (HCM), which is fairly common in the general population (occurring in 1 of every 500 individuals); this condition is responsible for an estimated one third of SCD cases in young athletes. Other common congenital causes include arrhythmogenic right ventricular cardiomyopathy (ARVC), Marfan syndrome, and ion channel abnormalities, such as long QT syndrome. These genetically linked diseases may account for an additional 10% of SCD cases.[8]
Older athletes...
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He Was So Active
September 20, 2006 11:41 AM
Another death. I can't go into the details, but a long-distance runner died of a heart attack.
His friends said, as they always say, "He was so active. How could this happen?"
We are beginning to see why. The human heart and vasculture were never made to do the extreme things heavy-duty runners and cyclists (and some others) do to it.
The inflammation load is huge and the diet is rotten. And they work synergistically to make things worse: the inflammation from the ischemia and microdamage is heightened by the flame of glucose.
Measuring health by how far you can run is a bad metric. So is using the bench press as a measure of anything other than a bench press.
A run is just a run and a bench press is just a bench press. Health and performance are something altogether different and far too complex for any single measure.
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Lab Tests and Field Tests
September 4, 2006 04:24 PM
I recall an incident when I was working at a think tank for the Navy. I'm fuzzy on the details (it was 37 years ago and I only heard of it second hand), but the story goes there were some field tests and lab tests on a weapons system. The analysts who did the statistics said: The difference between the field and lab performances were statistically insignificant. They were fired. I am sneaking up on the marathon discussion, be patient.
Why were they fired? Because every one who had ever operated the systems or witnessed the operation in the field and lab knew they were different. [I have had this same conversation with Duncan Luce, the esteemed mathematical psychologist, who says the labs only catch a glimpse of human abilities and often constrain responses because humans do the strangest and cleverest things that the experimenters had not anticipated.] The Bayesian statisticians also had their say on the matter. They said that a prior distribution, based on the experiences of military personnel, would argue that there would be a difference of some magnitude. So, it was a matter of how much the experiments in the lab and in the field moved the prior expectations. Well, in this instance the lab and field tests strengthened the prior expectation that there is a difference. Don't you think there would be one? Of course. I would. The lab is very different from the field. And it turned out that the personnel worked harder in the field to overcome equipment deficiencies that seldom showed up in the lab. [This is part of the story of how Big Blue, the IBM computer, beat the human bridge champion. It had human help making adjustments.] Another trivial issue was that there were few of either kind of test. If statistical significance of the old kind, before cheap computers could calculate the revised distribugtion, meant anything it meant it all depended on the size of the sample. Big sample, like some of the longitudinal Framingham and Nurses studies, make everything statistically significant in the old framework, even though they wouldn't cause you to put your socks on differently if you could see the field data.
This is how I approach the field and lab experiments on human performance. They ought to differ and one must weight the evidence plainly in front of our eyes against lab and epidemiological sorts of studies.
This is how I approach the studies on human performance and health...
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Coronary Heart Disease in (you guessed it) Marathon Runners
September 2, 2006 04:19 PM
We have been through this before. This abstract not only speaks to the danger of running marathons. It speaks to the obsessiveness of the people who do them. All of the 6 runners studied had warning symptoms. One died. Three went on despite symptoms. It isn't about health. It is proving something to themselves or some one else. That is always an easy way to harm yourself. What for? Who cares?
Well, read the rest from the Annals of the New York Academy of Sciences. Then throw away your running shoes.
Ann N Y Acad Sci. 1977;301:593-619.
Related Articles, Links
Coronary heart disease in marathon runners.
Noakes T, Opie L, Beck W, McKechnie J, Benchimol A, Desser K.
Six highly trained marathon runners developed myocardial infarction. One of the two cases of clinically diagnosed myocardial infarction was fatal, and there were four cases of angiographically-proven infarction. Two athletes had significant arterial disease of two major coronary arteries, a third had stenosis of the anterior descending and the fourth of the right coronary artery. All these athletes had warning symptoms. Three of them completed marathon races despite symptoms, one athlete running more than 20 miles after the onset of exertional discomfort to complete the 56 mile Comrades Marathon. In spite of developing chest pain, another athlete who died had continued training for three weeks, including a 40 mile run. Two other athletes also continued to train with chest pain. We conclude that the marathon runners studied were not immune to coronary heart disease, nor to coronary atherosclerosis and that high levels of physical fitness did not guarantee the absence of significant cardiovascular disease. In addition, the relationship of exercise and myocardial infarction was complex because two athletes developed myocardial infarction during marathon running in the absence of complete coronary artery occlusion. We stress that marathon runners, like other sportsmen, should be warned of the serious significance of the development of exertional symptoms. Our conclusions do not reflect on the possible value of exercise in the prevention of coronary heart disease. Rather we refute exaggerated claims that marathon running provides complete immunity from coronary heart disease.
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Junk Science
August 23, 2006 02:23 PM
Couldn't let this go by without some comment. I use this as a way to show the difference between proximate and evolutionary explanations (see Williams and Nesse, Why We Get Sick).
Keep those news stories coming in about extreme athletics and death, injury, and illness. We are compiling raw data that call attention to the problem and to stimulate an interest in doing the needed research.
From Maffy
How on Earth do you infer from this article that this guy's death had anything to to with his training or his vegetarian diet? The cause of death is never even mentioned, let alone the contributory factors. This is the worst kind of junk science. Citing isolated incidents that happen to support your theory and then extrapolating an unsubstantiated causal relationship from them. There is absolutely no effort to establish any kind of broad population analysis nor to compare the incidents to any kind of control group. Absolutely worthless.
I have been around. I have seen a lot of junk science in the court room as an expert, as a journal editor, as a long-time referee for many journals and as a reader of many journals. Asking a reporter to probe the deeper causes of the story is asking too much. I know, I talk to many of them and they have a deadline and limited training in the subject. Just today and yesterday I spoke with the WSJ, the AP, and have a request to speak with Bloomberg. I tell them to read my book and they say they don't have time and it is too hard. And it is. I can't blame them. So, I try to make sure they get most of it right.
The way to do Junk Science (see Peter Huber's fine book Galileo's Revenge for junk science in the court room) is to:
1. Call someone else's data and arguments "junk science". This you have done.
2. To set a standard for data that is beyond what is appropriate for the hypothesis or argument. You have set a standard so far out there, that you can reject any inconvenient piece of data that may threaten your position.
3. To attribute a silly claim to someone and then to say or show it is silly. You claim that I claim that there is some direct causal linkage here when I do nothing of the sort. The disclaimers leading up to the report are fully made and you attributed to me something I did not say or claim.
4. To discredit any data that may reflect adversely on a given position. There are, in fact, few data on these kinds of events. You may look in some futility to find good epidemiological studies of deaths, illness, or injuries among extreme endurance athletes. I have tried to find good data on this and did not succeed.
You are also confusing proximate cause with the deeper evolutionary cause of death and inflammation through excessive endurance training. You are looking for the proximate cause: he ran too far and too fast and his heart collapsed (measured how? itself a complex problem). The evolutionary explanation would be that the human body is not adapted to these extreme activity levels. They are unprecedented in the evolutionary context. The exhaustion, inflammation, and injuries these athletes experience are the body's attempts at adapting to these extreme and repetitive stresses. This is one of the role's of lactic acid accumulation in muscle; it shuts the muscle down before it is torn apart. When a runner gets diarrhea it is the same thing: the bowels are in an ischemic state and dump their load to survive.
There are well-known pathways through which cardiovascular disease, brain and other cancers, immune disfunction, inflammation, muscle apoptosis, elevated stress hormones, ischemia and a host of other pathological conditions can result from extreme endurance training. I have a number of posts on this. Moreover, the diets used by these wounded athletes are quite awful and damaging too. Then there are all the performance enhancing drugs and practices that take a toll.
So, this is an under-researched area and one of growing importance in view of the favorable coverage endurance athletes receive. Many of them seem to have an air of superiority too that is wholly unjustified. One way to call attention to what is a scientific problem of modeling the odds of injury or death from endurance training is to start collecting data on the events. Eventually, the sheer weight of the data may induce a researcher to begin the hard work of collecting solid data and doing the required analysis.
I remember when H. Hurt began to study motorcycle traffic deaths. It was an enormous undertaking; going to accident sites and painstakingly recording the scene, reconstructing the events, documenting the injury points on the body and so on. It was years before he could do some analysis of the data and the results revolutionized the understanding of motorcycle fatalities. It wasn't the motorcycle going too fast. It was drivers turning left right in front of them, claiming they did not see them. It was failing to use the front brake and losing steering control by locking the rear wheel and taking too long to stop. It was poor helmet design or no helmet.
We are at that stage now in analyzing extreme endurance sports and their effects on human mortality, illness, and injury. Here is hoping that by collecting news reports we may stimulate another Harry Hurt to do the hard work of documenting the dangers of this dangerous activity. Mothers: don't let your sons grow up to be marathoners.
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A Wellness Director Biker Death
August 22, 2006 01:17 PM
The news is coming in so fast it is hard to get it all up. This is another cycling death, following closely after the ride.
I would rather not comment, but you have to notice the discordance here of someone with a passion for wellness dying this way. But, all the articles say this and no one notices the disconnect; chronic and extreme endurance training are the anithesis of a healthy lifeway.
See the sad news here Another Cycling Death
Another one to put up after this.
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A Vegan Swimmer Dies
August 21, 2006 07:56 PM
This on a death from a reader. The topic has been up one day and we have a death and a cancer diagnosis to report to those of you who may think extreme endurance training is healthy.
If you are new to this site, understand this: I am not making light of these tragic deaths. I respect the choices each of these individuals made. Nor is it necessarily true that their form of extreme exercise was the cause. But, it is almost surely a contributing factor and no one should promote these extreme forms of exercise as healthy. Nor is vegetarianism healthy, as the widow states in this news artice. To the contrary, the evidence is there for anyone to see. Extreme endurance training and veganism are not good choices for a long and healthy life. Or even for a life filled with energy.
Gary Eaton who swam with the Georgia Masters program since 1993 (for both Dynamo and the Killer Whales), died during a swim workout on Monday. Gary was one of those persons you know you're going to like the first time you meet and you treasure their friendship. And he was an incredible swimmer..... I've reprinted his obit published in the AJC today. =========================================================================== ATLANTA Gary Eaton, 49, swimmer, dog loverBy HOLLY CRENSHAW
The Atlanta Journal-Constitution
Published on: 05/04/06
Sunday was a glorious day for Gary Eaton. He was a health enthusiast who was crazy about animals, and the Atlanta Dog Jog in Piedmont Park was made-to-order fun.
Running wasn't his thing, but years of competitive swimming helped him sprint to an easy finish with one of his rescue dogs, Loretta Mae."He actually came in second in the large dog category that day," said his wife, Laura Eaton of Atlanta, who cheered him from the sidelines with their 20-month-old daughter, Callie.
"He was just in the greatest shape. He ate very healthy and had the most incredible body."
Gary Lee Eaton, 49, of Atlanta died of heart failure at Piedmont Hospital on Monday after suddenly collapsing during his morning swim routine. The body was cremated. The memorial service is 10 a.m. today at St. Martin in the Fields Episcopal Church. H. M. Patterson & Son, Oglethorpe Hill is in charge of arrangements.
Mr. Eaton could not have been more fit, his wife said. He set his alarm clock for 4:45 a.m. Mondays, Wednesdays and Fridays to join his master's swim team for an early morning workout.
On Tuesdays and Thursdays, he slept in an extra hour, then headed to the gym before work.
His swimming took him beyond Atlanta's chlorinated pools to open-water swims in Lake Tahoe and to St. Croix, where in 2002 he finished ninth in the men's division.
The Kentucky native attended the University of Kentucky on a swimming scholarship and earned a bachelor's degree in business in 1979.
"Gary swam four years in college at the Division I level, and shockingly, he was swimming better in his 40s than he was a 22," said his friend Rick Pannell of Lexington.
Mr. Eaton started his banking career in Charleston. He moved to Atlanta in the late 1980s, where he worked as a loan officer, most recently at Quantum National Bank in Suwanee.
He never lost his love of Kentucky, both the state and the university's sports teams. He read several newspapers a day but always started with Lexington's.
His wife said she was banished when he was watching UK basketball, for fear she might speak mid-game.
Mr. Eaton's friends called him "Magnum P.I." because his fashion sense was stuck in the '80s.
"He had the sweetest personality, and what attracted me to him was that he was such a calming force," his wife said. "He gave the best advice. He really should have been a therapist."
Every time he cranked his car, Mr. Eaton made sure he had dog biscuits in his glove compartment. He stayed on the lookout for stray dogs, then lured them with treats and found them homes with his friends. He had a soft spot for Second Chances Animal Rescue, where he adopted two dogs.
Jojo, a hound-lab mix, still bears a one-inch-thick scar where previous owners let a rope grow into her skin, Mrs. Eaton said.
Loretta Mae, the spotted Treeing Walker coonhound that ran with him Sunday, had lost 35 pounds after she was abandoned in the woods.
Mr. Eaton was a vegetarian, partly for health reasons but mainly because he loved animals so much, his wife said.
"He thought there was enough pain in the world without causing any more."
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A Marathon Cancer
This from a reader. Our first of what I think will be many postings to this topic.
Sadly, former marathon world record holder and 9-time winner of the NYC Marathon Grete Weitz has cancer.
It might not be the marathoning, but it probably is. A sad diagnosis, but one I have come to expect of marathoners. Grete Waitz has cancer. She won the Gold Medal at the 1983 Olympics.
She is in some form of denial, but denial is good I think in cases like this. It is likely brain cancer, just as Lebow, the founder of the running group to which she belongs died of. See my post on how extreme running promotes brain cancer.
Ironically, she stills believes that running is healthly and is actively involved in promoting running as a healthy lifeway. You decide what you think, but the answers are piling up. It isn't.
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A New Archive
August 19, 2006 09:27 AM
After much thought, I have decided to add another archive called Endurance Training Deaths. When I see or a reader sees and sends me a news item about a death related to a running, cycling, triathlon or related death from an endurance event I will post it. There must be a close connection between the activity and the death, though this may be too stringent as some deaths or ill-health are related to the more chronic toll that over-training takes on the immune system or related from the metabolic problems that result from the high carbohydrate diet favored by endurance athletes. This is not about putting down these sports or making light of the deaths; it is simply an antidote to the favorable and misleading opinion about the relationship between endurance training and health. A bit is just fine, but too much is deadly. Ischemia, reperfusion injury, and inflammation are some of the pathways through which heavy aerobic training endangers the heart.
Do send me any verifiable news you find on this growing and much under-reported problem. I will gradually go back over the archives to label some of the earlier posts on this sad topic.
Here is the first, a small part of an article by Wes Phillips of Stereophile Magazine (one of my favorites) sent to me by a reader. It is a sadly ironic piece because the cycling that contributed to his death was intended to contribute to this person's health:
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Triglycerides and "Runner's Diet"
August 2, 2006 08:30 AM
I think you ought to see this comment by Audley so I am posting it.
Years ago when my triglycerides were off the charts, my doctor told me to exercise more to bring the levels down. At that time I was training for my black belt in karate 4 to 5 days a week, running 8 miles, 3 days a week, and weight training 3 to 5 times a week. Any more exercise would kill me. What was wrong? Diet. I was eating the runner's diet of pasta, pasta, and more pasta. I now eat a higher protein version of Art's diet, do high intensity weight training 2 or 3 times a week, walks with some sprints thrown in 2 times a week, and my numbers are normal. I wonder if a runner eating Art's paleo/med diet would be any healthier.
According to a study I recall, but won't look up right now, of all the measures of heart health related to cholesterol and triglycerides, the ratio of triglycerides to HDL is the best predictor of cardio events (this static measure was not compared to heart rate variability, which is a better near and long-term predictor). A ratio of Tri/HDL below 2 or 3 was an indicator of excellent heart health. Mine was so low it was nearly off the scale; if I recall it was about 0.3 or so.
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Marathoners and Other Sick People
July 31, 2006 09:04 PM
A lot of marathoners, triathletes, and high distance runners are ticking time bombs. You know that, but the evidence keeps coming. Here is an item from a doctor:
Interestingly, I recently had a patient in his 40s who was both vegetarian and a marathoner, whose angiogram showed severe triple-vessel disease not amenable to stenting, requiring surgery.
The same person was kind enough to send an article from Nutrition, Metabolism & Cardiovascular Diseases. The title and introduction are below.
The authors find that homocysteine (tHcy) is the culprit (you have seen this in my previous posts) and these runners know they must take B vitamins and folic acid to keep it down. Not enough. Homecysteine kills endothelial cells. The substance forms ridges in the endothelium and then the plague and cholesterol intrude to form mounds of foam cells. The cholesterol is actually attempting to heal the damage. Cholesterol is an event after the damage, not a cause of the damage, though it may cause additional problems as is true of any acute response to injury.
You will find that brief, high intensity training does not increase tHcy in men but might do so in women. I never recommend that women work out as hard as men for this and for many other reasons. The bottom line is that after a marathon half the individuals had tHcy levels that are considered to be above the cut-off point for ischaemic heart diseases (injury from oxygen insufficiency).
In other words, they were very sick and more at risk than a couch potato.
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More Damage from "Elite" Athletics
July 26, 2006 04:36 PM
Mark Sisson has added new data to his previous post to the effect that elite athletic training is the antithesis of health. I have put links to some previous posts I did on the subject. If you look at Mark's recent data, his earlier post, and my many posts on this topic you will throw away your jogging shoes. Or as I used to be tempted to say to joggers as I drove by, "Slow down and live." Really, how did all this get started? And why has it gone so far? And, why are these data not known to the public?
I used to get some cranky emails from committed aerobicizers telling me I was all wrong. The data are now overwhelming. And, did I mention the high incidence of brain cancer among multiple Boston Marathon competitors? Yes, I think I did but it bears repeating.
Mark's convincing data:
"Here are some real cases to review – and many of these are people I know personally: Greg Welch, one of the most versatile all-around triathletes ever (he won Ironman Hawaii, the ITU Worlds and the world Duathlon Championship) was forced to retire at age 37 due to heart problems. He has had over 10 open heart surgeries and wears a pace-maker. Mark Montgomery, who was a top pro triathlete for many years, had his pace-maker installed at age 46 as a result of V-tach issues. Johnny G, the developer of the popular “Spin” classes and a RAAM racer, has severe cardiomyopathy and recently had a pacer-maker installed. Maddy Tormoen, 3-time world Duathlete-of-the-Year and 35-year old Emma Carney, twice ITU World Triathlon champion each now have defibrillators implanted in their chests to correct life-threatening arrythmias. Chris Legh and Julianne White, both Ironman winners, have each had entire sections of their colon removed immediately after a race due to “ischemic conditions” where the blood supply to the GI tract was rerouted for so long (as the body diverted the blood to its periphery to cool itself) that whole sections of the colon literally died from lack of oxygen and nutrients. John Walker, one of the greatest milers of all-time was diagnosed with Parkinsons at age 46. Marty Liquori, another world-best miler was diagnosed with leukemia at age 43. Bruce Balch, Steve Scott and Lance Armstrong (all endurance athletes) all got testicular cancer after a few years of competing. Most of the top runners from the 80’s don’t run anymore; many can barely walk due to arthritic conditions. And we think endurance training is healthy?Then yesterday's LA Times cover story was on the 18 Pittsburgh Steelers who have died prematurely in the past 4 years. It's incredible.
Rusting Steel"Mark Sisson
Links to my earlier posts
Glucose Blunts Gene Expression
Top 10 Reasons Not to Run Marathons
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Elite Athletic Training and Disease
July 17, 2006 07:02 PM
My grandson Corey and I are off to the US MotoGP races at Laguna Seca early Wednesday morning. In my absence I am posting another one of Mark Sisson's terrific essays. In this, he further elaborates his thesis that elite athletes who are constantly presented to us in the media as super fit, in fact, are not. They pay a terrible price, as do all professional athletes, for their successes.
In my view, they are so specialized and overtrained they have little real fitness for life. Lab experiments on rats often show that those that play and run are more fit than their fellow cage inhabitants. Their running becomes habitual because that is all they have in the sterile environment of the lab cage. Elite athletes, in my view are similar to these caged rats. Their habitual and almost obsessed training puts them in a lab-like environment where they are not free-ranging wild animals. Recall the experiment where wild rats where compared with lab rats in their ability to hang from a wire. The lab rats hung until they dropped. The wild rats pulled up onto the wire and ran off.
I prefer to live like a wild animal, not an overtrained rat living in a cage.
As we have come to expect, Mark nails it. He has the right evolutionary perspective too and writes lucidly. See it below...
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Those Glucose Guzzling Cyclists
March 27, 2006 02:40 PM
And just in case the last post about muscle glycogen and gene expression made you give some thought to the Body Builder Mags and all that glycogen replenishment nonsense, here is one of the powerful reasons cyclists and marathoners are not all that lean. It also points to a way by which they might better their performance.
The hidden point here is that carb ingestion of the sort that most people do these days turns off genes that increase fat metabolism. FFA is liberated by exercise when in the fasted state, but not when you are in the filled-with-glucose state. And who isn't these days between eating donuts for the under-exercised and ingesting glucose for the body builders and endurance sports participants. I don't know any marathoners or middle distance runners who don't eat junk. That is almost all they eat so concerned are they with glycogen loading and replenishment.
Note that little know uncoupling protein again. UCP3 is turned down by carb ingestion. One of these days I will explain UCP3 or I may just leave it for the book.
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Marathoners Again
October 5, 2005 07:59 PM
I think it is no longer necessary to relate further health issues suffered by marathoners. I don't think many who read this blog do marathons, though more than a few did at one time.
Now comes this perceptive recollection by reader Parker Walker of once great marathoners gone bad. The list of problems and diseases suffered by once high level runners is damning of long distance, high volume running.
"Do you remember New Zealand's John Walker? He was a great Olympic distance runner but is now suffering from Parkinson's: Cool Running
Your marathon writing had me thinking about not only Walker but many, many of the distance runners over the past 20 - 30 years who have had severe illnesses:
Steve Ovett (Olympic 1500 champ and record holder in the mile)
Mark Conover (US marathon champ)
George Sheehan (running guru)
Priscilla Welch (marathon runner)
Steve Scott (US mile champ)
...and many others. A close friend of the family is still a marathoner in his 60s but has suffered from, of all things, breast cancer. He's been a distance runner all of his life but here is this lean, mean running machine having 1/2 of his chest cut off.
Former triathlon champion Scott Tinley once wrote a piece noting the human body has only so many races and mileage in it...after that, it no longer is fun to subject yourself to the trials and tribulations of hardcore distance training. Something to be said for that."
I have two further comments. First, if you look at my earlier post on how many heart beats are there in a lifetime, you will see that it is not generally true that you only get so many heart beats in a life. That conclusion is based on faulty reasoning, please see my earlier post for my reasoning and a discussion of the issues.
The second comment is this, and it is more general since it applies to body builders and the obese as well as to marathoners. It is this: our ancestors experienced anabolic and catabolic states intermittently and often. It is the alteration in states that triggers proper gene expression and mild stress responses that keep your body and brain healthy.
Body builders live too long in the anabolic state, with too little variation. Marathoners live too long in the catabolic state, with too little variation. Brief episodes of varying length in either state surely were the norm of ancient human life. We know this because the brain is highly adapted to ketones; the state of ketosis is triggered by episodes of hunger and negative caloric balance. Ketosis is good for the brain, in fact, it is a proven therapy for epilesy.
What I try to do, in a wholly random and unplanned way, is to alternate episodically anabolic and catabolic states. This is done primarily by alternating caloric balance through energy intake and expenditure, randomizing each.
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Marathoners and Injuries
September 30, 2005 05:42 PM
This morning's local paper had stories about five participants in the upcoming St. George Marathon. Their experiences were sad, expected, and funny all at once.
One of the competitors entered in the marathon runs 14 miles three days a week on a treadmill, works out two days a week with weights, and bicycles the two days of the week end. Overtrained? Of course. He was out just a few days ago and picked up the pace on a down hill (real as opposed to treadmill) run. He pulled a hamstring muscle. He still plans to compete.
Another competitor has developed a form of asthma that hits long distance runners. They use their aerobic system so extensively that their upper respiratory system takes a beating which sometimes results in an inflammation of the tract and sometimes lower into the lung. She knows she will have a bout with symptoms after the event, but she plans to compete anyway.
Yet another trains at 5AM so she can get her daughters up and off to school in the morning. She gets 4 hours of sleep a night. She didn't look very good in her picture. Just days ago she sprained a tendon in the front of her foot descending the stairs. She plans to compete nonetheless.
Another has Parkinsons and isn't sure he will make it. No evidence that he has been helped or harmed by doing marathons. But, I would bet on it that the consquences are negative.
Finally, the other is a paraplegic who does the marathon in a wheel chair. Bravo for him. But, on the other hand there are better and safer things to do. But, it is his choice. Well, he blew a tire on a downhill run and flipped the chair over. It didn't kill or hurt him. This time. He hopes to have it back together in time for the race. The St. George Marathon has some steep and long downhills.
Are they having fun? Is what they are doing healthful? Do they seem a bit compulsive? I think so. What I do isn't always safe, but it sure is fun and I have compulsion to set any records. Though, I would like to hit more home runs over the fence this year than last in the Huntsman World Senior Games next week. It shouldn't be hard, but home run hitting is one of those areas of extreme human accomplishment. My paper on home run hitting and steroids will be up on the site sometime next week.
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Deaths in the NFL
August 22, 2005 01:44 PM
It is too soon to say how Thomas Herrion, the latest NFL football player to die, died. Mr. Herrion died soon after the game. The single most important factor contributing to sudden athletic deaths is a preexisting heart condition. Most are undiagnosed. There is a lot of impact and bruising in a big time football game. But, there is a great underlying cardiovascular stress. The rushing and extreme bursts take time for recovery and the pace of the game often does not allow for this.
A very large person, in terms of body mass, has less vascular volume per unit of mass. And they have less heart mass and pumping volume as well. Organs do not scale fully with body mass. Height is also a factor because a tall person has a high column of blood whose mass must be supported by the heart.
NFL players are big, but they are fat too. Fat is a burden and adds no motive power. It does add shock absorbing tissue in football, but little else. The inertia it adds may be of some help to a defensive tackle. They become harder to move by others as well as on their own volition.
Most athletes are too fat to perform optimally. Lance Armstrong dropped fat and added lean body mass over the years, see my post, and this added about 10% to his power to weight ratio. In an earlier post, I showed that lean body mass was the underlying factor in the performance of superior high school wrestlers. And, I mentioned some time ago that Ivan Lendl ascended to his superiority when he dropped body fat.
And now comes this brief note in JAMA by Dr. Joyce Harp...
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Top Ten Reasons not to Run Marathons
August 17, 2005 09:23 AM
With my apologies to David Letterman, here are the top ten reasons not to run marathons.
10. Marathon running damages the liver and gall bladder and alters biochemical markers adversely. HDL is lowered, LDL is increased, Red blood cell counts and white blood cell counts fall. The liver is damaged and gall bladder function is decreased. Testosterone decreases.
From Wu, Worl J Gastroenterol. 2004 Sep 15: 10 (18): 2711-4, "RESULTS: Total bilirubin (BIL-T), direct bilirubin (BIL-D), alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and lactate dehydrogenase (LDH) increased statistically significantly (P<0.05) the race. Significant declines (P<0.05) in red blood cell (RBC), hemoglobin (Hb) and hematocrit (Hct) were detected two days and nine days d after the race. 2 d after the race, total protein (TP), concentration of albumin and globulin decreased significantly. While BIL, BIL-D and ALP recovered to their original levels. High-density lipoprotein cholesterol (HDL-C) remained unchanged immediately after the race, but it was significantly decreased on the second and ninth days after the race. CONCLUSION: Ultra-marathon running is associated with a wide range of significant changes in hematological parameters, several of which are injury related. To provide appropriate health care and intervention, the man who receives athletes on high frequent training program high intensity training programs must monitor their liver and gallbladder function."
9. Marathon running causes acute and severe muscle damage. Repetitive injury causes infiltration of collagen (connective tissue) into muscle fibers.
From Warhol et al Am J Pathol. 1985 Feb: 118 (2): 331-9, "Muscle from runners showed post-race ultrastructural changes of focal fiber injury and repair: intra- and extracellular edema with endothelial injury; myofibrillar lysis, dilation and disruption of the T-tubule system, and focal mitochondrial degeneration without inflammatory infiltrate (1-3 days). The mitochondrial and myofibrillar damage showed progressive repair by 3-4 weeks. Late biopsies showed central nuclei and satellite cells characteristic of the regenerative response (8-12 weeks). Muscle from veteran runners showed intercellular collagen deposition suggestive of a fibrotic response to repetitive injury. Control tissue from nonrunners showed none of these findings."
8. Marathon running induces kidney disfunction (renal abnormalities).
From Neyiackas and Bauer, South Med J. 1981 Dec; 74 (12): 1457-60, "All postrace urinalyses were grossly abnormal...We conclude that renal function abnormalities occur in marathon runners and that the severity of the abnormality is temperature-dependent."
7. Marathon running causes acute microthrombosis in the vascular system.
From Fagerhol et al Scan J Clin Invest. 2005; 65 (3): 211-20, "During the marathon, half-marathon, the 30-km run, the ranger-training course and the VO2max exercise, calprotectin levels increased 96.3-fold, 13.3-fold, 20.1-fold, 7.5-fold and 3.4-fold, respectively. These changes may reflect damage to the tissues or vascular endothelium, causing microthrombi with subsequent activation of neutrophils."
6. Marathon running elevates markers of cancer. S100beta is one of these markers. Tumor necrosis factor, TNF-alpha, is another.
From Deichmann et al in Melanoma Res. 2001 June; 11 (3): 291-6. "In metastatic melanoma S100beta as well as melanoma inhibitory activity (MIA) are elevated in the serum in the majority of patients. Elevation has been found to correlate with shorter survival, and changes in these parameters in the serum during therapy were recently reported to predict therapeutic outcome in advanced disease."
From Santos et al Life Sci. 2004 September: 75 (16): 1917:24, "After the test (a 30km run), athletes from the control group presented an increase in plasma CK (4.4-fold), LDH (43%), PGE2 6.6-fold) and TNF-alpha (2.34-fold) concentrations, indicating a high level of cell injury and inflammation."
5. Marathon running damages your brain. The damage resembles acute brain trauma. Marathon runners have elevated S100beta, a marker of brain damage and blood brain barrier disfunction. There is S100beta again, a marker of cancer and of brain damage.
From Marchi, et al Restor Neurol Neurosci, 2003; 21 (3-4): 109-21, "S100beta in serum is an early marker of BBB openings that may precede neuronal damage and may influence therapeutic strategies. Secondary, massive elevations in S100beta are indicators of prior brain damage and bear clinical significance as predictors of poor outcome or diagnostic means to differentiate extensive damage from minor, transient impairment."
Other studies indicate confusion in post-event marathon runners.
4. Marathons damage your heart. From Whyte, et al Med Sci Sports Ecerc, 2001 May, 33 (5) 850-1, "Echocardiographic studies report cardiac dysfunction following ultra-endurance exercise in trained individuals. Ironman and half-Ironman competition resulted in reversible abnormalities in resting left ventricular diastolic and systolic function. Results suggest that myocardial damage may be, in part, responsible for cardiac dysfunction, although the mechanisms responsible for this cardiac damage remain to be fully elucidated."
3. Endurance athletes have more spine degeneration.
From Schmitt et al Int J Sports Med. 2005 Jul; 26 (6): 457-63, "The aim of this study was to assess bone mineral density (BMD) and degenerative changes in the lumbar spine in male former elit