The Great Ganesha

An article in yesterday’s Times says that too much marathoning might just be a bad thing. What? After all I’ve said about how much running is good for you? Well, it’s not quite that simple. Running is still good for you, however,

After years in which almost no deaths were attributed to heart attacks at this country?s major marathons, at least six runners have died in 2006. [link]

Ouch. But one explanation is in the law of averages. Says, Rick Neales, director of the Marine Corps Marathon:

Statistically, maybe, it was inevitable.

Maybe it’s not statistics. Check this out: Researchers tested 60 (41 male, 19 female) runners before and after the 2004 and 2005 Boston marathons. In addition to testing for the usual suspects they also tested for troponin - a protein that is found in cardiac muscle cells, but is found in the blood when the heart undergoes some kind of trauma. Here’s what they found:

The runners had normal cardiac function before the marathon, with no signs of troponin in their blood. Twenty minutes after finishing, 60 percent of the group had elevated troponin levels, and 40 percent had levels high enough to indicate the destruction of heart muscle cells. Most also had noticeable changes in heart rhythms. Those who had run less than 35 miles a week leading up to the race had the highest troponin levels and the most pronounced changes in heart rhythm. [link]

Wow. So one thing is obvious - if you’re going to run the marathon, start to increase your weekly mileage ASAP so that you get it above 35 miles. But does this mean that marathoning is bad for you? Well, not quite. First off, the abnormalities disappeared over time. Secondly, says Dr. Arthur Siegel, the director of internal medicine at McLean Hospital in Belmont, Mass., and an assistant professor of medicine at Harvard (also a co-author in the study),

Their hearts appeared to have been stunned.

Ok, that didn’t help much, did it? But this guy had something a little more enlightening to offer:

?Although the evidence is not conclusive, it does look like the Boston study is showing some effect on cardiac muscle,? said Dr. Paul D. Thompson, 59, the director of cardiology at Hartford Hospital in Connecticut, and an author of an editorial that accompanied the study. ?It?s far too early to draw any conclusions,? he added. ?We?d be seeing lots more bodies piling up if there were real lingering long-term cardiac damage? caused by running marathons.

?Over all, the evidence is strongly in favor of the idea that endurance exercise is helpful in terms of cardiac health,? said Dr. Thompson, who has run more than 30 marathons. [link]

Ok, that’s a relief. But we’re not completely off the hook. There was another German study on middle aged marathoners (each of whom had completed at least five marathons). They found that:

More than a third of the runners had significant calcium deposits, suggesting they were at relatively high risk for a heart attack. Only 22 percent of a control group of nonrunners had a comparable buildup.

The researchers scrupulously avoided suggesting that marathoning had caused the men to develop heart disease. (After all, running may have kept them alive when they would otherwise have keeled over years earlier.) But neither did the authors rule out the possibility that in some baffling way distance running had contributed to the men?s arterial gunk.

Hmm, that’s not exactly heartening either. Yet, cardiologists still are big fans of running. Except if you have a genetic history of heart disease, then it might make sense for you to be a little extra cautious. Or worse yet, as Dr. Siegel suggests:

His advice to runners with any history of heart trouble is ?train for the race, getting the cardiac benefits of endurance exercise,? then watch the event on television.

The risk of going into cardiac arrest as a spectator, he said, is only about one in a million. (The applicable studies of spectators involved Super Bowl fans.) [link]

That’s gotta suck. But probably a lot less than a heart attack. I guess the bottomline is you should use your own common sense and if you have a history or a bad feeling about it, then avoid it. Still, common sense is not that common, as they say. Let’s wait it out to see what the researchers come up with. Until then, run slow, run easy and stop when you have to.