Health Risks in Marathon Running

In this current 2018 editorial and within the following scientific article, “The Goldilocks Zone for Exercise: Not insufficient . Not an excessive amount of,” by James H. O’Keefe, MD, Evan L. O’Keefe, MS, and Carl J. Lavie, MD.

Missouri Medicine updates subsequent research that has vindicated our earlier conclusions and assertions. New message: Frequent exercise is extremely important to health but in moderate amounts at low to moderate intensity. Long-duration-high intensity exercise isn't heart-healthy. Moderation in intensity and duration is particularly important after 40–45 years of age.

Subsequent studies have confirmed that marathon type, excess exercising is related to elevated CACS. At the foremost end of excess exercising, CV events may even be more common than in non-exercisers. Many examples exist of what's essential and/or healthy in small or moderate amounts could also be detrimental or maybe fatal in large amounts like medication dosage, trace elements, water or alcohol ingestion.

In their 2014 editorial overview, McCullough and Lavie also raised a cautionary note about excessive marathon-type exercise, posed excellent mechanisms by which hyper-exercise might damage the guts and its arteries and cause elevated CACS. They involved more research and wondered if the elevated CACS in marathon runners would carry an equivalent increased risk of CV events as similar scores in non-exercisers with high CV risk factors (smoking, obesity, hypertension, diabetes, etc.).

While I certainly am often accused of getting observational bias, my reading of the cardiovascular literature suggests that hyper-exercisers with otherwise few CV risk factors tend to make high calcium density, lower volume fibrous atheroma that is more stable and fewer susceptible to cause CV events than the low calcium density, high volume lipid-filled plaque that more commonly causes CV events. Newer techniques of arteria coronaria testing are ready to determine which sorts of atheroma predominate.

By: Jyoti Nayak

School Name: Birla School, Pilani