Health & Fitness

Question hangs over extreme runners: Can too many miles hurt the heart?

Can you run too much?

A Kansas City doctor and former marathoner discusses research on the potential effects of extreme running. This video originally published Oct. 13, 2016.
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A Kansas City doctor and former marathoner discusses research on the potential effects of extreme running. This video originally published Oct. 13, 2016.

Kurt Becker the former marathon runner is still mad.

Did he overreact, he wonders, over harrowing research by a Kansas City cardiologist and others that warned the running world that extreme distance running over many years may actually harm the heart?

Everyone went to see their cardiologists, Becker said. And a cardiac scan of calcified plaque in his coronary arteries — to his shock — scored at over 600, way above the healthy range.

“I panicked,” he said. It didn’t matter that he’d just reached a personal best in the Quad Cities Marathon that fall of 2013. It didn’t matter that he could then qualify for his dream of running the Boston Marathon.

He quit the long, long-distance scene and his 50 miles of running a week.

Except that now the 57-year-old Overland Park man is thinking he might pick it up again.

It’s a confusing time in the ultra-distance running world.

The Kansas City Marathon launches again this Saturday — an annual event that in 2015 saw 1,298 runners finish the 26.2-mile course. That was a 28 percent drop from the race’s peak of 1,791 in 2013.

Were runners discouraged? The reasons for the decline are unknown, and the same goes for a 10 percent drop in the number of finishers of endurance events reported nationwide over the same time span by Running USA.

Whether or not some competitors are backing off, serious runners know about the controversy.

“There was a lot of antagonism among the runners and substantial attempts to discredit our research,” said Carl “Chip” Lavie, a cardiologist at the Ochsner Heart and Vascular Institute in New Orleans.

A partner in the research was James O’Keefe, a Kansas City cardiologist at St. Luke’s Mid America Heart Institute.

Many local runners consulted with O’Keefe, including John C. Hagan III, an ophthalmologist and editor of the journal Missouri Medicine, which published their study in 2014. The first public presentations of the research came in 2012.

Hagan had been running great distances since 1967, for years running more than 30 miles a week, completing four marathons, two half-ironman triathlons and at least 25 Hospital Hill half-marathons in Kansas City.

“I was in denial for 40 years,” he said.

His cardiac scan hit an alarming 1,606, he said. While many factors, including genetic predisposition, can contribute to the score, the warnings in the research hit home.

One message from the cardiologists needs to be clear, Hagan said: Running is healthy. It will in most cases lower one’s cholesterol, blood pressure and body mass index — all good for cardiovascular health. It lengthens lives.

The research, however, raised questions in extreme cases when runners regularly exceed 30 miles a week over many years, and train not just for the occasional marathon, but for many of the grueling races.

While the research remains in dispute and ongoing, the findings are finally getting recognized by what has been a skeptical running establishment, Lavie said.

  

The magazine Runner’s World in September published a thorough though inconclusive analysis of the various studies with the headline: “Will Running Too Much Kill You?” The decision to run the story, Lavie said, suggests that the higher powers of running “are willing to listen to the potential risks, as long as we do not seem to be over-hyping the risks.”

“I was never trying to stop athletes from doing the (extreme running),” Lavie said. The risks are present, though relatively small, he said. His emphasis now is that the primary benefits of exercise are achieved in the first 30 to 45 minutes.

They got runners’ attention, that’s for sure, said Eladio Valdez, leader of the Runner’s Edge training group in Kansas City.

“Some stopped the marathons,” he said. “Some cut way back. It did affect our group.”

Valdez, now 48, had been running up to 70 miles a week during his peak training regimens, running 25 marathons in 25 years.

He’s cut back, he said, although he had physical injuries that were already easing him out of his competitive days.

Some extreme runners, including some who are cardiologists, are carrying on with high-mileage workouts.

“Running is my lifeline,” said cardiologist Jim Sear at St. Luke’s Hospital. He has four marathons and 14 half-marathons on his resume.

Not only does he think that cardiovascular benefits build with the extra hours on the road, but there are mental health benefits as well.

His family has a history of psychiatric illness, he said. “With all the stresses at work that I deal with, running has given me my life back. … I don’t see any cap on the distance (in reaping benefits).”

He and many other runners, including retired cardiologist Bill Brodine of Kansas City, take reassurance in research by exercise physiologist Thijs Eijsvogels at Radboud University Medical Center in the Netherlands and several partners.

The concern that excessive exercise may risk “deleterious cardiac effects … is interesting and worthy of scientific consideration,” they wrote. But they found that even with life-long endurance athletes “the benefits… outweigh the risks.”

Brodine, at 65, plans to go for his fourth Boston Marathon in the spring. While the work of O’Keefe and Lavie and others has made him wary, “I have become less fearful that I am hurting myself.”

Cardiologists can agree that anyone engaged in intense training, especially at an advanced age, should get their heart tested regularly, Brodine said. But as for the safe limits of exercise, he said, “there is no absolute answer here.”

Recently, runners on some of Kansas City’s serious athletic clubs were putting their hearts and legs to work at Shawnee Mission East High School.

Jeremy Jordan, 29, who runs with the Kansas City Smoke racing club, was ripping around the oval track, racking up some of the 70 to 90 miles he runs each week.

“It’s in the back of my mind,” he said of the research. He and 30-year-old Rob Holcomb of Overland Park were both wearing watches that track heart rate and other health markers.

“Runners have a keen sense of their body,” said Holcomb, who runs 50 to 70 miles a week.

These large numbers of miles aren’t normal bodily wear, say the runners, who at this level are driven by competition or inner goals.

“It makes sense,” said 33-year-old Jesse Chettle of Kansas City, “that anytime you’re trashing your body, like anything, you can do too much.”

He’s running some 60 miles a week now, but did more in his college days.

His fiancée, Lindsey McDonald, 25, leads the City of Fountains Athletic Club, and they try to help runners find that level that “compliments their lifestyle.”

She has run as many as 80 miles a week, she said. The runners will continue taking notice of what research shows, she said, but the advice seems to run in circles “like every other new diet they come up with.”

Becker is considering “nudging it back up” after dramatically cutting down his mileage.

But he has to be cautious because his family has a history — his father died at 53 of coronary heart disease.

He is sure — and doctors would say he’s probably right — that running has helped protect him from cardio failure. He knows he drove his cholesterol down.

But did he overdo it? That he’s not sure of.

Waddell & Reed Kansas City Marathon with Ivy Investments

▪ When: Saturday at 7 a.m. for marathon, half-marathon, team relay; 7:30 a.m. for 5K.

▪ Start/finish line: Washington Square Park (north of Crown Center), near the corner of 22nd Street and Grand Boulevard.

▪ Registration: Closed online. Late registration available 3-8 p.m. Thursday and 11 a.m.-8 p.m. Friday at the Health & Fitness Expo, Crown Center Exhibit Hall A. No race day registration.

 
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