Sigh. Is marathon running bad for your blah blah blah

I had originally decided that I couldn't be arsed posting this, but I saw a recent post in Outside magazine titled The Runner's Ticking Time: Why Runner's Need to Pay More Attention to Their Hearts which got my ire up again. Ignoring for a start the fact that one of the expert opinions that they quote is a registered dietician "who appears regularly on Good Morning America" (although at least dieticians are actually accredited, unlike nutritionists), the article is about the apparently high levels of heart attacks due to coronary artery disease that are seen in marathon runners. They even quote a paper from the Journal of the American College of Cardiology which says that "one in 50,000 will experience a heart attack from coronary artery disease during a marathon". Scary. Except that they miss out the kind of crucial (I think anyway) point that this is an incredibly small risk as compared to that of the general population. Here is the conclusion from the abstract in full:

Although highly trained athletes such as marathon runners may harbor underlying and potentially lethal cardiovascular disease, the risk for sudden cardiac death associated with such intense physical effort was exceedingly small (1 in 50,000) and as little as 1/100th of the annual overall risk associated with living, either with or without heart disease. The low risk for sudden death identified in long-distance runners from the general population suggests that routine screening for cardiovascular disease in such athletic populations may not be justifiable.

Too much running will kill you, just as sure as none at all (or so the Telegraph says anyway...)

Once again, we see another worrying study indicating that "running is bad for you". In this case, it is a story in the Telegraph with the title "Too much exercise as bad as too little". Ignoring for a moment the syntactic tautological verisimilitude of this statement, is there anything to this claim? Or is it a case of the media leaping on a piece of research and blowing it out of all proportions for a good byline?

The paper in question is this study in the journal Archive of Disease in Children, titled "Weekly sport practice and adolescent well-being". The study took a cohort of 1,245 adolescents (aged 16-20) and asked them to fill in an online survey asking them various questions about their exercise habits, socio-economic background, height, weight, and questions on their "well-being" (more on exactly what this means in a second). They split the individuals up into a number of groups based on whether they took part in:

• A low amount of weekly sport (0-3.5 hours)


• An average amount of weekly sport - the recommended 7 hours (3.6 - 10.5 hours)


• A high amount of weekly sport - around double the recommended (10.6 - 17.5 hours)


• A very high amount of weekly sport (> 17.5 hours)

They then show that, when compared against the recommended amount, doing a higher level of sport resulted in individuals being "healthier", whilst doing less resulted in individuals being "unhealthier" (as you might expect). However, when they did the same for those individuals who did a very high amount of weekly sport, they found that they were in fact "unhealthier". So not only are there diminishing returns to your health by increasing the amount of exercise that you do, but doing too much can actually result in a negative effect on your health. Hence the tag line of "too much exercise as bad as too little".

Ultramarathon Running Research Project - Thames Path 100 2013

This year, I have continued the project that I started last year with James Elson from Centurion Running, looking at various aspects of ultra running and how these relate to a runner's ability to complete the race. I still think that there is lots of interesting information to be mined from these data, and hopefully more people will take part in the surveys for the next few races. Anyway, below is the report that I produced for the 2013 Thames Path 100 mile race in its entirety. As ever, these are merely my own interpretations of the data, but I would love to hear from anyone that might have any alternative ideas. I hope that you find it interesting!

Introduction

Following on from last year's pilot project at the South Downs Way 100 mile race (SDW100) last year, we have now upgraded the analysis to look at all four of the Centurion Running 100 mile events in 2013. The current state of research into the factors that may affect a runner's ability to complete a 100 mile event is still very open, with several key studies beginning to delve into the key factors essential for all runners to consider.

The research of Martin Hoffman and the rest of the Western States Endurance Run Research Committee has produced several key papers, analysing both the effects of running 100 miles on the body, as well as the demographics of the runners who choose to run such events. Recently, the Ultrarunners Longitudinal TRAcking (ULTRA) study from Stanford University (which I recommend everybody takes part in if they haven't already by going to https://stanfordmedicine.qualtrics.com/SE/?SID=SV_aY1e47DdzVRjHKI) has begun to track a wide range of information for ultrarunners, which will then be tracked over the coming years with the hope of monitoring training styles and observing how these relate to injury rates.

Recently, more and more researchers have aligned themselves with race directors in order to obtain data on ultrarunners in the field. For many races, this may allow the study not only of runners' preferences and training styles, but also the study of the changes in physiology brought about as a result of running 100 miles. These studies will undoubtedly direct our current understanding of "optimum" training methods in order to ensure that running styles are tailored to specific physiological needs. Whilst I personally do not believe that there is such a thing as "the right way to train" (it is likely highly dependent on individuals), there are certainly universal truths that we can all benefit from fully understanding.

Our own study was a fairly simple yet powerful approach. We asked runners of the SDW100 to complete a pre-race survey (focussing on information on the runners themselves and normal training strategies) and a post-race survey (focussing on their approach to the race and how the race itself went for them), and combined these data with split times throughout the race. There were several goals with these data, but the main goals were to understand what sort of people typically take part in such events, what sort of training strategies are typically used, and how these relate to race-day performance.

In 2013, we will be performing these analyses on all four of the Centurion Running 100 mile races; the Thames Path 100, the South Downs Way 100, the North Downs Way 100, and the Winter 100. At the end of the year, we will combine these data into a single analysis to get a view of how runners have approached the different races through the year. These analyses are only possible because of volunteers choosing to take part in the surveys. But the more people who take part, the more interesting the findings will be. I hope that these results will encourage people to take part in the future studies and that we will soon have a deep pool of data to mine for interesting results.

On a personal note, my time for performing these analyses has been drastically reduced due to the birth of my gorgeous little girl. She's strong on her feet already so I'm sure she'll be a runner like Daddy! But unfortunately she also seems to have my lung capacity and ability to cope with no sleep... But I hope that you find what I have managed to cobble together between feeds interesting! These are entire my own opinions, but if you have any thoughts or comments feel free to contact me through my blog at constantforwardmotion.blogspot.com. As ever, all the best to everybody with your running, and I'll see you out on the trails!

Critical thinking

I think that most of us are savvy enough to realise that we shouldn't take stories in the media at face value, but it occasionally strikes me that not enough people critically evaluate the things that they read. In the running world there are many areas where people hold quite fervent views on what is the "best" way to do something; be it relating to diet (e.g. high carb vs. high fat), running style (e.g. forefoot vs. heel striking), shoe choice (barefoot, minimalist, Hokas, et al.), training methods (speed work or not for ultras?), training aids (does compression gear work?), etc. But one of the big problems that I see cropping up time and again, particularly with social media like Facebook and Twitter, are cases of what is termed confirmation bias - the tendency for people to take more notice of evidence that supports a view that they already hold. How often have you seen an advocate of barefoot running Tweet about the latest paper showing that barefoot running is more efficient? But how often do they Tweet about the latest research showing that no difference was found, or even that heel striking was shown to be preferable?

Let me just be clear; I am in no way commenting on the views themselves. I have my own opinions on all of these facets of running that have been borne out of experience (which is limited in terms of time, but extensive in other ways), as well as reading the limited scientific literature that exists. But I in no way claim that these opinions are correct. If I see compelling evidence that convinces me otherwise, I try things out, use what works for me, and change my opinions (as everybody should). To be honest, my view on a lot of these questions in sports science is that there is no right answer. You do what works for you. 

No; what I am commenting on in this post is the use of dodgy evidence to support these views. 

Western States 2013 - Live

So, being the incredibly cool guy that I am, I am currently spending my Saturday night watching the Western States Endurance Run unfold live overnight with a cold cider. Because I'm just the coolest, I have been playing around with the times to see what the field looks like to get an idea of who might take the win. Yeah.

As it stands, 6 runners have gone through 70 miles (Peachstone), in the following order:

Timothy Olson	10:43
Rob Krar	10:56
Mike Morton	10:58
Dylan Bowman	11:09
Ian Sharman	11:10
Nick Clark	11:22

Timmy Olson has held the lead for most of the race, but Rob Krar has been hot on his heels, Mike Morton has been edging his way up the field, and the rest of the chasing pack are not far behind. The heat is immense in California at the moment, so the question is; who's going to blow first? Can Timmy hold on until the end, or will Mike's pacing win the day?

This is a figure showing the speed between each checkpoint up to Peachstone for each of the 6 runners in the lead pack. Hal Koerner was in there as well, but something seems to have happened to him since Foresthill. I hope everything's okay. Anyway, take a look and see what you think.

My interpretations are as follows:

1. Timmy has been running incredibly strong so far and has built up a great lead. Of course now we need to see if he can hold this amazing pace.
2. The pace of these 6 runners has been fairly consistent, but in the last 20 miles we have really seen the differences start to creep in
3. Mike's pacing may well be the clincher here - he started off as the slower runner, but now his pace seems to be the fastest. He's slowly creeped up the field, and now is able to hold his pace whilst others are dropping theirs.
4. Similarly, Rob is running at a fantastic pace and could hold this to the end now. 
5. Top 5 for Brit Ian Sharman? Go Ian!

As we enter the final 30 miles, the real race begins. Now we see if people have set off too fast, or if the hot weather is going to affect things. My money is on Mike Morton coming through in the final hours as Timothy's pace slips. But I could be completely wrong, and we might see another epic finish from Olson! In particular, will he pick up the pace when Morton and Krar attack? Let's see!

It's looking like we will be seeing a podium of Timmy, Rob and Mike, but as to the order; I couldn't say. Whatever happens, I look forward to seeing the results. Maybe we'll see a sprint finish at the Placer High School track?!

Good luck guys!

Update:
Hal has now been updated as being in 7th through Peachstone. Not sure what happened, but his pace has dropped dramatically on the last section. Also, Olson, Krar and Morton are through the Rucky Chucky river crossing. Olson is still 10 minutes up.

Is Marathon Running Bad For Your Heart - Redux

Okay, this has bugged me a little bit and I had to write a post as a comment on what I have seen. I have previously commented on some of the research that has come out over the last few years suggesting that - to coin a sensationalist media-friendly phrase - Marathon Running Is Bad For Your Heart. I recently saw this TED talk from Dr. James O'Keefe M.D., where he discusses many of the same ideas. As a cardiologist, he used to exercise regularly as the generally accepted standpoint is that exercise is good for your heart, and the more the better. But he and his colleagues have since found that over-intensive running may in fact be bad for your heart. Instead we should all be running not too fast and not too far.

Now, as an ultramarathon runner, I am obviously biased in my opinions. However, I do know a fair bit about data analysis and (more importantly) interpretation. And based on what I have seen in the literature, I have yet to see anything that makes me particularly worried.

So let's have a play-by-play of the content of the video. Granted, the point of TED talks is to make a complex subject understandable by non-experts so this isn't a scientific presentation as such, but in this presentation you can see issues with the argument. I apologise for how long this post is, but I want to be thorough in my assessment. I do not claim to be an expert in the area of cardiology, and I certainly haven't read all of the literature (I just do this in my spare time for fun after all), but nothing that I have seen in these studies has suggested anything more than one possible interpretation of the data.

Centurion Running End of Year Analysis - 2012

I recently performed another bit of analysis, this time using the Centurion Running data from throughout the year as a kind of retrospective study of 2012, and also to look for any interesting trends. This wasn't anywhere near as in depth as the survey that we ran for the South Downs Way (there'll be more of that later this year), and the data that I used was just the checkpoint times available on the Centurion Running website. Despite this being a relatively simple look at pace profiles, we actually found some potentially interesting things, particularly relating to dropout rates. 

The nice thing about having access to the checkpoint times and not just the finishing times is that it gives us more scope to look at trends in pacing throughout the entire course. Also it is very useful to be able to pull out the dropout point of runners who were unable to complete the course, as I believe that this has highlighted some potentially quite interesting points relating to how runners are able to decide on which point to pull out at. I plan on doing something similar with the Western States data that I have played with in the past to see if we see similar trends to those shown below. More on that in a few weeks.

The report can be downloaded from the Centurion Running website here, but I have added the report below as well. Enjoy!

1 Introduction

2012 has been a fantastic year for Centurion Running. Following on from the inaugural North Downs Way 50 mile and 100 mile events in 2011, this year has seen a full timetable of ultrarunning events including the Thames Path 100 miler, South Downs Way 100 miler, North Downs Way 50 and 100 milers, Winter 100 and the now infamous Piece of String Fun Run. With the completion of the Winter 100, we have reached the end of the racing season and include here a retrospective for the main races in the Centurion Running 100 mile event calendar.

For the South Downs Way 100, we ran a survey of runners in a pilot project to look at factors relating to successful ultramarathon running completion. In 2013 we hope to roll this survey out to the other events to build up a database of information for 100 mile runners and allow us to look for interesting trends amongst the people who choose to run 100 mile events for fun. Please keep your eyes open for more information on this in the new year, and please take part as the more information that we are able to collect the better the findings will be.

For now, enjoy the holiday season and have a wonderful New Year. Happy running everybody!

How long is a piece of string?

This time in 3 weeks I will have finished running the inaugural Piece of String Fun Run. Well, I hope so anyway. There is every possibility that I may still be going - who knows! For indeed, this is the concept of the run, and the reason for the otherwise confusing name; we don't know how far it is going to be! There will be multiple potential routes, ranging anywhere from 100 meters to 1000 miles (and beyond?!), one of which will be chosen on the day. We'll be given a section to run. We'll run. We'll return to the start. We'll be given the next section. We'll run. We'll return to the start. You get the picture. And we'll do this until the Race Director lays his hand on our shoulder and tells us "well done, you've finished". Or until we collapse in a heap and wait for the paramedics to rescue our battered corpses. Whichever occurs first I guess.

Well, that answers that question then. Sorted. From http://relationshipocd.wordpress.com/2012/09/11/tip-8-how-long-is-a-piece-of-string/

The concept was thought up by the fevered evil minds of James Adams and James Elson. On paper, it doesn't sound so tough. It's in Oxfordshire, so the terrain won't exactly be up to Hardrock standards. We know the start time (despite their best efforts to lose some of us through the use of the ambiguous term "midnight Friday"), so there won't be any of the anticipation waiting for the conch shell to blow at Berkley. But the question is; if we don't know where the end lies, how can we mentally prepare for what's to come? When you inevitably feel like crap at mile 80 in a 100 miler, the fact that you only have 20 miles to go is a great mental boost. So how do you pull yourself out of the funk when you could be running for another 200 miles for all you know? Pacing is right out of the window, so this may end up as the slowest 10k of all time. Or I may be sprinting a 300 miler. The point is, it's going to be a bit of a mindf*ck, and I guess I'm just going to have to see how I get on. My saving grace is that I figure that mind games don't work so well on idiots like me!

But this got me thinking: how far can a person actually run without stopping? By not stopping I mean running with no obvious rests like stopping to sleep, whilst toilet stops, walking breaks and aid station stops are all part of the game and are going to be difficult to avoid. Obviously it is not possible to run forever, but history has certainly shown that we humans can run a really, really long way. From persistence hunting (essentially chasing your prey all day until it can't run any further) of the !Xo San bushmen of the Kalahari desert in Southern Africa and the Tarahumara Indians of Mexico, through Pheidippides' running 150 miles from Athens to Sparta to request help against the attacking Persians, to Pam Reed running 300 miles with no sleep in under 80 hours (narrowly pipping Dean Karnazes to the 300 mile record), there are plenty of feats throughout the ages that make "only" running 26.2 miles look like a walk in the park (of course  I'm talking purely distance here - the marathon is a much faster event, but let's not get into that debate here).

Ultramarathon Running Research Project - Pilot Study

Towards the start of the year, I contacted James Elson (Race Director of Centurion Running) about an idea that I had had. I had recently read a few papers by Martin Hoffman's group from the Western States Research Committee looking at factors that affected a runner's ability to complete the Western States 100 mile race. I had also signed up to the Ultrarunners Longitudinal TRAcking project at Stanford, which aims to follow ultrarunners and track their health over many years. I thought that it might be quite interesting to do some of our own researchr here in this country, and thought that James' series of 100 mile races was a perfect opportunity to do something similar, as they are very well organised, they are quite homogenous in their organisation, and James has a particular interest in delving into the stats behind ultra running.

The plan that I proposed to him was to create a couple of surveys for runners of his events to fill in: one before the race, asking questions relating to the runners themselves (biometrics, professional status, running history, etc.); and another survey after the event asking questions relating to how the race went, what their strategy was for the race, their nutrition, etc. By putting this information together with the split times from the event itself, my hypothesis was that we may be able to see some trends dropping out from the data. Yes, this is the kind of thing that I do for "fun"!

In the short term, this approach would give us a good overview of the race itself, the sorts of people who entered, and which runners took a sensible approach to racing. But my main aim was for the long term, building up a database of survey results and race performances for ultrarunners that, over time, will allow us to look at more specific questions relating to performance: Do certain training choices improve your chances of finishing a 100 mile race? Are certain racing strategies more likely to result in a finish/win? Do people with green eyes run faster than people with blue eyes? These burning questions and more may well be answerable in the future from such a database.

To kick things off, we organised a pilot project for the South Downs Way 100 at the end of June. This went very well, and we found some (I think at least) very interesting things from this that bode very well for the future. James has created a research page on the Centurion Running website where you can download the report that I put together (using my official "Dr" title to make it seem to people that don't know me that I have some air of professionalism about me...). Alternatively, I have replicated the report below so that I have a record of it on my little blog. Hopefully you find it interesting, and any comments will be gratefully received. Hopefully we can get even more people interested in taking part in the full project at next year's races!

Pacing the Western States Endurance Run

I recently saw a post on the Runner's World Sweat Science blog regarding pacing of swimmers and runners, and how this affects their performance. One of the papers that is discussed is this paper by Tucker et al. (2006), which shows pacing over a number of intervals for world record times at a variety of middle distance events (800m, 5 km, and 10 km). The results of this study seem to suggest that the optimum way to run these events is to go out strong at the start, settle into an even pace for the majority of the event, then finish strong again at the end (a so called parabolic profile):

A "parabolic" pacing strategy seems to be optimal for middle distance events (from Tucker et al.  (2006) c/o Sweat Science)

So I got to thinking - is there an optimum way to run a 100 mile event? Now, I think that this is a very difficult question to answer. Unlike track events, the terrain and conditions for a 100 miler event are so variable that judging pacing becomes a complex interplay between many different factors throughout the race; weather conditions, ground conditions, elevation change, fueling, hydration, navigation, gear choice - there is just much more to consider, and much more that can go wrong. Even ignoring the variable effects like weather, the elevation profile and terrain is so different between any two races, coming up with a simple strategy that would apply to all races is likely impossible. The optimal pacing strategy for UTMB (31,496 ft of ascent) is unlikely to be the same as that for the Thames Path 100 (2,100 ft of ascent) for instance.

Are ultrarunners slow?

So tell me if you've heard this one before?

"Pft. Ultra running? Ultra walking more like!"

Reading around various forums and blogs, it seems that some people have a negative view of ultrarunners. The main trope seems to be the opinion that ultrarunners are slow, and are basically speed-walking. Other more extreme views are that ultrarunners are failed marathon runners who weren't able to cut it. Rather than putting in the training to push their marathon PB to a new level, they just go a little bit further.

Of course, the obvious response to this is that, well, I'm sure 100m sprinters look at marathon runners and think exactly the same thing. My wife was a 200m sprinter when she was younger, and she couldn't understand why anybody would want to run any further than that. So if ultrarunners are slow and shambling in the eyes of some marathon runners, does that mean that marathon runners are viewed in the same way by sprinters? No. There is mutual respect - they're just two very different events; one focuses on pure explosive power, while the other focuses on endurance. When you get up to ultra distances, particularly those out on the trails, up mountains, or in other inhospitable parts of the world, additional factors come into play - gear selection, nutrition, hydration, pacers and crew are all important for marathon racing but are more complex for ultras, plus you also may have to deal with tougher terrain, navigation, etc. Is it any surprise that ultrarunners are slower than marathon runners when running up and down mountains?

But even despite this, is it really fair to claim that ultrarunners are slow? In many of these discussions, it seems to me that the comparisons being made are between top-class marathon runners and the average middle of the pack ultrarunner who typically is not out for a podium place, and is just there for the experience and the love of running. But there are ultrarunning guys and girls out there with blisteringly fast times. So when we compare apples with apples and look at the times for the top marathon runners vs. the top ultrarunners, does the accusation of being slow still stack up?

I decided to do a bit of digging; a bit of Google-ing and Wiki-ing and I had put together a list of the fastest times over a range of distances ranging from 100 meters to 100 miles (apologies if I've got any of these wrong, but if it's on Wikipedia it must be true...):

Tick tick tick...

I recently wrote a blog post looking at a recently published paper looking at the effects of endurance sports on cardiac function. Or, more specifically, I was looking at the reporting (and unsurprising overhyping) of this story by the media. What struck me while looking through the comments section of the Daily Mail's take on the story was how many people believe in the idea that we are all allocated a certain number of heartbeats in our lives, and so we shouldn't waste them doing stupid things like running marathons. As in example, this is a quote from Bobby from Inverness:

"You are allocated only so many heartbeats for a lifetime - don't waste them up in silly fruitless 'exercise' - live longer, have a nap"

I suspect that this quote was actually written in jest, but it seems that a lot of people think like this and use it as another excuse not to exercise. The theory is that, since when we exercise our heart beats faster, every hour of exercise is using up 2 or 3 hours of your life that you could be sitting on the sofa doing nothing. Now don't get me wrong - I like to lounge on the sofa as much as the next person. In fact, my second biggest hobby is playing on the XBox; an interesting juxtaposition to my favourite hobby of running. But could I really be reducing my lifespan with all of this running?

First of all, let's look at this theory. It's actually quite an interesting premise, and the evidence for it seems to come from the idea that animals with shorter lifespans have quicker heart rates than those with longer lifespans. So if you take the average lifespan of a species (in minutes) and multiply it by the average heartrate (in beats per minute), you get an estimate for the average number of beats of the heart in a lifetime. And this value seems to be similar amongst different species. I was pretty skeptical, so decided to have a look at a few examples for myself:

Is marathon running bad for your heart? Sigh...

I spotted a news story on the BBC News website this morning which claims that Marathon training 'may pose a heart risk'. This story has since caused a bit of a buzz on the interwebs, cropping up in various tabloids and on various discussion forums and blogs. Being a runner and a scientist, this of course piqued my interest. Is this something that I should be concerned about, or is this another case of sensationalism by the media? Take a guess...

First things first. The study in question is a paper published yesterday (6th December 2011) in the European Heart Journal by a group in Belgium entitled  "Exercise-induced right ventricular dysfunction and structural remodelling in endurance athletes". Unfortunately, it requires a subscription, but you can see the abstract here. Being a scientist myself, I have looked over the paper and thought that I would share my thoughts on the implications.

The study measures various aspects of cardiac function for 40 endurance athletes, each a specialist in one of 4 events which are, in order of duration; marathon, endurance triathlon (possibly Olympic length?), alpine cycling, or ultra-triathlon (Ironman distance). Measurements of cardiac function were taken using cardiac magnetic resonance imaging (cMRI) and echocardiograms, as well as analysis of biochemical markers of function such as B-type natriuretic peptide (BNP) and cardiac troponin I (cTnI), both proteins involved with contractions of muscle cells in the heart and hence good predictors of cardiac risk. For each athlete, three measurements were taken; the first was taken as a baseline 2-3 weeks prior to the event, the second was taken within an hour of crossing the finishing line at the event, and the final 'delayed' measurement was taken 6-11 days after the event.

Broadly speaking, they found the following key results: