31 January 2013

Hidden heart (updated)

What to make of this story in the Wall Street Journal, reporting studies that highlight the health disbenefits of running, and entitled somewhat sensationally "One running shoe in the grave" (at least it doesn't say "trainer", or in American English "sneaker")? First and foremost, I suspect, that you can find medical evidence to back up any argument you might wish to make. Indeed, the article quotes a couple of docs, who seem to be getting a bit too personal.

It's almost axiomatic that if you go to the doctor with a running injury you will be advised to stop running. My former GP was a member of the same running club as me, so I doubt that would have happened, although I can't now be sure how it might turn out, since her retirement: but running injuries aren't matters with which to trouble the National Health Service, which has its hands full with people who have no intention of living a healthy life, and perhaps no idea how to recognise one - who get their nutritional advice from TV ads, perhaps ... Visiting the doctor entails a long wait (well, too long for an impatient patient like me), first to get a date and then at the surgery. Running injuries are for Sharon to help me sort out, unless there's some additional element like putting my foot in a hole in an Oxford pavement while executing a sharp turn at high speed as I did in the Teddy Hall relay several years ago. That merited an X-ray, if only to support a possible claim (which I didn't make anyway).

But that's injuries, and the "one running shoe in the grave" syndrome is about heart problems. The BMJ's journal, Heart, on an article in which the report is based, has several articles in its archive on running, including this one from nearly two years ago (the link is to the abstract), this one from yonks ago (1979, long before I bought my first running shoes, which in turn was long before I became a runner) and this one from 2009. To this layman, to whom even the abstracts are largely incomprehensible, the two more recent ones seem to be saying that running is a risk factor, while the earlier one says that a pre-existing heart condition can cause death during a Marathon. (The 2009 article also seems to say that often the relevant pre-existing condition might be hard to detect, which strikes me as a very important observation.) The editorial on the basis of which the WSJ story rests is due out in the next issue of the journal, so I can't comment even on the abstract, although we could perhaps treat the WSJ report as one. (Update: here is a link to an extract, from which you can get to the full article if you cross the BMJ's plam with silver - at £24 for one day access to the article, I am passing.)

The WSJ seems to have drawn more conclusions in the story than are entirely justified. To me, it reads like a prescription for moderation rather than a warning that over-50 athletes (I use the word advisedly) are playing cardiac Russian roulette. What about its parameters? It considers 20 to 25 miles a week as "a lot", and the threshold speed mentioned is 8 mph (which shows, perhaps, that this was written by no runner: 7:30 in runners' language - minutes per mile that is). That doesn't sound like a particularly high mileage: it is a great deal more than I have managed for a long time, but less than my target, and well short of Murakami's 10K per day (and according to the book he followed that regime when he was about my age). However, 7:30 is more like 5K race pace than a "normal" speed - so where do I fit into the statistics?

I don't see anything here to put me off long, slow runs, and actually not much to put me off short fast ones either. The truth is that, like many runners, I have left behind running purely to keep fit, so analysing the activity purely in terms of heart problems isn't really relevant. Even if the chances of SCD (a piece of jargon I have picked up from reading abstracts!) were greatly increased, I would probably consider it a good trade-off to secure the manifold other health benefits. What's the use of staying alive but depressed? We all have to go sometime: Micah probably got it right.

No comments: