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  #1   ^
Old Sun, Nov-01-09, 21:39
Nancy LC's Avatar
Nancy LC Nancy LC is offline
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Default Does running cause heart disease?

Hmmm... this falls into the realm of studies the media wouldn't touch with a 10' pole.

http://www.paleonu.com/panu-weblog/...rt-disease.html

Well worth it to read the whole thing but if you're the sort that doesn't like to read technical stuff describing the methods used in the study then here's the money:
Quote:
Would you believe 12% of asymptomatic marathon runners had evidence of myocardial damage on LGE?

Would you believe that among the sedentary controls only 4% had abnormal LGE?


These were people who run marathons, lots of them.

More juicy tidbits:
Quote:
1) The more marathons run, the higher the likelihood of heart disease. The number of marathons run was an independent and significant predictor of the likelihood of myocardial damage.

The runners had about the same prevalence of non-zero coronary calcium compared to age matched controls randomly assigned from a survey population. This was so despite the Framingham risk score being lower for the runners and there being more than 5 times as many smokers among the controls.

2) Compared to age-matched controls, the runners had 40% higher HDL -c (mean of 74 mg/dl) and 18% lower LDL (121) Again, calcium scoring showed no benefit to these favorable lipid risk factors. Statin deficiency, I guess. How many torpedoes before the Bismarck of the Lipid Hypothesis finally sinks?

3) Compared to age and risk factor matched controls, 36% of runners had a calcium score above 100, versus 21% of age and risk factor matched controls. (High CAC means more coronary atherosclerosis) So if the “risk factors” like lipids and BMI and such really are helping you, running seems to be doing something to undo the effect.


His summation is quite witty and brilliant. Definitely worth reading.

Last edited by Nancy LC : Sun, Nov-01-09 at 21:44.
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  #2   ^
Old Mon, Nov-02-09, 12:21
amandawald amandawald is offline
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Absolutely brilliant article, Nancy: thanks for posting this!

Thank god I hate jogging, running, all of that stuff!!!

I do like to cycle, but I am no longer so ambitious and if I face a steep hill, I get off and push rather than get out of puff for no good reason.

It seems my instincts are better than they used to be...

But I really must get out my resistance-training equipment more often, too.

amanda
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  #3   ^
Old Mon, Nov-02-09, 12:28
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Carne! Carne! is offline
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very interesting. so many unknown unknowns. there is also a big difference with marathon runners and gym bunnies that do step classes 3x a week.

i do cardio about 2 hours a week...may start getting more into weight training classes. those get my heart racing too....
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  #4   ^
Old Mon, Nov-02-09, 12:39
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Sleazy title. How I wish he would have written, "Excess cardio..."

It's long been known that overtraining is not healthy and that competitive runners incur all kinds of risks - which they are willing to take.

But to generalize the headline to "running" is just the kind of inflammatory sleaze that makes the public health dialogue so, oh, unhealthy. Where are our manners. And I like the panu guy's thinking except for that.

Quote:
I think that not only does sustained “cardio” not protect you from atherosclerosis, I think it is quite likely that through repetitive shear stress with endothelial damage and promotion of an inflammatory state with attendant cytokinesetc., that it promotes atherosclerosis.
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  #5   ^
Old Mon, Nov-02-09, 12:51
amandawald amandawald is offline
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Quote:
Originally Posted by Carne!
very interesting. so many unknown unknowns. there is also a big difference with marathon runners and gym bunnies that do step classes 3x a week.

i do cardio about 2 hours a week...may start getting more into weight training classes. those get my heart racing too....


On the bolded part above:

isn't that what we perhaps should be avoiding???

amanda
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  #6   ^
Old Mon, Nov-02-09, 12:59
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Quote:
Originally Posted by amandawood

those get my heart racing too....

isn't that what we perhaps should be avoiding???
Only if you want to atrophy.

Some stress is good. A little stress on muscles is what tells the body to keep them because they are needed. Including the cardiorespiratory muscles.

TOO MUCH stress is what is bad. That's what you get from overtraining, or training hard when your metabolism is too broken to sustain it. Marathoners doing 35 miles a week have gone beyond stress to STRAIN - the stress on the body is so much that the body is deforming (with plaque and so on).

No guru or headline can tell from afar the difference between eustress and distress; I have to learn about my very own body.
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  #7   ^
Old Mon, Nov-02-09, 13:00
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NixCarbos NixCarbos is offline
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Quote:
Originally Posted by Seejay
Sleazy title. How I wish he would have written, "Excess cardio..."

It's long been known that overtraining is not healthy and that competitive runners incur all kinds of risks - which they are willing to take.

But to generalize the headline to "running" is just the kind of inflammatory sleaze that makes the public health dialogue so, oh, unhealthy. Where are our manners. And I like the panu guy's thinking except for that.




Sleaze. Yep.
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  #8   ^
Old Mon, Nov-02-09, 14:05
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Nancy LC Nancy LC is offline
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I wonder if maybe it's the bouncy stress on the heart. I know there's some issues with the brain and jogging, your brain gets a bit of a jarring perhaps the heart does too.
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  #9   ^
Old Mon, Nov-02-09, 14:14
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brpssm brpssm is offline
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It is quite a polemic I'm certainly not disagreeing with the findings, but I would comment on 2 things...1) Marathon running and training should not be equated to the types of 'cardio' training most people do. 2) I wonder if anyone has looked at the stress levels of marathon runners? I would venture to guess that a large proportion of marathon runners are classic Type A personalities...a personality type that generally has a lot of self-enduced stress. That would be something I would be interested in...

The paleonu.com author uses Salazar as an example of how marathoning causes heart attacks, here is some additional information from his cardiologist from Runner's World :

Quote:
PUBLISHED 09/07/2007

In an effort to educate other runners about the risk of heart attack, Alberto Salazar allowed his cardiologist to speak publicly about his case. Dr. Todd Caulfield, M.D., is the medical director for interventional cardiology research at Provident St. Vincent Medical Center in Portland, Oregon, and first met Salazar on the morning of the athlete's heart attack. Coincidentally, Caulfield had just finished his first marathon (Vancouver, 3:53:22) seven weeks before treating Salazar.

You can't eliminate all risk factors

Salazar had a lot of risk factors: a family history of coronary disease, and high blood pressure and high cholesterol, both of which were being controlled with medications. Being male is a risk factor, too. "Those are the things that got him into this situation despite his history as a world-class athlete," says Dr. Caulfield. "Even when you control for heart-disease risk factors, they still persist as risk factors. You can't completely mitigate against them."

You can't make heart disease disappear

Salazar's right coronary artery was about 70 to 80 percent narrowed, reports Dr. Caulfield. "We opened it up, put in a stent, and got great results," he says. "His heart hasn't lost any of its pumping capacity." The doctor expected Salazar to return to his usual activity and routine, and says his long-term prognosis is excellent. That said, Dr. Caulfield cautions that Salazar's heart has suffered. "He's got scar tissue, and he's got moderate coronary disease in his other arteries," says Dr. Caulfield. "This is a chronic condition."

The right meds matter

Salazar was already taking medications for his blood pressure and cholesterol, but Dr. Caulfield prescribed a more aggressive regimen and added a blood thinner. The doctor instructed Salazar to return slowly to his usual exercise, by walking first before he begins running. "He'll come into our rehab center for an exercise stress test in a month," says Dr. Caulfield, "so we can see how his heart reacts when he goes up to about 80 or 90 percent of his full effort."

Pay attention to small changes

As a runner, you give yourself a sort of poor man's stress test nearly every day, says Dr. Caulfield. "Any time you feel a new symptom that decreases your exercise capacity to the point where you can't do as much as you're accustomed to," he says, "call your physician, and say, 'Something is wrong.' You can't run through heart disease. We saw that mistake with Jim Fixx."

Your fitness does make a difference

According to Dr. Caulfield, Salazar's heart attack was "quite small," and his conditioning did help him. "If he hadn't been so active and fit and taking good care of himself," says Dr. Caulfield, "he might have been one of those guys who has a heart attack in his 30s instead of at 48."

Other perspectives just for completeness: Runner's World

Cardiac Troponin T Release Is Stimulated by Endurance Exercise in Healthy Humans
Summary:
Quote:
Cardiac Troponin Release In Marathon Runners Does NOT Indicate Heart Attack
Cardiac troponins are proteins released by heart muscle, and their appearance in the blood has been regarded as a strong and sensitive measure of a heart attack. The same troponins have been observed in marathoners after running 26.2 miles, leading some to conclude that the marathoners were suffering heart damage. However, a British sports medicine group has now tested nine marathoners during and after their marathon efforts. They concluded: "It appears unlikely that minor elevations in cTnT subsequent to endurance exercise are due to myocardial necrosis. Rather, it is possible that post-exercise cTn release represents reversible cardiomyocyte membrane damage that may reflect part of a remodeling process." In other words: no heart attack. Source: Journal Of The American College Of Cardiology.

I still say they really don't know what causes heart attacks, witness the divergent information on the role cholesterol plays in heart attacks, my guess is that it is a myriad of factors and not the same in each individual.

Although I won't be running any marathons anytime soon or ever, I will take my chances that moving this body around to get some cardio conditioning and building up and stretching my lean muscle mass will keep me in much better physical condition than sitting on my butt.

Last edited by brpssm : Mon, Nov-02-09 at 14:28.
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  #10   ^
Old Mon, Nov-02-09, 15:13
Nancy LC's Avatar
Nancy LC Nancy LC is offline
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Just to point out, there were 3 papers discussed in this article, with similar results.
Quote:
Here is how LGE works. When heart muscle is damaged, there are pathologic changes in the tissue that we characterize, in our highly precise way as medical scientists, as “scar tissue”. This scar tissue will have a pattern of blood pooling or stasis, where, unlike normal heart muscle, blood leaks in slowly, and then does not wash out as fast with time.

LGE exploits this phenomenon. We give an agent intravenously that shows up bright on MRI images called gadolinium (It’s actually a chelate as free Gd is poisonous) We can first of all use this to look for ischemia or temporary insufficiency of blood flow with stress. Then we get delayed images. On delayed images, normal heart muscle will return to its non- bright appearance, but the scar or damaged heart muscle will stay bright. The important thing to know is that we can detect such areas with much higher resolution than nuclear medicine techniques, and we can see non- transmural (less severe) infarcts and infarcts so small they have no effect on wall motion. This LGE technique has been validated with animal and human pathologic studies. It truly is best way other than autopsy to tell if there has been damage to the heart muscle.


Quote:
All subjects had cardiac MRI with LGE imaging. Those with LGE abnormalities were called back to have perfusion imaging as well to help tell if they had evidence for ischemia.

Sidebar: Ischemia means temporary and reversible changes in oxygenation of tissue. Infarction means ischemia has occurred to the point that tissue has died and this is irreversible. LGE means irreversible loss of tissue or infarction.


Quote:
Among runners with LGE, there were two patterns of abnormality. In the first pattern, found in 5, there was evidence on perfusion imaging and an anatomic pattern that confirmed these were typical ischemic infarcts. That is, they are evidence of heart attacks due to insufficient blood supply in the distribution of a particular diseased coronary artery. The kind of heart attacks we are all familiar with that kill 500,000 Americans a year. Two of the controls had these classic appearing infarcts.

Runners 5 classic heart attacks
Sedentary 2 classic heart attacks
...
Runners 7 non-classic heart attacks
Sedentary 2 non-classic heart attacks

So whether we are looking at classic heart attacks or non-classic, the ratio is about 2.5 or 3 to 1 in favor of being relatively sedentary.

But, you might say, how do we know this LGE is significant?

First, there was evidence of ischemia in most of the classic cases even if you don’t buy my statement LGE by itself is definitive evidence of a heart attack.

Second, in only 21 months of followup, 1 of 90 runners without LGE had a significant coronary event and 3 of 17 runners with LGE had a significant event. Significant events included two cases of collapse and EKG abnormalities after a race. None died, but all were proved to have severe coronary disease by conventional angiography and were stented or had bypass surgery. This event-free survival was significant by log-rank at the .0001 level.


I'd say judging from the follow up and the description of exactly what the dead tissue in the heart looked like, this wasn't just some strange chemical reading that runners get sometimes.

It would definitely be interesting to see if non-marathon runners have similar issues. And, is it only runners?
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  #11   ^
Old Mon, Nov-02-09, 16:21
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I would guess it's a general result of excess moderate-to-high aerobic heart rate exercise.

From Mark Sisson "A Case Against Cardio"

Quote:
The costs of chronic (repetitious) mid- and high-level aerobic work
- requires large amounts of dietary carbohydrates (SUGAR)
- decreases efficient fat metabolism
- increases stress hormone cortisol
- increases systemic inflammation
- increases oxidative damage (free radical production)
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  #12   ^
Old Mon, Nov-02-09, 16:22
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brpssm brpssm is offline
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Quote:
Originally Posted by Nancy LC
It would definitely be interesting to see if non-marathon runners have similar issues. And, is it only runners?

Yes it would be. I'm curious if anything similar has ever been done on, for example, tour de france participants.
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  #13   ^
Old Mon, Nov-02-09, 16:34
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There's some pretty good articles on overtraining for endurance athletes. it's been studied quite a bit over the last 30 years.
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Old Mon, Nov-02-09, 17:00
jschwab jschwab is offline
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I'm a runner and I've thought about this alot. I personally think it's the excess carbs required for distance running that are the problem and not the actual running. There are just not enough low carb runners being studied as a comparison field. Alberto Salazar flatlined for nine minutes and survived. I think I'd rather be in that category than in the "died and stayed died" category LOL. Marathoners just eat too much sugar - incredible amounts of sugar and carbs. There are running peoples around the world (where the whole tribe runs very long distances regularly) who have virtually no heart disease. I think you just get a very special kind of person running marathons in the US. Alot of people start running after they have a heart attack.
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Old Mon, Nov-02-09, 17:29
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Yeah on the running peoples but I don't think they *race* all the time or have that addictive quality to it, or that don't balance the running with social/group time and easy movement.

Maybe the anxious, overdoing-it vibe is is from the sugar and grains, who knows.

I was looking at some of the overtraining pages and found this interesting one from Salon about the over-the-top ultra athletes that was interesting - a far cry from the everyday person who just likes to run.

http://www.salon.com/health/feature...tics/print.html
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