Thursday, January 11, 2018

Bandera Post-Mortem: Finish at All Costs?

So, Bandera went very, very badly.

Usually I like to do a pretty detailed race report, but I don't have a lot of details to report from this one other than that it was bad.  I felt bad at the start, I felt bad on the first climb, I pretty much felt bad throughout.  I was hoping to run the first half of the race at about 8:30 pace--similar to what I had run two years ago through the first lap--but struggled to run 9:00/mile pace over the first 16 miles through AS3.  Rather than slow down, I tried speeding up to see if I could run my way out of feeling badly, and hammered the next six miles at just under 8:00 pace, coming through 22 miles at 3:12, within striking distance of the sub-4:30 I wanted to run through the first 50K, but it wasn't working; I started to feel worse and worse.  I finished the first lap in 4:46, about twenty minutes slower than two years go, and spent a few minutes convincing myself to head back out for lap two.  I'd like to report that I found my legs in the second half and had a strong finish, but I didn't.  I ran-walked for the first two hours of the loop before getting a sort-of second wind and running consistent 10-11 minute miles for the next couple of hours, ultimately finishing up in 11:19, nearly two hours slower than my breakthrough run in 2016.

The spoils of mediocrity.
This was my sixth national championship race since turning 40, and despite five top-3 age group finishes (Bandera, Caumsett, and North Coast in 2016, Rocky Raccoon and Cayuga in 2017), I was still searching for my first age group title.  Somehow, in what was easily my worst performance as a masters runner, I was able to secure my first age group national championship. All it took was running a terrible race, having Paul Terranova not show up, and having Chad Lasater age up to the 45-49 group.  What a silver lining.

One sentiment I hear all the time is that you learn more from races that go poorly than races that go well.  This sounds like a very wise thing to say, but I don't think it's true.  I take many lessons out of strong performances: I know what workouts were beneficial in my training, what worked in terms of race strategy and nutrition, and where I can expect to race relative to my competition.  I suppose there are lessons to be learned from failure, if you can attribute a poor race to a mistake you made in strategy, preparation, or fueling.  In this case, though, it's hard to feel like I learned anything that will help me the next time out.  My training for the race had been nearly ideal, and I certainly didn't feel as if there were any aspects of my preparation that were missing; my times in the short prep races were comparable to those I'd run in the previous two years.  I wasn't out too fast, either, actually running a slower pace than planned for the first 16 miles (which was hard to do with a huge field of fast guys hammering at the front).  Maybe I was overtrained; maybe I had pushed some workouts too hard; maybe I was too focused on hitting splits over the first 50K that I got out of my comfort zone too early.  Maybe, maybe, maybe.

Sometimes when people invoke that maxim--that we learn more from defeat than from victory--they are speaking less of concrete lessons that can help us apply changes to future performances, and more about the nebulous idea that we learn about ourselves and our limits when "the going gets tough."  That we have more strength than we think, that we didn't give up, that we can push through the next time we hit a bad patch.  In a way I suppose this is true--you do need to suffer at some point in a race to learn how to deal with that suffering.  Without learning that suffering can be endured, that it passes and gets better, we'd never make it through the rough stretches that define ultra running, and we'd never finish a race when we hit a bad patch.  I'm not someone, though, who believes this is a lesson we need to learn over and over.  I've been running races since I was twelve years old; I don't need to be reminded how to deal with suffering.  I've never subscribed to the finish-at-all-costs mentality.  I know I can finish; I'm not entering races to prove it to myself over and over again.  I run races to challenge myself to perform and to compete against other runners at a high level.  Everyone enters a race with a baseline goal of "just finish," but should we?  What did I get out of walk-running through a 6:30 50K over the second half of that race?  I accomplished none of my goals (other than the aforementioned age group win, which had nothing to do with me).  I didn't learn anything new about myself or my "limits".  I finished a race that I had no doubt I could finish very slowly if I needed to.  I got the same belt buckle I got two years ago.  (It's a very cool buckle, but still.)  Am I any more satisfied with this experience than I would've been if I'd stopped after a single very disappointing lap?  And if I am, should I be?  By any objective measure--my time, my place, my position in the field relative to other runners I know--this was a terrible performance.  Why should the fact that I was able to walk for several hours to avoid a DNF mitigate that in any way?

If you've got a brilliant answer, I'm all for it.  All I can come up with is that I now have four tickets in the lottery for Western States in 2019.  Here's to another opportunity to humiliate myself.

Thursday, January 4, 2018

Ultrarunner of the Year: My Ballot

I was honored to be included once again on the voting panel for Ultrarunning magazine's prestigious Ultrarunner of the Year award.  This was my third time voting, and it isn't getting any easier.  I know I complained last year, but at least in 2016 the top spots for both the men and women were pretty obvious.  This year we had no such luck.  I think pretty much everyone will agree on the top two women, although in which order they ultimately wind up is anyone's guess; I spent nearly as much time deciding between the two of them as I did on the rest of the entire ballot.  The remainder of the ballot was pure torture as usual.  I'm thrilled that I get to keep voting, but it really is an excruciating process and by the time I'm done my stomach usually hurts pretty badly.

Posting my ballot has inspired a lot of good-natured (and not-so-good-natured) criticism in the past, and this year with the launch of my new podcast, The Pain Cave, I decided to be a bit proactive in addressing this.  I invited New York ultra stud Jason Mintz, one of my staunchest (if friendliest) critics, on the pod to debate our picks.  Unfortunately Mintz had to cancel at the last minute, but our mutual friend Laura Kline was kind enough to step in and provide the counterpoint to my ballot.  Listen to the episode here; I'll list my ballot below, but Laura and I get into the nitty-gritty a little bit more and really go through our reasoning and justification for some of the decisions we had to make.

I don't yet have the final results tabulated for the Gunksrunner Ultra Rankings for this year, which is unfortunate since I like comparing them to my ballot.  I hope to have the results finished by the time Ultrarunning publishes the UROY results, and we can do a little comparison then.

Just a reminder: FKTs are not to be considered in this voting, not for UROY or Performance of the Year.  A separate committee votes on the top FKTs of the year.  So, feel free to tear apart my ballot, but dear god, don't criticize me for not including FKTs.

Women's UROY
1. Camille Herron
2. Courtney Dauwalter
3. Clare Gallagher
4. Katylyn Gerbin
5. Magdalena Boulet
6. Jacqueline Merritt
7. Kelly Wolf
8. Katalin Nagy
9. Cat Bradley
10. Devon Yanko

I'm not going to delve deep my reasoning for any of these categories; listen to the podcast as we spent nearly an hour doing that and I don't feel like rehashing that here.  The Camille vs. Courtney debate for the top spot was incredibly difficult, but Clare Gallagher was a pretty easy choice, for me at least, at #3.  Spots 4-6 were basically identical and I would've been happy with any order.  Toughest omissions: Keely Henninger, Anna Mae Flynn, Kathleen Cusick, Hillary Allen, Megan Kimmel, Sarah Bard, and Sabrina Little.

Women's Performance of the Year
1. Camille Herron's 100 mile WR at Tunnel Hill
2. Camille's win at Comrades
3. Courtney Dauwalter's 24-hour AR at Soochow
4. Camille (again!) 12-hour WR at Desert Solstice
5. Rory Bosio's overall win and women's CR at Tahoe Rim Trail 50-mile

Tough omissions were Cat Bradley's unexpected come-from-behind win at Western States, Clare Gallagher's win at CCC, Courtney's dominating win at Run Rabbit Run (despite temporary blindness), Katalin Nagy's (transient) 24-hour AR, and Michelle Leduc's Canadian Record at 100 miles (made easier to leave off the list by the fact that Camille ran over two hours faster this year).

Women's Age Group Performance of the Year
1. Liz Bauer (58 years old), first at Across the Years 6-day (418 miles)
2. Meghan (Arbogast) Laws (56), 9th at Western States
3. Sally Brooking (61), 4th at Mountain Mist 50K (5:46--and that's not an easy course)
4. Roxanne Woodhouse (54), first at Tahoe Rim Trail 100-mile
5. Jean Herbert (61), 9:21 at JFK 50

Men's UROY
1. Tim Tollefson
2. Jim Walmsley
3. Alex Nichols
4. Tim Freriks
5. Avery Collins
6. Sage Canaday
7. Mark Hammond
8. Hayden Hawks
9. Max King
10. Patrick Reagan

God, was this an unpleasant task.  Again, listen to the podcast for most of my reasoning; Laura and I discussed if it's fair to grade Jim on a curve, how much a DNF should count against you, why I'm such a Cornell XC homer, and the importance of big international races like CCC, Comrades, and UTMB.  My toughest cuts in this category: Dylan Bowman, Bob Shebest, Olivier Leblond, Jeff Browning, Jason Schlarb, Cody Reed, Brian Rusiecki, Kris Brown, Anthony Kunkel, and Eric Senseman.

Men's Performance of the Year
1. Olivier Leblond's 48-hour AR (262 miles)
2. Geoff Burns' 5:14 at Chicago Lakefront 50-mile
3. Tyler Jermann's 2:48 50K at Caumsett
4. Hayden Hawks' win at CCC
5. Guillame Calmettes' win at Big's Backyard Ultra

I found this category much easier this year than last, for some reason.  Jim had some amazing performances again this year, but nothing that captured the imagination of the ultra world like many of his 2016 exploits.  For some reason Tim Tollefson's third place finish at UTMB was fifth on my ballot last year but not this year.  So much for internal logic.  But I was much happier with this list than with my UROY top 10.  Toughest snubs: Jim's CR runs at Tarawera and Gorge Waterfalls, Tim's aforementioned UTMB race (and Jim, DBo, and Zach at UTMB, for that matter), and Tim Freriks' two huge wins at Transvulcania and North Face.

Men's Age Group Performance of the Year
1. Thomas Devers (60 years old), 3:38 50K (and first place) at the Tallahassee Distance Classic
2. Bob Hearn (51), 151 miles in 24 hours at Run4water
3. Rich Hanna (52), 6:18 at American River 50-mile
4. Jean Pommier (52), 3:19 at Jed Smith 50K
5. Gene Dykes (69), finishing the Triple Crown of 200s

So there you go.  Same rules from last year apply: feel free to rip me apart in the comments, but you have to vote for me for Run Ultra's Blogger of the Year first.  Cast your vote and flame away!

Monday, December 25, 2017

Guest Post: Stewart Dutfield's 2017 Journal

And now for something a bit different...

Local ultrarunner Stewart Dutfield was kind enough to share the diary he's been keeping for 2017 and I thought it would be fun to include it here. His journal is based on the diary of fellow Brit Alan Bennett and is a cool glimpse into the thoughts of a dedicated runner who enjoys experiencing the world around him. Hopefully Stewart will keep us updated with some semi-regular posts in 2018.


Trail markers at the terminus of the Long Path imply that it continues northward...
13 January. Old Stage Road, above Altamont in Albany County, is currently the northern terminus of New York's Long Path; Ken Posner's recent book describes his 350-mile journey that ended here with a wry twist. On a clear, cold Friday evening 18 of us arrived at the trailhead for a the first full moon adventure of the year. People had traveled for hours, from Connecticut and Westchester, to walk five miles in the dark and watch moonrise over the Hudson Valley. After Dick had fallen hard on ice fifty yards in, we encountered good footing except on the dirt roads (back country ice skating, anyone?). The trail climbed hardly at all, but the view from High Point took in all of Albany and beyond. The informal trail along the cliff edge led, at one point with the rising moon directly ahead, to another high overlook at Hang Glider Point. As we took snapshots of people doing headstands, a bright light emerged from the woods: a fat-tire cyclist, no doubt as surprised to see us as we were to see her. 

Wednesday, December 6, 2017

Blogger of the Year, Take Two!

I'm very happy to announce that for the second straight year I've been shortlisted by the fine folks at RunUltra for the Ultra Blogger of the Year award.  RunUltra is a UK-based website that is an amazing repository of all things ultrarunning.  Their content runs the gamut: training advice, gear reviews, reporting on elite results from all over the globe, articles on physiology, motivation, race preparation, and basically anything else you might want to know in the ultra world.  Those guys (and gals!) know their to be named once again to their shortlist of candidates is truly an honor.
Last year's vote came down to the wire, though a closer examination of the balloting apparently revealed some...irregularities.  I can neither confirm nor deny reports of Russian hacking.  Anyway, the great Sarah Lavendar Smith, author of the superb blog "The Runner's Trip" (as well as The Trail Runner's Companion, an excellent book) was ultimately named a most deserving winner.  Sarah's up for the award again this year, so let's see if we can give her a (legitimate) run for her money.

This was kind of a big year for us here at "A Muddy Par of Heels."  I tried to branch out a little with the Running and Your Heart series of posts, adding a bit of an informative/academic bent that I hope people found useful, in addition to the usual race reports and other nonsense you've come to know and love.  Also this year I launched my podcast, "The Pain Cave," a series of conversations about running in general and ultrarunning in particular that takes a closer look at some of the science behind the sport, and other relevant issues of the day.  I view the blog and the podcast as kind of a companion set; hopefully each has helped enhance your enjoyment of the other.  (You can find The Pain Cave on my new website,, which is still a work in progress but ultimately should bring all my various running-related interests under the same tent.)  Unfortunately Lexi didn't quite hold up her end of the bargain this year--she's busy co-writing a novel about dragons with a friend of hers--so if I don't win I suppose I can blame it on her.

If you enjoy the blog, please take a moment to vote for me on the RunUltra website.  (You can use that link there, but I also figured out how to link the voting page with the image at the top of this post--if you just click on the badge at the top of the page, it takes you right to the voting!  If that's not enough of a reason to vote for me, I don't know what is.)  Scroll down to my name--I'm the eighth name on the left side, just above some punter named Jeff Browning--and click "Vote" under my name.  Wait, you're not done!  Now scroll all the way down to the bottom of the page, fill in your name and email address, and press "Enter."  You should get a new screen that confirms you've voted.  Thanks!  One vote per email address please; we don't want any monkey business this year.  Voting runs until January 14.  Just do it now before you forget.  As a cool bonus, everyone who votes is automatically entered in a drawing for a super cool Suunto Trainer watch.

In all seriousness, thank you for all your support of this blog.  It's a silly pursuit, I know, but it really means a lot when I get positive feedback from people who read the posts and let me know they've gotten something positive out of it.  I'll keep bugging y'all to vote, and I hope I win, but just having that kind of support is what keeps me plugging away at this thing.  But, seriously, go vote now.

Sunday, December 3, 2017

Running and Your Heart, Part V: Coronary Calcifications

So I thought I was done with the Running and Your Heart series, but some questions came up that made me realize I needed to clarify a couple of points.  And I don't know, maybe we're not done with the series; I could see doing some more in-depth posts in the future about some specific issues.  A detailed post on atrial fibrillation might be in order.  For now, though, we're going to delve a bit deeper into coronary calcifications, their significance, and what the research means for us as distance runners.
image: the Heart Research Institute

As such, think of this post less as the fifth installment in the series and more as part IIIb, as we'll be addressing basically what we talked about in part III (and touched on briefly in part IV).  Let's recap some of the main points from that post.  The coronary arteries are blood vessels that carry blood to the heart muscle, supplying that muscle with the oxygen needed to carry out its function--namely, pumping blood throughout the body.  Blood flow through these blood vessels can be compromised by a disease process called arteriosclerosis--literally, a hardening of the arteries.  Generally, arteriosclerosis is caused by the accumulation of plaques within the walls of the arteries, resulting in a narrowing/hardening of the arteries (stenosis) that can impede the flow of blood to the heart muscle.  In times of increased stress on the heart (i.e., exercise), the demands of the heart muscle for oxygen are increased; if not enough blood is able to flow through these narrow, stenotic arteries to meet this demand, the heart muscle suffers from ischemia (lack of oxygen).  Prolonged ischemia, or complete occlusion of the artery, can lead to infarction, or death of a part of the heart muscle--which, if significant enough, can be debilitating or fatal.

Remember that in part III, we discussed the use of CT scans in detecting underlying coronary artery disease--namely, looking for calcium deposition in the coronary arteries.  Calcium is a component of many arterial plaques and is easily visible on high-resolution CT scans.  This test is especially useful in folks who don't have any symptoms of coronary disease but may have risk factors.  A growing body of research indicates that long-term endurance athletes--those who have been training at high levels or volumes for a decade or more--paradoxically have higher rates of coronary calcification than those of their age-matched peers in the general population, despite having much lower rates of many risk factors, like diabetes, hypertension, or obesity.  Remember that these studies have demonstrated correlation, not causation--we can't say that sustained exercise is the cause of this finding, only note that the relationship exists.  And recall also that we've yet to demonstrate what the real-world implications of these findings are--which is the point of this more involved discussion. To wit, the question: does having more coronary calcification lead to a higher risk of having a cardiac event?  The short answer is, yes--but for marathon runners, maybe not.

Numerous studies of the general population (that is to say, not specifically among marathon/ultramarathon runners) have correlated coronary artery calcification (CAC) scores to a higher risk of suffering a cardiac event, such as heart attack, death, or the need for revascularization (a re-opening of a blocked artery).  The exact degree of risk varies by study, but ranges from a four-fold risk increase to a twenty-fold increase have been reported in studies of varying size and quality.  Higher CAC scores are associated with a higher degree of risk, with significant risk increases generally seen with scores above 100 or 300 (zero is "normal").

OK, so that's bad.  Higher scores are associated with higher risk, and we've demonstrated that "obsessive" runners have higher scores, on average, than the general population.  That means our risk of suffering a significant cardiac event must be much higher, right?  Well, not necessarily.  First off, as I mentioned in the earlier post, there is research suggesting that long-term aerobic exercise leads to coronary arteries that have larger diameter, and have a greater ability to dilate.  (The autopsy of seven-time Boston Marathon champion Clarence DeMar famously revealed that his coronary arteries were two to three times wider than average.)  Secondly, to better understand our level of risk, we need to understand the nature of arterial plaque and the reasons one might suffer from a cardiac event.

Generally, narrowing of the coronary arteries, in and of itself, is unlikely to cause a cardiac event.  The precipitating factor in a cardiac event is often the rupture of an arterial plaque.  A piece of the plaque can break off and get carried "downstream" to a narrower part of the artery.  If it gets lodged there, it can cause a complete occlusion of blood flow to an area of the heart muscle, resulting in a heart attack.  So if we can identify which plaques are more susceptible to rupture, this will allow for a better stratification of risk.

Simply put, not all plaque is created equal.  Arterial plaque is generally composed of various substances: fat, cholesterol, calcium, and fibrin, to name a few.  One way of thinking of plaques is to classify them as either "hard" or "soft".  Hard plaque, made up of predominantly calcium, is generally considered more stable and less prone to rupture than softer (mostly cholesterol) or "mixed" plaque.  The good news is that while high-volume exercisers have higher CAC scores, they are much more likely to have hard, calcific plaques (read: stable) and much less likely to have mixed plaques than subjects who exercised the least.

So while we know that elevated CAC scores in the general population put people at risk for cardiac events, the risk for runners who have elevated CAC scores may not be the same, because of the composition of their plaques, and possibly the dilation of their coronary arteries.  Perhaps this is why, despite the fact that runners appear to have paradoxically higher-than-expected rates of calcification, cardiac events among habitual marathoners seem to remain relatively infrequent occurrences.

Thursday, October 26, 2017

Race Report: WC 50--There's No Cure for Stupid

This fall has been less about racing per se and more about setting myself up for 2018, when I have three big (for me) races on the calendar, plus hopefully an attempt at the Bob Graham Round (fingers crossed that trip comes together).  But racing can be part of training as well.  Races are good opportunities to experience stimuli that you might not be getting in your weekly training, either in terms of distance or intensity, and they can be a nice gauge of fitness as you shape your plans and goals moving forward.  My experience in September at Mountain Madness fell into the former category.  I travelled to North Carolina two weeks ago for the latter.

My sister and her family have lived in Charlotte for about 12 years now, only about 20 miles from the US National Whitewater Center, which is a really cool facility for aspiring elite kayakers and rafters.  Since opening in 2006, the center has grown to include rock climbing, zip lines, high ropes courses, and many miles of mountain biking trails, and they now host all sorts of events and races.  The WC 50, now in its fifth year, is the ultramarathon entry into the Whitewater Race Series, and a race I've wanted to run for some time due to its proximity to family.  The dates worked this year for a quick trip down for my nephew's birthday party and an early-morning jaunt in the trails.  I expected a low-key day out; I had no idea of the competition, but looking at previous results, I planned on running a relaxed effort near the front and seeing where my fitness level would get me.

We started in the dark, at 6am, on a fairly warm morning--temps were already nearing 70 degrees.  The race started out with a short "parade loop" around the whitewater course before heading into the trails for the first of three 10.2-mile loops.  I set off at a relaxed but quick tempo and was immediately at the front of a field of about 100.  By the time we hopped onto the singletrack about five minutes in, I was out in front with one other runner and it looked like we'd be on our own most of the day.  We ran together at a nice pace; the miles were marked with signs tacked to the trees, and we were clicking off splits in the 7:40/mile range on some fairly technical but runnable mountain bike trails.  It was a bit tough monitoring our footing with just headlamps, but it was fun running at speed through the darkness, and the early miles passed by quickly.  We ran together throughout the first lap.  The second half of the loop had a few significant climbs, though we kept up a solid tempo.  The mile splits suddenly had jumped up to over 10-12 minutes per mile, but I think this was due to incorrect markings as opposed to any change in our effort or actual pace.  (This sense was supported by subsequent laps, when we would again run 7:30-7:40 pace on the early "miles", followed by 10-12 minute "miles" later on.)  Regardless, we rolled through the first 11+ mile lap in about 1:39; I grabbed my Orange Mud handheld and ran on through the start/finish aid station, while my companion--a strong local runner named Chase Eckard--took a quick break with his crew before catching back up within the first mile of lap 2.

We kept the effort steady and chatted through the early part of the lap.  Chase said, "When do you think Karl will catch us?"  I knew that Karl Meltzer, the winningest 100-mile runner of all time, had been in town for the pre-race dinner, promoting Made to Be Broken, a film about his record-breaking run on the Appalachian Trail.  I hadn't realized he was racing, although I had considered the possibility.  For some reason I had assumed that if he was racing, it would be in the 50-mile, which had started at 5am on a course that incorporated our entire 10-mile loop plus an additional 7 miles on each of three 17-mile loops.  

"Oh, is Karl racing?" I asked.  

"Yeah," said Chase, "he started off at the back."

I have no idea why--partly because of my pre-race assumption, I guess, and partly because we were leading the race and why would I be leading a race against Karl Meltzer?--Chase's comment simply reinforced my notion that he was in the 50-mile.  I wasn't sure if he would run the opening 17 miles of his race in under 2:40 on this course, so by my twisted logic I wasn't clear if we were actually ahead of him or not at this point.  "Well," I said, "if we finished our first lap before he did, we might be ok; he might catch us later in this lap.  But either way, we'll pass him when he does the extra seven miles on lap two."  Chase didn't really have much to say about that, which given that Karl was actually in our race makes perfect sense; in retrospect I must have sounded like a freaking moron.

ANYWAY, we ran together until about the 16-mile mark, when Chase blasted away on a long downhill stretch and I eased off a bit, resisting the urge to really open up this early in the race.  Instead I took in some calories, slamming down two GUs in rapid succession (my first calories to that point, I realized, even with the fat adaptation I've got to be a little smarter about that) and settling into a nice solo rhythm.  I caught a few glimpses of Chase on some longer stretches, about a minute ahead at a couple of spots, before we started in on the climbing again.  I didn't expect to start racing for a few miles yet, but suddenly he appeared in front of me near the 20-mile mark, walking at the top of a long but runnable uphill.  We exchanged a few words of encouragement as I made an easy pass.  By the time we reached the end of lap 2, a little over a mile later, I already had about two minutes on him, and I was feeling good.  Barring disaster, I felt like I had it in the bag.

Disaster is exactly what happened about 25 minutes later.  I rolled through the opening miles of the final lap feeling a little tired but generally relaxed and strong.  My splits were within shouting distance of my first two laps.  I passed the 4-mile mark of lap 3, about 25 miles overall, in 3:52; doing some quick calculations (and taking into account the longer "miles" in the second half of the lap), I was looking at about a 4:55, maybe right around 5 hours if I slowed down a little.  I briefly stepped off the trail to fertilize the soil, not realizing I was near one of the myriad switchbacks on the course.  Somehow I got turned around and ended up on the wrong end of the switchback.  After a couple of minutes of running, I started getting a sinking feeling in my stomach.  The trails all looked the same, but some of those turns were looking too if I had just run them...and then I came around a corner and arrived back at the one-mile mark.

Well, that was just too much.  I sat down on a log by the side of the trail and had myself a little pity party; after a couple of minutes I started walking backwards towards the start, ready to throw in the towel rather than run another nine miles.  After a few minutes of that, though, I felt pretty stupid, having travelled all the way down and then not even bothering to finish; I thought about Jim at States last year, sighed, turned around, and trudged back over the same three miles I had just run.  I finally cruised into the mid-loop aid station about 40 minutes behind schedule.  The volunteers were all very confused--none of the leaders had actually gone past me--but after I explained what happened they were sympathetic, as they had seen Chase and I up front all day.  The told me Chase was now running second to Karl, which is how I came to finally realize that Karl had been in the 50K all along; they poured me a shot of bourbon, which at this point I figured what the hell, and sent me on my way.

Speedgoat Karl on his way to the win.
photo: US National Whitewater Center
I actually felt pretty good the rest of the way, and managed to pick off one or two other folks en route to finishing in 5:41, officially 6th but in actuality 5th (looking at the splits, the 5th place runner is credited with a second lap of 1:21--fifteen minutes faster than anyone in the race ran any other lap on the day, and almost 30 minutes faster than either his first or last lap, so there's no way that's legit, but whatever).  I felt fine afterwards, and actually wasn't even all that sore the next day, so it confirmed at least a decent level of fitness.  And for the first hour or two I didn't even care about what had happened; I basically shrugged afterwards talking to Karl and said "That's trail racing, shit happens."  But after a little while the disappointment really set in.  I had put over seven minutes on Karl after one lap; on lap two I had given back barely 30 seconds.  I had basically tossed away probably my only chance to beat a legend like Karl--and not some outside chance; the race was basically over--by being a fucking idiot.  

Lap 1
Lap 2
Lap 3
Karl Meltzer
Bill Shires
Chase Eckard
Paul Halaburda
Stephen Spada
Jason Friedman

In retrospect it was the perfect commentary on my ultra season for 2017.  I did fine, winning a couple of small races that I fully expected to win; I came into every big race (Rocky Raccoon, Cayuga Trails) in great shape and then had great performances sidetracked by weird shit happening.  Only difference was this time I brought the weird shit on myself.  A fitting ending to a frustrating year.  Fuck.

Twelve weeks to Bandera.

Monday, October 9, 2017

Running and Your Heart, Part IV: Running and Mortality


At long last, here is the final post in the "Running and Your Heart" series.  When we started I thought I'd finish this series in about 4-6 weeks.  Now it looks like we're pushing past 6 months.  Hopefully it will have been worth the wait.

So over the past several months we've (rather infrequently) investigated the relationship between long-term endurance exercise and the heart.  We've discussed normal heart function, cardiac adaptations to exercise, abnormalities that can arise from these adaptations, and the impact of marathon and ultramarathon running on coronary artery disease.  (As a brief aside, one of the theories that I discussed in the last post--that the increased coronary calcification seen in marathon runners is quite possibly hard, stable plaque that is less likely to rupture and cause actual problems--has since been supported by some recent studies.  Alex Hutchinson, whose work is generally spot-on, has a good summary of these articles in Runners' World.)  What I've tried to stress is that we should not be alarmist about these issues, but that we should not be naive either in thinking that our running makes us immune from heart disease.  Rather, we need to be aware of the potential problems that can arise from long-term training and be able to address these possibilities with our physicians in a responsible way.

OK, that's all well and good.  But when we start seeing articles with titles like "Fast Running is as Deadly as Sitting on the Couch, Scientists Find" and "Excessive Running Could Kill You", it's natural to feel a bit concerned.  We know running, on the whole, is good for us.  Since Jim Fixx gave us his seminal work The Complete Book of Running in 1977, detailing how running saved him from what seemed to be his genetically destined early cardiac death, we've taken it on faith that diligent training leads to longer lifespans.  But with all the studies in the past decade that have been hinting at correlations between long-term marathon running and paradoxical heart disease, is it possible that we're taking things too far?  Have we reached the point where all this running is actually shortening our lifespans?  (And wait a second, didn't Jim Fixx die pretty young after all?)

Much of the recent concern over the possibility that too much running might actually be bad for you centers on a couple of ideas.  One is the relationship between long-term marathon running and coronary artery disease, which we discussed in detail last time.  Just to sum up where I stand on this: I think it's pretty unambiguous that people who train vigorously for marathon-and-longer distance events for many years do have a higher incidence of coronary artery calcification than those who do not, and that the cardio-protective benefits of regular aerobic exercise require much less mileage and less intensity than many of us (including myself) are actually doing.  However, as I pointed out in the links above, not all coronary calcification is created equal; while you'd certainly prefer less calcification than more, and no calcification to any, the calcific plaques demonstrated in asymptomatic long-term runners are not the same in terms of composition (and possibly long-term risk) as those we'd associate with smoking, uncontrolled hypertension, diabetes, or other native disease states.  Even if we assumed that we may be at higher risk of suffering a serious cardiac-related event as a result of strenuous running (by no means a reliable assumption), I don't think the data support the conclusion that this risk outweighs the mortality benefit of the decreased incidence of high blood pressure, diabetes, and cancer that runners consistently demonstrate over their more sedentary peers.

The other idea that has received a lot of publicity in recent years is the so-called "U-shaped mortality distribution."  This concept is based largely on the work of James O'Keefe and other researchers involved in the Copenhagen City Heart Study, as well as Duck-chul Lee, who in 2012 presented a rather controversial abstract at the American College of Sports Medicine conference.  According to their research, when plotting mortality (the dependent variable) on the y-axis against mileage (the independent variable) on the x-axis, the data shows the highest mortality values at the lowest and highest ends of the exercise spectrum (i.e., a "U-shaped" distribution):

The "U-shaped" mortality curve.
figure: American College of Cardiology 

In other words, those runners logging much less mileage--as little as a mile a day in some cases, and certainly less than 20 miles a week--saw the greatest benefit in mortality, while those running more mileage saw little to no mortality benefit at all!

These are the studies that have prompted most of the terrifying headlines you've read in recent years, and these are the studies I want to talk about today.  Not to argue with their data, but to try to help us understand why some of the authors'--and the media's--conclusions are not necessarily as dire as we've been led to believe.

Lee et. al. demonstrated a 20% reduced risk of mortality for runners vs. non-runners over a 15-year follow-up period--great news!  However, the study appeared to show that runners averaging more than 20 miles per week had not only higher rates of mortality than those running less, but that their mortality rates approached those of sedentary, non-running peers.  However, these findings were based on the researchers' adjustments for various conditions, including body mass index (BMI), smoking, diabetes, and hypertension.  What does this mean?  When comparing different groups of people, researchers can run into a problem with what are called confounding variables.  These are differences between groups that might affect what you're trying to measure.  In this case, the researchers were trying to determine the relationship between running mileage and mortality.  Of course, there are many different variables that contribute to one's mortality risk, and without accounting for these variables, it's difficult to ascertain whether differences between groups of data is due to what you're actually trying to measure (running mileage) or to something else that you're not measuring.  So the researchers performed what's called statistical correction to take these variables into account.  Simply put, they eliminated the effect of as many of these confounding variables as possible, trying to answer the question: "If all other things are equal--if all of these groups are made to be the same in terms of their rates of obesity, diabetes, blood pressure, etc.--then what effect does mileage run have on their mortality risk?"

Let's be clear: there's nothing underhanded about this.  Statistical correction is a perfectly legitimate (and in most cases necessary) part of scientific research; it's how we attempt to discern cause and effect in situations with many different variables in play.  In this particular case, however, we run into a problem.  The reason that running might have a benefit on mortality is that it makes you healthier overall.  That is to say, vigorous runners are less likely to be obese, to have high blood pressure, or to suffer from diabetes.  If you eliminate these benefits as "confounding variables," it only stands to reason that the mortality benefits of running disappear from the data as well.  The problem with this study wasn't that the authors tried to correct for confounders; it was their classification of the benefits of exercise as confounding variables in the first place.  Alex Hutchinson was all over this pretty much right away, and in 2013, cardiologist Thomas Weber pointed out the problem in the journal Heart:

"One possible explanation for the U-shaped that the authors adjust for body mass index, hypertension and hypercholesterolaemia. Running has been shown to lower those risk factors in a dose-dependent fashion with no sign of negative returns until at least 50 miles/week. Arguably, adjusting for all these factors is akin to adjusting for low-density lipoprotein (LDL) values in a study analysing the survival benefit of taking statins to treat hypercholesterolaemia. Put simply, this editorial represents a selective interpretation of the available data, at the best."

What Weber is saying is, if you were studying the impact of a drug for cholesterol on mortality, and you had two groups (one which took the drug and one which didn't), it wouldn't make any sense not to look at the differences in the cholesterol levels between these two groups--how else would you expect the drug to improve mortality if not by impacting cholesterol levels?  Similarly, if we grant that running makes us healthier because it protects against hypertension, diabetes, and obesity, then those are very likely the reasons it would have a mortality benefit; removing those effects from the analysis doesn't make sense.

Indeed, when the final paper of this study was published in 2014, the researchers eliminated the statistical correction--and the U-shaped mortality curve seemed to vanish!  Instead, the authors, now concluded,

"[R]unners across all 5 quintiles of weekly running time, even the lowest quintile of <51 minutes per week had lower risks of all-cause and CVD (ed: cardiovascular disease) mortality compared with non-runners. However, these mortality benefits were similar between lower and higher doses of weekly running time. In fact, among runners (after excluding non-runners in the analyses), there were no significant differences in hazard ratios of all-cause and CVD mortality across quintiles of weekly running time (all p-values >0.10)."

That is to say, running even a little bit lowered mortality risk, and this lower risk appeared constant regardless of the time or distance run per week. Perhaps not surprisingly, this received significantly less media attention than the earlier version of the results.

Similarly, the researchers in the Copenhagen City Heart Study reported findings that seemed to support the U-shaped mortality curve, concluding:

"We found a U-shaped association between jogging and mortality. The lowest mortality was among light joggers in relation to pace, quantity, and frequency of jogging. Moderate joggers had a significantly higher mortality rate compared with light joggers, but it was still lower than that of sedentary nonjoggers, whereas strenuous joggers had a mortality rate that was not statistically different from that of sedentary non joggers." 

and cited Lee's paper in their discussion of the results.  Again, however, these conclusions don't tell the whole story.  While this study followed nearly 1100 runners over a 12-year period, only 40 of these runners qualified as "strenuous joggers" according to the rubric of the study (running at a pace of 9:00/mile or less for at least 2.5 hours/week), and there were only two deaths among this group during the course of the follow-up period--not nearly enough of a rate to draw any meaningful conclusions.  As researcher Steve Farrell pointed out,

"Say that 2 blindfolded men ran across a busy highway and were not struck by a car. Would anyone conclude based on those two events, that it is perfectly safe for everyone to run blindfolded across a busy highway?"

So what to make of all this?  It seems pretty clear that the substantial mortality benefits of aerobic exercise are conferred even after relatively small amounts of running--which is great news for the sedentary population and light exercisers in general--and I'd agree that at some point we reach a rate of diminishing returns, where further increases in mileage or intensity don't offer any additional mortality benefit.  But where that point lies has not been clearly defined, and I think that based on what we currently know, fears of increased mortality as a result of exceeding that threshold appear unfounded.  And generally, most of us who are interested in exploring our physical limits are doing so for reasons that go beyond "living longer."  As Amby Burfoot points out,

"Many aspects of exercise and running also follow a U-curve. This is why many people believe the moderate approach is the smartest path to follow. Of course, you’ll never qualify for the Boston Marathon that way. We all have to make our choices."

Certainly we don't need to run ultramarathons experience all the health benefits of regular exercise.  But it doesn't seem like we need to fear them either.