This Sunday is the 40th running of the New York City Marathon — and our renowned cardiologist reflects on its history, the significance of female runners and how your body reacts before, during and after a 26.2 mile run
The New York City Marathon is one of the largest marathons in the world, with 37,899 finishers last year. It is a World Marathon Major, and along with the Boston and Chicago Marathons, it is one of the preeminent long-distance annual running events in the United States. It is organized by the New York Road Runners and has been run every year since 1970. It has come a long way since its initial running of 127 competitors — only 55 of whom crossed the finish line — after completing multiple loops all within Central Park. The first finisher, with a time of 2:31:38, was a firefighter named Gary Muhrcke, who plans on running again this Sunday.
The New York City Marathon was one of the first to welcome women — in 1971. Roberta Gibb ran alongside the all-male Boston Marathon in 1966 and ran again without a number in 1967. That year another woman entered the race, Kathrine Switzer, under the name K.V. Switzer. There is great footage of the race officials attempting to physically push her out of their race, but she was running with her coach and boyfriend, and together, they prevailed. Kathrine Switzer thus became the first woman to officially enter and run the Boston Marathon. She went on to win the 1974 New York City Marathon and then led the effort to make the women’s marathon an official Olympic event. This did not happen until the 1984 Olympic Games in Los Angeles.
Women are evolving to become shorter and fatter? Could this be true?
Today, this seems hard to fathom (last year, women made up 34% of participants), but it is important that every woman running this Sunday appreciate how far we have come in such a short time. Track and field became an Olympic event for women for the first time in 1928. That year, despite a world record time by the winner, several of the women who ran the 800-meter collapsed on the field. Thereafter the Olympic organizers considered long-distance running too strenuous for women, and limited distances to a maximum distance of 200 meters. It took nearly 60 years to prove that women had the ability to run and compete in the marathon.
Marathon day in NYC is a celebration – it is uplifting – it is a special NYC holiday. But is it safe? Pheidippides, the young Greek messenger who is said to have run the first "marathon," ran from Marathon to Athens in 490 BC, delivered the news of victory over the Persians and then collapsed and died. Two weeks ago three men died at the 32nd annual Detroit Marathon and last year two of the 37,899 New York City Marathon finishers died after completing the race, the event’s first fatalities in 14 years (not counting Ryan Shay, the professional marathoner, who in 2007 died one day before the NYC marathon while competing in the U.S. Olympic trial in Central Park).
So just how safe is running the marathon?
The death rate for marathon runners is estimated to be 0.8 per 100,000. (Researches have calculated the triathlon death rate to be slightly higher at 1.5 per 100,000). This number is actually quite low given that approximately 450,000 Americans die from sudden cardiac death each year. The risk of dying from a heart attack goes up on average five to seven times during strenuous exercise (which includes marathons). For those who exercise the most, the increased risk is not nearly as high, but for the sedentary, it may be 50 times more. There is no question that exercise is good for you – it reduces your risk of heart disease and can improve your chances of living longer. And generally, the more, the better, but you do not need to run the marathon to have a healthy body or a healthy heart. Conversely, running a marathon does not exempt you from heart disease.
Can a broken heart actually kill you?
One should only consider running the marathon after adequate preparation and training. Most every training program calls for a gradual increase in long-run mileage, modest weekly mileage totals, interval training (running faster for shorter distances), cross training (exercises separate from running that build endurance, strength and flexibility) and periods of rest. A good diet, establishing healthy sleep patterns and practicing stress reduction, are also crucial. Not every runner needs to have a stress test, but every participant should have a general medical evaluation. It is important to listen to your body and consult your doctor if you experience chest pain, unexpected breathlessness, lightheadedness or palpitations.
Before the race, it is wise to "carbo-load." Carbohydrates build glycogen stores — our body’s most efficient source of energy. When the body’s glycogen stores are depleted, fatty acids become our main energy source — this process is much slower and creates the feeling of "hitting the wall." Ingesting glucose during the race helps prevent or delay this.
Body heat release and production can go up tenfold during a race. Hyperthermia (high body temp.) is common when marathon running. It is not unusual for body temperatures to approach 104 degrees F. at the finish line. Mental status changes are almost universal at 106 degrees, and death can occur at 107 degrees F. To keep cool, hats and breathable fabrics are recommended. Most runners should dress in layers so that they can respond to the different temperatures of the day. Re-hydrating is also essential to allow for continuous sweating, our most essential cooling mechanism.
Re-hydrating with just water however can increase the risk of "hyponatremia," or a low blood sodium level. Hyponatremia is a serious medical condition that can cause the brain to swell. It can result in seizures and is sometimes fatal. When you sweat, you lose both water and salt – so you need to replenish both. These "electrolytes" or salts are now readily available in sports drinks, sports bars and tablets – but bananas and pretzels can also work.
More recently, researchers have found that the stress of a marathon can cause an otherwise healthy heart to release enzymes similar to those found in patients having very small heart attacks. And for up to a few weeks, the heart’s ability to relax and fill can be compromised. These findings, however, have never been linked to any long-term negative effects. Other researchers have found a transient dip in the body’s immune system. Antibodies in the nose and airways – the first line of defense against upper respiratory infections – have been found to be reduced for a week or two, perhaps making one more prone to this type of infection
Overall, I am a big fan of the marathon, and I, as a New Yorker, especially love the New York City Marathon. It is a celebration of the human body and the human spirit. No longer is it an event limited to elite athletes; it has become a goal for so many more — including cancer survivors, amputees, grandmothers and individuals who never considered themselves athletes. The marathon inspires all of us to believe in ourselves, to reach higher and achieve. And along the way, most of the participants become fitter and gain a better appreciation of their bodies and their health – and this will last a lifetime. I, for one, cannot wait until Sunday.
Ten of the Greatest Female Olympians of All Time
[Photo Credit: Shutterstock]
