Last week, Bloomberg published an online article by Natasha Khan and Shannon Pettypiece, entitled "Men Over 40 Should Think Twice Before Running Triathlons," that opened with the line, "For men competing in triathlons past the age of 40, the grueling slog to the finish line could be their last."
I can tell from inquiries I've received and from online and Twitter chatter that this article received a lot of attention. Of course, there are a lot of male triathletes older than 40!
I don't ordinarily think of Bloomberg or BusinessWeek as a source for imofrmation about personal health. That Bloomberg would publish this article speaks to the current general interest in the intersection of health and endurance sport. And men older than 40 must certainly be an important demographic for Bloomberg.
At the outset, let's agree that the headine and lead sentence--probably furnished by an editor for the sole purpose of garnering attention--are sensational. The rest of the article is more balanced, though, and there's a fair amount of factual material that should interest male athletes. Let's take a look :
1. A personal account. As a jumping off point, the article shares the sad story of 55-year-old business executive and triathlete, Michael McClintock, who died of cardiac arrest after a training session. When athletes die at high-profile events like marathons or triathlons, the incidents capture the public's interest. When athletes die on the treadmill, the high school track, or the local swimming pool, they receive little attention. A handful of athletes die at running races or triathlons in the U.S. each year; several thousand athletes die each year in non-race settings. The story of Mr. McClintock is typical. One of my heart surgery partners died on a hotel treadmill a while back.
2. Sports-related sudden cardiac arrest (SCA) is truly much more common in adult male than adult female athletes. Like the article suggests, men older than 40 should think twice about exercise. Men in this age category should due diligence, with their physicians, to their heart health and any potential risk of participating in an exercise program or training for and competing in events like triathlon. That's only common sense. Sports-related SCA can happen with any sport, regardless of how strenuous it might appear. But other forms of heart disease are common in athletes and non-athletes, alike. Prevention is worthwhile. Finally, it's important to remember than women and younger men are not immune from the problems of SCA or heart disease in general.
3. Triathlon swim. In triathlon, the greatest risk for SCA does indeed occur during the swim, for reasons that are not entirely clear. The article mentions one potential theory related to the body's neurohormonal systems that has been proposed by British physiologists. I've written about this possibility here at the blog. This is just one theory. The truth is that we don't yet know enough about SCA during the triathlon swim. USA Triathlon prepared a checklist that may help athletes reduce their risk.
4. The experts are triathletes. It's nice to see the article quoting expert cardiologists who also happen to be triathletes. Dr. James O'Keefe is a very capable triathlete and Dr. Andre La Gerch is an exceptional runner (think 1:10 half marathon) and triathlete (think ~4:10 half Ironman). Perhaps some extra credibility on these issues! Their advice is sound. In particular, Dr. La Gerche reminds us to pay attention to warning signs of potential heart disease: chest pain/discomfort, difficulties breathing, palpitations, unusual fatigue.
5. The long-term. Dr. O'Keefe introduces the concept of some sort of "sweet spot" for exercise and the idea that "more is not necessarily better." We know very little at present, but there may well be important heart risks associated with prolonged involvement in endurance sport. We should pay careful attention as new information becomes available.
6. Competition changes. The article mentions the recent initiative by World Triathlon Corporation (WTC), called SwimSmart. I've written here at the blog about this initiative and a corresponding initiative by REV3 Triathlon designed to improve race safety. It's encouraging to see major event producers work to promote better race safety. WTC just introduced a terrific short video about swim safety narrated by acclaimed triathlete, Paula Newby-Fraser. It's worth watching.