Month: March 2015

Endurance Running: Heart Health or Heart Hell?

Shoe shot of post-run group

I am the tortoise. While all the hares are racing around the track, I’m at the back, being lapped, and lapped often. However, like the tortoise, I will be making up those laps and adding several more long after the hares have crashed.

Endurance running is for us tortoises; but is it healthy or destructive? Are the frequent Facebook shares, tweets, and emailed articles predicting the early death of all marathoners backed up by research? Reviewing the literature, the answer is no, as long as you stay within some limits.

“Well no, actually I don’t. I play real sports. Not tryin’ to be the best at exercisin’.” – Kenny Powers, “Eastbound and Down”

The Good News

The November 2014 meeting of the Society for Neuroscience focused on the two factors that have the greatest positive impact on brain health: aerobic exercise and intermittent energy restriction (IER) or intermittent fasting. (My adventures in IER are coming soon in a series of blog posts.) There are inarguable mountains of data to support the benefits of aerobic exercise and this includes running. Running is associated with improved physical and mental health, stress reduction, weight reduction and maintenance, as well as increased socialization, which contributes its own long list of benefits. New runners report positive lifestyle changes such as improved sleep, improved eating habits, and decreases in alcohol and tobacco use that contribute to the long-term physical and mental health benefits.

Running is pain and pleasure

Who wouldn’t want to run ten miles, uphill, on a hot summer afternoon? See, I’m smiling.

A 2012 review in the Mayo Clinic Proceedings (MCP) reports that physically active people live longer, have less chronic disease (such as coronary heart disease, hypertension, heart failure, and diabetes), and runners have a 19 percent lower risk of all-cause mortality. In 2014 a multi-university study with more than 55,000 adult subjects published in the Journal of the American College of Cardiology (JACC), found an even greater, 30 to 40 percent, lower risk of all-cause and cardiovascular mortality for runners. Research published in the American Journal of Epidemiology on longevity in joggers vs non-joggers, with over 17,000 participants from the consummate study of heart health, The Copenhagen City Heart Study, found that male joggers live 6.2 years and females live 5.6 years longer than their non-jogging counterparts.

The Bad News

With all these positives, what excuse do you have not to lace up your Nikes and head out on the road (besides work, napping, or Game of Thrones)?  Despite all the benefits, evidence of dangerous running-related side effects is accumulating. In the 1970s, Tim Noakes was the first to publish on the realities of running, which he mentions in his enlightening TEDxCapeTown talk. By 2012, the MCP review includes studies finding that “chronic intense and sustained exercise” can lead to patchy myocardial fibrosis, coronary artery calcification, diastolic dysfunction, and artery stiffening, with marathoners showing a 5-fold increase in artrial fibrillation and increased biomarkers of myocardial injury. However, the review concedes that these findings lack rigorous scientific support. Much of the reviewed data are from rat studies and most of the detrimental outcomes are reversible over time.

Graph of Increased Coronary Plaque in Male Marathoners

Mayo Clinic Proceedings article shows increased coronary plaque in male marathoners.

An intriguing finding published in 2014, shows that male marathoners actually have more coronary plaque than non-runners and it is unclear if this persists after the cessation of training. In summary, Dr. O’Keefe, et al., posit, “Accumulating information suggests that some of the remodeling that occurs in endurance athletes may not be entirely benign,” and it can take several years for elite athletes’ cardiac measurements to return to normal.

There are also supported differences in negative health outcomes between men and women. In a 2014 Progress in Cardiovascular Diseases (PCD) review, authors O’Keefe, Lavie, and Guazzi report currently unpublished findings that these plaques are not seen in women marathoners. Furthermore, the incidence of race death in marathoners is 5-fold higher for men than women. These differences may be attributed to better pacing by woman then men (Kim, J.H., et al., The New England Journal of Medicine, 2012)

This difference in pacing appears to be how we can keep endurance running healthy. And here comes the Catch 22: tell a marathoner to push himself farther, faster, and longer; but don’t go too far or too fast for too long and see how that works out.

The Diagnosis

A February 2015 paper based on The Copenhagen City Heart Study in JACC and the 2014 PCD review, describe the U-curve of running. Based on this U-curve, the sweet spot to maximize health benefits is: 6-12 miles/week, 6-7 mile/hour pace (8.5-10 minute/mile), and 3 times/week for a total of 50-120 minutes/week. In addition, 30 minute runs are optimal while 60 minute sessions generate increased oxidant stress and vascular stiffness. However, the error bars are substantial enough in the PCD review to question the significance. Plus, if the data are largely self-report and gathered using different methods (Garmin watch vs Fitbit vs back calculated), there may be inaccuracy, especially over the small scales of time and pace.

Graphs of optimal running circumstances for maximizing health benefits

There is a U-shaped trend but the error is large and data may be self-reported (O’Keefe, J.H., ProgCD, 2014).

If runners know they should observe some limits to maximize health, are they likely to follow these guidelines? In a 2014 study in the Journal of Orthopaedic & Sports Physical Therapy (JOSPT), Bruno Saragiotto finds that runners self-report difficulty limiting their training even though they believe it to be one of the two biggest contributors to injury (the other is stretching, which numerous studies have shown to have no impact on injuries). The belief in overtraining is true, excessive running can damage body structures and result in overuse injuries (Hreljac, A., 2005), but as Subject 49 in the JOSPT paper says, “…Running excites me when I start to run, when you are running you don’t want to stop, your body wants more, so you end up overloading your body and get injured… .” Well said, Subject 49. Running can be addictive and it usually takes more than the warning of negative outcomes to sway an addict.

The Prognosis

Running is a great way to stay fit mentally and physically and, no, running a marathon or two does not condemn you to an early grave. There are potential negative cardiovascular impacts of excessive running, but these require more rigorous and long-term research to verify. For now, if you stick to the sweet-spot of the running U-curve you will be running happily and healthily for years to come. Trail running improves life

What’s my Worth?

Feats of strength can substitute for negotiations

When negotiations fail: arm wrestle (Boston College Festivus 2010, Me and Megan Kelly).

For many of us, evaluating our worth in the professional world is daunting. This intimidation keeps us from negotiating and then leaves us asking, “what if…,” long after sealing the deal. For women, there may even be guilt associated with mishandling negotiations since no one wants to perpetuate the ominous “salary gap.” Women in Bio, San Francisco, offered a negotiation helping hand February 26th at Nektar to remove some of the fear from getting what you are worth.

First, let’s take away some of the pressure. We have all heard the statistic that women make $0.77 for every $1 that a man makes. Early in 2014 Christina Hoff Sommers addressed this misleading statistic in U.S. News and then revisited the the idea as Feminist Myth 5 in TIME later that year. The statistic is based on average income for men and women and when you control for specific jobs, the gap nearly vanishes. Based on the career adjusted statistics, the real emphasis should be on choosing more profitable college majors if women want to earn more, not more aggressive negotiating.

Mary Haak-Frendscho, the event’s moderator, did bring up an interesting statistic from a Pew Research Center article. According to the article, women, on average, earn 93 percent of what men earn until they are 35. After 35, the average earnings shift to the 77 percent statistic. What happens at 35? It is something to consider and I guess I will find out this year.

Now that we are able to negotiate guilt-free since the future of women-kind is not on our shoulders, how do we prepare to come to the table? BioCentury Executive Editor, Simone Fishburn’s advice to do extensive, “soul searching before you walk into a negotiation,” is the lynchpin of preparation. We have to know our priorities.

When I first went on the job market after my postdoc, I had a long and detailed list of “priorities.” After some soul searching, and some experience, it was clear everything fit in four points: 1) a professional environment; 2) a collaborative, supportive, and respectful team; 3) a flexible schedule; and 4) part of my job is something I would do as a hobby. Number 4 may sound unusual, but examples for me are roles with a writing component (this blog is for fun) or forming partnerships (I enjoy networking and talking shop). A simple set of priorities helps with evaluation of and negotiation of roles.

Dilbert on the art of negotiation

There is always something to negotiate.

We should also enter a negotiation with realistic goals. Startups are going to be very different then Pfizer, which is different than non-profits. Dorian Hirth, Senior Vice President of human resources at Nektar, and Mimi Hancock, Partner at Spencer Stuart, both emphasized reasonable expectations several times. As far as salary, there are some online resources like Salary.com, Glassdoor, and SimplyHired, but much of their information is self-reported and they tend to inflate industry standards. In biotech, I have not found them to be very useful. The Radford guidance is ideal and what human resource professionals consult, but it is a pay service. “Your network is one of the most important things you can do,” according to Hirth. Your network is ultimately your best tool for industry information and advice on setting expectations around your priority list.

A few negotiables that I had not considered that came up in the panel discussion were promotion schedule, conference attendance, and opportunities to interact with higher management or partners. It is a phenomenal idea to use negotiation time to secure opportunities and emphasize priorities. It may give you more leeway than the typical salary/vacation/equity route. For me, since a flexible schedule is important, negotiating early mornings in exchange for free evenings and conference attendance to keep me talking shop and networking are options.

With our priorities and a realistic plan, it is time to go to the table. Here our greatest asset is, “confidence in your skill set,” says Hirth. We should not be afraid to ask as the worst they can say is no. However, avoid being obnoxious. Emphasize your desire for things to work out and put forth solutions suggests Fishburn. Hancock advises to, “look for cues and clues,” that you may be souring the relationship and to be open, honest, and transparent.

Realism and practicality in negotiations

Stay true to your priorities and be prepared to walk away.

Finally, Fishburn reminds us that negotiations are still part of the interview process so, “listen to the things they are not telling you.” This will provide important insight into what the working environment will be like and the personality of the future boss. If you feel you are not being valued or that you will have to compromise on your priorities, walk away. The situation will not improve when you are with them 40+ hours every week.

The take away is: in a negotiation be informed, relaxed, and confident and get what you are worth, or walk away, something else will come along.