Marathon running for amateurs: Benefits and risks

The habitual level of physical activity of the human race has significantly and abruptly declined in the last few generations due to technological developments. The professional societies and government health agencies have published minimum physical activity requirement guidelines to educate the masses about the importance of exercise and to reduce cardiovascular (CV) and all-cause mortality at the population level. There is growing participation in marathon running by amateur, middle-aged cases with a belief that more intense exercise will give incremental health benefits. Experts have cautioned the nonathlete amateurs about the "exercise paradox" and probable deleterious effects of high-intensity prolonged exercise on CV and musculoskeletal system. The epidemiological studies suggest a "reverse J shaped" relationship between running intensity and CV mortality. The highest benefits of reduction in CV and all-cause mortality are achieved at a lower intensity of running while the benefits tend to get blunted at a higher intensity of running. The physicians should have a balanced discussion with the amateur runners training for a marathon, about risks and benefits of high-intensity exercise, and should evaluate them to rule out the occult coronary disease