Thursday, January 9, 2014

The Myth Of Health Risks In Ultrarunning

The Myth Of Health Risks In Ultrarunning:

Are Ultrarunners As Healthy As Corporate Media Outlets Are Biased?

by Tim Mathis

     On January 8th, sports medicine researchers from Stanford and UC Davis published initial findings from one of the first longitudinal studies on the health of ultrarunners. (A longitudinal study tracks a group of people across a long period of time – 20 years in this case.) It is published online here, which is awesome because anyone can access the data while they’re drinking their morning coffee or scanning their iPhone on their morning run. (It’s actually pretty readable, as far as scientific studies go.)

     Ever the faithful stewards of the public interest and proponents of healthy living, NBC News Health quickly picked up on the story and had an article about the study online by the end of the day, delivering the bad news. In their article, "Ultrarunners Aren’t Always Ultrahealthy”, they noted the study’s findings that sometimes runners get running related injuries like stress fractures and knee problems. Also, ultrarunners in the study report higher rates of asthma and allergies than the general population. Sorry ultrarunners – you’re doomed to a life of wheezing and splintered shin bones. Good news if you want to spend your day on the couch reading and rereading the NBC News site though – and no reason to stop being smug in those online comment threads about how healthy people are destroying their bodies doing healthy things!  

     But darned if the focus of the NBC story wasn’t exactly the opposite of what the researchers focused on in their conclusions! While it is true that they point out an increased rate of running related injuries, and an increased rate of allergy and asthma among ultrarunners, their general tenor is: Hey great news!  

     Some of their key conclusions were that:

       1) Among ultrarunners “there was a low prevalence of serious medical issues including cancers (4.5%), coronary artery disease (0.7%), seizure disorders (0.7%), diabetes (0.7%), and human immunodeficiency virus (HIV) infection (0.2%)”   

       2) "Compared with self-reported data from the general population, the prevalence of virtually all chronic diseases and mental health disorders appeared lower in the ultramarathon runners"

       3) “[U]ltramarathon runners have fewer chronic medical conditions…tend to miss little time from work or school due to illness or injury, and make limited use of the medical care system.”

     Aside from the part about not missing work much (averaging 2 days/year vs. the general population’s 4), NBC forgot to mention all of those points. To their credit, they did at least note (as the researchers did) that there’s a reasonable explanation for the allergy thing – spending a lot of time outside exposes you to a lot of allergens. They didn’t say that the increased rate of asthma among ultrarunners is small (3%), and is most marked in relation to exercise-induced asthma – because of all of the pesky exercising. They also didn’t note that injury rates were comparable to shorter-distance runners, or that the average number of days of work lost to those injuries was zero. It also didn’t talk about one of the more intriguing findings in the study, that older runners were actually less likely to report injury than younger ultrarunners. The adage that ultrarunning is an old person’s sport seems to bear out.  

     Media stories actively and unjustifiably discouraging healthy activities (and promoting unhealthy ones) aren’t anything new, of course. Everyone knows by now that you shouldn’t run (KNEES!), play team sports (CARDIOMYOPATHY!), or do Crossfit (TRAUMA!), but that wine and chocolate are nature’s greatest health foods. It’s also kind of predictable – if you want to generate clicks 1) piss some people off and 2) reinforce common prejudices and preconceptions. But it still seems like a weird, irresponsible phenomenon in an era where people have a hard enough time making healthy life decisions without media assistance.

     The good news is, media reports can be ignored. Data suggests that reality is still in favor of engaging in traditional human activities like moving through nature on your own two feet.  

Tim Mathis lives in Seattle and has been running trails with his wife Angel for a couple of years.  One time they ran across Spain fueled mostly on pastries and espresso.  He blogs occasionally at and has contributed to and Trailrunner Magazine.


  1. Nice to see you point out this research and the conclusions therein and in principle I think I agree with you but statements like, "Media stories actively and unjustifiably discourage healthy activities" without any corroborating evidence (other than this one story) don't really set you apart from this 'media' that you don't agree with. On a regular basis I see people like Steve Pool and Jeff Renner talk about and promote all kinds of healthy activities. I do agree that when your financial fortune relies on ratings you will seek them but a slightly less sweeping statement would have been more effective at convincing me. I definitely fall into the category of one who uses media to make life decisions and blogs that sensationalize (also to get those clicks) are just another form of media. :)

  2. As an ultrarunner it's great to hear that ultrarunning goes hand-in-hand with greater health, however there is the question of correlation vs. cause-and-effect: Does ultrarunning *cause* less chronic disease, or is it we lucky ones who have the gift of good health who participate in ultramarathons?

    1. Bruce, I was thinking the same thing. Obviously, ultra running isn't the cause of HIV but ultra runners have a low prevalence of HIV getting to your point.

    2. Yeah, correlation vs causation seems to be the single biggest error that most media outlets make when talking about anything related to science/health. Really frustrating!

  3. Martin, while I do think there are some legitimately different expectations for bloggers (who are basically amateur editorialists) and mainstream news outlets (who have at least some remaining cache when it comes to truth telling), I know that's kind of a cop out and your point is well taken. Particularly so, because the thing I care about more here is actually the phenomenon of media presenting imbalanced accounts of the negative impacts of exercise. (This Crossfit story was circulating a while back and fits in to the trend:

    The data itself in this case probably doesn't tell us much at all at this point - it's the first year report on a 20 year study which is observational in any case. Even after 20 years we won't have anything more than the correlation-type data Bruce, Angel and Justin are talking about. Still, there's been so little science focused on the impacts of ultrarunning that it's fun to have something to argue about, no matter how trivial.

    1. You are so right. My life changed when I became an ultrarunner. Of course, there were two or three years of IT Band issues, shin splints and severe tendinitis which threw a wrench into the process, but the increased miles and careful shoe selection made that all go away. Now I can snowboard all day without stop while buddies my age can't even take up snowboarding.

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