February: Heart

   A spike in marathon deaths over the past two years raises the question that has dogged running since it first burst into American popularity: Is it safe? No matter how ardently physicians and sports physiologists argue that you're more likely to die from not running, the risks are real. And the bets are being played out in the middle of your chest.

   To be sure, bad judgments in hydration and heat also kill runners every year. But by far, the greatest risks are tied to your body's central pump. You can eliminate some of these risks outright; others you can hedge. And there are still others that simply won't bend to training and will. You'll have to adapt your goals and desires to their mortal constraints.

   If you have a family history of heart disease, you need your doctor's blessing before you begin hard training. After 40, especially if you're male, an electrocardiogram, a blood test, and a treadmill stress test every two to three years will typically set you free. But if close relatives (your parents or a sibling) have heart disease, you should ask your doctor about a 64-slice CT scan. It’s a new, noninvasive technology that takes finely layered, 3-D images of your heart. It alerts doctors to otherwise undetected blockages in arteries. Early studies show it to be stunningly accurate.

   Good diet can also hedge the genetic odds stacked against you, especially high cholesterol. It can't reverse decades of bad habits however, and its benefits accrue over years. not in the relatively short time it takes to train for a marathon or shed 10 pounds. The same is true of various heart remedies, over-the-counter and otherwise, Fish oil, niacin, low-dosage aspirin, statins, beta blockers, and ezetimibe can lower a runner's risks for heart attack and stroke. But they're not miracle cures. Runners too easily oversell themselves on the benefits of drugs and good nutrition. It's an extension of the exuberance we get from training. Running makes dramatic changes in our bodies and in the way we feel. We can't help but believe that drugs and diet deliver the same quick results. They don't, and to believe otherwise is to dance with the Grim Reaper.

   In fact, consistency is the best friend a runner's heart can have - nowhere more so than in training itself. The episodic athlete who indulges months of sedentary living, but then begins training hard for a race runs a far greater risk of stroke or a heart attack than the runner who maintains at least a minimum level of aerobic fitness throughout the year. With age, the dangers of on-again, off-again training jump.

   It's painful to face the limitations of your mortal body. It's equally important not to panic yourself from headlines. The number of recent marathon deaths has risen because the number of marathons and their runners continues to rise exponentially. Make no mistake, running is good for your heart. It's just that you have to use your head about it.