In Depth
Exercise and fitness
Exercise and death: Am I safer on the couch?
Last Updated October 4, 2006
CBC News
Yes, it happens.
A couple of times a year, we hear stories of people dropping dead while pushing their bodies to the limit - usually running road races.
Most of the world's major marathons - including New York City, Chicago, London, Paris and Beijing - have experienced death. Boston - the world's oldest continuous marathon - has recorded two deaths in its 110-year history.
On Sunday, Oct. 16, 2005, a 36-year-old man from Oakville, Ont., collapsed and died minutes after he completed a half marathon in Toronto. It was the third death in five years at the event.
A year earlier, a 42-year-old man from Guelph, Ont., died a couple of kilometres before the finish. The cause of his death was never released, but a heart attack is suspected.
Two years earlier, an experienced marathoner died running the Toronto marathon. An autopsy showed a congenital heart defect that had previously gone undetected.
Jogging guru Jim Fixx is shown in this 1980 file photo. (CP Photo)
"To complete a half marathon demands regular exercise and discipline to get out there and train. More so for the full marathon distance," Jay Glassman, race director for the Toronto Marathon, told CBC News. "There are obvious stresses on your heart but in all the cases that we've experienced over the past five years, we know those gentlemen were in good shape and had regularly exercised."
However, being in top physical shape won't necessarily protect you from heart disease.
Perhaps the highest profile running death was that of Jim Fixx, the journalist-turned-fitness guru who was credited with giving birth to the first running boom in the 1970s.
Fixx was an overweight smoker before he took up running. His blood cholesterol levels were elevated. He had also experienced several warning symptoms, which he chose to ignore and had refused the option of undergoing an exercise stress test
As well, Fixx's father had died of a heart attack at the age of 43. Fixx was 52 when he dropped dead of a heart attack while on a seven-kilometre run in July 1984.
An autopsy showed Fixx had severe coronary artery disease. One artery was 95 per cent blocked, a second was 80 per cent blocked and a third was 50 per cent blocked.
In Sudden Death and Exercise, Dr. Timothy Noakes says on the day Fixx died of his heart attack, "1,000 other Americans would also have died of heart attacks. Few if any would have received nationwide coverage. Yet almost all of those deaths would have occurred in persons who were sedentary, or were smokers, or who had uncontrolled high blood pressure and elevated blood cholesterol concentrations. If only those sudden deaths occurring in athletes are reported in the press, it is understandable why the public acquire a distorted impression of the relationship between exercise and heart disease."
Noakes warns that runners should not get the impression that their elevated fitness levels mean they don't have to worry about heart disease.
"Regular exercise reduces the overall risk of sudden death in persons with latent coronary artery disease," he writes. "[But it] acutely increases the risk of sudden death during exercise for those with heart disease that predisposes to sudden death."
Runners are more at risk while they are out running - especially if they're running a marathon. But for the rest of the day, their risk of keeling over is much lower than the general population.
Another study followed the London marathon for 23 years. Over that time, there were seven cardiac deaths. In addition, five people who suffered heart attacks at the race were revived. All five were found to have suffered from coronary heart disease. The study found that the risk of death in the London marathon was one in 67,414 - "a risk which is comparable to many daily activities."
A November 2004 study published in Medicine and Science in Sports and Exercise found people who were regularly active in their 50s and early 60s were about 35 per cent less likely to die in the next eight years than those who were sedentary. For those who had a higher risk of heart disease, the reduction was 45 per cent.
And you don't have to run a marathon to be considered fit. People who walked, gardened or even went dancing a few times a week benefited - as well as those who took on more vigorous activities.
The study concluded there are definite benefits to getting off the couch.
The Heart and Stroke Foundation of Canada concurs. It suggests that people who enjoy good health should be able to begin some kind of exercise program without checking with their doctor first. But consult a physician if you:
- Have a heart condition.
- Are 45 or older.
- Are between 35 and 45 and have risk factors such as smoking, high blood pressure, elevated cholesterol, obesity, diabetes or a family history of heart disease.
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