Dr. Sanjay Sharma, medical director of the London Marathon, said these two studies are of particular importance because older non-elite marathoners constitute a large and understudied group – and that’s especially true for female runners. Worldwide, there are probably more than 1 million people per year running marathons, and the number is increasing by about 10% annually, he said.
Most marathoners lose around 3 kg of body weight during a race, so the women in the Medoc study, with their mean weight loss of only 500 g, were clearly well hydrated.
“We know that this is something that females do; they drink far more than males when they run,” according to Dr. Sharma of St. George’s Hospital in London.
He was particularly intrigued by the single-digit incidence of elevated cardiac biomarkers in the Medoc women. Rates are typically far higher in male runners. He proposed that this disparity raises a question: Could the gender gap in risk of sudden death during sports participation be related to testosterone?
“Maybe testosterone is bad for you,” the cardiologist mused. “Testosterone allows you to develop a big, lean body mass, allows you to push yourself much harder than the heart would like, maybe even causes endothelial dysfunction, may cause more cardiac hypertrophy, and it could in the long run be the reason why males are nine times more likely to die during exercise than females.”
In the London Marathon, for example, there have been 10 participant deaths in the last 30 years. All occurred in men.
Disclosures: Dr. Knebel, Dr. Carré, and Dr. Sharma reported no financial conflicts of interest.