When I was a young whippersnapper in j-school, I chose to focus on science and health reporting. My classwork, my senior honors thesis, my reportage for the student paper, the stories I pitched to local news organizations – all of my work had a health or science slant. Over the course of those years, I became pretty good at reading science and health reporting with a critical eye, and more often than not, the things I saw left me head-desking and face-palming all over the place. That dismay has only increased as I’ve spent more years working as a pro journalist and have been exposed to more and more reporting of all kinds.
I could go on for hours about this but I’ll just say that science often includes nuance, gray areas and probabilities, and those are things that do not translate easily into snappy, eyeball-snagging headlines and leads. The end result is science and health reporting that overstates research for the sake of grabbing bits of divided attention, and a public that often finds itself overwhelmed with confusion at conflicting research. (There’s a reason why the work of Alex Hutchinson of Sweat Science has become so popular.)
I’m writing about this today instead of all other days when the world is graced with questionable health news reporting because a story surfaced that touched on the sport that is nearest and dearest to me: endurance athletics.
On Monday, CNN.com ran an article entitled “Extreme endurance exercise carries health risks,” which focused on a Mayo Clinic meta-study that looked at 50 studies of extreme endurance athletes – ultramarathoners, Ironman triathletes – and found “excessive training and competing can cause cardiovascular damage such as scarring and enlargement of the heart and blood vessels, as well as irregular heart beating.” The lead author also talks about how some of his patients, who run several hours a day, are also prone to orthopedic problems.
Now I’m not going to argue that extreme endurance sports are always great for your body. That kind of physical activity definitely puts a strain on the body. Nor am I going to talk about the Tarahumara tribe and Born to Run, like a lot of the commenters did. Frankly, if all you want to do is increase your chances of being healthy, you can get away with doing a lot less than train for marathons and long multi-sport events. I can’t speak for all endurance athletes but I know that I do not run long distances because I think it’s good for me, but because I enjoy it.
Rather, what I take issue with is the way this research has been trumpeted despite the fact that the number of athletes to whom this research applies is vanishingly small. Let’s look at marathons, which is the shortest, most popular distance event cited as an “extreme endurance” sport. According to Running USA’s 2010 report, about 507,000 people finished a marathon in the United States in 2010. The U.S. Census put the population of the United States at over 308 million for the same year. Three-quarters – or about 231 million – of those people are over the age of 18. That means about one-fifth of a percent of the adult population of the United States completed a marathon in 2010.
I looked all over for numbers of finishers for ultramarathons, long-distance cycling events and Ironman triathlons, and I couldn’t find them, but I feel safe assuming that there are way more marathoners than there are of all three of those sports combined. And of the people I know who have trained or are training for these events, few of us take part in the several-hour training sessions cited by the lead author. Yes, we have long runs but those happen once a week and for only a few weeks while leading up to an event. Most of us do not train in ways that could be construed as “excessive.” (I would be curious to know what the researchers define as “excessive.”)
So basically, when we talk about “extreme endurance” athletes, we are talking about a teensy, tiny little fraction of the United States. Like, put a group of 100 people together to represent the whole United States, and we are talking about risks faced by the statistical equivalent of one of those people’s arms. (And please do not even start me on the fact that the author of the article mentioned the fact that sometimes runners die during road races, “cover your ass” clause or not.)
Now, contrast this with a story from last month about research that found nearly seven out of ten Americans do not exercise regularly. (Here’s another one that puts the numbers of people who do the minimum amount of recommended physical activity at a dismal 18%.) That’s a lot of people who are at increased risk for a whole mess of health issues, including the cardiovascular damage cited as a concern for endurance athletes. In fact, the number of people who face problems because their lifestyles are too sedentary is several magnitudes greater than the number of people who face problems because they work out too much, and the kind of health problems tend to be much more severe. I’m going to go out on a limb and say the real public health concern here is not the relative handful of people who complete Ironman triathlons each year.
In a perfect world, the average news consumer would look at these stories and go, Okay, so I’ll go work out a few times a week but I won’t get crazy with it. Unfortunately, that’s often not what happens. What happens is that people see the headlines, and maybe if they are a bit on the inquisitive side, they read a bit of the article, and then if it confirms biases they already hold (in this case, that exercise sucks), it will become part of the arsenal of information they use to justify their decisions and opinions about the world. (And I’m not saying this to be superior, because I do it too. We all do it.)
In fact, this happens so often that both the researcher and the news writer took care to say, hey, you still should exercise!
But the authors were also adamant that these findings should not dissuade people from regular exercise. Lead author Dr. James O’Keefe, a cardiologist at the Mid America Heart Institute, said, “We want people to understand that this in no way detracts from the importance of exercise. Physically active people are much happier than their sedentary counterparts. So much so, that they live up to seven years longer.”
According to the Centers for Disease Control and Prevention, adults should get at least 30 minutes of moderate exercise, like walking, five times a week, in addition to two days or more of muscle strengthening activity.
We have to be willing to engage with the news on a critical, thoughtful level. For most of us, our only access to health reporting comes filtered through the media, which means we are relying on people who are under pressure as they try to write one story as quickly as they can so they can move onto the next one – and who are often doing this without any specialized knowledge – to disseminate this critical information about our bodies. The CNN article was written by a medical producer who probably has a decent background, but even so she’s constrained by the demands of working in an online newsroom (constraints I am well familiar with, btw).
The answer isn’t to dismiss all health reporting out of hand nor to accept it all on faith, but to approach it with a critical mindset. Here’s a good set of guidelines to follow when reading any sort of health and science reporting, courtesy of Emily Willingham at Double X Science. Yes, it requires more work than just skimming the headline and a few paragraphs, but I think that effort is worth it.