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Authors: Dean Karnazes

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APPENDIX E

The Results Are In: How Dean Held Up

By Bryan Bergman, PhD,
University of Colorado Assistant Professor of Medicine
Carmichael Training Systems Pro Coach

 

Between the beginning and the end of the Endurance 50, Dean was subjected to ten blood draws and urinalysis. These blood samples were preserved and sent to a laboratory for analysis. The results were then sent to Carmichael Training Systems, where I analyzed them to determine the effect of running fifty marathons in fifty states in fifty days on various parameters of Dean’s health, including muscle damage, hydration status, inflammation, and immune function. Below are summaries of our findings with respect to each of these factors.

Muscle Damage

We expected to see fairly dramatic increases in Dean’s blood markers of muscle damage. The principal marker was creatine phosphokinase (CPK), an enzyme found principally inside muscle cells that leaks into the bloodstream when cells are damaged. A typical marathon runner has dramatically elevated CPK after one marathon, and it stays elevated for up to a week. Dean, however, is no typical marathoner. He had some muscle damage associated with the event. However, at his muscle damage high point, near the end of the Endurance 50, his CPK concentration was still one-fourth of what it would be for a typical runner completing only one marathon! This was a surprise, but shows how well Dean’s body has adapted to the demands of ultrarunning.

Hydration Status

Dean’s hydration status was monitored rigorously throughout the Endurance 50. We followed several parameters, including the percentage of red blood cells to total blood volume (hematocrit), red blood cell counts per liter (red cell density), and concentration of hemoglobin (the oxygen-carrying protein in our blood). Despite having a crew supporting him and reminding him to stay hydrated during these events, Dean still showed signs of dehydration several times during the Endurance 50. However, this potential problem was quickly remedied with increased intake of sports drinks. His markers of dehydration status never stayed elevated for two or more consecutive blood draws in a row. These data point to the constant challenge of staying hydrated, even with a support team looking after you.

Inflammation

We also measured blood levels of an inflammatory marker called interleukin-6 (IL-6). IL-6 is a cytokine (a special type of white blood cell) that is receiving a lot of attention in the scientific world right now because of the link between inflammation and heart disease. We were interested in IL-6 for two reasons: (1) It is one marker of inflammation during an event in which we expect to see considerable amounts of inflammation, immune system activity, and stress; and (2) IL-6 appears to be involved in glucose production by the liver, as well as glucose uptake by muscles. Thus, tracking changes in IL-6 along with changes in resting metabolic rate and muscle fuel utilization would provide insight into the role of IL-6 in ultra-endurance events.

Much to our surprise, IL-6 concentrations did not change very much during this event. Dean is an elite ultra-endurance runner, and once again he appeared to be in much less physiological stress than would be expected from such an arduous event.

Immune Function

Many publications have pointed to an increased risk of upper respiratory tract infections and decreased immune system function after one marathon. Therefore, we expected Dean’s immune system to be compromised during the Endurance 50. However, other than a probable viral infection during the first part of the event, we observed no changes in blood markers that would suggest a compromised immune system. We were also on the lookout for possible suppression of bone marrow red blood cell production that also can occur during periods of high stress. Dean’s bone marrow continued to produce red blood cells throughout the event and showed no signs of slowing. Clearly, his body did not perceive this event to be as stressful as we expected!

Summary

Overall, Dean sailed through the Endurance 50, with none of the common ailments that plague the more typical athlete during one marathon, much less fifty. We were very surprised that fifty consecutive marathons were perceived to be so “easy” by his body. This is a testament to Dean’s preparation and training, and shows us all what is possible when a very motivated and talented athlete sets his sights on a lofty goal.

References

Chapter 1. The Right Foot

Neilan TG, Januzzi JL, Lee-Lewandrowski E, Ton-Nu TT, Yoerger DM, Jassal DS, Lewandrowski KB, Siegel AJ, Marshall JE, Douglas PS, Lawlor D, Picard MH, Wood MJ. “Myocardial injury and ventricular dysfunction related to training levels among nonelite participants in the Boston Marathon.”
Circulation.
2006 Nov 28;114(22):2325–33. Epub 2006 Nov 13.

Chapter 6. United We Run

Linde K, Barrett B, Wölkart K, Bauer R, Melchart D. “Echinacea for preventing and treating the common cold.”
Cochrane Database of Systematic Reviews
. 2006 Jan 25;(1):CD000530.

Chapter 8. Running Wild

Faoro V, Lamotte M, Deboeck G, Pavelescu A, Huez S, Guenard H, Martinot JB, Naeije R. “Effects of sildenafil on exercise capacity in hypoxic normal subjects.”
High Altitude Medicine and Biology
. 2007 summer;8(2):155–63.

Chapter 15. The Heat Is On

Tucker R, Rauch L, Harley YX, Noakes TD. “Impaired exercise performance in the heat is associated with an anticipatory reduction in skeletal muscle recruitment.”
European Journal of Physiology
. 2004 Jul;448(4):422–30. Epub 2004 May 8.

Byrne C, Lee JK, Chew SA, Lim CL, Tan EY. “Continuous thermoregulatory responses to mass-participation distance running in heat.”
Medicine and Science in Sports and Exercise
. 2006 May;38(5):803–10.

Chapter 20. A Full Recovery

Roy BD, Luttmer K, Bosman MJ, Tarnopolsky MA. “The influence of post-exercise macronutrient intake on energy balance and protein metabolism in active females participating in endurance training.”
International Journal of Nutrition and Exercise Metabolism
. 2002 Jun;12(2):172–88.

Hartman JW, Tang JE, Wilkinson SB, Tarnopolsky MA, Lawrence RL, Fullerton AV, Phillips SM. “Consumption of fat-free fluid milk after resistance exercise promotes greater lean mass accretion than does consumption of soy or carbohydrate in young, novice, male weightlifters.”
American Journal of Clinical Nutrition
. 2007 Aug;86(2):373–81.

Chapter 23. The Long Run

Levy BR, Slade MD, Kasl SV. “Longitudinal benefit of positive self-perceptions of aging on functional health.”
Journal of Gerontology
. 2002 Sep;57(5):P409–17.

Chapter 25. Running Green

Miller KA, Siscovick DS, Sheppard L, Shepherd K, Sullivan JH, Anderson GL, Kaufmann JD. “Long-term exposure to air pollution and incidence of cardiovascular events in women.”
New England Journal of Medicine
. 2007 Feb 1;356(5):447–58.

Chapter 26. The Art of the Stride

Milner CE, Hamill J, Davis I. “Are knee mechanics during early stance related to tibial stress fracture in runners?”
Clinical Biomechanics
. 2007 Jul;22(6):697–703. Epub 2007 Apr 30.

Hasegawa H, Yamauchi T, Kraemer WJ. “Foot strike pattern of runners at the 15-km point during an elite level half marathon.”
Journal of Strength and Conditioning Research
. 2007 Aug;21(3):888–93.

Chapter 28. Second Wind

Kay D, Marino F, Cannon J, St. Clair Gibson A, Lambert MI, Noakes TD. “Evidence for neuromuscular fatigue during high-intensity cycling in warm, humid conditions.”
European Journal of Applied Physiology
. 2001;84:115–21.

Chapter 31. Adapt and Thrive

Luden ND, Saunders MJ, Pratt CA, Bickford AS, Todd MK, Flohr JA. “Effects of a six-day carbohydrate/protein intervention on muscle damage, soreness and performance in runners.” Presented at the 2006 Annual Meeting of the American College of Sports Medicine.

Saunders MJ, Kane MD, Todd MK. “Effects of a carbohydrate-protein beverage on cycling endurance and muscle damage.”
Medicine and Science in Sports and Exercise.
2004 Jul;36(7):1233–8.

Seifert J, Harmon J, DeClercq P. “Protein added to a sports drink improves fluid retention.”
International Journal of Sport Nutrition and Exercise Metabolism
. 2006;16:420–9.

About the Authors

Dean Karnazes might just be the fittest man on the planet, writes
Men’s Fitness
. His long list of accomplishments is astounding, though perhaps his even greater gift is his ability to help others achieve their fitness goals and become the best that they can be. A past columnist for
Men’s Health
, the world’s largest men’s publication, Dean was recently voted by
Time
magazine as one of the “Top 100 Most Influential People in the World.” He is a frequent public speaker and has traveled the world, meeting and running with people of all ages to extol the virtues of physical exercise, good diet, and healthy, active living.

Dean is a member of the California State Senate Task Force on Youth Wellness, and also serves on the board of Girls on the Run, a nationwide non-profit probram that encourages girls to develop self-respect and healthy lifestyles through running. His foundation, KARNO KIDS, whose motto is “No Child Left Inside,” has raised hundreds of thousands of dollars for children’s charities and for organizations that focus on environmental preservation and restoration and conservation of urban open-spaces.

When he's not running or chasing his own kids around their backyard—which he insists is he favorite workout routine—you can usually find him surfing, mountain biking, snowboarding, or hiking somewhere in the greater San Francisco Bay area.

 

Matt Fitzgerald is a runner, coach, and widely published journalist and author. A frequent contributor to
Runner’s World,
he has written several previous books, including
Brain Training for Runners.
Matt is also a certified sports nutritionist and maintains a popular Web site featuring training and nutrition information for endurance athletes (
www.mattfitzgerald.org
). He lives in San Diego with his wife, Nataki.

*
This number represents the accumulated number of calories I burned to this point in the Endurance 50 marathons. My source for the calculations was
www.coolrunning.com
.
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