Marathon running is gaining popularity worldwide. It’s now common to see communities in numerous countries hold running events, including short distances of two, three, or five kilometers, mini-marathons (10.5 km), half marathons (21 km), and full marathons (international standardized distance of 42.195 km). For those wanting a less intense and competitive experience, there are also numerous short-distance walking and running events, often called “fun runs”.
 

In this edition of Better Health, we talk with Dr. Montinee Sangtian, who has experience in organizing running events, which include marathons and triathlons in the USA. A specialist in Emergency Medicine, EMS, and holding a Disaster Medicine Fellowship Certification, Dr. Montinee reveals how to get your body ready for the challenges of running a marathon for the first time.
 

Why a marathon?

For many runners who have long trained and achieved personal running records, completing a full marathon is the ultimate test. However, this demanding form of exercise is not suitable for everyone.
 

“Marathon running is classified as an endurance sport, requiring muscular strength and endurance, as well as a robust cardiovascular system, where the runner performs repetitive movements in the same plane of motion for an extended period of time,” Dr. Montinee, says. “Marathon running requires a high and continuous amount of energy, which is a clear distinction from shorter-distance running or sprinting. Athletes must specially prepare for the unique rigors of running a marathon."
 

Those considering running a marathon must evaluate their physical ability before they get to the starting line. “Some people are careless about running marathons because they think that they can stop at any point of exhaustion, or that they can probably endure. However, a marathon should be no different from swimming, for example, where most people do not dare participate if they are not sure that they can make it to the finish line. In fact, with no physical readiness or sufficient preparation, running beyond our physical ability is dangerous because we may not be aware that we have exceeded our limit and we risk having a heart attack.”
 

Get ready before the race

Physicians recommend that before you run a marathon, you get a comprehensive annual health check-up. Many people do not get these regular assessments, however, when you intend to run a race of any distance, you should at least, initially consult a doctor to check your physical health and get specific advice. A check-up ensures that you have no underlying chronic disease or other conditions that could jeopardize your health. These problems include bone and joint diseases, hypertension, diabetes, asthma, and heart disease especially ischemic heart disease, cardiac arrhythmia and hypertrophic cardiomyopathy.
 

How long does marathon preparation take?

If your physician finds no problems that restrict running a marathon, Dr. Montinee recommends conducting a self-assessment to determine what category of runner you are. Typically, the levels are categorized as Beginner, Intermediate, Advanced, and Competitive.

Not even a beginner?

For a beginner, set a reasonable first target, and then, subsequently set goals to achieve gradual progress. If you never exercise on a regular basis, you should start with walking or running with breaks for about 30 minutes daily, three to five times a week. After sticking to this program for a while, you can proceed to short-distance running, such as a Fun Run, which requires two to three months of preparation. The goal is to gradually increase your running time and distance.
 

“At least one week before the race, a participant should do a practice run.” says Dr. Montinee. This rehearsal instills confidence and prepares the athlete for competition. Unprepared runners increase the risk of injuries and medical problems. As much as possible, athletes should train under conditions similar to what they will encounter in the actual race, such as humidity, distance, and route, to achieve physical adaptation.
 

For those who seek running a marathon, they should consult their physician or trainer to get advice about exercising, eating, and hydration and sweat rate (the amount of sweat lost in a one-hour exercise session), and specific techniques for safety and running efficiency.
 

Follow these instructions and recommendations:
 

• Choose well-organized running events. Screen potential races for systematic planning regarding accurate distance, route conditions, facilities, and safety. For example, the event should provide first-aid services with medical personnel and medical equipment (such as an automated electrical defibrillator (AED)).
• Do not run outdoors during hot daytime temperatures of over 35 degrees Celsius, particularly with high relative humidity.
• Use only your “broken-in” running shoes that fit the foot’s shape and sole, adequately absorb impact force, and suit the course and road surface. Don’t wear brand-new or untested shoes in a race.
• Refrain from alcohol at least 24 hours before the race.
• Do body warm-ups and stretches before every run.
• Have a meal one to two hours before the race. In the case of a marathon session of over two hours, doctors recommend consuming food or drinks with about one gram of carbohydrate/kilogram every hour; you may have liquid foods (e.g. gelatins) or an energy bar to energize your body during the race.
• Drink enough water to prevent dehydration. But be careful! Drinking too much water may cause mineral levels to drop to dangerously low levels, leading to brain swelling. Drink only enough water to quench your thirst. Alternate between water and sports drinks at 120 to 180 milliliters every 15 to 20 minutes.
• Long, continuous endurance exercises cause changes in the cardiac muscle, which poses a possible risk of heart disease. Even an experienced runner should have regular health check-ups.

Walking or running: it’s all good

For those not yet ready or who have health problems that preclude running, a study published in the Journal of the American College of Cardiology (JACC) in 2014 found that exercise of even just 10 minutes per day is beneficial to health and helps prolong life in comparison to those who do not exercise at all.
 

“Even walking is advantageous because the key to good exercise is to do it continuously and regularly,” says Dr. Montinee. “For example, a brisk walk or jog for just 30 minutes per day, three days per week benefits health more than a hard run once a month. You don’t need to overdo exercise. Just make sure it’s suitable for your current physical condition.”
 

What’s so good about running?

A part from being a convenient and inexpensive exercise, running also has other advantages:
 

• Helps increase muscular strength in several parts of the body – from legs and arms muscles to the cardiac muscle
• As a weight-bearing exercise, it helps strengthen bones
• Decreases blood pressure and blood lipids and regulates sugar levels.
• Reduces the risk of cardiovascular and cerebrovascular diseases
• Facilitates good metabolism and controls weight

“At least one week before the race, a participant should do a practice run.” Dr. Montinee Sangtian