A 27-year-old runner collapsed and died 300 metres from the nish line of the Toronto marathon this

past weekend. He was completing the 21 km half-marathon portion of the course. Top four major circumstances that lead to marathon runner deaths.

Running to death
Sweating
0 30 mins (5 km)

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What happens during a marathon

Body heat and heart rate rises:
Heart rate climbs to about 140 beats per minute in the rst half hour of the marathon. (Average resting heart rate is 75 beats per minute). Body temperature climbs to around 40 C (average is 37 C. Hotter weather can make it even higher. Extreme sweating to cool the body.

1 2 3

Heart disease in runners over 35 years

Heart attacks are brought on by the combination of the intense physical stress of running for an extended duration and the pre-existing disease in the runners heart or a lack of cardiac tness to handle the race.

Heart beat: 135 per min.

30 mins to 1hr Running is easy. Heart rate steady at 135 beats per minute. (10 km)

Comfort zone

The body is relying on carbohydrate fuel, in the form of glycogen manufactured by the liver. Start feeling thirsty.

Burning fat
1 to 2 hrs (20 km)

Burning fat

Genetic heart defects in runners under 35

Presence of a genetic defect in the heart itself that hasnt previously been detected or treated.

Store of glycogen will be running low and your body will now start to burn fat to power the muscles. Feeling more thirsty. Need to get regular drinks to stop dehydration.

Stomach cramps
2 to 3 hrs (32 km)

Lactic acid build up

Hyponatremia or low blood sodium levels

Sodium is lost through sweat. (high intensity athletes can lose up to 2 grams of salt per litre of sweat.) Adequate sodium balance is necessary for transmitting nerve impulses and proper muscle function. Drinking too much water during endurance sports can cause the sodium in your body to become diluted and further exacerbate the problems.

Muscle cramps Joint aches

Point where runners may "hit the wall. The bodys glycogen stores are now exhausted. Muscles must rely on the breakdown of fat. May suffer stomach cramps due to the fact that oxygen-rich blood has been diverted away from the digestive system to the muscles. Runners who have not trained properly can start to experience di culty breathing and there is too little oxygen reaching the muscles. By the end of this period, glycogen levels have bottomed out so blood sugar levels are very low. Blood sugar is needed as fuel for the brain, so you can feel fainty and cloudy. Some runners get mentally exhausted. You also start to go into anaerobic respiration. One of the by product of anaerobic respiration is lactic acid, which causes pain and muscular cramps. Joints, (knee caps, ankles) may become sore from the pressure of pounding on hard pavement.

Exhaustion point:
3+ hrs

Heat-related illnesses, such as heat stroke

Mostly caused by extreme dehydration. As the body becomes dehydrated, it loses the ability to regulate its temperature and as its temperature rises, the result can be heat exhaustion, heat stroke, heat induced coma and then death.

If you have survived the last stage, then you might just make it to the nish line. This is the point where people at risk may suffer from heart attacks, because the heart is under maximum stress. Dehydration is also more likely, which thickens the blood and slows down the circulatory system. This means the heart needs to work harder than normal to pump the thick heavy blood. Pace has slowed.
SUSAN BATSFORD, GRAPHICS EDITOR, TWITTER @SBATS1; INFOGRAPHIC BY NICK WHITE/QMI AGENCY