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As a 10-mile-a-day runner, Dave McGillivray thought he could eat whatever he wanted without worrying about his heart. "I figured if the furnace was hot enough, it would burn everything," said McGillivray, who is 59.
But a diagnosis six months ago of coronary artery disease shocked McGillivray, a finisher of 130 marathons and several Ironman-distance triathlons. Suddenly he regretted including a chocolate-chip-cookie recipe in his memoir about endurance athletics.
"My first reaction was, I was embarrassed," he said.
"Studies support a potential increased risk of coronary artery disease, myocardial fibrosis and sudden cardiac death in marathoners," Peter McCullough, a Baylor University cardiologist, wrote as lead author of an editorial in the current Missouri Medicine.
But many cardiologists are skeptical. "The science establishing a causal link between vigorous exercise and coronary disease is shaky at best," said Aaron Baggish, a Massachusetts General Hospital cardiologist who does triathlons and marathons. Even so, he said, "I've never once told a patient they need to run marathons or race triathlons to maximize health, as this is not accurate."