CME INDIA Presentation by Dr. S. N. Sethi, MD Medicine, Sethi Nursing Home, Kurukshetra.

Running, no matter how little, may lower death risk to 27%. So just “Add 10 Min for Your Health”- New Japanese Recommendation for Physical Activity Based on Dose-Response Analysis.

Let us motivate ourselves for Running

• Studies show that running, even 5 to 10 min/day and at slow speeds <6 miles/h is very beneficial.
• It is associated with markedly reduced risks of death from all causes and cardiovascular disease.
• This awareness may motivate healthy but sedentary individuals to begin and continue running for substantial and attainable mortality benefits.

The more I do, the more I realise that I AM AT THE TIP OF ICEBERG. Our basic focus should be fitness coupled with good nutrition good sleep, strength training, yoga and meditation to keep our selves more in parasympathetic mode.

Story of Dr. Sethi is so exciting

Dr. Sethi narrates:

• My age is 71 years.
• In 2011 while running on road, I met with a very severe road accident when my both bones of leg got comminuted fracture with intraarticular involvement with fracture of 6 ribs.
• I was operated in Ganga Ram, N. Delhi and was bed ridden for more than 3 months.
• I was told to forget about running.
• Before that, I was doing racing walk. Anyhow, very next year, I participated in IDBI. Marathon and then Airtel.
• It became my passion and perhaps obsession. I have done 125 marathons (Some highlights – one 50 km ultramarathon, 16 full 42.2 km marathons including international-Singapore marathon one ultra-marathon-50 km.)
• I stood 3rd in standard Chartered marathon, Mumbai-2017 in half marathon and stood 2nd in full marathon in 5th Hindustan marathon, New Delhi.
• Secured 3 rd rank (BRINZE MEDAL) in TUFFMAN MARATHON held on 25-9-22 in half marathon in Chandigarh.

• I attribute all this to yoga, disciplined life, regular sleep, gym. strengthening and swimming.
• I personally feel God has given us immense potentials which we don’t use.
• I was topper of Punjab university at time of admission to medical college, Patiala in 1971… what a great change perhaps destiny wanted the things to happen like this.

For success, I think there are 3Ds

1. Determination
2. Discipline
3. Dedication

And 3Cs

1. Consistency
2. Consistency
3. And Consistency Only

Passion Does Not Listen to Any Thing, So Could Not Wait For 25th September

Did my 100th – CENTURIAN – marathon covered in 2 hours 18minutes because it is just 5 days after my 99th marathon when body was in recovery phase, so it comprised my normal timing of 2 hours 9 minutes.

This journey of 100 marathons comprises of:

• 16 Full marathons -42.2 km
• 1 -Ultra marathon-50 km
• 83 -half marathons -21.1 km

My best timings have been:

• Half marathon – 1 hour 55 minutes
• Full marathon – 4 hours 14 minutes

Most memorable events are:

• Boston Marathon (virtual)
• Singapore Marathon
• Standard chartered Mumbai – 3rd rank in half marathon
• Hindustan marathon, New Delhi – 2nd rank

Tri-city magazine from Boston published Dr. Sethi’s story

• Dr. Sethi serves as a running inspiration to all. He was born in Punjab, India, and is 71-year-old.
• He is an Internal Medicine Physician and an avid runner, recently completing his 125th marathon on 5th March 2023.
• In 2011, while running on the roads of Kurukshetra, India, Dr. Sethi suffered a bad road accident which resulted in a comminuted fracture of the tibia and fibula in his left leg and six ribs, leaving him bed-ridden for over three months.
• Treating surgeons told him that running was out of the question for him, stating that “even being able to walk without help would be a miracle for him.”
• Dr. Sethi refused to yield to this medical prophecy.

• Slowly, he went onto participate in walking races and began running marathons at the beginning of 2015, four years after his injury. In the last six months, Dr. Sethi has been running marathons on a weekly basis and has participated in 16 42.2 km marathons and one 50 km Ultramarathon. Dr. Sethi names the 2021 Virtual Boston Marathon to be his most memorable. He earned an overall time of 4 hours and 43 minutes and ranked 31st in his age category of 70-75 out of 176 participants.

CME INDIA Learning Points

• One very important meta-analysis showed that running participation is associated with 27%, 30% and 23% lower risk of all-cause cardiovascular and cancer mortality compared with no running.
  • For cardiovascular (HR=0.70; 95% CI 0.49 to 0.98)
  • For cancer (HR=0.77; 95% CI 0.68 to 0.87)
• Also, a meta-regression analysis showed no significant dose–response trends for weekly frequency, weekly duration, pace and the total volume of running.
• Be assured that increased rates of participation in running, regardless of its dose, would probably lead to substantial improvements in health and longevity.
• Any amount of running, even just once a week, is better than no running, but higher doses of running may not necessarily be associated with greater mortality benefits.
• Long-distance running also provides physiological benefits for the human body
• Long-distance running can reduce risk of heart disease, diabetes, and obesity.
• Have proper assessment before starting running. Running can cause bone stress injury, bronchospasm, cramps, blisters, and other issues.
• It has helped people become healthier and happier for millions of years
• It has been shown to have an impact on the psychological function of sleep as well.
• According to one study, here were 3 major findings (2)

• Physicians should explain to patients the significant mortality benefits of running even as little as 5-10 minutes daily.
• Physicians should try to motivate patients to start running and to continue
  running as an attainable health goal.

Credit: Lee D, Pate RR, Lavie CJ, Sui X, Church TS, Blair SN. Leisure-time running reduces all-cause and cardiovascular mortality risk. J Am CollCardiol 2014;64:472–81.

• One systematic review synthesised result of 14 studies from six prospective cohorts with a pooled sample of more than 230 000 participants.
• The main finding is that running participation is associated with 27%, 30% and 23% reduced risk of all-cause, cardiovascular and cancer mortality, respectively.
• Even the smallest doses of running that were examined in the available studies (i.e., ≤1 time a week, <50 min a week, <6 mph and <500 MET-min/week) has been found to confer significant all-cause mortality benefits.
• There is no evidence that mortality benefits increase with greater amounts of running.

CME INDIA Tail Piece

Running prevalence

European countries:

• 31% in Denmark
• 19% in Belgium
• 18% in the Netherlands
• 15% in Finland
• 13% in Germany
• 6% in Spain
• 5% in the UK

References:

• Lee D, Pate RR, Lavie CJ, Sui X, Church TS,Blair SN. Leisure-time running reduces all-cause and cardiovascular mortality risk. J Am CollCardiol 2014;64:472–81.
• Lee DC, Pate RR, Lavie CJ, Sui X, Church TS, Blair SN. Leisure-time running reduces all-cause and cardiovascular mortality risk. J Am Coll Cardiol. 2014 Aug 5;64(5):472-81. doi: 10.1016/j.jacc.2014.04.058. Erratum in: J Am Coll Cardiol. 2014 Oct 7;64(14):1537. PMID: 25082581; PMCID: PMC4131752.
• Pereira HV, Palmeira AL, Encantado J,Marques MM, Santos I, Carraça EV and Teixeira PJ (2021) Systematic
  Review of Psychological and Behavioral Correlates of RecreationalRunning. Front. Psychol. 12:624783.
  doi: 10.3389/fpsyg.2021.624783
• https://pitjournal.unc.edu/article/long-distance-running-investigation-its-impact-human-health
• Pedisic Z, Shrestha N, Kovalchik S, et al Is running associated with a lower risk of all-cause, cardiovascular and cancer mortality, and is the more the better? A systematic review and meta-analysis.British Journal of Sports Medicine 2020;54:898-905

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