Marathons in Mid- and Later-Life

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It’s Q&A Day at 10almonds!

Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

So, no question/request too big or small

We had several requests pertaining to veganism, meatless mondays, and substitutions in recipes—so we’re going to cover those on a different day!

As for questions we’re answering today…

Q: Is there any data on immediate and long term effects of running marathons in one’s forties?

An interesting and very specific question! We didn’t find an overabundance of studies specifically for the short- and long-term effects of marathon-running in one’s 40s, but we did find a couple of relevant ones:

The first looked at marathon-runners of various ages, and found that…

  • there are virtually no relevant running time differences (p<0.01) per age in marathon finishers from 20 to 55 years
  • the majority of middle-aged and elderly athletes have training histories of less than seven years of running

From which they concluded:

❝The present findings strengthen the concept that considers aging as a biological process that can be considerably speeded up or slowed down by multiple lifestyle related factors.❞

See the study: Performance, training and lifestyle parameters of marathon runners aged 20–80 years: results of the PACE-study

The other looked specifically at the impact of running on cartilage, controlled for age (45 and under vs 46 and older) and activity level (marathon-runners vs sedentary people).

The study had the people, of various ages and habitual activity levels, run for 30 minutes, and measured their knee cartilage thickness (using MRI) before and after running.

They found that regardless of age or habitual activity level, running compressed the cartilage tissue to a similar extent. From this, it can be concluded that neither age nor marathon-running result in long-term changes to cartilage response to running.

Or in lay terms: there’s no reason that marathon-running at 40 should ruin your knees (unless you are doing something wrong).

That may or may not have been a concern you have, but it’s what the study looked at, so hey, it’s information.

Here’s the study: Functional cartilage MRI T2 mapping: evaluating the effect of age and training on knee cartilage response to running

Q: Information on [e-word] dysfunction for those who have negative reactions to [the most common medications]?

When it comes to that particular issue, one or more of these three factors are often involved:

  • Hormones
  • Circulation
  • Psychology

The most common drugs (that we can’t name here) work on the circulation side of things—specifically, by increasing the localized blood pressure. The exact mechanism of this drug action is interesting, albeit beyond the scope of a quick answer here today. On the other hand, the way that they work can cause adverse blood-pressure-related side effects for some people; perhaps you’re one of them.

To take matters into your own hands, so to speak, you can address each of those three things we just mentioned:

Hormones

Ask your doctor (or a reputable phlebotomy service) for a hormone test. If your free/serum testosterone levels are low (which becomes increasingly common in men over the age of 45), they may prescribe something—such as testosterone shots—specifically for that.

This way, it treats the underlying cause, rather than offering a workaround like those common pills whose names we can’t mention here.

Circulation

Look after your heart health; eat for your heart health, and exercise regularly!

Cold showers/baths also work wonders for vascular tone—which is precisely what you need in this matter. By rapidly changing temperatures (such as by turning off the hot water for the last couple of minutes of your shower, or by plunging into a cold bath), your blood vessels will get practice at constricting and maintaining that constriction as necessary.

Psychology

[E-word] dysfunction can also have a psychological basis. Unfortunately, this can also then be self-reinforcing, if recalling previous difficulties causes you to get distracted/insecure and lose the moment. One of the best things you can do to get out of this catch-22 situation is to not worry about it in the moment. Depending on what you and your partner(s) like to do in bed, there are plenty of other equally respectable options, so just switch track!

Having a conversation about this in advance will probably be helpful, so that everyone’s on the same page of the script in that eventuality, and it becomes “no big deal”. Without that conversation, misunderstandings and insecurities could arise for your partner(s) as well as yourself (“aren’t I desirable enough?” etc).

So, to recap, we recommend:

  • Have your hormones checked
  • Look after your circulation
  • Make the decision to have fun!

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  • The Autoimmune Cure – by Dr. Sara Gottfried

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    We’ve featured Dr. Gottfried before, as well as another of her books (“Younger”), and this one’s a little different, and on the one hand very specific, while on the other hand affecting a lot of people.

    You may be thinking, upon reading the subtitle, “this sounds like Dr. Gabor Maté’s ideas” (per: “When The Body Says No”), and 1) you’d be right, and 2) Dr. Gottfried does credit him in the introduction and refers back to his work periodically later.

    What she adds to this, and what makes this book a worthwhile read in addition to Dr. Maté’s, is looking clinically at the interactions of the immune system and nervous system, but also the endocrine system (Dr. Gottfried’s specialty) and the gut.

    Another thing she adds is more of a focus on what she writes about as “little-t trauma”, which is the kind of smaller, yet often cumulative, traumas that often eventually add up over time to present as C-PTSD.

    While “stress increases inflammation” is not a novel idea, Dr. Gottfried takes it further, and looks at a wealth of clinical evidence to demonstrate the series of events that, if oversimplified, seem unbelievable, such as “you had a bad relationship and now you have lupus”—showing evidence for each step in the snowballing process.

    The style is a bit more clinical than most pop-science, but still written to be accessible to laypersons. This means that for most of us, it might not be the quickest read, but it will be an informative and enlightening one.

    In terms of practical use (and living up to its subtitle promise of “cure”), this book does also cover all sorts of potential remedial approaches, from the obvious (diet, sleep, supplements, meditation, etc) to the less obvious (ketamine, psilocybin, MDMA, etc), covering the evidence so far as well as the pros and cons.

    Bottom line: if you have or suspect you may have an autoimmune problem, and/or would just like to nip the risk of such in the bud (especially bearing in mind that the same things cause neuroinflammation and thus, putatively, depression and dementia too), then this is one for you.

    Click here to check out the Autoimmune Cure, and take care of your body and mind!

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  • Top 10 Early Warning Signs Of Dementia

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    What’s a harmless momentary mind-blank, and what’s a potential warning sign of dementia? Dementia Careblazers, a dementia care organization, has input:

    The signs

    With the caveat that this is a list of potential warning signs, not a diagnostic tool, the 10 signs are:

    • Memory loss: e.g. forgetting important or well-learned information, such as one’s home address
    • Challenges in planning or solving problems: e.g. difficulty with tasks such as paying bills (for organizational rather than financial reasons), following recipes, or managing medications
    • Difficulty completing familiar tasks: e.g. trouble remembering rules of a familiar game, or directions to a familiar place
    • Confusion with place or time: e.g. forgetting where one is, or making mistakes with the date, season, or other time-related details. Note that anyone can be momentarily unsure of today’s date, but if someone thinks it’s 1995, probably something wrong is not quite right. Similarly, being wrong about who is the current national leader is often used as a test, too—assuming countries with enough political stability to not have five different national leaders in the past four years, including one who did not outlast a lettuce *side-eyeing the UK*
    • Trouble understanding visual images and spatial relationships: e.g. increased clumsiness, difficulty parking, or bumping into objects
    • New problems with speaking or writing: e.g. losing track in conversations, or struggling to find the right words
    • Misplacing things: e.g. losing items and being unable to retrace one’s steps to find them
    • Decreased or poor judgment: e.g. falling for scams, giving out too much information or money without investigating appropriately first
    • Withdrawal from social activities or hobbies: e.g. losing interest in activities one used to enjoy or avoiding social interactions
    • Changes in mood and personality: e.g. increased irritability, anxiety, or other noticeable changes in behavior and personality

    For more information on each of these, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Dementia: Spot The Signs (Because None Of Us Are Immune)

    Take care!

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  • In Defense of Food – by Michael Pollan

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Eat more like the French. Or the Italians. Or the Japanese. Or…

    Somehow, whatever we eat is not good enough, and we should always be doing it differently!

    Michael Pollan takes a more down-to-Earth approach.

    He kicks off by questioning the wisdom of thinking of our food only in terms of nutritional profiles, and overthinking healthy-eating. He concludes, as many do, that a “common-sense, moderate” approach is needed.

    And yet, most people who believe they are taking a “common-sense, moderate” approach to health are in fact over-fed yet under-nourished.

    So, how to fix this?

    He offers us a reframe: to think of food as a relationship, and health being a product of it:

    • If we are constantly stressing about a relationship, it’s probably not good.
    • On the other hand, if we are completely thoughtless about it, it’s probably not good either.
    • But if we can outline some good, basic principles and celebrate it with a whole heart? It’s probably at the very least decent.

    The style is very casual and readable throughout. His conclusions, by the way, can be summed up as “Eat real food, make it mostly plants, and make it not too much”.

    However, to summarize it thusly undercuts a lot of the actual value of the book, which is the principles for discerning what is “real food” and what is “not too much”.

    Bottom line: if you’re tired of complicated eating plans, this book can help produce something very simple, attainable, and really quite good.

    Click here to check out In Defense of Food, for some good, hearty eating.

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  • Which Comes First, Cardio or Weights? – by Alex Hutchinson

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    This is a book of questions and answers, myths and busts, and in short, all things exercise.

    It’s laid out as many micro-chapters with questions as headers. The explanations are clear and easy to understand, with several citations (of studies and other academic papers) per question.

    While it’s quite comprehensive (weighing in at a hefty 300+ pages), it’s not the kind of book where one could just look up any given piece of information that one wants.

    Its strength, rather, lies in pre-emptively arming the reader with knowledge, and correcting many commonly-believed myths. It can be read cover-to-cover, or just dipped into per what interests you (the table of contents lists all questions, so it’s easy to flip through).

    Bottom line: if you’ve found the world of exercise a little confusing and would like it demystifying, this book will result in a lot of “Oooooh” moments.

    Click here to check out Which Comes First, Cardio or Weights?, and know your stuff!

    PS: the short answer to the titular question is “mix it up and keep it varied”

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  • Exercise, therapy and diet can all improve life during cancer treatment and boost survival. Here’s how

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    With so many high-profile people diagnosed with cancer we are confronted with the stark reality the disease can strike any of us at any time. There are also reports certain cancers are increasing among younger people in their 30s and 40s.

    On the positive side, medical treatments for cancer are advancing very rapidly. Survival rates are improving greatly and some cancers are now being managed more as long-term chronic diseases rather than illnesses that will rapidly claim a patient’s life.

    The mainstays of cancer treatment remain surgery, chemotherapy, radiation therapy, immunotherapy, targeted therapy and hormone therapy. But there are other treatments and strategies – “adjunct” or supportive cancer care – that can have a powerful impact on a patient’s quality of life, survival and experience during cancer treatment.

    PeopleImages.com – Yuri A/Shutterstock

    Keep moving if you can

    Physical exercise is now recognised as a medicine. It can be tailored to the patient and their health issues to stimulate the body and build an internal environment where cancer is less likely to flourish. It does this in a number of ways.

    Exercise provides a strong stimulus to our immune system, increasing the number of cancer-fighting immune cells in our blood circulation and infusing these into the tumour tissue to identify and kill cancer cells.

    Our skeletal muscles (those attached to bone for movement) release signalling molecules called myokines. The larger the muscle mass, the more myokines are released – even when a person is at rest. However, during and immediately after bouts of exercise, a further surge of myokines is secreted into the bloodstream. Myokines attach to immune cells, stimulating them to be better “hunter-killers”. Myokines also signal directly to cancer cells slowing their growth and causing cell death.

    Exercise can also greatly reduce the side effects of cancer treatment such as fatigue, muscle and bone loss, and fat gain. And it reduces the risk of developing other chronic diseases such as heart disease and type 2 diabetes. Exercise can maintain or improve quality of life and mental health for patients with cancer.

    Emerging research evidence indicates exercise might increase the effectiveness of mainstream treatments such as chemotherapy and radiation therapy. Exercise is certainly essential for preparing the patient for any surgery to increase cardio-respiratory fitness, reduce systemic inflammation, and increase muscle mass, strength and physical function, and then rehabilitating them after surgery.

    These mechanisms explain why cancer patients who are physically active have much better survival outcomes with the relative risk of death from cancer reduced by as much as 40–50%.

    Mental health helps

    The second “tool” which has a major role in cancer management is psycho-oncology. It involves the psychological, social, behavioural and emotional aspects of cancer for not only the patient but also their carers and family. The aim is to maintain or improve quality of life and mental health aspects such as emotional distress, anxiety, depression, sexual health, coping strategies, personal identity and relationships.

    Supporting quality of life and happiness is important on their own, but these barometers can also impact a patient’s physical health, response to exercise medicine, resilience to disease and to treatments.

    If a patient is highly distressed or anxious, their body can enter a flight or fight response. This creates an internal environment that is actually supportive of cancer progression through hormonal and inflammatory mechanisms. So it’s essential their mental health is supported.

    several people are lying on recliners with IV drips in arms to receive medicine.
    Chemotherapy can be stressful on the body and emotional reserves. Shutterstock

    Putting the good things in: diet

    A third therapy in the supportive cancer care toolbox is diet. A healthy diet can support the body to fight cancer and help it tolerate and recover from medical or surgical treatments.

    Inflammation provides a more fertile environment for cancer cells. If a patient is overweight with excessive fat tissue then a diet to reduce fat which is also anti-inflammatory can be very helpful. This generally means avoiding processed foods and eating predominantly fresh food, locally sourced and mostly plant based.

    two people sit in gym and eat high protein lunch
    Some cancer treatments cause muscle loss. Avoiding processed foods may help. Shutterstock

    Muscle loss is a side effect of all cancer treatments. Resistance training exercise can help but people may need protein supplements or diet changes to make sure they get enough protein to build muscle. Older age and cancer treatments may reduce both the intake of protein and compromise absorption so supplementation may be indicated.

    Depending on the cancer and treatment, some patients may require highly specialised diet therapy. Some cancers such as pancreatic, stomach, esophageal, and lung cancer can cause rapid and uncontrolled drops in body weight. This is called cachexia and needs careful management.

    Other cancers and treatments such as hormone therapy can cause rapid weight gain. This also needs careful monitoring and guidance so that, when a patient is clear of cancer, they are not left with higher risks of other health problems such as cardiovascular disease and metabolic syndrome (a cluster of conditions that boost your risk of heart disease, stroke and type 2 diabetes).

    Working as a team

    These are three of the most powerful tools in the supportive care toolbox for people with cancer. None of them are “cures” for cancer, alone or together. But they can work in tandem with medical treatments to greatly improve outcomes for patients.

    If you or someone you care about has cancer, national and state cancer councils and cancer-specific organisations can provide support.

    For exercise medicine support it is best to consult with an accredited exercise physiologist, for diet therapy an accredited practising dietitian and mental health support with a registered psychologist. Some of these services are supported through Medicare on referral from a general practitioner.

    For free and confidential cancer support call the Cancer Council on 13 11 20.

    Rob Newton, Professor of Exercise Medicine, Edith Cowan University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • GLP-1 Drugs & Eye Health: Cause For Concern?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    First introduced as a diabetes medication, GLP-1 drugs quickly took hold for off-label use as weight loss aids, even when the science was still very young.

    Here’s one of our first articles on that, back in the day: Semaglutide’s Surprisingly Big Research Gap

    As for that popularity? Check out: 1 in 5 US Women Aged 50–64 Has Used GLP-1 RAs: What We’ve Learned

    Spoiler, one of the things we’ve learned is: Most People Who Start GLP-1 RAs Quit Them Within A Year (Here’s Why)

    One of the main things in their favor is, of course, that (for most people, anyway), they work (except when they don’t: Why Intermittent Fasting (& GLP-1 Drugs!) Might Not Work For You).

    In other words, a rocky road with pros and cons. So what’s this about GLP-1 drugs and eye health?

    We’ve been keeping our eye on it…

    …and the numbers keep going down, at least from what we’ve seen.

    See for example this study in 2024, that showed that those taking GLP-1 drugs for weight loss had an 8x higher risk of nonarteritic anterior ischemic optic neuropathy (NAION), which constitutes approximately 75% of ischemic optic neuropathy (ION) cases in adults:

    Risk of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients Prescribed Semaglutide ← and/but you’ll see the risk amongst those taking it for diabetes, rather than weight loss, was a 4x higher risk (rather than 8x higher, as in the weight loss group).

    Some studies in 2025 suggested GLP-1 drugs increase the risk by lower amounts, such as for example:

    If you’re wondering if “incretin receptor agonists” means the same thing as GLP-1 receptor agonists, the answer has been carefully hidden in the first line of the paper:

    ❝Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and the dual glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 RA tirzepatide—collectively termed incretin receptor agonists (IRAs)❞

    And to put it in numbers, it was a 2x increase in risk.

    Most recently (paper published today, at time of writing, let it not be said we don’t bring you hot-off-the-press health science news), researchers (Dr. Kamika Reynolds et al.) investigated the effect of GLP-1 receptor agonists (compared to other antidiabetic treatments) on the risk of NAION.

    In few words: over 18 months, ischemic optic neuropathy occurred in about 8.5 per 10,000 GLP-1 users compared with 5.5 per 10,000 sodium–glucose cotransporter-2 inhibitor (SGLT2) users, and 7.8 per 10,000 GLP-1 users compared with 4.2 per 10,000 dipeptidyl peptidase-4 inhibitor (DPP4) users.

    More clearly put, because that was an unusual way for it to be represented in the paper’s abstract, this means that GLP-1 users had:

    • 54% increase in risk compared to the SGLT2 group
    • 88% increase in risk compared to the DPP4 group

    You can read this paper for yourself, here: Glucagon-Like Peptide-1 Receptor Agonists and Risk for Ischemic Optic Neuropathy

    So, why is this probably not cause for concern?

    Well, “concern” is a bit subjective and relative, and this is with the caveat that this study was amongst diabetics, so those taking it for weight loss might have slightly higher numbers here, but for example that 2x increase in risk in the 2025 study was a jump from 0.02% to 0.04%.

    The more alarming figures in the latest study represent approximately a jump from 0.05% to 0.09%, and a jump from 0.04% to 0.08%.

    In other words, without it, the chance of getting it is very small, and with it, the chance of getting it is almost as very small.

    Want to learn more?

    You might also like this book that we reviewed a little while back:

    Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs – by Johann Hari

    Take care!

    Don’t Forget…

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