Links for Wednesday, August 29, 2018: Dirty Kanza Promotions, Dangerous playground comeback, Dutch cycling politics

This Dirty Kanza video showed up in my email yesterday

And this cornball teared up a little watching it. I'll carry a torch for this race as long as I live. 

Playgrounds that are just a little bit dangerous are coming back, baby

When I visited my alma mater last spring, I was pretty bummed out that the old playground, made up largely of concrete pipe:

concretepipe.org

and buried tractor tires:

http://lapaceksorchard.blogspot.com/

had been completely replaced with the same safety-first playground equipment you can find anywhere:

Not Skyline's playground, but it might as well be. They all look alike. (playcreation.com)

The problem with this kind of playground isn't that it's ugly or unsafe. It's that it's boring. And kids don't want anything to do with a boring playground. It can't compete with omnipresent screens. Public playgrounds that allow for slightly riskier play (think swinging and teeter-tottering) on a variety of surfaces--nothing exotic, just sand, grass, gravel, and the like--see 53 percent more visitors than the ultra-safe playgrounds like the one above, and kids are 18 percent more physically active.

“The take-home message ... is: Stop setting your bar at the level of the most anxious parent. If you do that, you’re guaranteed to produce boring and dull playgrounds,” said Tim Gill ... “If you set your bar at the level of the average parent or maybe even at the level of the parents … who do want some more excitement and challenge in their kids’ lives, then, things start to look different.”

I like different. An abrasion, bruise, or even a broken bone here and there is the cost of doing business for raising interesting, innovative, resourceful kids.

The Dutch are known for their everyday, casual love of cycling. But their policies and infrastructure didn't come easily

"Rotterdam, for example, was completely obliterated during the Second World War and rebuilt in this post-war, modernist image — designing cities around the automobile, where people would live outside the city, commute by car into the city every day, and everyone would have more light and space and air. They’d be living happily in the suburbs.

It didn’t take long for Rotterdammers to realize this wasn’t the future they wanted. The spaces they were building were inhospitable to walking and cycling and public transit. Cycling rates were plummeting. There were more road fatalities.

So, not just in Rotterdam, but in cities across the Netherlands in the ’70s, there was a real rejection of this car-centric urban planning.

Some of them resisted better than others. In Rotterdam, they managed to reverse the tide and retrofit some of these spaces for other modes of transportation. But certainly a lot of Dutch cities made mistakes. In Utrecht, they paved over canals. In Amsterdam, they came just a single city council vote away from demolishing the Jewish quarter of their city to build a four-lane motorway."

But now cycling transcends politics:

Chris Bruntlett: ...We had conversations with politicians there and they made it perfectly clear: Even the right-wing in the Netherlands has to support more spending on cycling.

David Roberts: Because of public pressure, public opinion?

Chris Bruntlett: Exactly. It’s not a tenable or realistic position to win an election when probably 80 percent of the population cycles at least once a week.

Building on all that NZ pregnancy cycling momentum from last week. (Pic: Modacity/Vox)

Links are back! (for now, at least): Tuesday, August 15, 2018

The Gravel Boom Could Save Road Biking's Soul

This is true, and mostly for the reasons Aaron Gulley lays out: fewer cars and an attitude of adventure rather than competition. None of the assholery that turns up at road races is present at the majority of gravel races, unless you count a few people trying to change it for the worse.

Gravel Rides Are Saving Small-Town America

I guess gravel riding is "saving" a lot of things today. "Saving" is too strong a word for the effect of gravel races on small towns; a couple hundred riders one or two days a year is nice, but I doubt if it pays for that new school library. But no doubt I have traveled to and spent money in a dozen towns over the last few years I would have completely bypassed if not for gravel racing.

Med students don't go to class. This is not a new phenomenon

I don't mean to pull any kind of hard work card, because people work hard in every imaginable job. But it's hard to overstate how precious your time is in med school. The volume of information is overwhelming, and even a good lecturer can't typically deliver the material in a time-efficient way. It's much easier just to look at other people's notes (as in note service in my day) or to watch the lecture via podcast or webcast at double speed later. And most professors just aren't good lecturers. Not even Nobel laureates. Maybe particularly not Nobel laureates; the skill set that makes a good investigator is far removed from the skill set of a good teacher.

What's interesting here is that the move to pass-fail grading systems--which I completely agree with--has made performance on the national "step" exams that much more important. This, according to Orly Nadell Farber, is what is driving the further diminution of attendance at lectures. My response to this is for NBME to stop giving step scores to residency program directors.

Doctors are pulling their hair out trying to get parents to limit screentime

U.S. kids get an average of over 7 hours daily in front of screens, almost all of it because increased use of smartphones, tablets, and other devices. Not that anyone who has seen a kid in a grocery cart at the store lately needs to be told that. Why is this important? Because the more time you spend zonked out in front of a television, the more fat you tend to have (what we five-dollar-word types call "adiposity”). And adiposity means bad things later on, like heart disease and diabetes.

So the American Heart Association is recommending--again--that children and teens to get no more than 1–2 hours of recreational screen time a day. They also warmed my heart by continuing to recommend against having screens, including phones, in bedrooms and while eating.

Re-post: You wanna do the Dirty Kanza 200? Here’s how.

If you're one of the lucky ones from last winter's lottery, you're a month out from the 2018 Dirty Kanza as of today. Maybe you're nervous about preparing. Well, since I'm a completely mediocre cyclist (see: painful, sunburnt non-finishing of last weekend's Open Range 200k) and I've still managed to complete two Dirty Kanza 200s, I thought I'd share again my experience with the DK and what I think makes for a successful day. Warning: what follows is advice for people like me who perform in the vast middle of the range of abilities on a bicycle:

Based on my performance, it is obviously not for people who expect to be on the pointy end of the race. If you're one of those, you can find good advice from folks like Ted King, Rebecca Rusch, Allison Tetrick, and Dan Hughes.

1. Prepare your body

If you want to really enjoy the day of the DK and feel confident about finishing, I think more preparation than that is probably needed. One of the hardest things about the ride is just the act of being on a bike for 12 hours or more. Not many of us do that routinely. So my recommended routine is something like 8-10 hours a week in the months leading up to springtime. Too late for that now, I know. But you still have some time to build fitness. Since hills are hard to come by here in central Kansas (not to worry, there's a crapload of climbing in the DK itself; see the profile below), I make sure 3 hours per week are intervals. I don't do anything fancy. I don't have an interval timer. One day a week I go to my favorite road/crit loop, pictured below, and I ride laps for an hour. At three spots on the map, each one of them 1/8 to 1/4 mile long, I sprint. If you don't have a nice tidy loop like this, just pick out landmarks ahead of you 300-400 meters and sprint to them a few times an hour on your usual rides a couple days a week. After each sprint, or just pick out a landmark a few hundred meters ahead of you and sprint to it. Rest a couple minutes and do it again.

That's the loop around Botanica in Wichita. 

The next best thing to do to prepare yourself is to ride a couple hard gravel races ahead of time if you can. Here in Wichita, I like the Rage Against the Chainring series. The races are short, about 50 miles each, but that's okay. The DK200 itself is really just four 50-mile races stacked up in a day.

And--this is really important--make sure you go for at least a couple of very long rides before the big day. Like, at least 3-4 hour rides. This isn't for cardiovascular or leg fitness as much as it is to see if your shoulders, back, and butt can handle long stretches on your bike. If you have trouble on these rides, be sure to get your fit checked out (see #2 below). 

Practice your hydration strategy. Again (dead horse alert), you probably go on rides without thinking much of food or water all the time. This is not one of those times. I'm a legendary sweater (I'm sweating just typing this [not really]), so I know my fluid needs are above the norm. I take that into account in my preparation. After intentionally riding long distances on some warm days, I came up with a strategy is to fill two large bidons with Skratch. I like Skratch because it doesn’t upset my stomach like more sugary drinks do. Preferably one of the bottles is insulated to stay cool. I drink it second. On top of this, I wear a one-liter hydration pack that’s just water. I found I could easily drink all three on a typical 50-60 mile ride.

Food-wise, you need mostly carbs, with a touch of protein thrown in. Don't make this complicated. Even as a physician, I get bored with talk of "nutrients." Use trial and error. My experimenting taught me that, even though I'm disgusted by gels, I needed to eat one gel every hour on long days like the DK. As they say, strawberry goo forever. Between every gel that I manage to choke down, I eat a snack-size Payday. After some experimentation with other bars, I found I liked them because they didn't melt in my jersey pocket. So if you're doing the math at home, that's eating every 30 minutes. It's not scientific. It's just what I've found my stomach can handle. 

2. Pimp your ride

This seems obvious, but between now and the race, make sure your bike works. You'll be amazed how many clickety-clackety derailleurs you hear on the course. This advice extends from the grips or bar tape to the tires to the drivetrain. That little click or loose spoke is annoying on a commute or a two-hour ride, but it’s potentially catastrophic on a 15-hour ride over rocky gravel roads. If your bike needs tuned up, do it a week or two ahead of the race so the cables have a chance to stretch before the big day.

Do you need anything new on your bike? Well, I'd at least consider new tires if yours are more than a year old. You'll wanna replace those old, squeaky brake pads with new ones, since the descents in the DK can be fast and hairy.

Really consider a GPS. I know they're expensive, and my goal here isn't to convince everyone to spend a bunch of money on their bike. But pre-loading the route makes it soooo much easier and nicer to stay on course, especially during the times you find yourself all alone. And occasionally someone gets asked for their GPS data to prove she finished the course and can't provide it. Don't be that person. 

3. Race day

Don't overdress. Kansas can still be a little chilly early in the morning in early June, but don't let it fool you. It'll be hot later in the day. That 80 or 90 degrees later on is what you should dress for, not the 50 or 60 that morning.

Have a plan for support during the race. If past is prologue, you'll have a color-coded spot to seek out in the parking areas of the checkpoints:

But the crowds are huge, so have a plan for your support to flag you down, or have a plan for where to find them within your designated area. I like the idea of having a flag flying to look for.

That's Colby Reynolds, past DK Half-Pint finisher and my badass 2017 Crew Chief. (other crew included wife and kids)

Have some other food handy with your crew. The DK is many things. For that one day, it's a license to eat. I hit the bananas and pickles at the rest stops, along with a bottle of Coke (I drink bug juice exactly one day a year, and it invariably keeps me from sleeping that night). Cut the ends off your Payday bar wrappers. They can be hard to get out of the package.

Take care of your butt. I know, I know: you ride a lot. But you don't ride 200 wet, dusty, sweaty miles in a day very often. I've used Chamois Butt'r and Deez Nutz, and I honestly can't tell them apart. They both work. I use a lot more Chamois Butt'r because they sponsor the DK along with some other local races here, and I want to reward them for their support. Use the stuff liberally. Apply a little at each checkpoint if you're unsure. This last year I forgot to re-apply at the third checkpoint, and by the time I hit Emporia, my perineum was a white-hot glowing ember.

As far as that goes, make sure you wear your best shorts for the DK. 

Ride with a goal in mind. If you have a heart rate monitor, set a goal HR and try to stick to it. Ditto power if you have a power meter. Speed is an unreliable indicator of effort in gravel races. Even former pros run lower speeds than you'd expect.

17.9 mph ain't no joke, but it's not what World Tour guys are used to riding, either. 

It can be very seductive to fall in with a group going ten percent faster than you're comfortable early on in the race. But you're gonna be out there for 12 hours or more. Going faster than is comfortable early on is a recipe for suffering later.

Don't try to win the race on the descents. Every year I've done the DK I've seen people have horrendous, ass-over-teakettle crashes on rocky jeep road descents. Jim warns everyone about it every year, and it still happens. And even if you don't crash, the risk of getting a flat tire going 45 mph down a rocky path is high. Be careful. 

This was the result of stupidity on firm, level ground, not a descent. But there were no witnesses, thank heavens.

5. The finish line

Sign your name on the DK Poster. This is mandatory:

Enjoy sitting on something--anything--that isn't a bike seat. 

Here's a checklist of what you may need for the DK:

1. Four to eight large water bottles (preferably half uninsulated, half insulated)

2. Hydration pack: If you're a light sweater, you may be able to get by without this, but it's risky in my opinion.

3. A dozen snack-size Payday candy bars. I eat one of these an hour (alternating with gels).

4. A dozen gels (pick your favorite flavored goo and eat one an hour). Alternate, minimally tested choice: Ted's Untapped Maple syrup.

5. Skratch. I use it in my water bottles and keep my hydration pack filled with water.

6. Three gallons of water (for refilling said hydration pack and bidons)

7. six-pack of Coca-Cola. Long races are the only time I allow myself bug juice. Old-fashioned Coke, with its caffeine buzz and high sugar content, is hard to beat at checkpoints.

8. Pickles and bananas. The data on pickles for cramp prevention is light and inconsistent, but the salt tastes great on a hot day. The bananas are bland and smooth enough to still taste good at the end of the day.

9. Sunscreen. Don't even try to go without it. Reapply at checkpoints, too. 

10. Butt lube. I like Chamois Butt'r. Have enough on hand to re-apply at every checkpoint.

11. Three extra inner tubes. This goes whether you're running tubeless or with tubes (I've done it both ways, and I can't say one is dramatically better than the other).

12. Patch kit.

13. Chain breaker. I hear stories of broken derailleurs every year, and if you can't shorten your chain your day is done. Get one that has an attached multi-tool or carry a multi-tool separately.

14. Extra chain link. Make sure you get one that matches the size of your chain, i.e., 10-, 11-, or 12-speeds.

15. Multi-tool. See above. 

16. Extra brake cable if you have cable-pull brakes. This isn't to carry with you, but it's nice to have at a pit stop if things go wrong. 

17. Extra shift cable. See above. 

18. Chain lube. When you lube your butt, lube your chain. I like wax-based lubes because they're less finicky about wet or dry conditions. 

19. Glasses cleaner and rags.

20. Extra water to clean your bike at checkpoints in case of heavy mud. 

21. Mini-pump (or a frame pump if you're old school).

22. Three CO2 cartridges (one for every spare tube).

23. Tire levers.

24. Headlight, fully charged (so bring your charger).

25. Taillight, fully charged (so bring your charger). 

26. Gloves.

27. Lawn chair.

28. Three moist towels folded inside plastic zip-loc bags. They'll be nice and warm when you take them out to wipe off your face between stages. 

29. GPS, fully charged (so bring your charger). I know this sounds like a techie ad for unnecessary doo-dads. And yes, the race organizers do a good job with cue sheets. But having the course loaded onto your GPS is so much nicer. And later, you'll have the GPS data to use to brag to friends. And you'll be able to turn off your phone. Phone reception is non-existent for much of the course, anyway, and your phone will drain its battery trying to find a signal.

And do bring your helmet, jersey, shorts, socks and shoes. That goes without saying. 

I won't be in the DK200 this year. I'm planning on doing the 25 mile ride with my son. Look for me at the finish line. See you there!

You wanna do the Dirty Kanza 200? Here’s how.

You may have heard that the new lottery for the Dirty Kanza opens Friday and continues from December 1st - December 16th, 2017. This replaces the old system that was in a sense a lottery of its own, run through the steaming-hot servers at bikereg.com. That's not me picking on bikereg.com. They have a great service. What I mean is that the volume of people applying to race through their site in past years overwhelmed the site, and I think a certain amount of luck went into whose ones and zeros penetrated the server to get a spot in the race.

Anyhoo, I thought today might be a good time to share some of my experience with the DK and what I think makes for a successful day. Warning: what follows is advice for people like me who perform in the vast middle of the range of abilities on a bicycle:

Based on my performance, it is obviously not for people who expect to be on the pointy end of the race. If you're one of those, you can find good advice from folks like Ted King, Rebecca Rusch, Allison Tetrick, and Dan Hughes.

And I'll likely update this post as I remember more. So if you see something embarrassing here the first time you read this, hopefully it's gone by the time you come back. 

1. Prepare your body

You're going to know whether or not you're in the race by early January. Don't wait until then to start preparing. I think it's possible to get in good enough shape in five months to complete the ride; don't get me wrong. But if you want to really enjoy the day of the DK and feel confident about finishing, I think more preparation than that is probably needed. One of the hardest things about the ride is just the act of being on a bike for 12 hours or more. Not many of us do that routinely. So my routine is something like 8-10 hours a week in the months leading up to springtime. Since hills are hard to come by here in Kansas, I make sure 3 hours per week are intervals. I don't do anything fancy. I don't have an interval timer. One day a week I go to my favorite road/crit loop, pictured below, and I ride laps for an hour. At three spots on the map, each one of them 1/8 to 1/4 mile long, I sprint. If you don't have a nice tidy loop like this, just pick out landmarks ahead of you 300-400 meters and sprint to them a few times an hour on your usual rides a couple days a week. After each sprint, or just pick out a landmark a few hundred meters ahead of you and sprint to it. Rest a couple minutes and do it again.

That's the loop around Botanica in Wichita. 

The next best thing to do to prepare yourself is to ride a couple hard gravel races ahead of time if you can. Here in Wichita, I like the Rage Against the Chainring series. The races are short, about 50 miles each, but that's okay. The DK200 itself is really just four 50-mile races stacked up in a day.

And--this is really important--make sure you go for at least a couple of very long rides before the big day. Like at least 3-4 hour rides. This isn't for cardiovascular or leg fitness as much as it is to see if your shoulders, back, and butt can handle long stretches on your bike. If you have trouble on these rides, be sure to get your fit checked out (see #2 below). 

Practice your hydration strategy. Again (dead horse alert), you probably go on rides without thinking much of food or water all the time. This is not one of those times. I'm a legendary sweater (I'm sweating just typing this), so I know my fluid needs are above the norm. I take that into account in my preparation. After intentionally riding long distances on some warm days, I came up with a strategy is to fill two large bidons with Skratch. I like Skratch because it doesn’t upset my stomach like more sugary drinks do. Preferably one of the bottles is insulated to stay cool. I drink it second. On top of this, I wear a one-liter hydration pack that’s just water. I found I could easily drink all three on a typical 50-60 mile ride.

Food-wise, you need mostly carbs, with a touch of protein thrown in. Don't make this complicated. Even as a physician, I get bored with talk of "nutrients." Use trial and error. My experimenting taught me that, even though I'm disgusted by gels, I needed to eat one gel every hour on long days like the DK. As they say, strawberry goo forever. Between every gel that I manage to choke down, I eat a snack-size Payday. After some experimentation with other bars, I found I liked them because they didn't melt in my jersey pocket. So if you're doing the math at home, that's eating every 30 minutes. It's not scientific. It's just what I've found my stomach can handle. 

2. Pimp your ride

This seems obvious, but in the weeks leading up to the race, make sure your bike works. You'll be amazed how many clickety-clackety derailleurs you hear on the course. This advice extends from the grips or bar tape to the tires to the drivetrain. That little click or loose spoke is annoying on a commute or a two-hour ride, but it’s potentially catastrophic on a 15-hour ride over rocky gravel roads. If your bike needs tuned up, do it a week or two ahead of the race so the cables have a chance to stretch before the big day.

Do you need anything new on your bike? Well, I'd at least consider new tires if yours are more than a year old. You'll wanna replace those old, squeaky brake pads with new ones, since the descents in the DK can be fast and hairy.

Really consider a GPS. I know they're expensive, and my goal here isn't to convince everyone to spend a bunch of money on their bike. But pre-loading the route makes it soooo much easier and nicer to stay on course, especially during the times you find yourself all alone. And occasionally someone gets asked for their GPS data to prove she finished the course and can't provide it. Don't be that person. 

3. Race day

Don't overdress. Kansas can still be a little chilly early in the morning in early June, but don't let it fool you. It'll be hot later in the day. That 80 or 90 degrees later on is what you should dress for, not the 50 or 60 that morning.

Have a plan for support during the race. If past is prologue, you'll have a color-coded spot to seek out in the parking areas of the checkpoints:

But the crowds are huge, so have a plan for your support to flag you down, or have a plan for where to find them within your designated area. I like the idea of having a flag flying to look for.

That's Colby Reynolds, past DK Half-Pint finisher and my badass 2017 Crew Chief. (other crew included wife and kids)

Have some other food handy with your crew. The DK is many things. For that one day, it's a license to eat. I hit the bananas and pickles at the rest stops, along with a bottle of Coke (I drink bug juice exactly one day a year, and it invariably keeps me from sleeping that night). Cut the ends off your Payday bar wrappers. They can be hard to get out of the package.

Take care of your butt. I know, I know: you ride a lot. But you don't ride 200 wet, dusty, sweaty miles in a day very often. I've used Chamois Butt'r and Deez Nutz, and I honestly can't tell them apart. They both work. I use a lot more Chamois Butt'r because they sponsor the DK along with some other local races here, and I want to reward them for their support. Use the stuff liberally. Apply a little at each checkpoint if you're unsure. This last year I forgot to re-apply at the third checkpoint, and by the time I hit Emporia, my perineum was a white-hot glowing ember.

As far as that goes, make sure you wear your best shorts for the DK. 

Ride with a goal in mind. If you have a heart rate monitor, set a goal HR and try to stick to it. Ditto power if you have a power meter. Speed is an unreliable indicator of effort in gravel races. Even former pros run lower speeds than you'd expect.

17.9 mph ain't no joke, but it's not what World Tour guys are used to riding, either. 

It can be very seductive to fall in with a group going ten percent faster than you're comfortable early on in the race. But you're gonna be out there for 12 hours or more. Going faster than is comfortable early on is a recipe for suffering later.

Don't try to win the race on the descents. Every year I've done the DK I've seen people have horrendous, ass-over-teakettle crashes on rocky jeep road descents. Jim warns everyone about it every year, and it still happens. And even if you don't crash, the risk of getting a flat tire going 45 mph down a rocky path is high. Be careful. 

This was the result of stupidity on firm, level ground, not a descent. But there were no witnesses I

5. The finish line

Sign your name on the DK Poster. This is mandatory:

Enjoy sitting on something--anything--that isn't a bike seat. 

Feel prepared to enter the lottery? Here's a checklist of what you may need for the DK:

1. Four to eight large water bottles (preferably half uninsulated, half insulated)

2. Hydration pack: If you're a light sweater, you may be able to get by without this, but it's risky in my opinion.

3. A dozen snack-size Payday candy bars. I eat one of these an hour (alternating with gels).

4. A dozen gels (pick your favorite flavored goo and eat one an hour). Alternate, minimally tested choice: Ted's Untapped Maple syrup.

5. Skratch. I use it in my water bottles and keep my hydration pack filled with water.

6. Three gallons of water (for refilling said hydration pack and bidons)

7. six-pack of Coca-Cola. Long races are the only time I allow myself bug juice. Old-fashioned Coke, with its caffeine buzz and high sugar content, is hard to beat at checkpoints.

8. Pickles and bananas. The data on pickles for cramp prevention is light and inconsistent, but the salt tastes great on a hot day. The bananas are bland and smooth enough to still taste good at the end of the day.

9. Sunscreen. Don't even try to go without it.

10. Butt lube. I like Chamois Butt'r. Have enough on hand to re-apply at every checkpoint.

11. Three extra inner tubes. This goes whether you're running tubeless or with tubes (I've done it both ways, and I can't say one is dramatically better than the other).

12. Patch kit.

13. Chain breaker. I hear stories of broken derailleurs every year, and if you can't shorten your chain your day is done. Get one that has an attached multi-tool or carry a multi-tool separately.

14. Extra chain link. Make sure you get one that matches the size of your chain, i.e., 10-, 11-, or 12-speeds.

15. Multi-tool. See above. 

16. Extra brake cable if you have cable-pull brakes. This isn't to carry with you, but it's nice to have at a pit stop if things go wrong. 

17. Extra shift cable. See above. 

18. Chain lube. When you lube your butt, lube your chain. I like wax-based lubes because they're less finicky about wet or dry conditions. 

19. Glasses cleaner and rags.

20. Extra water to clean your bike at checkpoints in case of heavy mud. 

21. Mini-pump (or a frame pump if you're old school).

22. Three CO2 cartridges (one for every spare tube).

23. Tire levers.

24. Headlight, fully charged (so bring your charger).

25. Taillight, fully charged (so bring your charger). 

26. Gloves.

27. Lawn chair.

28. Three moist towels folded inside plastic zip-loc bags. They'll be nice and warm when you take them out to wipe off your face between stages. 

29. GPS. I know this sounds like a techie ad for unnecessary doo-dads. And yes, the race organizers do a good job with cue sheets. But having the course loaded onto your GPS is so much nicer. And later, you'll have the GPS data to use to brag to friends. And you'll be able to turn off your phone. Phone reception is non-existent for much of the course, anyway. 

And do bring your helmet, jersey, shorts, socks and shoes. That goes without saying. 

I won't be in the DK200 this year. I'm planning on doing the 25 mile ride with the fam. Look for me on the tandem. See you there!

Are triathlons dangerous?

First things first: I've never done a triathlon. I swim like a St. Bernard. But I've done a lot of endurance bike racing, and I've been at more than one event with a death, the most recent the 2017 Dirty Kanza. So I was interested that in the latest Annals of Internal Medicine, investigators looked into a sudden death database to identify 135 race-related deaths and cardiac arrests in American triathlons between 1985 and 2016. Interestingly, right at two-thirds of deaths and arrests happened in the swim part of races, which usually comes first, before the bike and run. The editorialists spend a lot of energy trying to link swimming to some special form of stress from cold water or other factors that might be extra-dangerous. But to me, the swimming link seems consistent with the finding that in autopsies, about half of subjects had cardiovascular abnormalities, most often old-fashioned atherosclerotic disease. Swimming caught most of these people simply because it was the first event. Had running or cycling come first, I suspect one of them might have been the death leader. I'm not convinced by their observation that most marathoners die toward the end of races; anyone who's seen the scrum at the beginning of a triathlon knows that it's inherently different than the often walking pace seen at the start of a marathon: 

From http://www.zwemza.com/?p=5515, triathletes tempting fate. 

85% of victims were male, but I'm not sure the significance of that number, since >60% of participants (at least in pro Ironman races) are male:

From https://www.outsideonline.com/1964906/fight-gender-equality-ironman

And if you look at total Ironman competitors, the distribution of sex comes much closer to the death/cardiac arrest statistics:

But sex aside, we're forced to see that cardiac arrest and death are not rare among triathletes. Between 2006 and 2016, their incidence was 1.74 per 100,000 participants in the study. The risk of death increased with increasing age, unsurprisingly. Don't let this dissuade you from being more active. The benefits of physical activity far, far outweigh the risks in almost everyone. If you're inactive now and thinking of becoming active, or if you're active now and thinking of doing really hard-core things like triathlon, consider taking the American College of Sports Medicine's new-ish algorithm to your doctor and talking it over before you hit it really hard:

We don't know how really weird stuff like performance enhancing drugs effects this. My suspicion is that it's not good.