Take home message is that physicians as a group still do not understand athletes and consider overweight, under exercised, struggling under the effects of garbage nutrition as the norm for human beings.

I'm not sure if I agree with all of that as there is a lot that is understood, but doing something about it is a whole different ballgame. But, to add to the part of your statement that I do agree with, I read this provocative statement this week that really changed my perspective on some things:

"A sedentary life is now so prevalent that it has become common to refer to exercise as having “healthy benefits” even though the exercise-trained state is the biologically normal condition. "


http://www.sciencedirect.com/...ii/S0092867414013178

This is nothing new IMO. I almost had kidney damage that stemmed from hip surgery (I had rhabdo). My leg was strained during an 8 hour surgery and started breaking down. Muscles can start breaking down (CK) during exercise and too much breakdown will damage your kidneys. You can be in the best shape and well prepared for the event and still get rhabdo.

Hello All,

https://qz.com/...orary-kidney-damage/

Excerpts:

"Although marathon runners are widely regarded as some of the healthiest people on Earth, cranking out those 26.2 miles (42 kilometers) does a number on your body. In addition to all wear and tear it puts on your muscles, bones, and heart, it can also affect your kidneys. Researchers at the Yale School of Medicine found that 80% of runners who completed marathons had kidney function that looked similar to patients who just underwent heart surgery.

Hello All,

https://qz.com/...orary-kidney-damage/

Excerpts:

"Although marathon runners are widely regarded as some of the healthiest people on Earth, cranking out those 26.2 miles (42 kilometers) does a number on your body. In addition to all wear and tear it puts on your muscles, bones, and heart, it can also affect your kidneys. Researchers at the Yale School of Medicine found that 80% of runners who completed marathons had kidney function that looked similar to patients who just underwent heart surgery.

This is basic physiology, is it bad? Not really, it can cause issues in certain environments for certain individuals... it will most likley not damage your kidneys long term, just overload them short term, your heart will probably be affected way more long term.

1. Inadequate ventilation of the lungs causes respiratory acidosis. The rate at which carbon dioxide is eliminated from the body fluids through the lungs falls. This increases the concentration of carbon dioxide in the body fluids. As carbon dioxide levels increase excess carbon dioxide reacts with water to form carbonic acid. The carbonic acid dissociates to form hydrogen ions and bicarbonate ions. The increase in hydrogen ion concentration causes the pH of the body fluids to decrease. If the pH of the body fluids falls below 7.35, symptoms of respiratory acidosis become apparent.

Buffers help resist a decrease in pH, and the kidneys help compensate for failure of the lungs to prevent respiratory acidosis by increasing the rate at which they secrete hydrogen ions into the filtrate and reabsorb bicarbonate ions.

2. Rhabdomyolysis - more common then not, can be lethal, but in most cases is not.

People have "idiot proof" survival switches built in, before they die during marathon those switches kick in and save their a$$

Theoretical scenario: take some inactive person and let him run marathon, drug him a bit to turn off "survival mechanisms" I bet any money he will die in the process, or will be very close to death. Most of the healthy people will not die, they will stop first, but if you motivate them "properly" they could die.