(Don’t) just start running Viviane M. Conraads a , Johan de Sutter b , Johan Roeykens c and Sanjay Sharma d a Department of Cardiology, Cardiac Rehabilitation, Antwerp University Hospital, Edegem, b Department of Cardiology, AZ Maria Middelares Hospital Gent, University Gent, Belgium, c S.P.OR.T.S., Antwerp University Hospital, Edegem, Belgium and d Medical Director Flora London Marathon, King’s College Hospital, London, UK European Journal of Cardiovascular Prevention and Rehabilitation 2009, 16 (Suppl 2):S11–S13 As a student, participation in the 24-h Estafette Run was something that was decided upon the day before the start; however, as Bucks Fizz (former British Eurovision triumphs, not champagne!) would suggest; ‘now those days are gone.’ Nowadays, with the body no longer as fit as the mind, one tends to take a more considered approach. We recommend that instead of waiting for the passing of another New Year’s Eve to make that resolution, galvanize yourselves into action and make your minds up right now. In Barcelona, the city of the XXVth Olympiad, with the statement of this year’s congress ‘Prevention of Cardiovascular Disease’ impreg- nated deep in your frontal lobes, take the first step into the realms of a heart healthy life. As cardiologists and members of the European Society of Cardiology, we should practice what we preach. Before embarking on your new regime, seek preparticipation screening for cardiovascular disease if you experience anginal symptoms, have more than one established acquired risk factor for atherosclerosis, or a strong family history of ischaemic heart disease. Once you overcome this minor hurdle, you are ready to get going. Just remember though, many of us are not used to regular endurance training; some of us have piled on kilograms around the waist line in addition to undergoing advanced biological maturation (known by some as ageing) and may not have much idea about the importance of the correct shoes or clothing. How do we survive an initially overenthusiastic and unrealistic attempt to run the London marathon next year? One word,repeated twice; ‘pole´pole´’ (meaning ‘take it easy’ if you don’t speak Swahili). Here are a couple of useful tips to consider before throwing yourself headlong into a new and healthy infatuation. No pain, no gain? How to run effectivelyy For those of you who hate the idea of ‘gadgets’ [such as heart rate (HR) monitors] and want to combine a healthy and effective run with the pleasure of the countryside, or a chat with your neighbour, try to use the talk-test. Your workout should be intense enough to make you breathe deeply and to feel a little winded, but not unpleasant. If conversation is reasonably comfortable, you are working at a good moderate intensity. If you are able to sing, speed up! For vigorous intensity, you should feel the need to pause for a breath after a couple of words. The use of a HR monitor is the next step in optimizing your efforts. Running at between 80 and 90% of your maximal HR is known as your threshold, and is the highest effort level. Remember that the (220 minus age) formula is only a rough estimate of a parameter that follows a wide normal distribution, but is a reasonable starting estimate. To obtain a true guide to exercise intensity, submitting yourself to a cardiopulmonary exercise test and actually measuring your maximal HR, and specifically, defining your anaerobic threshold, is a reproducible objective way to tailor your training and is advised for those who find targets and numbers helpful, but this is no substitute for getting out there and getting going! Your body may protest Don’t forget to listen to your body. Remember to be objective when gazing in the mirror! If you are under- weight (BMI < 18) or overweight (BMI > 25), if you already suffer from a vulnerable Achilles tendon, a sore knee or a weak back, remember you are ‘not’ a sports doctor, and the last time you looked at a knee was at a Correspondence to Viviane M. Conraads, Department of Cardiology, Cardiac Rehabilitation Center, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Belgium Tel: + 32 38214672; fax: + 32 38213974; e-mail: Viviane.Conraads@uza.be Conflicts of interest: none. 1741-8267  c 2009 The European Society of Cardiology Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.