Body Build, Running, and Mortality

To the Editor.—  The term "nutritional arrhythmia" was coined by Thomas J. Bassler, MD (1980;244:1437), to describe three cardiac deaths among lean marathon runners.However, other than three anecdotes, there is no evidence for the existence of the entity that Bassler has named. Two of the three runners described had known heart disease; one had been, in the past, disabled by angina at rest. Bassler does not provide data on body size so the reader can determine whether, in fact, these runners were thinner than the average marathon runner. Even if these runners were slender, there is no evidence that the cardiac death rate of lean marathon runners is greater than the cardiac death rate of moderate-sized marathon runners. Finally, there were no data on food ingestion to determine whether there truly was a nutritional deficiency.Rather than coining a new term and frightening patients, why not state the obvious.