Biostrap x Iron Cowboy

The Conquer 100

On March 1, 2020, James “Iron Cowboy” Lawrence set out to complete what many would consider impossible, completing 100 consecutive long-distance triathlons in his hometown of Lindon, Utah- a feat which he termed the Conquer 100. While James is no stranger to endurance World Records, the Conquer 100 would ultimately double his previous record of 50 consecutive triathlons (the 50.50.50) and challenge his mind and body like no human ever has before.

While habitual physical activity has been shown to reduce the risk of cardiovascular disease, emerging research has shown that prolonged extremely high-volume endurance training may lead to cardiovascular maladaptation including enhanced coronary arterial calcification, arrhythmias, and myocardial fibrosis, a phenomenon typically observed in the late stages of cardiovascular disease and a predictive factor for sudden cardiac death 1. Several studies have identified factors associated with this prevalence in athletes, including the years of training 2 , the number of completed competitive marathonsor ultra-marathons of greater than 50 miles 3.

These cardiovascular changes along with the wear and tear associated with a high dose of mechanical stress, muscle catabolism, and oxidative damage during the Conquer 100 can lead to an acute effect on cardiovascular biometrics. Based on the wealth of clinically validated biometrics, Biostrap was selected as the Health Monitoring Partner for the Conquer 100 Project and assembled a world-class team of medical professionals from across the globe to review James’ data trends each and every day.

Why Biostrap?

Biostrap’s ability to remotely monitor my health from anywhere is a huge piece of the puzzle in giving us a chance at accomplishing what we believe may be endurance sports history.
- James Lawrence

Interesting Findings

• Despite the previous 50.50.50 challenge, the baseline clinical studies revealed superior cardiovascular function and no signs of significant cardiovascular maladaptation, clearing James for the Conquer 100 project.
• James’ nocturnal heart rate (HR) increased from 51.2 bpm at baseline to 69 bpm following Day 1 and an all-time high of 74.7 bpm in Week 4. Although some week-to-week improvements were recognized, his nocturnal HR would not return to baseline throughout the entire Conquer 100.
• Despite a significant decrease in sleep duration with an average of 4.9 hours throughout the Conquer 100, James’ body fought for restorative sleep and increased the relative percentage of deep sleep from 17.4% at baseline to 20.1% in Week 14.
• After Week 4, it took James less than 1 minute on average to fall asleep each evening, a clear sign of physical and mental exhaustion.
• James nocturnal HRV was 27% higher upon completion of the Conquer 100 than his baseline average of 51.9 milliseconds.
• On Day 101, James “Iron Cowboy” Lawrence decided to complete yet another long-distance triathlon bringing the total to 101 consecutive days of conquering a 2.4-mile swim, 112-mile bike ride and a 26.2-mile run.
• Upon repeat measurement of the Cardiopulmonary Exercise Test (CPET), James set a facility max wattage record on the cycle stress test.

Nocturnal Cardiovascular Trends

Heart Rate

To increase blood circulation in response to stressors, the heart rate increases, resulting in a higher cardiac output to meet the demands of physiological stress. Therefore, heart rate can be a valuable metric in understanding the cumulative psychological and physiological stress that is placed on the body.

James’ nocturnal heart rate (HR) increased from 51.2 bpm at baseline to 69 bpm following Day 1 and an all-time high of 74.7 bpm in Week 4. Although some week-to-week improvements were recognized, his nocturnal HR would not return to baseline throughout the entire Conquer 100. James’ average nocturnal heart rate was 67.6 bpm over the entire Conquer 100, a 32% increase from baseline.

Respiratory Rate

Regular exercise can increase the strength and function of the respiratory muscles, strengthen the heart, and improve circulation- ultimately improving the efficiency of the cardiorespiratory system, increased vagal tone, and leading to a decrease in resting heart rate and respiratory rate.

During the 8-week baseline phase, the Iron Cowboy’s nocturnal respiratory rate averaged 14.2 breaths per minute (brpm) but increased to 20.8 brpm following his first long-distance triathlon. Despite the accumulated stress and fatigue, James’ Biostrap revealed amazing trends related to his body’s ability to not only cope, but continuously adapt during the Conquer 100.

Reaching a peak nocturnal James’ showed respiratory rate average of 16.5 breaths per minute in Week 1, a marked decrease each and every week thereafter- reaching a personal best average of 12.1 brpm in his final recorded sleep session prior to Day 100.

Heart Rate Variability

Research has shown that well-trained athletes tend to maintain higher heart rate variability (HRV) values, with the highest being in endurance athletes4. However, additional studies have associated overtraining syndrome (OT) and increased susceptibility to training-related injuries with changes in autonomic function marked by a decrease in HRV5-6.

James’ baseline HRV was 51.9 ms. As expected, a significant downward trend was found over the first seven weeks of the Conquer 100 project, as James reached a personal low of 22.4 ms on Day 48.

Interestingly and unexpectedly, following the completion of Day 51, James’ HRV continued on an upwards trend through completion of the project with a Week 14 average of 69.1 ms - a 27% increase from his baseline HRV average.

Arterial Compliance

Arterial compliance has emerged as an independent risk factor of cardiovascular disease and is associated with the prevalence of hypertension, left ventricular hypertrophy and certain age-related conditions7-8. Unsurprisingly, researchers have found that competitive endurance athletes have demonstrated greater arterial elasticity than their non-exercise-trained or sedentary, age-matched peers9, which may explain the population’s greater cardiovascular functional capacity and lower risk of cardiovascular disease10. Because arterial compliance trends have never been thoroughly studied during this type of endurance event, this biometric was of particular interest to the Health Monitoring team and researchers.

Reported on a scale of 0-100, with high values indicating improved arterial compliance values, James’ average baseline arterial elasticity was 79.5. A significant upwards trend was recognized with a peak value of 99.4 recognized in Week 4 and completing Week 14 with an average value of 96.8.

Sleep Trends

Sleep Duration

Sleep may seem like a time to finally let the brain and body “shut off” following a long-distance triathlon, but research has shown that the brain is working even harder during sleep to restore and repair cells, process information for long-term memory, and perform important processes related to health and performance. Therefore, adequate sleep duration is among the most important yet overlooked components in athletic training. Leading up to the Conquer 100, the Iron Cowboy and his team anticipated a negative impact on James’ sleep quality.

During the 8-week baseline phase, James averaged just over 7.5 hours of time asleep per evening. Due to weather and other conditions out of his control leading to extended split durations, James was forced to rapidly sacrifice sleep time.

By Week 3, James was averaging just over 4 hours of sleep per evening and ultimately achieved less than 5 hours per evening throughout the entire Conquer 100 challenge. Nonetheless, he continued to wake up each day and complete a long-distance triathlon.

Deep Sleep

Slow-wave or deep sleep is a critical aspect of sleep quality and recovery because of its relationship with human growth hormone which is necessary for muscular recovery, growth, and repair11. However, research in athletic populations has shown that various aspects of physiological stress often lead to disrupted sleep12-14, including decreases in deep sleep duration which has been shown to increase the likelihood of training-related injuries by up to 1.7 times15.

Despite a significant decrease in sleep duration with an average of 4.9 hours throughout the Conquer 100, James’ body fought for restorative sleep and increased the relative percentage of deep sleep from 17.4% at baseline to 20.1% in Week 13. Still, his average deep sleep duration of 36.2 minutes throughout the Conquer 100 represented a 54% decrease from baseline and well below the ideal range of 120-150 minutes per evening.

Sleep Latency

Falling asleep too fast can be an indication of sleep deprivation and related reductions in cognition, motor performance, reaction times and emotional stability16. While it is normal for it to take about 15-20 minutes to transition from awake to sleep, James’ average sleep latency (time to fall asleep) was less than one minute after Week 4, a significant decrease from his baseline average of 22 minutes, a clear indication of physical and mental exhaustion.

Sleep Quality

Sleep is complex and requires comprehensive analysis of inputs including sleep duration, efficiency, stages, latency, awakenings, movements, and biometric trends. For simple understanding, Biostrap provides a 0-100 Sleep Score, with higher values indicating better overall sleep quality.

This comprehensive algorithm includes analysis of both absolute and relative thresholds in its calculation. During the 8-week baseline phase, James had an average Biostrap Sleep Score of 60.4. A significant decrease was recognized through Week 7 when his Sleep Score reached its lowest week average of 2.5, primarily attributable to decreased sleep duration and deep sleep, as well as elevated heart rate as contributing factors. James’ average Sleep Score throughout the entire Conquer 100 was 12.9.

Summary

On Tuesday, June 8, 2021, James “Iron Cowboy” Lawrence made history as he completed his 100th consecutive full-distance triathlon and still decided to wake up on Day 101 and do one more “victory lap”. In total, James conquered greater than 242 miles of swimming, 11,312 miles of cycling, and 2,646 miles of running for a grand total of 14,200 miles in 101 consecutive days, redefining the impossible and defying all logic of human potential and performance.

Despite the mental challenges, pain, injuries, poor sleep quality, and weather conditions, James smashed his previous record and raised the bar for competitive endurance athletics across the world, while raising money to support Operation Underground Railroad (OUR) in their mission to end child sex trafficking and exploitation.

The Physiological Effects of 100 Consecutive Long-Distance Triathlons on the Heart: The Iron Cowboy Case Study

In addition to the wealth of clinical-grade data provided by the Biostrap wrist-worn device, the Iron Cowboy has performed a series of blood labs and additional clinical tests at the UCLA hospital, which were also repeated immediately following the Conquer 100. These clinical tests include Echocardiography, Cardiac MRI, CT Angiogram, and Cardiopulmonary Exercise Test (CPET). These results, which are still being analyzed, will be summarized in an impactful case study with the primary objective of developing a better understanding of the relationship between exercise dose, physiological response, and health outcomes.

Stay tuned for more updates on this clinical study.

Health Monitoring Team

• Kevin Longoria - Chief Science Officer
  Biostrap
• Dr. Willem Gielen - Cardiologist & Chief Medical Officer
  Biostrap
• Dr. Ali Nsair - Medical Director
  MCS & Heart Transplantation, Interventional and Structural Cardiology, UCLA Sports Cardiology
• Dr. Thijs Eijsvogels - Exercise Physiologist
  Associate Professor, Radboud University Medical Center

About Biostrap

Biostrap is a science-driven platform developed to improve and optimize human health. Facilitating data collection through a proprietary and clinically reliable wrist-worn device, Biostrap utilizes machine learning to provide actionable data to improve sleep, recovery and performance. Biostrap analyzes each heartbeat for 29 unique parameters on its secure servers to ensure data reliability. Additionally, Biostrap is referenced in 14 publications and has 22 clinical studies validating its biometric measurements against gold standard medical diagnostics and use cases in specific medical conditions. Providing an individualized approach to consumers via an app and web dashboard, Biostrap also delivers customizable remote monitoring solutions for medical, clinical and fitness professionals. With its Biostrap Labs research division, Biostrap offers the opportunity for wellness companies to validate the efficacy of their products and services in a real-world setting. For more information on Biostrap's latest products and to stay up to date on company news, visit www.Biostrap.com and follow the brand on social media via LinkedIn, Instagram, Facebook and Twitter. The Biostrap app is available for download for iOS on the Apple App Store and for Android on the Google Play Store