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Run for Your Life…at a Comfortable Pace and Not too Far

marathon runners on a city street
Amby Burfoot, winner of the Boston Marathon in 1968 and editor-at-large for Run­ner’s World, in a recent in­terview for that magazine asked me, “So even if there are possible risks associated with marathons and other excessive endurance exercise; lots of bad things might happen to us when we get out of bed in the morning. Is this any different?”

I wrote back to Amby: Firstly, the host of bad things that can hap­pen when one gets out of bed in the morning are nothing compared to the dreadful things that tend to hap­pen to the person who stays in bed. My friend and colleague Dr. Mike Main tells his hospitalized patients, “Nearly everyone who dies in the hospital, dies while lying in bed. Don’t let this happen to you. Be ac­tive, to the extent that you are able.” The typical American sits at a desk or behind a wheel for the vast majority of his or her workday and then goes home and watches, on average, four to five hours of TV daily! Sitting and lying around are very dangerous activities.

Of all the risk factors for premature death, perhaps the most malignant is low cardio-respiratory fitness—being “out of shape.” Con­versely, a daily exercise habit is the single most powerful therapy for im­proving both the quality and quan­tity of your life (that is something that adds years to your life and life to your years). Getting just 30 minutes daily of moderate or vigorous physi­cal activity per day can cut your risk almost in about half for premature death, diabetes, Alzheimer’s disease, depression, and heart attack. People who regularly engage in physical exercise have markedly lower rates of disability, and an average life expectancy that is about seven years longer than sedentary people.

Dr. Chip Lavie, my close friend and research collaborator, and I ran together in Minnesota in rain, sleet or snow while we were training to be cardiologists at the Mayo Clinic 25 years ago. Both of us have been passionately interested in exercise, personally and profes­sionally, ever since. I continue to do a wide variety of physical activities for about an hour daily; this includes running not more than two to three miles with my two canine running partners three or four times weekly. I also swim, bike, lift weights, do yoga, skate, snowboard, hike, etc.

Research shows that the potential health benefits are not the main motivation for most regular exercisers and fitness buffs; rather, it is the mental benefits and improve­ment in their perceived quality of life. For me, vigorous exercise be­stows a state of focused relaxation, stress reduction, joy and gratitude for life - which wears off in about a day; which is why I work out at least once every 24 hours.

The last thing we want to do is give the average American another lame excuse to continue his or her favorite exercise - couch surfing while watching television. Our paper on the potential dangers of exces­sive endurance exercise is meant to shed light on a largely underappreci­ated risk of extreme exercise such as marathons, and ultra-marathons. Over years to decades, this type of prolonged strenuous running can take a toll on cardiovascular health, in essence causing premature aging, scarring, stiffening, thickening of the heart and blood vessels.

The benefits of exercise are analogous to a powerful drug; indeed, if we had a pill that does everything that exercise does, most cardiologists would go out of busi­ness. Still, like any potent drug, an ideal dose exists: enough to get the full benefit but not so much as to cause dangerous side effects. The lat­est data from our studies and others strongly suggests that the ideal dose of daily vigorous exercise is about 30 to 60 minutes. Heck, you can get the majority of improvements in cardio­vascular risk and longevity with a mere 20 to 30 minutes of walking per day. Indeed, if you do more than 60 minutes of strenuous exercise daily, you start to lose some of the health benefits seen with lesser amounts of physical activity. So ask yourself; why am I running marathons? If you are doing it for your health, you can do better by not overdoing it. I tell people who ask me about the advisability of running a marathon, “If you really want to do a marathon, go ahead and train up for it and do one…then cross it off your bucket list and get into exercise patterns that are more ideal for promoting overall health and longevity.”

If you listen closely to your body, you may feel some ill effects (such as palpitations, irregular heart­beats, chronic fatigue, and slower recovery) after overdoing exercise, especially as you get into middle age. Honestly, our own personal in­sights regarding this issue were part of the impetus that stimulated Chip and me to investigate the poten­tial downsides of chronic excessive strenuous exercise. Neither of us is any less enthusiastic about our love of daily exercise - we are just trying to be smart about doing everything we can to cross the finish line of life with a strong heart. . .at age 100. 

In Good Health

James O'Keefe, MD


Photo Credit:  Pixabay Creative Commons