American author and cardiologist James O’Keefe on Run for your life! At a comfortable pace, and not too far at TEDxUMKC – Transcript
James O’Keefe – American author and cardiologist
Great to be here. I’m a cardiologist, but before that, I was an exercise enthusiast. I’ve exercised, I bet, pretty much everyday of my life.
I had two grandfathers who were alcoholics. But for me, my way of coping with life is exercise. When I’m nervous, or anxious, or tired or, happy, or sad, or whatever, I exercise, if I have the time, and sometimes even when I don’t. You might have seen me in an airport, waiting for a flight, running up the down escalator with my backpack on, to kill 20 minutes.
But I always thought that exercise was the best thing for my heart, and I think it’s how I decided, at age 15, I wanted to be a cardiologist actually. But now that I am 56 [years old], and a lot of decades have gone by, I’ve started to have a few warning signs from my heart. A couple years ago I noticed this, and I got on a mission. I’m a research cardiologist, and I have a research fellow. And he and I have been working on this for the past couple years. And with the help of some of the brightest cardiologists from around the country, we had come to some startling new insights that seem to emerging about exercise.
This made me think twice about my lifestyle, and I’m worried I may have made a lethal mistake. I hope it’s not too late, but let me tell you the story.
So, as I said, I have been exercising for a long time. But if we go back 2,500 years, there was a guy named Pheidippides who ran the 26 miles from a battlefield near Marathon, Greece, into Athens to proclaim the news about a momentous victory over the Persians. When he arrived at the Emperor’s throne and said, “Victory is ours,” he abruptly collapsed and died.
Now, you may have heard that story before, but what you probably didn’t know is that Pheidippides was an accomplished runner. He’d been a Greek herald messenger his whole life. He ran a lot of miles everyday. I bet he was the fittest guy in Athens the day he died. That’s strange.
But now let’s go forward two millennia or more. When the Baby Boomers came of age, another boom happened: the running boom. If exercise was good for you as anybody could know, then more had to be better, and that was — the ultimate sort of test of running and endurance was a marathon. There was a physician who became famous back in the mid-70s by boldly proclaiming that if you could complete a marathon, you were immune to heart attack. This urban myth actually still holds sway with a lot of physicians.
One of my patients and friends is John. He is 68 now, but he’s been running for 45 years. As he puts it, if he hasn’t run 12 miles in a day, he felt like he was wimping out. When I saw him, he came into see me, and I said, John, let’s do a cardiac scan, a CT scan, simple, little, non-invasive, quick, high tech scan of your heart. Your arteries, I’m sure, will be soft and supple, clean and healthy. So that’s what a normal cardiac scan should look like: no calcium whatsoever in these arteries. His is over here; his score was 1,800. Anything above zero is abnormal, anything over 400 is severe; at 1,800, his arteries are harder than his bones! That can’t be good, and he didn’t have any other risk factors to speak of.
So in fact, people do die during marathons, but let’s be realistic. If you look at the latest data, the risk is minuscule: 1 in 100,000 participants. I’ve gotten to be friends with a guy named Amby Burfoot. Amby won the Boston Marathon in 1968. He is currently editor-in-chief and has been a long time editor at Large at Runner’s World Magazine.
In conversations we’ve had in recent months, he has challenged me. “If endurance extreme exercises are so bad, show me the bodies.” He’s got a good point; 1 in 100,000 is a pretty low risk. But I’m not so worried about that; running is supposed to add years to your life, and even life to your years. So, could it be shortening your life expectancy? I’m not worried about dropping into a risk, I am just trying to do the right thing, I’m a cardiologist, I’m in the business of finding out the ideal diet and lifestyle. And I’m coming to the conclusion that running marathons and extreme endurance athletics do not fit into that recipe.