A week ago, the Internet lit up with a headline that rocked runners. There were many variations, but it went something like this: Study suggests too much running causes shorter lifespan. The headline was wrong.
Anyone following the “how much is too much” debate might’ve thought the stories were reposted from 2012, when cardiologist James O’Keefe published an article in Mayo Clinic Proceedings claiming that long-term excessive endurance exercise—marathons, ultramarathons, Ironmans—may remodel the heart in a harmful way.
O’Keefe’s revelation garnered a lot of press, but it was a hypothesis with little science behind it. In fact, O’Keefe’s line of thought resembled something like a DirecTV commercial: When your cable company keeps you on hold, you get angry. When you’re angry, you go blow off steam. And so on and so forth until you end up in a roadside ditch.
The heart, O’Keefe explained to TIME, pumps about five quarts of blood per minute at rest. Running, it can pump 35 or 40 quarts per minute. Running for miles on end can overtax the heart. Overtaxing the heart can cause heart fibers to tear. Torn fibers will lead to scar tissue, which can lead to abnormal heart rhythms and a premature death.
It sounds logical, but O’Keefe’s reasoning and his conclusion that that running more than 20 miles per week could actually be bad for you were largely discounted by his contemporaries barring more solid scientific proof. One researcher I interviewed for Outsideeven called O’Keefe’s allegations “warmongering.”
Last week’s headlines referred to ongoing research called the "Masters Running Study" that hopes to one day draw its own conclusions about running and mortality. But it hasn’t yet. That’s why the headlines are wrong.
Other studies, including O’Keefe’s research and the oft-cited "Copenhagen Heart Study," which included a 27-year jogging sub-study that analyzed data from 1,878 runners between 1976 and 2003, promoted the idea of a U-shaped curve relating time spent exercising and mortality.
The "Masters Running Study," an online survey (you can take it here) spearheaded by co-director of the Cardiovascular Research Institute at Allentown’s Lehigh Valley Health Network, Dr. Martin Matsumura, sought to explain why that U-shaped curve may exist—why people who run more than 20 miles per week could, according to O’Keefe and the Copenhagen study, shorten their lifespans.
Matsumura and his colleagues looked into whether or not NSAID use, medication, and cardiac risk factors such as hypertension, smoking, and diabetes played a role in creating that curve.
The results so far: a shorter lifespan in people who run more than 20 miles per week could not be explained by an increase in cardiac risk factors such as smoking, diabetes, hypertension, or a family history of coronary artery disease, because there wasn’t one; both sub-20 mile-per-week runners and higher volume runners had similar backgrounds. Nor could it be explained by an increase in NSAID use, because runners who ran less than 20 miles per week actually used them the most, or the use of other drugs like aspirin.
These results were recently presented at the at the American College of Cardiology's annual meeting in Washington, D.C., sparking the flurry of headlines cursing avid runners to an early death. Because none of the factors mentioned above could explain the curve, “that caused the media to interpret that sure enough, it must be running” that’s the culprit, Matsumura says. “But I still don’t think we know.”
Matsumura believes O’Keefe and the Copenhagen study draw conclusions about running and health that may not apply to today’s runners, as they began recruiting runners in the ‘70s.
“When you think back to runners in the ‘70s, I think training, diet, and education were different. The medical community didn’t really know how to approach runners,” Matsumura says. “Today’s runners are a very self-educated and proactive group. They know about nutrition and training. I think the contemporary runner is definitely a different beast than those 20, 30 years ago.”
Matsumura and his colleagues hope more people will participate in the "Masters Running Study" and that, in another decade or so, he and his colleagues be able to draw more scientific conclusions about that curve and the effect of running on the modern runner’s mortality.
(It must be noted that it’s entirely possible that today’s “modern runner” will look like a Converse-wearing ‘70s runner to the runners of the future, and so this running-mortality, exercise-threshold, who-does-it-apply-to debate could beat on for all eternity.)
“We now have well over 5,000 runners recruited for this study,” Matsumura says. “We’ll be following them so we’ll know if they drop dead from running.”
It all started in August, when I was 12 miles into a 15-mile run on a rural Missouri highway. Shin splints and achy feet were realities I’d learned to live with. But with one decisive landing, my left foot cracked inside that lug-outfitted, cotton candy–pink Newton shell.
Fast-forward six months to a healed metatarsal stress fracture, a two-week trek through Europe, and a lot of reduced mileage—and you’d find me raring to go on some lovely spring runs. But I was pain-riddled. It was my tibia this time. Let’s put this lightly: I did not handle it well.
No runner ever does. Especially not Desiree Davila Linden, the hardworking, nose-to-the-grindstone woman who went from running the race of her life at the 2011 Boston Marathon to suffering a stress fracture in her femoral shaft (yes, a stress fracture in the body’s strongest bone).“The injury was super-upsetting,” she says. “But you have to realize that it’s real, that you have to give up your race, and that you’ll get better.”
It’s a rebuilding process, explains Linden, and injuries are just a natural part of the sport. They’re going to happen, and they can be opportunities—if we take them—to learn about ourselves.
So it makes sense that my first reaction to the injury was denial. (Just keep running, and it’ll take care of itself, right?) The human body has to be that impressive—I mean, if a salamander can regrow its tail, I can whip up some bone mass, no problem. So I continued my routine of six miles here, nine miles there, and a few 13-milers tossed in for good measure. Every morning, getting out of bed got harder and harder.
My second reaction? Acceptance—and a new plan. My leg hurts, and it will keep hurting. It has a crack in it that’s slowly turning into a ravine. Not the best way to heal, clearly.
If an Olympian is telling me that some extra time spent in the pool, on the elliptical, or anywhere that isn’t the roads I run on is a good thing, then, by golly, I should listen. So I did.
“There’s this cool thing you can tap into while being injured—this mindset of ‘I’m tougher than I thought, and I know how to hurt a lot,’” laughs Linden. “It says a lot about you as a person if you break your bones from running.”
I’m on a new plan—less running and more of everything else—and I’m OK with that. It’s fun to take on the challenge of working out without tying on my trainers for a run. And I am sore, which I didn’t know was even possible at this point in my fitness “career.”
I may not be on the path I want to be on right now, but this one is offering some pretty nice alternative routes. Maybe being injured isn’t such a bad thing after all.
American marathoner Meb Keflezighi doesn't wind up on the podium—including the top spot at the 2009 NYC Marathon—from sheer luck. It requires months of hard training, perfect pre-race preparation, and some smart strategy once the race starts. That combination has helped him claim third place at Boston in 2006. He'll be back in the hunt this year. We caught up with the 38-year-old to learn how he watches, waits, and makes his move to victory.
I definitely like to be in the front, hopefully not in the lead. It’s a narrow start. You don’t want to get stuck in the middle. This year, the start is going to be very emotional.
If the Early Pace Is Slow:
You have to wait. Somebody will go. Kenyans usually hammer early, so you have to know their background. A couple days before the race, I’ll study names and numbers. If three or four take off, I have no choice but to go with them—just make sure those guys are legit. One might falter, two might survive. Or vice versa, but that one guy has it won already. Ethiopians will never take the lead. Never. They’re going to wait till the last 5K, the last mile, even the last 500 meters.
Once the Pack Shrinks:
You’re trying to beat their psyche. You have 25 miles to solve it.
If Ryan Hall Starts Singing Like He Did in the 2011 Chicago Marathon:
I always believe as elite athletes, we should make it very comfortable through 18 or 20 miles at whatever pace it is. But if he’s singing at mile 23 or 24, then he has the energy to do whatever he wants.
Where to Make a Move:
The course can’t tell you. No way. It depends who’s in the mix and what their strengths and weaknesses are. That’s where the intelligence of competition comes.
Read the Competition:
You have to test them uphill, downhill. Study their mechanics. If they’re leaning back going downhill, you know they’re fried. Uphill, if they put their head down, okay, he’s trying to do everything he can just to pump.
If they’re right behind you, they’re trying to draft off you. Somebody trying to draft will clip your feet. It happens all the time. That’s a sign of fatigue. They cannot concentrate enough to stay away.
If they are not next to you, they’re struggling. When they’re struggling, take advantage of it—whether it’s 10 miles to go, five miles to go, or three miles to go. You just have to make a calculated decision.
Once you get to those Newton hills or Heartbreak Hill, take advantage of your strength. If they let you go, you gain confidence, spread the gap, and you’re going to be home free.
In a marathon, if you have [created] 20 feet or 20 meters [of space]—it’s hard to make up with two miles to go. In a 5K or 10K, you can probably pick it up, but in a marathon, your mind says Go, your body says No, thank you.
If I’m in the lead and people cross the road right behind me, I know I have a good gap—because otherwise they would be courteous to let the runner go first. If you hear less people cheering after you went by, you know you have a gap. If you hear someone saying their name and ‘Come on!’ it’s very close.
I’d rather do anything and everything to get away from everyone with a mile to go versus making it down to the last 400 to 500 meters.
Nobody likes to lose, nobody likes to get passed. In 2010, I spent every ounce of energy I had with a ruptured quad and I finished, but Ryan [Hall] passed me. He played it smart. But misfortunes do happen. Unless it threatens my life—if I fall and I’m bleeding, then I have to think twice. But if I can manage to go at a decent pace, I’m gonna go. Even if you’re hurting, it’s hard to stop in Boston.
I’ve fallen victim to those one-step-ahead runners who feel the need to demonstrate their superiority. I’ve been the pace-breaking partner who promises an eight-minute recovery pace and somehow tricks you into shaving minutes off each mile. I’ve shown up late, been ditched, chattered nonstop when peace and quiet were desired, cringed for talkative miles when all I wanted was peace and quiet, coerced a longer route into the works on a short route day, and turned long runs into single-digit endeavors.
To sum my confession up, I’ve sometimes been a horrible running buddy. And I need help. Which is where Jerry Macari, founder and coach of New York City’s RunUrban training programs, comes in. He’s here to make me—and you—into a much better runner partner.
When you schedule a workout, show up. Accountability is a virtue. So show up, no matter the weather or daily crisis. Despite life’s disasters, when you lace up your shoes, your outlook will change. “Running with a partner is what gets you out the door—you look forward to seeing them,” says Macari.
Allow for spoken—and unspoken—bonds. When your workout partner needs to talk about the misadventures of their day, listen. Colorado fitness blogger Kelly Stevenson puts it perfectly: “Know when to shut up and let them talk it out.” More often than not, partner runs become much more than just that: they become an important opportunity for conversation, venting, and pseudotherapy.
When you agree to a distance and a pace, stick to them. Spontaneity may be the spice of life, but it doesn’t make for a particularly sweet run. When you’re planning on a six-miler at 8:30 pace, run a six-miler at 8:30 pace. Not only does that ensure your own racing progress, but it also prevents those last-minute decisions that can undermine any training plan.
Be a motivator—and a fan. When that last mile repeat seems insurmountable, encourage. One of the biggest benefits of have a partner is having a motivator. “It works because, when one runner isn’t feeling so great, the other one is; when one runner is having a hard time going, the other one can keep pushing,” Macari explains.
If rowing across the Pacific Ocean with your significant other doesn’t sound tough enough, how about doing it without any energy gels, granola bars, or sports drinks?
Fueling a massive endurance effort with almost no sugar or carbs isn’t the most traditional route for athletes, but Sami Inkinen and Meredith Loring want to prove that it can work. This June, the married duo plans to go from San Francisco to Honolulu as part of the inaugural Great Pacific Rowing Race—and to see that through on a diet of fat and protein. (Inkinen and Loring believe sugar and processed carbohydrates only hinder athletes.)
This unconventional approach is reminiscent of the increasingly popular paleo and low-carb diets, which have been embraced by CrossFit addicts, dieters, and triathletes alike. Whether the low-carb craze is the best approach for active individuals (let alone endurance athletes) remains controversial. Some nutritionists have embraced the high-protein, high-fat approach, asserting that it reduces inflammation, stabilizes blood sugar, and eliminates the need to eat regularly during distance exercise. But other scientists say our bodies need carbohydrates during exercise to avoid muscle depletion, to keep metabolism functioning properly, and to achieve optimal performance.
“Carbs are like super-high octane fuel for athletes,” says Matt Fitzgerald, author of Racing Weight, as well as the upcoming book Diet Cults. “The best endurance athletes in the world—runners in East Africa—eat a very high carbohydrate diet.”
The dissenting opinions carry over to Inkinen and Loring’s planned ocean crossing. Stephen Phinney, the pair’s nutritional advisor and a physician-scientist who wrote The New Atkins for a New You, has become an advocate for the low-carb approach for endurance athletes, explaining that the diet reduces inflammation and muscle soreness. Phinney believes Inkinen and Loring will have no trouble fueling their long-distance row with a diet that contains just 10 percent carbohydrates—and that they’ll be able to avoid energy swings and experience faster recovery rates.
“If Sami and Meredith were racing in a five-kilometer event, a well-formulated ketogenic diet might not be the best strategy,” Phinney says, referring to a high-fat, low-carb diet. “But they’re going to be rowing 12 to 14 hours a day, for 45 to 60 days, at relatively low intensity.”
Other sports scientists, however, state they’d never recommend a low-carb approach during an endurance competition, even if the athletes are exerting at a steady rate. Michael Joyner, a physiologist at the Mayo Clinic, says most top distance athletes consume carbs when they’re racing because that’s what improves performance. Carbohydrates boost the central nervous system, keep metabolic pathways working, and provide energy, Joyner explains. Fitzgerald also advocates carb consumption for athletic competition, adding that such food offers a superior energy source during exercise stress.
Despite the controversy over the low-carb approach for exercise, Inkinen and Loring are certain the fat-and-protein diet they’re signing on for is the one that will best serve them for the 2,400-mile ocean crossing. They plan to race 14 other boats, singles, pairs, and fours among them. Along with safely completing the crossing, the couple hopes to set a record for the fastest Pacific Ocean crossing for a pair.
The ocean menu will include nuts, coconut butter, salmon, dehydrated vegetables, lard, macadamia nuts, and, as a treat, unsweetened dark chocolate. They won’t consume any caffeine because they believe it will hinder sleep during the two-hour breaks. Per day, Inkinen will consume about 9,000 calories, and Loring will total about 5,000—so they’ll carry about a million calories’ worth of food in the boat.
“We see this adventure as a way to prove that you not don’t need sugar in real life, but you also don’t need it in exercise,” Loring says.
Loring first adopted a low-carb, low-sugar diet in 2004, with Inkinen following suit a year and a half ago. Inkinen believes the dietary change made him less prone to illness and improved his performance in distance triathlons. Both say they don’t need frequent snacks during exercise because they’ve trained their bodies to run on fat stores—and that, as a result, they feel better while racing.
“We don’t have sugar crashes, so we don’t have to eat as often,” says Inkinen. “We no longer have to rely on gels every 30 minutes.”