I was an exercise enthusiast. I've exercised, I'll bet, uh, pretty much every day of my life. It 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, uh, 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'm 56 and a lot of decades have gone by, I've started to have a few warning signs from my heart.
A couple of 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 of years. And with the help of some of the brightest cardiologists from around the country, we, um, have to come to some startling new insights that seem to be emerging about exercise. It's 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 say, I've been exercising for a long time but, uh, if we go back 2500 years, there was a guy named Phidipides who ran the 26 miles from a battlefield near, uh, Marathon, Greece into Athens to proclaim the news about a momentous victory over the Persians. And 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 Phidipides was an accomplished runner. He'd been a Greek herald messenger his whole life. He ran a lot of miles every day. I'll 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 what was the ultimate sort of test of running endurance was a marathon. There was a, uh, physician who became famous back in the mid 70s by boldly proclaiming that if you could complete a marathon, um, 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's 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 in to see me, and I said, john, let's do a cardio scanning on you. Let's have CT scan. Simple, little non evasive, quick, high tech scan of your heart. Your arteries, I'm sure, will be soft and supple and clean and healthy. So that's what a normal cardio scan should look like. No calcium whatsoever in these arteries. His is over here. His score was 1800. Anything above zero is abnormal. Anything above 400 is severe. At 1800, his arteries are harder than his bones. That can't be good. And he doesn't have any other risk factors to speak of. So, in fact, people do die doing marathons. But let's be realistic. Uh, if you look at the latest data, the risk is minuscule one in 100,000 participants. I've gotten to be friends with a guy named Ambie Burfoot. Ambie won the Boston Marathon in 1968. He is currently editor in chief and has been a longtime editor at large at Runners World magazine. In conversations we've had in recent months, he's challenged me, if endurance, extreme exercise is so bad, show me the bodies. He's m got a good point.
One in 100,000 is 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 in a race. I'm 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. So, that being said, let me be clear about this. There is no single step you can take in your life to ensure robust health and remarkable longevity than a, uh, habit of daily exercise, okay? And this is a study of over 400,000 Chinese that was just published within the last year.
We published an editorial along with this afterwards, but they found that vigorous exercise this is all cause mortality reduction. The more reduction, the better. And this is minutes of daily exercise. So 10, 20, 30 minutes of daily exercise up, uh, at 40, it starts plateauing. At 45 or 50, you get a point where, uh, it, uh, plateaus. So further efforts and time do not convey appear to convey further improvements in life expectancy. Down here is moderate exercise, light to moderate exercise. Walking housework day to day, moving around. Just get off your seat, move around. More is better there. It's not quite as beneficial as vigorous exercise, but more is better. You can exercise all day, it seems, without getting yourself in trouble if you keep it down. So, um, I guess one of the sort of my heroes, um, if you'd say, I love evolutionary medicine.
I think if you look in the world of nature into our deep past, you can find the template for ideal health even in our modern world. Charles Darwin was wrong about one thing, though. It's not the survival of the fittest. In fact, it's the survival of the moderately fit. Okay? If the best you can do is walk one flight of stairs before to rest, things are not looking good. It could be a bumpy ride in the next few years. Okay? On the other hand, if you can dance or lightly swim, or if you can even jog 6 miles an hour, that's a ten minute mile. Come on. That's a pretty comfortable pace, right? Your mortality plummets. And if you, after warming up on a treadmill, can achieve a speed of seven to seven and a half miles an hour, you're pretty much bulletproof.
When you look at, uh, outcomes. And in fact, further attainments of peak fitness do not translate into further increases in life expectancy, okay? It plateaus out. In fact, there's a little trend that maybe it might even go up a little bit. So, uh, important concept is the dose makes the poison. It's true with a lot of things, all right? And if we could come up with a pill that gave all the benefits that we got from exercise, I'd be looking for work. In fact, exercise not only cuts, uh, your chance of premature death in half, but it reduces risk for heart disease, alzheimer's, osteoporosis, depression. It is an amazing drug. But just like any drug, there is an ideal dose range. If you don't take enough of it, you don't get the benefit.
You take too much of it could be harmful, maybe even fatal. Right? When you're sitting here listening, sitting around, like most Americans spend most of their day sitting, doing nothing, your heart's pumping, just idling along about a gallon a minute, about four or five liters a minute. If we went out, went for a run right now, and you ran hard, that would go up four, five, six fold six, five, six gallons a minute. That's a workout. Your heart is working hard, but that's what it's meant to do at intermittent. Intermittently, maybe a few minutes, 510, maybe 30 minutes, maybe up to 60 minutes. But by 60 minutes, something starts happening. This stretch in the chamber starts overwhelming the muscle's ability to adapt.
The catecholamine levels, the adrenaline levels rise, the free radicals blossom, and it starts burning the heart. It starts searing and inflaming the inside of your coronary arteries. Okay, so we're not really meant for these sustained levels of exercise for hours at a time. If you go to a marathon, and this has been done several times, you take a, ah, troponin level. At the end of the marathon, over half of them will have elevated troponins. What's a troponin? Troponin is a sacred chemical to us. Cardiologists. When we see a troponin goes up, it means one thing heart muscle has died. Normally, we hop into action because that generally means there's a heart attack going on. We need to get a vessel open. In this case, these are little micro tears from this stretching and the searing. And it's not a big deal if you do it once.
These are little mining micro tears. They heal. A few days later, it's gone. The vessel, the heart's back down to normal size. But you do this over and over again, and the chambers start dialing up. They get scarred, they get stiff, they get thickened. Uh, uh, if you look closely, you can see these little white patches in these veteran extreme endurance athletes that accumulate in people who've been doing this for years and decades. Their heart becomes older before it's time. We're asking too much of it. We're overwhelming the heart's capacities. And this is a fascinating study done by a cardiologist that I know and his son, who's also a cardiologist.
These, who are both avid runners up in Minnesota, they did a study looking at the CT scans, like I showed you, of John's. They looked at a group of marathoners, uh, who've been doing this for at least 25 years, at least 25 marathons during that time, compared to sedentary controls. And you can see here, they had 62% more plaque. Despite fewer risk factors, people say that can't be true. In fact, a, uh, German cardiologist just replicated this study showing in 108 marathoners similar findings. Hard to dismiss.
Veteran endurance athletes also have about a fivefold increased risk of atrial fibrillation, a dangerous, irregular heart rhythm. There's sort of an, uh, epidemic of this going on among runners, because we've only been doing this for a few decades, and it takes a while for this to develop. And even more worrisome when we see this as cardiologists, our pupils dilate, our heart rate goes up. This is ventricular tachycardia. This is a potentially life threatening rhythm. And we can see this from the scarring in the ventricle in some endurance athletes. So, Born to Run is a book that was published, a nonfiction book, published, um, just in the last well, it was 2009. The hero of this story is a guy named Micah True. Um, he dropped out of American culture, went down to live with the Tara Hermara Indians in the northern part of Mexico, in the Copper Canyons. And he was an epic runner, legendary for his ability to run, uh, long distances, 100 miles, races.
The Indians down there nicknamed him Caballo Blanco, the White Horse, for his ability for his remarkable endurance. So Micah True died, sadly, 58 years of age on a routine twelve mile, uh, training, uh, run in the, um, wilderness of New Mexico in March of this year. When they did the autopsy, they found an enlarged, thickened heart with scar tissue. The coroner said Idiopathic cardiomyopathy. But I looked at that path report. It reads like a description of the pathology we might expect to see in some extreme endurance athletes. My colleague who wrote some of these papers with me, Peter McCullough, has coined the term fideppities cardiomyopathy.
That's what he had. So there's a couple papers coming out in the next two months, and we're publishing a couple papers as well that are going to change the thinking about exercise. This is one of them by Chip Lavie, one of my colleagues and maybe my best friend. Uh, uh, he's, uh, from down in Oshner Clinic in New Orleans. So this was a look at 50,000 runners. I mean, 50,000 people, 52,000 people followed for decades. On average, 15 years, but up to 30 years. And they compared the non runners about 14,000 to the runner to the runners are 14,000. The non runners were 38,000. And what they found was that runners lived longer, 19% longer. But if we look closer, you'll see that the runners compared the non runners here.
The risk of death, uh, the, uh, reference is one. If you ran more than 25 miles per week, your benefits went away. You only got this 25% to 27% reduction in mortality if you ran between, say, five and 20 miles a week, ideally ten to 15 miles a week. And when we looked at the running speed, sure enough, if you ran too fast over 8 miles an hour, which is a 730 pace, the benefits went away. Now, they weren't worse than the non runners, but heck, if you're running that much, you'd think you'd get some health benefits. No. You have to back off to a six or seven m mile an hour pace, which is about a ten minute mile an hour jog.
Okay. And interestingly, how many days a week? Seven days a week. If you're running, the benefits go away. You need to run fewer days, two to five, ideally. So another study will all be published, uh, soon, from this one from across the pond. Uh, the Copenhagen City Heart Study compared non runners to runners, and they found the same thing. The relationship appears much like alcohol. Mortality is lower in people reporting moderate jogging than in non joggers or those undertaking extreme exercise. The moderate joggers got a 44% reduction in mortality. They lived six years longer, but it went away. If you overdid it. Okay, so the truth is or the truth is that exercise does confer powerful benefits, and the belief is more is better. But we're learning that more is not better in this case. Okay. One of my good friends. Megan Newcomer is a Triathlete from New York City. She grew up next door. She's a dear family friend. She's one of the top triathletes in the country. She did ten races last year. She's 30. She won half of them. The other half, she collapsed in heat exhaustion, dangerous heat exhaustion. Near the end of the race.
I told Megan, Meg, if you want to be in the real Olympics, which you very well could be, you just keep hammering away, maybe up your game a bit. But if you want to be alive and well for the 2052 Olympics 40 years from now, you need to back it way off. Back your pace off and find some healthier exercise pattern. So there's one last study I want to tell you about. This was a study this last year that looked at mice and they hammered these mice. They ran them to exhaustion every day for four months. And you know what? This replicated those same findings we saw on Micah True and these other findings I've been telling you about. But what provides hope to me is that when they took these guys off their iron mouse training regimens, their hearts came back down to normal.
The fibrosis even melted away, and their ventricular irritability and the atrial fibrillation tendencies, all gone. Well, I'm a man, not a mouse. But here's hoping. Maybe that works in humans, too. Anyway, we're not meant to run. We're not born to run. I should say we're born to walk. Okay? We need to be walking more today. We need to be strolling. We need to be moving your body rather than sitting every chance you get. Move and do some high intensity interval training from time to time. But personally, I've found that what I do now is I've shortened my runs. Up I go when I run a half, uh, I run one and a half to, at the most, 3 miles, typically about 2 miles. And I, uh, take the pace down. I walk with my wife. I play with my kids.
I stop in meadows or parks and do some yoga. When I'm swimming, rather than churning away, I get on my back and I do some nice gentle backstrokes. And I watch the clouds sail overhead and see the birds soaring in the sky. And I can feel my heart relaxing and healing and getting better. Okay? So all things in moderation is not a new concept. Um, this was something that one of Odipity's contemporaries, the father of medicine, said 2500 years ago. The right amount of nourishment and exercise, not too much, not too little, is the safest way to health. Okay? So I've never presented in my 30 years as a cardiologist, such controversial data. But the truth is, this is a Ushaped curve, okay? And the couch potatoes are using this as an excuse to continue their sedentary behavior. And then there's the whole extreme exercisers.
People like me who don't want to hear this message. In fact, they kind of want to kill the messenger. I've, uh, been getting a lot of sort of adverse comments about this research. But you know, what I've decided is that you need to snuggle in to the safety of the middle of the U curve when it comes to exercise or when it comes to anything else in life. And to me, I've decided that running too fast and too hard is only going to speed my progress towards the, uh, finish line in my life. So I'd set to back it off and hopefully enjoy more sunrises and sunsets. Thank you.
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