Running Finally Proves Its Worth

“If you are not yet a runner, [this book] will show you how to become healthier and happier than you have ever imagined you could be. It will do so no matter how out of shape or fat or old or ungraceful you are, and no matter how many times you have tried other exercise regimens and failed.”

So begins “The Complete Book of Running,” the 314-page bestseller by Jim Fixx that first appeared 25 years ago, kicking off a mass movement of legs and arms that would later be described as a fitness revolution.

Tens of millions of Americans began running in the late 1970s, and they soon felt lean and strong and more physically confident than they could remember, just as the book promised. And though Fixx never claimed that jogging was guaranteed to lengthen their lives, he implied as much, writing that--with running--”the heart becomes a distinctly more efficient instrument, capable of doing more while working less hard.”

His very tone appalled many doctors. Whatever the benefits of jogging, they argued, the repetitive pounding alone could damage the spine, the uterus, the stomach; would, over time, ruin hips, ankles and knees prematurely; and surely would cut short the lives of those with weak hearts who pushed themselves too hard.

As if to confirm their fears, on July 20, 1984, Fixx himself collapsed and died of heart failure--while jogging. He was 52 and seemingly in the best shape of his life.

“Those who were naysayers at the time said, ‘Look, Jim Fixx did all that running, and it sure didn’t do him any good,’” says Dr. William Haskell, a professor of medicine at Stanford University School of Medicine who studies the effect of exercise on health. “How good could it be?”

A quarter of a century after it all began, doctors now have some good answers to that question--because millions of the men and women who started running as young or middle-aged adults have never stopped. These people have been running regularly for their entire adult lives, and researchers have been watching to see what has happened to their bodies and minds.

Several clear health benefits have emerged, Haskell says: Compared with sedentary people, habitual runners have an increased life expectancy of two to seven years; a 30% to 40% lower risk of developing heart disease; and only half the risk of developing Type 2 diabetes, he said. In some high-risk groups, a running regimen can cut heart disease risk by more than half, as well.

Researchers cannot pinpoint a precise level of running that delivers optimal health benefits for everyone. But improvements in strength, blood pressure and other measures of physical health quickly show up in sedentary people who run just a half-hour (two to five miles) a few times a week; and those benefits usually increase with increased distance and speed up to 40 miles a week, and even more for some people.

The living evidence may be found in almost any of the country’s long-running track clubs. One of the oldest in California is a Palos Verdes Peninsula-area group that formed in 1967 and now includes 50 people, most of them retirement-age, with more than two decades of running behind them. The group meets every Sunday morning for a one- to two-hour run, followed by breakfast.

“We’ve become old men together,” says Dr. Tom Bassler, a 69-year-old retired pathologist and one of the founders, “but I tell you, we don’t live like old men. Many of our members are in their 70s or 80s; these guys are still working, running, goofing around, building stuff. One just wrote a book.”

Flavio Bisignano, 74, a restaurant owner, has been putting in at least seven miles almost every day since the Nixon administration, including the regular Sunday breakfast runs. “I have diabetes in my family on both sides, and yet I have had no problems, and I have to believe that’s because of the running,” he says. “I truly believe that without running I would be dead by now.”

Like many such long-standing clubs across the country, the Palos Verdes group has an extraordinary health record. In more than 30 years, Bassler says, just three members have died: one of a brain tumor, another in a plane crash, the third in a carjacking. There have been no heart attacks; no strokes; no heart trouble at all, he says.

Many solo runners who have stayed active report a similar experience. Roberta Gibb of San Diego was the first woman to finish the Boston Marathon. That was in 1966; she was 23. “I can tell you this: I have never stopped running, and my doctor says I’ve got the physiology of a 30-year-old,” she says. “People look at me and think I’m in my 30s and 40s. My joints are limber, and I’ve really had no running injuries at all.”

Dealing With Concerns About Injuries, Arthritis

Through the years, and even after Fixx died, more and more doctors began to see jogging as a powerful guard against heart disease, even in people who had survived heart attacks. But there were lingering doubts about the pavement-pounding--the continuous rattling of bones and joints could not be healthy.

“You heard it all the time: ‘Today’s runners will be tomorrow’s total knee replacements,’” says Dr. James Fries, a Stanford University School of Medicine rheumatologist who has studied longtime runners.

It makes sense. After all, serious joggers do turn their ankles, twist their knees and injure their legs--more so than non-runners, doctors agree. “We have an orthopedic surgeon who runs with us, and every morning there are four or five guys lined up to talk to him, complaining about shins, knees, feet, you name it,” says Bob Trujillo, 70, a restaurant owner and another member of the running group.

Dr. John Pagliano, a podiatrist and running club member, has been charting injuries for more than two decades, in thousands of runners, and has compiled a chart of the most common ones: plantar fasciitis, a common cause of heel pain, which strikes 16% of regular runners; shin splints, affecting 9%; and sore knees, which plague almost 7%. Knee problems are most likely to lead to serious arthritis.

“The risk factors for getting arthritis are your age, your weight, the pace at which you run--and previous injury,” says Dr. Nancy Lane, a rheumatologist at UC San Francisco.

Yet here again, many lifelong runners have come through unscathed. Dr. Paul Straub, 69, a cosmetic surgeon and Sunday morning club member, has been running for 30 years. “I’ve had two serious knee injuries, and the longest kept me out nine months. But then I just worked my way back into the runs. I know of no one in our Sunday morning club who has stopped because of arthritis. Our group is immensely better off because of what we’ve been doing,” he says.

In part, this is a matter of self-selection: Over time, men and women whose joints hurt too much eventually just quit the sport. And those who keep going “tend to be skinny, light-boned, motivated, educated people who are aware of how much they can push their bodies,” says Dr. Jonathan Chang, an orthopedic surgeon who teaches at USC and is a former competitive runner .

Bisignano, for example, now does what he calls the “Italian shuffle,” which is much slower than the stride he used when competing.

Many doctors now believe that this kind of running--steady, but careful, on normal joints--may actually protect many people from developing arthritis. “I call this the use-it-or-lose-it phenomenon,” Chang says. “It’s exactly opposite of what was postulated years ago. In study after study we see that those chronic runners who are not trying to run through injuries, and who take care of themselves, are protected against arthritis.”

Like any weight-bearing exercise, too, regular jogging slows the age-related loss of bone mineral density, a marker for osteoporosis, several studies have shown. This doesn’t mean running builds bone, doctors say; only that it seems to delay the fractures that occur in aging bones. “Instead of fracture occurring at, say, age 70, it might occur at age 90,” Haskell says.

The bottom line, says Fries: For those who are able to keep it up, jogging can delay significant disability for more than 10 years. “In everything from grip strength to walking to getting up from a chair,” elderly lifelong runners score higher than sedentary people, he says.

None of which is to say that grunting and huffing for an hour or so a day is entirely without risk. Like Fixx, people do still dropdead while jogging (though doctors say it’s very rare). And just about every compulsive runner out there says there’s an even greater danger--overdoing it.

“When you start routinely running, say, 40 miles a week or more, and you cannot, ever, miss a run,” says Tim Church, a researcher at the Cooper Institute for Aerobics Research, in Dallas, “that’s where I start to make a distinction between a normal runner and a pathological runner.” When pushed this hard, over long periods, the body simply doesn’t have time to repair itself, and the result is often chronic fatigue and nagging joint pain.

Easing Moderate Anxiety, Stress

But for the great majority of lifers, running has provided a daily dose of sanity. “When it comes to severe depression and other mental illness, exercise is not going to help you; it’s not going to butter the biscuit,” says Thomas Plante, a psychologist at Santa Clara University. “But we know that moving your body for even a half-hour a day significantly eases moderate anxiety, depression and stress.”

In ongoing studies, Plante says he’s finding that the sensations of mental well-being from jogging in fact have little to do with how hard or fast people go, or their level of physical fitness. “It’s belief,” he says. “When people believe strongly that what they’re doing is extremely good for them, then in effect it becomes true.” He says the effect is analogous to the mental health benefits that researchers have observed in people with strong religious beliefs.

“The Sunday runs, I tell my wife, are better than going to church,” Trujillo says.

Says Gibb, a solo runner: “When you’re healthy, just moving and breathing is pleasurable. It’s so primal--humans have been running forever. The rhythm, the breathing hard, moving your shoulders, the sense of self of your body, moving along the Earth: I think we sometimes forget, we are physical animals.”

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Pluses and Minuses

Studies have shown that, compared to inactive people, regular runners have increased life expectancy and a lower risk of developing heart disease and Type 2 diabetes.

Of course, there is a downside. Runners appear to be more prone to leg and knee injuries, including plantar fasciitis (heel pain), shin splints and sore knees.

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On the Run

After a dip in the 1990s, the number of recreational joggers is climbing.

Year -- Number of runners

1985 -- 30 million

1990 -- 24 million

1995 -- 20.5 million

2000 -- 22.8 million

Source: National Sporting Goods Assn.