Charlie's Blog: The Tragedy of Micah True

12.17.2023

The Tragedy of Micah True

DISCLAIMER: I am not a doctor, personal trainer, or healthcare professional. These are just my opinions. Consult a physician before starting any exercise program.

I don't want anyone to do anything except come run, party, dance, eat, and hang with us. Running isn't about making people buy stuff. Running should be free, man.
MICAH TRUE

Micah True was 58 when he died. He outlived Jim Fixx by six years. Like Fixx, True was an avid runner. In fact, he was an extreme ultrarunner and the hero in Born To Run known as "Caballo Blanco." True also died like Fixx from a bad ticker. True's heart was enlarged and showed evidence of scarring. It is the contention of Dr. James O'Keefe that running killed Micah True. I agree with O'Keefe.

James O'Keefe presented his argument concerning True's death in this Ted Talk. I highly recommend watching the whole thing, but I will summarize it here. It is possible to take endurance exercise too far. You can have too much of a good thing. Micah True was a perfect experiment in this regard as he ran for many years for extremely long distances. True described himself as a "trail running bum" similar to surf bums and climbing bums who spend the bulk of their days pursuing their passions. All that running took a toll on his heart. Naturally, there are those who differ with O'Keefe on this theory. These people are in denial.

Exercise is like anything else. You need exercise, but you don't want to overdo that exercise. It is all tied to the dosage. For Micah True, he took an overdose. That shatters a myth that I suspect the editors at a certain running publication would like to keep intact. High mileage running and marathons sell a lot of stuff. I can't help but draw a parallel between these running purveyors and tobacco company executives in denial about the hazards of their products. Micah True got it wrong. Running is totally about making people buy stuff.

The Gentle Reader already knows where I stand on this issue. I think walking is better than running. Plus, I don't make a red cent off of that opinion. I have no financial conflicts of interest when it comes to this debate. Unfortunately in life, where people stand on things usually depends upon where they are getting their money.

I am tempted often to devote a project entirely to a single topic of interest because this would increase traffic to that project and also advertising prospects. Unfortunately, I think being a single topic blogger is a hazard to objectivity. I have the freedom to present the empirical evidence and even change my mind on an issue because I haven't built my living on the thing.

I think running is an overrated and oversold activity. Because of this, people pursue it when they shouldn't while others are discouraged by it and remain on the couch. Walking is the middle path. Exercise doesn't have to be extreme to be beneficial.

Show me the bodies.
AMBY BURFOOT

UPDATE: I have really enjoyed reading the combox comments on the O'Keefe video, Run for your life! At a comfortable pace, and not too far: James O'Keefe at TEDxUMKC. Here is a selection of the ones I liked the best:

I have been an endurance athlete/triathlete my entire life. My perfect Saturday was a 45-mile bike ride, followed by an 8-mile run with a 5 hours rest afterwards and then an afternoon masters swim chased with several pints at the La Jolla Brewing Co. I always thought that my activity would make me bulletproof, and I'd live to be 100. 2 years ago, after a vigorous masters swim in the lead lane with an ex-olympian, holding times that I would be proud of in my 20's and 30's,- I went home, had a sandwich, sat down at my desk and (with no prior history - family or otherwise) had a heart attack. They told me it was SCAD (Spontaneous Coronary Arterial Dissection) It was a super rare type of heart attack that effects women having a baby (90%) and endurance athletes (10% male). It floored me. I asked my Cardiologist "what caused this?" he said - "I don't know". I asked, "Will it happen again?"  he said - "I don't know". I now hang in the back, I am at about 65% of where I was 3 years ago, I take long walks and am enjoying the view from the middle/back of the pack. I'll be 60 next year, and I know my kids would like to see another 40 more.

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What a wonderfully informative presentation. This avoidance of high intensity for long periods is also shown in Mafetone program. At 63 I thought I had a responsibility to push myself harder to give myself the best shot at a long healthy life. Not now, I am going to keep the intensity down and settle for plenty of low intensity exercise.

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This is one of the best talks when it comes to exercise and safety.

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Thank you for this lecture. I kind of suspected that the law of diminishing returns, which applies to everything else in life, would apply to exercise as well. Thanks for going over the evidence for this.

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I'm an avid walker.  I love to walk.  Sometimes I even enjoy a nice run or some hill climbs.  The runners in my life don't understand.  They're into their best time.  Training for that next race.  We don't understand each other.  I walk to lower my stress and be happy.  I hope it does good things for my heart.

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Much of this information, in bits and pieces, has been around for decades but the good doctor FINALLY puts together a sensible way to look at how we should approach our exercise habits in accordance with the older and, now, the newer research. His presentation style is low-key and comforting...

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Wow. This blew my mind. Completely contrary to what conventional wisdom has fed us for the last 30 years. Thank you for sharing.

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I have been an endurance athlete for about 10 years now training for Ironman triathlons off and on...and I have definitely noticed some negative health related things that occur when my training time periods rise above a certain level.

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Fantastic talk. I certainly believe our bodies are not designed for endurance sports.

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I felt my heart relaxing while listening to his speech. Nice indeed.

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This opened my eyes a bit. The word I'll take from this is - Moderation! Life in moderation is healthier. Being efficient and optimal is more important than overdoing things. From now on I'll eat moderately, exercise adequately, and enjoy work. Thank you!!

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everything he said was true and backed by solid data. Thank god we finally have people like this changing the ignorant face of exercise.

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Brilliant!!! Everything in moderation has always been the best advice.

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Amazing!   The readers of runners world won't be happy about this study.  Apparently for maximum health you should be running 2 times a week, roughly no more than 10-15 miles per week.  WOW!

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This research is consistent with centenarians.  For example, Jeanne Calment only rode her bike around town.  Not to far and not too fast.  She started riding her bike at 3 years old and did so until 110 years old.  She lived to 122.  The centenarian Greeks also did a lot of low impact exercise such as shepherding sheep up hills.

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Years go by, but this speech remains true.

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This is an amazing Ted talk with robust scientific data that shakes the very foundation of endurance athletics . Thanks.

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I was a devotee of Jim Fixx; studied his book,  "The Complete Book of Running" .  And, was shocked when he dropped dead while running.  Luckily I never had time to become more compulsive than a couple of half-marathons, and years of 7 miles on the weekends (with, of course 3 mile normals)

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My friend's husband was a passionate cyclist pushing it every day. Very fit, looking great, full of life, good job as an engineer etc - perfect life you'd think. He died on his bike in his 60s, heart attack... She was absolutely devastated and felt cheated, how come, he was so fit etc... Now we hear more and more of pro athletes collapsing and dying suddenly. I think society is becoming more aware now but we need to take this message further, exercise is like water, you don't hydrate, you die, you overhydrate, you die. That's why I enjoy being a couch pot... no, I'm kidding :) I enjoy mixing my training with strength training, I'll do 20-30min of moderate to high cardio + 20-30 min of strength training. That way I feel good. When I was pushing my cardio too much I noticed I was sick all the time and I didn't feel that well most of the time, usually tired. The problem is that intensive cardio past 50--60 min is like a drug, you get high from it, it feels great for a second, you're the king of the world but like every drug that makes you high, it can be very dangerous.

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By Cracky James O'Keefe just told me that I should be doing exactly what I have been doing, I walk moderately twice a day 40 miniutes and a few other activities.   I used to run marathons and exercise like a fanatic, but burned out, good thing too.

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GREAT talk by Dr. James O'Keefe. Brings to mind the tragic story of Jimm Fixx = author of the Complete Book of Running - only to die in 1984 from jogging with multivessel disease on autopsy - which is eerily similar to Micah True's story (Caballo Blanco) that Dr. O'Keefe describes. It makes sense that some exercise is good - moderate exercise is better - but extreme exercise (done repetitively without rest) may be fatal.

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Kenneth Cooper's "Aerobics" in 1968 was the first wave in the running craze. He cautioned in his  book, the benefits of running are many but if you run more than 3.2 miles you are doing it for reasons other than health

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the middle way is the right way, thank you for sharing this life saving insight

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The scientific confirmation of the common sense approach to exercise.

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To live intensely can put you in a hospital.  The problem is not dying. It's hanging on with diminished health.  I'm 74 and walk a lot.

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Genius and Common Sense together.

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Clearly there is a difference between health and fitness performance.

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Not a surprise heavy-duty runners don't like to hear this message.  What it doesn't take into account is the pyschological/mental aspects of vigorous exercise.  Some people don't want to slow down or reduce the amount of exercise because they don't feel as good as with their current dosage of activity.  Hard to go from Type A behavior/personality to Type B.  Runners, in particular, often have a hard time "cross-training".  They have a hard time getting mental boost from exercise if it's not long enough or fast enough.  Often, can't comprehend how they could have underlying health conditions with all of the exercise they get, especially when they feel great.  The "invincible" shield takes hold, as seen in some of the previous comments here, where one has the attitude of, "I'm not hurt and I feel awesome, so I can keep doing this for the rest of my life".

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Thanks. I rate this as the best TED talk ever. Evidence-based, sound reasoning, well presented, and taking action on what's presented will have massive benefits to those who do so. Great work! You pulled together a lot of high quality studies into a succinct presentation.

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The 45 people who disliked this video are obviously marathon runners in denial.

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Runners will not like this video.  However, Caballo Blanco ran 150-160 miles a week, and the state medical examiner’s office has determined the cause of Caballo Blanco's death as idiopathic cardiomyopathy, a heart ailment.

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When my father was in his 50's he ran several marathons and ended up being diagnosed with idiopathic cardiomyopathy.  Marathon running is not good for the heart.

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very controversial topic but i think theres increasing data to support this guy. as an excercise enthusiast, i hate hearing this stuff too. its a shame but... probably gotta cut it back. 2-3 mile jogs humming along at 8 min/miles several times a week is the way to go. nice moderate pace swims 20-30 mins and that's it.

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lol my knees regulate my heart damage.  Thank you.

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I almost wanted to hate him for his message until he said "Don't shoot the messenger"

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Shared this video with a runner and he wasn't happy.

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Why run? Because it feels so good when I stop!

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I hate running,walking is my thing