Vital Sings: Extreme Training

Premieres: May 25, 2020.

Dr.Sanjay Gupta: 00:22

The human body and mind are capable of extraordinary things. We’re always challenging ourselves in new, innovative, and exciting ways, but there’s one goal that has remained elusive, and that is for a human to run a marathon in under two hours. This is Vital Signs. I’m Dr. Sanjay Gupta. In order to reach unthinkable goals, it takes a lot, a lot of time … It takes a lot of understanding of physiology, nutrition, and hydration. It takes understanding products, it takes understanding human performance, and it takes understanding mental fortitude. Here at the Nike World Headquarters in Oregon, they’re focusing on all these things. They want to break a world record, and hopefully teach all of us something in the process.

Dr.Sanjay Gupta: 01:05

One of the most iconic records was the four minute mile, first achieved in 1954 by British medical student, Roger Bannister. Running at a speed of 15 miles per hour, Bannister did what many considered impossible, suggesting the barrier wasn’t just physical, but psychological. After years of failed attempts, his record was beaten just a few weeks later. Since that miracle mile, runners have continued to chase records over longer and longer distances. In particular, 26 miles and 385 yards, better known to you and me as a marathon.

Dr.Sanjay Gupta: 01:38

Today, the time set in 2003 by English runner Paula Radcliffe remains unbroken, but it’s a different story for male competitors. In the past decade alone, the men’s world record has been broken five times, dropping by one and a half minutes. The current record of two hours, two minutes, 57 seconds, is held by Kenyan, Dennis Kimetto, after his remarkable run  at the Berlin marathon in 2014. Now a different race is underway to reach beyond what many are calling running’s last frontier, the sub two hour marathon.

Brett Kirby: 02:13

The first place to start is for a body weight. You’ll measure your weight and your height.

Dr.Sanjay Gupta: 02:18

This is Nike’s sport research lab, the NSRL, and it’s a rare chance to step inside. In just a few minutes, they’re going to put me to the test to see how I stack  up against three athletes Nike has identified for this record-breaking attempt. A lot happened before anyone ever set foot in this lab, and it started largely with Matt Nurse and Tony Bignell.

Tony Bignell: 02:44

We’re a little bit like right brain/left brain. He’s the smart one. He’s smart. We’ve got the PhD.

Dr.Sanjay Gupta: 02:48

Which is that, the right brain or the left brain?

Tony Bignell: 02:50

I don’t know, I don’t know. I don’t even know. He’ll tell you. We really are a little bit the art and science. I work more on the sort of the creative side, and  Matt really works hard on the science side.

Dr.Sanjay Gupta: 03:02

I mean, how audacious is this?

Matthew Nurse: 03:05

I think it’s enormous. I think it’s enormous from a psychological barrier perspective. If you look at sort of the four minute mile and what a barrier that was, and shortly after Roger Bannister broke it, it just started falling.

Dr.Sanjay Gupta: 03:16

Let me as you, Tony, when you first heard this, was it absolutely confident, optimistic? What was your initial reaction when you first heard this challenge?

Tony Bignell: 03:29

Yeah, I probably wasn’t super optimistic, honestly, because I was, you know, even that mile, I ran a mile, and you know how hard it is to crack bits of seconds off by training really, really hard.

Dr.Sanjay Gupta: 03:41

This is not the only effort underway to break the record. Adidas also has a project in the works, as well as another private group in the United Kingdom. Breaking the two-hour marathon mark has long fascinated athletes and scientists alike. Just last month, a study was published in the journal Sports Medicine, detailing three factors to break the barrier. Nike has identified five pillars for what they are calling the Breaking Two project.

Dr.Sanjay Gupta: 04:10

When you look at these buckets, Tony, and I know your answer is likely to be that all the buckets are important here, but again, I’ll name them, and I’m just curious which of these you think is the most important. It’s products, training/physiology, nutrition/hydration, environment, or athlete selection. Is there one that’s the most important?

Tony Bignell: 04:30

I think you’ve got to say athlete selection.

Dr.Sanjay Gupta: 04:33

The hopes and dreams of this project are pinned on three men, all from East Africa: Lelisa Desisa, 26 years old, from Ethiopia, current personal best, 2:04:45, Zersenay Tadese, 34, from Eritrea, with a marathon best 2:10:41, and Eliud Kipchoge, 32 years old, from Kenya, at 2:03:05, just eight seconds off the current world record.

Dr.Sanjay Gupta: 05:03

Two of them being in their 30’s, I was surprised by that. Should that surprise me?

Matthew Nurse: 05:07

I don’t think so. I think there’s a training component and there’s a grit com ponent. You can’t go in and the very first time hit that mile 21, 22, and you see that imaginary wall hit you. There’s something about sort of fighting through that, and you know, like in any championship, you have to have been there a few times, sometimes, to understand what it means, and to know how to push through it.

Dr.Sanjay Gupta: 05:27

In the lab, Brett Kirby and Brad Wilkins have been working with the three athletes on everything from nutrition and hydration to a concept known as running economy, how to use the least amount of energy while covering the most ground in the fastest time. Of course, the physical aspect is one thing. The biggest barrier might be a mental one. It does sort of raise this question. Why hasn’t it been done?

Brad Wilkins: 05:53

I think one of the things is that, in a marathon race, it’s exactly that. It’s a race, so all they have to do, mentally, is beat the person behind them. They don’t have … It’s a mental construct that they don’t necessarily have to go after two hours, because they’re going to get their payday if they just beat the person behind them.

Dr.Sanjay Gupta: 06:11

Each of those five pillars does have to work together, but perhaps no more so than with training and product. In order to try and achieve a goal like this, there’s several things that they’re focusing on with the athletes. One is the types of products they’re wearing, clothes that are a little bit more form fitting, and also, the shoes. These are prototypes of what the athletes  are going to be wearing. Another big bucket, as we’ve talked about, is the type of training and testing they’re going through. I’m going to get an idea of what that entails right now.

Brett Kirby: 06:44

Just try to settle into the rhythm here. There you go.

Dr.Sanjay Gupta: 06:49

Are there risks or dangers to a project like this, for the runners?

Matthew Nurse: 06:54

I don’t think so, and I’ll say that from, you know, part of what we do is we have strict controls on how we conduct science and how we work with  athletes. At the end of the day, they’re human subjects for us, to a large degree, too.

Dr.Sanjay Gupta: 07:05

Is there a lesson in these things for the rest of us, if you will?

Brett Kirby: 07:09

I think that one of the main things we can take away, for everybody, is the idea to not be afraid of what appears impossible. A lot of times, we could say, for example, two hours, three minutes faster than the current world record, impossible. Then we will say, “I shouldn’t even try it.” With these types of athletes, what we should all take away is don’t be afraid of it. Let’s try  it.

Dr.Sanjay Gupta: 07:32

We’re going to learn how I measure up against the three runners, and what these elite athletes are teaching science that could benefit even the casual runner from head to toe. Also, how else can we push our bodies to the limit?

Keith Walkman: 07:47

Don’t be afraid if it gets a little bit like hard work.

Dr.Sanjay Gupta: 07:48

Some formal soldiers have a few ideas.

Keith Walkman: 07:52

Let’s go.

Dr.Sanjay Gupta: 07:55

It’s a Tuesday evening in the Nike Sport Research Lab in Beaverton, Oregon, and I’m working up a sweat.  I’m wearing a prototype of the shoe designed for three runners who will try to break a record long thought impossible, finishing a marathon in under two hours.

Bret S.: 08:11

We’ve taken about three minutes off the world record over the past 20 years, so to go another three minutes in one shot is a huge leap.

Dr.Sanjay Gupta: 08:19

Bret Schoolmeester has been working on the footwear for the Breaking Two attempt. I want to show you, so I ran in these shoes yesterday, and I’m going to show you this video and see what you think.

Bret S.: 08:28

I would say you’re less of a heel striker  than most runners we see, so more of a mid foot touchdown.

Dr.Sanjay Gupta: 08:34

What was really interesting, I’ll just say, is that I did feel like I needed to be in motion. A thin carbon fibre plate sits between two pieces of foam to make the base of the shoe. This area right in here, that joint …

Bret S.: 08:46

Yep.

Dr.Sanjay Gupta: 08:47

When it bends like this, you lose some energy.

Bret S.: 08:51

Exactly.

Dr.Sanjay Gupta: 08:52

Is that part of the secret sauce here?

Bret S.: 08:54

It’s 100%. Yeah, at the MPT joint, MTP,  sorry, your foot is doing a lot of work, and there’s energy lost in different directions there. What we’re able to do is save that energy through the stiffness. Where before you lose energy in every stride, we’re allowing you to lose less energy.

Dr.Sanjay Gupta: 09:12

Is there a point when you look at a shoe and you say, “It’s almost too good?” I mean, you know, is it an unfair advantage at some point?

Bret S.: 09:19

I think, frankly, the conversation around is this thing so good it should be illegal, is really flattering. What we didn’t set out to tell the team is, “Make it good, but not so good.” We said, “Give these athletes every  benefit we can give them.” We’ve been making shoes with foams and plates for years, as have many other people.

Dr.Sanjay Gupta: 09:37

There is a governing body, though, that looks at these things, as they do in race car driving and other things as well. Will these shoes have any problems getting approved?

Bret S.: 09:45

We’re confident no.

Dr.Sanjay Gupta: 09:47

Ultimately, though, we’re not just talking about the three runners. Consider this. In the United States alone, roughly half a million people cross the finish line of a marathon every year. Though there are consumer versions, the shoes the athletes will wear during  the attempt were made just for them, personalised based on factors like the way they run and their weight. That personalization is key in the lab as well.

Brett Kirby: 10:11

I think each learning you have about the athlete that becomes personalised is the first insight, is let’s first start with what you need, and that’s a huge gain, because before, it was maybe you just give a template suggestion. Specifically on training, we could easily see that there’s some people who respond to long distance type of training, and there’s some people who respond to really high intensity trainings.

Dr.Sanjay Gupta: 10:31

High intensity interval training combines bursts of intense activity with short recovery periods. Research suggests this kind of exercise can be more effective than moderate workouts, and that means pushing the body to the limit is no longer reserved only for elite athletes. We’re going to step away from the track for a moment to see what endurance training can look like for the rest of us.

Dr.Sanjay Gupta: 10:57

It’s a cold Sunday morning here in South London.  While many people are still in bed, a small group of locals are wide awake and ready to go.

Keith Walkman: 11:08

All right, guys. Let’s go fall in two ranks here. We need the blues this end, reds green.

Dr.Sanjay Gupta: 11:11

They’re here for British Military Fitness. They are bootcamp style classes led by ex-military personnel like Keith Walkman, a former Royal Marine commandant.

Keith Walkman: 11:21

Give a little Sunday morning rub. All our instructors at British Military Fitness have to be from the forces, so either Navy, RAF Army, or Marines,  and they have to be personal trainers or PTIs as well, so they’re all fully qualified. Class lasts less than an hour. Most of them will have a kind of five 10-minute blocks where we’ll do relays, circuits, team challenges.

Keith Walkman: 11:45

Let’s go. That’s all the blue. The idea is we throw in lots of different things, so it’s all interesting, because for most people, exercise can be a bit boring, so if we throw in loads of different games and routines and exercises, it makes it a lot more interesting, and people are actually more likely  to come a lot longer and enjoy it more.

Keith Walkman: 12:03

Don’t be afraid if it gets a little bit like hard work.

Dr.Sanjay Gupta: 12:06

In the United Kingdom, one in seven people are members of a gym, but British Military Fitness is part of a growing demand for training sessions that are both outdoors and out of the ordinary.

Keith Walkman: 12:17

Four, five, let’s go. Nice fast taps. One, two, one, two, like that. One, two, like that.

Keith Walkman: 12:22

I think the biggest thing we bring is sympathy, or empathy. Like when I was in the Marines and you go for your commando training, you  are going to extreme training. What they do is they push you to your limits, and then you realise, when you get to that point where you think, “I can’t do this anymore,” you go through that sort of barrier, and out the other side.

Dr.Sanjay Gupta: 12:43

For Bianca O’Donnell, this hard work is just one more step on her road to recovery.

BiancaO’Donnell: 12:49

I was diagnosed in April, 2016 with Hodgkin’s Lymphoma, which is a form of blood cancer, and had six months chemotherapy. I was quite  active and quite sporty beforehand, so, running triathlons, and I wasn’t able to do anything whilst I was sick. That was probably one of the things I found most tough.

Speaker 9: 13:10

Three, three, three, three. Three.

Dr.Sanjay Gupta: 13:12

Research has shown that high intensity interval training can also have benefits for people with conditions like diabetes, heart disease, arthritis.

Keith Walkman: 13:21

Excellent work this morning, guys. Great effort.

Dr.Sanjay Gupta: 13:24

As we continue pushing our bodies to new limits, it does raise a question.  Can we get too much of a good thing? Here in Liverpool, at the John Moores University, they are trying to find an answer. Working with elite athletes from Real Madrid, British cycling, and the local Liverpool football club, researchers are finding out what happens when we put our body and our heart through training.

Dr. David O.: 13:52

We know that if you exercise regularly, and we suggest around about three hours per week, we know that reduces your  cardiovascular risk.

Dr.Sanjay Gupta: 14:03

Each day, the average heart beats 100,000 times, pumps about 2,000 gallons of blood through the body. When we exercise, we increase the volume within our heart, from the right hand side, which pumps blood to our lungs, and the left, which sends blood to our brain and the rest of our body. Over time, this can change the structure of our heart, something Dr. David Oxborough examines using cardiac imaging.

Dr. David O.: 14:30

Ben’s an athlete, okay? The first thing that you should be looking at here is the heart rate, and the heart rate’s very slow. This is because the heart doesn’t have to beat so fast to generate the amount of volume that’s required over a minute. He’s got a big heart, and we can prove that by looking at these types of measurements.

Dr.Sanjay Gupta: 14:50

Although training at the highest level often relies on pushing our bodies to the limit, the benefit of exercise on our heart seems to lie in moderation, in recovery.

Dr. David O.: 15:00

The most important thing is that moderate, regular exercise is good for the heart, and it will improve your life expectancy.

Dr.Sanjay Gupta: 15:08

Coming up, we find out if these long distance runners are on track to break an incredible barrier. Loch Lomond, Scotland. This breathtaking stretch of water attracts visitors from across the world. Most come in search of peace and tranquillity,  others in search of something a little more exhilarating.

Speaker 11: 15:41

Swimmers into the water.

Dr.Sanjay Gupta: 15:46

This is ice swimming, competing in water colder than five degrees Celsius, or 41 degrees Fahrenheit.

Jess Campbell: 15:54

I love ice swimming competitions. There’s a sense of energy and just a sense of life.

Dr.Sanjay Gupta: 16:01

Here at the British championships, the UK’s best ice swimmers have gathered. Among them, Jess Campbell, who holds the British ladies’ record for swimming an ice kilometre.

Jess Campbell: 16:15

When I swim in really difficult conditions, the water’s very choppy, I just have to assure myself that I can finish.

Dr.Sanjay Gupta: 16:28

For Jess, training takes place  five days a week, here at one of Britain’s oldest open air pools. This is a sport where training in extreme elements is critical, not just for success, but for survival. Regular icy swims allow Jess’s body to acclimate, learning to navigate dangers which include hyperventilation, high blood pressure, and hypothermia.

Crowd: 16:57

Go. Go.  Whoo. Whoo hoo.

Dr.Sanjay Gupta: 16:59

Dr. Ruth  Williamson is leading the medical team here at the event in Scotland, making sure that competitors undergo rigorous health checks.

Dr. Ruth W.: 17:08

The ice kilometre and the ice mile, they’re real endurance sports. This is something that you train for. You get your body used to getting into the cold water and being able to get over that cold shock, and then with training, your muscles adapt to working with a lower blood supply.

Dr.Sanjay Gupta: 17:29

Early studies suggest  cold water swimming could be a potential treatment for depression by activating the sympathetic nervous system, and it offers participants a dose of adrenaline and adventure.

Dr. Ruth W.: 17:40

If I think back to the last century, people were exploring and trying to push the boundaries. We can go to the moon, we can do other extreme things, and many of those things have been done, but there’s that, “What can I do with my own body?” You really feel superhuman when you’ve swum a kilometre in water like  this.

Dr.Sanjay Gupta: 18:02

These superhuman feats are an extreme test for the body, but one researcher believes that our human limits lie not in the muscle but in the mind. Dr. Samuele Marcora has spent the past decade studying the relationship between endurance and the brain. His findings have yielded some surprises.

Dr. Samuele M.: 18:24

Most people think that endurance exercise is limited by muscle fatigue. However, we found in several studies that also  mental fatigue can limit your endurance performance, not just what’s going on in the muscle, what’s going on in your brain.

Dr.Sanjay Gupta: 18:38

Athletic performance can be improved using brain endurance training. Boring, repetitive, tiring, these computerised tasks target parts of the brain to increase our resistance to mental fatigue.

Dr. Samuele M.: 18:54

The key is that all of these tasks requires what we define as inhibitory  control. You have to force yourself to do a certain response in order to achieve the goal.

Dr.Sanjay Gupta: 19:08

In trials, brain endurance training improved performance by over 100%, compared to 40% from those who only worked on their physical training. This isn’t just training for elite athletes.

Dr. Samuele M.: 19:22

The easiest way to implement, if you like, something similar to brain endurance training, for example, is to train on purpose in a state of mental  fatigue.

Dr.Sanjay Gupta: 19:31

For Dr. Marcora, training our brain in this way could unlock potential, offering athletes the key to set new records, like the sub two hour marathon.

Brett Kirby: 19:42

Perfect spot on the treadmill. Looks good.

Brad Wilkins: 19:44 5:50.

Dr.Sanjay Gupta: 19:45

Overcoming mental fatigue is a big focus for the team at Nike trying to break the record. I’ve been breaking a sweat on the treadmill in the sport research lab, while Brett Kirby and Brad Wilkins monitor my oxygen consumption. This is the same test they conduct  with their three athletes.

Brett Kirby: 20:02

We’re going to go ahead and slow you down now.

Brad Wilkins: 20:09

All right, we’ll get this off you. Perfect. A little workout?

Dr.Sanjay Gupta: 20:12

Yeah.

Brad Wilkins: 20:12

We can show you a little bit more data on this one. 185 millilitres per kilogramme per kilometre, so a little bit better than your 192, so you’re more …

Dr.Sanjay Gupta: 20:23

So I was better and faster.

Brad Wilkins: 20:24

Yeah.

Brett Kirby: 20:24

Interesting.

Brad Wilkins: 20:24

Your economy …

Dr.Sanjay Gupta: 20:25

Or more economical, then.

Brad Wilkins: 20:26

Yep, more economical, faster, so, and you looked, just from visually,  you looked smoother. You looked like you were kind of cruising a little bit smoother, so that’s a really good running economy.

Dr.Sanjay Gupta: 20:36

My numbers aren’t bad. I have to say, I’m pleasantly surprised, but get this. What I just did in a few minutes, the athletes have to do at twice the speed for a full two hours. A March day in Monza, outside of Milan, Italy.  This is a Formula One racetrack. It’s also the site of the marathon attempt, selected for reasons like humidity and altitude. Today, the three athletes will run it for the first time in a half marathon test, the first chance for the team to find out if they are on target to make history.

Brett Kirby: 21:23

All three of these athletes showed us that they weren’t afraid of challenges, that they were willing to basically look at  extreme goals and say, “We can do that. This may seem impossible to many others, but with all this right support, we believe we can achieve something as kind of audacious as a two hour type of marathon.”

Dr.Sanjay Gupta: 21:44

This doesn’t look like your standard marathon, from the shoes, to the clothes, to the pace runners, the flat track. Hydration is delivered on mopeds instead of typical water stations. Basically, optimise each aspect to see if this is even humanly  possible, and then work backwards from there. Eliud Kipchoge is one of the three athletes, and the current Olympic champion. He’s considered by many as one of the world’s best marathon runners.

Eliud Kipchoge: 22:13 (also subtitled)

All human beings can stretch beyond their thinking and do something extraordinary. That’s why I’m trying under two hours, and be the first human being to cross and run under that two hours. It will be more than the  discovery of the internet.

Dr.Sanjay Gupta: 22:32

While Kipchoge was able to break the one hour mark for this half marathon test run, there’s still a long road ahead. The actual attempt is scheduled to happen the first weekend of May, and then we’ll know if the human body is capable of reaching this extraordinary level, the next chapter in the history of sport, our bodies, and our brains.

END