Fred Kasch jogs several times a week. If you pass by his house on Edgeware Road in Kensington at the right moment, you might catch a glimpse of him stretching in his driveway, although you probably wouldn’t give him a second look.
He’s a short, lean man who looks to be in his mid-60s, and God knows there are plenty of those around this town, fit retirees clad in running shoes and exercise shorts. Kasch, however, is 86. And he says when he first moved to San Diego in 1948, “I was the first and only person who was running here. In the whole town!” The sight of him pounding over the streets was so bizarre that people called out derogatory comments.
He wasn’t omniscient, so Kasch concedes it is possible one or two other “lone nuts” might also have been jogging somewhere in the county back then. But he knew of none, and the common wisdom in 1948, he points out, was that exercise harmed adults. A lot of people thought it was one of the factors that wore people out, that hastened their inescapable slide into infirmity.
Kasch didn’t believe this. He had the conviction that just the opposite was true, that exercise promoted health and could prolong vitality. This was an unscientific belief. No studies substantiated it, and his new employer, the physical-education department at San Diego State University, hadn’t hired Kasch to conduct research. When he moved here, research at SDSU “was verboten!” he says.
“You weren’t supposed to be doing it.” His job was to teach and coach, and he devoted long hours to both activities. But at the same time he couldn’t resist turning a scientific eye on the question of what happens to the human body when it engages in regular physical activity. Some of the innovations and discoveries Kasch made over the years contributed to the nationwide exercise boom of the 1970s. Today they rank as landmarks in the burgeoning field of exercise physiology.
Kasch grew up in Chicago. His mother and father were the children of German immigrants, and “on my father’s side, they were a stodgy old people who thought all you ever did was work.... My father was never allowed to do any sports of any kind. He had to go to work at age 16. My parents’ idea of a picnic was eating on their screened-in porch!” Instead, the larger world around Kasch fostered the active life that challenged his body. In 1920, when he was 7, his home on Chicago’s Far West Side was still within sight of undeveloped prairie. “There was no television, no radio. We played games all the time. We ran all over and terrorized the neighborhood by jumping fences and opening gates and playing hide-and-seek; sports was one of the things you could do. So exercise and health just came naturally to my mind.”
It’s an obvious connection. Kasch points out that “the Greeks had the idea 2000 years ago,” and many traditional cultures have emphasized the value of hunting, dancing, and military skills. As literacy began to spread throughout the West, the notion developed that physical fifness was desirable. The first modern gymnasium opened in Copenhagen in 1799, and in Germany, a movement known as the Turnverein (from the German turnen, “to practice gymnastics,” and Verein, “club or society”) preached the cultivation of health through gymnastics and calisthenics. German immigrants in the 1840s and 1850s brought this concept with them to America, and Turnvereins became important social centers in the New World. Kasch says in Chicago, the Turners (as they came to be known in this country) “talked the powers that be into having physical education in the schools, and they volunteered their efforts to be the teachers, without pay.”
He adds, “All the way up to the 1920s, most of the heads of physical education in universities in this country were physicians — which points to the fact that they believed physical activity made for healthful living.” But no one was scrutinizing that belief in the laboratory, and a development in the ’20s took the field of physical education even further away from the realm of rigorous academic inquiry. “The games idea came up,” Kasch says. “Everyone was to participate in games, and you had attention being paid to sportsmanship and the sociological relationships that develop between the participants during the course of playing games.”
This preoccupation dominated the field of physical education when Kasch in 1931 enrolled at the University of Illinois’ Urbana campus, then the leading center in the country for physical education. Upon graduation, he received an invitation to join the faculty, with the understanding that as he taught he would also work on his master’s degree. In 1937 the U of l’s medical, dental, and pharmaceutical campus in Chicago asked him to move there to develop recreational courses for its students.
Kasch says by then he was feeling more and more hungry for scientific information about exercise physiology. “All the way through, I had been looking for scientific courses. But there was nothing.” In 1941, he started work on a doctorate through a summer program at New York University, one of only a handful of schools to offer a Ph.D. in the field. But once again, “I got cheated!” Kasch exclaims. Even in the doctoral program, the idea of how exercise could contribute to health received little more than lip service. And with America’s entry into World War II, Kasch’s doctoral studies had to be postponed as the government pressed the nation’s physical-education professionals to develop crash programs that would prepare soldiers and officers for combat.
“We had to get these slobs fit,” Kasch says. By 1943 he had 750 charges who were under the jurisdiction of the Army and Navy but were studying dentistry and medicine. To improve their stamina, Kasch ran with them daily — something he’d never done before. He found he enjoyed it.
Looking back on the war years, Kasch notes that the crash course in conditioning given to all those fighting men ultimately damaged the image of physical fitness in this country. Since the goal had been to whip the men into shape fast, for the most part the trainers “didn’t care about how they did it,” Kasch says. “They just poured it on and beat the heck out of these guys. And of course it hurt. The men didn’t like it, and when they came back, they said. To heck with this physical-education stuff!’” Kasch says the veterans who enrolled in college after the war even succeeded at having physical education thrown out as a requirement. “They didn’t have to take it.”
Disdain for exercise extended well beyond the ranks of the former soldiers. “There were a lot of people in various scientific disciplines — psychology, medicine, you name it — who thought that exercise was a bunch of baloney and that you didn’t need it,” Kasch says. Some of his university colleagues were teaching that “exercise after age 35 would beat up your blood vessels and injure your heart.... It was very negative.”
But the first whisper of a different breeze was beginning to stir. In 1946, Kasch’s boss at the University of Illinois, Seward Staley, called for a meeting of the heads of all the university-based physical-education programs across America. To the ones who responded, Staley voiced his belief that it was time to shift attention away from sports and games and to start studying the physiology of exercise. “He said to them, ‘The war’s over. It’s time for us to become very academic and very scientific.’ ”
Staley inaugurated a demanding Ph.D. program in physical education at the U of I in which students immersed themselves in chemistry, physics, and physiology, as opposed to lighter fare such as the history of recreation. Kasch didn’t enter this program, but in 1947 he returned to his summer doctoral studies at NYU. The next year, when he got the job offer from San Diego State, he moved his wife and four children westward, but for several years he commuted with them every June to the East Coast to continue working on his Ph.D. The summer program was located about 40 miles out of New York City in a state park, Kasch recalls. He and his family hauled a Curtis Wright Clipper trailer there every year all the way from San Diego. “I rigged the car up so that it had a shelf across the back windows,” Kasch says. “Two kids slept up there. One of them slept on the backseat, and one of them slept on the floor. And we would drive all night. It would be illegal today, but that’s how we traveled. I pulled that trailer 90,000 miles.”
During the rest of the year, Kasch juggled a diverse group of balls. He coached gymnastics and freshman baseball, and he taught classes in subjects ranging from archery to kinesiology (the study of human movement). In his spare time, he continued running, despite the popular sentiment “that middle-aged men who exercised were childish and self-indulgent." Running shoes hadn’t been invented yet, so to protect his feet on his four-mile outings into the sagebrush to the west of 55th Street, he donned leather track shoes that a cobbler in Norway made for him by hand. Sometimes he talked students into accompanying him, even though Kasch’s jaunts far exceeded what was then .thought of as “distance running” in the high schools and colleges. “Then the high school cross-country run was 1.9 miles,” Kasch says. “That was as much as boys were allowed to go!” As for girls, “Nobody thought about them running,” he says, adding that in the 1936 Olympics, women were not allowed to run more than half a mile. “Because otherwise it was thought that they would injure themselves.”
By 1952, Kasch had met one male student who shared his disregard for such concerns. “This chap, Joe Brooks, lived in El Cajon, and he would run to San Diego State. Sometimes he’d run back, too.” Kasch says Brooks was a strong enough runner that he wanted to participate in a marathon, a rare but not unknown event in those days. Although “the only real marathon of any size in the United States was the one in Boston,” Kasch says a small group of distance runners up in Petaluma in Northern California had been staging an informal marathon every year. “Maybe 20 or 25 people participated in it,” the retired professor recalls. “Most of them were older people who didn’t train year-round. They’d start training maybe a month beforehand. So in 1952 another student and I took Joe Brooks up there.”
Kasch had an idea for an experiment. “People run out of energy in the course of a marathon. They need to be fed. I had concocted a drink made of lemon juice, orange juice, water, and sugar, and I put it in little six-ounce medicine bottles that we could hand to Joe. We gave them to him at 15 miles and again at 18 and 20 and 23. And he could drink it and throw the bottle away." The strategy worked. “He won! He ran the course in 2 hours and 45 minutes, which is not very fast compared to today’s times. But for then it was pretty good.”
Kasch says he never tried to market this precursor to Gatorade. He was too busy teaching and coaching and trying to complete his Ph.D. work. For his dissertation, he had decided to accept the challenge of a University of Illinois medical doctor who worked with rheumatic fever patients. Rheumatic fever primarily strikes children who’ve been infected with a certain strain of streptococcus bacterium. Bad cases can inflame and even scar the heart. In the early 1950s, pediatricians treated the illness with aspirin, sulfa drugs, and complete bed rest, but once the symptoms had subsided, they had no way of assessing what activities the child could safely recommence. “How much function do these kids have?” Kasch says. “Are they allowed to run, or are they only allowed to walk?” His task was to figure out a way to determine the youngsters’ cardiovascular capacities.
One crude gauge was to count their resting pulses, but when Kasch did that he found wide variation among the children. At the worst extreme, he recalls one boy who had lain on his back without moving for two or three months, a regime that doubtless contributed to cardiac atrophy. When Kasch took this boy’s pulse at 7:00 a.m. one morning, it was 120, he recalls. “It should have been 80 or maybe 90 at the most! But instead, the amount of blood pumped per beat was so little that his heart rate had increased to 120. He could hardly get out of bed.” Other children, however — like the one “little rascal” who had locked his nurse in a closet — seemed indistinguishable from their healthy peers. To evaluate these kids, Kasch needed to make their hearts work.
He says the common way doctors did this then was to make patients hop up and down on one foot for 30 seconds, then listen to the beating organ. “That was the stress test of the ’50s.” Kasch tried to develop a similar test for the children, but he found there was too much variation in the way they hopped to enable comparison. He knew that some researchers had come up with “step tests” as an alternative. The two existing ones were cumbersome to administer, but Kasch recruited children from his neighborhood to help him develop a streamlined version. “My back room [in Kensington) was my laboratory.” The Kasch Step Test, as it’s known today, requires subjects to step up and down a 12-inch riser 24 times per minute for a total of three minutes. When he took it back to Chicago and tested it on 27 boys who’d had rheumatic fever, he found that all could tolerate doing this. Kasch then would take their pulses immediately. When he returned to San Diego, he went to Franklin Elementary School, which his own children attended, and got permission to look through the files (“I understand you can’t do that anymore”) of 27 boys whom he matched in height, weight, and age with the Chicago boys and then tested. He says the average post-exercise heart rate for the normal kids was around 90, compared with 120 for the children who had been sick.
Kasch’s step test gave pediatricians a tool for prescribing exercise for post-recovery rheumatic fever victims. And it soon proved useful far beyond that limited population. In 1958, the professor began using it when he founded the first adult fitness program in the United States.
The program began like this. Around 1952 Kasch started exercising on a regular basis with a small group of SDSU professors. At first they played basketball, but the games eventually gave way to jogging sessions. The members of this informal group seemed to thrive, but Kasch noticed that other friends who weren’t exercising weren’t faring as well. "They were beginning to develop high blood pressure and irregular heartbeats and stuff like that. They were falling apart.”
One night at a party, he broached the idea of a group that would be open to any man who wanted to exercise. Several people greeted the idea with enthusiasm, and Kasch says they recruited friends and work associates. Kasch scheduled the first meeting for February of 1958, and he administered his step test to everyone who attended. That spring, he led participants two or three times a week, primarily in the men’s gym. “I would put them through exercises for flexibility and stretching and some modified strength exercises, and then we’d get up and walk/jog around a circle.” Sometimes they played volleyball. Sometimes Kasch made the men skip. “I kept changing it so they wouldn’t get bored."
From 10 or 12 members, the group doubled in size. And then, “I made a very, very serious error,” Kasch recalls. “We met through June, and then 1 went somewhere that summer to teach or do something.” When he returned in the fall, he found he couldn’t reassemble the group.
“That was a lesson to me: if you’re going to do this, you do it 12 months a year,” Kasch says. He’d become convinced that such a full-time effort was worth undertaking. “So I arranged to formalize it through the university extension and charge something like $30 a semester. I had to get a minimum of 20 people because the budget was $600, and the head of the business office was a hard-nosed character.... Well, I got 17 to sign up and I needed 20. So 1 took 90 bucks out of my own pocket and found three people and gave them freebies. That’s how we got started.” From the beginning, the group included high-risk individuals. “We had people with high blood pressure. We had people who’d had heart attacks.” The idea of exercising such people was then anathema to most physicians. “Back in those days, the standard treatment for heart disease was rest, rest, rest,” Kasch says. But maverick ideas were emerging. For Kasch’s part, he felt the high-risk participants would be safe “because we kept monitoring their heart rates all the time, even out on the field. And the heart rate tells you exactly where they are. Also we kept the exercise (for the heart patients) at a lower intensity.”
By the early 1960s, Kasch was hankering to set up a more formal program for cardiac rehabilitation patients, and one night at a dinner meeting of the San Diego County Heart Association, he sat across the table from just the man to help him do that. At first glance. Dr. John Boyer must not have looked like a promising candidate. A 42-year-old internist specializing in cardiology, Boyer weighed 170 pounds and smoked a pack and a half of cigarettes a day. He’d stopped doing serious physical activity while in medical school. Yet Kasch’s meticulous and enthusiastic account of his work with the Adult Fitness Group fired the doctor’s imagination. Boyer recalls, “I thought, ‘Gee, here’s a guy who’s way ahead of his time.’ ” Within a week or two, the cardiologist began walking and then jogging. He threw away his cigarettes and never touched them again. Within six months of meeting Kasch, he had shed 25 pounds and gained back sufficient cardiovascular capacity to compete with many 20-year-olds. (He would go on to run in several marathons.)
He agreed to work with the professor, though he found his lab somewhat primitive. “We were still doing the step test then,” Kasch recalls, “and we didn’t have any electrocardiogram equipment.” Instead, Kasch and his assistants strapped a stethoscope to each test subject’s chest and connected it to a three-foot-long tube that in turn was attached to ear pieces. “He [Boyer] came into the lab and said, ‘You can’t get heart rates like that!’ ” Kasch recalls. But when Boyer listened, he retracted his statement. “One thing that’s good about Jack is that he’ll have a big opinion, but when he’s proven wrong, he'll change it,” Kasch says. “He’s open-minded.”
“We were the first exercise physiologist/physician team in the country,” Boyer says. With a doctor available to interpret the data, Kasch acquired an electrocardiograph, and by about 1965 Kasch and Boyer were ready to launch a formal rehabilitation program for heart-disease patients, “a pretty bold step then,” Boyer says. “My colleagues thought I was crazy.” However, the vast majority of the heart patients improved when they exercised, according to Boyer and Kasch, who by the late ’60s were doing sophisticated measurements of that improvement.
Although the Kasch Step Test is still in wide use today (the YMCA relies heavily upon it, for example), it’s really “not that good a test,” according to its developer. “You can’t be that exact with it,” he explains. “It’s not strenuous enough to separate the really highly fit people from the mediocre or low fit.”
Cardiovascular fitness has long been assessed by measuring the maximum amount of oxygen that a subject can utilize per minute. Every human activity — be it tooth-brushing or strolling at three miles an hour or running at three times that pace—requires oxygen. The more strenuous the activity, the more oxygen must be consumed. And the amount of oxygen required for any specific action is pretty much the same whether the person is an Olympic athlete or a couch potato.
The difference between the fit and the unfit person is their oxygen-burning capacity. Whereas an Olympic rower can use as much as 70 to 80 milliliters of oxygen per kilogram of their body weight per minute, the maximum oxygen uptake for the average 40- to 60-year-old American man is about 32 ml/kg/minute. At the low end of the scale, heart attack survivors might have a maximum capacity of as little as 10 to 15 ml/kg/minute. This difference in abilities means not only that the average or the unfit person can’t do some of the things elite athletes can, but also that the things they all can do will feel very different to each. Whereas strolling along at three miles an hour (an activity that burns about 10 milliliters of oxygen per kilogram per minute) will use only a seventh or an eighth of the elite athlete’s capacity, it will tax about a third of the capacity of the average American nun. And it might leave the heart-disease sufferer gasping— or prostrate.
Fitter individuals can utilize more oxygen per minute because they’re better at circulating blood through their bodies. Their hearts pump with more force and efficiency, their veins and arteries allow the blood to flow through with less resistance. But it’s a lot harder to measure cardiac function than oxygen uptake, so since the 1800s researchers have concentrated on the latter. They have typically measured maximum oxygen uptake by having the test subject breathe into a gas-collection bag for a precise amount of time while working to the limits of his capacity (running as fast as he can on a treadmill, for example, or pedaling as hard as possible on a stationary bicycle). After the exercise session, analysis of the contents of the bag reveals how much oxygen the person was using. Since large people use more oxygen than small people, these measurements are calculated per kilogram of body weight in order to cancel out body-size differences.
Kasch had taught himself how to do the painstaking calculations back when he was working with the rheumatic-fever patients. But at first he didn’t test the maximum oxygen uptake of every participant in the Adult Fitness Program; he lacked the time and the budget to do so. By the early 1960s, however, Kasch was using the maximum-oxygen-uptake test more routinely, and between 1966 and 1968, he and Boyer relied upon it as a key indicator in the first scientific study they did together.
The World Health Organization was then declaring that coronary heart disease had reached "epidemic” proportions, and a number of researchers were suggesting that sedentary living contributed to this. Epidemiologists, for example, had noticed that people with physically demanding jobs had fewer heart attacks. The notion that people might exercise in their leisure time to protect their hearts was also beginning to reach a wider audience.'
But though pioneers like Kasch had gathered plenty of anecdotal evidence suggesting that middle-aged men could become fitter by engaging in regular exercise, "There were no definitive studies showing this back in 1967,” Kasch says.
So he and Boyer set out to produce one. Funded by the U.S. Public Health Service, they recruited nine men between the ages of 39 and 60 who’d been sedentary for at least five years. For a control group, Boyer convinced six of his nonexercising patients to be guinea pigs. ("Dr. Boyer could sell ice to the Eskimos” Kasch says with admiration.) The two men made each test subject work out twice in the lab initially, “to be sure we had good reliable and valid data” They found that at the outset the control-group members were in slightly better shape than the exercisers-to-be. Their maximum oxygen uptake averaged 33.8 milliliters per kilogram per minute, versus 32.6.
The experimental group then began meeting three times per week to do calisthenics and to walk and jog. “And we tested them at 6, 12, 18, and 24 months.” The nonexercisers submitted to testing at those intervals. “Here were these couch potatoes that we tested all those times, and they tolerated it!” Kasch exclaims. “It was amazing! Nobody will ever do that again.”
By the end of the study period, two of the exercising men had dropped out But those who remained had left the nonexercisers in their cardiovascular dust. Various measurements gathered by Boyer and Kasch suggested that the aerobic workouts had trained the exercising men’s hearts to contract more strongly and conditioned their veins and arteries to dilate more readily (thus offering less resistance to the blood flow). In a separate study conducted about the same time and published in the Journal of the American Medical Association, Boyer and Kasch showed that the blood pressures of hypertensive men dropped significantly after six months of just twice-weekly exercise. “If we would exercise people seven days a week, we probably could make much bigger changes in blood pressure,” Kasch says today.
At the conclusion of the two-year study period, whereas the average maximum oxygen uptake among the nonexercisers had declined slightly (from 33.8 to 32.7 ml/kg/min), the exercising men had increased their aerobic capacity, on average, to 39.9 ml/kg/min. This represented a gain of more than 22 percent. Clearly, the answer to whether regular exercise could make middle-aged men more fit was yes.
Furthermore, the two-year study raised an interesting question. By the late 1960s, research had demonstrated that the average person’s aerobic capacity declines at a rate of roughly 1 to 2 percent per year. But these studies hadn’t looked at individuals who were getting regular vigorous exercise. If one were to monitor veteran exercisers over time, would they defy the pattern of steady deterioration?
In 1974 Kasch realized he could find out. He possessed data from a corps of 16 committed exercisers whom he had begun testing in 1964 and 1965. Seven of these were faculty members associated with the Adult Fitness Program (including Kasch and Boyer), while nine were participants in the program. Some had had their cardiovascular systems assessed almost every year. Kasch tested them all again in 1974, and in 1976 he reported on what he found in the journal Medicine and Science in Sports. At the end of the ten years, the men's average resting blood pressure was 123/76 — considerably below the average (136/83) for men their age (just over 55, on average). They hadn’t gained any weight. And their average maximum oxygen uptake had slightly improved — going from 43.7 to 44.4 ml/kg/minute. In other words, they were in at least as good shape — in fact, somewhat better — than they had been when they were ten years younger.
The study “really threw the whole field of exercise physiology into a tizzy,” Kasch says. “People couldn’t believe it. Because it wasn’t logical — a 55-year-old man being just as good as he was at 45, if he exercises." It suggested, Kasch says, “that you don’t have to fall apart.”
The next logical question was: for how long could the study subjects continue to maintain their level of fitness? For all his passion for exercise, Kasch didn’t think the answer would be “forever.” He assumed that the human body contains fundamental aging mechanisms that — in the long run — cannot be resisted. But Kasch suspected that regular vigorous activity could postpone the decline and extend life span. To test this hypothesis, the subjects in his study would have to continue exercising and Kasch would have to continue testing them as they got older and older. This in fact has happened. One of the original 16 men dropped out of Kasch’s study after the ten-year results were published, and four others have passed away. (Two died of lymphoma, both in 1991 at the age of 83; one developed Alzheimer’s disease and succumbed to it in 1993 at the age of 78; and pneumonia killed the fourth man at 74 five years ago.) However, the remaining 11 subjects (including Kasch and Boyer) are still religious about working out, and Kasch has tested them all five more times over the years, making the study the longest-running one of its kind anywhere in the world.
“It will never happen again either. We happened to be in the right place at the right time,” Kasch asserts. He says San Diego’s climate was a crucial factor in keeping the group together. “If it had been in Chicago or St. Louis or Cleveland or New York, forget it!” Upon retirement, the participants would have scattered. As it is, two of Kasch’s subjects have moved from San Diego, but Kasch has managed to get them to return whenever he has scheduled a follow-up evaluation.
The others have remained here, and to a man they express enthusiasm for their routine exertions. “I feel better when I do it [mostly jogging and weight-training], and I miss it when I don’t,” says Lindsay Carter, the youngest member of the group at 67. Ralph Grawunder, who’ll turn 70 at the beginning of October, says he finds his workouts (on strength-training and aerobic machines at his gym) to be such a source of pleasure, “even if we had research that definitively proved this was bad for you, I’d still keep at it.” Milt Austin says his conversion to exercise is “probably the reason why I’m still here.” Now 82, Austin wasn’t athletic in his youth, and by the time he turned 40, he was working “eight days a week” as the manager of a busy Art Leitch real estate office in Lemon Grove. But when a friend told him about SDSU’s fledgling Adult Fitness Program, he found time to join, and over the years he both swam and ran as a member of the program. He became a devoted cyclist and for some years averaged 125 miles per week on his bicycle.
Last year Austin suffered a minor stroke, so he doesn’t pedal around the city anymore, but he owns a Nordic Track and an Aerobic Rider, and he says he spends a half hour on each piece of equipment at least five days every week. Like him, some of the other members of the group have had to find alternative activities. Seventy-one-year-old Bill Phillips, a former colleague of Kasch’s in SDSU’s physical-education department, eight years ago needed to have both knees replaced, and as a result, he no longer runs. But he’s a competitive swimmer of such stature that last year he took 12 first places for his age division in national competitions. Swollen and painful knees began to trouble Bob Lazar, a former manager of Pacific Telephone, and Abe Friedman, another former SDSU professor, as well as Boyer, so all of them now do things that inflict less joint stress (such as walking and using aerobic machines). Dave Jessop, a retired optometrist from La Mesa who at 88 is the oldest of the study subjects, says he made a gradual switch from running to jogging to walking his black Labrador retriever. “But I also swim,” Jessop adds. “I hike. I skin-dive. I hunt. I work in the garden.”
Kasch’s laboratory tests of the men have proven, if anything, more impressive than their anecdotal testimony. Of particular interest was the evaluation that he did at the 28-year mark. For it Kasch and Boyer decided to compare the group of long-term exercisers (who then numbered 12) to a sedentary control group. They randomly compiled a list of men who had been tested by the Adult Fitness Program and exercised three times a week for a while but then had dropped out and avoided any regular activity for 21 years. Kasch contacted 12 of them, and none turned down the invitation to be retested. The test results told a dramatic story. The exercisers (who were then 71.3 years old on average) had experienced some decline over the 28 years since they were first tested. Their maximum oxygen uptakes had dropped from an average of 45.9 milliliters per kilogram per minute to 39.4 — about a half a percent per year. The dropouts, however (whose age averaged 68.8 years), had lost capacity at a rate of 1.9 percent per year — almost four times the rate of the active men.
In other ways, too, the dropouts appeared to he a pretty sorry lot. Eight of the 12 had some form of arteriosclerosis (compared to only 1 of the 12 exercisers), 7 had high blood pressure, and 1 man had had a coronary bypass. The nonexercisers’ lung function had plunged by 40 percent, and their average resting blood pressure had climbed to 149/90 (compared to 128/85 when they were first tested). In comparison, the exercisers had an average bkxxl pressure (119/75) that one might expect to find in a group of 20-year-olds.
The control group members were in such bad shape that Kasch says he would never want to test them again; even a brief workout session would be too dangerous, he thinks. He did assess the exercisers again, however, in 1996 and 1997 (roughly at the 33-year mark), and those results will be reported in Age and Ageing later this year. Kasch says his group’s aerobic capacity has continued to decline at a rate of about a half percent a year— about half the rate that’s reported most commonly among the general public. And Kasch believes the study now can be said to confirm his assumption that exercise increases longevity. While the average life expectancy for American men is around 72 or 73, he says the average age of the 15 men in his study (including the men who died) is now 78. “And the remaining people are very, very much alive.” Certainly they’re going to reach an average age of 80, Kasch thinks. “That would put us out to seven or eight years beyond life expectancy. That’s an appreciable amount!"
Kasch says at least one colleague in another city has suggested to him that the study ought to continue until the last man in it dies, but Kasch thinks, “It probably doesn’t really make sense to do that." He’d like to bring the group together in the fall of 2001 and test everyone one final time. “At that point I’ll be 88 and Dave Jessop will be 90. The youngest person will be 69. The average age will be about 80.” The study will have lasted 37 years. “That isn’t too bad,” Kasch judges. “I defy anybody else to do it.”
If the end of the long-term study is in sight, the Adult Fitness Program is still thriving and has served as the model for roughly 100 similar programs all over the country. Kasch no longer oversees his original one; he retired from San Diego State at the end of 1980, and a professor named Jeanne Nichols now directs the program. She says several thousand men and women have participated in it over the years. In 1972, because of liability concerns, university administrators declared that the program could no longer accept people with heart disease, but anyone else who’s willing to pay the annual fees is still welcome to join.
All prospective members begin by undergoing two days of comprehensive testing (for which SDSU charges $290). Students working on their master’s degrees in exercise physiology check the test subject’s lung capacity, record resting pulse and blood pressure, and draw blood for analysis. They weigh each person underwater— the most accurate way of determining what percentage of the subject’s body is composed of fat.
When the test subject returns two days later, students attach electrodes to his or her chest. Then the person runs or walks on a treadmill while a cardiologist watches the heart’s electrical activity on a monitor. These days would-be participants no longer breathe into a gas-collection bag while they’re working to their maximum capacity. Nichols says the bag is uncomfortable, and she worried that it might hinder the subject’s ability to communicate any dangerous symptoms. Instead, graduate students use formulas to estimate the maximum oxygen uptake. Although Kasch, who loves precise data, sneers at the potential for error in such estimates, Nichols defends their reliability and points out that most Adult Fitness Program participants no longer are subjects in ongoing research into aerobic capacity. She says the point of measuring the oxygen uptake is just to give the person a basic idea of his or her fitness level. The point of the stress test is to identify latent heart disease (which the test can do between 40 and 80 percent of the time, depending upon how many coronary arteries are blocked). Healthy people get a prescription for the level of exercise they should be doing.
Nichols says some people exercise on their own after being tested. Others (who pay between $120 and $250 additional per year) participate in three-times-weekly morning or evening classes. Around 67 individuals between the ages of 38 and 92 currently do this. Some walk and some jog. Although the swimming classes have been eliminated, Nichols says strength training was added about ten years ago, and recently she’s begun trying to incorporate activities to improve balance (one of the hotter areas of concern nowadays, since falls can be so devastating). Apart from the benefits of the specific activities, the social aspects of the program are a powerful attraction, testifies Charlie Ross, a retired newsman who’s been a member for around 20 years. “There’s peer pressure, pure and simple,” he says. “Everybody keeps track of everybody, so there’s no goofing off.”
Kasch says the social aspects of the fitness program have always been powerful. He sounds like he enjoyed them himself. But he has plenty else to pre-occupy him nowadays. His first wife died in the 1970s, but about six years ago Kasch, at 79, married a widow from Wisconsin. They live in her house in Lake Geneva June through December, then return to Kasch’s house in Kensington and stay until about May. Medical and scientific conferences and lecture appearances also lure him on the road several times a year, plus he continues to dabble in small research projects. For fun, he skis and hikes and Boogie boards and hunts deer with a bow and arrow. With all that, he drove 17,000 miles in just one seven-month interval last year.
Wherever he is, he tries to keep up his personal exercise regimen five or six days a week. He devotes about 20 minutes to muscle work—“two or three sets of pull-ups, three or four sets of pushups, and two or three sets of dips.” He does some stretching, and then he spends about 40 minutes working his cardiovascular system. Sometimes he rides his stationary bike, which has the advantage of allowing him to read archery magazines while he pedals. But he says nothing can raise his heart rate like donning his running shoes and taking to the street.
If the sight of Kasch running stopped being an oddity decades ago, his running shoes still rank as one. They look a bit like ancient saddle shoes, with the saddles a blood-red color and the rest of the oxford a dirty cream. Although they bear no obvious logo, they were made by New Balance. Kasch explains that back in 1964 he went running one day with his friend, fitness guru Ken Cooper, and Cooper recommended the then-new footgear to him. Kasch found an El Cajon shoe store that carried the brand, and he bought a half dozen pair in a size that was too long. He took these to a local shoemaker and had him cut off the tips to make them fit Kasch’s feet, which are very wide, with the first three toes in a straight line. Kasch also found the manufacturer of the shoes’ “ripple soles” and stockpiled a bunch. He’s worn the same shoes ever since, replacing the soles whenever they’ve worn out.
They don’t provide any padding to speak of, but Kasch doesn’t believe you need it. “Good padding is wrong,” he declares. ‘The idea is to have this padding to make it easy to run on the hard surfaces. Well, there was a study done by a couple of Canadians a few years ago.. .and what they found was that when you have this thick padding, the sensory nerves in your leg don’t get the feel when you hit. For that reason, the muscles don’t contract soon enough to hold the knee joint in place. But if you have a thinner sole, you get the feeling, and the quadriceps muscles will hold this joint in place so that it’s not sliding around. But this goes against what would seem logical — that you need a padded shoe to take the shock.”
Kasch would seem to be living proof of the contrary view. For all the running that he’s done, his knees have never bothered him. His calves and thighs still look chiseled, and the skin that covers them is still smooth and creamy. Only when Kasch starts to run does his age begin to show; after a block or two, he has to slow to a walk. This galls him. Back in the ’70s and early ’80s, “I used to train at an eight-minute-mile pace that was just a breeze.” He could run backward at that speed, for heaven’s sake, when he was coaching the Adult Fitness Program members. But he says another thing the regular testing of his long-term study has shown him is that declines in fitness don’t occur in a linear fashion.
In his case, his maximum oxygen uptake stayed above 46 ml/kg/minute from 1964 until the late 1980s. Then it dropped to about 40, where it remained steady for another ten years. “And then all of a sudden — bong! — it went down again.” His number was just below 35 in 1996, the last time he was tested. He thinks this happened because that year he developed a severe case of pneumonia — a stroke of bad luck that he still recounts with disbelief. About a year and a half ago, he came down with another serious respiratory infection. “So it’s taken something out of me,” he says. “I’m slowly getting back. But you don’t get back so fast at my age.”
One recent glorious spring morning, he was working on his conditioning by doing interval training—jogging until his pulse climbed and then walking until it settled down. As he walked, Kasch reflected on an irony that has unfolded during the course of his career. The studies that demonstrate the health benefits of exercise could fill a library, and Kasch says the American College of Sports Medicine claims that something like 160 exercise-related jobs have come into being. Yet a majority of Americans have never been in worse shape. A third are obese, and the number appears to be rising. Only about 15 percent of U.S. adults engage in regular vigorous physical activity for a minimum of 20 minutes three times a week, according to the Surgeon General’s 1996 report on physical activity and health. About a quarter of all Americans 18 or older get no physical activity at all in their leisure time, the same source says.
Kasch says many of his colleagues are now taking the position that the way to change that is to start out with lower expectations. Rather than trying to persuade nonexerciscrs to start running, health authorities should work on getting them to take up an easy activity such as strolling or gardening. Kasch doesn’t quarrel with it. He agrees that it should prove easier to sell to the sedentary masses. And some of the individuals who respond may go on to increase their activity to the point where it protects them from dying of heart attacks.
Toward those who don’t, however, Kasch confesses to having a negative attitude. If you show people the harmful consequences of inactivity and they still refuse to get active, well, he’s not the sort of man to stew over it. He’s the sort to keep his eyes on what he’s doing, which at the moment is running, even though he’ll have to slow down in another block or two. He’ll walk a bit. Then he’ll run some more. He’ll do it over and over. Tonight he’ll sleep well, and tomorrow he’ll be out on the street, stretching and moving again.