To the limit: Dr Hugh Montgomery in training for a 135km marathon in Spain
Sophie Goodchild12 April 2012

This year's Flora London Marathon runners will cover the normal distance of 26 miles 385 yards. But for Dr Hugh Montgomery that's just not going nearly far enough...

Pushing himself to the physical limit is Dr Hugh Montgomery's passion. The endurance expert has run three 100km ultra-marathons, scaled the world's sixth highest mountain — Cho Oyu in Tibet — jumped naked from a plane at 14,000ft and set a world record for the longest time playing the piano under water.

While the rest of London is preparing for the marathon, his latest challenge is to follow in the footsteps of pilgrims.

In June, the London intensive care consultant is off to Spain to run the 135km from Tricastela to the holy city of Santiago de Compostela. An average person would take five days.

Montgomery aims to complete the journey in just one. It's all in a good cause — he is raising money for SafeHands for Mothers, which helps reduce maternal and infant deaths in the third world.

A conventional 42km marathon is achievement enough for most people. But for Montgomery the distance is just not stimulating enough. Instead, he goes ultra-running — defined as any distance of more than 100km. The doctor, who works 12-hour days at University College Hospital (UCH), defines himself as a "turbo nutter" whose philosophy is that "everything in life is an opportunity".

"My biggest fear is dying unfulfilled," he says. "I just think 'why not?' and find it hard to say no. And I don't want to regret not trying something." Running marathons is not just a hobby for 46-year-old Montgomery. As well as saving lives, he heads up University College London's Centre for Cardiovascular Research. His scientific work has helped unlock the secret of how the human body can keep going for incredible distances, a topic many of us will be thinking about with only two weeks to go until the London marathon.

Just under a decade ago Montgomery made a major scientific breakthrough — he identified the gene responsible for fitness. Everyone has two copies of this gene known as "ACE". But around one in four people are born with a special genetic combination that enables them to respond better to training. Tests on army recruits and mountaineers show these alpha types gain the most muscle mass and lose more body fat during intensive physical training. They can also survive on low oxygen levels — crucial for endurance sports.

So does Dr Montgomery have the elite version of ACE? The answer is no, despite his athletic achievements. In science-speak he is a "DD" — the type with the greatest genetic disadvantage.

Yet good genes are not the only ingredient for enduring long distances, he stresses. The real secret of keeping going is a strong mind, pacing yourself, using "fuel" efficiently and not aiming to come first unless you're fit enough.

"The mind is very important," he says. "It's amazing what you can do if your life depends on it. If you look at life in an intensive care unit then the die is cast depending on how fit you are.

There are people who choose to go on or give up. That said, while you can drive yourself to do extraordinary things, it's like constructing a building out of jelly if you don't have the physical capacity." Montgomery's research has implications way beyond endurance exercise. It could aid critically ill patients, such as those with cancer whose bodies are wasting away, and could help develop treatments for heart attack or stroke.

The human body is, he says, "an amazing machine" and the secret of driving it is learning how to deliver fuel and oxygen to the body so the muscles can work efficiently. The fitter you are, the more effective your body is at using oxygen, so you burn less fuel. Burning less fuel is crucial on long distances such as marathons because the body only stores a limited amount.

"If you had to drive to Scotland quickly, you'd use the car with the biggest engine," says Montgomery. "But if I said do it on one tank of petrol, you'd use a fuel-efficient vehicle." The same principle applies with your body, he says. Marathon runners should be "thin, thin, thin" with efficient muscles, a strong heart and good lungs to get the oxygen in.

Can you train to be like this? "Of course. Sharron Davies (the former Olympic swimmer) wasn't born with broad shoulders. She developed them.

As you train, your heart muscle gets thicker within days, your lungs become more efficient and you physically grow more small blood vessels for transporting oxygen." Montgomery's regime starts with a five-mile cycle ride to work from the home in Hackney he shares with wife Mary, a paediatric doctor, and their children, Oscar, six, and threeand- a- half- year- old Fergus. At the end of his work shift, he cycles home and goes for a run. Gym workouts are limited to one a week. He uses a stepping machine to work on his lower limbs and does pull- ups to strengthen his upper body. Curry is his food of choice but he switches to pasta before a race.

Today he weighs in at a lean 81kg ( he is 6ft 2in). But he has not always been a well- oiled running machine.

He was so unfit in his late twenties that a five- minute session on a gym bike left him vomiting with exhaustion.

" I was 29 and working ridiculous hours in the NHS. The trigger for getting fit was going down the gym with a friend, overdoing the exercise, and throwing up with exhaustion.

We were like: ' How did we get like this?' The first four months of training were horrid. The only thing that kept me going was shame." It was working with the Army that introduced him to ultra-marathons.

At the same time as his own fitness epiphany he began research into the body's response to training in extreme conditions. His guinea- pigs were Army recruits. They told him about the 100km Trailwalker run in Hong Kong. At the time, he had not even completed a half- marathon, let alone an extreme run.

" By the end my feet were covered in blisters and I was hobbling. But nothing in life is enjoyable if it's easy. Humans don't feel satisfied unless we're really challenged.

There's pleasure in getting to know how your body works. I never give up on something I've decided to do, but the key is not trying to come first .

You should only push yourself if you are physically able." It is hard to imagine Montgomery ever being idle. When he's not extreme running or saving patients he writes children's books, and his screenplay for a thriller called Reputation is in production.

He has only run the Flora London Marathon once but he describes it as a " fantastic" experience. His message for runners in this year's race is " enjoy it — and pace yourself".

" There's no point running if you're just going to suffer. It should be like being at your own wedding: there are all these people saying ' we like you and we want you to succeed'. They're lining the streets cheering you on.

It's all about having a good day out.

And don't try and come first."

'My biggest fear is dying unfulfilled. I don't want to regret not trying something'' I never give up on something I've decided to do, but the key is not trying to come first'

More information: www.safehands.org

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