“5/2, tried that, and I know someone who religiously followed the Hay diet/Atkins/Keto/Paleo diets. I even met a Breatharian (just air to eat!), nothing works,” bemoaned a patient. Another talked of their gym plan/walking 10,000 steps/ultimate workout/cardio in guilt laden tones. Then I heard of work life balance/mental gym & health gurus. Despite all these wonderful ideas {and most if not all, contain pearls of wisdom} we still struggle to keep our health and looks. In the ‘diets’ the missing ingredient was knowledge of the gut microbiome which now provides an exciting explosion of insight as to how our food keeps us healthy. If there is a secret for our digestion is there one for our bodies?
The Bible states that we are ‘wonderfully and fearfully made’, but made for what? It seems we started as hunter gatherers for 500,000 years and our bodies were formed for walking, running and squatting. Later for 20,000 years we were moulded by an agricultural life of stretching, lifting, bending and squatting. Then 200 years ago the industrial revolution mass produced the chair (and there are now 7 chairs for every person in the world).
Now, we sit.
We are sitting at the breakfast table, sitting in the car to work, sitting at work, sitting for lunch, returning to sit through the afternoon. Thence car home…and on the couch for the TV. In his wonderful book Primate Change, Prof V. Cregan-Reid estimates that the average employed adult sits 15 hours per day.
In 2010 an American cancer society study compared women who were sedentary for less than three hours per day with those who were sedentary for more than six. The latter had an increased risk of death of 94% during the trial. It turns out that similar to lack of sleep (that one cannot catch up after a week of late nights by spending Sunday mornings in bed), we cannot do hardcore exercise to make up for the stationary lifestyle.
In 2020 British stats reveal that our average day is six and half hours in front of the screen before we add in yet more sitting around.
At this point we need to leave the science of statistics (so often called ‘evidence based’) and use logic-based deduction. When the tissues of the body are under-used there is a reduced flow of blood and the inter-cellular fluids stagnate. Just as a slow flowing stream will silt up, so the tissues will start to accumulate debris and deposits. At first this will negligible, like tax at 1% but as the months pass it will take a greater toll. Remember a VAT rise from 8% to 17.5%. This was said to be the leading cause of business bankruptcy and similarly a stealthy rise of dregs in the tissues will cause degeneration. Just as a good business deal will keep a firm afloat but not change the direction of decline, so a visit to the gym will be wonderful today but leave the reckoning till tomorrow.
Like tuning a piano, finding the adjustments needed for one’s own body is both a skilful art and satisfying science. Perhaps first is to realise each piano is different so each player must learn about their own instrument and not rely on the average, ie take advice but make a decision based on knowledge learned from using your own body. One women’s perfect hairstyle is another women’s fright. Next is to include movement in your day. Even office-based work can include built in activity be it a roly-poly stool, a stand-up desk or even a bicycle desk! Other ideas are to include regular breaks for errands etc, change seating, change the seat adjustment. The real winner, however is to create movement in your work. Also ensure it is thought out for those working for/with you and notice when it gives increased energy. A London survey in 1953 found that bus conductors had half as many heart attacks as the drivers, so bear this in mind if people laugh at you.
It turns out that ‘being fit’ is not about triathlons and exercise machines, which are great for strength building and endurance, but a question of ‘sit a lot and you won’t stay fit for long’. Perhaps we have come to believe that if we’re not training for a Marathon we might as well not bother to do anything? In Dan Buettner’s book, the Blue Zones, we are introduced to the joy-filled lives of the eldest [and healthiest] communities in the world – older people who still use their bodies for growing their food, walk or cycle to wherever they wish to go, take time to prepare simple meals to share with friends or family - brings an inner smile and a breath of hope for our future. Indeed, it all turns out to be simple - Keep on the go and you will go on.
I had to sit still! for three hours to write this so thank you for reading it.
Aug 2020
Christopher Grey, Osteopath
Four Wins - a presentation to Damian Hinds MP
I’d like to explain the relevance of active travel to health alongside environmental issues. I have been a health practitioner 30 years although I started as a chemist from Imperial college – please forgive if the stats sound dry. I see every day first hand how activity is key to longevity.
A popular saying is that helping people live longer will increase the burden on the NHS, more years of infirmity and chronic pain to fund etc. Curiously animal experiments of delaying cell ageing through altering DNA or diets show a compression of the disease time at end of life[1]– by up to 50%! This is documented in humans in the Blue Zones, the five areas in the world where people live the longest. They have 75% less dementia than in the US (about 65% less than us). Prof Rose Ann Kelly of Trinity College, Dublin, medical longevity expert writes “All Research shows healthier lifestyle compresses the years of morbidity ie chronic ill health by up to a half.”
I would like to turn now to the ‘Ageing and health expenditure report’ on the Gov.uk website.
Average years of poor health in 2016 was 17yrs and 8months. This being 19.3 in women and 16.2 in men. These figures are rising steadily and yet it notes “Costs (to the NHS) are higher of dying at a young age IE below 70 and appear to decrease with increasing age.”
Using Gov.uk statistics we find care costs to the NHS in these infirm years is an average of 10K pa so per person adding up to 177.5K for each of us – note nursing homes range from £27 to £39Kpa!
So if the slowing the ageing process saved;
10% that’s £17K pp for NHS end of life care
50% it’s up to £89K pp for NHS end of life care
Now remembering that end of life care is by far the largest part of the 160bn NHS budget, this at 10%, is 11bn while at 50% it’s 59bn. Eye watering figures not to mention increased productivity to carry on working as well as less years of pain!
Locally from the HCC (Hampshire County Council) website we spend 2.6bn on care of the elderly/nursing homes. Applying the above figures 0.26 to 1.3bn could be saved.
How can we change people’s health? To affect food choices is challenging politically, to change mental health (so important in longevity) is expensive etc however we can change activity through promoting and encouraging active travel which after mental health is the next most important.
There are a myriad of research papers on this but I would like to pick out three.
*Biobank study 2017[2] entitled ‘Association between active commuting and incidental heart disease, cancer and mortality’. It is widely quoted in the BMJ
Sample base 250,000 people, North of England
Walk to work vs driving; 30% decrease in heart disease
Cycle to work vs driving; Decrease of 40% decrease in all mortality, 40% in diabetes, 50% in heart disease and 50% in cancer!
Similar findings were published in 2011 in Denmark again with ¼ million people.
*In an ongoing project in Southern Edinburgh, ROSPA[3] reports; where they have reduced the speed limits to 20mph have shown a 7% increase in walking, 5% increase in cycling while a 3% decrease in car journeys.
It has also saved in 2 years over 12 million on health budgets by reducing the mortality of road accidents from 8% to 2% (quite apart from these lives saved.)
This report also noted that Bristol’s 20mph reduction had increased walking and cycling by 12%
Of note is www.cycling.org website finds cycle vs car to work gives cancer down 45%, cardio-vasc disease down 46% and all deaths down 41%.
*The last is about peak bone mass growth[4]
This occurs between 12.5 and 14. High bone mass from these years mean that people enter osteoporosis 13 years later. Of note is that in the elderly there are more visits to A & E re fractures than heart attacks.
Schools by nature are for studying and 7 out of 10 parents do not think roads are safe for children, so it’s sit down for breakfast, sit in the car and sit at school. Repeat. Further there are other aspects such as mental health, socialising, confidence/little pockets of safe independence…
Peak bone mass/density is related to weight bearing activity like Walking/cycling to school.
Four big wins;
Win 1: Save billions for NHS and 100’s 0f thousands for HCC
Win 2: Reduce the number of people suffering from frightening chronic diseases
Win 3: Help rebuild our rapidly declining communities
Win 4: Be noted as the party or/and council that achieved this transformation
Actually, 5: By reducing Green House Gas emissions we help safeguard future generations.
How?
20 mph in all residential streets except perhaps link roads. Note some councillors say the police charge 7 thousand for this, however others disagree. 2nd Note rumour says 20 mph signs do not work – they are very successful in Selbourne, Edinburgh, Brighton, I could go on. I also note that it will take time for it to become the new norm just as seat belt wearing did. If they had been changed 5 years ago they would by now be normal.
Pedestrianize town centres. Again, rumour has it that business will suffer, but here in the South, Chichester and Winchester are ‘Destination Towns’ and thriving economic communities. Obviously, those with access problems would be accommodated. But imagine any town centre dotted with trees, places to sit, to gather, children playing while parents watch from pavement cafes, local growers selling local produce, easy access for charities etc.
Dedicated cycle lanes – lots and preferably joined together! Of course, Car owners would object however there are 3.1 million cycle sold per year compared to 7.5 mill cars. So proportionately, 30% of the road budget/area should be for cycles. Currently, 6 out of 10 adults surveyed said they found roads to dangerous to cycle on. Ask Joel how he get’s around in the Netherlands. Has he cycled during this trip? Why not?
There are excellent models out there. Chris Boardman is available for consultation and maybe HCC could share the costs of such with CCC or others?
Christopher Grey B.Sc. D.O. June 2023
[1] Age Proof, P51, Prof Rose Ann Kenny
[2] Biobank study 2017, Cycling.BMJ
[3] ROSPA Nov 2020 ’20 mph zones and limits factsheet’.
[4] Optimizing bone health in children and adolescents 2014, American Academy of Pediatrics,