Chapter 41

Sidetrack  (vi) 

Cardio, Couch or Calories?

Imagine it’s your 21st birthday.  You’ve just been given a present you could never dream of: a brand new car, carefully selected to match your personality, your interests and your physical characteristics. 

A sporty type might end up with something nippy or maybe the road version of a rally car designed for endurance.  A quirky, arty type might find themselves in a VW beetle or 2CV with flowered motifs, whilst high-flying achievers would be assigned the BMWs and Audis.  Social, girls-about-town get the Minis and Fiestas, perfect for their flitting here, there and everywhere lifestyle, whilst the practical chaps take delivery of brand new estates and SUVs.   And if you need to change style due to life-style change, having a family for example, you can exchange for a more suitable one, but please note, it won’t be a new one, its age and condition will be exactly the same as the current state of the one you started with.

What a brilliant gift!  There’s just one catch:  It’s the only car you will ever own.

What?  Seriously?

Yup. I’m afraid so……But don’t worry, it’s quite possible to make it last a lifetime. 

Really, what even into old-age?

That’s right.  If you just look after it, keep it serviced, it will still be going strong for another fifty years, unless you’re very unlucky.

And guess what?  The government will help make sure things are okay.  Each year they’ll do a thing called an MOT to check that the basics are all working fine and give you a certificate to say that you’re safe for another twelve months.

Sounds great.  And tell me again what I’ve got to do?

Easy.  Just use the right fuel, keep the lubricants topped up, replace the tyres when they’re worn out, keep any eye on the bodywork, and above all, deal with any warning lights on the dash if they come on.   But here’s the important thing: this car has been designed to be used.  Don’t leave it in the garage or sitting on the drive.  If you do, the engine will lose its spark, the tubes will become clogged, the wiring begin to fray, the rubber on the tyres start to perish, and the battery run flat.  Just make sure you give it a regular spin.  A couple of times a week should do it; it doesn’t need to be a long run up the motorway as just a few short, sharp trips are enough to keep it in shape.

So how come most of us don’t look after this fantastic gift?  And how come the government doesn’t do more to persuade us?

And the consequence of this is that all the garages in the country are overwhelmed by emergency breakdowns, repairs and recovery.  And even if they manage to stay out the garage, the quality of most of the vehicles still out on the road is continuing to decline, storing up further problems for the organisations and institutions supposed to keep everything safe and on the road. 

It’s a fact that we’ve probably spent more on buying the actual cars we’ve owned over the years than we’ve ever done on our one and only body.  If you then add in all the bills for keeping your car on the road, the balance of expenditure between these two assets seems completely skewed in the wrong direction.  It’s self-evident that you can usually do without one for a few days if necessary, whilst you can’t do without the other for even a few minutes if it stops working.

But it’s worse than that.  Rather than just neglecting to keep our body serviced, most of us have actually contributed to an accelerating deterioration.  We’ve abused it by electing to use the wrong food as fuel, failed to keep the joints supple, allowed the muscles to prematurely lose their power, and blatantly ignored the fact that our chassis and engine need to be given a regular spin.

Why has this happened?  Well the root of the problem is that, despite a couple of million years of evolutionary refinement, we’ve managed in the just the space of a couple of generations to uncover a couple of ‘design problems’ 

The first problem is connected to the design limits of the system.  Focused for millennia on a daily scavenge for sufficient nutritious food, our bodies are unprepared to deal with a sudden overload. The hunter-gatherer diet of nuts, berries, fruit and fish, supplemented with the occasional bonus of mammoth or antelope steak, was generally sufficient to keep the fuel tank topped up.

Consequently the body and its systems adapted to be able to efficiently use and control the ingredients.  Suddenly, in the last few decades, there’s a surplus of fuel being injected and some of the constituents of this excess are proving difficult to deal with.  Too many vitamins isn’t the end of the world; they just can evicted and come out in the wash.  Too many sugars or fats, on the other hand, cause the body to store them away; a type of  insurance in case you need to run for longer than usual next week to escape a chasing lion or against that next drought when you won’t be able to find your favourite mangoes.  Unfortunately, the usual store cupboard for sugars and fats has only so much room, so the excess just builds up in all the places that it really shouldn’t and the control systems for keeping it all in balance and in the right places starts to fail.   And just to make it a little harder most of us add another toxin to the mix on a regular basis with that extra glass of red wine or pint of IPA.  We all know the result of overload: it’s the obesity, diabetes, liver disease, strokes, heart failures and all the rest we keep getting warned about.

The evolutionary process is clever; it will respond to all sorts of changing circumstances, but it can’t do it in a generation.

The second problem just makes the first problem worse.  Rather than being associated with system limits, this other problem is an actual flaw in the ‘design software’ itself.  Basically, somebody left in a line of genetic code, let’s call it the ‘only if I have to’ gene, the purpose of which is to ensure the body doesn’t waste resources and energy if it doesn’t need to.  Sensible, you might think, but beware, because the body has another special talent.   It can adapt quite quickly to the demands we place upon it.  Remember we’ve been designed by evolution to be able to jog for hours across the savannah running down antelopes, or walk steadily for days across mountain landscapes or arid deserts to find new pastures.  All we need to do is remind the body of this fact and it can switch back on some of these latent attributes.  Even today, despite our comfortable existence, Mister and Missus Average can tune up their body in a matter of weeks.  

‘Want to do the local Park Run or finish the London Marathon?’  A few short runs will reactivate the system and just six months’ training should be enough to boost the mitochondria in the muscle cells and the oxygen carrying capacity of the blood to a sufficient level to keep going for 26.2 miles.

‘Want a six-pack stomach or to be able to bench press half your body weight?’  Just a couple of sessions lifting weights in the gym will at least slow the muscle decline that started in your thirties and, within a couple of months, you’ll begin to notice the desired change in body shape. 

‘Want to learn how to dance or play tennis?’  It’s the same thing: after a few weeks, the nervous system and muscles will establish the links and start to remember the moves.

And any of these adaptations are just the obvious, visible and apparent ones. Below the surface there’s more good stuff that starts to go on.  The whole system responds positively: the right hormones are produced, food is better utilised, waste is flushed out, joints are lubricated and tendons and ligaments strengthened and the neural activity and links in the brain are enhanced.  And the chances are, even a short amount of exercise will encourage the body to sleep better with all the associated benefits of well-being and recovery.

But here’s the issue with the body’s ability to adapt.  It works in the opposite direction as well. 

Reduce the level of exercise and mental stimulus and this design flaw allows the body to drop a gear or two.  After all, there’s no point allocating resources to maintaining muscles and a cardio system when apparently there’s no need to do so.  Sit on the sofa too long and the body will adapt to what it thinks is the new normal.  The muscles waste, the cardio system loses efficiency and things start to tighten and seize up.

None of this has been a problem until recently as all of our ancestors have been so busy running away from marauding lions, escaping threatening enemy tribes and other catastrophes that they barely had time to sit down around the campfires doing nothing.  And it wasn’t like a declining body would have been particularly noticeable; few of us made it beyond middle-age anyway and it was only the powerful and well-off who exhibited the results of an over-indulgent life.  Henry VIII and Friar Tuck spring to mind.  It really is during the last generation and not the preceding 20,000 generations that most of us have been able to enjoy a bumper selection of processed food and drink, whilst simultaneously being offered entertainment options which require nothing more than a chair to sit on and a finger to flick a control device.

So just to restate the bleedin’ obvious:  Eat the wrong stuff, don’t do any exercise and our wonderful vehicle, the only one we’ve got, will start to show signs of wear and tear, might struggle to start or travel as far as it used to, and might even give up the ghost before its potential expiry date. 

So why aren’t we doing something about it ourselves?  Why aren’t we being ‘really’ encouraged to do something about it?  Why are the powers-that-be, who are responsible for keeping the nation safe and healthy, allowing it to happen?  And why are the corporate forces and social influences leading us in the wrong direction not being properly regulated?

Just a few thoughts to be going on with…

It’s back to those rogue genes and an inbuilt lack of willpower in all of us.  Most of the time, given a choice, we’ll opt for the easy road, the path of least effort, the tastiest food, or the source of most pleasure.  Some of us fight these tendencies some of the time but not everyone has the opportunity, money or inclination.  Life sometimes just gets in the way and there’s always something else to do.  Gentle education and awareness hasn’t proved effective at changing our communal mindsets; we’ve still not been persuaded that we should devote as much love and attention to our bodies as we seem prepared to throw at our cars. 

So surely the messaging needs to be stepped up.  And let’s keep it simple and not worry too much about some of the scientific nuances.  In fact, everyone in the population should be able to reel off the top five as easily as they can recall at least half of the Ten Commandments. 

1. Consuming more calories than are used up by physical activity will lead to weight gain.

2. Using more calories in physical activity than are consumed will lead to weight loss.

3. Eat a balanced diet.  Too much sugar, fat and carbohydrates will upset the body control mechanisms and cause problems elsewhere

4. Exercise is beneficial to the body and mind of us all; every bit helps but more is almost always better

 5. Exercise is especially important as we grow older.

Note -

From our thirties onwards exercise is even more vital to help slow the decline in muscle-mass (2% a year), bone density (2% a year in women), heart performance (1% a year), flexibility and cognitive functions.  In fact pretty much everything decreases apart from body fat which is just another undesirable consequence of ageing.

Couldn’t be simpler.  These little mantras need to be everywhere and become a code to live by just as much as not stealing, not telling lies, or not bunking off with the neighbour’s other-half.  Ram them home at school, in the media, on the buses and trains, everywhere. 

And if the simple messaging isn’t working?   Well we should expect some encouragement from those employed, or elected, to keep us safe and healthy.  Em…tell me that again.

A few examples illustrate how seriously our custodians view this task.

Free school milk for the over-sevens was abolished in 1971. 

School meal menu ‘options’ introduced over the last twenty years.  Not surprisingly the kids tend to choose the least nutritional, cheaper to produce, dishes.

Plans to enhance the 2018 levy on sugary drinks by introducing a sugar and salt tax have been shelved in 2022.

Between 1979 and 1997, the Conservative government sold off around 10,000 playing fields. (The Labour government sold off 226 between 1997 and 2010).

The number of swimming pools has been steadily declining since the 1970s as ageing Victorian Baths have not been replaced at the same rate.  The dispersion of pools around the country is also far from being even with the highest density not surprisingly being in London.

PE teacher numbers and time spent doing PE at school are down 25% since my school days, of which 10% has been since the 2012 London Olympics, reneging on a commitment that the Games would leave a lasting legacy for the youth of the country.

The lack of a coordinated, focused and funded commitment to urban public transport and safe options for pedestrians and cyclists means people choose to take the car.  Whoever heard of the ‘school run’ a generation ago?  It can be done properly; just look at London or across the Channel. 

Why don’t the government get it?  They’re perfectly prepared to look after our safety and well-being from other threats.   MOTs, licensing, fines, speed and alcohol limits and the like do a decent job of keeping us safe from ourselves on the roads.  

Gun laws, drug legislation, seat belts and tobacco and alcohol restrictions have been generally successful at stopping us really hurting ourselves.  But when it comes to preventing us allowing our bodies to slowly deteriorate to a dangerous condition, politicians have been reluctant to act; not being accused of furthering a ‘nanny state’ or interfering with our individual freedom to choose is viewed as more of a priority than ‘heading off at the pass’ the tidal wave of health costs and misery that’s coming down the line, led by a vanguard of waddling adults and children.  Just go and sit in Outpatients at a major hospital for a few hours to see where we’re going.

It needs a step change in actions to support a step change in the messaging.  How about:

Annual MOT health checks for everyone from school age onwards, including the issue of a certificate with any failures or advisory actions clearly identified and explained.

Remedial actions to be supported and monitored by fully-funded Community Personal Trainer/Nutritionists and community programmes.  Gyms, village halls, parks, schools both private and state, and so on will be required to allocate some time and facilities to complement what should be achievable at home and at little or no cost.  On-line courses can work; I know, most of my crash recovery physio was conducted via two-way video.  And with smart watches, Fit Bits and the like, it’s quite possible to keep an eye on how things are going

So what happens if a family or individual refuses to respond to the ‘fix-it’ plan and repeatedly fails the Health MOT for ‘self-induced’ conditions?   Most of us respond better to being hit in the pocket than to just words and threats, so how about an NHS Levy on their income, council tax or benefits?  Let’s call it the ‘haven’t looked after myself’ charge and make it cumulative with just enough exemptions to ensure those with conditions beyond their control don’t get penalised.

And whilst on the subject of responding to being hit in the pocket, let’s do something about the supply side.  Voluntary codes don’t cut it.  Local councillors are quite happy to allow yet another fast-food joint to open on the High Street rather than forgo the extra business rate income.  Fizzy drink and processed food manufacturers are quite happy to talk about reducing sugar and salt content whilst pushing the products via other insidious targeting.  Privatised bus companies publicise their improved technologies at the same time as cutting services.  In all my years working in the domestic appliance business, the only time our company actually responded to changing requirements on pollution, waste, and recycling was when confronted by legislation; anything other than that didn’t generate the right response and, with shareholders to satisfy, it’s only when penal costs threaten the bottom line that change will occur.  

So again the government needs to act and introduce legislation and compulsory, in-your-face education to support healthy nutrition and lifestyles.  Tax any overload of those ingredients we don’t really need to push the price of the product up and let market forces come into play and use the money to help fund the community programmes.  And whilst we ’re at it, let’s make the promotion of unhealthy food as restricted as we’ve managed to make cigarette advertising.   

When it comes to transport and getting people out their cars, we need public transport to be in public ownership where sensible pricing and subsidies can be properly balanced with investment rather than dividends.  Just compare our chaotic railway and bus systems with the service in London or any European country to see that it can be done perfectly well.  That leaves facilities; stop the closures and sell-offs and invest in open spaces, community sport and exercise hubs, pools and cycle paths.

Big Brother, Nanny State, call it what you will, but something’s gotta change and if we won’t take responsibility ourselves, we need something or someone to do it for us.  That ‘something’ is the NHS with a funded focus on education and prevention rather than just cure, and that ‘someone’ is the people we elected to keep us safe and healthy.  Our Government needs to accept its share of the responsibility and get on with it; it’ll cost far less than just waiting for the tsunami we know is on the way to actually arrive.

Stand by for a deeper dive into the way forward in Manifesto !