The Miracle Pill

by Peter Walker

  It is when you’re able to get about by bike, however, that the benefits really multiply. It’s fair to say I am an unabashed advocate of everyday cycling for transport. I have written an entire book explaining why more of it is a good thing, not just for the rider but for everyone else. Particularly in places like the UK, it is not always easy, or in some cases even possible, to make cycling part of your regular transport regime. However, for those with shorter commutes, or other journeys, especially in urban areas, it can be more straightforward to do than many believe. If you are able to integrate cycling into your life, even if not every day, the benefits are almost too numerous to list, and go well beyond the remit of this book.

  Aside even from the almost implausible health impacts, getting around by bike means you start to commune with your town or city in a different way, travelling at human-scale speed, but sufficiently rapid to cover significant distance. Streets and neighbourhoods suddenly open up. Rather than a destination being, say, three miles away, intangible and distant, it is suddenly twenty minutes’ gentle ride, straightforward, predictable, punctual. Even the weather is more real. You feel the sting, or the caress, of the changing seasons against your face, noticing every alteration, every gradual shift. I wrote at the start of this book about how cycling helped unlock in me the sheer glee of feeling physically vital. This has never dimmed. There are times, even on the wearily familiar streets of my commute, when the realisation sweeps through me that I am privileged to use my body in this way, and that it won’t be forever.

  The one you’ll keep doing

  I am, however, not the expert here. For this book I talked to many of the world’s leading researchers on activity, and how to better integrate it into our lives. At the end of our conversations, I would often ask how they found their own ways to remain physical. Several conceded that it took a certain amount of effort. But, as you can imagine, it was something they had all thought about a lot.

  I-Min Lee, perhaps the modern academic world’s most prominent activity researcher, grew up in Malaysia. There, she says, exercise was not particularly encouraged, and she only became active as a student of Ralph Paffenbarger, ‘because it would be incredibly embarrassing not to exercise when you were doing physical activity research’. Very much identifying herself as someone who doesn’t particularly enjoy formal exercise, Lee says she tries to walk or take stairs where she can, and has faced many of the same modern-world staircase pitfalls as me. ‘In a lot of buildings I worry about going up the stairs, because I’m worried I’ll be locked in the stairwell,’ she tells me. ‘Sometimes if I’m in a hotel, I’ll get someone with me and I’ll say, “Stay the other side, if I can’t get back in, let me in.” You don’t want to be stuck in there in the middle of the night and having to open an alarmed door.’11

  A lot of the researchers I talked to discussed how they try to stay active amid what are, in the main, sedentary jobs. As well as having a standing desk, Genevieve Healy tries to walk around her office as much as possible. ‘It can be as straightforward as, instead of sending someone an email, you just go and have a brief standing meeting with them,’ she says. William Haskell, for several decades one of the most influential people in the inactivity world, says that when he is at his office he will always ‘stand up and go walk down the halls and talk to people rather than calling them on my phone’.12

  On the day I speak to him, Richard Mackenzie had made being active part of his journey from the commuter town north of London where he lives, to his university – after dropping his infant son at nursery, he ran to the local train station, and then once in London ran to his workplace. This does, he admits, take a fair bit of planning and commitment: ‘I would think that many other people would not do that. It’s partly because of my job.’ Mackenzie was in the army reserves, and says he formerly believed that activity ‘had to be an hour of intense exercise, or I’m not doing anything worthwhile’. His mantra is now more forgiving: ‘I think it’s very much, if I can only manage twenty minutes, that’s fine. I’m not going to beat myself up mentally that I haven’t done enough. It’s fine. I’ll try and do more next time.’13

  Kirk Erickson says that, for him, a lot of the battle is about simply remembering to move: ‘I’m just like everyone else. I get engrossed, and piles of work get on my desk – I can’t move for hours at a time. And so I have to remain very cognisant of my behaviours and make sure that I get up, take breaks, take lunch breaks where I take a good walk.’ His leisure-based compensatory activity is to watch a Netflix series on an iPad while using a treadmill: ‘We always need to find activities that we enjoy. Because if you start trying to do something because you know it’s healthy, but you don’t enjoy it, it’s unlikely you’re going to continue to adhere to it.’14

  Jan Gehl says that even at the age of eighty-three he is nagged by his daughter, a doctor, to make sure he walks enough, even if he does not always manage the mandated 10,000 daily steps. ‘No,’ he admits. ‘But I aim to be between 7,000 and 9,000. That’s quite good. And it’s easier when I travel. Heathrow airport will always give you 5,000 steps.’15

  Steven Blair is marginally younger, at eighty, and says that his former activity as a keen if ‘not very good’ marathon runner has now turned into walking, as well as muscular resistance training. When he turned seventy, Blair set himself the ambitious target of walking 5 million steps a year, which averages out at just under 14,000 a day, which he has reached every year since. He sums up his approach like this: ‘It’s mainly doing something, and what will work for you. People ask, “What is the best activity to do?” And my simple-minded answer is, “The one you’ll do and keep doing.” ’16

  Blair is, of course, being deliberately self-mocking. This is a man who has spent almost sixty years in academia, most of it at the vanguard of research into why people are inactive, how they can become more active, and what happens, on individual and population-wide levels, if they do not. He was the lead editor on the landmark 1996 US government report which effectively introduced inactivity to the global policy mainstream. And his words are very much at the heart of what, more than twenty-five years later, still needs to happen.

  ‘Physical activity’ is a technical term, and can feel slightly dry, almost joyless. This book is, I hope, instead more of a love letter to one of the most fundamental elements of what it means to be human – to be in motion, to exert yourself, to feel that natural yet almost inexpressible sensation as some of the 600-plus skeletal muscles in your body burn joyfully through their ever-replenishing stocks of adenosine triphosphate to do… well, something. Anything.

  It could be a walk around the block to a friend’s house. It might be ascending a flight of stairs into work. Those fatigue-resistant leg muscles could be instead pedalling you across town to a meal with a loved one in a favourite restaurant. Your body might be engaged in a relatively sedate three METs of effort, or raising a brief sweat at ten or twelve, as you cycle up a hill. It matters not. We’ve already seen the endless benefits that come from using the human body, even occasionally, in the way it was intended through countless centuries of hunting, gathering, farming, strolling, leaping and playing. So how do you do more of it? For now, forget the gym, or the running shoes. Think instead about your day-to-day routine, and how movement fits into it, or how it perhaps could. This won’t always be easy, and if so will most likely be caused by factors well beyond the control of you or any individual. But, somewhere, that physical routine, that daily exhilaration from being in motion, is there. So go out and find what it is. And then just keep doing it. It’s really as simple as that.

  ACKNOWLEDGEMENTS

  As mentioned several times, I’m not an epidemiologist, or any kind of scientist, so I’m indebted to all the academics and others who talked me through their areas of expertise. I should single out a few for particular thanks. Harvard University’s I-Min Lee is probably the world’s most renowned expert on – and most prolific researcher into – the perils of inactivity, but found time to spea
k to me several times, and to answer email queries. Robert Ross and David Dunstan didn’t only explain their work, they also tackled my slightly presumptuous personal appeals about, respectively, body fat percentages and how much I sit down.

  Richard Mackenzie explained his research on type 2 diabetes, and then very kindly checked the chapter on the physiology of inactivity, suggesting a few tweaks. He also arranged for my battery of physical tests at Roehampton University, expertly conducted by Oana Ancu, one of his research students.

  At King’s College Hospital, Martin Whyte and Phil Kelly let me follow them on their ward rounds while firing endless questions at them, which they answered with great thought and much wisdom.

  I am hugely grateful to all the ministers, officials, experts and everyone else in Finland and Slovenia, who talked me through their countries’ efforts to get their populations moving, and to Jan Gehl in Copenhagen. Enormous thanks also to all the politicians and others in the UK who talked to me, not all of whose input is quoted by name.

  * * *

  I researched and wrote this book while working as a journalist during one of the most tumultuous political periods in recent UK history. So thanks to my lovely fellow occupants of room 15 along the parliamentary press gallery corridor, who accepted my occasional disappearances for phone calls with distant academics – Guardian colleagues Heather Stewart, Jessica Elgot, Rowena Mason, Rajeev Syal, Kate Proctor, Maria Remle, John Crace and Andrew Sparrow, plus Bloomberg’s Rob Hutton. Thanks also to the Guardian’s architecture correspondent, Oliver Wainwright, for suggesting people to speak to about movement-friendly cities. I’m also very grateful to Mary Stewart-David, who helped me with a temporary base in which to write.

  * * *

  I’m hugely indebted to my amazing agent, Rachel Mills, who encouraged this book throughout, and had some crucial ideas on how it could be structured.

  I am incredibly grateful to Fritha Saunders, my editor at Simon and Schuster, who immediately understood what the book was about, and to Suzanne Baboneau, in charge of adult titles at S&S, who was also immediately enthusiastic and knowledgeable. Many thanks also to Frances Jessop, who led the copyediting process, and her team.

  Two very personal thank yous. Firstly to Shelly: the frontline of editing/ideas, who helped to make the book much better than it would have otherwise been and is still the person I still most enjoy talking to. And lastly, thank you to Ralph, who happily went undercover wearing an activity tracker at school, and more generally provided a daily reminder of how vital, intuitive and joyful everyday exertion should be in anyone’s life, no matter what your age.

  We hope you enjoyed reading this Simon & Schuster ebook.

  Join our mailing list to get updates on new releases, deals, recommended reads, and more from Simon & Schuster.

  CLICK HERE TO SIGN UP

  Already a subscriber? Provide your email again so we can register this ebook and send you more of what you like to read. You will continue to receive exclusive offers in your inbox.

  ENDNOTES

  Introduction

  1 Inactivity statistics are collected separately by each UK nation, so the total figure is somewhat approximate. NHS Health Survey for England 2016: Physical Activity in Adults http://healthsurvey.hscic.gov.uk/media/63730/HSE16-Adult-phy-act.pdf

  Public Health Scotland: Physical Activity Overview http://www.healthscotland.scot/health-topics/physical-activity/physical-activity-overview#:~:text=Half%20of%20all%20adults%20aged,deaths%20in%20Scotland%20each%20year.

  Government of Wales: National Survey for Wales 2018–19, Adult Lifestyle https://gov.wales/sites/default/files/statistics-and-research/2019-06/national-survey-for-wales-april-2018-to-march-2019-adult-lifestyle-534.pdf

  Northern Ireland Health Survey: First Results (2016/17) https://www.health-ni.gov.uk/sites/default/files/publications/health/hsni-first-results-16-17.pdf

  2 NHS Health Survey for England 2015: Physical Activity in Children http://healthsurvey.hscic.gov.uk/media/37752/hse2015-child-phy-act.pdf

  3 Pedro C. Hallal et al., ‘Global physical activity levels: surveillance progress, pitfalls, and prospects’, The Lancet, Vol. 380, No. 9838 (2012): 247–57.

  4 Sue Bowden, Avner Offer, ‘Household appliances and the use of time: the United States and Britain since the 1920s’, Economic History Review, Vol. 47, No. 4 (1994): 725–48.

  5 David Kynaston, Modernity Britain: Opening the Box 1957–59 (London: Bloomsbury, 2013), p. 61.

  6 Office for National Statistics: Long-term trends in UK employment, 1861 to 2018. Chart using Bank of England historic data.

  7 Figure provided by cycling author and historian Carlton Reid.

  8 Department for Transport, National Travel Survey: England 2018. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/823068/national-travel-survey-2018.pdf

  9 Department for Transport, National Travel Survey: England 2018.

  10 Public Health England: Research and analysis – Brisk walking and physical inactivity in 40- to 60-year-olds (June 2018).

  11 National Travel Survey: England 2018.

  12 Data from Active People Interactive research tool on Sport England website.

  13 I-Min Lee et al., ‘Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy’, The Lancet, Vol. 380, No. 9838 (2012): 219–29.

  14 Peace Research Institute Oslo: Trends in Armed Conflict, 1946–2018. It says about 53,000 died in war worldwide in 2018.

  15 For example, NHS figures say about 78,000 people a year die in the UK because of tobacco, against an estimated 100,000 due to inactive living.

  16 Public Health England, Physical activity: applying All Our Health (October 2019). This says inactivity is responsible for one in six UK deaths, and there are about 600,000 deaths per year across the UK.

  17 Interview with the author.

  18 Lars Bo Andersen et al., ‘All-Cause Mortality Associated with Physical Activity During Leisure Time, Work, Sports, and Cycling to Work’, Archives of Internal Medicine, Vol. 160, No. 11 (2000): 1621–8.

  19 Statistic from Asthma UK.

  Chapter 1

  1 Timothy M. Ryan, Colin N. Shaw, ‘Gracility of the modern Homo sapiens skeleton is the result of decreased biomechanical loading’, Proceedings of the National Academy of Sciences of the United States of America, Vol. 112, No. 2 (2015): 372–7.

  2 Jennifer M. Hootnam, ‘Physical Activity, Fitness and Joint and Bone Health’, in Physical Activity and Health, eds Claude Bouchard, Steven N. Blair, William L. Haskell (Champaign, Illinois: Human Kinetics, 2012), p. 247. Citing Arthritis Foundation research.

  3 Alison A. Macintosh, Ron Pinhasi, Jay T. Stock, ‘Prehistoric women’s manual labor exceeded that of athletes through the first 5500 years of farming in Central Europe’, Science Advances, Vol. 3, No. 11 (2017).

  4 David R. Bassett Jr, Patrick L. Schneider, Gertrude E. Huntingdon, ‘Physical Activity in an Old Order Amish Community’, Medicine and Science in Sports and Exercise, Vol. 36, No. 1 (2004): 79–85.

  5 UK Data Service: Urban Population Database, 1801–1911 (Robert J. Bennett, University of Cambridge).

  6 Lorraine Lanningham-Foster, Lana J. Nysse, James A. Levine, ‘Labor Saved, Calories Lost: The Energetic Impact of Domestic Labor-saving Devices’, Obesity Research, Vol. 11, No. 10 (2003): 1178–81.

  7 NHS: What should my daily intake of calories be? https://www.nhs.uk/common-health-questions/food-and-diet/what-should-my-daily-intake-of-calories-be/

  8 Physical Activity and Health – A Report of the Surgeon General (1996). https://www.cdc.gov/nccdphp/sgr/pdf/sgrfull.pdf

  9 Interview with the author.

  10 James S. Skinner, ‘The Fitness Industry’, in The Academy Papers: Physical Activity in Early and Modern Populations, eds Robert S. Malina, Helen M. Eckert (Champaign, Illinois: Human Kinetics Books, 1988).

  11 NHS Health Survey for England 2016: Physical Activity in Adu
lts

  12 NHS Health Survey for England 2016: Physical Activity in Adults

  13 Health Survey for England 2015: Physical Activity in Children http://healthsurvey.hscic.gov.uk/media/37752/hse2015-child-phy-act.pdf

  14 Pamela Das, Richard Horton, ‘Rethinking our approach to physical activity’, The Lancet, Vol. 380, No. 9838 (2012): 189–90.

  15 Pedro C. Hallal et al., ‘Global physical activity levels: surveillance progress, pitfalls, and prospects’, The Lancet, Vol. 380, No. 9838 (2012): 247–257.

  16 Salomé Aubert et al., ‘Global Matrix 3.0 Physical Activity Report Card Grades for Children and Youth: Results and Analysis From 49 Countries’, Journal of Physical Activity and Health, Vol. 15, No. S2 (2018): S251–S273.

  17 Shu Wen Ng, Barry Popkin, ‘Time Use and Physical Activity: A Shift Away from Movement Across the Globe’, Obesity Reviews, Vol. 13, No. 8 (2012): 659–80.

  18 William L. Haskell, with Steven N. Blair and Claude Bouchard, ‘An Integrated View of Physical Activity, Fitness and Health’, in Physical Activity and Health, eds Claude Bouchard, Steven N. Blair, William L. Haskell (Champaign, Illinois: Human Kinetics, 2012), p. 415.

  19 Carl J. Caspersen, Kenneth E. Powell, Gregory M. Christenson, ‘Physical Activity, Exercise, and Physical Fitness: Definitions and Distinctions for Health-Related Research’, Public Health Reports, Vol. 100, No. 2 (1985): 126–31.

  20 Interview with the author.

  21 Jennifer Smith Maguire, Fit For Consumption: Sociology and the Business of Fitness (Abingdon: Routledge, 2008).