It’s a mystery to many people why a disease like diabetes—which causes heart disease, blindness and can result in amputations—is on the increase, when 80% of cases are preventable by making simple lifestyle changes. Why do people head down this path when they know that it leads to disease, disability and early death?
Healthcare has been very effective in picking up the pieces with more effective treatment, particularly in areas such as cancer and heart disease. Yet it appears powerless in staving off the steady rise of non-communicable diseases (NCDs) globally, including heart disease, stroke, cancer, dementia, arthritis, diabetes and many others.
As a GP, if I have a patient with iron deficiency, I give them iron tablets. If they have a cancer, I ask a surgeon to remove it. If they have depression, I ask a clinical psychologist to treat the patient. The referral and treatment process is a closed loop, all within the NHS.
The same pattern has been used to treat obese patients who are referred to dieticians and inactive patients who are referred to exercise. But this assumes the problem is just a temporary blip that needs a small correction and after a few sessions everything is sorted.
This assumption is of course wrong. The problems of obesity and inactivity are deep rooted. So it’s no surprise that the approach taken by the NHS and healthcare systems around the world to prevent NCDs is not really working.
What is really causing the increase in non-communicable diseases?
Obesity grabs the headlines and is thought to be the cause of many diseases. However, it is in fact physical inactivity that is more important than obesity as a risk factor—only 10% of the benefits of physical activity in preventing heart disease are due to weight loss.
What is the science behind it?
The reason physical activity is so important is that our bodies were designed to be active. As soon as we become sedentary our aging process accelerates and we create a perfect environment to initiate disease. The problem is not helped by long hours spent in front of a computer screen.
The changes take place in mitochondria—the batteries of our cells which are absolutely critical to life. Physical activity also releases anti-inflammatory enzymes from muscle that bathe all cells of the body with an anti-inflammatory medicine ensuring that the body’s inflammation is reduced. It is chronic inflammation that causes so many diseases.
What change in society has led to this change?
Those in the lower socioeconomic groups have a higher inflammatory count than those in higher groups. Chronic inflammation therefore follows a social gradient even when adjusting for risk factors, so there is another cause of this chronic inflammation and this appears to be chronic stress.
Chronic stress leads to inactivity and creates more chronic stress. Chronic stress leads to the desire to consume high calorie foods since the body thinks it is preparing for a bad time ahead. Chronic stress increases the need for immediate gratification of smoking, alcohol and drugs as a way to cope with this never ending anxiety and low grade fear.
This chronic stress triggers the release of cortisol and adrenaline that directly affects the release of free radicals in the mitochondria leading to chronic inflammation.
Chronic stress and inactivity lead to mitochondrial damage and trigger chronic inflammation that lead to almost all NCDs.
So, what’s the solution?
All the evidence on physical activity shows that walking gets the inactive to become active:
Invest in the environment to encourage walking. The areas where we live—cities, towns and villages—have to be walking friendly and this investment will be the single biggest investment in health.
Increase physical activity in work places. Educate employers and groups to ensure that the whole population can become more active and sociable using incentives, games and simple fun.
Once allowances for physical activity in the work place and the areas where we live are created, good habits are formed that will put us all on the path to better health.
