Guest blog by @JosephLightfoot

The State Of Our Health

Britain is facing a health crisis and the statistics paint a bleak picture for the future.

Why Is This Happening?

Humans are evolved to be highly active and to consume natural, unrefined food. However, our lifestyles have changed radically. As a population, we are now largely sedentary and consume more refined food. Our lives are out of step with our genetic heritage resulting in obesity and chronic disease.

Healthcare professionals do an incredible job in challenging conditions. However, our training lacks emphasis on how to use lifestyle advice to empower people to live healthy lives.

My Personal Experience

If I had to sum up my time at medical school in one sentence, I’d do so like this:

I have learnt about disease, but I haven’t learnt about health.

Whilst there are many contributing factors to the current state of our nation’s health, I think the lack of education for healthcare professionals on lifestyle advice is a particularly important area.

The lack of education and training has resulted in many professionals who are unable to effectively help their patients stay healthy, and a healthcare system, which focuses almost entirely on reactive measures and only steps in when patients are already ill.

I don’t think this is good enough.

The Future

My vision for healthcare can be summed up by this fantastic quote from Thomas Edison.

“The doctor of the future will give no medicine, but will interest her or his patients in the care of the human frame, in a proper diet, and in the cause and prevention of disease.”

The Move Eat Treat Campaign

In order to achieve this vision, I founded a campaign called Move. Eat. Treat. Along with the rest of the campaign team, I am working to promote the importance of preventative medicine with the aim of eventually developing a healthcare system, which doesn’t wait until patients become ill before it acts, but works to keep the population healthy – a true health service that is proactive rather than reactive.

We believe that the best way to achieve this is to educate healthcare professionals on how to deliver effective lifestyle advice. We hope that this will lead to a sea-change in culture within the healthcare system to one that assertively seeks prevention instead of cure. Then this will be followed by policy and organisational changes to prioritise prevention via promotion of healthy lifestyles.

Lifestyle should be a core theme of healthcare education, alongside other key pillars such as anatomy, physiology, and pathology. This campaign wants to pave the way for updated curriculums and provide education to both undergraduates and current healthcare professionals.

We Need Your Help

However, we need your help. The most successful campaigns have all had significant public backing. The first goal of the Move Eat Treat campaign is to gain 100 000 signatures on our petition.

With support, we have a voice and we can lobby the people and organisations that can bring about the changes in the healthcare and education systems that are so desperately needed.

You can sign that petition HERE .

We hope you’ll also consider sharing the campaign with friends and colleagues via email and social media. The infographics used above which illustrate the problems we face can be freely downloaded HERE.

A Final Word

The Move. Eat. Treat. vision is a lofty one, but with your help we believe we can make a positive change to healthcare philosophy and help keep people healthy.

Move. Eat. Treat isn’t the same old drone from your doctor about losing weight. It’s about creating innovative solutions, tools and guidance to really equip people to be, and more importantly, stay healthy.

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Joseph Lightfoot BSc(Hons) is a final year medical student at the University of Manchester.  He is also currently the strength and conditioning coach to England Under 19 Lacrosse team. Along with the other members of the Move Eat Treat team he is campaigning for a proactive healthcare system.

For more information about the campaign and our goals visit www.moveeattreat.org

Mike Evans circulated this to his hockey team of kids early in December 2011.  #1 educational video on YouTube. Remember that low fitness (<30 mins of physical activity daily) kills more Americans that smoking, diabetes, and obesity combined (smokadiabesity).

Click on this link. Watch it, share it. Do it yourself.

Encourage patients to watch it and start today! Great ‘sticky’ message capturing Steve Blair’s evidence that this treatment will save more American’s lives than a cure for smoking, diabetes and obesity put together. That’s a fact!

It passed 2 million views in February, 2012. Wow!!

On Monday the Guardian published It’s not obesity that’s killing us – it’s the lack of exercise. Inspired by research presented at UKSEM (see also Blair Physical inactivity: the biggest public health problem of the 21st century, and BJSM Warmup 2011; 45), the Guardian exhorted us to focus less on obesity and more on physical activity. With 191 comments, 1000 Facebook likes, and 71 tweets (in 48 hours) it doesn’t take a social media expert to figure that this topic is hot.

A critical question is whether exercise is THE primary tool for weight loss (rather than just as part of a healthy lifestyle).

Does exercise promote weight loss?

King, Horner et. al’s have a great article – Exercise, appetite and weight management…in BJSM Online first.

Professor Timothy Noakes (and @GaryTaubes) add these insights to the discussion in this guest blog:

Photo courtesy of Gavin Clarke, Flickr cc

What astonishes me is the continuing failure of so many people, my medical colleagues included, to realize that the solution to personal obesity is so simple. The cause for most people is exactly as Gary Taubes described it – a diet too low in fat and protein and too high in carbohydrate especially sugar. If you are over forty, overweight, personally motivated, and not eating a high fat/high protein/low carbohydrate diet, then you are missing out – your life is passing you by.

The second key is also as Taubes describes it – obesity begets inactivity whereas leanness promotes activity. Trying to get lean by exercising whilst continuing to eat the “healthy” high carbohydrate diet will be unhelpful for most with an elevated BMI (and who are are therefore by definition, carbohydrate intolerant/resistant). You need first to lose the weight by changing to a high fat/high protein/low carbohydrate diet. As the weight falls of (as it does very dramatically at rates that most will not believe), the desire to exercise becomes increasingly overwhelming. In time the desire to exercise becomes addictive.

Trying to encourage overweight people to exercise without first changing their habitual eating patterns (not diet, please note) will never produce the same outcome as will one in which the initial focus is on changing to a high fat/high protein/low carbohydrate diet.

As Gary Taubes describes, this has been known since 1861 but was written out of the medical and popular literature after 1970 when Dr Ancel Keys essentially single handedly developed the global fear of fatty foods that mislead the world and led directly to the epidemic of obesity and diabetes that began to engulf especially people in the developed world especially after about 1977.

Until we rid ourselves of the ridiculous idea that carbohydrate foods are somehow “healthy” (for all) and fatty foods are unhealthy, and as long as we allow our eating patterns to be dictated by industries that aim remorselessly to increase global consumption of sugar and refined carbohydrates, then we cannot solve the global problem of obesity and diabetes.

But at an individual level we can take control by realizing that obesity is a genetic/nutritional disorder caused by excessive carbohydrate consumption in those who are carbohydrate-resistant (and who are therefore unable to metabolize carbohydrates especially fructose, appropriately but who will store the excess calories in fat, rather than expend them in physical endeavor).

Dr. Timothy Noakes is a Sports Physician, Exercise Physiologist and Discovery Health Professor of Exercise and Sports Science at the University of Cape Town and Sports Science Institute of South Africa.

ACSM posted the following to members…

Yesterday’s U.N. Side Event on Physical Activity and Noncommunicable Diseases (NCDs) brought together an extraordinary group of world ministers of health, public health professionals, physical activity advocates, scientists, elite athletes and other experts. The focus was on physical activity as a global health opportunity, informing the deliberations of the U.N. High-Level Meeting on Noncommunicable Diseases taking place today and tomorrow.

Live Webcast U.N. Roundtables

The U.N. sessions on NCDs will be webcast live at www.un.org/webcast ( http://www.un.org/webcast ) . Under Live Schedule at right, click on Channel 4 to access the roundtable discussions on NCDs (Monday at 10:00 a.m. and 3:00 p.m. EDT).

No apologies for plugging the Swedish National Institute for Public Health who have produced an amazing medical tool – evidence based exercise prescription for many, many, medical conditions. If you are in the UK you will be familar with the BNF – this should accompany every BNF and be used more often!

In Australia the equivalent is MIMS and in Canada CPS.  Clinicians should be reaching for this instrument more often than the stethoscope – it would have more impact as an intervention by any measure!
The great thing is that it can be downloaded for free! No excuses!

The link to the downloadable PDF version is in the subject line of this blog. You can read the authors’ brief editorial in this month’s BJSM for free.

We had planned to have the BJSM podcast done by March 1st and we still may – but the issue busted to the home page ahead of schedule so please bear with us if you are looking for the podcast. Lots of great podcasts up on the home page for free (the one with Steven Blair is very relevant) but nothing about this Bible of Physical Activity Prescription yet. I’ll update on the podcast here and via Twitter (@BJSM_BMJ).

Recent specialist status has led Australian sports and exercise physicians receiving more referrals from GPs; MRI referral is also in the specialist’s scope of practice. However, at the same time as these physicians were recognized for having special expertise in exercise prescription — addressing the worlds biggest public health problem –  physical inactivity, patient rebates for the service was cut!

An umbrella body for Australian sport has expressed its concern over this paradox; local media have followed the story but the Minister for Health has not commented when this blog was posted.

New York City Health Department has launched an aggressive video campaign to educate Yorkers that sodas have 16 packs of sugar in a 20 oz drink (about 600 ml, say 1.5 cans). The story is certainly ‘sticky’ – clear, unexpected, concrete, credible, emotional.

The background, of course is that obesity is not as big a problem as inactivity/lack of fitness. Imagine if we could get folks to appreciate that lack of fitness is EIGHT times as bad for you as drinking that soda! Now there’s a video for someone to make!