The Miracle Pill

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The Miracle Pill Page 12

by Peter Walker


  In terms of health benefits, the heart rate data indicated I spent pretty much all the journey exerting myself moderately or vigorously. The watch, made by the US firm Garmin, splits the efforts you make into five ‘zones’ based on your maximum heart rate. According to the company’s charts, even zone one indicates an exertion of between 50 per cent and 60 per cent of the maximum, which still officially counts as moderate. To be overly cautious I excluded my zone-one time, and took moderate activity to be zone two (60 per cent to 70 per cent of maximum), with vigorous as three or above. Even calculated like this the amounts stacked up gratifyingly. The there-and-back total was about five and a half minutes of moderate activity, and a bit over twenty-five minutes of vigorous exertion.

  If you remember from earlier chapters, while the recommended minimum amount of moderate activity needed to maintain health is half an hour, five times a week, for vigorous effort this halves, to just fifteen minutes a day. My sample commute alone seemingly gives me almost two days’ worth. That’s not bad as an added extra for something I mainly do because it is reliable and fun.

  This is, of course, a study with a sample size of precisely one, with the subject also being the researcher. There’s an argument that as someone who has cycled for years, I’m perhaps more likely than average to exert myself, even when trying to avoid an excessive sweat. I also have to confess that on the final section of the return leg that day, riding up the gradual hill to the street where I live, I tried to keep up with a much younger rider on a lightweight bike. But, again, that’s one of the benefits of cycle commuting – you do sometimes end up trying harder than you planned.

  There is one, final question. How fit does this very routine regime leave me? One answer, provided by the activity watch, is my resting heart rate, for which it helpfully gives a seven-day average. At time of writing it tells me mine is forty-eight beats a minute. This is a fairly broad gauge, but the general metric is that resting rates below sixty are rare unless you are pretty active. So that’s a good first sign.

  Before I sound too complacent, I must introduce another measure. Just before the lockdown I put myself through a much more rigorous regime at the sports science department of Roehampton University, the base for Dr Richard Mackenzie, whom we met in Chapter 2. This is a VO2 max test, which measures maximum oxygen uptake. With a score expressed in millilitres of oxygen absorbed per kilo of body weight per minute, it is seen as a good gauge of aerobic fitness, even if its precise worth is endlessly debated in academic circles.

  It is not a comfortable process. It is done by what is termed a ‘ramp test’ – basically, putting your body under ever greater strain until you have to give up, slumped and wheezing. I did mine on a stationary bike, where I had to produce higher and higher watts of pedalling power over time, all the while with a clammy mask covering my face, connected to a machine. It was not made any easier by the fact I did it while suffering from a slight chest infection. And yes, I am perhaps getting my excuses in early.

  When the results came back my score was forty, which for my age puts me in a category – depending on which chart you check – just between ‘good’ and ‘excellent’. And yet I was pretty disappointed. Why? It’s because I had done the same test a few years earlier and scored fifty-three, which put me in the wonderfully named class of ‘superior’. At the time, my bike commute was roughly twice as long – I was still based at my newspaper’s headquarters rather than parliament – and I did other activities, like swimming.

  This was, in a weird way, perhaps a wake-up call. Yes, all the evidence shows that even my fairly brief and routine commute brings me almost incalculable health benefits, and keeps me notably fitter than the great majority of middle-aged men. But, as we saw in earlier chapters, one of the many amazing things about physical exertion is that the health dividends almost never stop – more is just about always even better. That is perhaps one minor consideration before you integrate an activity like cycling into your everyday life – it can all become a bit addictive.

  This is the point at which a sceptic might say: what good is an ‘excellent’ or even ‘superior’ VO2 max score if you end up dead? The biggest single reason cited for why so few people cycle in the UK is safety, particularly perceived safety. Such concerns are hugely understandable, and play an enormous part in low levels of active travel. At the same time, however, they should be put into proportion and context.

  As we heard at the start of the book, an estimated 100,000 people a year in the UK die early because of health issues connected to inactive living.8 In contrast, over the same period around 100 cyclists are killed on the country’s roads.9 Yes, this is in part because of the relatively small numbers who cycle, and the figure could and should be less. Exact comparisons are difficult, but the best estimates suggest that cycling in the Netherlands, with its thousands of miles of separated bike lanes and two wheeled–friendly road culture, is between three and four times safer than in the UK.10

  Even so, however, the odds are still very much with you. UK government figures show a serious injury or fatality happens, on average, every million miles cycled. A 2010 study by Dutch academics attempted to balance the health benefits of activity from cycling against the various risks, not just crashes but also the effects of air pollution. In the Netherlands, with its many miles of safe cycle lanes, as you might expect the balance was very firmly pro-bike, with the benefits-to-risks ratio calculated at nine to one. But even when the UK’s less safe roads for cyclists were factored in, this fell only to seven to one. That is still pretty overwhelming.11

  However, it takes more than citing a few statistics to persuade people to cycle. One innovative study by Professor Rachel Aldred, a UK academic who is a leading expert on why people do and do not ride bikes for transport, involved trying to separate out the data on deaths and injuries from the lived experience of those actually getting around on two wheels. Her eloquently titled Near Miss Project asked participants around the UK to pick a day when they were going to cycle and then fill out an online diary about what happened. More than 80 per cent of those who took part recorded at least one frightening experience, ranging from a too-close overtake to much more serious incidents. On average, people faced an event deemed ‘very scary’ once every week, with the vast majority connected to the actions of drivers.12

  This is the context within which the near-unbelievable health dividends of regular cycling must be placed. Many people buy a bike with the best intentions of using it daily, but give up when a driver decides to carelessly skim them at 40mph. The same is even true for walking, even if the primary barriers are different. Pedestrian deaths and injuries are a reality, with more than forty pedestrians a year in Britain killed by vehicles on pavements.13 The UK is among just a handful of European nations where pedestrian injuries have risen in recent years.14 As I’ve had to stress more or less throughout this book, in virtually every area of physical activity, there are much greater factors in play than personal willpower and motivation.

  To invite or to repel

  So how did we end up here? Jan Gehl’s self-description as being ‘anti-motorist’ as well as an anti-modernist is telling, because the post-war rise of the planned, inorganic city was as much about the cars as the buildings. Three years after Gehl left university as a fresh-faced and obedient advocate of the new consensus, the UK saw the publication of what was, in retrospect, one of the most malignly influential publications of the era. Traffic in Towns15 first came out in 1963 as a planning report, but achieved the rare feat for such a document of becoming so popular it was later issued as a paperback book. Written by Colin Buchanan, an engineer and town planner, it expressed some concern at the rising tide of motor traffic but concluded this was the future, and thus many more roads must be built. Buchanan wondered briefly about the idea of also constructing bike routes, but dismissed this, saying it was ‘a moot point’ whether there would realistically be many cyclists remaining a few years down the line.

  This was the era when c
ountries around Europe, as well as the USA, were embracing car culture, with entire historic districts of cities flattened to make way for urban motorways and ringroads. This influx of motor vehicles brought a resultant drop in active travel, and a hugely increasing death toll as these new drivers interacted with the unprotected road users who still tried to brave the streets. A handful of places fought back. In the early 1970s, a prominent Dutch journalist, whose six-year-old daughter had been killed by a speeding driver as she cycled to school, launched a campaign called Stop de Kindermoord, or Stop the Child Murders,16 sparking a campaign of civil disobedience in the Netherlands which directly led to successive governments reshaping the nation’s roads. Denmark, too, saw mass protests slightly later.

  In most other countries, however, Buchanan’s vision of car-only personal urban transport largely came true, with significant knock-on effects for people’s physical lives, not all of them obvious. One 2007 study assessed various neighbourhoods in the Australian city of Adelaide on how friendly to walking they were. It found that even after accounting for other variables, women who lived in low-walkability areas watched significantly more television than those in places where walking was easier. The same was not found for men, a difference the authors said could be connected to factors such as men being less concerned about, for example, the traffic danger of low-walkability streets.17

  Another study in Melbourne discovered that a walkable neighbourhood was one of the strongest factors in whether or not children travelled to school on foot or by bike, rather than being driven by a parent, and that this in turn played a big part in whether they were active in other areas of their life.18

  So what constitutes a neighbourhood in which people might be more tempted to get out of the car and walk – even to a bus stop or train station – or cycle? The answer combines the most practical of engineering measures with something much more esoteric, something almost between philosophy and activism.

  For example, Jan Gehl’s architectural practice is on Vesterbrogade, one of central Copenhagen’s busiest streets, and when I walked to his office it was packed with motor vehicles. But on either side of the vehicle lanes are broad cycle routes, separated from the traffic with a kerb, and then another step up to the pavement. Along the middle of the road is a narrow, cobbled median strip, allowing pedestrians to cross one lane of traffic at a time.

  Gehl is passionate about the ability of people on foot to be able to meander around the city as they choose, and not have to walk 200 metres to wait at a dedicated pedestrian crossing. He is particularly scathing about the idea, ubiquitous in the UK but unknown in Copenhagen, of having to press a button to activate a pedestrian green light. ‘It’s a human right to get across the street,’ he fumes. ‘It’s not something you should apply for. It’s only in Britain, and British-dominated areas like India and Australia, where you find this idea. If you want a lively and good city you should be able to cross almost at will, which is why in Copenhagen we have this median.’

  Gehl’s mantra is that the urban environment should ‘invite’ people to cycle or walk, make it obvious and appealing. Life Between Buildings spells this out in a series of choices: ‘To assemble or disperse; to integrate or segregate; to invite or repel.’ The book urges readers to reimagine towns and cities in their traditional purpose, a place for people to wander and roam, where encounters with others are usually unprompted and serendipitous, where children can spot friends playing outside and go to join them, in safety. It stresses the fundamental human instinct of being interested in other people. One fascinating study mentioned in the book recounts how researchers tried to examine how many people looked into the various window displays along Strøget, Copenhagen’s pedestrianised main shopping street, only to discover that the most popular thing to look at was a construction site – but only when the workers were there. People were the key, not things. ‘That life between buildings is a self-reinforcing process also helps to explain why many new housing developments seem so lifeless and empty,’ the book explains. ‘Many things go on, to be sure, but both people and events are so spread out in time and space that the individual activities almost never get a chance to grow together to larger, more meaningful and inspiring sequences of events.’19

  Gehl has spent years finessing an opposite approach in his work reshaping cities. One vignette he recounts about the ways a more human-friendly urban landscape can improve how people both move around and interact is his work in Moscow. There, he tells me, his emphasis on useable public space proved so successful in prompting the types of accidental interactions inherent to a successful city that it was the catalyst for many new romances, and he is now officially credited with starting a Moscow baby boom.

  Many of the practical details of this approach are set out in Soft City,20 a recent book by David Sim, who is now the creative director of Gehl’s architectural practice. Packed with example photographs of temptingly liveable urban neighbourhoods – almost none of which appear to be in the UK – Sim, who is himself Scottish, explains the vital role of spaces through which people can intuitively walk and spontaneously mix. Thus, land around apartment blocks should be a contained enclosure which feels communal, not a windy hinterland that belongs to no one. These blocks should have multiple entrances for easy pedestrian access, and ground floors filled with cafés and shops, rather than blank-faced offices, so people have a reason to congregate. One-way streets are frowned on, not just because they encourage more rapid driving speeds, but because they lose the intuitive sense of public transport, with buses unable to run on the same road in both directions.

  There is an important directive to encourage walking: the pavement should be effectively continuous, with pedestrians having automatic right of way at minor junctions, rather than turning cars. The book asks: ‘Why should pedestrians on a main thoroughfare have to stop and wait at every single side street when the vehicles travelling in the same direction don’t have to?’ It is a fair point.

  In the UK, the city that has perhaps the most ambitious plans to start moving towards a model of more active living is Greater Manchester, which aims to construct more than 1,000 miles of safe, connected walking and cycling routes in the next few years. Running the project is Chris Boardman, the former Olympic and Tour de France cyclist who went on to set up his own very successful bike company, before becoming an eloquent spokesman for better everyday cycling. In 2017 he was tempted out of what sounds like an enjoyable semi-retirement by the mayor of Manchester, Andy Burnham, with a brief to transform the city.

  While the centre of Manchester has acquired a series of new pedestrianised squares and shopping streets in recent years, it is still criss-crossed by roads packed with traffic, and encircled by a busy ring road, part of which is a classic 1960s example of an elevated urban motorway, the Mancunian Way. When I meet Boardman in a bustling café on one of these new pedestrian plazas, a short walk from his office building, he explains that the hope is to create a network of cycling and walking routes that will, in a Jan Gehl style, invite people to use them. ‘If you take anyone from Manchester and stand them on a street in Denmark or Holland and say, “Which do you prefer, for you and for your kids?”, they’ll say, “This,” ’ he says. ‘And who wouldn’t? So nobody’s got a problem with the destination. That’s your starting point. It’s about how you move things.’

  Boardman’s wish is for people driving on their commute to look out of the car window, see others cycling or walking, and then decide that would be a better solution. ‘It’s not just about safety,’ he says. ‘It’s got to look easy. If it’s not the easiest solution, or at least as easy as what they’re doing now – driving – then why would they change?’ Boardman’s template for any proposed scheme in the new bike and walking network is ‘whether a competent twelve-year-old’ could use it. He indicates the packed café: ‘It’s got to be understandable by anybody in this room. For a twelve-year-old, a pensioner, anyone.’21

  To an extent, the practicalities of how you achieve
such a transformation move into the formal mechanics of city design, which is slightly outside the scope of this book. But the most important thing to remember is that none of this is magic, or untested, or in doubt. A city planner in the UK only has to look a small distance across the North Sea to places like Copenhagen, or to Utrecht, which prides itself as being the most cycle-friendly city in the Netherlands, and where about 60 per cent of all trips in the centre happen by bike.22 These places have been planning for better cycling and walking for decades, and wherever you look, the principles are pretty much the same.

  One fundamental idea dictates that on busier streets with more rapid motor traffic, cyclists need a protected route, a kerb-separated lane where the safety is continuous, for example with bike-only traffic signals at junctions. That is perhaps the more straightforward element. On smaller roads, particularly residential ones, the necessity is to greatly slow down motor traffic to no more than 20mph, ideally less, through a combination of clever street design, robust enforcement and, over years, a change in the traffic culture. Some Dutch residential streets make the point abundantly clear by putting up signs saying, ‘Cars are guests’.

  Along with this – and it is here that some British politicians tend to have a mild fit of the vapours – must come changes to make driving less convenient for small, urban trips. A common approach is known as modal filtering, where certain streets are made access-only for cars, using separated bollards through which cyclists and pedestrians can easily pass. Thus, a journey to a local shop might take ten minutes on a bike but significantly longer in a car, nudging people into being active. The reduction in vehicle traffic also makes the streets more appealing for walking and play.

 

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