The Miracle Pill

by Peter Walker

  Another complication is that, at the time of writing, many more people are not just working from home, but look set to be doing so for some months, perhaps even indefinitely as companies realise how much they can save on commercial rents. If the ergonomics of an office can be tricky, creating a movement-friendly work environment at the kitchen table or in your bedroom is even more challenging.

  But there was one more question about my sedentary life I wanted to know. If I do ever resume my usual three-and-a-half-mile daily bike commute to and from Westminster, will the physical exertion of the cycling cancel out all health risks of prolonged sitting down?

  Research would seem to indicate it should at least mitigate some of it. Probably the most thorough answer so far was published in The Lancet in 2016. A Norwegian–Australian–American co-production, this was a meta-study that pulled together data from dozens of papers on the risks of sitting and of inactivity, totalling more than a million people. In good news for me, it found that for people in the highest 25 per cent for physical activity, a category my commute alone would propel me into, the risks of early death were no different between those who sat for less than four hours a day and those who averaged more than eight hours.37

  But I wanted some outside confirmation. So I sent Professor David Dunstan a series of charts downloaded from my activity tracker showing a fairly typical week in the Westminster office and from a weekend. How worried should I be, I asked him? The reply arrived a few days later, with Dunstan correctly guessing from the charts that I did not have a sit–stand desk. ‘Your pattern is fairly typical for an office worker, with the exception that you are highly active,’ he said, hearteningly, even adding a cheery, ‘Well done!’ to the fact the read-outs somehow showed me averaging more than 10,000 steps a day, a total assisted by trips to the twice-daily Downing Street press briefings, and the eccentric layout of the parliamentary estate, which means I can walk for five minutes to fetch a coffee or get some lunch.

  There were, however, some caveats. Dunstan noticed that particularly during weekdays there were periods of up to two hours at a time in which I would barely move. ‘As a general guide, one should try to take a break from sitting every thirty minutes,’ he wrote. ‘You mostly achieve this, but there were a couple of periods that this wasn’t the case. We call these “danger zones” with our workers and attempt to get them to identify such zones and make adjustments.’38

  These were resonant words. Yes, my commute, plus the fact that, as the activity tracker shows, I have a tendency to walk more than I perhaps realise, does bring protection. But two hours without a break is a very long time for blood-filled, lipoprotein-rich leg and back muscles to stay essentially dormant, drastically scaling back their vital role in the processing of sugars and fats. Things needed to change.

  I don’t want to present my working and writing life since then as a revolution, one in which I have eliminated huge parts of my sitting time with a James Levine-like zeal. Banished from the office and without access to a standing desk, let alone a treadmill one, I have had to improvise. Much of the writing of this book has taken place in a borrowed flat fairly close to where I live. It is temporarily uninhabited – hence I could borrow it – and thus unfurnished. I brought with me an old table and chair, where I still spend a reasonable amount of the writing day. But I have tried, wherever possible, to mix things up, perching my laptop on whatever surface is about the correct height, adjusted as needed by a pile of hefty physical activity textbooks. This has included the kitchen worktop and the top of a built-in cupboard by the front door. I’m typing these words with the computer leaned precariously on a windowsill, wobbling slightly if I press a key with too much emphasis. This is still all very conscious, prompted sometimes by the beeping of the smart watch. But with luck, by the time the writing is finished, it could have become a habit.

  As I’ve said before, this book isn’t meant to be a guidebook to better health. I’m also aware that there is a chance a reasonable proportion of readers will already be quite physically active. If so, this chapter might be the moment to really start paying attention. You might walk, run, cycle or otherwise Zumba well beyond the 150 recommended minutes a week, but being too sedentary can bring its own risks, and it can be alarmingly easy to overlook. After all, it’s just a matter of sitting down.

  Next steps:

  Given the many knock-on changes from coronavirus, even after lockdown ends it seems likely that many people will work from home more often, which can be a challenge for sitting time. If few offices have sit–stand desks, even fewer homes do. And going to your kitchen to make lunch isn’t even as much movement as a walk to a sandwich shop or canteen. So try to find ways to stand up to work at home, if you can. I’ve now bought a fairly cheap laptop stand with adjustable, folding legs. If I set it to the right height on a table, I can stand to type. I try to alternate – one hour sitting, one hour standing.

  8 Youth, Age, and Why Activity Matters Lifelong

  It’s fair to say that the initiative which has perhaps most improved the physical fortunes of British children over recent years had an unlikely catalyst. It was 2012, and Nigel Buchanan, a retired solicitor, was volunteering at St Ninian’s primary school in Stirling, central Scotland. The 79-year-old led after-school chess clubs, taught children the penny whistle and organised outdoor adventure courses in the grounds of his large house on the edge of the city.

  On this particular day he was standing next to Elaine Wyllie, the headteacher, as they both watched a group of pupils taking a PE lesson inside the assembly hall. Wyllie takes up the story: ‘Nigel turned to me and said: “Look at the children, Elaine, they’re not fit!” I was a bit aghast, but on the other hand I could see what he meant. It was in part because he was from another era, wartime, when children were different.’ Wyllie happened to mention the observation to the school’s PE teacher, asking her if Buchanan was right. Wyllie recounts: ‘She said: “I teach in five schools – only the fit ones are fit. Most of them are exhausted by the warmup in PE. The only exceptions are those in the running club, and girls and boys who play football. The rest? No, not fit.” ’

  Soon afterwards Wyllie had to cover a PE lesson with a class of nine- and ten-year-olds. So she decided to see for herself: ‘It was February, but it was mild, so I thought, “I know, I’ll get them to run round the field as a warmup, and see how they get on.” They were up for it, but it was like the polar opposite of Chariots of Fire. Five or six were in the running club and they were fine; they could have gone all day. But with the rest – it was a field the size of an ordinary football pitch, with a path round it, and most of them, by the far end of the field, were doubled up with a stitch, out of breath.’

  Wyllie says she was appalled, but also, as she puts it, ‘narked’ at Buchanan for being right. So when the PE teacher returned they hatched a plan: get the class she had taught to run for fifteen minutes a day, every day, using a path around the same school field. They asked the pupils for ideas as to how this could work. One boy said his grandmother had got fit by running and walking alternately between lampposts on the streets, so they began by doing this, using the cherry trees on the route. And so it began. Wyllie says the idea was to review the programme in a month: ‘I thought, “There’ll be no review, this will fall apart.” ’

  She was wrong. Most children were exhausted on the first couple of days. But by the end of the first week, she says, they were ‘glowing’, and appeared more focused in class. Soon, other classes wanted to take part, and before long the whole school was running every day. ‘In that first month, the change in the children was transformational in terms of their fitness and their mental health,’ she recalls. ‘And in the following year or so, also in their body composition and their weight.’1

  This was the beginning of the Daily Mile, a name which emerged by accident after the initial class wanted to know how far they were running. It turned out that the track was about a fifth of a mile long, and the pupils averaged five laps, with the
distance staying broadly similar for every age group. Wyllie has since retired as a teacher and now leads a charity seeking to get the Daily Mile introduced into as many schools as possible. The energy giant Ineos sponsors the charity, and I meet her at their discreetly plush London offices, around the corner from Harrods.

  For adults, running for fifteen minutes would very much be seen as formal exercise. But Wyllie stresses that this is not the case for children, particularly of primary age: ‘We didn’t try to introduce sport. It was just being active. It’s about giving children, in a safe space, the opportunity to be children, and do what they do naturally.’ The Daily Mile ethos, developed with the St Ninian’s children in those initial few weeks, decrees that there is no special equipment or preparation needed. Children run in their school clothes, and it always takes place outside. It is meant to be sociable, so they can chat as they go. The running is non-competitive, allowing children to go at whatever pace they want, or even not at all, although Wyllie says the latter is rare: ‘Very occasionally a child doesn’t want to take part, and they stand aside for one minute, and then they start walking. And then they’re running. It never fails.’

  The aim is to be as inclusive as possible, with the lack of sports clothing avoiding any cultural or religious issues. Pupils with disabilities take part as well, with help if needed, and Wyllie says it has tended to prove very popular for children with autism. The Daily Mile is, she says, fifteen minutes of ‘fun, fresh air, freedom, friends’ in the school day: ‘They very quickly get to the point of, “When’s the Daily Mile?” It’s not an escape from the classroom. Schools are much more child-pleasing than in my day. But they love and need the Daily Mile.’

  It now takes place in over 7,000 primary schools around the UK, and has spread to more than seventy other countries. With this expansion has come new discoveries. Teachers can run as well if they want, and it has turned out this can provide a good moment for children to confide problems, whether about school or their home life.

  Wylie says research has also shown that the Daily Mile is one of the few school-based interventions to defy a principle commonly seen in education called the ‘Matthew effect’. This observes that if you start a programme aimed at assisting those who are least able, for example in reading, it often ends up widening the attainment gap because those who are already doing well improve even faster than the strugglers. But with the hugely steep dose–response curve for physical activity and health, the biggest gainers with the Daily Mile are children who began in the bottom 30 per cent for fitness levels.2

  ‘All these things are happening because it’s not sport, it’s not PE – it’s childhood,’ Wyllie says. ‘That was the key – children won’t do what they don’t like. They like it and that’s why it’s sustainable. I would not have given it a snowball’s chance in you-know-where of succeeding. But even after that first month, we could see that we had stumbled on something. We knew it was sustainable, we knew it was universal and we knew it was transferable. A bit like ET coming to Elliott, the Daily Mile came to us. If Mr Buchanan had not said the children are not fit, I wouldn’t be sitting here. It would never have happened. It was a completely serendipitous sentence, and good on him for having the cheek to say it.’

  Wyllie is a hugely inspiring person to meet, and tells her story with genuine passion, even though I must be about the thousandth person to whom she has recounted it. And her scheme has achieved huge things. But in some ways, the Daily Mile is a symptom of failure. A typical ten-year-old should not be doubled up, wheezing, at the end of a few minutes’ jog.

  If the gradual evaporation of everyday activity is a worldwide crisis, then it is perhaps children who have been let down the most. Childhood, particularly in the pre-adolescence years of primary school, should be about constant movement – not sport, but self-guided exploration, exertion and fun. But for countless millions of modern children this is no longer the case.

  There are many reasons why. A risk-averse culture has curtailed children’s ability to roam under their own power. At the same time the dominance of motor traffic has created genuine peril to outdoor play, setting in place a vicious circle in which parents think the only way to keep their children safe is to drive them everywhere. Meanwhile in schools, ever-more intense academic curriculums have eroded time for play and sport, keeping children seated and docile during the moment in their lives when they should instead be at their most mobile, noisy and anarchic.

  As we have seen, the UK statistics for adult inactivity are fairly bleak, with around a third of men and more than 40 per cent of women failing to meet even the minimum recommended level of 150 minutes of moderate activity per week.3 For children the picture is considerably worse. When the last national study was completed in 2015, fewer than a quarter of children in England reached their required minimum of an hour a day of moderate-to-vigorous activity.4 This is a global problem, with teenagers particularly at risk. As we saw in the first chapter, four in five adolescents worldwide are not sufficiently mobile, with almost all countries jeopardising their young people’s future health.5

  It is nonetheless a more complicated picture in some ways. For example, however adamant Nigel Buchanan was about the greater fitness of children from earlier generations, this can be difficult to prove definitively. Some research has disputed the idea of a long-term decline in children’s aerobic capacity, or even that there is a definitive link between their physical activity levels and measurable fitness.

  Other studies, however, side with Buchanan, and point to an apparently rapid physical decline. One research project assessed the aerobic fitness of ten- and eleven-year-olds in Essex in 2014 and compared it to tests done on the same age groups in 2008 and 1998. It found that a decline in fitness levels not only existed but was accelerating.6 Another study, using data from the same group, found that while the children had become taller and heavier between 1998 and 2014, their muscular fitness was significantly lower.7

  Direct comparisons with Buchanan’s wartime-raised generation, let alone even earlier ones, is hugely difficult given a lack of directly comparable data. Some researchers have tried to get around that obstacle by studying modern youngsters who live in old-fashioned ways. Echoing the study of Amish farmers we saw earlier in the book, one group of Canadian researchers assessed the fitness of children from the Old Order Mennonites community, comparing them to their peers who live more typically modern lives. Like the Amish, the Mennonites reject all modern technologies, and the study found the children amassed about two or three hours a day of activity, mainly from walking and farm chores. Not unexpectedly, they tended to be leaner, stronger and fitter than the group living more contemporary lifestyles. One intriguing side note is that the only strength test in which the Mennonite children proved worse was press-ups. The researchers surmised that this was simply because they had never previously heard of a press-up, let alone tried to do one.8

  Deficits in aerobic fitness and muscular strength can be fairly swiftly made up. As Elaine Wyllie discovered, the bodies of even habitually immobile children can be gratifyingly adaptable. But this cannot be put off forever. Movement in childhood is crucial to laying the groundwork for better overall health as an adult. Some of this can be linked to cardiovascular exertion. For example, one Danish study tested the fitness of about 750 nine-year-olds, and then examined them again ten years later. It found that even after accounting for other factors like allergies and heredity, the least fit children were four times more likely to have shown signs of asthma in the subsequent decade than the most fit.9 While inactivity in itself does not cause asthma, for children with a risk of the condition, those with better fitness appear less likely to develop it.

  Perhaps the most significant long-term impact is on bones. As we have seen in previous chapters, bones adapt to the repeated loads put on them, an effect officially known as Wolff’s Law, after Julius Wolff, the nineteenth-century German anatomist who devised the theory. This plays a massive role in bone density, a key indicat
or of possible frailty in later life, notably through conditions like osteoporosis. About 70 per cent of the strength of our bones comes from their density.

  A significant proportion of this is laid down in childhood, particularly adolescence, with bone density tending to peak in early adulthood. How much is laid down depends on the amount of force placed on the bones through physical motion. Studies have shown that the process known as healthy bone remodelling happens best between 2,000 and 4,000 microstrain units,10 which translates into what should be the usual childhood regime of regular running, jumping and walking. This is especially vital for girls, who are more at risk from the consequences of weak bones when older. But this is not happening. Adolescence is precisely the moment when millions of children become less active, particularly girls. Teenage girls are not only less likely to be active than boys, but the gap is widening.