by Peter Walker
22 Estimates for the size and revenues of the global fitness industry vary considerably: the figure of about £65 billion comes from the Health Club Management Handbook.
23 Olivia Zaleski, Kiel Porter, ‘Peloton Picks Goldman Sachs, JPMorgan to Lead IPO’, Bloomberg News, 25 February 2019.
24 Figures taken from the ultramarathon section of the Findarace.com website.
25 Statistics from 2019 State of the UK Fitness and Swimming Industry Report, by the Leisure Database Company.
26 Interview with the author.
27 Jo Ellison, ‘The dumb-bell economy: inside the booming business of exercise’, Financial Times, 9 February 2018.
28 UK Sport: Historical Funding Figures – Summer Olympics https://www.uksport.gov.uk/our-work/investing-in-sport/historical-funding-figures
29 Public Health England: Annual Report and Accounts 2018/19.
30 Active People Interactive research tool on Sport England website.
31 Department for Transport. National Travel Survey: England 2018 (p. 2) https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/823068/national-travel-survey-2018.pdf
32 Active People Interactive research tool on Sport England website.
33 Stian Alexander, ‘Brits wasting £558m on unused gym memberships – with 11% saying they haven’t been in a year’, Daily Mirror, 23 January 2017.
34 Interview with the author.
Chapter 2
1 Claude Bouchard, with Steven N. Blair and William L. Haskell, ‘Why Study Physical Activity, and Health?’, in Physical Activity and Health, eds Claude Bouchard, Steven N. Blair, William L. Haskell (Champaign, Illinois: Human Kinetics, 2012), p. 4.
2 Matthew M. Robinson et al., ‘Enhanced Protein Translation Underlies Improved Metabolic and Physical Adaptations to Different Exercise Training Modes in Young and Old Humans’, Cell Metabolism, Vol. 25, No. 3 (2017): 581–92.
3 Zoë Corbyn, ‘Elizabeth Blackburn on the telomere effect: “It’s about keeping healthier for longer” ’, The Observer, 29 January 2017.
4 Larry A. Tucker, ‘Physical activity and telomere length in US men and women: An NHANES investigation’, Preventative Medicine, Vol. 100 (2017): 145–51.
5 Natassa V. Tsetsonis, Adrienne E. Hardman, Sarabjit S. Mastana, ‘Acute effects of exercise on postprandial lipemia: a comparative study in trained and untrained middle-aged women’, American Journal of Clinical Nutrition, Vol. 65, No. 2 (1997): 525–33.
6 Francine E. Garrett-Bakelman et al., ‘The NASA Twins Study: A multidimensional analysis of a year-long human spaceflight’, Science, Vol. 364, No. 6436 (2019): 127–8.
7 Interview with the author.
8 Updated edition: 2018 Physical Activity Guidelines Advisory Committee Scientific Report. Co-chairs of committee: Abby C. King and Kenneth E. Powell https://health.gov/sites/default/files/2019-09/PAG_Advisory_Committee_Report.pdf
9 Michael F. Leitzmann et al., ‘Physical activity recommendations and decreased risk of mortality’, Archives of Internal Medicine, Vol. 167, No. 22 (2007): 2453–60.
10 Steven N. Blair et al., ‘Physical Fitness and All-Cause Mortality: A Prospective Study of Healthy Men and Women’, Journal of the American Medical Association, Vol. 262, No. 17 (1989): 2395–401.
11 I. M. 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.
12 World Health Organization, Global Health Risks: Mortality and burden of disease attributable to selected major risks (2009). https://www.who.int/healthinfo/global_burden_disease/GlobalHealthRisks_report_full.pdf
13 I-Min Lee et al., ‘Annual deaths attributable to physical inactivity: whither the missing 2 million?’, Correspondence in The Lancet, Vol. 381, No. 9871 (2013): 992–3.
14 J. N. Morris, J. A. Heady, P. A. Raffle, C. G. Roberts, J. W. Parks, ‘Coronary heart-disease and physical activity of work’, The Lancet, Vol. 262, No. 6795 (1953): 1053–7.
15 Mihaela Tanasescu et al., ‘Exercise Type and Intensity in Relation to Coronary Heart Disease in Men’, Journal of the American Medical Association, Vol. 288, No. 16 (2002): 1994–2000.
16 2018 Physical Activity Guidelines Advisory Committee Scientific Report.
17 2018 Physical Activity Guidelines Advisory Committee Scientific Report.
18 Jaakko Tuomilehto et al., ‘Prevention of Type 2 Diabetes Mellitus by Changes in Lifestyle among Subjects with Impaired Glucose Tolerance’, New England Journal of Medicine, Vol. 344 (2001): 1343–50.
19 Statistics from the charity Age UK in 2013 https://www.ageuk.org.uk/latest-press/archive/250000-older-people-hospitalised-due-to-a-fall-every-year/
20 World Health Organization, Physical Activity and Adults https://www.who.int/dietphysicalactivity/factsheet_adults/en/
21 Interview with the author.
22 Interview with the author.
23 Catrine Tudor-Locke et al., ‘How fast is fast enough? Walking cadence (steps/min) as a practical estimate of intensity in adults: a narrative review’, British Journal of Sports Medicine, Vol. 52, No. 12 (2018): 776–88.
24 Terence Dwyer et al., ‘Objectively Measured Daily Steps and Subsequent Long Term All-Cause Mortality: The Tasped Prospective Cohort Study’, PLOS One, Vol. 10, No. 11 (2015).
25 I-Min Lee et al., ‘Association of Step Volume and Intensity with All-Cause Mortality in Older Women’, JAMA Internal Medicine, Vol. 179, No. 8 (2019): 1105–12.
26 Interview with the author.
27 2018 Physical Activity Guidelines Advisory Committee Scientific Report.
28 Hmwe H. Kyu et al., ‘Physical activity and risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events: systematic review and dose-response meta-analysis for the Global Burden of Disease Study 2013’, British Medical Journal, Vol. 354:i3857 (2016).
29 I-Min Lee, Howard D. Sesso, Yuko Oguma, Ralph S. Paffenbarger, Jr, ‘The “Weekend Warrior” and Risk of Mortality’, American Journal of Epidemiology, Vol. 160, No. 7 (2004): 636–41.
30 Gary O’Donovan, I-Min Lee et al., ‘Association of “Weekend Warrior” and Other Leisure Time Physical Activity Patterns With Risks for All-Cause, Cardiovascular Disease, and Cancer Mortality’, JAMA Internal Medicine, Vol. 177, No. 3 (2017): 335–42.
Chapter 3
1 William Buchan, Domestic Medicine: or, a Treatise on the Prevention and Cure of Diseases by Regimen and Simple Medicines (1769).
2 Carleton B. Chapman, ‘Edward Smith (? 1818–1874) Physiologist, Human Ecologist, Reformer’, Journal of the History of Medicine and Allied Sciences, Vol. 22, No. 1 (1967): 1–26.
3 Percival Horton-Smith Hartley, ‘The Longevity of Oarsmen’, British Medical Journal, 1:4082 (1939): 657–62.
4 Alan Rook, ‘An Investigation into the Longevity of Cambridge Sportsmen’, British Medical Journal, 1:4865 (1954): 773–7.
5 Family history by Joshua Plaut sent to the author.
6 Oxford Brookes University: Professor Jeremy Morris CBE FRCP in interview with Max Blythe (1986). Video: https://radar.brookes.ac.uk/radar/items/2d190b9a-e481-43e6-9956-5b39be502f63/1/
Transcript: https://radar.brookes.ac.uk/radar/file/2d190b9a-e481-43e6-9956-5b39be502f63/1/Morris%2CJ.pdf
7 Simon Kuper, ‘The man who invented exercise’, Financial Times, 12 September 2009.
8 Interview with Max Blythe.
9 Interview with Max Blythe.
10 Interview with Max Blythe.
11 Geoff Watts, ‘Exercising his passion – interview with Jerry Morris’, British Medical Journal, Vol. 321, No. 7255 (2000): 198.
12 Kuper, ‘The man who invented exercise’.
13 Jerry Morris, ‘Physical activity versus heart attack: a modern epidemic – personal observations’, in Epidemiologic Methods in Physical Activity Studies, ed. I-Min Lee (Oxford: Oxford University Press, 2008).
14 Interview with Max Blythe.
&nbs
p; 15 Kuper, ‘The man who invented exercise’.
16 Morris, ‘Physical activity versus heart attack: a modern epidemic – personal observations’.
17 Watts, ‘Exercising his passion – interview with Jerry Morris’.
18 Kuper, ‘The man who invented exercise’.
19 Kuper, ‘The man who invented exercise’.
20 Interview with the author.
21 Hans Kraus, Wilhelm Raab, Hypokinetic Disease: Diseases Caused by Lack of Exercise (Springfield, Illinois: Thomas, 1961).
22 Ralph S. Paffenbarger Jr et al., ‘Work activity of longshoremen as related to death from coronary heart disease and stroke’, New England Journal of Medicine, Vol. 282, No. 20 (1970): 1109–14.
23 Ralph S. Paffenbarger Jr, Alvin L. Wing, Robert T. Hyde, ‘Physical activity as an index of heart attack risk in college alumni’, American Journal of Epidemiology, Vol. 108, No. 3 (1978): 161–75.
24 Ralph S. Paffenbarger Jr, Robert T. Hyde, Chung-Cheng Hsieh, Alvin L. Wing, ‘Physical Activity, Other Life-style Patterns, Cardiovascular Disease and Longevity’, Acta Medica Scandinavica, Vol. 220, No. S711 (1986): 85–91.
25 The Women’s Health Study, a long-term study of nurses and other health professionals in the US and Puerto Rico.
26 Interview with the author.
27 Interview from 1996 by Associated Press, quoted in Valerie J. Nelson, ‘Dr. Ralph Paffenbarger, 84; linked exercise, longevity in influential study’, Los Angeles Times, 16 July 2007.
28 Jeremy Pearce, ‘R. S. Paffenbarger Jr., 84, Epidemiologist, Dies’, New York Times, 14 July 2007.
29 Kenneth H. Cooper, Aerobics (New York: M. Evans & Company, 1968).
30 Amby Burfoot, ‘RIP – Dr. Ralph Paffenbarger (1922–2007), Friend, Ultramarathoner, Fitness Pioneer’, Runner’s World, 12 July 2007.
31 V. Berridge, A. Mold, ‘Jerry Morris memorial conference’, Public Health, Vol. 125, No. 3 (2011): 172–3.
32 Kuper, ‘The man who invented exercise’.
33 Interview with the author.
34 Interview with the author.
35 Watts, ‘Exercising his passion – interview with Jerry Morris’.
36 Kuper, ‘The man who invented exercise’.
37 I-Min Lee, Charles E. Matthews, Steven N. Blair, ‘The Legacy of Dr. Ralph Seal Paffenbarger, Jr. – Past, Present, and Future Contributions to Physical Activity Research’, President’s Council on Physical Fitness and Sports Research Digest, Vol. 10, No. 1 (2009): 1–8.
38 Author’s interview with I-Min Lee.
39 Kuper, ‘The man who invented exercise’.
40 Virginia Berridge, ‘Celebration: Jerry Morris’, International Journal of Epidemiology, Vol. 30, No. 5 (2001): 1141–5.
41 Interview with the author.
42 Interview with the author.
43 Jerry Morris (chair of investigator), Allied Dunbar National Fitness Survey (Health Education Authority/Sports Council, 1990).
44 Kuper, ‘The man who invented exercise’.
45 Dennis Hevesi, ‘Jeremy Morris, Who Proved Exercise Is Heart-Healthy, Dies at 99½’, New York Times, 7 November 2009.
46 Ann Oakley, ‘Appreciation: Jerry [Jeremiah Noah] Morris, 1910–2009’, International Journal of Epidemiology, Vol. 39, No. 1 (2010): 274–6.
Chapter 4
1 Interview with the author.
2 The King’s Fund, ‘Data briefing: why NHS budgets have always been a bugbear’, February 2008 https://www.kingsfund.org.uk/publications/articles/data-briefing-why-nhs-budgets-have-always-been-bugbear
3 NHS England, 2018/19 Annual report, p9 https://www.england.nhs.uk/wp-content/uploads/2019/07/Annual-Report-Full-201819.pdf
4 Office for National Statistics, ‘How has life expectancy changed over time?’, 9 September 2015 https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/lifeexpectancies/articles/howhaslifeexpectancychangedovertime/2015-09-09
5 Royal College of Physicians, ‘Fifty years since Smoking and Health: Progress, lessons and priorities for a smoke-free UK’, March 2012: p vii https://www.rcplondon.ac.uk/file/2547/download
6 British Heart Foundation, ‘UK Factsheet: July 2020’ https://www.bhf.org.uk/-/media/files/research/heart-statistics/bhf-cvd-statistics-uk-factsheet.pdf?la=en
7 Office for National Statistics, ‘National life tables, UK: 2016 to 2018’ https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/lifeexpectancies/bulletins/nationallifetablesunitedkingdom/2016to2018
8 Office for National Statistics, ‘Health state life expectancies, UK: 2015 to 2017’ https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthandlifeexpectancies/bulletins/healthstatelifeexpectanciesuk/2015to2017
9 Office for National Statistics, ‘General Lifestyle Survey Overview – a report on the 2011 General Lifestyle Survey – Chapter 7’, March 2013 https://www.ons.gov.uk/peoplepopulationandcommunity/personalandhouseholdfinances/incomeandwealth/compendium/generallifestylesurvey/2013-03-07
10 Age UK, ‘Later Life in the United Kingdom 2019’ https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/later_life_uk_factsheet.pdf
11 Interview with the author.
12 Diabetes UK, ‘Tackling the crisis: Transforming diabetes care for a better future – England’ https://www.diabetes.org.uk/resources-s3/2019-04/Diabetes%20UK%20Tackling%20the%20Crisis.pdf
13 Diabetes UK estimates 4.7 million people in the UK have diabetes, with 90% of these having diabetes type 2. Diabetes UK fact sheet https://www.diabetes.org.uk/resources-s3/2019-02/1362B_Facts%20and%20stats%20Update%20Jan%202019_LOW%20RES_EXTERNAL.pdf
14 Diabetes UK, ‘The cost of diabetes’, 2017 https://www.diabetes.org.uk/resources-s3/2017-11/diabetes%20uk%20cost%20of%20diabetes%20report.pdf
15 Diabetes UK, ‘Nearly 7,000 children and young adults with Type 2 diabetes’, November 2018 https://www.diabetes.org.uk/about-us/news/children-young-adults-type-2-rise
16 Public Health England, ‘Physical inactivity: economic costs to NHS clinical commissioning groups’, April 2016 https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/524234/Physical_inactivity_costs_to_CCGs.pdf
17 Estimated cost is $131 billion, before adjusting for BMI, and $117 billion after; Susan A. Carlson, Janet E. Fulton, Michael Pratt, Zhou Yang, E. Kathleen Adams, ‘Inadequate Physical Activity and Health Care Expenditures in the United States’, Progress in Cardiovascular Diseases, Vol. 57, No. 4 (2015): 315–23.
18 Ding Ding et al., ‘The economic burden of physical inactivity: a global analysis of major non-communicable diseases’, The Lancet, Vol. 388, No. 10051 (2016): 1311–24.
19 Interview with the author.
20 Interview with the author.
21 Patrick Butler, ‘Tory county council runs out of cash to meet obligations’, The Guardian, 3 February 2018.
22 Interview with the author.
23 Marco Pahor et al., ‘Effect of structured physical activity on prevention of major mobility disability in older adults: the LIFE Study randomized clinical trial’, Journal of the American Medical Association, Vol. 311, No. 23 (2014): 2387–96.
24 NHS Long Term Plan https://www.longtermplan.nhs.uk/
25 Interview with the author.
Chapter 5
1 Jan Gehl, translated from the Danish by Jo Koch, Life Between Buildings (Washington DC: Island Press, originally published 1971, this edition 2006).
2 Interview with the author.
3 United Nations Department of Economic and Social Affairs, ‘World Urbanization Prospects 2018’ https://population.un.org/wup/Publications/Files/WUP2018-Highlights.pdf
4 Mark Easton, ‘Five mind-blowing facts about what the UK looks like’, BBC News, 9 November 2017.
5 Department for Environment and Rural Affairs, ‘Official Statistics: Rural population 2014/15, Updated 27 August 2020’ https://www.gov.uk/government/publications/rural-population-and-migration/rural-population-201415
6 C
arlos A Celis-Morales et al., ‘Association between active commuting and incident cardiovascular disease, cancer, and mortality: prospective cohort study’, British Medical Journal, Vol. 357, No. 1456 (2017).
7 Andersen et al., ‘All-Cause Mortality Associated with Physical Activity During Leisure Time, Work, Sports, and Cycling to Work’.
8 Public Health England. Physical activity: applying All Our Health (October 2019).
9 In 2018 there were ninety-nine cyclist fatalities; Department for Transport, ‘Reported road casualties in Great Britain: 2018 annual report’ https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/834585/reported-road-casualties-annual-report-2018.pdf
10 The calculation is approximate, as it depends how you measure it. One 2012 study (see reference below) calculated that cycling in the UK was 3.4 times more dangerous than in the Netherlands, based on deaths per million hours ridden. But Professor Rachel Aldred, an expert on cycling from Westminster University, has taken these figures and factored in the higher numbers of older people who cycle in the Netherlands, and the greater chance of death they face due to complications from injuries like broken bones (in the Netherlands if someone dies within thirty days of a traffic incident, it is marked down as a road death). On this basis, she estimated cycling in the UK is just over four times as dangerous; Jennifer Mindell, Deborah Leslie, Malcolm Wardlaw, ‘Exposure-Based, “Like-for-Like” Assessment of Road Safety by Travel Mode Using Routine Health Data,’ PLOS One, Vol. 7, No. 12 (2012).
11 Jeroen Johan De Hartog, Hanna Boogaard, Hans Nijland, Gerard Hoek, ‘Do the Health Benefits of Cycling Outweigh the Risks?’ Environmental Health Perspectives, Vol. 118, No. 8 (2010): 1109–16.
12 Rachel Aldred et al., ‘Cycling Near Misses: Findings from Year One of the Near Miss Project,’ 2015 http://rachelaldred.org/wp-content/uploads/2019/03/Nearmissreport-final-web.pdf
13 Analysis by Professor Rachel Aldred of Westminster University for her ‘Project Pedestrian’ study. It found that 548 pedestrians were killed in the UK on pavements or verges between 2005 and 2018.