Imperial College London released a peer-reviewed paper in 2021 which came to the extraordinary conclusion that the more junk food a child eats the more likely they are to become overweight:

‘British children are consuming ‘exceptionally high’ proportions of ultra-processed foods (UPFs), increasing their risk of obesity and damaging their long-term health…Researchers found that not only do UPFs make up a considerably high proportion of children’s diets (more than 40% of intake in grams and more than 60% of calories on average), but that the higher the proportion of UPFs they consume, the greater the risk of becoming overweight or obese’.

We’re all grateful that such a paper was published because we would never have known the problem existed, let alone know what to do about it. Without the steady stream of scientific papers, our world may grind to a complete halt as the world now appears to be run by experts who’ve made a whole career of being funded to state the bleedin’ obvious.

Whenever there’s a problem, it’s always best to defer as soon as possible to an expert - preferably someone who has no experience in business and no skin in the game. Luckily, Imperial College provides us with the wisdom of Professor of Public Health Christopher Millett who’ll explain to us how we got into this pickle and offer some effective ways to tackle this obesity challenge - he might even tell us how other countries are doing things differently.
After all, he is an expert and has answers that us mere mortals would never be able to think of:

‘Through a lack of regulation, and enabling the low cost and ready availability of these foods, we are damaging our children’s long-term health. We urgently need effective policy change to redress the balance, to protect the health of children and reduce the proportion of these foods in their diet.’

Oh. Ok. That’s it, is it?
The only possible ways to solve this is for the Government to regulate us even more?
The language of experts is framed in absolute certainty and conviction in there being only one solution. There’s no curiosity, desire or even wiggle room to explore perspectives and solutions together - it is their way or the highway.

Education Is Not A Proxy For Intelligence

Of course, the researchers who toil away in their Ivory Towers offer solutions rooted in their own reality - and the more specialised the field, the narrower the perspective they have. There seems to be a complete terror of peeling back the layers to examine the root causes of issues, as well as an accompanying terror that, once examined, the best solution would be a simple one.

There are a couple of red flags I see repeatedly when it comes to these experts. Firstly, when they recommend ‘simply’ adding something else to a system without conceding that there may be unintended consequences to tinkering. Secondly, recommendations are always framed as being solved by the power of more - more money, more funding, more rules, more tax, more regulations.

I asked before - what is the role of the Government in public health?:

Government has far exceeded the number of rules with a peak net benefit as well as the uncomfortable fact that Government intervention doesn’t produce prosperity.

Rachel Louise Moran posits the concept of the ‘advisory state’ which is the use of Government research, publicity, and advocacy aimed at achieving citizen support and voluntary participation to realise social goals. Instituted through outside agencies, posters, glossy pamphlets as well as legislation, the advisory state is the Government out of sight yet intimately present in the lives of citizens. Action is always done under the pretext of care and paternal concern for us, these subtle ways serve to mask governmental interference in personal decisions about diet and exercise….

Big Government affects us all because it decides how it thinks best to spend and allocate our money. In 2019, the tax burden in the UK was at a 50-year high: taxes reached 34.6% as a proportion of GDP in 2018-19, the highest level since 1969-70.

Fines and Regulation are Taxes on the Poor

Fines act as both punishment and deterrent for ‘undesirable’ behaviour, whether it is a speeding ticket, parking fine, littering, or a missed payment.

Because fines and penalties are often imposed at a flat rate, they affect the poor far more than the rich. In fact, wealthy people are happy to pay money in lieu of other consequences, “what can I pay to make this go away?”.

Jeff Bezos paid more than $16,000 in parking fines while his Washington, D.C. mansion was renovated. The tickets were issued for ignoring ‘no parking’ signs, parking in spots reserved for residents, vehicles blocking zebra crossings and obstructing the path of pedestrians. They amounted to around 0.000012% of his total wealth at the time.

Alongside the wealthy, corporations often consider fines as a cost of doing business; the six biggest banks in America have paid collectively $200 billion in fines and penalties since 2000 - and earned $1.3 trillion in net income over the same 20 years.

Regulations are ‘a law, rule, or other order prescribed by authority, especially to regulate conduct’ and punishment for not following varies from fines, market restrictions, withdrawing licensing to court action.The cry for regulation often is accompanied by the demand for subsidies in the form of loans, tax breaks, regulations and other preferences given to an individual, business, or institution, usually by the government.

Corporations who are already in business can use regulation as a way of keeping future competition out of the market and even encourage it. The cost of regulations acts as a kind of invisible tax, they can be expensive to comply with and this cost is passed on to the customer - which then means the poor lose out again.

On the surface, it seems like a benevolent act, a way to help and support those in need. However, scratch the surface, and it becomes apparent that subsidies benefit a few at the expense of many:

• A 2015 study found that 90% of the money from subsidies went to large corporations.

• The same study found that 30% of businesses with over 1,000 employees compared to 0.2% of businesses under 250 employees received subsidies.

• Competing businesses which don’t receive subsidies are at a disadvantage to those who do.

• Politicians decide what businesses are ‘worthy’ of subsidies and which aren’t.

• As the proof is in the pudding, it turns out that most subsidies are long-term failures in the economic sense but still achieve cultural or political goals.

• Transferable subsidies enable the recipient sell it on to unrelated third parties. This allows whoever buys the subsidy to lower their own tax liability.

Now, back to the study I mentioned earlier:

‘National dietary guidelines should be updated to emphasise preference for fresh or minimally processed foods and avoidance of ultra-processed foods (UPFs), in line with guidelines developed in Brazil, Uruguay, France, Belgium and Israel.

UPFs should be taxed and minimally processed foods should be subsidised to make healthier food choices more affordable. Other actions include restricting promotions and all forms of advertising of UPFs, especially those targeting children, and mandatory bold front-of-pack product labelling.’

OK, that sounds sober, sensible and serious glancing but here’s a test for you - what are some of the hidden assumptions contained within this statement?

Here’s a few things that I found:

1. Labelling is proven to work as a method of dissuading people from buying products.

2. Companies will not seek ways to tweak their products so they are no longer classified as UPFs and thus exempt from new rules.

3. National dietary are guidelines correct and the people who write the guidelines are not influenced by any outside interests.

4. It is ethical to penalise people through taxation by pricing people out of being able to buy them.

5. Subsidises work in the way they are intended to.

6. Taxation is an ethical solution to all the problems of the world, it always has been and always will be.

Coulda, Woulda, Shoulda

Pay attention to whenever experts use the word ‘should’ and notice how it is presented as a declaration of fact, of reality - this is the way, the only way, to achieve the outcome. Implicit rules take the form of things people should do and promote an inflexible, rigid and closed-minded approach. When the flag of ‘Should’ is flown it is a trap because there’s no invitation to curiously explore ideas nor to enter into dialogue, borne out of a refusal to accommodate for the complex and nuanced nature of our world.

As an example, note how these two openers land:
“Who’s right?” vs “Let’s explore why we see this differently.”

Subtraction: The Space In-Between

Take note of whenever a solution is talked about; addition is always favoured over subtraction. One study found that when stakeholders suggested 100’s of ways to improve an organisation, fewer than 10% of those improvements involved taking something away. There is nothing inherently wrong with addition; but if it is the default path to solving solutions, then it means we - and the experts - are missing an entire class of solutions. Whenever there are cries to ‘do something’ it implies that things need to noticeably change and evidence of good subtraction is that it is not noticeable, seeing as it’s marked by the absence of something.

Sunset Clauses

Remembrance of Things Past by Marcel Proust is rated as the longest novel by the Guinness Book of World Records coming in at 3,000 pages and 1.2m words long and estimated to take around 114 hours to read. It is a mere pipsqueak in comparison to the UK tax code, which is 17,000 pages and 10 million words long and yet, according to tax lawyers, more isn’t more - because they consider the most efficient tax code in the world to be in Hong Kong which is a mere 276 pages long.

I’ve no idea how relevant most of the information contained within the ever-increasing tax code is, but this eternal accumulation could be avoided by using a sunset clause whenever something new is added. This clause establishes an expiration date where the statute, rule or regulation will no longer be valid and automatically expires on a specific date; at which point it can either be extended, left to expire or modified to suit the current situation better.

We learned earlier that adding complexity creates unintended consequences and 10 million words offers plenty of opportunities for large Corporations to pore through the tax code for loopholes for legal tax avoidance.

Despite there being a compelling case that a 276 page tax code may generate the same - or more - revenue in the UK, there appears to be a complete lack of desire to try anything new or different.

Build Subtractive Thinking In To Day-to-day Processes So It Becomes A Normal Way Of Approaching Problems

• Create a rotating role of a Chief-Subtractor. This role requires the person to come up with a list of ways to achieve the goals and solve problems by subtracting and they remind their team to consider subtraction a viable choice.

• Subtract-before-we-add policy when making decisions. Consider the option of removal before defaulting to addition.

• Challenge people to come up with a list of everything an organisation could subtract or remove in the coming year.

• Make evidence of good subtractions visible.

• Asking the right questions is key to finding the right answers.
  “what can we add to make it better?” AND “what can we remove that might make something better?

• Set an expiration or review date for all new policies, rules, laws and regulations. Does that data show that it has done what it was meant to do?

• Don’t start something new without seeing what you can remove or stop doing first.

Keep It Simple Stupid

Those who sit in their Ivory Towers far removed from the problems they’re solving, choose one terrible measure after another, never learning the lessons of their past failures and always finding blame elsewhere. They often opt for outcomes that are vague, idealised and difficult to measure and end up warping the whole system’s priorities in the process, causing more harm than good and rarely - unless through chance - succeeding in solving the root cause.

Despite what these experts would have you believe, systems are not purely mechanistic because it comes down to how the people running them behave - which is a moral question. Symmetrical rewards and consequences (known as having skin in the game) along with aligned incentives create a completely different result than forcing people through threat of fines and punishment. ‘Show me the incentives and I will show you the outcome’ is a mantra yet to be enthusiastically embraced by experts who never have to live with the failure of their policies.

How about if we stopped being bamboozled by qualifications and asked them to explain exactly how they thought the policy they were advocating would bring about the effects they claimed it would?

It would not be enough to flippantly advise another regulation or tax, they would also have to back this up by tracing, step by step, from start to finish, the causal path from the policy to the effects it was supposed to have to show how it would work in practice, in the real world outside their ivory tower. Let these experts stand up and be judged by the outcomes of their policies and not just by the amount of papers they publish.

I didn’t intend for this piece to go in the direction it did; I thought it would be a lot less …spicy. But it really did occur to me that this is a huge problem in the ever-expanding bureaucratic state we live in where the Government follows policy given by ‘respectable’ Universities which can serve as convenient scapegoats if things don’t work out. There’s no incentive for anything to get better; the main incentive is for things to continue on as they are, in a perennial status-quo, whilst the population are left to eat cake.

- F

REFERENCES

Association Between Childhood Consumption of Ultraprocessed Food and Adiposity Trajectories in the Avon Longitudinal Study of Parents and Children Birth Cohort' by Chang, K. et al. is published in JAMA Pediatrics. DOI: 10.1001/jamapediatrics. 2021.1573

Adams, G.S., Converse, B.A., Hales, A.H. et al. People systematically overlook subtractive changes. Nature 592, 258–261 (2021). https://doi.org/10.1038/s41586-021-03380-y

Meyvis T, Yoon H. Adding is favoured over subtracting in problem solving. Nature. 2021 Apr;592(7853):189-190. doi: 10.1038/d41586-021-00592-0. PMID: 33828311.

A New, Simple, Revenue Neutral Tax Code for Business

US banks rack up $200bn in fines and penalties over 20 years

Simon Luechinger, Christoph Moser, The value of the revolving door: Political appointees and the stock market, Journal of Public Economics, Volume 119, 2014, Pages 93-107, ISSN 0047-2727, https://doi.org/10.1016/j.jpubeco.2014.08.001

Innovation Versus Complexity: What Is Too Much of a Good Thing?

The End of Bureaucracy

The GRIM test: A simple technique detects numerous anomalies in the reporting of results in psychology

What’s Wrong with Social Science and How to Fix It: Reflections After Reading 2578 Papers

The Eatwell Guide: Public Health England

It’s time to ban obesity in NHS employees

Why Incentive Plans Cannot Work

The Behavioural Insights team, popularly known as the ‘Nudge Unit’

Evaluating State and Local Business Incentives

Shortchanging Small Business: How Big Businesses Dominate State Economic Development Incentives, October 2015, Greg LeRoy, Carolyn Fryberger, Kasia Tarczynska, Thomas Cafcas, Elizabeth Bird, and Philip Mattera, Good Jobs First National Policy Resource Center

Jeff Bezos paid over $16,000 in parking tickets during his mansion’s renovation

Well, hello again!

I haven’t been on here writing as I am one of those people who always feels as if there’s nothing to say because everything’s already being said better by others. I had a look at the analytics and I was surprised that I wasn’t actually howling into the wind, that there were people who were reading my work and perhaps I can spark something in someone’s mind as so many writers have inspired me; pay it forward as they say.
But I’ve resolved to make it a personal goal to write a piece a month; I can surely cobble together the small crumbs in my mind to make something that might strike a chord with someone.

Recently I’ve heard many people discuss the importance of reading old books, things from before our time and age. It helps to shatter this idea that history unfolds as a ‘natural progression’ and challenges the inevitability of how history pans out.
In January of 2020, I read a biography of George Orwell, which challenged my own preconceptions:

Up until reading that passage, it had never occurred to me that there were people who could possibly dislike the arrival of central heating, let alone someone with the intellect of Orwell.

How could this be?

He dove into this deeper in an essay called ‘The Case for the Open Fire’ which was published in a 1945 edition of the Evening Standard newspaper, saying “the survival of the family as an institution may be more dependent on it than we realise”.

Like I said, I read this nearly 3 years ago, and the paragraph never left me. We had been living without heating for two winters at that point to save money and I’d felt small and ashamed about it; now I wondered if it was something I was framing incorrectly and started to think about it in a different light. Fast-forward to today and the cost-of-living, we’re told, is on everyone’s minds, with many facing the modern choice of ‘heating or eating’ for the first time in their lives, presumably surprised that this resource is not eternal and rests on shaky foundations.

More things kept happening to taint my view of eternal technological progress as an unmitigated good; the realisation of others around me hopelessly addicted to their smartphones and to social media, unable to function in daily life and left without skills to navigate it thanks to their own TV-addicted parents.

Are we now finally getting the bill for the past 100 years of technological progress?

How can we contemplate going ‘backwards’ to living without heating?

Technology promises freedom and convenience. Because we act as though things are ‘naturally progressing’, we thoughtlessly accept these new devices into our lives, without for one moment considering there are any down sides.

The reality is, all things come with trade-offs and, as we sit here in the loneliest moment of human history surrounded by technology which promised the opposite, perhaps we’d be wise to pause, take our time and cultivate a bit more cynicism about the promise of the future.

Interlude: Amish Intentionality

The Amish are a surprising case study on intentionality, particularly when it comes to the use of personal devices. Michael J. Coren wrote in his article:

‘It’s not that the Amish view technology as inherently evil. No rules prohibit them from using new inventions. But they carefully consider how each one will change their culture before embracing it. The Amish stance toward any invention isn’t that they reject it outright. It’s that they start by assuming they don’t need it, then adopt it only if they decide it’s in line with their values. They make a distinction between using something and owning it as well as between technology at work and at home. After observing a given technology’s effect on outside society, each Amish community can vote on whether to accept or reject it.’

Some Amish communities have solar panels to generate electricity because the technology allows them to maintain their energy independence. If a person is seriously ill, checking into a hospital is acceptable, but they refuse to own things such as cars and television because they’ve decided those technologies erode their community and neighbourliness. They trialled the use of credit cards but, over time, it became clear that over-spending and debt created negative consequences on the community.

Every six months, the Amish district councils sit down and discuss whether or not it’s something they think would be beneficial for their society as a whole and if it aligns with their values. There are times where they decide absolutely that this is a new technology they need because, after weighing up the pros and cons, the advantages and disadvantages and benefits and drawbacks, it’s only then they consciously decide to accept or reject something. They use technology, but they do it selectively and are able to curate and design their lives by asking:

“Is this what we want?”

Kevin Kelly sums it up in his article: ‘this is how the Amish determine whether technology works for them. Rather than employ the precautionary principle, which says, unless you can prove there is no harm, don’t use new technology, the Amish rely on the enthusiasm of Amish early adopters to try stuff out until they prove harm.’

There’s a slim chance that the Amish will sleepwalk into the future and be surprised to discover that their teenagers are functionally addicted to their phone, video games or internet porn. They’re unlikely to be shocked that constant use of a smartphone has reduced and split our attention span to the extent we are unable to pay full attention to a task or person in front of us as we are engaged in Continuous Partial Attention.

Author Steven Berlin Johnson describes this as a kind of multitasking: “It usually involves skimming the surface of the incoming data, picking out the relevant details, and moving on to the next stream. You’re paying attention, but only partially. That lets you cast a wider net, but it also runs the risk of keeping you from really studying the fish.”

This article describes CPA as:
‘Leading to a higher level of stress in the brain, prohibiting reflection, contemplation and thoughtful decisions. It also dilutes efforts to focus and concentrate on the present (effectively paying attention to what you are doing in the moment instead of shifting from one activity to another). This constant connectedness also affects real-time relationships and lowers productivity levels, leading to over-stimulation and lack of fulfilment.’

Tyler McKenzie’s writes:
In Gulliver’s Travels (written in 1727), the Lilliputians think Gulliver’s clock is his god because he keeps checking it. After interrogating him, the Lilliputians conclude the following:

Back to central heating via Chesterton’s Fence

The Amish, it seems, have innately grasped the principle of Chesterton’s Fence and it’s something to keep in mind whenever a reform of anything is proposed. I now consider it a Natural Law, akin to Newton’s Third Law of Motion, because the older I get, the more I realise that many things are counter-intutive and terrible decisions can appear as sensible ones – it’s time itself that reveals such folly.

• What were the consequences of central heating?

• What was lost and what did we gain?

• Was it worth it in the long-run?

• Are we better off in mind, body and spirit with central heating?

Wim Hof has made the cold desirable and every hipster worth their salt takes cold showers or plunges into icy lakes any chance they get, yet this doesn’t appear to extend to the rather less Instagram-worthy photos of sitting in a house without putting the central heating on.
Still, this discourse around finding the benefits in discomfort and suffering – which are taboo these days – are helping move the Overton window a bit.

Perhaps central heating is the exception and not the norm; it’s just that we’ve lived through a tiny time-frame whereby we can consume endlessly and cheaply with no demands placed upon us to regulate ourselves. We’ve lived entirely through the exception and consider it the norm.

Entitlement walks hand-in-hand with being taking everything for granted, yet it is not a right to have central heating at all. It’s driven me loopy with the many ways we’ve conspired to waste energy – blasting heating in shops which have their door left open, leaving lights on in offices and homes when they’re empty, walking around in shorts and t-shirt mid-winter. These flagrantly wasteful practices shows how this precious resource is now just another thing we have and can use with no consequences for our actions.

Humans, like all creatures of this World, are regulated less by our temperament and more by our environment which constrains and keeps us in check.

This environment has changed considerably thanks, in part, to central heating.
Like the Amish, we must now be intentional with how we design our lives and recognise there is a cost to all new things, a cost that may not be known for decades.
What is the price we must pay for excessive comfort?
Weakness in mind, body and spirit and the inability to tolerate suffering or adversity of any kind.
A weak society will not be a pleasant one; indeed it is said that weak men create hard times.
When adversity does knock on your door, welcome it and thank it for building your character.

F

Further reading:

PS Please bear in mind BOCTAE - But of course there are obvious exceptions. Debating exceptions is tedious and I don’t want to get bogged down by the weeds.

PPS I am English in England; I cannot speak of other countries, be they hot or cold. What I do know is that, up until less than a century ago, we grew up without central heating. That alone tells me that it is not a necessity for survival, but a luxury afforded to us in this moment of history to enjoy.

For those of who have never played whac-a-mole, it was originally an arcade game with large circle shaped holes that each contain a mole that randomly pops up and down. Using a mallet you attempt to whack them back down and win points for your effort; the more difficult levels have multiple moles popping up at the same time.

Once a doctor has whacked one symptom, more pop up - perhaps due to side-effects of medication or because the symptoms a patient is presenting don’t coincide with the root cause of a disease, injury or disorder.

Every time a symptom pops up, it gets whacked with a prescription, a test or a scan with little or no thought into figuring out where the pesky moles are coming from or if there’s a way for them to stop popping up in the first place. These new symptoms are also whacked away with more medicine or treatment, yet even with more drugs (and more side effects) the person may hesitate to describe themselves as healthy.

When the root cause of any symptom is left unaddressed, the problem will continue to persist regardless of how many times the doctor whac-a-mole’s those symptoms with his medicine mallet. Curing a symptom is never a substitute for curing the cause and endless trips to the doctor will be one round after another of symptom-treating, possibly at significant cost to your health.

In IT, the term whac-a-mole is used to describe ‘a pervasive problem keeps recurring after it is supposedly fixed, or any situation where some type of undesirable outcome is recurring.’ Dr. Dan Kalish used the term in his 2012 book as an analogy of the current American healthcare system, which has become increasingly dependent on the use of medicines to eradicate symptoms instead of curing disease.

Modern allopathic or conventional medicine appears to not understand or be interested in addressing the root cause of symptoms and has devolved into the pursuit of controlling symptomatic indicators by prescribing medication. Some GPs here in the UK have spent the last 16 months taking phone calls and not seeing their patients in person at all; ironic considering that in our lifetime there is a good chance these same doctors will be find themselves out of a job, replaced by Artificial Intelligence. Researchers at the John Radcliffe Hospital in Oxford, England, have developed an AI diagnostics system that’s more accurate than doctors at diagnosing heart disease, at least 80% of the time. Anyone who has experienced the near-impossible task of getting an appointment for a doctor in the UK may not need that much persuading to switch over when the time comes.

The NHS figures show that around 10,780 admissions were caused directly by obesity while the rest were for problems related to obesity, a rise of 17% from the previous year. Admissions directly caused by obesity were highest in people aged 45 - 54, lowest in people aged under 16 or over 75 and women made up 64% of cases.

Of the admissions where obesity was a factor but not the main reason for admission, the most common of these were for appointments during pregnancy, knee and hip arthritis and heart disease. Obesity admissions were twice as likely in the most deprived areas of the country compared to the least deprived.

The C-Word

Being obese or excessively overweight increases the risk of severe illness and death from Covid-19, a July 2020 Public Health England report confirms. The current evidence does not suggest that having excess weight increases people’s chances of contracting Covid-19 however, the data does show that obese people are significantly more likely to become seriously ill and be admitted to intensive care compared to those with a healthy BMI.

A study found that people with a BMI of 35 - 40 have an increased risk of death from Covid-19 by 40% and this rises to a 90% increased risk of death when a person has a BMI over 40.

Evidence published both in the UK and internationally suggests that being severely overweight puts people at greater risk of hospitalisation, The risk of intensive care unit admission and death from Covid-19 increases substantially as body mass index (BMI) increases and 7.9% of critically ill patients with Covid-19 had a BMI over 40 in intensive care units, compared with 2.9% of the general population.

This could indicate why countries which have both obesity problems and an ageing population had high death rates attributed to Covid-19. Flipped on its head; the more unhealthy a population, the less unexpected it is when large amounts of unhealthy people die from things that don’t affect those who are healthy or not elderly. This seems to be reflected in the ONS data which published a report showing that 772 people under the age of 65 were recorded as Covid-19 deaths with no underlying health conditions between March and June 2020 (they’ve not continued to update this information to present day).

Do As I Say, Not As I Do

Something that doesn’t go unnoticed but is rarely spoken about is the shockingly high level of obesity within the NHS itself. According to a Royal College of Physicians estimate, 700,000 NHS employees - including 1 in 4 nurses - are obese, yet only 15% are seen or assessed

Obesity is recognised as contributing significantly both to illness and employee absence so considering the NHS is the fifth largest employer in the world, this translates into large amounts of money being spent to deal with these issues. A report into health and wellbeing in the NHS suggested that if current rates of sickness were reduced by a third, this would result in an estimated annual direct cost saving of £555 million as well as 3.4 million additional available working days for NHS staff every year.

Primary care trusts (PCTs) are responsible for overseeing area hospitals and ensuring their quality, yet an audit of London PCTs showed that only 8% had specific policies for physical activity, 19% had healthy eating policies and few had policies targeting broad health issues. The authors of the report say that doctors and healthcare staff ‘do not receive adequate training in obesity, healthy eating, physical activity and behaviour change techniques or the prevention of excessive weight gain’ yet, unsurprisingly, the main barriers cited to the creation of proactive wellbeing programmes were lack of funding (a perennial ‘reason’) and lack of time.

Considering the NHS themselves highlight how obesity is linked to heart attacks, diabetes, cancer, strokes, cardiovascular problems, it begs the question - why are they not enacting proactive policies to educate, treat, inform and prevent obesity? After all, an ounce of prevention is worth a pound of cure.

In 2015 McKinsey & Company published a study showing that the UK government currently spends 5% of the entire budget of the NHS every year on the direct medical costs of conditions related to being overweight or obese. The per capita spending on patients increases significantly between people with a normal BMI (<25) and different overweight classes. Between a normal BMI (<25) and overweight (25-29) there is an increase of 31% or £247 per capita. For obese class 1 (30-34) there is an increase of 58% or £469, for obese class 2 (35-39) the increase is 80% or £642 and for the highest weight class, obese class 3 (>40), there is an 86% or £688 increase.

The UK has the second-highest rate of obesity in the world and the largest in Europe, with a quarter of all adults classed as obese with almost two-thirds (63%) of adults in England classed as overweight or obese. In 2018 the majority of adults in England in 2018 were overweight or obese (63%) and it’s estimated that the majority of the population will be classified as obese by 2050.

Annual spend on the treatment of obesity and diabetes is greater than the amount spent on the police, the fire service and the judicial system combined with £48 billion a year spent managing the social causes and healthcare of obesity. Obesity is classed as the biggest strain on the NHS and is a huge financial burden; how ironic considering that the many people who claimed we needed to protect the NHS by simply staying in our houses, haven’t spent as much money or propoganda in highlighting the obesity epidemic which continues, year after year.

A Legend In Our Own Mind

Nothing lasts forever and no matter how powerful, all governments, kingdoms or societies ultimately fall. The Roman Empire’s decline was gradual, probably imperceptible to those living through it. 1920 marked the year the British Empire became the largest Empire in history yet 100 years on, Britain clings on to past glories and still claims to be important and influential on the international stage, unable to come to terms with the loss of power and prestige.

American political scientist Kenneth Waltz created a set of five criteria to determine what defines a great power:

• Economic Capability

• Military Strength

• Resources

• Political Stability & Competence

• Population & Territory

By these measures, Britain has now dropped out of the premier league of world affairs. It is hard for anybody let alone a nation to accept they’ve passed their peak, however Britain is a shadow of its former self and its decline is visible in terms of ever-reducing material and diplomatic capabilities. Note how tenaciously we cling on to the ‘special relationship’ we have with America, even though Washington is far more interested in Asia than Europe. As far back as 1991, American ambassador to London Raymond Seitz said: “Never forget that the United States is only interested in Britain in so far as Britain is a player in Europe.”

The decline of the West coincides with the rise of the East and the world is moving into a duopoly, with America and China the current great powers, with Russia and India on the ascendancy. Britain slides down the rankings and this relegation to a new, less important and influential role will prove to be exceptionally painful and difficult to accept.

The decline of an Empire can often be mirrored with the decline of morals and ethics within it, as James Traub writes:

‘In The History of the Decline and Fall of The Roman Empire, Edward Gibbon luridly evokes the Rome of 408 A.D., when the armies of the Goths prepared to descend upon the city. The marks of imperial decadence appeared not only in grotesque displays of public opulence and waste, but also in the collapse of faith in reason and science. …A decadent elite licenses degraded behavior, and a debased public chooses its worst leaders.’

We now find ourselves living in a country whose future is far less certain and ‘glorious’ than its past. Our strong beliefs in self-reliance, resilience, stoicism and self-determination have been replaced with an attitude of expecting something for nothing. Government welfare now supports so much of the country it has come to be seen a natural right for everyone forever. Yet, when so many policies end up making the wrong thing easy and the right thing hard, it shouldn’t be a stretch to imagine that when there are no negative consequences for ignoring you health and no financial costs to pay for your own healthcare, an attitude of entitlement grows unchecked. When healthy people who rarely use a healthcare system are forced to subsidise other people’s healthcare costs in the form of higher and higher taxes then it is only a matter of time before things reach a breaking point.

What holds costs down is patients acting like consumers, looking out for themselves in a competitive market. Providers fight to win business by keeping costs down and quality up…When someone else pays, costs always go up....(and) we consume without thinking.

- John Stossel

Conclusion

If obesity is such a huge burden to our healthcare system (which we have venerated and vowed to protect), and when per capita spending on patients increases significantly between normal BMI and different overweight classes, what are the incentives for people themselves to change their behaviour and make healthier lifestyle choices?

When a significant number of hospital admissions are obesity related, who really is it that’s being reckless and not protecting the NHS with their behaviour?

I have written before (here and here) about the the various aspects of healthcare we rarely like to address. As I also mentioned, I’m not in favour of a radicalised, emotion-driven response to complex issues. It feels satisfying to tie all arguments about the NHS into a bow called ‘it needs more money and it’ll be fixed’, yet this must also be questioned.

Why does it need more money?

Is it due to bad management?

Is an increasingly unhealthy population demanding too much from it?

With an ageing population, and the increasing prevalence of chronic lifestyle-related diseases, if the NHS is going to continue in its current form, it needs to reflect the changing needs of the population it serves. It needs to be proactive promoting health and wellbeing instead of concentrating on recovery after illness. The issues connected to obesity are not going to go away; they are going to compound over time and, instead of deluding ourselves our NHS is the jewel in the crown of a healthcare system envied throughout all the world, we need to be realistic and question if the model is simply unable to cope with the demands of modern-day society which is so different to the world when it was created in 1948.

As would be expected, a declining empire would be matched by a decline in living standards; wage growth is not expanding at a pace that keeps up with the rising cost of living nor the growing costs of healthcare, so where is the ever-increasing NHS budget going to come from?

The NHS is funded mainly from general taxation and this growing gap cannot be plugged indefinitely by raising taxes and treating the British public as cash cows, yet we are acting as if it’s natural to have an unlimited supply of money to deal with the problems obesity causes.

What is shocking is the ease with which we have normalised obesity and accepted it as a part of everyday life; it’s as if, collectively, as a country we’ve metaphorically and physically let ourselves go. However, awareness is the first part of the process; introspection is hard, but we can forge a new identity if we accept our place in the world. To start the transformation, the only pie we need to be eating for the foreseeable future is that of the humble variety.

REFERENCES

Statistics on Obesity, Physical Activity and Diet, England 2021

It’s time to ban obesity in NHS employees

NICE calls for NHS staff to become active to cut obesity

Action on obesity: Comprehensive care for all

Excess weight can increase risk of serious illness and death from Covid-19

Excess weight and COVID-19: insights from new evidence

The NHS is the world’s fifth largest employer

How does UK healthcare spending compare with other countries?

Covid-19 deaths with no underlying health conditions, broken down by age

Davey RC, The obesity epidemic: too much food for thought? British Journal of Sports Medicine 2004;38:360-363.

Health matters: obesity and the food environment

The obesity crisis | McKinsey Study

Can India learn to be a ‘Great Power’?

Mahase E. Covid-19: Why are age and obesity risk factors for serious disease? BMJ 2020; 371 :m4130 doi:10.1136/bmj.m4130

CDC study finds about 78% of people hospitalized for Covid were overweight or obese

A Recessional Power: How Britain’s Claim to Be a Great Power Has Been Fatally Undercut

List of largest empires

Insurance Is No Answer

Just How Special is the U.K.-U.S. ‘Special Relationship’? One Briton’s View

The United States of America Is Decadent and Depraved

Living Standards 2017The past, present and possible future of UK incomes

How the NHS is funded | The King's Fund

Revealed: How the world gets rich – from privatising British public services

UK Sin Taxes Now A ‘Cash Cow’ For Government: Report

Taxman accused of using small businesses as a 'cash cow' after unveiling 'draconian' penalty regime

This is a social democratic government, not a Tory one

Robert Sallis, Deborah Rohm Young, Sara Y Tartof, James F Sallis, Jeevan Sall, Qiaowu Li, Gary N Smith, Deborah A Cohen. Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult patients. British Journal of Sports Medicine, 2021; bjsports-2021-104080 DOI: 10.1136/bjsports-2021-104080

They used imaging software to identify joint centres using digital markers and to calculate joint kinematics (a branch of mechanics that deals with pure motion, without reference to the masses or forces involved in it) and all testers underwent a structured training programme, involving a thorough description of the procedures.

Three valid trials for each leg from both the single-leg squat and the vertical drop jump test were included and researchers then analysed the deepest position of each trial. For the vertical drop jump (where you drop down off a box and immediately jump as high as you can), they also analysed the frame of initial heel contact, i.e. when the foot was flat on the ground.

The takeaway of the study showed that we don’t know what predisposes individuals to higher ACL tears and lends credence to not putting too much weight on these two screening assessments when determining ACL tear risk.

In a previous blog post I wrote about the origin of keeping our knees-over-toes:

This belief originated from Dr. Karl Klein when he published his research in 1961 stating that deep squatting over-stretched the ligaments of the knee. After being picked up by Sports Illustrated in 1962, his theory became accepted across the board - the Marine Corps eliminated the squat jumper from their programme and gym teachers were banned from using the full squat in physical education classes. The myth was born and, to this day, walk into any gym and see most people only squatting to a parallel depth and bending their knee as far as their toe.

It’s important to recognise that we are far from complete in our knowledge and we know very little about the way about how the body actually works - that’s why I really like reading these studies because they run counter to ‘accepted wisdom’ and challenge our prevailing norms. The knee-over-toe myth has become entrenched along with many others including the R.I.C.E protocol (Rest-Ice-Compression-Elevation) whenever anyone is injured or has trained hard. You may not know that Dr. Gabe Mirkin, the physician who coined the acronym ‘R.I.C.E’ in 1978, wrote a blog post in 2015 updating his position:

‘Ice has been a standard treatment for injuries and sore muscles because it helps to relieve pain caused by injured tissue. Coaches have used my ‘RICE’ guideline for decades, but now it appears that both ice and complete rest may delay healing, instead of helping…A summary of 22 scientific articles found almost no evidence that ice and compression hastened healing over the use of compression alone, although ice plus exercise may marginally help to heal ankle sprains’.

Dr. Mirkin’s post is worth reading in full and he touches upon various points including how anything that reduces inflammation also delays healing, why ice also reduces strength, speed, endurance and coordination and his recommendations for new treatment protocols.

We need to keep space for new ways of doing things, be unattached enough to discard old knowledge if new information is compelling enough, and remember that we don’t know what we don’t know. If science changes from being a mode of inquiry into a form of authority we follow slavishly, we’re likely to forget that common sense and our own observations can also guide our actions. Your well-intentioned coach or trainer may give you advice but perhaps their information isn’t the most up-to-date; if there is currently no accurate way to predict who will suffer non-contact ACL injuries and who won’t, ask them to show you where their evidence to the contrary comes from and weigh it up for yourself.

REFERENCES

Agnethe Nilstad, Erich Petushek, Kam-Ming Mok, Roald Bahr & Tron Krosshaug (2021): Kiss goodbye to the ‘kissing knees’: no association between frontal plane inward knee motion and risk of future non-contact ACL injury in elite female athletes, Sports Biomechanics, DOI: 10.1080/14763141.2021.1903541

Exceptions to the joint-by-joint approach – by Greg Lehman with commentary from Bret Contreras

Krosshaug T, Steffen K, Kristianslund E, Nilstad A, Mok KM, Myklebust G, Andersen TE, Holme I, Engebretsen L, Bahr R. The Vertical Drop Jump Is a Poor Screening Test for ACL Injuries in Female Elite Soccer and Handball Players: A Prospective Cohort Study of 710 Athletes. Am J Sports Med. 2016 Apr;44(4):874-83. doi: 10.1177/0363546515625048. Epub 2016 Feb 11. Erratum in: Am J Sports Med. 2017 Jul;45(9):NP28-NP29. PMID: 26867936.

The use of Cryotherapy in Sports Injuries,’ Sports Medicine, Vol. 3. pp. 398-414, 1986

“Is Ice Right? Does Cryotherapy Improve Outcome for Acute Soft Tissue Injury?” JEM, 2008; Feb. 25; 65–68

Dr. Gabe Mirkin - Why Ice Delays Recovery

Tseng, Ching-Yu1; Lee, Jo-Ping2; Tsai, Yung-Shen2; Lee, Shin-Da3; Kao, Chung-Lan4; Liu, Te-Chih2; Lai, Cheng- Hsiu2; Harris, M. Brennan5; Kuo, Chia-Hua1,3 Topical Cooling (Icing) Delays Recovery From Eccentric Exercise–Induced Muscle Damage, Journal of Strength and Conditioning Research: May 2013 - Volume 27 - Issue 5 - p 1354-136, doi: 10.1519/JSC.0b013e318267a22c

Scialoia, Domenic & Swartzendruber, Adam. (2020). The R.I.C.E Protocol is a MYTH: A Review and Recommendations thesportjournal.org/article/the-r-i-c-e-protocol-is-a-myth-a-review-and-recommendations.

Bleakley CM, Glasgow P, Webb MJ, Cooling an acute muscle injury: can basic scientific theory translate into the clinical setting? British Journal of Sports Medicine 2012;46:296-298.

RICE: The End of an Ice Age

The 12,529 participants wore tracking devices for 7 straight days, which measured how much time participants were sedentary or engaged in light or moderate-to-vigorous physical activity and they were only removed when bathing or sleeping. The findings were divided into five age groups: children (ages 6-11); adolescents (ages 12-19); young adults (ages 20-29); adults at midlife (31-59); and older adults (60-84). Researchers also used data from the National Health and Nutrition Examination Survey from the 2003-2004 and 2005-2006 survey cycles.

For all age groups, men generally had higher activity levels than women, particularly high-intensity activity, but after midlife, these levels dropped off sharply compared to women. Among adults 60 years and older, men were more sedentary and had lower light-intensity activity levels than women.

“Activity levels at the end of adolescence were alarmingly low, and by age 19, they were comparable to 60-year-olds,” says the study’s senior author, Vadim Zipunnikov, assistant professor in the Bloomberg School’s Department of Biostatistics. The study confirmed that recommended guidelines were not being met. For instance, the World Health Organization (WHO) recommends at least 60 minutes of moderate-to-vigorous physical activity a day for children aged 5-17. The study found that more than 25% of boys and 50% of girls ages 6-11 and more than 50% of boys and 75% of girls aged 12-19 had not met the WHO recommendation.

Sedentary children become sedentary adults

Dawn Skelton, professor of ageing and health at Glasgow Caledonian University and an adviser to the Royal Osteoporosis Society, said today’s children are far more sedentary than previous generations and their bones may weaken and fracture earlier than usual because these children haven’t laid down a good baseline of bone through movement, ageing will start happening much earlier and falls could be more serious due to the lower bone density. Children need to be as active as possible it is the time when we lay down the majority of our adult levels of bone density - after the age of 15 it’s not as easy to lay down bone, and growth slows significantly.

The problem of sedentariness in children is a hidden one will become more apparent as they get older; unless sedentary habits change, this generation of children could end up with hip fractures in their 40s and 50s instead of their 70s. This is because it’s much more difficult to build up bone density in adulthood than it is in childhood - an adult can increase bone mass by 3% by doing 3-4 hours a week of bone-loading exercise, whereas 13-year-olds doing the same amount of exercise can increase bone mass by 10%.

Does Exercise Cause Fragility Fractures?

The following is taken from An Expert Consensus Statement on Physical Activity and Exercise for Osteoporosis published by the Royal Osteoporosis Society:

Frailty and other health conditions may reduce the ability to be active and exercise, especially at higher levels of intensity or impact, although some evidence is reassuring. In addition, frail individuals are at a higher risk of fracture but are less likely to undertake physical activity. People with osteoporosis should be encouraged to do more rather than less. This requires professionals to adopt a positive and encouraging approach, focusing on ‘how to’ messages rather than ‘don’t do’.

Physical activity and exercise have an important role in the management of osteoporosis, promoting bone strength, reducing falls risk, and the management of vertebral fracture symptoms. They should form part of a broad approach that includes other positive lifestyle changes, combined with pharmacological treatment where appropriate. The evidence indicates that physical activity and exercise is not associated with significant harm, including vertebral fracture; in general, the benefits of physical activity and exercise outweigh the potential risks.

Immobility has been established as a major risk factor for fracture; bone is strengthened when muscles and impact forces create a ‘load’ on the bone that causes adaptations inside. Without the pull of gravity, bone density is reduced. Even with short periods of bed rest for example, bone density and strength are lost rapidly, although this is reversible to some extent with remobilisation. Bone is constantly repairing and regenerating, so it can adapt and respond to the regular pulling, twisting and bending that muscles exert on it. This adaptive response is greater the higher the intensity and frequency of force, and in response to force that is ‘variable and dynamic’.

Overall, there is little evidence of harm, including fractures, occurring whilst exercising. Bone strengthening exercises are therefore unlikely to cause a fracture and there was no evidence of symptomatic vertebral fracture in association with impact exercise or moderate to high intensity muscle strengthening exercise. There were, however, modest improvements in quality of life, balance, pain and fear of falling.

Antifragile In Mind And Body

We have yet to see what happens when generation of sedentary children become adults; we can guess that the healthcare system is going to be overloaded with an increasingly older population who will be suffering hip fractures earlier in life due to not laying down bone density when they were young.

As I mentioned in a previous blog post:

• Falls are the second-leading cause of accidental death worldwide

• Approximately 10-20% of falls result in fractures

• 1 in 3 adults aged 50 and over dies within 12 months of suffering a hip fracture

• Fatal falls are rising sharply for those aged between 45 and 64, jumping by 44% between 1999 and 2007

Fragility fractures already cost the NHS an estimated £4.4 billion per year, and falls in the 40-plus age group have increased 20% from the previous generation, so it seems likely this figure will only increase for the coming generation who’ve spent the majority of their childhood sedentary and with low bone density.

As long as public policy is focused on solutions instead of causes, there will be uncomfortable realities which will need to be faced such as where will the extra tax money come from to fund people afflicted with chronic lifestyle diseases? Not to mention, what will it be like to live in a society in which so many people (old and young) are suffering from chronic health conditions throughout their life?

In his book, Antifragile, Taleb introduces the concept of an antifragile mindset which goes far beyond being adaptive; you use the experience to improve and become stronger in the face of stressors. This isn’t the same as just being resilient in the face of bad things happening: it’s about becoming stronger because of them. Plan, but be adaptable, and design your lifestyle so that you’ll benefit from chaos and uncertainty instead of spending your life strategically avoiding difficulties.

“Some things benefit from shocks; they thrive and grow when exposed to volatility, randomness, disorder, and stressors and love adventure, risk, and uncertainty. Yet, in spite of the ubiquity of the phenomenon, there is no word for the exact opposite of fragile.
Let us call it antifragile. Antifragility is beyond resilience or robustness. The resilient resists shocks and stays the same; the antifragile gets better.”

- Antifragile by Nassim Nicolas Taleb

Doctors and the medical industry have so many medicines to treat people and methods of diagnosing disease, yet there are scant answers explaining why these diseases are increasing year-on-year, nor any reasons explaining the root cause or the prevention of them. It is up to us to take our health into our own hands irrespective of current government policies or initiatives. Lucky for us, here in the UK our ever-paternalistic government is currently promoting the idea that prevention is better than cure, as can be seen in this 2018 policy paper:

Prevention Is Better Than Cure
Our Vision To Help You Live Well For Longer

‘We have made great progress in improving the health of the nation - helping people to live longer lives. However, people are spending too many years in poor health, with these gains in health not felt equally across society. But this is not inevitable; much of ill-health could be prevented. Prevention is crucial to improving the health of the whole population, and helping secure the health and social care services we all value and rely on. It will also boost the health of our economy.

I am delighted that with the long-term funding settlement for the NHS, there will be an extra £20.5 billion a year by the end of the next five years. This is the single largest cash injection for the NHS ever, giving us a unique opportunity to radically change the focus of health and social care onto prevention.

We cannot continue to invest in the same service models of the past. We will not meet our mission with 'business as usual'. This vision sets out that greater focus, and spending, is needed on prevention, not just cure. With an ageing society and people living with multiple complex conditions it is imperative that this rebalancing happens - to keeping people well, living in the community, and out of hospital for longer. This means services which target the root causes of poor health and promote the health of the whole individual, not just treating single acute illnesses. In practice this requires greater funding for pre-primary, primary and community care - and support for the staff who work in these services.

Prevention cannot be solved purely by the health and social care system alone. Everyone has a part to play, and we must work together across society. This includes recognising the responsibilities of individuals and families in reducing the chances of becoming unwell in the first place, but also how the wider environment we live in determines our health.’

REFERENCES

Varma VR, Dey D, Leroux A, Di J, Urbanek J, Xiao L, Zipunnikov V. Re-evaluating the effect of age on physical activity over the lifespan. Prev Med. 2017 Aug;101:102-108. doi: 10.1016/j.ypmed.2017.05.030. Epub 2017 Jun 1. PMID: 28579498; PMCID: PMC5541765.

Strong, Steady and Straight: An Expert Consensus Statement on Physical Activity and Exercise for Osteoporosis

Strong, Steady and Straight: Physical Activity and Exercise for Osteoporosis Quick guide: summary

Children who spend too much time on their phone are at serious risk of hip fractures in 40s as sedentary lives cause weakened bones, study says

Chastin SF, Mandrichenko O, Helbostadt JL, Skelton DA. Associations between objectively-measured sedentary behaviour and physical activity with bone mineral density in adults and older adults, the NHANES study. Bone. 2014 Jul;64:254-62. doi: 10.1016/j.bone.2014.04.009. Epub 2014 Apr 13. PMID: 24735973.

Rodríguez-Gómez I, Mañas A, Losa-Reyna J, Rodríguez-Mañas L, Chastin SFM, Alegre LM, García-García FJ, Ara I. Compositional Influence of Movement Behaviors on Bone Health during Aging. Med Sci Sports Exerc. 2019 Aug;51(8):1736-1744. doi: 10.1249/MSS.0000000000001972. PMID: 30829961.

McMichan L, Dick M, Skelton DA, Chastin SFM, Owen N, Dunstan DW, Fraser WD, Tang JCY, Greig CA, Agyapong-Badu S, Mavroeidi A. Sedentary behaviour and bone health in older adults: a systematic review. Osteoporos Int. 2021 Mar 25. doi: 10.1007/s00198-021-05918-2. Epub ahead of print. PMID: 33768342.

Policy paper: Prevention is better than cure: our vision to help you live well for longer | This document sets out the government's vision for putting prevention at the heart of the nation's health.

ideas have Real World consequences

With the steady decline in organised religion among the British, other beliefs have stepped in to fill the vacuum, guiding us and providing a framework with which to live our lives. The decline of organised religion hasn’t ushered in a world that is rational, logical and rooted in empirical scepticism; our modern materialistic secular world is full of new superstitions, rituals and faith. One of the most visible of these new doctrines, after gaining traction for many decades, blossomed in 2020 - that of safetyism.

Carl Jung, one of the most famous psychotherapists of all-time, wrote about how modern mass society has ‘produced an individual who was unstable, insecure and suggestible’ and claimed that a third of his patients were suffering from ‘no clinically definable neurosis, but from the senselessness and emptiness of their lives. This can be defined as the general neurosis of our times.’

Psychiatrist Theodore Dalrympe writes how ‘determinism (whether it be of the economic or genetic variety) has led to fatalism…. relativism has led to a willful abstention from judging any action or individual as bad or as comparatively better or worse than anything else.’ We sit in relative safely in our human zoo, protected from many challenges we used to face. But the bars of the cage remind us of our limitations as domesticated creatures and we comfort ourselves with material possessions perhaps as a way to forget how the lack of adversity has also stripped our lives of meaning and purpose.

Victims Of Comfort in The Nanny State

The phrase ‘nanny state’ conveys a view that a government or its policies are overprotective, regulate matters considered to be private or personal and undue governmental interference undermines peoples’ autonomy. Paternalism, the context of government, is when restrictions are imposed on our freedom in order to protect us - they bypass our free choice in order to serve our best interests. Many paternalistic interventions are so embedded that we forget they exist such as seatbelt and helmet laws. Interventions that are considered paternalistic are often cited as evidence of the nanny state because they limit people’s freedom and are done for their own (supposed) good. Health & Safety is an area where we can see this clearly happening; whilst reforms were clearly needed in the past, it has outgrown its original remit and continues to invade our lives through its unswerving desire for life to become safer and safer.

The Nanny State Index is a league table of the worst places in the European Union to eat, drink, smoke and vape and shows us that countries which regulate tobacco more heavily do not have lower rates of smoking nor do those which regulate alcohol more heavily have lower rates of drinking. There is no correlation between scoring highly on the Nanny State Index and a country having a longer life expectancy.

One would hope that if there would be some positive trade-offs for allowing the State such access into our personal lives to tell how what we can eat, drink and smoke. It is natural to assume that the more a government introduces nanny state policies, the better our health outcomes, the problem is this isn’t the case and, instead, we have a set of paternalistic policies that restrict freedom and make us poorer while failing to achieve their stated objective.

Despite these policies always claiming to be in our best interests, they inevitably create a number of problems such as:

• raising prices via taxation or monopoly

• restricting choice

• restricting trading hours

• raising the cost of living

• black markets when prices rise

• restricting competition and innovation

• draining police resources and creates excessive bureaucracy and paperwork

Our view on government restrictions is shaped by how we, as individuals, weigh up the relative importance of two competing arguments which occupy opposite ends of the moral and, sometimes, legal spectrum.

The case in favour of increased state control appeals to the importance of harm prevention and paternalism and the case against appeals to the value of individual autonomy.

Rarely do we hear the moral argument presented in the mainstream press, yet it is the crux on which everything else rests; why do we never talk about the level of control granted to the government to make choices on our behalf?

What kind of world do we want to live in when government after government has a say in every aspect of our existence, governing more and more of our decisions?

Indeed, are the people in government the most virtuous, moral, ethical people to be allowed free rein with such a power to restrict our behaviour and levy punishments for not complying with their rules?

Safety First!

In 1903 the Motor Car Act was introduced, requiring mandatory vehicle registration and for drivers to obtain a licence which made it much easier to track owners of vehicles and enforce rules more rigidly. However, it wasn’t until 13 years late, in 1916, that the London ‘Safety First’ council was established as a response to the ‘alarming increase in road accidents’ during blackouts as The Great War was waged. In 1917, accident data was collated and the end of the war didn’t mark the end of the Safety First Council; an organisation was created with the noble intention of reducing traffic accidents grew into a moral crusade that, to this day, uses fear and virtue to push its agenda.

After World War Two, Labour won a landslide election and introduced sweeping reforms to Britain that were rooted in collectivism that included the nationalisation of industries, state direction of the economy and security ‘from cradle to grave’. These radical changes would change the character of Britain, creating more dependency on the state and discouraging individual responsibility; it was now the Government’s job to keep us safe by reminding us what we could and couldn’t do.

Huge changes took place in the aftermath of the war including:

• The 1944 Butler Act which reformed schooling, the commitment to full employment in the same year.

• The 1945 Family Allowance Act.

• The 1946 National Insurance Act.

• The 1946 was the year it became apparent that there was a baby boom at the same time there was a housing shortage.

• The 1947 Town and Country Planning Act, which laid the foundation of modern town and country planning.

• In 1948 the NHS was created.

Many cities had been reduced to rubble due to wartime bombing and town planners were eager to combat housing shortages in new ways; huge swathes of the country were levelled and rebuilt with the car placed front and centre in their designs. In fact the war came to be seen as a blessing in disguise, allowing the country to be reshaped and reconfigured in a more rational way through central planning. Architects and town-planners rubbed their hands in glee and put their stamp on the country with brutalist style council estates, tower blocks and new towns such as Stevenage and Milton Keynes. By 1975 a total of 440,000 tower block flats had been built with the help of a government subsidy that increased with every extra storey.

Stevenage was designated as the first ‘new town’ in August 1946, during the aftermath of World War Two

Housing at Fullers Slade, Milton Keynes

University of East Anglia, Norwich

Town Centre, Peterlee

New Town of Harlow, Essex

Thamesmead, London

Park Hill, Sheffield

Stevenage

New Town Housing, Fullers Slade, Milton Keynes

Moss Heights, Glasgow

Public policy encouraged driving in the post-war period and car ownership more than doubled in the 1950’s. By 1955 there were over three million cars on Britain’s roads, the number of licensed vehicles in Great Britain has increased from about 4 million in 1950 to over 34 million in 2010.

In 1952, less than 30% of distance travelled in Britain was by car, van or taxi, 42% was by bus or coach, and 17% by train. The proportion reached 85% in the late 1980s and has stayed roughly constant since then - as has the total distance driven each year. Travel by bus and coach has been in long-term decline, accounting for just 4% of total distance travelled in 2016, a tenth of the figure of the early 1950s.

This was a huge shift from pre-war Britain and created a completely new way of life, with people commuting to work, fracturing communities and making the streets a less social space to spend time, hugely impacting children. Despite the radical modernism of the buildings, the planners and architects had failed to build with people in mind and close-knit traditional communities were never recreated as the architects appeared to have forgotten the principles of human-centered design. The new estates and tower blocks suffered from many social issues and crime and came to symbolise the decline of Britain, especially as it coincided with high unemployment and deindustrialisation as the 1970s wore on.

The street was our playground

Traditionally, neighbours and extended family kept an eye on children playing in the street, but slum clearance and housing ‘improvement’ schemes broke up these bonds and destroyed the informal monitoring of children’s play. An assumption grew that streets are for car drivers and, as car ownership boomed, this created a huge increase in traffic accidents involving children, forcing them off the streets and into their houses at the same time that TV ownership increased from 350,000 people in 1950 to nearly 10 million by the end of the 1950s. Since 1946, every generation has been heavier than the previous one – and it is the most overweight people who are becoming even heavier, with 1 in 10 children born in 1946 becoming overweight or obese by age 11, compared to roughly 1 in 4 today.

Many point out that the amount of child road deaths has fallen substantially between 1970 and 1990, claiming that all the endless safety measures of signs, speed limits and speed bumps has been the reason for this change. Perhaps that is true, but it could also be because most children stopped playing outside and were driven to school instead of walking or cycling. Researchers, Hillman, Adams and Whitelegg, concluded: ‘Road accidents involving children have declined not because the roads are safer but because children can no longer be exposed to the dangers they pose.’

Until very recently, children played outside on the streets with other children. This happens rarely nowadays and many children grow up indoors.

In 1971, 80% of children aged seven and eight were allowed to go to school on their own and by 1990, the figure had fallen to 9%. This downward trend wasn’t inevitable and plenty of other developed nations designed their roads and infrastructure in ways that enabled and encouraged children to continue being independent:

In Odense, Denmark, at city of around 200,000 people, 4 out of 5 children bike, walk, or skateboard to school. As many schools have a cycle network that is safe enough for children to ride on their own on the way to school, it’s not uncommon for 6 year olds to cycle to school without their parents.

In the Netherlands, 26% of primary school children still travel independently to school and the average age for them to go without their parents is aged 8.6.

In Japan some schools mandate that children travel to school alone and it’s expected that children aged 6 are supposed to be independent by the time they start school and it’s not unusual for children to commute for up to an hour using the train service which is famous for being safe, clean and reliable.

‘Japanese kids learn early on that, ideally, any member of the community can be called on to serve or help others. Taking responsibility for shared spaces means that children have pride of ownership and understand in a concrete way the consequences of making a mess, since they’ll have to clean it up themselves. This ethic extends to public space more broadly (one reason Japanese streets are generally so clean). A child out in public knows he can rely on the group to help in an emergency.’

The 1970s marked the beginning of newspapers increasing their readership through ‘clickbait’ sensational articles about stranger danger and hidden dangers of playgrounds. This led to the risk-averse designs we now see today - impact absorbent rubber surfaces, safety-certified fibreglass boulders and, by the 1980s, many new laws were passed which required playgrounds to adhere to strict criteria. A new market was created, and companies advertised their services as prioritising safety - which came at a higher cost to build, install and maintain these new sterile playgrounds. David Yearley, head of play safety for the Royal Society for the Prevention of Accidents, argues that “as a society, it’s difficult to say, ‘we need to accept a 1 in 60 million chance of death.”

In America, the situation was even more dire as the healthcare system is structured in such a way that there needs to be blame in order for insurers to cover the increasing costs of medical care. This meant that personal responsibility was shelved in favour of finding fault and a culture of suing meant fewer companies were willing to open themselves up to lawsuits by installing ‘risky’ play equipment.

Playgrounds used to encourage challenge and risk and look incredibly dangerous to our modern eyes.

Tim Gill, author of No Fear: Growing Up in a Risk Averse Society, notes that there is an ‘inappropriate transfer to playgrounds of principles from workplace health and safety…in most workplaces the presence of physical risks – vertical drops, wobbly bridges or narrow balance beams – is a problem to be solved, whereas in a playground it is often an asset.’

In the book The Coddling of the American Mind, authors Haidt and Lukianoff discuss the unintended consequences of safetyism - the idea that people are weak and should be protected, rather than exposed, to challenges. What began as a focus on physical safety – removing sharp objects and choke hazards, requiring child seats, and not letting children walk home alone has morphed into protection from all kinds of harm, including emotional safety which doesn’t tolerate ideas that could trigger psychological distress. A well-intentioned safety culture has led to ‘paranoid parenting,’ unstructured play time has been replaced by screen time, in a never-ending cycle of fragility as the focus on physical and mental safety - ironically - makes children weaker.

Fragility is a self-fulfilling prophecy, distorting our perception of risk because when children are protected they cannot develop appropriate resilience or coping skills to handle obstacles nor can they develop healthy self-esteem. Just as our bones strengthen through stress (in what’s known as Wolff’s Law), the same is true for our mental health; resilience is created from facing many different situations.

Stresses are necessary to learn, adapt and grow and, without varied life experiences, our minds do not know how to cope with day-to-day stressors. Over-protection can lead to learned helplessness, when people feel they have no control over a situation and the belief that our own behavior has no influence on consequent events. This leads to a vicious cycle whereby whenever someone is faced with a negative situation they don’t have the tools necessary to change their circumstances, reinforcing their feeling of powerlessness which, in turn, can lead to depression and anxiety.

The design of post-war housing, transport and infrastructure have deprived children of their ability to play outside and, although Britain has seen a huge increase in prosperity since the war, there are huge consequences for cossetting and over-protecting children that will be felt for generations to come. Slowly, there is a shift happening and people are beginning to see the benefits of risk, so perhaps this is the last gasp of the decades-long drift toward overprotecting children.

the growing death taboo

Despite incredibly material advances and technological progress this past century has brought us, many studies continue to show that we are depressed, unhealthy and unhappy. According to recent reports, our society’s ability to meet our psychological and psychosocial needs ‘appears to have declined’ and we are miserable, angry and fearful. Given the rise in anxiety disorders, just as we have enjoyed ever greater prosperity and security, it’s painfully clear we’re failing at personal risk management.

Could much of our modern woes be connected to death becoming more and more taboo?

Up until very recently, if someone was ill, the burden of care was assumed by family, friends and neighbours. This has now passed onto medical caretakers who are strangers and in unfamiliar, purpose-built facilities. In the same way that giving birth is medicalised, death is now facilitated by experts. The unpleasantness of the dying process, which was once witnessed and understood, became hidden and many of us have never experienced death at all, except perhaps a beloved pet.

A death-denying culture may not be one that is happy, fulfilled or content. Ray Kurzweil stated that ‘death gives meaning to our lives. It gives importance and value to time. Time would become meaningless if there were too much of it.’ With so much perceived time ahead of us and never witnessing death firsthand, we are able to push much of our lives, dreams and aspirations into the eternal future which is when we believe much of our happiness will be realised.

The medicalisation and invisibility of the process of dying leads to a distortion of reality; when we acknowledge death, we become more self-aware about our habits, lifestyle and decisions. Death forces us to become more alive and to understand the temporary nature of our time here. For some, it is also the ultimate existential crisis (as seen in many a mid-life crisis), because it can only be faced when we ourselves are authentic, truthful and honest.

‘One of the greatest lessons I’ve learned is to avoid excessive comfort…Craving perpetual relaxation, security, stability, a sense of safety that clings to us like a plastic wrapper, a warm embrace to eliminate all obstacles and suffocate all daring. We’ve got painkillers for the pain, sleeping pills for insomnia, medication for anxiety, Netflix to kill the time (thus killing the only thing we cannot have more of), Spotify to strangle and choke silence, alcohol for illusory courage, Tinder to suppress loneliness, and social media to construct a false bubble of perfection and bliss. We hunger to create these bubbles where, like in Huxley’s Brave New World, we sacrifice at the altar of perpetual comfort our ability to cope and learn from discomfort…To benefit from the comfortable, we must also be intimately familiar with the uncomfortable. This means sometimes accepting boredom, hunger, pain, loneliness, silence, imperfection, and sadness as a way for us to re-enter the space we seem to have lost along the way - the space where all the chatter fades away and we’re left alone with our thoughts.’

- Marin Mikulic

Perhaps it’s true that ‘real life’ will rear its head, hit us in the face and we’ll be too feeble to survive because we’ve spent our entire lives coddled and protected. Could the increasingly division we see throughout our society be in part one in which some of us accept death and embrace risk and some of us fear death to such an extent we spend most of our lives avoiding it?

The Toxic Cult of Sentimentality

In 1762 Jean-Jacques Rousseau wrote ‘The Social Contract’ in which he argued that the State will promise to protect its citizens if they relinquish their right to self-defence. He lived in France during a turbulent period known as The Age Of Enlightenment which laid the intellectual foundations for the French Revolution in 1789 and resulted in the creation of the French Republic. This period of time was marked by the development of the scientific method, which led to questioning about tradition, the status quo and placed supreme faith on the power of reason and knowledge as the basis for the creation of better society. Rousseau’s work remains influential to this day, although we have seen the dark side of relinquishing our right to defend ourselves against the State as the 20th Century’s sobering figures of democide show.
Curiously, at the around the same time Rousseau was writing in France, Scottish historian Alexander Tytler put forth a theory that described a repeating cycle in history, claiming that societies and civilisations went through this 200 year cycle over and over again:

‘A democracy is always temporary; it simply cannot exist as a permanent form of government. A democracy will continue to exist until the time voters discover they can vote for generous gifts from the public treasury. From that point, the majority always votes for the candidates who promises the most benefits from the public treasury. The result is that every democracy finally collapses due to loose fiscal policy, which is always followed by a dictatorship.’

Perhaps the two superficially opposing ideas are interwined on a deeper level; as people trade their personal power for the protections of the State this leads to an increasing outsourcing of personal decision making and accountability for our actions, with a by-product of becoming infantilised in our emotions, unable to move past superficiality and sentimentality.

What are the dangers of abandoning logic in favour of sentimentality? Feelings aren’t effective substitutes for critical thinking or empirical observation and making decisions based primarily on feelings leads to conflict with others because, as Theodore Dalyrymple ‘sentimentality toward some is often accompanied by brutal and unfeeling rage toward others.’

A sentimentalist is simply one who desires to have the luxury of an emotion without paying for it..We think we can have our emotions for nothing. We cannot. Even the finest and the most self-sacrificing emotions have to be paid for. Strangely enough, that is what makes them fine. The intellectual and emotional life of ordinary people is a very contemptible affair..they always try to get their emotions on credit, or refuse to pay the bill when it comes in..Remember that the sentimentalist is always a cynic at heart. Indeed sentimentality is merely the bank holiday of cynicism.

- Oscar Wilde

Just Culture: Balancing Safety and Accountability

The bureaucracy of Health & Safety seems less about managing the safety of the workers companies are responsible for, and more about managing company or personal liability. How often in your own life have you witnessed the ineffectiveness of bureaucratic ‘solutions’? Rarely do they seem to dig down into the root causes of issues and instead just create another layer of red tape and paperwork.

Safety culture has a habit of ignoring the plethora of data which shows how none of the recognised twelve psychological factors are consistently and reliably linked to actual safety incident rates. Organisations need to stop obsessively focusing on psychological factors when assessing safety culture and concentrate their improvement efforts on tangible situational and behavioural factors which are clearly linked to actual safety performance.

Dr Lucian Leape said that ‘the single greatest impediment to error prevention is that we punish people for making mistakes’ and Don Norman notes that ‘people make errors, which lead to accidents, accidents lead to deaths and the standard solution is to blame the people involved. If we find out who made the errors and punish them, we solve the problem, right? Wrong. The problem is seldom the fault of an individual; it is the fault of the system. Change the people without changing the system and the problems will continue.’

Blame is about finding fault and it isn’t about holding someone responsible for something. It is inherently judgemental and it doesn’t focus on changing, improving or fixing anything - unlike responsibility which is focused on accountability, a far more noble aim. Failure is a common companion of blame, so we avoid it at all costs; indeed many of us never get started with anything because we fear the shame of failure so much. Until we are able to individually and collectively reframe failure as an essential ingredient of success, some of us will spend our entire lives avoiding it.

A culture - whether it is a family, an organisation or a nation contains within itself the seeds of its own destruction if it is based on blame. Derek Sivers noted that it’s easy to not understand what is around you, because it’s all you know and culture is invisible, we’re surrounded by it but it’s only possible to understand it once you leave and go somewhere else with different values. We mistake what is normal and familiar to us as the true way of doing things - some people might experience this when they change jobs and note how the management culture creates the whole culture of an organisation (for better or worse). Derek coined the phrase ‘fish don’t know they’re in water’ to express this concept, emphasising that it is not until you take a fish out of water that the fish can compare an experience to something else. In English we use the inverse idiom of being ‘a fish out of water’ to describe someone who is uncomfortable in an unfamiliar situation and - fun fact - we’ve been using this phrase since at least 1483 when Geoffrey Chaucer wrote it in The Canterbury Tales. I have one more aquatic analogy that ties into culture, one that - again - the crabs in a barrel mentality. Lanre Dahunsi explained how this ‘mentality is a metaphor derived from a pattern of behavior noted in crabs when they are trapped in a bucket. While any single crab could easily escape, its efforts will be undermined by others, ensuring the group’s collective demise. The moment you try to leave the stereotype or comfort zone, the crabs in the barrel are always there to bring you down to their level and this can be observed everywhere, such as the workplace, families, friends, and places of worship.’

Blame culture has very different norms than a just culture; culture affects our perception, perceptions drive behavior and the culture we belong to has a direct impact on our behavior. The concept of a just culture has arisen out of systems thinking which is a way of exploring and developing effective action by looking at connected wholes rather than separate parts. Instead of blaming someone when things go wrong, it seeks to consider wider systemic issues to understand actions in context and focuses on developing a mindset of openness, trust and fairness instead of fear of punishment.

Conclusion

On the surface, safety appears benign and comforting; dig a little deeper and it becomes clear that personal freedom must be sacrificed in order to accommodate its increasing grip; the new laws or safety rules put in place eventually become constricting. Once safety culture is in place, it becomes entrenched as institutions grow around it and looks for more ways to justify its existence; after all who’s going to dismantle the safety-industrial complex and lose jobs and lucrative contracts?

All photos copyright Eric Pickersgill

Our culture, absorbed in a spiral of become ever more safe and tolerating less and less future risk, heralds the decline of the West. It is a stark reminder of our growing ageing population, whose presence will impact and shape the culture and attitude of the country. In 2001, for the first time, there were more people aged 65 and older than people under age 16 living in the UK. When the share of people aged 65 and over is projected to rise to 29% of the population by 2070, the landscape of our society will reshape to reflect back the values and beliefs of these people. If 2020 has taught us anything, it is that an ageing population will be more vulnerable - and less anti-fragile - to disease and less able or willing to change and adapt. They may be obsessed with avoiding death, and our culture will become more and more risk averse to appease this sector of society, yet this avoidance risks curtailing everything that makes life worth living.

Safetyism is founded on someone else knowing what’s best for you; you are freed from having to determine your own choices, freed from weighing up logic and proportion before you take action; you just need to follow rules set out in front of you. This freedom from responsibility also has a price; soon we will lose any sense of proportion because when safety is placed above all else, a risk-averse culture follows, one that infantilises us and strips us of important skills. After all, nothing’s our fault anymore as we’re being looked after. Only in the human zoo could this state of affairs exist.

We all pay the price of inaction, of not doing things, and children bear the brunt of this joyless, unlived, unexperienced life bordered on all sides by the diktats of others telling them what’s safe and what isn’t. In the real world, life is filled with risk - physical, emotional, financial, social - and reasonable risks are essential for healthy development. For 95% of human history we lived as hunter-gatherers, risking our lives to survive and, thanks to our courageous ancestors, we are here today. In a society where there aren’t enough challenges in life, we create our own after all, they do say that never are we more alive than when we’re close to death. Not only is it inappropriate to assume that life is essentially safe, it’s a false premise to build a life on top of; we can pretend there is zero risk but on a long enough timeline the survival rate for everyone drops to zero.

What if we shifted the conversation from the risk of doing things, to asking what the risk is of not doing things?

Can there be rewards if there are no risks?

What would our culture look like if we consigned the safety-first mentality to the dustbin of history and all of its constraints, blame and barriers?

We must begin to paint a picture of the world we want to live in; here’s an idea of mine for what it’s worth - we learn to judge risks through failure (which isn’t seen as a negative experience, just a process of learning and iterating). We live our lives with a curiosity-first mentality, rooted in a wider just culture and find other ways to motivate each other that aren’t based on shame and punishment.

Nanny-state measures chip away at the divide between the personal and the political—and they are bipartisan. Since 2010, Conservative-led governments have not shown much resistance to paternalistic interventions that one would regard as the natural preserve of the Left. Nor have they shown much appetite to stand up to trigger-happy bureaucrats. If the Right, while in power, makes no principled objections to bans on food and drink, why should conservatives or pro-market liberals expect the Left to show restraint when it gets its turn? If advertisers are not permitted to deviate from a centrally determined set of values, why not prohibit dissenting voices altogether?

Nanny-statism also swells the ranks of bureaucrats whose instincts, almost by definition, are unlikely to be laissez-faire. Manning the desks of quangos—quasi-autonomous nongovernment organizations—are meddlers who, if left unsupervised, will only expand state intrusions into daily life. They are also given pulpits, and the credibility of an important-sounding job title, from which to criticize the government for not doing enough. The result is a trend of ever-diminishing freedom.

- Oliver Wiseman

Safetyism is rooted in a totalitarian mindset and is a form of virtue signalling; a sentimental claim for emotional and personal safety which is merely cover for a power grab. Fragility, adherence to safetyism, and an emotional desire to be protected leads to the suppression of free speech and to the growth in authoritarianism, as C.S. Lewis explains:

‘Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. It would be better to live under robber barons than under omnipotent moral busybodies. The robber baron’s cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience.’

Feelings are always valid but they’re not always a helpful reflection of reality and we have now reached a point where many of us prefer comforting lies to hard truths. There is nothing wrong with educating ourselves and our children on certain dangers they will face, learning to cross the road is a proportionately sensible action, as is wearing a seatbelt or helmet when you judge the risks but we need to pay attention to when these things are mandated into law, because it’s at this point that a paternalistic government has crossed an unseen but nonetheless psychologically ‘real’ border, which marks a change in the relationship between a sovereign individual and the State.

Lockdowns are the result of a process long in the making, of nearly a century of sub-contracting out of personal choice and responsibility to the State. I’m dismayed by the number of my people who think safety-culture is right and proper. Ultimately they’re the real enemies, the people who will gladly surrender not only their own freedom, but also yours, mine and unborn generations, for the sake of their own ‘safety’ and ‘protection’.

REFERENCES

David Cameron targets health and safety rules

Evidence from safety culture that risk perception is culturally determined

Children’s Risky Play From an Evolutionary Perspective: The Anti-Phobic Effects of Thrilling Experiences.

Health and Safety in Contemporary Britain: Society, Legitimacy, and Change Since 1960

Governing risks in modern Britain: danger, safety and accidents, c. 1800–2000

The Safety Culture Construct: Theory and Practice

The Overprotected Kid

Childhoods in Place and Placeless Childhoods: An Historical Geography of Young People In Yorkville and East Harlem 1940-2000

No Fear: Growing Up in a Risk Averse Society

New Playgrounds Are Safe—and That's Why Nobody Uses Them

Children's Experience of Place

The Nanny State Index (NSI)

One False Move: A Study of Children's Independent Mobility

The Battle of the Consumer in Postwar Britain

Transport Statistics Great Britain: 2011

New, B. (1999). Paternalism and Public Policy. Economics and Philosophy, 15(1), 63-83. doi:10.1017/S026626710000359X

Key Facts: Poverty and Poor Health

Just Culture: The Key to Quality and Safety

Creating a Just Culture – Rethinking Patient Safety

The Safety Anarchist: Relying on human expertise and innovation, reducing bureaucracy and compliance

Sentimentality as an aesthetic flaw

Cruel When Not Kind : On sentimentality and brutality, two sides of a coin

Whatever will the health and safety brigade have to say about that? Traditional park wants to recreate its 1920s' playground - when rides were rides and harnesses were unheard of

Post-war town planning: How to kill a city

Stamatakis E, Primatesta P, Chinn S, et al, Overweight and obesity trends from 1974 to 2003 in English children: what is the role of socioeconomic factors? Archives of Disease in Childhood 2005;90:999-1004.

The rise of the obesity epidemic

In Japan, first graders travel solo to school on the train

Why Are Little Kids in Japan So Independent?

Japanese Six-Year-Olds Can Ride Trains Alone Thanks to the Country's Amazing Infrastructure

How many Dutch children still go to school by bike ? The rise of driving.

In This Danish City, 5-Year-Olds Bike To School On Their Own

27 SURPRISING Finnish Education System Facts and Statistics.

Five Things Norwegian Schools Do Differently

The Comfort Crisis - Embrace Discomfort To Reclaim Your Wild, Happy, Healthy Self By Michael Easter

'I've done away with railings as they are very expensive': 90-year-old book shows how inventor of children's playground had complete disdain for health and safety 

The reason you should never go down a slide with your child

Malo periculosam libertatem quam quietam servitutem - I prefer dangerous freedom over peaceful slavery

Nannied from Dawn to Dusk

Study Shows Kids Persist Less When Parents Step In to Help

The Crab in the Barrel Mentality

This is Water by David Foster Wallace

Fish don’t know they’re in water

Why is Culture Important and How Does it Influence People?

Oxfordshire to become first ‘smoke-free’ county in England as health chiefs ban smoking outdoors as lockdown ends - in bid to stamp out the habit by 2025

Systems Thinking for Safety: Ten Principles A White Paper

Systems Thinking for Safety/Principle 3. Just Culture

The effect of admitting fault versus shifting blame on expectations for others to do the same , Lozano EB, Laurent SM (2019) The effect of admitting fault versus shifting blame on expectations for others to do the same. PLOS ONE 14(3): e0213276. https://doi.org/10.1371/journal.pone.0213276

Stop Bloody Bossing Me About: How We Need To Stop Being Told What To Do

Five councils to BAN smoking outside bars and restaurants - with two more authorities to follow under plan make UK smoke free by 2030

I wrote this post after finding photos of porters in 1920s London carrying baskets on their head as they worked in Covent Garden market, a tradition that lasted from the 1650s until 1974, when the market relocated to the outskirts of the city. Delving a bit deeper, it appears that head-carrying is a universal feature of all cultures, including the West until relatively recently. Despite moving into a more natural movement based lifestyle - as much as is possible in human zoo that makes up the majority of the world - head-carrying seemed barbaric, a sign of oppression and something we were glad to do away with, burdened as it by the connotations of poverty and misery. Yet I wondered if there could be a place for it in modern life and whether it could even be useful as a way to counteract our modern postures, which are shockingly different from those who live in other cultures and our ancestors (see my gallery of images below).

Researchers have found that people can carry loads up to 20% of their own bodyweight, African women carry head-supported loads of up to 60% of their bodyweight far more economically than army recruits carrying equivalent loads in backpacks and Nepalese porters routinely carry loads equally to 200% of their body weight for many days up and down steep mountain footpaths at high altitudes.

Numerous studies show that tumplines, a sling for carrying a load on the back, with a strap that passes round the forehead. and other head-carry techniques are more metabolically efficient than carrying a rucksack because, when used correctly, weight is evenly distributed down the spinal column. Lung capacity isn’t restricted as it can be when using sternum straps, which is important at high altitudes where people are at risk of hypoxia.

‘My back got progressively worse until an expedition to Nepal in 1978. There I noticed how the local people all had huge fillets of muscle running down both sides of their spinal columns. They spend their lives carrying awkward loads in excess of 45kgs over high passes. And they were doing all that carrying with just a crude, plaited bamboo tumpline. I immediately saw the solution to my problem. As long as I had to carry a pack I might as well be exercising my back at the same time! Besides, I’ve never been able to fully utilize modern packs. Hip suspension packs work only on the flats for me. Whenever I try to go even slightly uphill, my hips feel like they are going out of joint. Carrying heavy loads with just shoulder straps leaves me with sore shoulders and back pain at the end of the day. And I can’t breathe with sternum straps.’

- Yvon Chouinard founder of the company Patagonia

Notice which postures are used in fashion shoots and advertising campaigns.

In the days before perfectly flat roads and their wheeled counterparts, head-loading was an efficient way to carry awkward shapes such as firewood bundles and buckets of water over rough terrain. Perhaps this connection of the dirt tracks, farm labour and the bad old days has meant we have negative associations to the practice. This is contrasted against the upper classes frequently training their women to be ladylike by walking with books on their heads. The books acted as instant feedback for posture, as slouching would cause the book to fall. The practice was thought to originate in Royal Courts, which valued women’s ability to glide across the room and was a sign that they knew how to behave and would make a respectable wife.

The Baby Boomer generation that came of age in the 1960’s was characterised by a desire for radical change and an intolerance of traditional values. They rejected ‘old-fashioned’ manners, etiquette and common courtesy preferring a more laid-back, familiar approach to life and the gap between the public and private self narrowed. Life became much more casual in attitude, appearance and actions so rigid, aligned postures correlated to a rigid, conformist attitude.

The spine acts like a jack

Whenever we are reminded of our bad posture, we stick out shoulders back and presume we’re in alignment. It is much harder to move the head into alignment with the spine when it juts out in front of us as our brain has acclimatised itself to its position and, when conscious intention slips, so too does our posture. The complex movement pattern of being in alignment requires the use of many muscles that may have atrophied in modern bodies, such as the deep stabilising muscles of our neck and down our spinal column. What I find interesting about head-loading is that many different things are happening at the same time, things that would be difficult to consciously do. Weight on the head triggers an automatic response from the body to create a stable axis to most efficiently distribute the weight and alignment is the natural outcome of this. If there is postural dysfunctional through leaning too far back, forward or out to the side, then the body will seek to reduce the centre of mass; the ideal would be as if we were standing in a cylinder.

Roger Perrin was a French physiotherapist who studied head-loading on the mechanics of the body and concluded that the spine acts like a jack. It reacts with a vertical, upwards movement as the head pushes up to counteract the forces of weight. He suggested that as well as the accepted spinal movements (anterior, posterior and lateral flexions, rotation and gliding), another potential movement of the vertebrae should be recognised which he called vertebral erection, the spine lengthens and reduces its curvature.

Joel Carbonnel summarises some key points from Roger Perrin’s research:

• Hand-carrying a 15kg weight (for example a suitcase) differs greatly from carrying the same weight on the top of the head. To carry a suitcase by hand requires more effort than to support it on the head. The latter method brings two mechanical advantages: a single axis corresponding to the gravity line of the body, and a small displacement (0.6 to 0.8% of the person’s height).

• On average, when someone has to support 15kg on the head, it takes one second for the spine to react in a jack-like manner, and the gain in length is in the order of 12mm. Although this gain is relatively small, the postural and morphological changes are impressive. The average lengthening is 12mm, however there may be greater gain in height for a very slouched individual.

• When someone has a load on the top of the head, there is a release of the front muscles and the superficial ones of the back.

• Walking with head-supported loads significantly decreases the oscillatory movements of the spine in the three planes – the spine tends to move in a more parallel plane, relative to its long axis (from back to front), while preserving its vertical lengthening response to the load.

Esther Gokhale notes that: ‘I suspect our long anthropological history of head-loading, together with the adaptive value of musculature protection against the compressive force of gravity on our spines, may explain our responsiveness to a load on the head.’

Healthy posture contributes to being able to live pain-free

Our posture has a huge impact on our health and having a forward head posture can negatively affect many bodily functions including blood pressure, gastrointestinal problems, hormone production and can diminish lung capacity by as much as 30%. Over time poor posture results in pain, muscle aches, tension and headache and can lead to long-term complications such as osteoarthritis and degenerative joint disease through the accelerated ageing of intervertebral joints. Ideal posture is the position from which the musculoskeletal system functions most efficiently and there is a direct relationship between chronic poor posture and chronic pain conditions, partly because of how an unnatutural forward head posture pulls the spine out of alignment and increases strain on the muscles, ligaments, fascia and bones of the spinal column.

1925: Market trader Alfred Bailey practising with 15 baskets at Covent Garden, London, for the basket-carrying championships.

The familiar modern, sedentary posture results in our head being held in a forward position which stresses the lower cervical vertebrae and one study notes that ‘for every inch (2.5cm) of Forward Head Posture, it can increase the weight of the head on the spine by an additional 10 pounds (13kg)’.

Dr. Roger Sperry, a neuropsychologist, neurobiologist and Nobel laureate, stated that “better than 90% of the energy output of the brain is used in relating the physical body in its gravitational field. The more mechanically distorted a person is, the less energy available for thinking, metabolism and healing.”

Head-loading is impossible to perform correctly without achieving an ideal head and neck alignment. Alongside the development of the relevant stabilising muscles that develop, so too does a particular gait pattern which is a third more efficient than our normal walking gait.

Carrying a load on the head seems to trigger an energy-saving mechanism in the gait. Research carried out by Giovanni Cavagna measured the forces exerted through the feet of women walking normally and head-loading. Despite there being no visible change in the way the women walked, the moment when our leg is lifted before being placed on the ground, shortened substantially. This efficiency of movement enables them to convert more of their potential energy into forward motion rather than muscle heat.

Studies haven’t agreed upon the ideal weight and frequency of head-loading; too much and there is likely to be damage to the cervical spine and too little and we may end up with forward head postures that also damage our cervical spine. Somewhere lies the sweet spot; the same goes for the balance between the dangerous repetitive loading of the ‘developing’ world and the dangerous sedentary behaviour of the ‘developed’ world.

How to head-load

With the incredible array of workouts and methods on the market today, very few - if any - include any form of weighted head-loading. It’s even gone under the radar of the functional fitness crowd, who love their core and stabilising routines. 2021 shall be the year this universal skill is re-discovered for its therapeutics and aesthetic value (and no doubt someone will monetise it).

Here at Movementum we prefer to focus on whole-body movements that our ancestors used in their daily life instead of creating endless exercise routines targeted on fixing a particular issue. Exercise itself is a symptom of domestication, so we are excited to add this new movement into our life and our aim is to be able to carry our weekly shopping home using this method. However, we are starting slowly because we don’t want to damage our cervical spine by over-loading and over-training, so we’ll start light in order to strengthen the right muscles and build up spinal bone density. I’ve read some blogs which have stated rather bluntly that head-loading only works well if you’ve been practicing it for many years; this is true, but can be applied to all skills in life - we generally get better the more we do something.

Research has shown that people can carry loads of up to 20% of their own body weight without expending any extra energy beyond what they’d use by walking; any increase in the load does indicate that metabolic costs seem to increase proportionally with load weight. Initially, head-carrying will require more energy than using a rucksack.

To begin with place a bag of rice in a tea towel (you can start at 500g or 1kg depending on your fitness and injury history) and knot it closed. Place on your head and walk around. You can sit at your desk, watch TV or put a timer on and wander around your house for ten minutes. Build up weight and time progressively.

Give it a go and let me know your experience in the comments below.

REFERENCES

Lloyd, Ray & Parr, B & Davies, Simeon & Cooke, Carlton. (2009). Subjective perceptions of load carriage on the head and back in Xhosa women. Applied ergonomics. 41. 522-9. 10.1016/j.apergo.2009.11.001

The mechanics of head-supported load carriage by Nepalese porters, G. J. Bastien, P. A. Willems, B. Schepens, N. C. Heglund, Journal of Experimental Biology 2016 219: 3626-3634; doi: 10.1242/jeb.143875

Liu, Wentai & Chae, Moo Sung & Yang, Zhi & Kim, Hyunchul. (2009). Design of Advanced Neuroscience Platform. Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference. 2009. 5535-8. 10.1109/IEMBS.2009.5333190.

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Yvon Chouinard: Ode to Tumplines

The Science of Carrying Things on Your Head

Why It’s Better to Carry Weight on Your Head

Dead Weight

Reviving Head Carrying

The Basket Men of Covent Garden

Energetics of Load Carrying in Nepalese Porters, Guillaume J. Bastien, Bénédicte Schepens, Patrick A. Willems, Norman C. Heglund, Science 17 Jun 2005 : 1755

Perrin Roger. Rééducation vertébrale, Principes Techniques. Librairie Le François. Paris. 1979.

Can One Carry Heavy Things on Their Head Pain-Free? A Review of Geere 2010

Teaching My 95-Year-Old Lithuanian Mom the Gokhale Method

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On Walking, Carrying Loads, and Efficiency

Dave BR, Krishnan A, Rai RR, Degulmadi D, Mayi S. The Effect of Head Loading on Cervical Spine in Manual Laborers. Asian Spine J. 2021 Feb;15(1):17-22. doi: 10.31616/asj.2019.0221. Epub 2020 Mar 30. PMID: 32213796; PMCID: PMC7904483.

I was reading a friend’s blog post recently where he recounted a passage from a book which really stuck with me.
I think it’s a great way to visualise our life and to contextualise how health isn’t another thing we need to deal with, but something foundational on which the rest of life is built:

Think as your health as the number one and is followed by a zero for each of the things you are grateful for; a wonderful family, close friends, delicious food, a satisfying job or financial security. With good health your life might be valued in the thousands, millions or even billions, but without health all you are left with is a bunch of zeros.

The report also told financial companies there was a ‘sizeable opportunity’ for them to profit from health and wellness initiatives, especially if they presented these as ‘enablers of social good’. The powerful incentive for proving you lead a virtuous, healthy, non-sedentary lifestyle will lead to reduced premiums and other perks. As Vitality put it: ‘The healthier you get, the more we’re able to offer you. It’s a virtuous circle that’s good for you, good for us, and good for society.’

Some new research from Coventry Building Society has shown that nearly 90% of those who exercise more regularly, at least once a week or more, are more likely to put some money away each month. However, of those who don’t exercise, fewer than three in every four (74.2%) have a regular savings habit. Irrespective of the ridiculous simplification of extracting meaning from this, expect more tenuous links between health and finances to be made as justification for these wearables. Remember, correlation doesn’t equal causation - for instance, someone on a higher income is more likely to exercise and save money than someone on minimum wage. Income is one main connections to health and is seldom mentioned in the corporate media and rarely is factored into any of these schemes.

Such simplistic rhetoric taps right into the heart of our desire to contribute to society, to do the right thing for the greater good. There’s little conversation about who decides what constitutes health, what that entails and whether anyone will stand to profit from defining those terms. Will you be punished for ignoring the highly questionable food pyramid and opting to intermittently fast or live on a carnivore diet?

If you’re not paying for the product, you are the product

In America, data brokers aggregate and sell an average of 3,000 pieces of data per person; information gleaned from retailers, social networks and financial firms that, collectively, paint an incredibly detailed picture of people’s lives. Detailed and highly lucrative; the more information there is about you, the more money there is to be made.

When it comes to matters of health, insurance providers get very interested - and many see fitness trackers as a way to sell more premiums. A recent survey revealed that 63% of insurance executives seeing wearables having a ‘significant impact’ on the industry, and that their use in premiums would be ‘wide-spread’ in just two years. Heath insurers have started subsidising Apple watches and users can then bring down how much they pay back each month by completing activity goals set by the insurance company - monitored and verified by Apple.

Over the past few years, mobile devices and wearables have been passively or actively tracking a huge amount of personal data about us. Equipped with sensors from heart-rate tracking to GPS, they routinely capture all kinds of metrics and store them whether we like it or not. Companies can take advantage of this by including health monitoring within a finance app - which allows them to access information about our spending habits, too. Data like this helps banks understand our saving habits and gives them valuable insights into which people are likely to be the best customers. The Holy Grail is glucose monitoring because of the insights that could give into what someone has eaten which is a crucial data point for insurers, since diet has a far greater impact on health than activity.

Data is the new oil

To benefit from wellness banking you must share more personal data with your bank than ever before and allow it to track your movement, exercise routine and diet; the more you’re willing to share, the more rewards you’ll receive.

The rise of ‘open banking’ is the system of allowing access and control of consumer banking and financial accounts through third-party applications. Open banking allows customers to give permission for the bank to share data with other banks or organisations - just as you can access your data across a range of places, so can your bank.

It’s becoming increasingly easy for banks to profile our spending habits now we pay for so much by card or smartphone. Some banks are connected to loyalty cards which increase the amount of data available about you, on top of the data about your shopping habits, purchases and normal card spending. Accurate profiles can be built up about us and our habits and this data can be sold or shared with our companies such as advertisers. Banks claim to only use this information to spot fraud and flag up an account if a card is being spent somewhere out of the ordinary. Whilst this may be true, such information can also be used for profiling customers and, in an world where companies stand to profit, convenience will always be presented to us as worth the cost of giving away our privacy. After all, we may even be rewarded for it, though the rewards are likely to be worth significantly less than these companies stand to make with all of our the data.

Hot on the heels of data-gathering comes AI (Artificial Intelligence), a huge subject that warrants further discussion in the future. It is hard to over-emphasise how much of a paradigm shift this will soon create; already companies are discussing things such as personalised pricing of insurance (sometimes referred to as behavioral premium pricing or dynamic pricing solutions) which uses machine learning to find data patterns. These patterns are created through analysis using a variety of sources, such as your loyalty cards, in order to predict future behaviour.

Confidential data such as diagnosis, medical reports and images are already being used by AI to educate itself and, over time, this machine learning will diagnose the onset of illnesses and warn people to take precautions and necessary steps to mitigate the consequences. There’s not much discussion about what the consequences may be financially, economically or socially if we choose to ignore the AI’s advice.

AI is sufficiently sophisticated to be able to analyse large amounts of medical data about someone, accumulate it in a single place and use the data to analyse and predict previous and present health problems. A study published in February 2020 took data from routine CMR scans, compared them with the patient’s outcomes and the results showed how the AI was better than human doctors at predicting a patients’ chance of death, heart attack, heart failure and stroke.

Ethical Concerns

It is hopelessly naive to assume all these companies have our best interests at heart just because they say they do in their advertising. Their primary objective is to make a profit and there is a lot of profit to be made in data. They may claim that the data is being collected for a single purpose - optimising your health - but it could easily be used for something else such as targeted advertising. Vikram Renjen, the Senior Vice President of Insurance for Sutherland notes: ‘With supplemental GPS data, wearables could monitor and report on compliance to the rehabilitation protocol of a disability claimant. Improved compliance would shorten the time until return to work.’

What happens if your bank or insurance company gets hacked and mountains of your data is leaked?

If the aim of an insurance company is to cut healthcare costs in exchange for financial rewards then does the end justifies the means? In other words, will these companies be setting you inappropriate goals just to get you to hit your target figures? How will they tailor workouts to your personal situation and will they punish you for not complying with theirs? What if you are injured due to over-training from the goals set by the company?

Perhaps all your data makes you undesirable to be insured. What then? Will you have to change your entire life to fit what these companies deem healthy?

There are more questions that answers in this ever-evolving technological world we’re living in. Do we want to live in a world where we are bribed like children to do things like taking care of ourselves? Isn’t that what we should be doing already?

All my questions point at a deeper problem in our society where we increasingly come to expect others - often the ‘benevolent’ Government or for-profit companies - to take care of us and act with our best interests at heart. Such an infantilised view of the world will only make us vulnerable to exploitation. Instead, it would be wiser to look towards voluntary solutions to tackle societal issues rather than coercive ones.

REFERENCES

Banking on healthcare: The new health and wellness frontier

Brits who get in shape are more likely to have their savings in shape too

Kelly MP, Barker M. Why is changing health-related behaviour so difficult? Public Health. 2016 Jul;136:109-16. doi: 10.1016/j.puhe.2016.03.030. Epub 2016 May 13. PMID: 27184821; PMCID: PMC4931896.

Global Wellness Trends Report: The Future of Wellness 2021

All online junk food ads to be banned in tough anti-obesity proposal

Wearable Tech Is Plugging Into Health Insurance

Smartwatches and health insurance: Good or bad?

Physical activity tracking in private insurance

Step and save: The truth about wearables and health insurance

63% of insurers believe wearables will transform industry – here’s how

The worrying potential of wearable data

FTC Data Broker Report

Vlaev, I., King, D., Darzi, A. et al. Changing health behaviors using financial incentives: a review from behavioral economics. BMC Public Health 19, 1059 (2019). https://doi.org/10.1186/s12889-019-7407-8

From Credit Scores to “Behavioral Scores”: What Numbers Say About You

AI measures blood flow to predict death, heart attack—and is more accurate than humans

The Prognostic Significance of Quantitative Myocardial Perfusion, An Artificial Intelligence–Based Approach Using Perfusion Mapping, Kristopher D. Knot, Andreas Seraphim, Joao B. Augusto, Hui Xue, Liza Chacko, Nay Aung, Steffen E. PetersenJackie A. Cooper, Charlotte Manisty, Anish N. Bhuva, Tushar Kotecha, Christos V. Bourantas, Rhodri H. Davies, Louise A.E. Brown, Sven Plein, Marianna Fontana, Peter Kellman, James C. Moon, Originally published 14 Feb 2020 https://doi.org/10.1161/CIRCULATIONAHA.119.044666 Circulation. 2020;141:1282–1291

Bank refuses to release mortgage for woman deemed at higher Covid risk

Everyone wants to tend their inner fire these days and, if you’re no exception, then join Billy at this free online summit in March.

Who wouldn’t want to embody their natural masculine and create deeper connections with themselves and their loved ones.

I cannot guarantee you will leave the summit a better person, but you might.

I could spend another paragraph seducing you with Instagram-caption promises of how you - yes, you! - can tap into the deepest regions of your soul, uncover limits and open the way to pure, unadulterated endless bliss.

Except this is 2021 and we’ve all been burned by internet promises and hype, so instead I shall convey my talk in a gif to you:

- Billy

A sea squirt may look like a swaying tube, but looks can be deceiving; it is one of the most highly evolved marine invertebrates. They are members of the phylum chordata, which includes animals with spinal cords like fish, birds, reptiles, and humans, and their deceptively simply tubular adult body houses systems for digestion, reproduction, and circulation as well as a nervous system.

There are more than 3,000 known Sea Squirt species which can can survive up to 30 years in the wild and they are hermaphrodites - with both male and female reproductive organs. Sea squirt undergoes retrogressive metamorphosis, which means that very complex anatomy of larva transforms into very simple anatomy of adult animal. They spawn by releasing eggs and sperm into the water at the same time. After about three days, eggs develop into tadpole-like larvae, and they spread into the ocean by wiggling and twitching. The larvae uses a spinal cord connected to a simple eye and tail for swimming and a primitive brain helps it locomote through the water - but this doesn’t last long. Because the larvae aren’t capable of feeding, this free-swimming stage lasts only a short amount of time and, once it finds a suitable place to attach itself, a rock, substrate or some other solid object such as the hull of a boat, it never moves again.

Now it’s settled, the sea squirt starts the digestion of its own body and begins to absorb all the tadpole parts of itself - the tail, primitive eye, cerebral ganglion (brain-like organ) and notochord (spine-like structure). This process usually lasts 36 hours and leads to creation of sac-like creature equipped with two siphons and circulatory, digestive, and reproductive systems. Unlike other members of the chordate family which keep their spinal cords and brains for the rest of their lives, the neurons that control locomotion will never be needed anymore so it literally eats its own brain.

Embodied Cognition

For many centuries we have operated from the theory that our consciousness resides in the brain, snugly encased in our skull, separate and disembodied from the body it controls. The brain as control centre, shapes raw sensory data into an approximation of external reality and is summed up by Descartes famous phrase, ‘I think, therefore I am’. Could it be that our cognition is a product of how our we’ve evolved with our environment? Embodied cognition is challenging this long-held idea and posits that the mind is not only connected to the body but that the body influences the mind and may also be shaped by the world around us, ‘I am, therefore I think’.

Embodied cognition is the claim that the brain, while important, is not the only resource we have available to us to generate behaviour. Instead, the form of our behaviour emerges from the real-time interaction between a nervous system in a body with particular capabilities and an environment that offers opportunities for behaviour and information about those opportunities. The reason this is quite a radical claim is that it changes the job description for the brain; instead of having to represent knowledge about the world and using that knowledge to simply output commands, the brain is now a part of a broader system that critically involves perception and action as well.

Jeff Thompson, Ph.D

More research is needed into these claims but, if the body, brain, and environment interact through perception and action to give rise to intelligent behaviour, it would change the landscape of healthcare interventions and treatments. Perhaps the idea that the brain, body and the world are separate will be seen as archaic, replaced by a more holistic view of cognition and intelligence taking place simultaneously in the brain, the body and the environment around us.

Our bodies are an important part of the learning process

As humans, we directly interact with physical stimuli through our five senses - touch, taste, hearing, smell and sight - to understand and navigate the world; we are all, literally, born to move. Movement stimulates the growth of new neurons and synaptic connections and increases the levels of endorphins, dopamine, norepinephrine and serotonin, all of which play a role in how we deal with stress, our willpower and motivation, as well as regulating our emotional state.

Many studies have suggested that the parts of the brain that control thinking and memory are larger in volume in people who exercise than in people who don’t. Tests have shown that with mild exertion people perform better on tests of attention and memory and walking regularly increases the increases the volume of the hippocampus (a brain region crucial for memory) and elevates levels of molecules that both stimulate the growth of new neurons and transmit messages between them. even the abundance, survival, and overall health of new brain cells.

Exercise improves our thinking skills and memory through stimulating physiological changes such as reducing insulin resistance and inflammation, along with encouraging the production of chemicals that affect the growth of new blood vessels in the brain (known as growth factors), and myokines, which act as natural antidepressants.

Movement has a protective effect on our brain, which makes it less susceptible to cognitive decline and neurodegenerative disease.

Watching TV Is A High-Risk Activity

Much as people would love to believe there’s nothing they can do to change their fate; study after study shows clearly the connection between genetic and epigentic changes related to cognitive decline is dependent upon lifestyle factors, many of which we have an ability to change. These are known as modifiable risk factors, aspects of your life where you can take measures to change, including diet, exercise, social interaction, how much time you spend in your comfort zone repeating the same things over and over or if you step outside of it to challenge yourself - physically or mentally.

If regular brain exercise improves cognitive function, then it stands to reason that the opposite is also true - if you don’t use your brain then you lose cognitive function.

A 25 year study conducted by the U.S. National Cancer Institute at the National Institutes of Health, looked at whether there were any long-term effects of watching TV. The researchers followed 165,087 adults between 50 and 71 years old, beginning in 1994 and ending in 2011. The researchers found those who watched more than five hours of TV per day had a 28% greater incidence of death during the period compared to those who watched less than 3 hours per day.

Another study, published in 2002, claimed that 68% of American high school students don’t participate in daily physical education. Unlike the generation who are middle-aged and older, these children are growing up sedentary from birth, so it’s likely that the damaging effects of being sedentary will be even more noticeable, from an earlier age than the current elderly population. Movement and exercise are known to increase the baseline of new neuron growth - we grow more brain cells when we move than when we don’t and this leads to better memory, increased cognition and reduces the chances of depression.

Society is fixated on the physical body and whether it is ‘in shape’, but nary a peep is heard about the condition of our brain. Movement acts on the body through affecting (amongst other things) our bones, muscles, and cardiovascular system and acts on our brain by strengthening areas like the corpus callosum, basal ganglia and cerebellum and strenuous physical exercise stimulates the growth of new neurons in the hippocampus, the part of the brain that is critical for memory.

Without stimulation or novelty, cognitive function declines and people who participate regularly and actively in lifelong activities (be they intellectual, social or cultural) experience fewer cognitive complaints, perform better on formal cognitive tests and are less likely to develop neurodegenerative disorders.

The risk of cognitive decline cannot be laid squarely at the door of our inherited genetics; study after study shows how important modifiable risks factors are as well. These are lifestyle factors that can be controlled to a certain extent in order to avoid dying from a lifestyle or degenerative disease when you age. High blood pressure, raised cholesterol, diabetes, smoking, drinking alcohol, physical inactivity, obesity, unhealthy eating, social deprivation are all modifiable depending on our lifestyle and all play a part in shaping our risk profile.

Inactivity Leads to chronic health issues

Research published in 2019 estimated that direct healthcare costs incurred as a result of prolonged sedentary behaviour causes a considerable burden to the NHS. They claim that 69,276 UK deaths might have been avoided in 2016 and calculate that, for 2016-2017, the total NHS costs attributable to prolonged sedentary behaviour were £700 million. This was divided up into costs for cardiovascular disease (£424 million), type-2 diabetes (£281 million), colon cancer (£30 million), lung cancer (£19 million) and endometrial cancer (£7 million).

Study author, Dr Mussap said: “Uninterrupted sitting constitutes a substantial risk to physical and mental health.  There are known associations with poor musculoskeletal health, a range of cardiovascular diseases and even cancer. There is a common yet incorrect belief that prolonged workplace sitting is not problematic if a person is physically active during their recreational time”.

The effects caused by prolonged sitting cannot be undone by being active for a short amount of time a day, yet for many they assume that they can offset the costs of being sedentary by a small burst of high-impact cardio. These people have been termed ‘active couch potatoes’ because they meet the demand for physical activity but still sits down for long periods of the day. The workplace has, until recently, not been part of the discussion when it comes to maintaining health and moving throughout the day; yet, depending on the culture of your workplace, it may not be socially acceptable to move much. The culture of workplaces will need to be addressed in order for meaningful change to happen and an acknowledgement that all forms of sedentary behaviour form a chronic health risk.

Conclusion

Modern life has become structured in a way that makes it very easy to avoid movement; we sit in cars to travel, sit at our desks for work and come home to sit in front of the TV to ‘relax’. The downgrading of real-world experiences in favour of virtual ones has been accelerated due to Government Covid-19 restrictions and it’s difficult to see how we’ll reverse that trend as virtual reality is on the horizon and shopping in the high street is an unpredictable and unpleasant experience (thanks to parking fees, clone towns with the same shops and inconvenient opening times).

Our mind may have adapted to this de-physicalised world but our bodies are still physiologically hunter-gatherers; how this tension will resolve itself is yet to be known. An optimal human life is one where we are active throughout all of our life, from birth to death, and our increasingly sedentary lifestyles will correspond to chronic health problems earlier in life than we have seen with the current eldery population, who enjoyed very physically active childhoods. If people do start getting chronically ill younger in life then this will cause a huge burden on the healthcare system and, in turn, the taxpayer will be required to pay higher taxes to pay for treatments and interventions.

Plenty of evidence shows how movement increases the number of brain cells and imaging sources, anatomical studies, and clinical data shows that moderate exercise enhances cognitive processing. This may also work in reverse; if we pursue physical inactivity then we lose a lot of the potential cognition and brain power gained through movement. The problem is that we’re not sea squirts and some form of movement is a non-negotiable if we want to maintain any kind of quality of life - in one study it found that a lack of exercise together with increased television watching doubles your risk of cognitive impairment later on:

“High television viewing and low physical activity in early adulthood were associated with worse midlife executive function and processing speed. This is one of the first studies to demonstrate that these risk behaviors may be critical targets for prevention of cognitive ageing even before middle age.”

The sea squirt analogy is more symbolic than literal; nevertheless the sea squirt consumes its brain because it has no more need to move.We must change our perception of risk from snowboarders tearing down mountains, to people sitting on the sofa staring at a screen for hours on end. Thomas Sowell wrote ‘the great escape of our times is escape from personal responsibility for the consequences of one’s own behaviour.’ When it comes to health this is true for a certain amount of time, but we only kick the can down the road; eventually the problem we’ve given to our future self becomes our present self.

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UK adults spend 12 hours a week watching on-demand TV but only 90 minutes exercising

How Much Time Do People Spend on Social Media?

UK Time Spent with Media 2019

Mobile Internet Statistics

Embodiment and grounding in cognitive neuroscience

Where Do Thoughts Occur?

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