Exercise in futility

It can be exhausting trying to follow official health advice in this day and age. We are told to reduce fat, sugar and salt in our diet, to stop smoking and cut down on alcohol, and to eat five portions of fresh fruit and vegetables every day, for fear that our expanding girth will result in an ‘obesity timebomb’. The UK’s chief medical officer, Sir Liam Donaldson, recently issued his exhaustive ’10 tips for better health’, covering every aspect of our lives from safe sex to safe driving (1).

As if trying to keep up with all of this wasn’t taxing enough, Donaldson has now issued a report entitled At Least Five a Week: Evidence on the impact of physical activity and its relationship to health, condemning the UK’s ‘couch potato culture’ and telling us to do more physical exercise. Donaldson’s shorthand advice is that we should all exercise for 30 minutes a day, five days a week. But as the ominous ‘at least’ in the report’s title suggests, we are expected to do much more than that.

According to the report: ‘achieving the recommendation of at least 30 minutes of at least moderate-intensity physical activity on five or more days a week (a total of 150 minutes) will represent a significant increase in energy expenditure for most people, and will contribute substantially to their weight management. However, in many people, and in the absence of a reduction in energy intake, 45-60 minutes’ activity each day may be needed in order to prevent the development of obesity. People who have been obese and who have lost weight may need to do 60-90 minutes of activity a day in order to maintain their weight loss.’ (2)

Phew. And not only do you have to fulfil your exercise quota – in true Stalinist fashion, you are obliged to enjoy it as well. According to the report, ‘it is important that activity should provide benefits for the individual in terms of wellbeing – for example, improved mood, a sense of achievement, relaxation, or simply release from daily stress’ (3). But how are you supposed to buy, never mind eat, five portions of fresh fruit and vegetables, and fit in 90 minutes of exercise each working day, without getting stressed, if you can’t even have a few beers and a fag to unwind at the end of it all?

We should question the chief medical officer’s presumption in telling us what we should and shouldn’t do with our free time. In At Least Five a Week, Donaldson notes that ‘current levels of physical activity are a reflection of personal attitudes about time use and of cultural and societal values’, and argues that ‘perceptions…need to be changed – too many people think they are already active enough’ (4). This is less about offering us objective advice about our health, and more about relentless government interference in our lives.

You would think it a mark of civilisation that an increasing number of us in the West are free to choose how much physical exercise we indulge in, rather than being condemned by circumstance to daily drudgery and a hand-to-mouth existence. But it seems that the Department of Health would like us to do away with the benefits of cheap food and automated industry, and revert to a hunter-gatherer existence. Take this passage from the report: ‘It is only recently in human evolution that energy expenditure (primarily searching for sustenance) has not been inextricably linked to energy intake. With the industrial revolution and more recently the emergence of technological advances, a serious mismatch has emerged between food availability and the energy required to access food.’ (5)

One attempt to resolve this ‘mismatch’ is the ‘trim trolley’, a combined shopping trolley and exercise machine recently introduced in Tesco stores (6). But there is something deeply retrograde about the prospect of people shoving weights around supermarkets, in an attempt to expend sufficient energy to entitle them to eat. Is it not the job of our chief medical officer to assist us with the health problems that arise in the civilised society we actually inhabit, rather than reengineering society so that it resembles something less civilised?

Obligatory exercise has its place – specifically in schools, whose students have not yet earned the adult freedom to choose how much exercise they take. It is telling, however, that when children’s sport is discussed in At Least Five a Week, it is in terms of therapeutic benefits, rather than physical health. According to the report, ‘sport and exercise can provide an important arena for youngsters to be successful and this is experienced through positive effects on self-esteem and self-perceptions of competence and body image’. But in truth, it is exactly this touchy-feely emphasis on self-esteem that has seen proper competitive sports all but chased out of UK schools in recent years (7).

At Least Five a Week has to grapple with a curious paradox, which is explored elsewhere on spiked by Jennie Bristow – how is it that ‘a culture obsessed with boosting our self-esteem puts so much time and energy into public information campaigns telling us how thoroughly disgusting we are?’ (see A really bad habit). In order to promote physical exercise, without coming across as being insensitive toward the obese or the otherwise sedentary, a section of the report is devoted to ‘Physical activity, psychological wellbeing and mental illness’. Here we are warned of the dangers of ‘exercise addiction’, which is apparently ‘a consequence of persistent underlying psychological dysfunction, obsessive-compulsive symptomatology, perfectionism, drive for thinness, or extreme body dissatisfaction’ (8).

If there is such a thing as ‘exercise addiction’, then by implication there is such a thing as too much exercise. Not content to patronise sedentary individuals by telling them that they need to do more exercise, At Least Five a Week also patronises the physically active by suggesting – in a section entitled ‘Risks from physical activity’ – that they need to do less exercise. It would appear that meeting officialdom’s detailed requirements for being an appropriately healthy individual is a tricky business, and a full-time occupation – not to mention a completely futile one.

If obese individuals, or anyone else for that matter, would like to reduce their weight – and it should be up to them whether they want to or not – then it is not exactly rocket science that the two principal ways of achieving this are by eating less and by exercising more. Neither the obese, nor the excessively physically active, nor the majority of us who rest somewhere in between, need 120 pages of Department of Health propaganda to figure this out.

(1) See The chief medical officer’s ten tips for better health (.pdf 15.0 KB), Department of Health, Spring 2004

(2) At Least Five a Week: Evidence on the Impact of Physical Activity and its Relationship to Health (.pdf 1.86 MB), a report from the Chief Medical Officer, 29 April 2004, p24

(3) At Least Five a Week: Evidence on the Impact of Physical Activity and its Relationship to Health (.pdf 1.86 MB), a report from the Chief Medical Officer, 29 April 2004, p29

(4) At Least Five a Week: Evidence on the Impact of Physical Activity and its Relationship to Health (.pdf 1.86 MB), a report from the Chief Medical Officer, 29 April 2004, piv

(5) At Least Five a Week: Evidence on the Impact of Physical Activity and its Relationship to Health (.pdf 1.86 MB), a report from the Chief Medical Officer, 29 April 2004, p16

(6) Trolley offers supermarket workout, BBC News, 28 April, 2004

(7) At Least Five a Week: Evidence on the Impact of Physical Activity and its Relationship to Health (.pdf 1.86 MB), a report from the Chief Medical Officer, 29 April 2004, p32. See Every loser wins, by Alex Standish; One-nil to sympathy, by Derek Allen

(8) At Least Five a Week: Evidence on the Impact of Physical Activity and its Relationship to Health (.pdf 1.86 MB), a report from the Chief Medical Officer, 29 April 2004, p77