The NHS spends £10 billion a year tackling diabetes and its consequences, but this could be reduced if people rode bikes or walked to work, MPs said yesterday.
A group of MPS from all parties met for a debate on cycle safety in the House of Lords after the annual parliamentary bike ride from Kensington to Westminster, reports Kaya Burgess in The Times.
“At a time when we have millions of pre-diabetic adults, if cycling was a pill, every GP across the country would be prescribing it,” said Mary Creagh, the shadow transport secretary.
“In terms of added value, in terms of concentration for kids in lessons, in terms of massive health benefits - get more people walking and cycling and we’ll have gone some way to reducing that £10 billion a year burden on the NHS from diabetes.”
Dame Sally Davies, the government’s chief medical officer, said last year: “Cycling for all or part of your 150 minutes of physical activity each week can help to prevent or manage over 20 long-term conditions, including heart disease, stroke, type 2 diabetes, some cancers and mental health problems.”
According to Ms Creagh, Labour’s policy review is examining ways to encourage more people to ride. However, Liberal Democrat MP and chair of the All-Party Commons Cycling Group, Julian Huppert said: “One thing I didn’t hear [from Ms Creagh] was a commitment to actually spend any money.”
Research published last August indicated that cycling, walking and even using public transport were associated with lower risk of being overweight and therefore reduced chance of developing type II diabetes.
Cyclists were around half as likely to have diabetes as drivers.
According to Diabetes UK, around three million people in the UK have diabetes - about one in 20. Type 2, or later onset diabetes is connected with obesity and inactivity - and rates have soared over the last 10 years.
Improved public health is often cited as one of the best reasons for making cycling a more attractive way to travel. British Cycling in February claimed that if 10 per cent of trips were made by bike – well below the levels seen in countries like the Netherlands and Denmark, but a fivefold increase on the current situation here – the NHS in England and Wales could save £250 million a year.
Add new comment
29 comments
The other issue with counting calories is that calorie contents of different foods are more or less guesswork because they are estimated from a few measured items, and the measurements (traditionally by burning in a bomb calorimeter) don't necessarily reflect what nutrition/energy you would extract if you consumed the item which depends not only on the biochemistry but also how well the item is cooked, whether it is diced or pureed etc. So 100 calories of protein and of carbs do not provide the same energy to the body, and '100calories' of well cooked minced steak are different to 100 calories of rare steak.
Exercise and a balanced diet will work for everybody. Calorie counting and fad diets in the absence of exercise will have mixed results for all sorts of reasons, but I suspect most people who don't lose weight on restricted calorie diets aren't 'cheating', they are just screwing up their metabolisms; thermodynamic laws don't apply.
Riding a bike will benefit beyond the notional calories consumed by the exercise
I'm sure the physiology is more complicated than some make out (we aren't simple furnaces) but the real complications are sociological rather than physiological. The way that obesity is not randomly distributed across demographic groups, nations, or eras, surely demonstrates that?
Agree with oozaveared that there's a big pyschological/emotional aspect to it. The fattest people I've known were all struggling with personal problems and tragedies that would have had me reaching for something a lot stronger than a burger.
I'm not fat - I'm Phat, and what's wrong with that?
ooh heck.
I just checked in and I seem to have created a debate.
Yes of course we can get as complicated as we like about nutrition and it can be complicated.
I was talking about weight loss though. Now the trouble with getting very detailed and complex about this is that it doesn't help people lose weight. Complexity encourages them to prevaricate and frankly to think it's too complex.
If fat people ate a bit less and did a bit more exercise then they would lose weight. The best way to monitor this is simple calorie counting.
The reason for that is that it not only keeps tabs on the numbers in a way that people can readily understand. (what hgets monitored get done). It also helps people to be honest with themselves. But most importantly in the process of calorie counting people learn where the hidden calories are. They start looking at the nutritional info on packets or looking up what the data is on other foods. ie its educational.
Most calorie counting apps on smart phones also have a calculator for exercise. So you can get a net Kcal count.
For 99.9% of people losing weight counting calories works.
and yes you can make it complicated if you like but then people don't bother. It's not helpful at that basic stage of getting people to stop shoving excess calories in their gobs and do a bit more exercise.
Thasall
Yeah, calorie in, calorie out, is ignoring the second law of thermodynamics. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC506782/
The make up of the food you eat, how it is digested and what processes are needed will make a huge difference. Not to mention, when you eat the food.
My view with carbs is that it has been over-simplified. People assume it means we should avoid all carbs. Fact is, people eat too much carbs. But, our bodies rely on carbs, just not as many as we are all consuming. Christ, I just saw an add for a double layer pizza on the tv. Hidden carbs though probably a worse problem with things like modified starch, added sugar and the like in just about all processed foods.
Some pretty good advice here
http://www.webmd.com/food-recipes/news/20090323/7-rules-for-eating
Re NHS, diabetes and fat people. It's not rocket science or a new discovery. Most people are pretty lazy and eat and drink far too much. All fat people should not be given medical treatment but instead given a bike and a pair of trainers and told to get their big butts moving. If they don't achieve an acceptable weight and standard of health they should be fined. I am sick of looking at fat people when I am out. It is getting as bad as the US. It is shameful. Looking at them as in some places there are so many, makes me feel ill. Something has got to be done. And fat obese kids is child cruelty/neglect by parents.
You seem to be confused.
In another thread you were arguing aganst encouraging more cycling because it would, you alleged, cost the Treasury money.
Errr …….. no numptee. I was stating that Government, NOT ME, does not really want to promote cycling as it would lose a shed load of cash in taxation i.e. it's income would be massively reduced if many gave up their cars and turned to cycling. So because of this cycling infrastructure and facilities are so CRAP in this country. It will ever be thus.
Riding bikes should be taken as seriously as smoking therapy by the NHS and offered to the same level. It's that important.
Yes, cycling may not make you stick thin overnight, but you will lose weight and you will become healthier.
OK, I'll do this in a Jerry Springer voice:
Is it time for the NHS to take a more preventative approach? After all people go to the doctors when it's sometimes already too late, and that's when the treatment is more expensive.
Doctors could prescribe cycling as an option when your weight reaches a certain level.
If you insist to maintain a lifestyle that will likely lead to problems, perhaps you would then have to take out insurance to mitigate the cost later on, which you could receive back if said condition did not materialise.
Or is it that this is simply as Darwin theorised - survival of the fittest...
You decide. Till next time, look after yourself and each other
Darwin's Theory of Evolution - Survival of the fittest was NOTHING to do with FITNESS. It proposes that where factors that affect a species' survival change, those species which adapt best to the change whether it's as a result of restriction of food supply, threat from predators, climate, selection of mates, etc to produce the next generation, WILL survive.
A species could be extremely fit but not survive if it is resistant or unable to change to overcome the condition or change threatening it's existance.
Really??? Who knew?
Next you'll be telling me his theory of reEvolution had nothing to do with bikes. I for one hope you evolve a sense of humour.
I'm not sure how much truth there is in this but I have heard that stress also encourages your body to store fat and burn less calories.
Anyone know if this is the case or if the maths really is as simple as calories in - calories out?
As a type-2 diabetic I am a strong advocate of the financial benefit to society of activities like cycling. My average of 8 hours a week on the bike won't cure my diabetes (it runs through the paternal side of my family) but hopefully my high level of fitness will delay the inevitable heart attack and/or stroke until I am well into my old age (non-productive years). As per the article, the economic benefits of this are significant. Using my father as a case study, I estimated his major stroke cost society $1M over the subsequent 10 years of his life. He was retired so there was no additional loss of economic productivity (e.g. paying taxes) which could easily double the negative impact for a working adult.
I believe there should be some financial incentive to encourage diagnosed and pre-diabetics to exercise on a regular basis. The goal according to my GP is 3-4 hours of exercise a week (exercise being something that elevates your heart rate into the "green" zone). This could tied into an overall health program where you would be able to encourage annual physicals and quarterly A1C testing. The doctor's role would be to verify and sign off on the "payment".
While I could half-jokingly make the business case that society should pay me to ride my bike, a cash payment would leave this wide open to abuse. Maybe something as simple as a sales tax exemption for activity related purchases. Your doctor would effectively "prescribe" issuance of an activity card (annually) that you could present went purchasing specified goods and services. Here in Canada we already have a few mechanisms that could serve as templates: tax exemptions on the purchase of a bike (the first $1K) and native status cards which exempt you from all sales taxes.
"Cyclists were around half as likely to have diabetes as drivers."
Grr. As if cycling and driving are mutually exclusive. I cycle and drive so does that mean I'm half as likely as myself to get diabetes?
I support their aims though. If everyone replaced a few of their car journeys with cycling and changed nothing else, they'd be better off. It would be a lot cheaper than stomach stapling and diabetes treatment as well, even if they gave out free bikes to all.
There's a huge great elephant in this room.
Execise is great, it burns calories and increases levels of fitness. But most health promoters put way too much emphasis on the exercise and not nearly enough on the reduced eating and drinking.
People are massively shocked when they learn how few calories they'll burn for what (to them) may seem like a lot of exercise.
They are also sometimes quite shocked about how many calories they stuff in their gobs.
As an example I cycled in to work this beautiful morning. It's 20 miles each way. At roughly 35Kcals a mile that some US university says is the average Kcal burn for a man of my heights and weight doing moderate cycling, the total for the whole round trip is 1400 Kcal. So I can eat pretty much what I like without being silly. I can even have a few beers tonight and still remain below a 2000 net Kcal intake.
Now getting someone off the sofa and on to a bike 40 miles will seem like a marathon. I've listened at work and heard people getting wowed for 15 mile charity ride. For a lot of people a few miles is a long way. Let's say they do 10. Well that'll knock about 300 - 400 calories off. Maybe even less.
That's fine if you just eat your 2000 calories and burn an extra 400 you'll lose weight. Maybe a pound a week. Just don't eat a donut on the back of it. Cos that's about the same and you are back to square one.
And let's face it you don't become obese just eating 2000 Kcals a day did you. Maybe they eat 3000 in which case they'll just slow down the rate at which they are getting fatter.
So yes exercise is good for you. It can help you lose weight by burning calories but only so long as you know that the exercise burns many fewer than most people think and a lot of foods have way more than you'd expect.
As a old git pessimist I'd say that the sort of people that are obese are also the sort of people that will reward their 10 mile bike ride with a donut or two.
They will be fitter though.
There's another great elephant within your post. The assumption that 'calories' consumed are what makes the difference in weight loss. Not true. It's the consumption of carbohydrates that counts.
I don't know where you got your nutritional information but that really is utter tosh.
Weight loss and weight gain via exercise and diet are simple thermodynamics.
http://en.wikipedia.org/wiki/Laws_of_thermodynamics
Calories in v Calories out. You can cut carbs out altogether but if you eat net 3000 Kcals of protein per day you will gain weight. If you only ate net 1000 Kcals of carbs you'd lose weight.
That's not to say that your body won't react in different ways to an imbalance like that but the fact is that Calories Kcals are a measure of energy. Energy in via fuel, energy out via metabolic function and exercise.
According to the voodoo that some witch doctor has convinced you of, the person living on a bowl of rice and some veggies a day and who's very active is going to get fat. But if you just had 30 portions of eggs and bacon and sat on a sofa you'd be getting thinner. No carbs see?
OK that's a perjorative analogy to make the point, but you know that the analogic example would be false so why do you believe it's true as an essential fact?
One of the main reasons why some people find it hard to lose weight (apart from not wanting to enough) is that all kinds of voodoo about weird metabolisms, heavy bones and special magical types of food lead to odd diets flying around all the time. Nutrition and balance are important ideas but not the main point with weight loss.
All the diets work, if they work at all, on the same basis, net calorie reduction. Eating less fuel in and exercising more energy out That's the case because that's the only thing that can work.
Many diets will offer a significant reduction in carbs. I think that's where you got confused. Yes if you cut carbs from your diet it will be a lot easier to keep the net Kcals down, than if you don't. Hence lots of diets focus on cutting carbs out. But it's not the lack of carbs that is working. It's the reduction in Kcals that cutting out generally calorie richer carbs provide. Cutting carbs is an easy win in the overall goal of cutting Kcals.
Sorry to be a dog in a manger about it but people (not necessarily here) need a clear message. Eat less move more. Not some quackery disseminated to make a quid out of a huge money spinning weight loss industry where a simple clear message will kill the golden goose.
I used to think this way too, but now I've moderated my views. Essentially weight change is more complex than simply eating more/less calories (and carbs have less cals than fats/proteins). As inputs change metabolic rates change; the biochemical pathways that create and store fat respond differently to different food compositions and timings, the ability to recognize satiety is different for different foods and so on. I suspect most sedentary people do eat too much carb because they have been brainwashed to avoid all fat (transfat in biscuits cakes and processed food is bad, but other stuff isn't).
I believe it isn't "eat less and do more exercise" it's "eat a balanced diet and do more exercise". It's also a pretty simple concept that doesn't need a diet book - just lay off the pies, ready meals and takeaways; cycle down to the greengrocer and butcher and cook your own stuff and you'll be fine.
I don't know where you get your nutritional information from either but I can assure you that it is entirely flawed. To suggest that it is "all about the laws of thermodynamics" is actually nonsense. The human body is far more complex than a basic machine.
I would agree with you that a given amount of calories will power a basic machine, like a car for example, for a projected distance at a given speed. However, if you should bruise said car, by banging it against the garage door for example, will it repair itself? Obviously not, because the fuel you put in it does not provide the means to do so. With protein and fats within your diet then your body *can* repair itself.
If you take your car and drive it up and down the motorway at high speed every day .. will it grow a bigger engine? Obviously not, however your body *will* grow a bigger 'engine' with the correct nutrition and exercise. It needs protein, fat and carbohydrate to do so.
Truth is you can consume 3K+++ 'calories' of steak, eggs and cheese everyday, without doing any exercise whatsoever, and you will undoubtedly lose weight. That's not a theory ... it's a fact.
I want to see the state of your bloods at the end of this. And your lower intestine. And a stool sample. Mostly for entertainment value.
You're mixing up weight control, nutritional and exercise needs there. By and large, a calorie is just a calorie, and a net calorie deficit (or excess if bulking) will result in weight loss (or gain). The type, amount and intensity of exercise carried out will result in the different fitness and performance gains the athlete is aiming for, and to some extent, determine the athlete's nutritional needs in terms of macro content of their diet.
The nutrition and training for a GC cyclist would be different for a track cyclist, for example. The former is on a semi permanent cut, and focussed on maintaining health, low BF and sustained cardiovascular output. The latter is more concerned with explosive power output, and their diet would be more based around increasing that and repairing the damage that their training would do.
For the vast majority of us, a balanced, varied diet with somewhere around the right amount and balance of macro and micro-nutrients in combination with a decent amount of physical activity will sustain and improve health and fitness in the long term. There's a reason the vast majority of nutritionists and doctors recommend this rather than Dukan, Atkins, or whatever variant of low carb paleo 5/2 detox diet is in this week. It's real science vs quack science.
I do take the point, but I think the issue is often over-simplified: calories in vs calories burned. And I've sometimes found the opposite of your donut concern can be true.
Namely, if I spend my journey home from work sitting sedentary in a car in a traffic jam, on arriving home I feel sluggish and am more likely to sit on the sofa eating toast. If I cycle briskly, maybe calling in at the pool for an early evening swim, I feel energised and will just crave water to rehydrate.
In this respect I think exercise, as well as being directly beneficial, can encourage a different perception of oneself and encourage a broader lifestyle change. At the very least, any time you spend exercising isn't time spent idly grazing...
Admittedly I don't have any evidence to back this up (and I'm not obese).
That works for me as well. It's endorphins. Exercise increases these hormones associated with the pleasure centres of the brain. It's a mild high and a feeling of well being. And yess that's an appetite suppressant in fitter people. Obese people tend not to have the same reaction to exercise because they don't generally have the ability to exercise long enough to trigger the endorphins. What happens instead is that they get a blood sugar low.
That's broad brush of course. More importantly though, obese people tend to have habits around using food emotionally. So if they feel low they typically feel inclined have a treat to cheer themselves up. If they feel happy about something they may be inclined to celebrate with a foody treat. Essentially obesity is ais an emotional problem linked to food. Much like alcoholism is an emotional problem linked to alcohol etc etc.
It's the emotional bit that needs fixing. Otherwise it's will power. That's harder with food than with booze for example because an alcoholic can develop strategies to avoid booze. There's no sensible way to avoid food.
That's an interesting point. It's not one that I've considered before, but it rings true to my ears... Certainly people's RELATIONSHIP with food is a big factor in what causes people to eat so much, and may override or alter the body's basic mechanisms for saying, 'Stop, you've fulfilled your dietary needs'.
I've think got a reasonably accurate... 'hunger system' for ensuring I eat the sensible stuff in sensible quantities, and it varies depending on how I've been exercising. It's a pretty obvious system to design into a human body, but the fact that human bodies weren't designed to do pretty much no exercise what-so-ever (as is possible to survive doing now), may... screw stuff up a bit.
Anyway, incorporating sensible amounts of exercise into everyday life is a good thing regardless. And it may change one's relationship with food in the process. Although, I that doesn't mean one wont simple have to decide to 'eat less cake' as well.
It's always seemed to me that it's the exact opposite: too much emphasis on dieting, not enough on being active.
This might be because I'm a woman and the messages aimed at me are different.
However I hear colleagues talking more often about their latest diet than their latest exercise regime.
But exercise has benefits beyond just weight loss. If you're obese then losing weight is important for your health and joints and lots of other things. But if you're normal weight or only overweight it's more important to work on metabolic health, not weight. And that means exercise, not eating a salad on the sofa.
Also, they haven't factored in the rise in A&E visits due to new riders adjusting to clipless pedals. Saw a guy on a super six Dura ace kitted super bike perform a perfect sideways extended stationary lean. It must have hurt but he jumped up straight away and sped off, probably crying but the shame was greater.
I bet Shimano are smiling.
I get the point they are making but you may as well say:
-taking the stairs rather than the lift will save £2 billion a year
-Saying no to a big mac will save 10,000 lives a year
-Not drinking coke will free up 1 million hospital bed spaces
-Bocotting Greggs will save 8 million tonnes in excess cotton and other clothing materials
-Fat Parents stop feeding your children shite - Priceless
It would be useful if there was some real data to back up such claims. For example, is there a comparable survey of Danes or the Dutch, which shows a much lower level for such conditions, along with obesity in general?
I don't think they just pluck this stuff out of nowhere, but you make a good point. It would be nice to see the precise chain of reasoning that leads to these claims and see how robust the evidence is (or isn't).
Though a nation-level comparison as you suggest isn't going to cut it, as there are any number of other variables involved. Its not as if the Netherlands and the UK are identical in every respect bar cycling. (The Dutch are apparently the tallest people in the developed world, but I don't think bikes make you tall! Good nutrition probably does that)
Still, one can't help but notice that countries with very low levels of cycling (like the UK and even more so Australia) have very high levels of obesity (still can't get over the fact that Australians are second only to the US in that respect - I always thought the stereotype of them was surfer dudes obsessed with sport!). Even its not likely to be a direct causal thing I bet they are related via a national culture of looking askance at physical exercise.
Edit - oh, and I'm sure I've read somewhere that the two occupational groups with the highest levels of heart disease are lorry drivers and taxi drivers. Though again, that's probably as much or more to do with those groups' traditional eating habits as the enforced sedentary nature of the job.