Diabetes NHS cost £10Billion, why no backing for cycling

[thirdcrank]

On the exercise-at-school point, it seems that a lot of school playing fields are being disposed of for house building. There are also reports of academies being set up in premises built for other purposes and therefore without much in the way of a playground.

[Cugel]

Whilst I can easily understand there could be medical reason behind weight issues but the truth is with this modern age kids are becoming more overweight. Is it really likely that the incident of medical reasons account for this increase? Or is it more likely that those children were overweight through lifestyle choice and indulgence by the parents?

Vorpal - you're criticising me for this opinion fair enough but you've always struck me as evidence based person who often looks up the evidence on a topic before posting. If you did that with childhood obesity and medical reasons what would you find? An increase in medical conditions or a fat greater increase in obesity due to lifestyle reasons?

I don't deny that people are more sedentary, leading to increases in weight. But you don't know anything about the circumstances of the people in question. Are they really likely to have underlying medical issues? No. But you don't know.

It can't be blamed entirely on lifestyle choice and indulgence, either. If learning about exercise and healthy eating is key to preventing childhood obesity, why do children spend their time in school sitting on their backsides? And why, when they go to lunch are they fed starchy slop?

Why don't schools take children to parks, on hikes, or out in their neighborhoods? Why don't they teach kids how to cook healthy meals. Give them time during the school day to be active (other than part of their lunch break)? The school curriculum does not currently allow these things. Kids get some lessons in what foods are healthy and how much exercise they should get, but they don't actually do it. What kind of a message does it send when kids are sat on their backsides all day to be told that they shouldn't sit on their backsides all the time?

Worries about traffic and crime means many (most?) parents keep their children from going out and playing the way previous generations did. Two working parents may mean less time to take children to activities like football or orienteering. You can say that's 'lifestyle choice', but there is constant pressure to prevent physical activity.

As for evidence, if you look at my post on the linked thread, there are a couple of studies linked to that that show 'overweight' people (and in some studies obese people) have similar health outcomes to people who have 'normal' weights.

That post does not include information about children, but outside of looking at whether overweight children become overweight adults (they are 3 times more likely to be obese in adulthood), there is a relative paucity of information. There are some studies about development of children according to weight, that show that overweight children have slightly better cognitive development and obese children have slightly slower physical development, and are more likely to suffer from psycho-social issues. https://www.sciencedirect.com/science/a ... 0615300120

Like with adults, childhood obesity is associated with various medical issues, such as type 2 diabetes, disrupted sleep patterns, poor immune function, impaired mobility, increased blood pressure and hypertension. They are also more likely to suffer from asthma.

I am certainly not suggesting that we should all gain weight, simply that
1) it is a complex issue, and very seldom due solely one thing or another
2) there is plenty of evidence linking overweight and obesity to specific health issues, and very little that it has a big impact on health outcomes
3) when people do seek help from the NHS, the help available is often limited
4) there are many cultural pressures to prevent good lifestyle choices, and few to encourage them

One of the studies discussed in the thread linked above shows that the biggest impacts of healthy habits on longevity are vigourous exercise, and not smoking. Weight maintenance had a much smaller (but not negligible) impact.

There is no disagreement with the notion that those who are overweight or obese are not always so because of lifestyle choices. But there is a lot of evidence that a very significant amount of those who are overweight and obese are so due to lifestyles that are short of physical exercise and good nutrition.

There is no disagreement with the notion that lifestyle causes of being unhealthily overweight and obese are not always a true choice, since the pressure of advertising and other cultural institutions tends to persuade or even force people to partake of lifestyles that cause, amongst other things, unhealthy overweight and obese people.

But there may be disagreement about how many of the obese are unhealthy because of their avoidable obesity. And disagreement about how to deal with this problem as a health problem for the NHS and its taxpayers (not to mention the individuals concerned and their families).

You suggest that since we people-in-the-street don't know the individual causes of obesity or their health outcomes, we should not judge. This sound very liberal but may also be seen as a cop-out. It can be argued that we all have a social responsibility to help those who are unhealthy because obese to find and adopt solutions. Whilst these solutions should generally be positive - provision and encouragement of the means to exercise and eat better; removal of hard-to-resist temptations; medical procedures - there is scope for other mechanisms of encouragement.

One is to deal with fundamental causes, such as the pushing of sugar and other junk foods, which could be reduced, taxed, banned or otherwise made a less likely "lifestyle choice". Another is to make choosing to be unhealthily obese a shameful condition in the eyes of society at large - just as it is shameful to be a drug addict, a degenerate gambler, a wife beater or any of the other highly damaging things which we can and do penalise, look down on and discourage ... and hope to cure because they are choices.

Yes, I know those things are generally regarded as much worse than being unhealthily obese. But its a matter of degree, not a difference in kind, of poor behaviours.

Such shaming should always come with the helping hand for achieving redemption. For every admonition issued to an alcoholic who damages himself, neighbours and the local NHS causality department, there should be an Alcoholics Anonymous and other effective aids to allow the alcoholic to recover. Ditto the unhealthily obese. But like or not, shame is a means to motivate people to change. It just has be the right kind, amount and applied in a context of helping rather than punishing and condemning outright. Mere mockery or sneering, as you have noted, will not work.

Cugel

[Vorpal]

Shaming is absolutely the wrong thing to do. People who are fat-shamed gain weight rather than lose it. It does not motivate anyone.
https://www.telegraph.co.uk/news/2017/0 ... nsylvania/
https://www.healthline.com/nutrition/fa ... ings-worse
https://www.eurekalert.org/pub_releases ... 091014.php

I'm not suggesting the we should do nothing. People in general should be encouraged to get more exercise and eat less sugar, and otherwise engage in healthy habits. PR campaigns to educate people about healthy lifestyles, engaging children in school in exercise and healthy eating; these are good things.

Other things I have suggested above, such as counselling combined with education and coaching. If the government funded things like this, with NHS particpation, it would save money, rather than costing it.

But what a particular person should do? Well, that is between them and their GP or specialist, and it should no more be my business than their alcoholism. Or Diabetes. Or sex life.

If someone asks me for bike training to help get fit, I'm happy to help.

[ianrobo]

agree with all that Vorpal says here but we need incentives as well. So for example if I was an employer I would give extra benefits to those that cycled/walked to work as I think those that do are fitter, more motivated and productive than car drivers.

Secondly do what Nottingham does and tax car places at work because classed as a free gift to workers. So for example cyclists do not get this nor walkers ...

it is about partly persuasion, nudge politics and positive action ...

[Vorpal]

agree with all that Vorpal says here but we need incentives as well. So for example if I was an employer I would give extra benefits to those that cycled/walked to work as I think those that do are fitter, more motivated and productive than car drivers.

Secondly do what Nottingham does and tax car places at work because classed as a free gift to workers. So for example cyclists do not get this nor walkers ...

it is about partly persuasion, nudge politics and positive action ...

Benefits given under such incentive programs should be tax free.

[ianrobo]

agree with all that Vorpal says here but we need incentives as well. So for example if I was an employer I would give extra benefits to those that cycled/walked to work as I think those that do are fitter, more motivated and productive than car drivers.

Secondly do what Nottingham does and tax car places at work because classed as a free gift to workers. So for example cyclists do not get this nor walkers ...

it is about partly persuasion, nudge politics and positive action ...

Benefits given under such incentive programs should be tax free.

of course ... not thinking of more on basic pay of course, that is not fair but extra days holidays for example ?

[Vorpal]

of course ... not thinking of more on basic pay of course, that is not fair but extra days holidays for example ?

The company I work for has a system (run by an independent third party) where people can register exercise, cycling, going to the gym, skiing, etc. Each time I enter something, my entry goes into a draw (active travel to & from work, counts double) for a prize at the end of each month. The prizes are 'active' oriented and could be anything from a water bottle to a couple of sessions with a personal trainer to a trip.

The only time I have ever won the monthly draw, I got a free weekend cycling trip on the company. Two nights in hotels, food & bike hire (If wanted), and train tickets to & from, all paid for. That is tax free in Norway, but not in the UK. The same system is used in the UK offices. I don't know if they have a monthly draw, there.

[ianrobo]

of course ... not thinking of more on basic pay of course, that is not fair but extra days holidays for example ?

The company I work for has a system (run by an independent third party) where people can register exercise, cycling, going to the gym, skiing, etc. Each time I enter something, my entry goes into a draw (active travel to & from work, counts double) for a prize at the end of each month. The prizes are 'active' oriented and could be anything from a water bottle to a couple of sessions with a personal trainer to a trip.

The only time I have ever won the monthly draw, I got a free weekend cycling trip on the company. Two nights in hotels, food & bike hire (If wanted), and train tickets to & from, all paid for. That is tax free in Norway, but not in the UK. The same system is used in the UK offices. I don't know if they have a monthly draw, there.

sounds perfect and for me a company would gain so far more than they use, taxes here would probably classed as a benefit in kind but just have to lobby the govt, not that this one we have would care !

[TrevA]

agree with all that Vorpal says here but we need incentives as well. So for example if I was an employer I would give extra benefits to those that cycled/walked to work as I think those that do are fitter, more motivated and productive than car drivers.

Secondly do what Nottingham does and tax car places at work because classed as a free gift to workers. So for example cyclists do not get this nor walkers ...

it is about partly persuasion, nudge politics and positive action ...

And yet, despite the workplace parking levy and the very expensive tram network that it pays for, Nottingham is still one of the most congested cities. WPL doesn't discourage car use. People will just pay it and carry on driving.

[pete75]

agree with all that Vorpal says here but we need incentives as well. So for example if I was an employer I would give extra benefits to those that cycled/walked to work as I think those that do are fitter, more motivated and productive than car drivers.

In a working career spanning forty years I've never found people's ability to do their job is at all related to how they travel to the workplace.

[Vorpal]

agree with all that Vorpal says here but we need incentives as well. So for example if I was an employer I would give extra benefits to those that cycled/walked to work as I think those that do are fitter, more motivated and productive than car drivers.

In a working career spanning forty years I've never found people's ability to do their job is at all related to how they travel to the workplace.

http://www.hrmagazine.co.uk/article-det ... productive

[pete75]

agree with all that Vorpal says here but we need incentives as well. So for example if I was an employer I would give extra benefits to those that cycled/walked to work as I think those that do are fitter, more motivated and productive than car drivers.

In a working career spanning forty years I've never found people's ability to do their job is at all related to how they travel to the workplace.

http://www.hrmagazine.co.uk/article-det ... productive

My experience has been different to the one described in that piece of journalese. In any case where I worked for the last thirty years no hours were lost by people being late because we had flexi time and hours were measured on a monthly basis. Before that I was employed in places where folk grafted and did real work. No time was "lost" to the employer because everyone was on the clock and, in theory at least, weren't paid until they got there. Besides that shifts started at 7 so outside commuting hours.

[Vorpal]

My experience is that cyclists among office workers have more energy and take less time off sick. People who do other exercise before work mostly fall into the same thing. There are other articles, and some studies that back it up, but I doubt that they distinguish between labour-intensive jobs and office jobs.
https://www.triplepundit.com/special/bu ... ductivity/
https://www.bikeradar.com/commuting/new ... ity-37536/
As you might guess the Netherlands has studied stuff like this
http://www.vcl.li/bilder/518.pdf
I haven't looked for the studies in Dutch.

[pjclinch]

agree with all that Vorpal says here but we need incentives as well. So for example if I was an employer I would give extra benefits to those that cycled/walked to work as I think those that do are fitter, more motivated and productive than car drivers.

In a working career spanning forty years I've never found people's ability to do their job is at all related to how they travel to the workplace.

Active travellers tend to be healthier. Healthier people tend to have have less sick time. So while they may not be any better at the job, they're more likely to be doing it for more time.

[ianrobo]

agree with all that Vorpal says here but we need incentives as well. So for example if I was an employer I would give extra benefits to those that cycled/walked to work as I think those that do are fitter, more motivated and productive than car drivers.

In a working career spanning forty years I've never found people's ability to do their job is at all related to how they travel to the workplace.

Active travellers tend to be healthier. Healthier people tend to have have less sick time. So while they may not be any better at the job, they're more likely to be doing it for more time.

in other words more productive and the UK has awful productivity figures compared to other countries Like DE, FR and NL