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

[RickH]

I just wanted to point out that health promotion measures (the official term has fallen out of my brain at the moment ) have in recent years been mainly the responsibility of councils rather than the NHS &, similar to the situation in social care (exacerbated by cuts to funding from central government), there has been a lack of joined up action.

There are signs that, at least in some parts, that may improve.

[reohn2]

IMO the reason for a lack of cycling infrastructure or enthusiasm for cycling in the UK for any reason is that central and local government simply couldn't give a monkey's for cycling unless it's to win medals at the Olympics,everywhere I ride in any direction from my home there's been no increase of cycling infrastructure of any kind for the past 40 years,but in that time motor traffic has in creased dramatically whilst public transport has decreased in proportion.
The interest in cycling but for few pockets in some major cities is dire,we live in a backward class ridden country choking on it's own pollution and getting fatter by the generation,with remedies available in the form of better public transport,health eating,and exercise.
The fact is that government at all strata is dire too because it's owned by big pharma,and big business Mac's and Coke a Cola to name just two.
That's the state of the nation,the load on the NHS by this lack of real action by government is profound IMO and things will get worse before they get better if they ever do,I hope I'm wrong

[The utility cyclist]

Funny but KFC fried chicken and a lot of McDonalds have a better nutrition value than stuff sold to kids by Marks and Spencer and Waitrose - i was having a similar discussion on a rugby forum. Too easy to blame companies selling a product that is loaded with fat/salt/carbs but it's not those foods as an every now and again treat that is the problem. It's lazy and II'll go as far as saying stupid irresponsible parents who allow their kids to eat too much of it too regularly and not getting them exercising as it's too easy to let them sit in front of a screen in some capacity.
Those kids in turn turn into fat lazy adults and the cycle continues (or not in actual cycling)

[Psamathe]

Maybe relevant article in Guardian today

UK parks save NHS more than £111m a year, study suggests
...
Regular users of parks and green spaces are likely to be healthier and make fewer visits to their GP, research by Fields in Trust suggests. The charity estimates such spaces provide more than £34bn of wellbeing benefits , by improving mental and physical health.

Ian

[Cugel]

Maybe relevant article in Guardian today

UK parks save NHS more than £111m a year, study suggests
...
Regular users of parks and green spaces are likely to be healthier and make fewer visits to their GP, research by Fields in Trust suggests. The charity estimates such spaces provide more than £34bn of wellbeing benefits , by improving mental and physical health.

Ian

What is this foolish reduction of every value to a cash value? Many non-cash values can't meaningfully be translated into a cash value, except by a stupid accountant or an even stupider politician with some ekonomik dogma installed.

Are the pleasant feelings of being in green spaces or thrusting at the pedals through such a locale to be reduced to £4 9s 11d a go? Does this mean that you can pay the dosh and get the pleasant feelings without being in the green space or doing the pedalling?

Perhaps some fool thinks that he can pay a weekly small sum to remain healthy, without bothering to eat nutritious grub, do some exercise or participate in any procedure other than slumping on the sofa whilst eating 20 bags of Prongles and watching The Tour of Yorkshire?

But perhaps these cash values simply equate to the amount of extra money a business can make by having employees who are not depressed so much or off sick? Perhaps the NHS will save a few bob? There's surely a lot more to green space groking, cycling and other good lifestyle values than that.

Cugel

[Psamathe]

Maybe relevant article in Guardian today

UK parks save NHS more than £111m a year, study suggests
...
Regular users of parks and green spaces are likely to be healthier and make fewer visits to their GP, research by Fields in Trust suggests. The charity estimates such spaces provide more than £34bn of wellbeing benefits , by improving mental and physical health.

Ian

What is this foolish reduction of every value to a cash value? Many non-cash values can't meaningfully be translated into a cash value, except by a stupid accountant or an even stupider politician with some ekonomik dogma installed.

Are the pleasant feelings of being in green spaces or thrusting at the pedals through such a locale to be reduced to £4 9s 11d a go? Does this mean that you can pay the dosh and get the pleasant feelings without being in the green space or doing the pedalling?
......

Unfortunately I think things are being reduced to a cash value analysis by our political classes. They seem to care nothing for the wellbeing of us all but seem pre-occupied with profitability, austerity, etc. - all financial measures.

I don't agree with it but I think it's what our ruling classes have created.

Ian

[reohn2]

What is this foolish reduction of every value to a cash value? Many non-cash values can't meaningfully be translated into a cash value, except by a stupid accountant or an even stupider politician with some ekonomik dogma installed.

Are the pleasant feelings of being in green spaces or thrusting at the pedals through such a locale to be reduced to £4 9s 11d a go? Does this mean that you can pay the dosh and get the pleasant feelings without being in the green space or doing the pedalling?

Perhaps some fool thinks that he can pay a weekly small sum to remain healthy, without bothering to eat nutritious grub, do some exercise or participate in any procedure other than slumping on the sofa whilst eating 20 bags of Prongles and watching The Tour of Yorkshire?

But perhaps these cash values simply equate to the amount of extra money a business can make by having employees who are not depressed so much or off sick? Perhaps the NHS will save a few bob? There's surely a lot more to green space groking, cycling and other good lifestyle values than that.

Cugel

It all equates to knowing the cost of everything (in £ s d) and the value of nothing,ask any rampant capitalist,of which we seem to have in abundance in government presently

[pete75]

Are you saying, though, that no one should ever be induced to feel shame by others concerning any kind of behaviour at all, including both the self-damaging and the damaging-to-others? If so, I would like to see you make the case for that position, inclusive of reasons why we should forgive drunk drivers, wife-beaters, child abusers, misogynist gropers, psychopathic demagogues and Toads running over cyclists because they're in the way. WIll attempts to shame them always just make them worse, a la Trump?

Of ye go.

Cugel

Did I say no one should feel shame at all? I think not. WHat I am saying is that people suffering quite series illnesses which may or may not be their "own fault" deserve sympathy not "blame and shame" from those who think as you appear to.
Comparing child abusers , drunk driver etc to people suffering an illness which may, perhaps unknowingly, have been caused by bad lifestyle choices is a little far fetched to say the least. You should be ashamed of your self.

[Vorpal]

Are you saying, though, that no one should ever be induced to feel shame by others concerning any kind of behaviour at all, including both the self-damaging and the damaging-to-others? If so, I would like to see you make the case for that position, inclusive of reasons why we should forgive drunk drivers, wife-beaters, child abusers, misogynist gropers, psychopathic demagogues and Toads running over cyclists because they're in the way. WIll attempts to shame them always just make them worse, a la Trump?

I don't think anyone said that, and you are taking it to an extreme, as if equating someone who is obese with a criminal or criminally violent.

Fat-shaming people tends to lead to weight gain. I said that, and there is plenty evidence to support it. It has nothing whatsoever to do with drunk drivers, nor did anyone say that shame serves no purpose.

[Cugel]

Are you saying, though, that no one should ever be induced to feel shame by others concerning any kind of behaviour at all, including both the self-damaging and the damaging-to-others? If so, I would like to see you make the case for that position, inclusive of reasons why we should forgive drunk drivers, wife-beaters, child abusers, misogynist gropers, psychopathic demagogues and Toads running over cyclists because they're in the way. WIll attempts to shame them always just make them worse, a la Trump?

Of ye go.

Cugel

Did I say no one should feel shame at all? I think not. WHat I am saying is that people suffering quite series illnesses which may or may not be their "own fault" deserve sympathy not "blame and shame" from those who think as you appear to.
Comparing child abusers , drunk driver etc to people suffering an illness which may, perhaps unknowingly, have been caused by bad lifestyle choices is a little far fetched to say the least. You should be ashamed of your self.

You suggested that I am equating those who can do nothing about their unfortunate health condition with those who can. Not so. Please read more carefully in future.

You do have an argument that the fat shaming of people who are obese because of lifestyle choices may not stimulate them into the better behaviours. However, there are many modes of shame. The type you describe is mockery, condemnation, an attitude bereft of anything of practical help. I'm not suggesting that kind of shaming but rather a socio-cultural mechanism (implemented via mass media) that discourages irresponsible self-indulgence and provides extensive facilities for changing damaging personal habits for improving personal habits.

The improving habits would include cycling and many other forms of physical activity, as well as better food sources and eating habits.

The "better food sources" does, however, mean the discouragement of junk food advertising and selling - perhaps even manufacture. The encouragement to exercise probably means a forced reduction in the provision of passive entertainment styles. So cultural shaming people about their self-indulgent, self harming habits is but one means of suggesting that (and hopefully motivating) people to adopt better behaviours.

But if you prefer that everyone should be allowed to self-destruct, often at the expense of the taxpayer and the lives of many other people around them, particularly their families, in the name of "freedom from admonition" ...... I disagree. We humans are communal, despite what the libertarians and neoliberal free marketeers say. What one lot of people does affects many others. Shame is one social mechanism (as old as humanity) by which communities stay coherent and, er, healthy (in the widest sense).

And yes, of course I myself have been shamed for this and that. Often it changed my behaviour for the better. It's one mechanism whereby children put aside childish attitudes and become adults. If you don't like the notion "being shamed" call it "acquiring a sense of responsibility". Does that help?

Cugel

[Tangled Metal]

It's one thing to harm your own health but does anyone have a view on parents canvassing their kids health by indulging them? I'm thinking of a recent trip to a good chippy in the lakes. A rare "treat" for us brought about by a late day coming down from a long walk in the hills (long for our 5 year old and our puppy). However I saw a father and two daughters. He was middle aged but looked fairly slim and like he looked after his health through diet and exercise. The youngest daughter looked to me to be clinically obese and the older daughter was only slightly thinner.

I normally hate discussions about size, weight, etc. However it annoys me to see fit looking parents with obese children. They do know better and do better fit themselves. Why not their children.

BTW obese parents with obese children are no better but I don't get as annoyed by that. Perhaps annoyed isn't the word but it's that feeling the parents are abusing their kids by neglecting their weight, diet, exercise and health.

[Vorpal]

Do you not think that when you look at those girls like that, thinking that a fit looking father has two fat girls, they don't see that? Do you think that it helps their feelings of well-being to have people look at them like that?

You don't know anything about them, so please don't judge them.

Maybe the girls are on medication that makes weight control difficult. Or they have thyroid issues, or mental illness, or any of a number of other things that make it difficult to manage weight. Maybe they just got unlucky in the gut-bacteria draw.

Perceptions of 'overweight' and 'obese' are culturally driven, and not entirely supported by medical evidence. Yes, obese people are at higher risk for some conditions; no argument there. But studies have shown that people who are 'overweight' have the same health outcomes as people who are 'normal' weight. (more info viewtopic.php?f=49&t=121499&hilit=overweight+outcome#p1227939 )

I have a friend who hospitalised herself trying to lose weight. She could not lose weight because of other medical issues and medication for them, but she practically starved herself trying. I also have a cousin who has been overweight / obese most of her life. The only time she was ever able to lose weight was when she stopped taking medication for ADHD, but the rest of her life became unmanageable. She also worked for several years with a dietician, and ate a prescribed diet and followed an exercise plan, and was unable to slim herself.

For another thing, nobody wants to be overweight or obese. And while it may seem simple to just say eat less and exercise more, it is a very complex topic with many underlying issues. Weight is tied to many other aspects of health, including mental health, but the NHS, and our culture do not provide good support for overcoming those issues. For example, when someone is depressed, if they get any help, it is very oftern prescriptions which may cause weight gain, rather than enabling weight loss.

If we really want to address the 'obesity epidemic' (assuming there is such a thing) we need to deal with people on a case-by-case basis and provide a combination of things such as counselling, dietary advice, coaching and/or exercise classes, etc. And it has to be within the financial means of participants. An app on a smart phone might work for some, but it's not enough for many.

[reohn2]

Vorpal
Spot on,I totally agree.
Family trauma over recent years has led to some disturbing effects on some members,it's been a real eye opener from a mental POV,very stressful which revealed itself in surprising and distressful ways.
I suspect those who judge simply haven't been there.

[Tangled Metal]

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?

[Vorpal]

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.