Eminent NHS physician and health policy influencer Sir Muir Gray is on a crusade against the modern problems of preventable disease, loss of fitness, and mistaken beliefs about ageing.
Many of us these days spend hours a day at a desk, as pictured here at Oxford's Taylor Institute Library, but Muir Gray recommends walking or standing as much as possible
By Sir Muir Gray
A poure widowe somdel stopen in age
was whilom dwellynge in a narowe cotage…
Somedel stope, or somedel stopen, is Chaucer’s wonderful description of the poor widow in the Nun’s Priest’s Tale, in the manuscript safely safely stowed in the Selden End. Somedel stope could certainly be applied to many academics but the stoop that is so characteristic of the image of older people as epitomised, for example, in the dreadful traffic sign, is not the result of ageing, except in a very few people. It is the result of three other processes that affect us in the modern world – preventable disease, loss of fitness, and mistaken beliefs and negative attitudes about ageing and older people.
The new environmental health problem
It is 150 years since the drains were laid in London, heralding the first public health revolution which tackled the great scourges of the nineteenth century at their root, namely the pollution of water by sewage. Other environmental problems took longer to solve – the Clean Air Act was not passed until 1956, for example. What is claimed now is that health issues are seen as personal or “lifestyle”, not environmental, with a few exceptions. The growing concern about air pollution is now impinging upon the consciousness of decision-makers because air pollution affects the districts where rich people as well as those where poor people live, just as the spread of cholera from the Stepney and Shoreditch to Chelsea and Westminster played no small part in accelerating the drive for social change, fuelled by the strong impetus of enlightened self interest.
With the exception of air pollution, however, it seems that our modern epidemics of heart disease, stroke, dementia, bronchitis and cancer are the result of either our genes or our lifestyle.
The ageing process itself comes in for a fair degree of blame, particularly when it comes to loss of mobility, but the evidence is increasing that the problems we face are not principally due to our genes, which can take about 20 percent of the blame, nor to ageing, which is, of course, inter-related to genetics, reserving the term “ageing” to refer to a normal biological process.
People who are affected only by ageing will be independent at the age of 90, could still have a Reader’s Card maybe even at 100 too, and they could be upright, betraying no signs of stope.
To help people reach 90 and live well we certainly need to give them messages about lifestyle but to recognise that this is a new environmental problem.
The post-paleolithic environment
Various names have been given to the environment in which we live. One is the obesogenic environment, namely an environment in which it is very easy for energy intake to be greater than energy expenditure. Another more scientific name is perhaps the post-paleolithic environment, and Daniel Lieberman, in his scholarly book called The Story of the Body emphasises that the problems we face are the problems of living with a paleolithic body in a post-paleolithic world.
There are many manifestations of this, some of them the modern epidemics such as the epidemic of heart disease or Type 2 diabetes, which some people argue should be called walking deficiency syndrome or the hyper-sitting syndrome. The choice of this name is to emphasise that the problem in the environment that we face is partly the easy availability of high calorie foodstuffs, but many people would give even more importance to the change in our lifestyle which means that we now largely work in a very dangerous occupation, namely an occupation that requires us to sit for eight or more hours a day, often preceded and followed by an hour in a car. Sitting is a problem imposed upon us by our environment, an environment in which we have come to rely more on the car, in which cities and towns and work patterns have taken the car into account in their planning and development, and of course an environment in which the computer screen and the television screen play an increasingly important part.
Most academics suffer from the Hyper Sitting Syndrome, spending at least eight hours a day sitting, and often more. The inactivity increases the risk of our modern epidemics such as heart disease and Type 2 diabetes Even more worringly for academics it is now also evident that the risk of type of dementia that is due to failing blood supply – vascular dementia – can be reduced significantly by physical activity. Sitting peering at a book or computer screen also causes backache, neckache, shoulder pain and repetitive strain injury.
Students hard at work at St Antony's College's library in north Oxford
The benefits of standing and walking
Obviously there are many different types of exercise, of which Walking Plus is the most widely relevant, namely walking plus ten minutes a day for strength, suppleness and skill fitness.
However, at work there are terrific opportunities for mitigating the problems posed by sitting. These need not involve the purchase of expensive standing desks; the simple purchase of plastic crates from an office store allows many people to stand, and of course there are very old fashioned technologies available such as the lectern and the standing desk. The Victorians knew this because much of their work as done at a standing desk with a sloping surface and a little bar across the foot on which first one and then the other leg could be rested to relax the hamstrings. Now is the time to help academics lead a healthy lifestyle and the Bod could play a major role in doing so.
Standing in the Bod
The Bod, the affectionate name that many people have for the Bodleian Library, has, of course, now another connotation as in the syndrome called Dad’s Bod or middle aged spread! But if we focus on the Bod itself we have to praise the wonderful new chairs that are made available but ask why we should not take steps to reintroduce standing in the Bod.
In Duke Humfrey, Bodley’s Librarian pointed out the marks that could still be seen where the lecterns were once situated, allowing people to bend, pick up a chained book, and pull it up to open on the sloping shelf. Surely we need to return to promoting standing reading. Standing may not seem a great form of exercise but if someone who sat eight hours a day even stood two hours a day, the net effect is equivalent to running six marathons a year.
Perhaps we should also introduce the Hourly Stretch , a reminder every hour to readers to stand up and stretch for three minutes, which could become a ritual as deeply ingrained as the Seventh Innings Stretch in baseball crowds
Pity the poor scholar somedel stope in age
Scholars live a life relatively protected from many of the dangers of occupations such as driving or building, but it may be that the construction industry is now safer than the academic industry because academics have to spend so much of their time in that dangerous activity of sitting. It is true that there is activity interspersed during the day but it is important to remember that Aneurin Bevin said once that the only exercise doctors got was jumping to conclusions! What is needed is to make lecterns available in the Bodleian and I would be pleased to lead a sponsored walk to raise funds for their purchase.
If Chaucer came back to day he would perhaps start ‘The Academic’s Tale’ with these lines
A poure Skolar, somedel stope in academe
From years of study at bokes and screen