Coronary heart disease and physical activity of work

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The End of Illness by David B. Agus

confounding variable, Coronary heart disease and physical activity of work, Danny Hillis, discovery of penicillin, double helix, epigenetics, germ theory of disease, Google Earth, Gregor Mendel, impulse control, information retrieval, Larry Ellison, longitudinal study, Marc Benioff, meta-analysis, Michael Milken, microbiome, Murray Gell-Mann, pattern recognition, Pepto Bismol, personalized medicine, randomized controlled trial, risk tolerance, Salesforce, Steve Jobs, systems thinking, TED Talk, the scientific method

Annals of Internal Medicine 142, no. 1 (January 4, 2005): 37–46. Epub November 10, 2004. Morris, J.N., and M.D. Crawford. Coronary heart disease and physical activity of work: evidence of a national necropsy survey. BMJ 2 (December 20, 1958): 1485–96. Morris, J.N., J.A. Heady, P.A.B. Raffle, C.G. Roberts, and J.W. Parks. Coronary heart-disease and physical activity of work. Lancet 265, no. 6795 (November 21, 1953): 1053–57. Morris, J.N., J.A. Heady, P.A.B. Raffle, C.G. Roberts, and J.W. Parks. Coronary heart-disease and physical activity of work. Lancet 262 (November 28, 1953): 1111–20. Mukherjee, S. The Emperor of All Maladies: A Biography of Cancer.

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Today, we could envision a similar chart where construction workers and laborers would still be found on the lower left, and corporate executives and receptionists would be on the upper right. That is, unless those whose jobs revolve around computers and desks use their “leisure time” wisely—and actively. Source: J.N. Morris et al. Coronary heart disease and physical activity of work. Lancet 2 (1953): 1053–57. Reprinted with permission. Among the other visionaries who worked in Morris’s footsteps was Ralph S. Paffenbarger, who shared the 1972 Olympic prize in sports science with Morris. Equally as charismatic and irrepressible as Morris, Paffenbarger added a few more important and cogent facts to the story of exercise, which would further help this new area of medicine gain a foothold in the general community.

The Miracle Pill by Peter Walker

active transport: walking or cycling, agricultural Revolution, autonomous vehicles, Boris Johnson, Brexit referendum, call centre, car-free, Coronary heart disease and physical activity of work, coronavirus, COVID-19, driverless car, experimental subject, James Watt: steam engine, Kickstarter, lockdown, longitudinal study, meta-analysis, randomized controlled trial, Sidewalk Labs, social distancing, Stop de Kindermoord, the built environment, Traffic in Towns by Colin Buchanan, twin studies, Wall-E, washing machines reduced drudgery

In what Morris later called ‘one of the tensest moments of my professional life’,19 he received data about postal workers, which showed that postmen who delivered mail by bike or on foot also had roughly half the incidence of heart disease as their inactive colleagues, the clerks and counter staff. Finally convinced his hypothesis was sound, Morris submitted the article to leading medical journal The Lancet, where it appeared in issue 6795, on 28 November 1953, under the sober and succinct title, Coronary Heart Disease and Physical Activity of Work. As part of my research into the family history, I visit Tamara Lucas, whose father was Morris’s cousin and grew up alongside him in Glasgow. By coincidence, Lucas works for Elsevier, the publishing giant whose titles include The Lancet. We meet at its central London office, where she leads me to the magazine’s archive, a small room with floor-to-ceiling shelves filled with original copies, many pages featuring the authors’ handwritten corrections and annotations.

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., ‘Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy,’ The Lancet, Vol. 380, No. 9838 (2012): 219–29. 12 World Health Organization, Global Health Risks: Mortality and burden of disease attributable to selected major risks (2009). https://www.who.int/healthinfo/global_burden_disease/GlobalHealthRisks_report_full.pdf 13 I-Min Lee et al., ‘Annual deaths attributable to physical inactivity: whither the missing 2 million?’, Correspondence in The Lancet, Vol. 381, No. 9871 (2013): 992–3. 14 J. N. Morris, J. A. Heady, P. A. Raffle, C. G. Roberts, J. W. Parks, ‘Coronary heart-disease and physical activity of work’, The Lancet, Vol. 262, No. 6795 (1953): 1053–7. 15 Mihaela Tanasescu et al., ‘Exercise Type and Intensity in Relation to Coronary Heart Disease in Men’, Journal of the American Medical Association, Vol. 288, No. 16 (2002): 1994–2000. 16 2018 Physical Activity Guidelines Advisory Committee Scientific Report. 17 2018 Physical Activity Guidelines Advisory Committee Scientific Report. 18 Jaakko Tuomilehto et al., ‘Prevention of Type 2 Diabetes Mellitus by Changes in Lifestyle among Subjects with Impaired Glucose Tolerance’, New England Journal of Medicine, Vol. 344 (2001): 1343–50. 19 Statistics from the charity Age UK in 2013 https://www.ageuk.org.uk/latest-press/archive/250000-older-people-hospitalised-due-to-a-fall-every-year/ 20 World Health Organization, Physical Activity and Adults https://www.who.int/dietphysicalactivity/factsheet_adults/en/ 21 Interview with the author. 22 Interview with the author. 23 Catrine Tudor-Locke et al., ‘How fast is fast enough?

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actin (protein) 40 active applause 176–7, 180, 271 Active Ten app (Public Health England) 57, 269 adenosine triphosphate (ATP) 40, 41, 276 Aldred, Rachel 119–20, 139 Alzheimer’s disease 5, 49, 186, 226, 232, 233, 234 Agricultural Revolution/Agrarian Revolution 15–16 Amager Bakke/Copenhill waste-burning energy plant, Denmark 134–5 Amish people 17–18, 208 anaerobic respiration 40 Annual Travel Survey 3 anxiety 5, 50, 57, 112 Araujo, Claudio Gil 229–32 Aspern, Vienna 140 asthma 10–11, 160, 172, 209 Atlas, Charles (Angelo Siciliano) 31 Barnet Graph of Doom 100–1 basal metabolic rate (BMR) 51, 158, 191 Better (non-profit social enterprise) 224 BeUpstanding 195–6 bike couriers 11–13 Biobank public health project 114 biophilia 133 Bjarke Ingels Group (BIG) 132–5, 138–9 Blackburn, Elizabeth 41–2 Blair, Steven 19–20, 21, 46, 169–72, 275–6 blood pressure 5, 41, 46, 48, 57, 75, 90, 160, 225, 227, 265 Boardman, Chris 124–5, 127, 137, 264 BodPod 172–3, 174 body mass index (BMI) 146–7, 150–2, 161–4, 167, 170, 171, 172, 173, 193, 243 bone density/health 16–17, 22, 23, 44, 46, 49, 67, 101, 209, 223, 227–8 Boyd, Andrew 105–6 breast cancer 48, 160 British Medical Journal (BMJ) 64, 65, 80 Buchan, William: Domestic Medicine 63 Buchanan, Colin: Traffic in Towns 120–1 Buchanan, Nigel 203–4, 206, 207–8 Buchner, David 228 Bull, Fiona 98–9 Burden of Disease, WHO 47, 90 Burfoot, Amby 78, 79 Burnham, Andy 124, 264, 266 bus drivers, heart attack rates in London 61–2, 71–3 Bushy Park Time Trial 250 calories 13, 19–20, 19n, 27, 51, 54, 75, 113, 114, 146, 148, 153, 155, 156–7, 158, 165–6, 169, 190 Cambridge University 64, 65–6, 187 cancer 5, 41, 48–9, 62, 79, 90, 114, 160, 186, 187, 227, 231–2 car children and 216, 219, 258, 263–4, 265, 272 electric 137, 268 lobby 263 social engineering and 254, 258 town/city planning and 110, 111, 113, 121, 120–2, 124, 125, 126, 127–8, 129, 130, 131, 135, 136, 137, 138, 140, 141, 142, 191–2, 263, 265, 268 walking supplanted by 2, 3, 5, 53 cardiovascular activity 168–9, 209, 271–2 cardiovascular health bus drivers, heart attack rates in London 61–2, 71–3 children and 2, 213 coronavirus and 265 diabetes and 95 Harvard Alumni Health Study 75–7, 134 heart attacks 41, 48, 50, 62, 70, 71, 74, 75, 76, 77, 91, 92, 93, 106 heart disease 5, 43, 46, 48, 59, 68, 69, 70–4, 81, 82, 88, 89, 114, 152, 154, 243, 244 inactivity first linked to 47–8 life expectancy and 93 longshoremen health study, San Francisco 75 low-density lipoprotein (LDL)/triglycerides and 41, 43, 46, 185 mitochondria and 40, 41 rheumatic heart disease 68, 69–70, 82, 152 sitting and 5, 185, 186, 187, 199 Centers for Disease Control (US government) 95, 228 chair 178–9 Chan, Margaret 152–3 children 22–3, 203–20, 235 adult health, movement in childhood and 11, 209–10 BMI and 51 bone density and 16, 23, 49, 67, 209–10 childhood movement diminishing into adolescence and onwards 11, 210–11 cycling and 121, 130, 214, 237–8, 246, 247 Daily Mile and 203–7, 212–13 decline in activity/inactivity statistics 1–2, 10–11, 22–3, 24, 203–11, 252–3, 254, 256 girls, low activity levels in 141–3, 204, 209, 210–11, 256 independent childhood mobility, perceived cosseting of children and 216–20 life expectancy and 97 obesity and 84, 152, 153, 252–3, 256–7 schools and see schools social care and 100 social engineering and 244, 245, 246, 247–9, 252–3 town/city planning and 121, 122–3, 130, 138, 139–40, 142, 216–20 cholesterol 43, 185, 242–3 cigarettes 10, 29, 47, 62, 75, 76, 79, 92, 98, 105, 176, 177, 242–4 cognitive function 5, 46, 49, 57, 87, 186, 226, 232, 233, 234 Coldbath Fields Prison, London 63–4 colon cancer 48 co-morbidity 89, 91 commuting 58, 111, 114–18, 125, 127–9, 148, 183, 184, 199–200, 221, 270, 273, 274 Cooper, Ashley 129 Cooper, Ken: Aerobics 78, 79 Copenhagen, Denmark 109–12, 122–3, 125, 134, 135, 184, 240 Coronary Heart Disease and Physical Activity of Work 61–2, 71–3 coronavirus pandemic 8–10, 13, 33, 88, 90, 100, 115, 116, 130, 138, 154, 172, 173, 182, 183, 192, 198, 201–2, 214, 240, 247, 248, 257, 259–61, 263, 264–9 Cregan-Reid, Vybarr: Primate Change 178–9, 189 Criado-Perez, Caroline: Invisible Women 141 cycling body fat and 173 calories and 113 car travel supplants 2, 3, 127, 217–18 children/schools and 121, 130, 214, 217, 237–8, 246, 247 commuting/everyday cycling for transport 7, 9, 13, 27–8, 34, 58, 104–5, 113, 114, 115–20, 129, 137, 177, 182, 183, 184, 199, 213, 254, 261, 265, 270, 272–3 couriers 11–13 Denmark and 7, 111, 121, 128, 130, 135, 239, 240, 249, 268 electric-assist bicycle/e-bike 128–30, 135 Finland and 236–8, 246, 247 heart attacks and 74 lanes/routes 9, 28, 82, 111, 119, 120–1, 122, 124, 130, 133, 192, 237, 246, 253–4, 265, 267–8 leg strength and 224, 231, 276 METs and 51, 52, 58, 115, 129 mortality and 114–20, 121 Netherlands and 119, 121, 125, 127, 128, 239, 240, 249, 268 Olympics and 34 overweight people and 166 Peloton 31 postmen and 73 safety/road danger 28, 118–19, 121, 125–6, 128, 137, 216–18, 240, 260 Slovenia and 253–4 social engineering and 236–8, 239–40, 246, 247, 249, 253–4, 256 share schemes 106 short car trips and 136, 137, 143 town/city planning and 33, 111, 112, 113, 114–20, 121, 122, 124–6, 127–31, 136, 137, 141, 143, 191, 192, 236–9, 246–7, 249, 253–4, 256, 263–4, 267–8 cytokines 42, 161, 162 Dahl, Roald 217–18 Daily Mile 203–7, 212–13, 214, 249, 251, 261, 262 Davies, Adrian 5, 35 dementia 5, 49, 87, 88, 226, 227, 229, 232–4 Denmark cycling in 7, 111, 121, 128, 130, 135, 137–8, 184, 239, 240, 249, 268 town/city planning in 109–12, 114–15, 121, 122–3, 125, 128, 130, 131, 132–5, 268 Department for Transport, UK 3 depression 5, 50, 106, 250 diabetes 88, 90, 95, 102, 186, 187, 192–3, 227 pre-diabetes 37, 59, 188 type 1 37, 94 type 2 4, 5, 36, 37, 41, 42, 43, 46, 48–9, 57, 89, 93–4, 99, 106–8, 129, 145, 146, 151, 160, 162–3, 167, 185, 193, 215, 222, 265 Diabetes UK 108 Disneyland 135–6 Dober Tek campaign 254–5 Doll, Richard 79 Donaldson, Liam 79 driverless cars 136, 137 Dunstan, David 192–3, 200 duurzaam veilig (sustainable safety) 126 electric-assist bicycle/e-bike 128–30, 135 electric vehicles 128–30, 135, 136–7, 268 endocrine system 42 Equinox (US gym chain) 32 Erickson, Kirk 226, 233–4, 275 exercise see individual exercise and area of exercise ‘fat and fit’ 147, 169–75 fat, body 42–4, 145, 146–7, 151, 161, 162, 165–6, 167, 169–75, 185, 188, 193, 242, 255 financial costs of inactivity 87–143 mortality and morbidity and 90–3 NHS/universal medical systems and 87–108 non-medical long-term action against preventable conditions and 102–8 social care and 100–2 total additional costs imposed on health services due to inactivity 94–5 Finland 236–47, 258 cycling in 236–8, 246, 247 Finnish Schools on the Move 211–12, 246, 252 Global Report Card study on childhood activity levels and 252–3, 255 Helsinki central library 252 Network of Finnish Cycling Municipalities 247 social engineering in 236–47, 249, 252, 262, 264 Sports Act (1980) 245–6 Sports Act (1999) 246 Winter Cycling Congress 238, 246 see also individual place name Fitbit 54, 181 fitness industry 3, 31, 33, 34 fitness watches 116, 181, 270–1 food corporation lobby 148 ‘four by four’ threat (four most damaging NCDs) 90 Frauen-Werk-Stadt (Women’s Work City), Vienna 140–1 Freiburg, Germany 137–8 Frome, Somerset 141–3 Garmin 116, 181, 270–1 Gehl, Jan 109–12, 120, 122–4, 125, 126, 131, 135, 184, 268, 275 Life Between Buildings 110, 122–3, 131 Gill, Tim 138, 218–20 No Fear: Growing Up in a Risk-Averse Society 219–20 Glasgow University 66, 68, 134, 163 Global Report Card study on childhood activity levels 24, 252–3 glucose intolerance 37, 38, 167, 185, 192–3, 194 Gobec, Mojca 254–5 Googleplex, Mountain View 133, 196 Greater Manchester 124–5, 127, 264–6 gyms 1, 4, 26, 30–5, 51, 106, 149, 166, 167, 220–1, 223–4, 256, 276 Hartley, Sir Percival Horton-Smith 64–5 Harvard Alumni Health Study 75–7, 134 Harvard University 46, 52, 74, 76, 77, 134, 171 Haskell, William 26, 274 Hatano, Yoshiro 54 Health Education Authority 210 health gap (gap between life expectancy and healthy life expectancy) 92–4, 95, 99–100, 222 Healy, Genevieve 194–6, 274 heart attacks 41, 48, 50, 62, 70, 71, 74, 75, 76, 77, 91, 92, 93, 106 see also cardiovascular health heart disease 5, 43, 46, 48, 59, 68, 69, 70–4, 81, 82, 88, 89, 114, 152, 154, 243, 244 see also cardiovascular health heart rate 13, 27, 53, 116, 117, 129, 181, 197, 270 Hidalgo, Anne 192 high-density lipoprotein cholesterol (HDL) 43, 185 Hillman, Mayer: One False Move 217–18 Hillsdon, Mervyn 79–80, 83, 84, 85 Hippocrates 63 Hobro, Denmark 131 hunter-gatherers 5, 15, 16, 17 Hunt, Jeremy 261–4 Imbeah, Alistair 224 inactivity financial costs of 87–143 see also financial costs of inactivity obesity and see obesity sitting and see sitting see also individual area and consequence of inactivity incidental activity (activity which takes place as part of your regular day) 27, 114, 220 individual responsibility 2, 30, 58, 148, 263 industrialisation 2, 30 inequality (of income and opportunity) 103 Ineos 205 inflammation 42, 48, 68, 161, 162, 223 Institute of Hygiene and Occupational Health, Sofia 165 insulin 36, 37, 38, 42, 43, 57, 146, 161, 162 International Olympic Committee 81 International Space Station 44 Johnson, Boris 259, 260, 261, 264, 266, 267 Kail, Eva 139–43 Kelly, Mark 44 Kelly, Phil 88–9, 96–7, 103–5, 107 Kelly, Scott 44 Keston, John 225 keto diet 146 King’s College Hospital, London 87–9, 91 Kiuru, Krista 238–9, 245 Korhonen, Nina 246, 248–9, 252 Kraus, Hans: Hypokinetic Disease: Diseases Produced by Lack of Exercise 74 lactic acid 40–1 Lancet, The 23, 46, 47, 73, 95, 98, 128, 153, 199, 210 Lean, Mike 163–4 Lee, I-Min 46, 47, 52, 55, 56, 59, 60, 74, 77, 78, 80, 81, 82, 274 Levine, James 189–92, 193, 194, 196–7, 199, 201 Lewis, Thomas 68, 71–2 life expectancy 91–2, 99, 221–2 health gap (gap between life expectancy and healthy life expectancy) 92–4, 95, 99–100, 222 lipaemia 43 liver 161, 186, 187 Longevity of Oarsmen study, The 64–5 longshoremen health study, San Francisco 75 low-density lipoprotein (LDL) 43, 185 Lucas, Tamara 73–4, 83, 85 lung cancer 48, 79 lung function 5, 95–6 Lykkegaard, Kasper 181–2 Mackenzie, Richard 36–8, 43, 59, 117, 274–5 Maguire, Jennifer Smith 31, 32, 33 Mancunian Way, Manchester 124–5 Marin, Sanna 238 Marmot, Michael 82–3 ‘Matthew effect’ 206 Mayer, Jean 154–6, 157, 175 Physiological Basis of Obesity and Leanness 155–6 McGovern, Artie 31 meals, movement and processing of fats and sugars after 43–4, 167, 183, 188, 194, 272 mental health 49–50, 74, 204, 211 MET (metabolic equivalent) 51–2, 58, 115, 129, 178 metabolic disorders 5, 43, 49, 74, 95 see also individual disorder name metabolic rate 39, 51, 158, 191 micro mobility 135 Miliband, Ed 266–7 minimum amount of moderate activity needed to maintain health, recommended 116–17 mitochondria 41, 48, 167 Mitrovic, Polona Demšar 254 modal filtering 126 morbidity 89, 91–3, 160, 168–9, 227, 256–7 Morris, Annie 66–7 Morris, Jerry 61–3, 64, 65, 66–74, 75, 77, 79, 80–6, 152, 154, 241 Morris, Nathan 66–7, 83 Moscow 111, 112, 123 Mosley, Michael 229 movement decline of everyday 15–35 rediscovery of benefits of 61–86 see also individual type of movement muscle leg 224, 231, 276 skeletal 40, 42, 43, 167, 276 smooth 40 strength/muscle training 22, 223, 228, 271–2 wastage 22, 42, 223–4 Muscular Christianity 30 myosin (protein) 40 ‘nanny state’ 9, 243–4, 262–3, 264, 265 NASA 44 National Fitness Survey (1990) 84 National Health Service (NHS) 9, 70, 101, 164, 179, 223, 266 cost of inactivity to 9, 89–90, 93–7, 101, 104, 106–7, 153–4 social prescribing 105–6 National Lottery 33 Nebelong, Helle 219–20 Netherlands 119, 121, 125, 127, 128, 166, 239–40, 249, 268 Nieman, David 265 Niemi, Joonas 246, 248–9, 252 non-communicable diseases (NCDs) 90, 98 non-exercise activity thermogenesis (NEAT) 190–1, 194–5 North Karelia, Finland 241–3, 244, 245, 257 obesity 5, 19, 89, 98, 144–75, 215, 241 activity required to lose significant amounts of weight 144–7, 164–9 age and 152 basal metabolic rate and 158, 191 BMI and 146, 150–1, 160, 161–4, 167, 170, 171, 172, 173 body fat percentage and 146–7, 151, 165, 167, 170, 172–4, 193 childhood and 84, 152, 153, 212 costs of 95, 153–4 crisis 152–3, 154, 157 deaths and 47, 90, 160, 163, 170, 171 energy balance and 154–9 exercise benefits for 59, 144–7, 156, 158, 159, 165–6, 167–8 ‘fat and fit’ 169–75 health conditions associated with 160–1 obesogenic foodscape and 148–9 sex and 152 Slovenia and 256–7 stigma 147, 149–50 sugar and 146, 148, 156, 166 waist circumference and 161–4, 169, 172 weight loss/Watson and 144–6, 147–8, 149, 162, 166–7, 171, 173, 175, 270 worldwide spread of 152–3 Odense, Denmark 130 Ojajärvi, Sanna 247 older people/ageing staying active and 220–35 town/city planning and 138–9 Old Order Mennonites community 208 Olympics 33–4, 124, 224, 228, 255 (1964) 54 (1996) 33, 81 (2000) 33 (2012) 23 150-minutes of moderate exercise per-week recommendation 21–2, 26, 38, 54, 201, 270 active travel and 112 children and 207 commuting and 127–8 definitions of moderate and intense exercise 22 MET and 58 moderate activities, WHO list of possible 52 mortality and 45 older people and 222 strength training and 271–2 weight loss and 164 osteoporosis 16–17, 209, 227 Paffenbarger, Ralph 62, 64, 74, 75–82, 84–5, 101, 134, 225, 274 Paris 191–2, 197, 268 Parkrun 106, 249–51 pavement 120, 122, 124, 130, 140, 141, 237, 265, 268 pedometers 53–4 Peloton 31 personal choice, myth of 25–30 personal trainers 31 Peska, Pukka 46, 240–5, 257, 262–3 Physical Activity and Health (eds Bouchard, Blair, Haskell) 39 Physical Activity Guidelines Advisory Committee (PACAG) 45, 48, 57 physical activity level (PAL) 51 Pichai, Sundar 133 Policy Studies Institute 217 polypharmacy 89 portal theory 161 poverty 67, 68, 69, 82, 152, 180 Poynton, Frederic 68 protein 37, 40 Public Health England (PHE) 3, 22, 33, 57, 94–5, 97, 169, 269 Raab, Wilhelm: Hypokinetic Disease: Diseases Produced by Lack of Exercise 74 Radcliffe, Paula 36 ramp test 117–18 rheumatic heart disease 68, 69–70, 82, 152 risk-averse culture 207, 219 road danger 28, 119, 121, 125–6, 128, 137, 216–18, 240, 260 Roehampton University 36, 117, 172 Rook, Sir Alan 65 Ross, Robert 149–50, 157, 160, 161–2, 163, 164, 168–9, 171, 173, 174, 175 Rost, Leon 132–4, 135, 136, 139 Royal College of General Practitioners 105 running 1, 3, 9 ageing and 225, 227, 275 ATP and 40 bone density and 16 childhood and 203–7, 209, 210, 212–13, 214, 215, 246, 255 exercise industry and 31 home running treadmills 147 METs and 51, 58 150-minutes of moderate exercise per-week recommendation and 22, 52, 201 overweight people and 167 Paffenbarger and 76, 77, 78–9, 80, 225 Parkrun 106, 249–51 ultrarunning 32 schools 20, 27, 30, 121, 210–20, 236, 237–8, 239, 244, 245, 246, 247, 248, 252–7, 261–2 cycling to 121, 130, 214, 237–8, 246, 247 Daily Mile and 203–7, 212–13 English curriculum, physical education and 212, 248, 261–2 Finland and 211–12, 246, 252–3, 257 free school meals at 245 girls low activity levels in 204, 209, 210–11 Global Matrix 3.0 Physical Activity Report Card and 24, 252–3 independent childhood mobility, perceived cosseting of children and 216–20 playing fields 103, 107 Scottish schools curriculum, physical education and 212 sitting in 211–16 Slovenian 212, 255–7 social engineering and 237–8, 239, 244, 245, 246 sedentary behaviour 177–202 see also sitting Sens 181–4, 271 short-termism 107 Sidewalk Labs 136 Sim, David: Soft City 123–4, 126–7 Sinton-Hewitt, Paul 250 sit-stand test 228–31 sit-stand workstations 195, 196, 198–9, 200, 202 sitting 5, 13, 24, 26, 39, 49, 54, 62, 72, 176–202, 211–16 active applause and 176–7, 180, 271 average amounts of 179 breaking up prolonged 176–7, 180, 181, 182, 190–1, 193, 194–5, 197, 200, 271, 275 chair and 178–9 diabetes and 185, 186, 187, 188, 192–4 exercise and effects of 184, 199–201 fidgeting and 190–1, 194–5 health effects of 176–7, 185–8 low-density lipoprotein cholesterol (LDL)/triglycerides and 185 ‘new smoking’ headlines 177 schools and 211–16 sedentary behaviour defined 177–8 sit-stand test 228–31 sit-stand workstations 195, 196, 198–9, 200, 202 tracking/measuring 179–84 TV viewing and 178, 186, 187–8, 189, 192 workplace and 189–92, 195–9, 201–2 skeletal muscles 40, 42, 43, 167, 276 skinfold body fat test 173–4, 255 Skinner, James 21 sleep 5, 42, 50, 57, 184 Sleep, Leisure, Occupation, Transportation, and Home-based Activities (SLOTH) 25 Slofit programme 255–6 Slovenia 24, 212, 253–8, 261 Smith, Edward 63–4 smooth muscle 40 social care 97, 99–101, 108 social engineering 236–58 cycling and 236–8, 239–40, 246, 247, 249, 253–4, 256 Finland and 236–47, 249, 252–3, 255, 257, 258 see also individual area of Finland kindergartens and 252 mortality rates and 240–5 ‘nanny state’ objections to 243–4 obesity and 241, 252–7 Parkrun 249–51 political support, need for complete 244–5 schools and 236, 237–8, 239, 244, 245, 246–7, 248, 252–3, 255, 256, 257 Slovenia and 253–7, 258 sports facilities funding 245–6 tax and 245–6, 252 Youth Sports Trust, UK 247–9, 251 social medicine 61, 68–71, 83 Social Medicine Unit 61, 69–70 socialism 66, 67–8 social prescribers 105–6 Spevak, Harvey 32, 35 Sport England 34 stairs 28–9, 131–4 Starc, Gregor 255–7 St Mary’s Hospital, London 93 St Ninian’s primary school, Stirling, Scotland 203–7, 213 Stockholm, Sweden 141 Stop de Kindermoord (Stop the Child Murders) road safety mass protests, Netherlands (1970s) 121, 240 strength/muscle training 22, 223, 228, 271–2 stroke 5, 46, 61, 81, 89, 160, 180, 186, 267 technology, monitoring of activity levels and Active Ten app (Public Health England) 57, 269 activity trackers 38, 57, 116, 180–4, 200–1, 214–15, 269, 270–1 Sens activity tracker 181–4, 200–1, 214–15, 271 television viewing 26, 82–3, 121, 186–9, 192 telomeres 41–2, 226 10,000 steps a day target 26, 38, 52, 53–5, 56, 184, 200, 270, 275 Titmuss, Richard 68–9 town/city planning (built environment) 5, 28–9, 108, 109–43, 210 active travel and 109–43 Amager Bakke and 134–5 Buchanan and 120–1 cars, hegemony of 110, 111, 113, 120–2, 124, 125, 126, 127–31, 135–8, 140, 141, 142, 143, 191–2, 263, 265, 268 Copenhagen 111–12, 122, 123 coronavirus lockdown and 130–1 cycling and 111, 112, 113, 114–20, 121, 122, 124–6, 127–31, 136, 137, 141, 143 driverless cars and 136–7 duurzaam veilig (sustainable safety) concept 126 e-bikes and 127–30 Gehl’s philosophy 109–12, 120, 122–4, 125, 126, 131, 135 Googleplex, Mountain View and 132–4 health dividends of active travel and 114–20 Manchester and 124–5, 127 Odense and 130 older people/those with disabilities and 138–9 stairs and 131–2 Toyota Woven City 135–6, 137, 138–9 Vauban, Freiburg 137–8 walking and 109, 112, 113, 114, 115, 120, 121–7, 129, 130, 131, 132, 133, 134, 136, 137, 140, 141, 143 women and girls, discrimination against 139–43 Toyota Woven City, Japan 135–6, 137, 138–9 tracking, electronic activity 13, 17, 21, 26, 38, 52, 53–5, 56, 57, 113, 116, 180–4, 190, 200–1, 214–15, 269–71, 272 transport use see individual mode of transport travel, active 9, 24, 112–14, 118, 121, 126, 127, 131, 136, 143, 191, 216 see also individual mode of travel Travers, Andrew 100–1 treadmill desk 199 triglycerides 43, 185 True Finns 245 Tudor-Locke, Catrine 53–4, 56 Tulleken, Xand van 29–30, 44–5 Uber 137 ultrarunning 32 University of Massachusetts 53 Utrecht, Netherlands 125 Utzon, Jørn 111 Valabhji, Jonathan 93, 99, 104 Varney, Justin 97–8, 169, 198 Vartiainen, Juha-Pekka 237 Vauban, Freiburg, Germany 137–8 Vienna, Austria 140–3 VO2 max test 117–18, 173 walking Active Ten app and 57, 269–70 ageing and 102 assessing/tracking 26, 38, 52, 53–5, 56, 181, 182, 183, 184, 200, 269–70, 272 bone density and 16 brisk/speed of 3, 9, 22, 48, 52, 53, 55, 57, 60, 74, 79, 84, 86, 114, 167, 269 children and 11, 209, 214, 215, 216, 218, 246, 247 commuting and 114, 130 cycling and 114, 115 danger and 120 decline in 2, 3, 9, 16, 18, 19, 27–9, 33, 208, 216 fat processing/reduction and 43, 48, 185 150 minutes of moderate activity a week recommendation and 52–4 social prescribing and 106 stairs and 28–9, 131–4 10,000 steps a day target 26, 38, 52, 53–5, 56, 184, 200, 270, 275 town/city planning and 109, 112, 113, 114, 115, 120, 121–7, 129, 130, 131, 132, 133, 134, 136, 137, 140, 141, 143 weight loss and 144–5, 157, 165, 166, 167 workplace and 196, 197, 199, 200, 201, 202, 274, 275 WALL·E (film) 25–6 Watson, Tom 144–6, 147–8, 149, 162, 166–7, 171, 173, 175, 270 Downsizing 145 weekend warriors 58–9 Wellington, Chrissie 250, 251, 252, 257 Whyte, Martin 87–9, 91, 94, 95–6, 102–5, 106–8 Wicks, Joe 10 Wiggle 270 Wijndaele, Katrien 187–8 Winter Cycling Congress 238, 246 Wollaston, Sarah 263 Wolff’s Law (bones adapt to the repeated loads put on them) 209 women 6 BMI and 51 bone density 16, 18, 227 cancer and 48 diabetes 151 girls, low activity levels in 141–3, 204, 209, 210–11, 256 life expectancy 92, 222 modern decline in activity among 19, 22, 24 obesity and 150, 151, 152, 153, 154, 157, 159, 160, 161, 162–3, 164, 165, 171 150-minutes of moderate exercise per-week recommendation and 22, 207 public space and 139–43 sitting and 186 walking and 53–4, 55, 84, 121 World Health Organization (WHO) 22, 47, 52, 98, 151, 152–3, 210 World Obesity Forum 154 Wright, Chris 247–9, 252, 257 Wyllie, Elaine 203–4, 205, 206, 209, 212, 213, 262 Youth Sports Trust 247–9, 251 First published in Great Britain by Simon & Schuster UK Ltd, 2021 Copyright © Peter Walker, 2021 The right of Peter Walker to be identified as the author of this work has been asserted in accordance with the Copyright, Designs and Patents Act, 1988.

Exercised: The Science of Physical Activity, Rest and Health by Daniel Lieberman

A. Roger Ekirch, active measures, caloric restriction, caloric restriction, classic study, clean water, clockwatching, Coronary heart disease and physical activity of work, correlation does not imply causation, COVID-19, death from overwork, Donald Trump, epigenetics, Exxon Valdez, George Santayana, hygiene hypothesis, impulse control, indoor plumbing, Kickstarter, libertarian paternalism, longitudinal study, meta-analysis, microbiome, mouse model, phenotype, placebo effect, publication bias, randomized controlled trial, Ronald Reagan, selective serotonin reuptake inhibitor (SSRI), social distancing, Steven Pinker, twin studies, two and twenty, working poor

., et al. (2010), Effects of aerobic and resistance training on hemoglobin A1c levels in patients with type 2 diabetes: A randomized controlled trial, Journal of the American Medical Association 304:2253–62. 28 Smith, G. D. (2004), A conversation with Jerry Morris, Epidemiology 15:770–73. 29 Morris, J. N., et al. (1953), Coronary heart-disease and physical activity of work, Lancet 265:1053–57 and 1111–20. 30 Baggish, A. L., et al. (2008), Training-specific changes in cardiac structure and function: A prospective and longitudinal assessment of competitive athletes, Journal of Applied Physiology 104:1121–28. 31 Green, D. J., et al. (2017), Vascular adaptation to exercise in humans: Role of hemodynamic stimuli, Physiology Reviews 97:495–528. 32 Thompson, R.