The exercise deficit

Lino Bugeja’s article Getting To Grips With Sports For All (September 15) raises a very valid point by stressing that opportunities for physical activity and recreation should be open to all.

A little while ago government schemes “to promote sports as part of daily routine” were announced (Three Schemes To Promote Sports As Part Of Daily Routine, April 19). Two of these schemes, though well-intentioned, can hardly be regarded as benefiting the population at large. One provides for a 15 per cent refund on the purchase price of sports equipment and the other, so-called “20/20 Sport Training Leave Scheme” – reportedly for the benefit of “prominent and national sports people” – compensated athletes for hours’ training time in lieu of work. As Mr Bugeja rightly observed, such schemes introduce an unhealthy competitive element which only favours the few while depriving thousands of children and youngsters of the opportunity for healthy exercise. While it cannot be denied these schemes are well-meant, they only benefit dedicated sportsmen while not providing opportunities for exercise which are accessible to all citizens at all times.

Most important of all, as Mr Bugeja rightly points out, children, youngsters and the old are excluded by these schemes by virtue of their exclusive relevance to the few “high performers and medal winners” – and not the population at large. These schemes therefore cannot be considered to support the concept of promoting physical exercise (or “sports”) as “part of daily routine” because most ordinary peoples’ daily routine is constrained, not by the availability or otherwise of sports facilities but by their environment – be it school, work or residential area. For the vast majority of people, providing an environment which prompts inclusion of physical activity into their daily routine is a crucial element which is repeatedly omitted and needs attention.

The third scheme, that of subsidising the purchase of bicycles, is a very welcome step in the right direction but the catch is that it is unlikely to be of benefit to health so long as Malta remains so bicycle-unfriendly in every way. Most of these subsidised bicycles will therefore not be used and get consigned to a corner where they will gather dust over the years.

The pivotal role of physical activity in health maintenance is a relatively new concept. Epidemiologist Jeremy Morris, who recently died at the ripe old age of 99 years, was the first to focus attention on the importance of exercise for health and longevity.

In 1949 Dr Morris published the results of a study in which he compared the frequency of heart attacks in (double-decker) bus conductors, postmen, post office sorting staff and bus drivers. The results showed that more physically-active work such as that of bus conductors and postmen protected against coronary heart disease during middle age. The rest is history.

Another landmark was the introduction of the useful descriptive adjective “obesogenic”. This word, coined in the 1990s, is increasingly used to sum up the environmental threat facing Western society. An “obesogenic environment” is one that lacks the influences, opportunities or conditions of life which promote fitness and hinder obesity. Or, put more simply, an obesogenic environment is “an environment which makes it difficult to do exercise while making it easy to eat large quantities of mostly unhealthy foods”.

Malta, as usual, lags behind in progress on matters relating to a healthy environment, the very idea of investing in an environment which might enhance our quality of life and provides cues which persuade people to take more exercise remains totally alien. Exercise is indubitably a “best buy” from a health point of view but without healthy surroundings, no amount of well-intentioned efforts of health professionals is likely to make an impact. Unfortunately, Malta persists in her obsession with commercial development and seems intent on covering every available space with unnecessary apartment blocks, high-rise buildings and underground garages. As long as the need to create an environment which makes physical exercise more palatable to children and adults continues to be neglected, so our quality of life will continue to be eroded.

In short, as a result of our government’s relentless pursuit of wealth, we in Malta will become increasingly physically unfit and obese through being victims to our unhealthy surroundings.

How to make our surroundings more conducive to a healthy lifestyle is a vast subject in itself; (This subject is partially covered in the Think Tank publication Towards A Low Carbon Society – the Nation’s Health, Energy Security and Fossil Fuels (paras 296-393 and 393-416) available at www.tppi.org.mt/cms/index.php/reports).

It only suffices to repeat Mr Bugeja’s words: “… obesity is rampant (and) the joyous sounds, mirth and laughter of children playing in our streets have completely disappeared… a concerted drive is urgently required from all the stakeholders, and that includes local councils, to ensure mass participation in physical recreation and sports with the sole aim of a better quality of life for all”. How very true.

The author is a medical doctor.