Reducing the risk of and coping with, disease

Disease occurs more often the older the age group studied and although some of these diseases are related to the ageing process most of them are due to a different cause – having lived for a long time.  This is not the same thing.

The more years you live with a bad diet or in an unhealthy environment the greater the likelihood that you will develop a disease. But this is not a result of ageing.

The wake-up call for many people is the diagnosis of high blood pressure or Type 2 diabetes or any other of the modern epidemics is, the kick in the pants, that they need.   Sixty percent of people aged 60 have a condition such as Type 2 diabetes or high blood pressure.  As do more than seventy percent of people aged 70 and above.  And, as the decades increase the percentage of people having more than one condition increases.   But what do we mean by conditions and how do they relate to disease?

Once upon a time diseases were pretty clear-cut! You either had tuberculosis or a broken leg or you didn’t.  However, medicine has changed over the years as the population has aged.  Now we use the word ‘condition’ to mean a state in which your health is impaired or you are at risk of some serious complication, even though you didn’t know you had it until a doctor or nurse told you.

High blood pressure is an example of a condition, so too is Type 2 diabetes.   By this we mean that there is not a sharp cut-off point between people with the condition and people without the condition.  Identifying high blood pressure as a problem is through measuring your blood pressure.  But, doctors and nurses have arbitrary limits about the level of blood pressure. So, when they say, “You have got high blood pressure, I’m afraid.”, what they should really say is, “Your level of blood pressure is such that the increased risk of stroke and dementia is now at a level at which I recommend you consider taking medication to reduce your blood pressure.  Although I have to warn you that the medication itself has side effects.  And although you have never noticed this increase in your blood pressure you may well notice the effects of taking the medicine that I could prescribe to bring it down.”.

This is, of course, quite a long rigmarole but it is something which we are increasingly saying to people. This is to understand that it isn’t a disease they’ve got but a condition. These are conditions of modern life caused by the environment. This environment leads to inactivity which in turn leads to the steady increase in weight that so many people experience from the age of 20 onwards.

But, increasingly the doctor will also say now that “your blood pressure is not dangerously high.  So before offering you drug treatment we would like to offer you a fitness programme. Physical activity, combined with weight loss will bring your blood pressure down to level at which you will not benefit further from drug treatment”

There are, of course, diseases that are still quite distinct and different – rheumatoid arthritis, for example, or heart failure.  But we also need to be thinking about fitness for both conditions and diseases.  Even if these diseases reduce your ability to move and makes it more difficult to take exercise, the scientific evidence is now clear that increasing physical activity is essential. Never more so than after the onset of a disease or condition and is sometimes as least as important as the medical treatment itself.

Some diseases such as arthritis do reduce your ability to exercise, as shown in the figure below. But what we also find that people lose fitness more quickly after the onset of their disease or condition than before it.

Too many people are simply given pills when a disease or condition is being diagnosed.   But not enough are given pills plus advice on exercise!  The medical profession is waking up to this and recently the Academy of Medical Royal Colleges published a major report called Exercise – the Miracle Cure.  Yet, despite this, the focus is still on pills and operations in in too many consultations, too many health centres and too many hospital clinics.

And, on top of this, well-intentioned relatives can add to the problem by their efforts to help. “Don’t you worry about the shopping, ducky, I’ll do that for you.  You don’t want to walk to the shops when it might rain.”  The new facts of life are that walking to the shops, as briskly as you can, is even more important if you have a long-term condition than if you don’t.

Reproduced from Sod Sitting, Get Moving!: Getting Active in Your 60s, 70s and Beyond Hardcover – 9 Mar. 2017 by Sir Muir Gray (Author), Diana Moran  (Author), David Mostyn (Illustrator)To buy a copy click here