The most effective way we can all protect and improve our health is by taking regular exercise.

No medication a doctor can prescribe is anywhere near as good at keeping us well; regular physical activity not only reduces the risk of developing all the degenerative diseases of later life, it is also a highly-effective treatment for most of them.

Walking is one of the best ways of taking regular exercise.

Modern diseases

Over the past century there has been a complete change in the patterns of disease which kill or disable us.

Until well into the 20th century the commoner health scourges included tuberculosis, smallpox, typhus, scarlet fever, pneumonia, cholera and a host of other infections.

Now these deadly diseases are largely a thing of the past and the main threats to health and long life are the degenerative conditions of old age.

In contrast to the infections of times gone by, we are now the victims of obesity, heart disease, diabetes, osteoporosis, stroke and a variety of cancers.

Collectively these are known as non-communicable diseases (NCDs). The risk factor common to all these conditions is lack of exercise!

The long-term result of the NCDs is ill health in later life and frailty in old age. Even if we manage to avoid developing one or more NCDs, lack of exercise and too much sitting about still leads to frailty.

The hallmark for frailty is muscular weakness, which robs us of our mobility, our ability to carry out the activities of daily living and our independence later in life.

The consequences of frailty

Frail people become increasingly at risk of illness and injury. The most dramatic result is falling and causing hip fracture, but even relatively minor illnesses can reduce the ability of frail people to look after themselves and may result in emergency admission to hospital.

Being an inpatient means further inactivity and aggravation of muscular weakness and frailty. It has been estimated that ten days in a hospital bed leads to ten years’ worth of lost muscle mass in people over the age of 80.

Lack of exercise leading to premature frailty has severe consequences both for individuals and for society.

The role of exercise

Frailty and dependence are not an inevitable result of ageing! They result from lifestyle choices, from sitting about too much and moving about too little.

Nearly all the NCDs are caused by or made worse by a lack of exercise. Moreover, nearly all of them can also be treated or improved by taking more exercise.

We should all take action to reduce the chance of developing frailty and becoming disabled by these debilitating conditions. Taking exercise keeps us physically fit and increases both length of healthy life and total life span.

It is not only the body which is helped by exercise. Regular physical activity like walking reduces the risk of depression, lessens stress, improves feelings of wellbeing and helps to ward off dementia.

All of these advantages are also promoted by the social interactions of taking exercise as part of a group.

Which exercise should we take?

It doesn’t matter which exercise we choose, but it should be enjoyable. For many people, the best choice is walking. Walking is something nearly all of us do, mostly because it is the way we get about.

Unlike many forms of exercise, we do not need any teaching to do it. It is a physical activity which promotes physical fitness with all its benefits.

It allows us to enjoy the countryside and, as part of a group, can be a highly-sociable activity. It also costs nothing, except for an occasional pair of walking shoes. What could be better?

How much exercise?

The benefits of physical activity are related to the amount we do: how hard we exercise, how often we do it and how long we keep going.

The government’s written guidelines recommend 150 minutes of moderate exercise or 75 minutes of vigorous activity each week.

When the activity levels of samples of the population are measured they fall well short of the targets, with only between five and ten per cent actually following the guidelines.

For older people, the figures are much lower; fewer than five per cent of over 75-year-olds take as much exercise as is recommended for maintaining good health.

How often, how hard, how long?

The government’s guidelines are broad and helpful but they do not tell us about the benefits of different ‘doses’ of exercise.

The steepest benefit to health comes from increasing from doing nothing to doing just a bit! So if we take no exercise at all, just upping that to, say, a ten-minute walk a day will significantly reduce the risk of becoming ill.

If we want to gain further advantages we must do more: the more the better.

Walking is an ideal exercise to allow a gradual increase in activity level. It can be done at any intensity (speed) and most of us can do it as often as we like and for as long periods as we wish.

Walking is easy to do, fits in well with most people’s daily life, is free and can be a social and enjoyable way of keeping fit.

Walking at a speed that feels comfortable for half-an-hour a day – or even for quarter of an hour twice a day – on five days a week is enough to meet the government’s guideline of 150 minutes of moderate exercise a week.

If we walk very briskly, enough to make us a bit short of breath, just 15 minutes a day gives the recommended level of 75 minutes of vigorous exercise weekly.

For even more benefit this can be increased. It is almost impossible to take too much exercise, though the increase in benefit of the exercise does get lower.

The speed of waking is important. Fast walking reduces the signs of biological ageing more than slow walking. Fast walking is also more effective in increasing physical fitness and reducing the risk of dementia and heart disease.

Finally...

If you are not taking regular exercise, try getting out and just walking! You can do it alone or join one of the numerous local walking groups.

Alton probably has more walking groups than most other places in the UK. The range of choice is enormous and you should find no difficulty in finding walks whose speed and distances suit you.

Finally, keep safe! Wear brightly-coloured outer clothing. Wear a reflector on dark winter days. On roads, walk facing traffic. If you are in a location unfamiliar to you, walk with a companion.

Let’s leave the final word on the subject to Charles Dickens:

The sum of the whole is this: walk and be happy; walk and be healthy. The best way to lengthen out our days is to walk steadily and with a purpose’

Happy new year!

Hugh Bethell

One of the founders of Alton’s innovative Cardiac Rehab Centre