Peter Walker 

The Miracle Pill: How we must avoid a sedentary lifestyle

We are bombarded with images of fitness and sport, everything from the sculpted torsos of reality TV shows to stories about cycle races and ultra-marathons. But at the same time, four in ten British adults, and 80% of children, are so sedentary they don't meet even the minimum recommended levels for movement. What's going on? 

We speak to Peter Walker, author of The Miracle Pill, to understand what a sedentary life is, what the effects can have on our overall health and wellbeing, plus how we can put steps in place to avoid it. 

This Miracle Pill is a chronicle of this very modern and largely unexplored catastrophe, and the story of the people trying to turn it around. But it also offers readers an empowering individual template for change - as well as, for some, a wake-up call that their lifestyle might not be quite as healthy as they believe. There is also a chance to win a copy of the book at the end of the interview.

Thank you for taking the time to talk to me. I must admit, the subject of your book ’The Miracle Pill’ is one that both fascinates and frightens me in equal amounts. As someone who seems to be tied to a desk for numerous hours in the day, how concerned should I be about being sedentary?


Without wishing to start with an arguably pedantic answer, there's two perils to think about here – sedentary living and inactivity. The first is sitting down too long, while the other means not pushing your body into at least some type of exertion often enough. A lot of the risks are similar, but they're separate. And yes, sitting down for very long periods every day does bring a greater chance of long-term illness. The good news is that if you're sufficiently active elsewhere in your life, a lot of the risks from sitting are mitigated. You can also improve the odds by regularly breaking up your seated day, standing up or walking around every 20 minutes or so.

What are the knock-on affects of an inactive life?


Over decades, physical inactivity (and sedentary living) bring greater risk of a whole medical textbook-worth of conditions, everything from cardiovascular disease and strokes to high blood pressure, type 2 diabetes, some cancers, long conditions, even greater chance of depression, and later in life of Alzheimer's and other types of dementia. Plus, of course, more risk of dying young. 


How did it get to this situation?


To an extent, the world has become less active in part for very valid reasons. A lot of the everyday exertion people would have got a couple of generations ago are things we're glad to be rid of, like hand-washing clothes, or beating rugs or chopping wood for the fire. Transport is another area where a lot of physical movement has gone, not always for the good, with huge numbers of even tiny, one-person journeys done via car, rather than walked or cycled. One issue is that governments have put all this onto individual responsibility, when a lot of the change is structural. People haven't suddenly got lazier, they just live in a world where movement has been designed out of life.

When we look at the major advances in technology, are our children and grandchildren in even more danger of slipping into a sedentary lifestyle?


Technology definitely plays a role. For example, in recent years even the everyday exertion of walking to a restaurant, or to a cinema, has been obliterated for many people with the rise of app-summoned takeaway food and streamed films. But the modern world's bias against movement goes way beyond gadgets. For example, think about the last time you were in a hotel or office block. The lifts would be have been obvious – right in front of you. But finding the stairs would probably involve hunting down a corridor for a fire exit, hoping the door isn't alarmed, and then the risk of ending up trapped in a windowless stairwell. It's not exactly intuitive.

What impact could this have on the NHS and is this the next global health pandemic?


The impact on the NHS is already here, and it's huge. Researching the book, I spent a day with two senior doctors overseeing admissions to a big teaching hospital. This was just before Covid, and they told me that the majority of the patients they saw, sometimes almost all of them, had ailments connected to inactive living. They also both agreed that without some fairly urgent action, mass inactivity will fairly soon make the NHS as we know it unviable, as million of people live for decades in increasingly poor health. This pandemic is already here – inactive living is responsible for an estimated 100,000 deaths a year in the UK, every year.


Why do you think this health emergency doesn’t get as much coverage?


You can understand why Covid prompted such massive government action. By contrast, inactivity is not transmissible, it takes decades to have an impact, and the effects are secondary – it's not an illness or condition in itself, but instead makes other ailments more likely. Politicians are aware of it, and regularly promise action. But nothing much ever happens, at least in the UK.

Are there any early signs we need to look out for?


I think it's less a case of looking out for warning signs than just being mindful of how much – or little – activity we're doing. The good news is that what you might call the dose-response curve for activity is extremely steep at lower levels. Even ten minutes of brisk walking has an immediate impact on, say, reducing your chances of developing type 2 diabetes. And even if you have been diagnosed with a condition linked to diabetes, it's not too late. One of the doctors I spoke to, a diabetes specialist, had a patient whose type 2 diabetes went into remission after he changed his job. He had become a postman, and the daily walking transformed his health.

"Even ten minutes of brisk walking has an immediate impact on, say, reducing your chances of developing type 2 diabetes. And even if you have been diagnosed with a condition linked to diabetes, it's not too late."

With the current Covid pandemic in mind; many of us are spending more time at home, and only being able to exercise for an hour a day - what should readers be aware of, and introduce to create a less sedentary life?


One of the key messages of the book is that while formal exercise – going to a gym (in non-lockdown times) or for a jog – is obviously great for you, for many people it's hard to maintain. The real way to embed activity is to make it part of your everyday routine. In more normal times, this could involve trying to walk or cycle to work, school or college, or even parking your car a ten-minute walk from the office. In lockdown things are tougher, especially when we're allowed just this one outdoor period a day. But you can try various tricks, for example working from home with an impromptu standing desk, like putting your laptop on a pile of books on a table. Or try walking to a shop to cary groceries home. As well as aerobic exercise, activity guidelines stress that people should carry weight regularly.


If you could make any policy changes, or introduce one thing into an individuals life, what would it be?


The slightly boring answer is that it depends on the individual. I asked a very eminent US academic about the best activity choice, and his answer was: "The one you'll do and keep doing." More specifically, if they are possible then active travel – walking and cycling – is an amazing way to get more activity into your life.

The Miracle Pill by Peter Walker (Simon & Schuster)

RRP: £ 16.99 (Hardback)

Click below to buy a copy and for a chance to win.