‘Active travel’ pedalers jockeying for health on the roads of London, UK/Wikimedia Commons

Studies offer cheap, easy prescription

Want to live better and significantly increase your chances of living longer?

No problem. Get up off your ass and move at every opportunity.

Researchers from Australia and Denmark last month added to what is becoming a mountain of research showing that those who engage in daily, physical activity stay healthier and live longer.

Reporting in the peer-reviewed British Journal of Sports Medicine, their life-table analysis study calculated that “if all individuals (in the U.S.) were as active as the top 25 percent of the population, Americans over the age of 40 could live an extra 5.3 years on average. The greatest gain in lifetime per hour of walking was seen for individuals in the lowest activity quartile where an additional hour’s walk could add 376.3 min ( approximately 6.3 hours) of life expectancy.”

Their study follows on an examination of what the Brits call  “active travel” published in the peer-reviewed journal BMJ Public Health in July. That study  reported that an examination of the health records of 82,297 Scots aged 16 to 74 years tracked from 2001 and 2018 found that “active commuters (those who walked or cycled to work) were less likely to suffer from a range of negative physical and mental health outcomes than non-active commuters.”

“Compared with non-active commuting,” the study reported, bicycle commuters cut their risks of all-cause mortality by 53 percent, of hospitalization for any reason by 90 percent (despite the danger of being hit by motor vehicles while on a bicycle), of cardiovascular disease (CVD) by 76 percent, of being put on heart medicine by 70 percent,  of death from cancer by 49 percent, of hospitalization for cancer by 76 percent, and of being prescribed drugs due to mental health problems by 80 percent.

“Pedestrian commuting,” the study said “was associated with” a 91 percent lower risk of hospitalization, a 90 percent lower risk of CVD hospitalization or of having a CVD prescription, and a 93 percent lower chance of a mental health prescription.

American lifespans, many might remember, took a big hit during the Covid-19 pandemic that killed so many of those reported to be suffering from “comorbidities” or what were once called chronic illnesses. Many of the dead were suffering from diseases fueled by the sedentary lifestyle that has become a norm in the world’s richest and most comfortable country.

The pandemic might now be largely over, but the latest predictions for the future lifespans of evermore sedentary Americans are not pretty.

Far from healthy

American lifespans are already lagging beyond most Europeans and many Asians, and the lifespan gap is only projected to increase in the years ahead.

“Life expectancy in the U.S. is forecasted to increase from 78.3 years in 2022 to 79.9 years in 2035 and to 80.4 years in 2050 for all sexes combined,” the Institute for Health Metrics and Evaluation at the University of Washington reported at the start of this month.

That’s the good news. The bad news is that the Institute warned that this “modest increase” is expected to lower the country’s global ranking among the 204 countries and territories measured in the ongoing Global Burden of Disease tracking study.

The U.S. was rated 49th in 2022. It is expected to fall to 66th in 2050 behind 43 countries that have already topped the 80.4-year average Americans are aiming for in 2050.

As recorded on the Worldometer tracker, the U.S. is already nearly five years behind countries like Japan, Korea and Switzerland where people walk more and drive less. All those countries now have life expectancies exceeding 84 years. 

Despite the U.S. being a world leader in medical research, the American population isn’t expected to be even close to where those countries are now come 2050. At the moment, the country is only about a year and a half ahead of Cuba and China and is likely to fall behind them by 2050.

This despite the fact that Cuba has been in an economic freefall since the middle of the pandemic.

“A severe economic crisis in Cuba, among the worst since Fidel Castro´s 1959 revolution, has led to shortages of food, fuel and medicine and contributed to a record-breaking exodus of migrants north to the United States,” Reuters reported in the middle of last year, noting that its economy minister offered no hope for a quick fix to the “inflation, fuel shortages, plunging farm production and a cash crunch” facing the island nation.

Then again, maybe that is on some level a good thing. People who can’t afford to drive have to walk, and walking has been shown to be a good thing.

Finnish researchers last year linked walking and cycling to lower levels of circulating C-reactive protein (CRP), a marker for the low-grade inflammation that fosters many major, non-communicable diseases and weakens the immune system.

“Evidence is compelling on the potential of physical activity to reduce circulating CRP levels,” they reported in the peer-reviewed European Journal of Public Health. “Prior studies have suggested that higher exercise intensities and endurance training may lead to the largest benefits, especially in middle-aged or overweight adults. However, high-intensity interval training seems insufficient to reduce circulating CRP levels, at least in populations with metabolic disorders.”

Their findings on active travel proved somewhat surprising in that commuters aren’t usually engaged in high-intensity exercise. Still,  the researchers reported commuting on foot or by bicycle “for at least 45 minutes a day was associated with lower levels of low-grade inflammation.”

Their findings, they added, did align with those of a small Danish trial that in 2017 assigned physically inactive, healthy, overweight and obese participants “to a six-month bicycle commuting intervention. Women had to bike nine to 15 kilometers (5.6 to 9.3 miles) and men 11 to 17 kilometers (6.8 to 10.6 miles) daily. These distances were calculated so that related energy expenditures would be in line with the physical activity guidelines (150 minutes of weekly moderate-intensity physical activity. The trial showed a 30 percent decrease in the cyclists’ CRP levels during the six-month cycling period.”

Many countries in Europe are now aggressively promoting “active travel” both for improved health and climate benefits. Doctors in Sweden have also been prescribing physical activity for 20 years, and the Europen Commission this spring recommended all European member states adopt the Swedish model. 

Active travel is, sadly, not the “thing” in the U.S. that it is becoming in Europe, and though a small number of U.S. doctors are involved with the global but nearly invisible Exercise is Medicine initiative, it can be argued that the majority are mainly “Drug Pushers” as Atlantic magazine headlined now close to 20 years ago.

At that time, reporter Carl Elliot called out the increasingly unholy relationship between physicians and “pharmaceutical sales representatives.”  Since then, pharmaceutical companies have further amped up the heat on sales by taking heavily to the airwaves to pitch potential patients on drugs they should demand from their doctors, as if the doctors were prescribing enough already.

There is no sign this has done much to improve the health of Americans. As MedPage Today headlined last month “Over 50% of U.S. Adults Qualify for Ozempic, Wegovy,” the semaglutide drug first prescribed to treat the country’s epidemic of Type 2 diabetes and later discovered to be an effective weight loss drug. 

“More than 38 million Americans have diabetes (about 1 in 10), and about 90 to 95 percent of them have type 2 diabetes,” according to the Centers for Disease Control (CDC), which warns that being “overweight” and “physically active less than three times a week” are among the major, controllable risk factors.

The agency also reports that less than half of adult Americans now meet the recommended, minimum standard of 150 minutes of moderate aerobic activity per week.

“Almost a quarter of adults report that they do not engage in any physical activity outside of their jobs, and sedentary lifestyles are an important reason that two-thirds of U.S. adults are overweight or obese,” the U.S. Department of Transportation adds.

DOT’s pitch is that by improving bicycle and pedestrian facilities, transportation agencies create opportunities for people to exercise recreationally and build exercise into their daily routine by bicycling or walking to work, shops, and services.”

Unfortunately, little has been done to actually improve bicycle and pedestrian travel in the U.S., and where actions have been taken, they often run into strong opposition from a society suffering badly from motonormativity.

When Anchorage removed a third lane from several downtown streets this summer to create a bike lane and make travel safer and easier for pedestrians on foot or bike during the busy tourist season, the city’s motoring public went apoplectic at the idea this might slow their travel through the area by a few minutes. 

It sometimes seems almost like Americans want to spend the maximum time sitting on their fat asses behind a steering wheel or screen of some sort as they rush toward an early death. Much of the country appears addicted to motor vehicles or hooked on the internet, or in many cases both.

The U.S. Department of Energy has reported that the 64 percent of Americans who drove to work in 1960 had increased to more than 86 percent by 2010 while the percentage walking had fallen from 10 percent to less than 3 percent.

Walking and “other means,” which would include cycling, was down even more from a combined 16.7 percent in 1960 to a combined 4.4 percent in 2010. Some appear afraid to get out of their motor vehicles because of the risk of being run over by other motor vehicles.

“The real and perceived danger and discomfort imposed by traffic discourage walking and bicycling,” some researchers have reported. “Although it can be difficult to measure these effects, observed behavior provides good evidence for these effects.”

A fear-driven America is becoming a never-get-out-of-the-vehicle country.

After Bryn Huxley-Reicher, a policy analyst at the left-leaning Frontier Group, crunched the data available from the Organization for Economic Co-operation and Development and the U.S. Bureau of Transportation Statistics in 2022 to put together a chart of the countries in which people drive the most, he found Americans driving about four-times as much as the Japanese.

His calculations might have been biased high given the Group’s political leanings, but there is no one arguing Americans don’t spend more time behind the wheel than residents of other countries. The data here isn’t as easy to find as you might think, but some countries do track it well.

The Federal Statistical Office for Switzerland estimated that in 2021 the average citizen of that country traveled 30 kilometers per day to work with most of the travel – 20.8 kilometers or about 12.5 miles  – done in a car or truck.

The U.S. Department of Transportation in the same year reported the average American drove 9,729 miles per year for an average just shy of 26.7 miles per day. Or, looked at another way, the average American had driven more miles before lunch than the average Swiss would drive all day.

As for walking, pedometer-measured step counts of Americans done in 2003 found them taking an average 5,117 steps per day compared to the 7,168 of the average Japanese and the 9,650 of the average Swiss.

The study reported the step count in Japan had stayed constant since 1995. U.S. step counts were then declining and, given the small number of people walking to work now, are likely still declining.

“Obesity is a major health concern in the United States with 34 percent of American adults now classified as obese as determined from measured height and weight,” the authors of the 2003 study reported in the peer-reviewed journal Medicine & Science in Sports & Exercise. “U.S. obesity rates have increased over the past 40 year and are generally higher than that in other developed nations. Low levels of physical activity may be contributing to the obesity epidemic. Factors such as a built environment that restricts opportunities for walking and bicycling, heavy reliance on personal automobiles, declining occupational activity, and increased time allocated to sedentary leisure-time pursuits are contributing to physical inactivity.”

The consequences for American lifespans were not mentioned, but are now becoming obvious. Up-to-date studies on how much Americans are walking today are hard to find, but the CDC thoroughly tracks the obesity rate. The agency in September reported that 23 states, Alaska among them, now have obesity rates over 35 percent with only eight states under 30 percent and many of those close to that mark.

Obesity is directly linked to metabolic syndrome which is in turn linked to shorter lifespans. We are, it would seem, our own worst enemies in the country. But there is a cheap fix:

Get up, turn off this computer, and get moving.