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The role of exercise in promoting good general health, and helping to prevent heart disease, strokes and diabetes is well established. No wonder, then, that long‑distance running keeps growing in popularity. Popular tracks and parks have never been busier, with groups in stretchy Lycra and fitness trackers on their wrists. The internet is awash with exercise videos, while figures earlier this year showed that gym memberships have climbed to a record 11.5m. The 16.9% of people aged 16 or over in Britain who belong to a gym is one of the highest proportions in Europe.
The older teenagers and young adults of generation Z are a key demographic behind this social trend. And recent news from the world’s biggest cancer conference, in Chicago, shows how right they are to take the health benefits of fitness seriously. A landmark trial compared the outcomes of patients in several countries who were placed on a programme of structured exercise – assisted by a personal trainer – with those offered standard health advice.
The results showing that exercise could be as effective as drugs, without the side-effects, in preventing the recurrence of colon cancer, were described by Prof Sir Stephen Powis, the national medical director of NHS England, as “really exciting”. The expectation is that the study will influence treatment guidelines worldwide – including in the increasingly fitness-conscious UK.
But there is another narrative about exercise in Britain that is hard to reconcile with the one above. This is that we are a chronically unwell, overweight and sedentary population, whose health problems are only partly linked to the Europe-wide demographic challenge of ageing. These difficulties are widely recognised to be psychological as well as physical, with particular concerns around the worsening mental health of children and young people, which is widely linked to the rise in smartphone use.
Which of these accounts of British fitness habits is more accurate depends which segment of the population is being scrutinised. Government figures show that the age gap – with 16- to 24-year-olds the most physically active age group – is not the only one. There is also a significant socioeconomic disparity. Students and adults in managerial and professional jobs are much more likely to keep active than manual workers or people who are long-term unemployed. As with other indicators of health, such as weight or smoking, there is a clear correlation with income. Richer people with more education and higher social status are more likely to be well.
Could gen Z buck this trend with its more general embrace of fitness, which some point out is far cheaper than pub-going? It is too soon to be sure. Some young people believe their gym-going habits are as much about economic insecurity and status anxiety as they are about commitment to health.
But as ministers finalise their 10-year plan for the NHS, which is expected to place a strong emphasis on prevention, they have an opportunity to build on, and shape, the way that exercise is offered and experienced. That being physically active is good for you is reinforced by the latest cancer study. But a preoccupation with personal appearance can be debilitating. A public health approach to exercise should seek to maximise the gains and minimise the harms associated with fitness culture.
