Friday, February 15, 2013

Green(?) prescriptions

In keeping with the government's commitment to not dealing substantively with major issues, today Health Minister Tony Ryall told a waiting nation that exercise was still - STILL! - the best medicine.

The best medicine for what, we found ourselves asking. Mr Ryall explained: "The government wants more New Zealanders being physically active to help improve their health and that’s why a record thirty six thousand people were issued with a Green Prescription for exercise, an increase of nearly ten thousand compared to 2008." 

A 'green prescription' appears to be where you go to the doctor to get some assistance to lose weight and the doctor tells you to do some exercise. It's not particularly green unless all those patients start eating rabbit food as they are undoubtedly advised to do. Oh yes, and this bogus tripe has the advantage that it doesn't cost the government any money.

And a one and a two....shake that thang...
Now there's no denying that most New Zealanders could stand to get a bit more exercise, especially those of us who can't even turn our heads to look when we drive because we're too fat. But the reasons people are overweight is way way more complex than simple indolence.

Most weight problems in developed countries arise from what we're shoving into our gobs. Sugar, fat and processed carbohydrates are the main culprits, especially in the lethal combinations found in junk food. If Tony Ryall wants people to lose weight and improve their health, he should be issuing press releases urging people to give up soft drinks and candy bars. But wait! This is a government who couldn't wait to eliminate food standards in schools when they got into government in 2008, has already tried to ditch the Fruit In Schools programme, and has dismissed almost any form of food labelling. In other words, they're letting the fast food industry do what they want and are hoping like heck people will work the excess off.

Except that they won't. The link between exercise and weight loss is weak at best. While it's true fat Olympians are reasonably rare, most lesser mortals don't have the resources to work out full time while someone else supports them financially. More importantly, exercise makes people hungrier so they eat more, and can have unintended consequences for people's metabolic rates (ie their bodies adjust so they continue to store energy). And there are plenty of people in South Auckland who are technically overweight but are active in social sports such as touch or volleyball. The Mr Ryall's of the world are doing the rest of us a disservice by equating 'lean' with 'healthy'. An active overweight person generally (ie on a population basis) has better health than a lean couch potato.

This problem (because it is a big problem in several respects) also needs to be seen in the light of the lives people lead. Many overweight people work unsociable hours that mean the only food available to them when they knock off is greasies and shakes. Who, working 30 hours per week for $13.85 per hour (that's right, Mr Ryall's office cleaner) can afford steamed chicken breast with pasta garnished with rocket salad? And get it a 2 o'clock in the morning? Is Mr Ryall seriously suggesting his office cleaner should add to her load and commence an exercise regime so she loses weight?

There is no doubt that the diabetes tidal wave is well on its way but let's be realistic about how we can start to manage it. We could begin by having the Mr Ryall's of the world not being afraid to step on the toes of multi-national death merchants. Start by limiting advertising junk food to children, introduce a traffic light food labelling system, and think about how people on low incomes can start to afford good quality food on a regular basis. Green prescriptions are not even a band aid: for most overweight people they're a false promise.