‘Lifestyle is medicine’ but who is the Life Style doctor? - Part I


By John van Heel, EFAA

The WHO and the Health Council developed guidelines for healthy active living and healthy eating. If people have the knowledge about these guidelines, and what they can bring if applying, but also what harm they bring if not, most people would take steps to start a healthier life.

Unfortunately, modern man in western society has an unhealthy lifestyle. Obesity and diabetes have epidemic forms. Diabetes and obesity among the young is increasing alarmingly. The contribution of obesity to the disease burden is almost 10%. Obesity is a major risk factor for chronic illnesses such as diabetes and cardiovascular diseases (Zorg voor Gezondheid RIVM). Obesity is an explosively increasing problem worldwide. The number of people (adults and children) who are too heavy is also increasing fast in Europe. In 1980, 1 in 15 children aged 4 to 14 were obese; this was in 1 in 8 to 9 children in 1997. This has increased to 1 in 5 children in following six years. In the Netherlands, over 1 million people have diabetes (2014), and they are joined by over 70,000 new cases every year. The RIVM predicts that the number of people with diabetes will increase by a third (32.5 per cent) between 2005 and 2025.

Health care is sick.
Modern curative care primarily consists of symptom-fighting measures, because of which health care is increasing unacceptably. In 2005, 68.5 billion euro was spent on health care in the Netherlands, equalling almost 13.5% of the gross domestic product. RIVM calculates that the healthcare cost will be over 200 billion by 2040. Medicalisation is offered as a solution in most cases of chronic illness, because of which people require life-long medication. A diabetes patient costs almost 15,000 euro a year, while the average Dutchman only consumes 4,200 euro for medical care annually (RIVM) and healthy people even less than 1,000 euro a year. Effective primary prevention seems to be the only solution.

Investing in exercise is effective
Pedro Videla, professor of economics at the IESE Business School, indicated the state of affairs of health care costs, threats to society and opportunities for the fitness industry at the European IHRSA conference. He began with “The costs of health care could result in bankruptcy in many countries round 2050. In 1995, already 53% of the American population was obese; in 2005 this had increased to 62%. This is expected to be 90% in 2020. “Every euro spent on more prevention should be spent on exercise” explained Videla. “Every euro spent on cardiovascular diseases and depression yields 7.1 euro. Every euro spent on exercise yields a staggering 13.1 euro (see illustration). “Prevention is the only solution to this problem. You, the fitness industry, can become the health production industry the world needs so badly.” Videla emphasised that our expertise on healthy exercise is our one and only USP we should make much more use of.

Baby boomers
The need for effective prevention is increasing due to greying of the population and improved medical care. Baby boomers are over 50 and medical care is resulting in an increasing age in western society. Life expectancy at birth in the 1950-2007 period has increased from 70.4 to 78.0 for men and from 72.7 to 82.3 for women. Based on an analysis of past mortality trends, Statistics Netherlands believes life expectancy will increase up to 81.5 for men and up to 84.2 for women in 2050 (RIVM). And we all want to age healthily and actively. Because those over 50 are also becoming aware of the importance of exercise, an increasing number of this age group is coming to sports centres. This is, however, just the beginning. I predict that budget clubs will be swamped by young people, aged under 35 to 40, and that regular quality centres will mainly have people in their forties and fifties as their customers.

Fitness as part of the solution
The fitness industry is more than an exercise industry. From the arrival of cardio-fitness and exercising to music, an increased number of people with a specific lifestyle and objectives and/or a specific chronic ailment have found their way to the sports centre.
Fitness is no longer the objective or just a sport, fitness is increasingly becoming a part of the solution. The new combination norm advised by the WHO (World Health Organisation), ACSM (American College of Sports and Medicine) and NISB (Netherlands Institute for Sport and Physical Activity) teaches us that for good physical health, we need to exercise for 30 minutes a day, do 20 minutes of high intensity exercise three times a week and that we have to do six to eight muscle exercises twice a week. This norm stands for good health, but unfortunately, less than 15% of the European population meets this norm. It therefore comes as no surprise that obesity and diabetes are the top common diseases and that prospects are bleak. The 5 x 30 exercise norm is reached through recreational exercise, the fit norm of 3 x 20 minutes intensive exercise a week can be reached through various types of sports and in the sports centre and muscle exercises can be done at the fitness centre, in combination with a diabetes prevention coach, twice a week.