
The Guardian view on fitness: evidence of the benefits of exercise keeps growing, but who is listening?
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.

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Telegraph
an hour ago
- Telegraph
Royal College of Pathologists comes out against assisted dying
The Royal College of Pathologists, which represents medical examiners, has come out against assisted dying. It said it could not support Kim Leadbeater 's Terminally Ill Adults (End of Life) Bill because of the role that it was expected to play in the assisted dying process. Under the Bill, assisted deaths will not be automatically referred to a coroner, which is usual practice for potentially unnatural deaths and when a drug, authorised or otherwise, brings about death. This will mean that it is for medical examiners to scrutinise assisted deaths. The professional body that represents them says that they are not qualified to do so and warn that a lack of resourcing means that medical examiners may be pulled away from other parts of their vital work. Ms Leadbeater on Tuesday defended not involving coroners in the process. She said there was 'no justification for putting the family and loved ones of the deceased through an unnecessary and potentially traumatic coroner's inquiry' because adequate safeguards were in place. It comes as the Bill returns to the Commons for a debate on Friday, and a vote on the legislation is expected next week. Dr Suzy Lishman, senior adviser on medical examiners for the Royal College of Pathologists, said that the college had no position on the 'ethical issues' of legalising assisted dying. In a statement, Dr Lishman said: 'The college's concerns relate only to the involvement of medical examiners after an assisted death has taken place. 'As part of their scrutiny, medical examiners would need to review the process leading up to the decision to authorise an assisted death and the circumstances of the assisted death, which they are not qualified to do. 'Notification to the coroner following an assisted death would ensure independent judicial review, which is particularly important given the concerns raised by many individuals, organisations and medical royal colleges about the lack of adequate safeguards in the Bill for vulnerable people. 'Lawyers, not doctors, are the most appropriate professionals to review these deaths. The medical examiner system was implemented to detect problems with medical care, not to identify discrepancies or malintent in the legal process required for assisted deaths.' Dr Lishman also raised concerns about the need of 'significant' training and resources needed for medical examiners to be able to perform the role in the process. She said that this would risk 'potentially taking medical examiners away from their current important role'. The Royal College of Pathologists concluded: 'Coronial referral for assisted deaths would be in line with current regulations, with all deaths due to a medical intervention or medicinal product being notified.' Last year, Thomas Teague KC, the former chief coroner for England and Wales from 2020-24, expressed concern about the lack of coroner involvement in the Bill. In a letter to The Telegraph, he wrote: 'Since the coroner's jurisdiction affords a powerful deterrent against misfeasance, the public may wonder why the Bill proposes to abandon such a robust safeguard.' A letter signed by around 1,000 doctors from across the NHS published this week said that the Bill is a 'real threat to both patients and the medical workforce'. They said: 'We are concerned that the private member's Bill process has not facilitated a balanced approach to the collection of evidence and input from key stakeholders including doctors, people with disabilities and other marginalised groups.' The Royal College of Pathologists is the latest royal college to come out against the legislation, after the Royal College of Psychiatrists voiced their opposition to the Bill last month. Ms Leadbeater said: 'The Bill does not prevent any assisted death being referred to a coroner, however this would not be required in the majority of cases. 'Coroners investigate deaths that have been reported to them if they think that the death was violent or unnatural, the cause of death is unknown, or the person died in prison or in custody. None of these would apply to a legal, assisted death under the terms of this Bill. 'Eligibility for an assisted death would have been assessed in advance by two independent doctors and a multi-disciplinary panel overseen by a commissioner who would be a High Court judge or retired judge. 'Each of these assessments would be subject to the extensive safeguards contained in the Bill to protect everybody, including the most vulnerable. 'Consequently, most cases would not require a judicial investigation after a person has died, and there would be no justification for putting the family and loved ones of the deceased through an unnecessary and potentially traumatic coroner's inquiry. 'However, in the event of any doubt at all, it would be open to a medical examiner, a family member or anybody with concerns to ask a coroner to investigate.'


Daily Mail
3 hours ago
- Daily Mail
Cash strapped NHS board to cut nappies for newborns in bizarre bid to slash costs
Bosses at a cash-strapped health board are to axe the free provision of disposable nappies in maternity wards – to save just £8,000 a year. Executives at NHS Grampian decided parents of healthy newborns can foot the bill for the absorbents as they struggle to manage the board's budget. The development comes despite the fact a study last month revealed the board had the highest-earning manager in Scotland's public health service. Scottish Conservative MSP Tess White MSP said: 'It's a measure of the SNP 's chronic underfunding of NHS Grampian that they've axed the provision of nappies for newborns. 'With NHS Grampian paying a medical director a whopping £242k a year, making him the highest earning NHS manager in Scotland, new mums will rightly question whether huge wage bills at the top should be prioritised over the needs of patients.' NHS Grampian needs to reduce a deficit of £23million but the anticipated savings form the nappies would amount to just 0.035 per cent of the total required. Other planned belt-tightening proposals include the reduction of services over public holidays while spiritual care would also be scaled back. Last month, it emerged that the health board has been escalated to stage four of NHS Scotland's National Performance Framework amid concerns over finances and governance. Holyrood ministers decided to step up scrutiny at NHS Grampian after it needed a loan of more than £67million to tackle overspend. Documents put before the board tomorrow (Thu) say about the nappies: 'This proposed saving relates to discontinuing the provision of disposable nappies for all well babies born in Aberdeen Maternity Hospital, Dr Grays Hospital, Inverurie Community Maternity Unit and Peterhead Community Maternity Unit. 'Note that a reusable nappies voucher is provided in the baby box supplied to all pregnant women in Scotland by the Scottish Government.' It goes on to say the proposal has 'potential negative impacts' as it could be seen discriminatory against babies or pregnant women and it would impact those on lower incomes. However, to mitigate the lack of kit in maternity wards it adds: 'It is intended that pregnant women will bring their own supply of nappies for their babies who are born well and not admitted to the neonatal unit.' The paperwork clarifies the move would not affect babies who require special-sized nappies that are admitted to the neo-natal unit. But the overall savings from the move are understood to be in the region of just £8,000 a year. In 2024, NHS Grampian welcomed around 4,800 babies. On average each newborn needs up to 10 nappies a day putting the annual requirement for the health board to around 50,000 per year. In January 2022 a consumer website said the average price of a nappy was 14.6p and allowing for inflation it could now be around 16p costing NHS Grampian the total of £8,000. A recent study by the campaign group Taxpayers' Alliance (TPA) revealed the health board manager earning most in Scotland in 2023/24 was Paul Bachoo, acute medical director and portfolio lead (surgery and clinical support) at NHS Grampian, with a total remuneration of £242,500 – enough to pay for the nappy provision for the next 30 years. A spokesman for the National Childbirth Trust, or NCT, warned of the impact on new parents and said: 'The early hours and days of having a newborn can be a challenging period for parents, and postnatally the NHS has a responsibility to support new babies. 'Parents may have arrived in hospital unexpectedly, following a traumatic birth, or may not have arrived with a packed birth bag with newborn nappies. 'Offering a supply of free to access nappies is an essential item in the immediate hours after birth, and giving parents a moment to catch their breath, and find the appropriate nappies for their baby upon discharge from hospital.' Critics said the move to axe the free provision of nappies is just the latest example of the Scottish Government's failures over the National Health Service. Scottish Liberal Democrat leader Alex Cole-Hamilton MSP said: 'Health board budgets are facing the squeeze, but cruelly snatching away nappies that don't even cost much is hardly the way to deal with it. 'What's next? Cots and blankets? 'The Scottish Government should be working with health boards to devise a proper strategy to ease these budget pressures. But as usual, the SNP are failing to step up and deliver for our NHS.' Scottish Labour health spokeswoman Jackie Baillie added: 'Right across Scotland NHS boards are being forced to make difficult choices as pressure mounts on frontline services. 'The SNP has taken NHS Grampian into special measures so it is directly responsible for these cuts. 'This cut will take a toll on new families and barely make a dent on the board's eyewatering deficit. 'The SNP must work with Health Boards to ease the dangerous financial pressure on local services and protect patients.' Shimeon Lee, policy analyst at the TaxPayers' Alliance said the plan to cut disposable nappies was a 'poorly targeted move which will save very little' when top bosses were paid such large amount. He added: 'Recent TPA research found that the NHS wastes hundreds of millions on electricity and postage costs, highlighting where trusts could make better use of their resources. 'Instead of penny pinching from babies, the health bosses should focus on meaningful efficiencies to cut costs.' The NHS Grampian paperwork also warns that any increases in costs would minimise the impact from the planned savings. It adds: 'There are a number of risks associated with the financial recovery plan for 2025/26 which would leave NHS Grampian with no flexibility to manage any in year cost pressures that arise.' A spokesman for NHS Grampian said the 'board is being asked to approve those savings at the meeting on Thursday'. Health Secretary Neil Gray said: 'The Scottish Government has received the financial recovery plan from NHS Grampian and we will continue to work with them as they work towards a position of financial sustainability. Our expectation is that proposed savings are proportionate, while also protecting frontline services. 'As part of the escalation to Stage 4 of the NHS Scotland Support and Intervention Framework there is a programme of enhanced scrutiny and support from the Scottish Government. I am confident that, through these actions, we will soon have a clear plan to stabilise the system and set the right conditions for the necessary, longer term transformational work – with the key aim being to ensure the sustainable delivery of high quality healthcare services for the benefit of local people.'


The Sun
3 hours ago
- The Sun
I still wake up in the night panicking I haven't given Derek his meds – stress of caring for him left me needing surgery
CARING for someone you love is a tough, relentless and, very often, such a lonely task. But it is also a privilege that all carers embrace. 7 7 Looking after my husband Derek — who died in January 2024 aged 56, four years after being left seriously ill from Covid — was one of the greatest honours of my life and I wish I was still doing it today. The children and I were so grateful he had survived despite the terrible damage the virus had done to him, and that with the help of doctors, nurses and professional carers we had the chance to give him the best life possible. Being a carer, its joys and its responsibilities, stays with you even after you have lost the person. I still wake up in the middle of the night panicking that I haven't given him his medicine, or that I have forgotten to move him every hour to prevent the painful contractions in his limbs. The next second I realise he no longer needs that care. There is a moment of relief — that I did not let him down — before a tsunami of sadness hits. Caring takes over your whole life. You don't begrudge it, but you suffer because of it. A report by non-profit organisation Carers UK this week reveals that 58 per cent of carers struggle to look after their own health. Four in ten have cancelled medical appointments to prioritise the person they look after and 1.2million live in poverty, including 400,000 in deep poverty. Almost half of adults who have looked after a loved one have physical or mental problems as a result, with seven in ten living with long-term conditions afterwards. That works out as 10.7million people whose lives have been turned upside down and left with serious health problems. I was one of the lucky ones, with hugely caring family and friends and supportive employers, but the harsh reality is that my own health still suffered. One day in November 2022, I was heading to Good Morning Britain when I woke up with searing chest pain. I could barely move, but I forced myself into the car. On the way in, I threw up. By the time I arrived at the studio, something was clearly wrong. Dr Hilary told the producers to call an ambulance. Instead of going on air, I was in hospital, wired to machines, with doctors fearing a heart attack. Thankfully, it was not. It was what they described as a 'heart event'. The stress of fighting for Derek to get the support he needed along with the physical demands of being a primary carer 24 hours a day was such a strain that my body was feeling the effect. And there were other signs too. Missed appointments. No time to rest. My autoimmune thyroid condition — neglected during Derek's illness — has now worsened significantly. Surgery now looks likely. It could have been avoided. During a three-week gap in care, while the system tried to work out which agency should give Derek the life-saving care he needed, I had no choice but to try to get through looking after Derek 24/7 completely alone. How could the only answer be to abandon someone who couldn't move, couldn't safely be left alone — but was fully aware and trusted me — to God knows what, just to have a cry for help answered? By the end I was so sleep-deprived I was scared it was no longer safe — for me, for the children, let alone for Derek. In desperation I called health services again and this time refused to get off the phone until some answer was given. In the end, the person on the other end of the phone, who was also clearly exhausted, told me, 'There is nothing I can do but — and this isn't official — you are not alone and what I always say to people is take him to A&E and leave him there, then they legally have to do something.' I knew she meant well but how could we have come to this? How could the only answer be to abandon someone who couldn't move, couldn't safely be left alone — but was fully aware and trusted me — to God knows what, just to have a cry for help answered? 7 7 PLEASE HELP HELPERS By Grace Macaskill MILLIONS of people throughout the country are struggling under the weight of looking after loved ones. According to a new survey, almost half of carers have seen a decline in their own mental and physical health. Research by Carers UK also found that four in ten current or former carers – equivalent to 10.7million people – put the health of disabled, older or sick relatives before their own. This leads them to skip medical appointments, tests, scans or therapy because they are unable to get someone to look after the person they are caring for. Carers are also more likely to suffer health problems, with 70 per cent dealing with issues compared to 59 per cent of the general population, according to last year's GP Patient survey in England. Helen Walker, chief executive of Carers UK, said: 'Sadly, caring for someone often comes at a personal cost and carers still face significant inequalities. If you are caring for someone it's likely that you will experience poorer health, financial strain, challenges accessing employment and education opportunities and be at greater risk of loneliness and isolation. 'It can be a negative cycle for many carers who experience worsening physical or mental health and are unable to take a break to look after themselves. 'The impact of this can be long- lasting, but we know that change is possible – from the Government investing more in support for unpaid carers and the NHS having clear measures of help for carers, to rights at work and support within education.' I didn't take him, I just couldn't, physically or morally. Final straw I got through another day somehow until a family member took time off their work to come — and we got through. But others are not so lucky. And they are simply breaking and fearing even worse is to come. I have more friends than ever taking on caring roles. And my own mum is now caring full-time for my dad following a stroke, and they are both in their eighties. There are millions out there in far worse situations than I found myself in. Carers UK has raised serious concerns about the Government's proposed welfare changes, particularly reforms to Personal Independence Payment. If eligibility becomes stricter, many carers could lose vital financial support and their Carer's Allowance. These changes could affect up to 150,000 carers, with losses of more than £8,000 a year per household. For many, barely surviving, that would be the final straw. Carers are the backbone of this country — but are being broken under the weight. They are doing the work of a second NHS. Silently. Without pay. Without recognition. Every day, 12,000 more people become unpaid carers. And every day, 600 workers leave their jobs to care full-time. Britain depends on an army of unpaid carers who save the country £184billion a year — more than the entire NHS budget. But who is caring for them? This week is Carers Week and, just as the Chancellor prepares to give her spending review today, investment in the sector is at an all-time low. So my message to Rachel Reeves is: Please do not forget the carers. Put them at the heart of your plans. Invest in their health, give them real support and recognise the vital role they play. When you support carers, you take pressure off the NHS, you keep people out of hospital and you help get them home — where they want to be, where they belong. Carers are not asking for praise. They love what they do. They are just asking not to be forgotten. Not now, not again, and not when they are holding up the very fabric of our country with their bare hands. 7 'SERVICES TERRIBLY LACKING' MUM-OF-TWO Suzanne Buckner works round the clock caring for THREE members of her family. Her 18-year-old daughter Lottie is deaf and has diabetes and tumours in her liver, her son Freddie, 24, has autism and a personality disorder, and husband Mark, 63, suffers from clinical depression. Educational consultant Suzanne, 58, of Three Mile Cross, Berks, says: 'Things can get overwhelming at times. 'Lottie needs more traditional nursing like injections and medicines, while Freddie could be trashing the house having a meltdown and Mark could be non-verbal because he's depressed. Yet there's so little help out there. 'Lottie should have got help from social services as a child but wasn't given any. "She's been so isolated. Freddie gets an access-to-work grant for his job as a mechanic but we have to apply for that every month. It used to be online but now it all has to be done by post. 'When he was at school, they couldn't cope with his issues and I had to set up my own school. 'Mark has been sectioned twice and had CBT treatment but the mental health services are terribly lacking. 'I can go from special educational needs to mental health caring to nursing all in one day. Some weeks are just exhausting.'