Quebec doctors can now prescribe exercise(cbc.ca)
cbc.ca
Quebec doctors can now prescribe exercise
http://www.cbc.ca/news/canada/montreal/quebec-doctors-can-now-prescribe-exercise-1.3215821
12 comments
> nutritionist, who gave him a diet plan.
> Some months later, he went back to the nutritionist for a checkup, and the nutritionist was shocked that he'd actually followed her plan
"I didn't mean it! You know usually it's just a formality. But, uh, keep up the good work."
> Some months later, he went back to the nutritionist for a checkup, and the nutritionist was shocked that he'd actually followed her plan
"I didn't mean it! You know usually it's just a formality. But, uh, keep up the good work."
The password policy includes not sharing it at the drop of a hat.
yeah sorry, I deleted that part.
[deleted]
>though he complained that he was always hungry.
What a miserable way to live. :(
What a miserable way to live. :(
Depends on what you want. A friend of mine told me he had come to terms with being overweight - he said he preferred being overweight over what it took to be slim.
My father enjoyed his life, and preferred the benefits of being slim.
My father enjoyed his life, and preferred the benefits of being slim.
I've lost a couple dozen pounds through dieting and now am in the keeping it off phase. It's hard because it's not like making progress toward a goal, it's just being hungry all the time. I was less healthy but more happy when I just ate delicious pastry all day long. It's hard to maintain.
A colleague of mine had quit smoking 20 years earlier. I asked him if he still felt the urge to smoke. He laughed and said it was a daily struggle.
He fell off the wagon and resumed smoking some months later.
Beating these kinds of things is a lifelong struggle. I wish you the best in your endeavor.
He fell off the wagon and resumed smoking some months later.
Beating these kinds of things is a lifelong struggle. I wish you the best in your endeavor.
I imagine it depends on the person, as well. I lost 22 lbs ages ago, and I can't say I'm hungry. If anything, I still overeat, I just don't go completely overboard on candy and other junk.
The biggest problem is changing your habits, not so much your food. For example, if I'm home, I'll eat properly, but if I go out with friends we'll end up getting a burger at some point.
The biggest problem is changing your habits, not so much your food. For example, if I'm home, I'll eat properly, but if I go out with friends we'll end up getting a burger at some point.
Sorry, I meant 44 lbs (20 kg). Stupid imperial!
Have you tried upping your fiber intake? I'm not saying it is easy turning away a heaping slice of cheesecake, but I'm never actually hungry and I'm at a very healthy body fat percentage. Whenever I'm hungry and I shouldn't have more calories I just eat carrots, pickles, or an apple. If I over do it the night before I make sure to put some overnight oats in the fridge. That and water and my hunger completely subsides.
It's so obvious it's amazing this hasn't already been a thing since the beginning of the obesity epidemic. Specific exercise instructions are more likely to be followed than a vague admonition to "exercise more". I wonder if gym memberships will be covered as care by health insurance plans? They're certainly a lot cheaper that hospital stays!
I think the problem is that the implementation process -- creating an actual exercise program -- is quite non-obvious. As far as I know, the studies that have been done on the dose-response curves of various exercises have reached somewhat inconsistent results, except that they consistently show significant inter-individual variability for a given tuple of type, dose, and outcome measure (NB: they do not generally show a single unified axis of exercise super-responders and non-responders, a common interpretation of such studies in the news media).
For the general population not trying to optimize performance in a specific sport, the nuts-and-bolts business of "what exercise should I do?" is fraught with bargeloads of pseudoscience, tribal lore, magical thinking, fad-chasing, and actively-amplified marketing nonsense.
And then if, despite the atmosphere of uncertainty, you convince yourself to try something and it doesn't work for you, that method's dedicated acolytes will waste no time in telling you that you must be doing it wrong, must by lying about something, are just looking for excuses to be lazy, and so on.
It's not really an environment that's shaped for success.
For the general population not trying to optimize performance in a specific sport, the nuts-and-bolts business of "what exercise should I do?" is fraught with bargeloads of pseudoscience, tribal lore, magical thinking, fad-chasing, and actively-amplified marketing nonsense.
And then if, despite the atmosphere of uncertainty, you convince yourself to try something and it doesn't work for you, that method's dedicated acolytes will waste no time in telling you that you must be doing it wrong, must by lying about something, are just looking for excuses to be lazy, and so on.
It's not really an environment that's shaped for success.
> For the general population not trying to optimize performance in a specific sport,
Therein lies the solution. Pick a sport you enjoy, do it as many times a week as your schedule permits, but bend your schedule so it's at least twice.
Voila, 2+ hours of strenuous exercise per week.
Therein lies the solution. Pick a sport you enjoy, do it as many times a week as your schedule permits, but bend your schedule so it's at least twice.
Voila, 2+ hours of strenuous exercise per week.
How many sports must one try before being allowed to conclude that "a sport you enjoy" isn't in the cards?
As many as it takes? I don't know ...
Really that's what P.E. is for, they were supposed to have exposed you to many sports so that you could find one you like.
I found boxing because I watched a few boxing movies. Then I decided to try and I liked it. Now here we are 6 odd years later and I'm training four times a week. Still no fights though, probably getting into that next year.
Surely you have some gut feeling about what you might enjoy? How do you find movies or tv shows that you enjoy watching? Or websites you enjoy visiting? How many tries did it take? How many tries did it take to find friends you enjoy hanging out with?
These aren't some deep dark secrets of life. It's just normal everyday stuff. Don't overthink it.
Really that's what P.E. is for, they were supposed to have exposed you to many sports so that you could find one you like.
I found boxing because I watched a few boxing movies. Then I decided to try and I liked it. Now here we are 6 odd years later and I'm training four times a week. Still no fights though, probably getting into that next year.
Surely you have some gut feeling about what you might enjoy? How do you find movies or tv shows that you enjoy watching? Or websites you enjoy visiting? How many tries did it take? How many tries did it take to find friends you enjoy hanging out with?
These aren't some deep dark secrets of life. It's just normal everyday stuff. Don't overthink it.
P.E. did expose me to many sports. I didn't really like any of them; some were more tolerable than others, but that's hardly equivalent to enjoyment. I don't dislike physical activity in itself (though it was practically impossible to maintain any consistent volume before my sleep apnea was treated), and I think I understand at an intellectual level why "people enjoy sports". But empirically the reward processes haven't happened for me.
Anyway, the reason I'm harping on this is that vague, noncommittal advice like "find a sport you enjoy" is exactly the sort of thing that a true exercise prescription ought to be able to avoid. Doctors don't pull out the Rx pad and write down "find an anticonvulsant that works for you".
Anyway, the reason I'm harping on this is that vague, noncommittal advice like "find a sport you enjoy" is exactly the sort of thing that a true exercise prescription ought to be able to avoid. Doctors don't pull out the Rx pad and write down "find an anticonvulsant that works for you".
In that case, just bite the bullet and pick the sport you hate least.
If you want to minimize the commitment: weightlifting is pretty efficient time-wise and effective.
If you want to minimize the commitment: weightlifting is pretty efficient time-wise and effective.
> "It's so obvious it's amazing this hasn't already been a thing since the beginning of the obesity epidemic."
Why is that obvious? Because you think there's a link between being overweight and exercise?
Exercise does not promote weight loss. (You can do a quick google search if you don't believe it.)
The most important thing to influence weight loss is the nutrition.
On a related note, I find it borderline sadistic that we make fat people believe they are fat because they are lazy and don't exercise enough.
Why is that obvious? Because you think there's a link between being overweight and exercise?
Exercise does not promote weight loss. (You can do a quick google search if you don't believe it.)
The most important thing to influence weight loss is the nutrition.
On a related note, I find it borderline sadistic that we make fat people believe they are fat because they are lazy and don't exercise enough.
That is an odd, bold claim to make, that exercise doesn't promote weight loss.
I'm at something of a loss to explain how, without changing my diet, but with adding 30-50 miles of cycling (plus a little jogging) a week, I've been losing around 5 pounds a month for the last six months.
Honest question time: if it isn't the exercise, what is it?
I'm at something of a loss to explain how, without changing my diet, but with adding 30-50 miles of cycling (plus a little jogging) a week, I've been losing around 5 pounds a month for the last six months.
Honest question time: if it isn't the exercise, what is it?
Exercise clearly helps, but it all comes down to energy balance. You can eat less, or increase calories burned through exercise to generally get the scale heading in the right direction. The problem some people have is when exercise increases their appetite to the point where they continue consuming too many calories.
I looked at the article that OP referred to. It's main critique is using exercise instead of diet as a weight loss tactic. The point was that you don't need exercise to maintain a healthy weight as long as the energy balance is there.
On one end of the spectrum, athletes in certain sports can maintain a lean physique while eating insane quantities of calories. On the other end, maintaining a healthy bodyfat is possible in the absence of exercise by nutrition alone.
Exercise comes with its own set of benefits independent of bodyfat, and it sounds like you have chosen to meet your energy balance by increasing calories burned instead of decreasing caloric intake, but it's not the only strategy that can have success.
Sources:
"Can't outrun a bad diet" http://bjsm.bmj.com/content/49/15/967
I looked at the article that OP referred to. It's main critique is using exercise instead of diet as a weight loss tactic. The point was that you don't need exercise to maintain a healthy weight as long as the energy balance is there.
On one end of the spectrum, athletes in certain sports can maintain a lean physique while eating insane quantities of calories. On the other end, maintaining a healthy bodyfat is possible in the absence of exercise by nutrition alone.
Exercise comes with its own set of benefits independent of bodyfat, and it sounds like you have chosen to meet your energy balance by increasing calories burned instead of decreasing caloric intake, but it's not the only strategy that can have success.
Sources:
"Can't outrun a bad diet" http://bjsm.bmj.com/content/49/15/967
> The problem some people have is when exercise increases their appetite to the point where they continue consuming too many calories.
It's very difficult to overeat good exercise with good food.
If your idea of exercise is to sit around at the gym for an hour and do a couple of lifts, that's not gonna help. I've seen a lot of that. People go there for two hours, but only get like 15 minutes of real exercise done.
But if your idea of exercise is to go on a 10k run, or doing a boxing class for an hour ... well those are going to burn around 700 calories. That's a lot of calories for someone who's supposed to eat 2000 a day.
Eating 2700 calories (your normal 2000, plus the 700 you burned) is hard if you're not eating cake and stuff. I personally struggle every day to keep my weight from plummeting because the amounts of food I have to eat are astounding. Especially on the days when I do a 30km run (that burns 2500 calories).
Honestly, it's taken me over a year of sustained effort to train my metabolism to digest these sorts of quantities of food.
And yes, I am an edge case. My point is that you can outrun a bad diet. It will take a lot of running though.
PS: the biggest mistake people make is thinking that weight == health. You can be skinny and still super unhealthy.
It's very difficult to overeat good exercise with good food.
If your idea of exercise is to sit around at the gym for an hour and do a couple of lifts, that's not gonna help. I've seen a lot of that. People go there for two hours, but only get like 15 minutes of real exercise done.
But if your idea of exercise is to go on a 10k run, or doing a boxing class for an hour ... well those are going to burn around 700 calories. That's a lot of calories for someone who's supposed to eat 2000 a day.
Eating 2700 calories (your normal 2000, plus the 700 you burned) is hard if you're not eating cake and stuff. I personally struggle every day to keep my weight from plummeting because the amounts of food I have to eat are astounding. Especially on the days when I do a 30km run (that burns 2500 calories).
Honestly, it's taken me over a year of sustained effort to train my metabolism to digest these sorts of quantities of food.
And yes, I am an edge case. My point is that you can outrun a bad diet. It will take a lot of running though.
PS: the biggest mistake people make is thinking that weight == health. You can be skinny and still super unhealthy.
> (...) if you're not eating cake and stuff.
Ding ding ding. That's the nutrition part. I could easily eat that 700 extra calories by eating pizzas. Hell, I'd probably eat 900 extra calories after a big exercise. (But I would absolutely not run 30 km...)
The problem is that the people eating this stuff are continually being told that they need to exercise more. Then they get hungrier and eat the stuff that you can always eat more. They kill themselves on the treadmill and see absolutely no difference.
Ding ding ding. That's the nutrition part. I could easily eat that 700 extra calories by eating pizzas. Hell, I'd probably eat 900 extra calories after a big exercise. (But I would absolutely not run 30 km...)
The problem is that the people eating this stuff are continually being told that they need to exercise more. Then they get hungrier and eat the stuff that you can always eat more. They kill themselves on the treadmill and see absolutely no difference.
Yeah, I see your point.
Is nutrition really that hard for people? It doesn't take much, just avoid the obviously bad stuff like candy, pastries, and anything non-dry that can stay fresh for over two weeks without freezing.
You don't even have to eschew sweet stuff, just opt for the artificial sweetener. They don't add hidden calories and [probably] won't give you cancer despite what the FUD says.
And in my experience, people who do eat the bad stuff, start craving more real foods when they exercise well. The body needs nutrients and it will ask for them. You just have to listen.
But I'm probably out of touch with how hard this is. It's been years since I started fixing my diet.
Is nutrition really that hard for people? It doesn't take much, just avoid the obviously bad stuff like candy, pastries, and anything non-dry that can stay fresh for over two weeks without freezing.
You don't even have to eschew sweet stuff, just opt for the artificial sweetener. They don't add hidden calories and [probably] won't give you cancer despite what the FUD says.
And in my experience, people who do eat the bad stuff, start craving more real foods when they exercise well. The body needs nutrients and it will ask for them. You just have to listen.
But I'm probably out of touch with how hard this is. It's been years since I started fixing my diet.
You're putting down the weight lifters but I would argue that weights is better than cardio. With weights you build your strength, your muscles then consume more even when not exercising. Too much cardio starts burning your muscle giving you the skinny fat look.
Cardio takes a long time, an hour each day for 5 days is 5 hours. Can burn more at the weights. Unless you do sports that need endurance (MMA, boxing, rugby, …) you don’t need cardio. Strength training will increase your cardiovascular fitness above average.
Cardio takes a long time, an hour each day for 5 days is 5 hours. Can burn more at the weights. Unless you do sports that need endurance (MMA, boxing, rugby, …) you don’t need cardio. Strength training will increase your cardiovascular fitness above average.
Lifting is awesome. But you have to actually do it, not just sit around chatting or lifting at 40% your capacity like I see way too many people do.
If you aren't sweating, you aren't getting a workout.
Coincidentally cardio will make you better at lifting. When I recent got back to lifting for a few months I could power through 20 sets of compound lifts in an hour. By the time I change weight, I'm ready to go because my regenerative capacity is so quick (boxing will do that to you). Back when I was just lifting, 20 sets took over teo hours and the gains were very comparable.
I'd lift more, but it makes me slow.
If you aren't sweating, you aren't getting a workout.
Coincidentally cardio will make you better at lifting. When I recent got back to lifting for a few months I could power through 20 sets of compound lifts in an hour. By the time I change weight, I'm ready to go because my regenerative capacity is so quick (boxing will do that to you). Back when I was just lifting, 20 sets took over teo hours and the gains were very comparable.
I'd lift more, but it makes me slow.
I don't think Swizec was trying to say that cardio is better than lifting, but rather that a high volume of exercise is needed to burn a lot of energy. A lot of people go to the gym, but mostly do it for the social meaning of "going to the gym" rather than actually using that time efficiently on a good workout.
Exactly this.
Fat people are generally fat because of excess caloric intake. The amount of physical (aerobic) exercise needed to even burn off a can of Coke is incredible.
Fat people are generally fat because of excess caloric intake. The amount of physical (aerobic) exercise needed to even burn off a can of Coke is incredible.
A can of coke contains about 155 calories. An average person can do practically anything which is reasonably considered exercise for 30 minutes and burn that off: http://www.health.harvard.edu/diet-and-weight-loss/calories-...
Hardly "incredible".
Research has shown that diet is more critical than activity in the occurrence of obesity, but that doesn't been that activity doesn't matter at all.
Hardly "incredible".
Research has shown that diet is more critical than activity in the occurrence of obesity, but that doesn't been that activity doesn't matter at all.
A coke is ~10% of your daily calorie needs.* It's not that exercise is ineffective it's junk food has stupid high calorie counts plus it's easy to digest. On top of that most Americans have an incredibly lazy lifestyle. If your extremely active and stick with actual food eating enough can feel like a chore.
PS: A coke is also 8 to 24 oz which is a fairly wide range.
PS: A coke is also 8 to 24 oz which is a fairly wide range.
So many gyms are predatory and it just plainly irks me that they ask for such a high price or a long period of membership. It is valuable but I don't think their costs are so high.
I would definitely join a gym if it was deductible or even paid for or had state run facilities. But I guess that's a little too much to ask.
I would definitely join a gym if it was deductible or even paid for or had state run facilities. But I guess that's a little too much to ask.
Go to the YMCA?
In 2014, doctors in Boston were able to begin prescribing a Hubway bike share membership: https://www.bostonglobe.com/metro/2014/03/27/new-program-wil...
In Boston's case, it's a mutually beneficial arrangement for the city: healthier citizens and less traffic on the roads by converting drivers to bikers.
In Boston's case, it's a mutually beneficial arrangement for the city: healthier citizens and less traffic on the roads by converting drivers to bikers.
I'm not sure -- is the increased health contraindicated by the increased chance of injury or death from unobservant car drivers?
The health benefits outweigh the risks [1], if measured by increased life span. This is a relatively common question about cycling.
[1] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2920084/
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Edit for clarity.
[1] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2920084/
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Edit for clarity.
I'm not entirely sure who wins here. The prescription doesn't mean much aside from that insurance will pay fitness-related bills. But exercise doesn't have to cost anything. Even in the most unwalkable cities there's some place you can go to just walk around in.
And who wouldn't doctors prescribe exercise to. If someone comes asking their doctor for an exercise prescription so that they can get a free gym membership, there's no reason for the doctor to say no (save for cases where the patient has a heart disease or similar where regular exercise is inadvisable). Not only will it not hurt the patient, it'll in fact help them. It will also help the doctor as it will help present them as someone who listens to patients and it helps fill appointments.
If this becomes widespread, the result will be more expensive insurance (or in Quebec, higher taxes) and more expensive fitness programs.
And who wouldn't doctors prescribe exercise to. If someone comes asking their doctor for an exercise prescription so that they can get a free gym membership, there's no reason for the doctor to say no (save for cases where the patient has a heart disease or similar where regular exercise is inadvisable). Not only will it not hurt the patient, it'll in fact help them. It will also help the doctor as it will help present them as someone who listens to patients and it helps fill appointments.
If this becomes widespread, the result will be more expensive insurance (or in Quebec, higher taxes) and more expensive fitness programs.
It helps a lot to have a trainer. In fact we should be paying for gym and fitness trainers for pretty much anyone who wants it. The benefits are extraordinary especially in Canada where we all pay for everyone's healthcare.
Yes exercise costs nothing. But it is often repetitive and boring. And in Canada it's cold 1/2 the year so having some place indoors is very helpful and having it paid for is even more encouraging.
We need to make exercise free, fun, and with trainers that work with people. It needs to be like gym in school on days where the gym teacher didn't have a stick up his/her ass... for anyone at any age.
Yes exercise costs nothing. But it is often repetitive and boring. And in Canada it's cold 1/2 the year so having some place indoors is very helpful and having it paid for is even more encouraging.
We need to make exercise free, fun, and with trainers that work with people. It needs to be like gym in school on days where the gym teacher didn't have a stick up his/her ass... for anyone at any age.
The business model of a gym requires that 90% or so of the members never actually show up. The rates charged would have to go up enormously if they did.
An awful lot of garages have a treadmill in the corner buried under other junk, as the resident's good intentions to get in shape inevitably evaporated.
An awful lot of garages have a treadmill in the corner buried under other junk, as the resident's good intentions to get in shape inevitably evaporated.
Even if you made it free, most people still would not show up. But baby steps. Healthcare costs are huge and so are economic costs of sick employees, if they are diverted towards gyms, not much will be lost and much will be gained.
Going out for a walk is free, and few even do that. I doubt free gyms would make a dent.
> fitness trainers for pretty much anyone who wants it
Oh god, yes! I did not realise how much difference it makes. Even just having the time scheduled on the days you'd rather do something else is really helpful. But a person to actually tell you what to do, or just chat with you makes the whole experience N times less boring.
Oh god, yes! I did not realise how much difference it makes. Even just having the time scheduled on the days you'd rather do something else is really helpful. But a person to actually tell you what to do, or just chat with you makes the whole experience N times less boring.
> It helps a lot to have a trainer. In fact we should be paying for gym and fitness trainers for pretty much anyone who wants it. The benefits are extraordinary especially in Canada where we all pay for everyone's healthcare.
This mindset that the government should be spending tax revenue on anything beneficial is bizarre.
This mindset that the government should be spending tax revenue on anything beneficial is bizarre.
> This mindset that the government should be spending tax revenue on anything beneficial is bizarre.
Anything? Did they say that? Health care of citizens is not "anything", it is a very imporant thing. More important than military, guns, flying to the moon, and many other things. So yes, they should be spending the hell of out of that tax revenue to keeps citizens healthy, productive and not have hundreds of millions of chronically sick patients all needing hundreds of thousands of dollars worth of care every couple of years.
Anything? Did they say that? Health care of citizens is not "anything", it is a very imporant thing. More important than military, guns, flying to the moon, and many other things. So yes, they should be spending the hell of out of that tax revenue to keeps citizens healthy, productive and not have hundreds of millions of chronically sick patients all needing hundreds of thousands of dollars worth of care every couple of years.
There's a pretty clear potential for overall net savings, if the cost of providing citizens access to fitness programs is less than the cost of providing additional healthcare to those citizens if they remain sedentary.
Any doctor can prescribe exercise, including doctors in the US. You don't really need a lot of equipment, you don't really need gym membership. The issue is whether or not the patient will be compliant with an exercise regimen, and educating them on the importance of exercise and physical activity in general.
If the purpose of this is to allow exercise during the actual work day - that would be interesting, but would require the cooperation of employers or some type of federal regulation - in the US, maybe thrown under FMLA.
If the purpose of this is to allow exercise during the actual work day - that would be interesting, but would require the cooperation of employers or some type of federal regulation - in the US, maybe thrown under FMLA.
All that is missing now are doctors to give the prescription. (seeing a family doctor in Quebec is really difficult)
Thats great. Yeah, there is a huge difference between saying, go exercise, and giving a prescripted regimen. Hopefully they can start having funded exercise programs in the community or based on the general prescriptions the doctors are giving.
Considering all the problems the Quebec medical industry has at the moment, I still wouldn't trust Quebec with the care of myself or my family. It's such an abusive system.
In Ontario it's not that much better sadly.
I wonder how well this meshes with the fact that a lot of cities aren't built for walking. Walking is in general good, but is it responsible for your doctor to prescribe you an activity that is actually illegal in the area where you live, due to there being no sidewalks and walking on the street being illegal.
Does anyone outside of prison really live in a place where they can not walk as much as they want in a given day?
Even in Alaska in the middle of winter... you can walk around your work or a store or something... seems like a bit much to worry about, no?
Even in Alaska in the middle of winter... you can walk around your work or a store or something... seems like a bit much to worry about, no?
There are fitness clubs and/or access to treadmills everywhere. No-where has any ever said "every-time I try to exercise normally I risk getting arrested" ever.
Can you name some cities where walking is illegal? Or even areas of cities where walking is illegal?
I'm not certain about the illegal part, but plenty of urban development is very unpleasant to walk in. A lot of suburbs and a lot of city centers ravaged by urban renewal are plain repulsive, and even dangerous due to all the high speed traffic, to walk around in. It's easy to say for a doctor to "go walk outside", but not everybody can exit their front door in an area that's welcoming to walking or cycling.
Most suburbs are incredibly easy to walk in. As newish development almost all have sidewalks and are on residential streets.
Are you going to walk to a grocery store? Probably not. But if your goal is walking there is no problem.
Are you going to walk to a grocery store? Probably not. But if your goal is walking there is no problem.
A lot of the ticky-tacky McMansion cul-de-sac developments constructed from about 2000 to the end of the last housing boom in the United States don't have sidewalks. However, in my experience, the streets become de facto multiple use pathways for walking, bicycling, driving, etc.
Sure. And many of the downtowns of car-oriented cities have sidewalks too. Having sidewalks doesn't make it a place people want to walk around in, it just means the developers are complying with zoning rules. For many suburbs in particular (not all, but many), walking around there is like walking around a fishbowl: fine for 5-10 minutes, until you hit a large road lined with strip malls; where you'll turn back. It's just not a place for a person. People won't do it. A colleague moved to to such a newish development. She drives to the park to walk with her toddler. Her "goal" is walking, and she could do it on her street. But she does it in a place that's actually for humans, not for cars. No amount of sidewalks is going to change that. So I disagree completely, it is a problem. Walking may be possible, the bureaucrats saw too that, but it doesn't mean it helps people to do it.
Anyway, I will say, there's a personal preference surely, and I know perfectly happy people who live in car oriented neighborhoods, and couldn't care less about driving everywhere. But I very much think those places are a trap, and they sneak up on you. Elderly people who physically deteriorate, because there is no regular physical activity in their life, and suddenly find themselves at the mercy of their children: they are a burden (and I speak from experience). Children who can't go anywhere by themselves unless they're chauffeured, they are a burden. Many of these neighborhoods are long term liabilities too; the tax base after the first generation has moved out is often not sufficient to keep up all that infrastructure (depends from suburb to suburb). Many municipalities are borrowing for infrastructure maintenance. It is like if you would borrow money to change the lightbulbs in your house. It just means you have too many lightbulbs. The same with our cities, they have too much long term maintenance obligations. Roads and bridges to services all that sprawl are not investments, they are liabilities. And that's nothing to say about the aesthetic affront of these places (Where's your next vacation: Wildwood Estates or whatever it's called. Or downtown Savannah?); the environmental impact (loss of habitat, carbon blah blah); the low-value long term proposition (people store their retirement funds in particle board construction, somehow). Anyway, I'm really just parroting what others have been saying about the suburbs for decades, but I surely believe it. It is a genuinely compelling argument. Car-oriented city development is an experiment that we did not anticipate the long term consequences off. We are starting to see them now. And one of those consequences is that people reject their built environment as a place to move around in on their own two feet. So exercise becomes something optional, something you have to fit in, not something that comes naturally, to the point that we actually need Mr. Doctor to prescribe us our daily dose of moderate physical activity.
Anyway, I will say, there's a personal preference surely, and I know perfectly happy people who live in car oriented neighborhoods, and couldn't care less about driving everywhere. But I very much think those places are a trap, and they sneak up on you. Elderly people who physically deteriorate, because there is no regular physical activity in their life, and suddenly find themselves at the mercy of their children: they are a burden (and I speak from experience). Children who can't go anywhere by themselves unless they're chauffeured, they are a burden. Many of these neighborhoods are long term liabilities too; the tax base after the first generation has moved out is often not sufficient to keep up all that infrastructure (depends from suburb to suburb). Many municipalities are borrowing for infrastructure maintenance. It is like if you would borrow money to change the lightbulbs in your house. It just means you have too many lightbulbs. The same with our cities, they have too much long term maintenance obligations. Roads and bridges to services all that sprawl are not investments, they are liabilities. And that's nothing to say about the aesthetic affront of these places (Where's your next vacation: Wildwood Estates or whatever it's called. Or downtown Savannah?); the environmental impact (loss of habitat, carbon blah blah); the low-value long term proposition (people store their retirement funds in particle board construction, somehow). Anyway, I'm really just parroting what others have been saying about the suburbs for decades, but I surely believe it. It is a genuinely compelling argument. Car-oriented city development is an experiment that we did not anticipate the long term consequences off. We are starting to see them now. And one of those consequences is that people reject their built environment as a place to move around in on their own two feet. So exercise becomes something optional, something you have to fit in, not something that comes naturally, to the point that we actually need Mr. Doctor to prescribe us our daily dose of moderate physical activity.
Highways and streets without sidewalks or suitable verges.
If the road outside your house doesn't have a sidewalk, like in most of America, then you live in a place where it's illegal to walk, since you cannot legally walk on the road. Though technically, you can still do laps around your house, as long as trampling your lawn doesn't impede on the local homeowners' association's rules.
I think everyone has been overly harsh. While walking is not illegal almost anywhere it is nigh on impossible in many countries, for example the UAE. Walking may also be very, very dangerous to be out on the streets due to corruption, reckless drivers, crime, oligarchs, etc.
I imagine that goes down well at an appointment. Someone you might see once a decade or less giving you lifestyle advice.
I am sure it is ignored the same as people who are 200 pounds overweight ignore "You need to lose weight"
On the other hand, this is awesome. Giving them a concrete goal. A lot easier to say "Walk 30 minutes a day, 7 days a week" than "Exercise more"... go exercise!
(Not sure exactly how the cube system works, but it seems more concrete.. maybe it is the exercise version of the calorie?)
On the other hand, this is awesome. Giving them a concrete goal. A lot easier to say "Walk 30 minutes a day, 7 days a week" than "Exercise more"... go exercise!
(Not sure exactly how the cube system works, but it seems more concrete.. maybe it is the exercise version of the calorie?)
Most people aren't in a situation where they can go a decade between seeing a doctor (and it's in Quebec, so the American healthcare exceptionalism doesn't apply)
If that's the case, then people are much unhealthier on average than I'd assumed. What do they visit about?
The total number of people with at least one chronic medical condition is pretty huge (possibly even a majority), which gets obscured because we usually only talk about prevalence for individual diseases/disorders.
That's a tad worrying. I've found some statements to that effect when I did a search on that last night and some stuff about obesity, do you have any sources giving a breakdown tied to individuals (not names, but like person#whatever has X Y Z) so I'm not double-counting?
Once a decade? Everyone in my family gets annual checkups from our family doctor.
How lucky are you! I live in Quebec, and Family doctors are almost non existent for the vast majority of adults, and even infants.
Some months later, he went back to the nutritionist for a checkup, and the nutritionist was shocked that he'd actually followed her plan. He became one of those unicorns who kept the weight off until he passed away 30 years later, though he complained that he was always hungry.