Live to 100? Maybe we all stand a chance if we listen to Devi Sridhar

The Herald Scotland

2 days ago

The world and social media are brimming with influencers doling out the latest in longevity advice. Often they are wellness bros and millionaires, like tech entrepreneur Brian Johnson, offering tips on supplements, fasting techniques, ultimate diets and exercise regimes, from a position of privilege.
Devi Sridhar, most famous perhaps as an advisor and commentator during the Covid pandemic, is not in that mould, but nevertheless her book, How Not to Die (Too Soon), coming with its acknowledgement that she would like to live to be 100, tackles the same question.
'I think my point,' the University of Edinburgh professor says, 'is actually have we been looking at this the wrong way? I'm very frustrated by this whole tech approach, the self-help literature of just like think yourself well.'
'A running theme for me is time and resources. It's a very privileged perspective that people will have an hour or two to go to the gym during the work week or that people don't have caring responsibilities that mean that actually they can't build in time.'
Last month, in the run up to The Herald's Edinburgh series, for which I focused on the city's transport issues, frequently touching on active travel, I spoke to Sridhar. I'd previously interviewed about her work as an advisor and commentator during the Covid pandemic, but on this occasion the subject was her latest book, How Not To Die.
I knew she was an advocate of movement, active travel and exercise. Even back then, in the aftermath of the pandemic, Sridhar had spoken about her interest in wider public health issues, particularly around exercise and chronic disease, and also of her plans to qualify as a personal trainer – which she has now done.
This newsletter is chiefly about energy and environment, but of course part of that is how we move through the world. Active travel is one of those concepts in which public and individual human health and planetary health meet. We may cycle, walk or, but we may also do it for our own fitness – and luckily in one swoop we can contribute to both.
Active travel is a win, win, win – the only possible proviso being that as we structure our environments more around active travel, we ensure that those who can't so easily cycle or walk are also included.
Sridhar recognises the way these impacts crossover. 'So much of the stuff that causes climate change actually causes health problems. So almost I feel like the framing for low emission zones should have been less about environment and more 'You're affecting your own health. Don't think about fifty years down the line or what's happening with the climate; it's actually like what's happening in terms of your risk of having various kind of health issues.'
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How Not to Die (Too Soon) draws attention to what Scotland has been doing right as well as wrong. Free tap water, strong gun control laws, relatively good air quality, free bus travel for young people, a leader in anti-smoking laws, a National Health Service that, though straining and imperfect, does provide for all. She is particularly enthusiastic about the free bus travel. 'Get young people using the buses, walking thinking, I can get around my whole day. Why would I get a car that costs money?'
Sridhar also mentions a recent cancer scare. 'I'm completely healthy now,' she says. 'My cancer was treated. I guess my take-away from it was how lucky I was to have access to NHS Scotland and that I didn't have to worry about cost or is there a doctor which would be relevant in so many other places if I lived including the States.'
But, on Scotland, it's not all positive. The country, she points out, is struggling on diet, obesity rates, chronic disease, preventive care, and mental health provision. This is, after all, the home of the Glasgow Effect, the drug death capital of Europe.
Though Sridhar is now herself a personal trainer, an advocate of working on 'the triangle of flexibility, cardio and strength', she doesn't believe that exhorting people to get down to the gym or the sports centre is what is needed. Rather, our society and environment need to be structured to make moving around the easy and obvious choice.
'It's how,' she said, 'do you get your whole population moving? I don't think we should call it sport, we should just call it moving. And I think that's where maybe we need to change it to being like you're sporty or you're not sporty.'
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'We need a mainstreaming of the idea that there are other forms of being active. If you really like being outside, which can include walking on the beach for an hour, that can be just as good for your body as playing basketball or something where you might feel like that's beyond my comfort zone.
Sridhar's interest in physical exercise was nurtured early, during childhood in the United States. Her father was very into sports, and, she says, 'felt that he didn't want me or my siblings falling into that kind of traditional gender roles or even immigrant kind of roles.
'And because he spent a lot of time doing sport, I ended up being in places that were sporty. And so whether you like it or not, you ended up having that kind of ingrained.'
'The answer I came to from looking at other places is that you have to kind of make it invisible, accessible and something you just don't have to plan your day around. You walk to the bus stop, you walk back. You can cycle easily and sometimes you may think, 'Oh, cycling's faster than driving because of the lanes.'
Those places she looked at included, unsurprisingly, Amsterdam, but also Paris which is making great strides towards becoming an active travel city. 'A lot of it comes down to their relationship with vehicles and being like can I have a path because if you create a path that's separate completely like physically separate, you do see rates going up, it's not it's not that people don't want to cycle.
'People are scared of cycling on busy streets because the biggest risk to a cyclist is a vehicle, and it's not because drivers are bad intentioned or want to hit a cyclist. It's because of how you design the road and the road safety system, bearing in mind that people do make accidents like humans are prone to error. You can't design a system where you assume that it will work perfectly.'
Having physically separated lanes, rather than just a painted line, makes, she points out, a huge difference.
She also doesn't want to see this pitched as a war between cyclists and motorists, since many people are both. 'People want to do both. They're like, I want to be able to drive if I need to drive, or there's elderly people or children or pets and they need to move. So I feel the framing needs to be more around options, more around freedom. Take a car if you need to take a car. But don't be forced to take a car.'
One answer to the challenge of healthier populations is how we design our cities – and a fitter city is one that makes active travel, moving around on one's own steam, the simplest choice.
'Whether it's kids walking to school or parents walking to work or ever, and they will do it generally in the simplest way for them. So then it becomes a design problem of how do you make that the simplest solution and the safest solution?
She also tells a story of how cultures can change. The Netherlands for instance wasn't always the cycling friendly country it is now but only became so in the 1970s, following what began as a parents' campaign around road safety.
'Culture isn't static. It's not that places are like, you're just culturally that way. Places evolve and they change. People say the Dutch like to cycle. Well, they like to cycle because the city's built around cycling. If you build it, they will come.'
How Not to Die (Too Soon) by Devi Sridhar is published by Penguin.