The Miracle Pill:
Why a sedentary world is getting it all wrong

Peter Walker

Simon and Schuster 2021
A book review by Danny Yee © 2021 https://dannyreviews.com/
The Miracle Pill is a broad-ranging explanation of the importance of physical activity for health and well-being, based on conversations with scientists, public health experts, and politicians; Peter Walker also describes using modern sensor technologies to track and measure his own movement. The focus is on the United Kingdom, but a range of other countries and cities and local governments also feature.

"The Long Decline of Everyday Movement" goes back to the Neolithic, but focuses on how everyday life has become steadily less active over the last century or so. This is not a matter of personal choice, and urging people to take up sport or gym-going is not a solution.

"Small Doses Have Big Impacts" explains how exercise can improve everything from fat concentrations to all-cause mortality, reducing the risks of various cancers, type 2 diabetes, dementia, and so forth. Even small amounts of exercise can have significant effects: "there are remarkably few circumstances under which being physically active for even slightly longer, or a bit more vigorously, will not do you some good".

"The Man Who Discovered Movement" is essentially biographical. It centres Jerry Morris and his key 1953 article in The Lancet, "Coronary Heart Disease and Physical Activity of Work", but also looks at Ralph Paffenbarger in the United States.

In "The Tidal Wave: How Inactivity is Bankrupting Governments", the negative effects of inactivity are approached from a social perspective, stressing the public health costs, on social care as well as the health system. Conditions such as type 2 diabetes may not kill people, but are expensive to manage.

"Without concerted, significant, interventionist action at a national political level, the sorts of universal health and social care systems many millions of people take for granted could effectively be gone within a generation"

"Towns and Cities on a Human Scale" looks at some of the possibilities for incorporating activity into everyday life: the potential of cycling (the subject of Walker's earlier book Bike Nation), the need to end the hegemony of cars, lessons from Jan Gehl and Copenhagen, and Vienna's emphasis on the female experience of the city.

"Being Slim Isn't Enough: Why Inactivity and Obesity are Different" explains that weight largely depends on diet and is poorly connected with exercise, but that being more active improves health regardless of weight — and may even be more important.

"Your Everyday Life is Dangerous" explains that sitting is bad for health and that it is possible to be active but at the same time sedentary — with an active commute to a desk-bound job, perhaps. It touches on different kinds of sitting (television watching seems to be particularly bad) and attempts to change work practices through such measures as standing desks and walking meetings.

"Youth, Age, and Why Activity Matters Lifelong" emphasizes the importance of physical activity for children and the problems with sedentary school days; for older people, physical activity will not only extend life but massively improve its quality and reduce risks of cognitive decline. (Some simple tests for evaluating balance and strength are described.)

"The Power of Social Engineering" presents some case studies: how Finland managed to reduce coronary mortality in North Karelia in the 1970s, Parkrun and other attempts to address child inactivity in Britain, and Slovenia's childhood physical activity programs.

And in "So What Now? A New Era of Health" Walker talks to some politicians about possible options as transport returns to normal when lockdowns lift. He also summarises his experience with technology and re-emphasizes the importance of everyday activity.

It is not a "how to" book, but each chapter of The Miracle Pill ends with a note suggesting simple things people can try themselves. The last of these recommends letting politicians know about support for active travel, and Walker has a strong public policy focus throughout; The Miracle Pill does an excellent job of combining individual and social perspectives.

July 2021

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Related reviews:
- Peter Walker - Bike Nation: How Cycling Can Save the World
- books about health + medicine
%T The Miracle Pill
%S Why a sedentary world is getting it all wrong
%A Walker, Peter
%I Simon and Schuster
%D 2021
%O hardcover, notes, index
%G ISBN-13 9781471192524
%P 312pp