How to bounce back from the ‘deconditioning pandemic’
Lockdown has left many out of shape physically and mentally, but some simple steps can help us get fit for summer, says Maria Lally
Earlier this month, the Duchess of Cornwall praised her 71-yearold husband for being “as fit as a mountain goat” and leaving others “miles behind” on long walks.
But what about the rest of us? As we emerge into a slightly more normal world, months of lockdown have had a deconditioning effect on millions of older people, according to Sir Muir Gray, a visiting professor in the Nuffield Department of Primary Health Care at the University of Oxford, and Dr William Bird, who both wrote in the British Medical Journal about a looming “deconditioning pandemic”.
According to Dr Bird, an honorary senior lecturer in environment and human health at the University of Exeter, midlifers are likely to have become deconditioned in two ways over the past four months.
“There has been a physical deconditioning caused by reduced activity, but also a mental one caused by fear and fewer social connections,” he says. “We already know it only takes a four-day hospital stay for the deconditioning process to start. Although lockdown hasn’t been quite as dramatic as a spell in hospital, the effects are similar.”
Dr Bird points to a report published by the Academy of Medical Royal Colleges in 2015 called Exercise the Miracle Cure, which explored the dangers of inactivity. “While rest plays a vital role in recovery, what emerged in the report was that when hospital patients were treated quickly, but left in bed waiting to be discharged, something called deconditioning syndrome began.”
Whether people have been in hospital with Covid-19 or not,
Dr Bird and Prof Muir say that among older people, especially those who have been shielding, lockdown may have triggered the same syndrome.
“It may even be due to something as simple as wellmeaning family members or neighbours offering to do your shopping every week,” says Dr Bird. “There’s a saying that if you want somebody to become weak and die, do everything for them.”
This is because muscles are an important organ in their own right, he adds, and maintaining them is important in preventing ageing and frailty. If you lose muscle mass you age rapidly and become more prone to disease.
“Muscles even deal with sugar metabolism, and play a role in diabetes prevention,” says Dr Bird. “Muscle mass declines naturally with age, but there’s plenty you can do about it. While a 60-year-old can’t regain the muscle tone of a 25-year-old, they can stop the decline from being so steep.”
The single most important thing is exercise, says Dr Bird, who says it even trumps diet, Sudoku, and avoiding other age accelerators such as stress and loneliness (more on these later).
“As they get older, many people slow down, but studies show you actually need more activity as you age. People with underlying health conditions also need more activity.”
Therefore, Dr Bird says, functional fitness is a good place to start: lifting shopping bags, rather than getting others to shop for you or doing online shops, gardening, walking, pottering, doing exercises at home that use your own body weight, for example, squats or planks or push-ups. And Pilates.
“Older people need not to be sedentary,” says Dr Bird. “There’s a huge amount of literature that says they need 150 minutes of exercise every week. Pre-lockdown Sport England figures showed that older people were more active than ever, whereas 20- and 30-somethings, who were commuting and sitting in offices, were doing less. But within four months, lockdown seems to have reversed this. Months at reduced levels of activity will have an impact on all four aspects of physical fitness – strength, stamina, suppleness, and skill.”
Earlier this year, Sport England published research that found people aged 55 to 74 were increasing their activity levels. However, when lockdown began, the over-70s were advised to be particularly stringent in following social distancing measures. So many stayed at home.
Dr Bird says that while precautions must still be taken in the war against Covid-19, it’s important to remember that physical inactivity also kills people and has a direct effect on mortality through its impact on cardiovascular disease, diabetes and cancer.
“The second part of the deconditioning process is a mental one,” he says. “Many older people have the fear factor when it comes to going to shops or restaurants. They may have fewer social connections than before. Then there’s fear and uncertainty around jobs, pensions and house prices.”
He explains that when we’re fearful or anxious, we’re less likely to be active: “It’s evolutionary. Lockdown has caused many of us to eat more and move less, because our bodies are designed to conserve energy in times of stress.”
Getting a handle on stress is, almost as important as exercise, according to Dr Bird. “It’s important to appreciate that a loss of cognitive and emotional well-being as a result of isolation and loneliness will increase the risk of dementia. And the three main ways to maintain mental well-being are community, nature and purpose.”
First, you need a community of people around you, whether that’s family, friends, neighbours or colleagues. This has been difficult in lockdown, but there are ways around it; socially distant walks with friends, for example, and as lockdown eases, staying in touch becomes even easier.
“Secondly, connect with your surroundings. Humans have always been affected by their surroundings and there are health benefits linked to spending time in nature, including increased activity and more robust mental health, even if it’s a daily walk around your village or nurturing a window box. Feeling a sense of belonging to where you live alters brain waves and helps the brain deal with stress.”
Lastly, we need a sense of purpose, which can be difficult if you’ve been furloughed or are shielding. “If that is the case, take up some courses; learn to cook or start a project in your garden. Volunteer in your local area, even if it’s just helping a neighbour. If you feel useful, you’ll feel less depressed.”
Dr Bird and Prof Muir predict that if we don’t take action now, the coronavirus pandemic will be followed by a deconditioning pandemic, which will have its own health drawbacks. “Winter is 15 weeks away and if it’s a bad one, if we have a second wave, it will knock us for six. We need to make a concerted push now to get ourselves fighting fit.”
So starting from this week, we’re bringing you a six-part summer reset plan devised by husband and wife team Luke and Jo Gray, from Living Retreats. Luke, a 60-year-old personal trainer, and wife Jo, 50, a nutritionist, have worked with footballers, athletes, and retail guru Mary Portas.
“We’ve seen the news about a potential second wave taking hold throughout winter, when people in midlife will be more vulnerable,”
‘Many people slow down as they age, but studies show they need more activity’
‘We need to be in the best condition to face a possible second wave of the virus’
says Jo. “So we all need to be in the best possible condition in the coming months. Typically, this time of year I have clients wanting to get into shape to fit into summer clothes, but now their reasons are more serious; it’s about assessing their health, losing weight and building up their immune system so it’s as strong as can be. And it’s easy. It only takes 20 minutes of simple exercises a day and some simple lifestyle tweaks.”
Luke says people can start off the plan from different levels of fitness: “We have a female client who is 77 who can hold a plank for six minutes, and a 73-year-old man who can do 68 pressups in a row.
“But we also see people with families and busy jobs who come to us in their forties or fifties, who haven’t done any proper exercise in the last 20 years. It can benefit everybody, so in your later years you’re more likely to be diseasefree, mentally young, happy, resilient and strong.”