GOLD STANDARD                                             Richard J B Willis

Inspite of the fact that Great Britain managed to get 9 gold medals in the Olympic Games which puts it joint ninth on the medal winners' list it fails to get into the top 10 golds per million of the population.  Kudos goes to Bahamas at 3.125 GPM, followed by: Norway 1.099, Australia 0.851, New Zealand 0.792, Hungary 0.787, Cuba 0.761, Jamaica 0.721, Greece 0.540, Sweden 0.451, and Georgia 0.375.

As Dr Alan Maryon Davis says, '… despite our marvellous medal haul, the great British population seems to be moving in the wrong direction.'  Statistics in the latest General Household survey shows that the number of people engaging in physical activity continues to fall, and is most marked in the 16-19 age groups where we might have expected the greatest physical activity.

Sports pitches, gyms and games areas have never been so good or so prolific as at the present time yet so underused.  Goethe's observation that 'Knowing is not enough, we must apply, willing is not enough, we must act,' is more than apt.  With all the varied sports fixtures and their publicity we certainly cannot say that we do not know, so it must be an unwillingness to apply that holds us back!

Many claim to be willing to participate but still do not act.  The biggest purchases for the home are often exercise machines which are ultimately disposed of as they take up too much houseroom.

It is not only exercise that suffers from our ambivalent attitudes.  The government has seen fit to remind us of our need to lower the intake of sugar, fat and salt, to quit smoking and to reduce alcohol intake.  The fat in children's lunch boxes has increased by 3gm over the past year.  After sandwiches, crisps were found in 69 per cent of lunchboxes, along with biscuits and chocolate bars (58 per cent of lunchboxes), with cereal bars coming in at 29 per cent.

Although we know that smoking kills we still allow over 2M people in the UK to work in places that allow smoking throughout the workplace, and another 10M (38 per cent of the workforce) to work where smoking is allowed somewhere on the premises.  Second-hand smoke in the workplace is estimated to kill 700 people a year, three times the number killed in industrial accidents.

Lloyds pharmacies introduced a free in-store glucose testing service starting in June of 2003.  Already they have screened over 500,000 people for type 2 diabetes.  Of those people referred to their GPs 72 per cent had either type 2 diabetes or elevated blood glucose levels.  A different survey – The Euro Heart Survey – showed that 58 per cent of the 4,900 people with heart disease surveyed had diabetes but did not know it.

So what more is it that we need to know before we apply, how more willing must we be before we act?  The National Institute for Clinical Excellence (NICE) continues to turn out guidelines for doctors and for patients.  Must we wait for these guidelines to push us into action, or by acting can we set our own gold standard?  Here is one area where we can all be winners.