For the past two weeks we have been trekking through the prestigious Himalayan mountain range to Everest Base Camp.
Thankfully we all made it, and sure learned a lot along the way about what truly constitutes healthy living in the local people here.
We also passed through many villages, unreachable in anyway other than foot. So to be able to live here, the local people have adapted in some quite astonishing ways.
As shown in some of the images above, these people carry in excess of 2.5-3 times their bodyweight (120kg+), for 8+ hours per day, up the mountains, at altitude, often in flip flops on very challenging terrain.
I simply had to experience it myself.
The postures these folks have adapted to is a great example of what our body is capable of if our culture and society dictates we require it too. I did a brief search for the rates of pain and injury in these people which unsurprisingly has very little data. This 2018 paper did ask 246 farmers of the nearby district Bkahtapur where they feel pain or discomfort and not surprisingly they reported aches and pains in all the major body areas we see in the west, including the most frequent complaint being the low back (36% of the sample). 1 There was no consideration for disability however to show how these complaints affect their ability to participate in their work or activities of daily living. From my experience I would suspect that the alternatives to a very swift return to earning money are limited and that the people here simply have to return as soon as possible.
It wasn’t just amazing spinal tolerance and capacity we witnessed, see the video below for the bilateral ankle pronation that was completely normal for this person and many others we saw. Interestingly only 13% of the sample in the above paper reported ankle or foot pain! A fantastic demonstration of us humans as non-linear complex systems. There is no one 'correct way' we should do almost anything, including walking.13
Looking beyond the impact of pain, perhaps one of the most striking things we saw was how the people here were so happy with apparently so little (or did they have everything?).
From a research perspective, we know that for the greatest burden on healthcare in the western world it is difficult to beat exercise as our prescription. Yet, we also know that there is no superior exercises to another and it is very difficult to find an exercise more effective for back pain than walking.2,3,4,5,6,7,8,9,10,11,12
One of the criticisms of prescribing ‘walking’ however is that it just isn’t that sexy. This trip has served as an experiment to see if we can sex walking up a little.
Perhaps having a really motivating end goal is what we need to inspire us to get out walking and active. Our trip to Nepal was something we started paying for 12 months ago as part of an organised payment package. This way, normal folk like us can afford this sort of trip that many perceive to be financially out of reach.
High background activity (walking 8+ hours a day), limited food intake (exclusively vegetarian) replicated blue zone cultures and on average we each lost a stone. We did not see overweight locals, excessive weight is simply not conducive with the lifestyle. Anything we can learn here and apply ourselves back home? Maybe.
We are already looking at our adventure for 2020 to start planning this summer, which is looking like a trip to Africa and Mt Kilimanjaro but before then, we have a 42 mile cross Wales walk on 22nd June 2019.
Walking, more inspiring than once thought perhaps, the evidence certainly supports it, both for pain and weight loss.
Best get to it, maybe see you there!
Luke R. Davies & the #B2Rhealth team :)
Mahto, P. K. and Gautam B. (2018). Prevalence of Work Related Musculoskeletal Disorders in Agricultural Farmers of Bhaktapur District, Nepal, International Journal of Occupational Safety and Health, 8(1), P.3-7.
Hurley, D. A. et al (2015). Supervised Walking in Comparison with Fitness Training for Chronic Back Pain in Physiotherapy: Results of the SWIFT Single-blinded Randomised Controlled Trial, Pain, 156(1), P.131-47.
Shnayderman and Katz-Leurer, M. (2013). An Aerobic Walking Programme Versus Muscle Strengthening Programme for Chronic Low Back Pain: a Randomised Controlled Trial, Clinical Rehabilitation, 27(3), P.207-14.
Park, S. M. (2019). Walking more than 90 Minutes / Week was Associated with a Lower Risk of Self-reported Low Back Pain in Persons Over 50 Years of Age: A Cross Sectional Study Using the Korean National Health and Nutrition Examination Surveys, Spine, 19(5), P. 846-852.