Back to Roots, Blue Zones & Walking in the Himalayas - Everest Base Camp 2019

For the past two weeks we have been trekking through the prestigious Himalayan mountain range to Everest Base Camp.


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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 walked anywhere from 10-25km per day

We walked anywhere from 10-25km per day

Through one of the most stunning landscapes on Earth…

Through one of the most stunning landscapes on Earth…

We passed many yaks. (Thats Everest peaking through in the middle)

We passed many yaks. (Thats Everest peaking through in the middle)

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.

Having this neck strap and awkward weight on just for a few moments was a very humbling exposure to normal life for these people. I took a video (below) of a porter carrying heavy planks down a very tricky bank. Check it out!

Having this neck strap and awkward weight on just for a few moments was a very humbling exposure to normal life for these people. I took a video (below) of a porter carrying heavy planks down a very tricky bank. Check it out!

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.

There is no correct way to walk
— Guccione et al (2019)

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?).

By age 8, this lad will be able to operate almost all the required duties to run his household, tells Padam, our guide. Family orientation is something central to the longevity of Blue Zone living.

By age 8, this lad will be able to operate almost all the required duties to run his household, tells Padam, our guide. Family orientation is something central to the longevity of Blue Zone living.

The people here grow up symbiotically with the animals they work. A ‘purpose’ each day that makes getting up important.

The people here grow up symbiotically with the animals they work. A ‘purpose’ each day that makes getting up important.

Almost every village we passed welcomed us with something similar to this…..

Almost every village we passed welcomed us with something similar to this…..

Ignore the cute picture of the baby yak, the video shows an elderly lady working hard to produce her families food, background exercise and an integral connection to the food she will eat.

Calling for all researchers to provide us evidence for something superior to walking for chronic back pain. We are still looking.
— Paul McCambridge, B2R director (2019)

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

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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.

Group stop off for tea, lunch and take in the views.

Group stop off for tea, lunch and take in the views.

Some of the B2R team taking a moment, after reaching the bottom of a (very large) mountain.  Left to right: Asbjorn, Rhys and Luke.

Some of the B2R team taking a moment, after reaching the bottom of a (very large) mountain.

Left to right: Asbjorn, Rhys and Luke.

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.

High background activity, limited (vegetarian) food and on average a stone lost each.
— Blue Zone living

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 :)

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REFERENCES

  1. 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.

  2. 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.

  3. 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.

  4. Hendrick et al (2010). The Effectiveness of Walking as an Intervention for Low Back Pain: a Systematic Review, European Spine Journal, 19(10), P. 1613-1620.

  5. Milosavlievic, S. et al (2015). Walking Away from Back Pain: One Step at a Time - a Community Based Randomised Controlled Trial, BMC Public Health, 14(144).

  6. O’Connor, S. R. et al (2015). Walking Exercise for Chromic Musculoskeletal Pain: Systematic Review and Meta Analysis, Arch Phys Med Rehabil, 96(4), P.724-734.

  7. Hancock, M. J. (2016), Prevention of Low Back Pain: A Systematic Review and Meta Analysis, JAMA International Medicine

  8. Walking Away From Back Pain (2013) Tel Aviv University, Newsroom.

  9. Lee, J. S. and Kang, S. J. (2016). The Effects of Strength Exercise and Walking on Lumbar Function, Pain Level, and Body Composition in Chronic Back Pain Patients, J Exerc Rehabil, 12(5), P.463-470.

  10. Babatunde, O. O. et al (2017). Effective Treatment Options for Musculoskelal Pain in Primary Care: A Systematic Overview of Current Evidence, PLoS One, 12(6).

  11. Walking and Strength Training for Back Pain: No Difference (2016). Ingram, Pain Science.com Health Blog.

  12. 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.

  13. Guccione, A. et al (2019). A Dynamical Systems Approach to Movement Systems as Emergent Phenomena, Physical Therapy, 99(1), P.3-9.