Intended for healthcare professionals

Reviews Soundings

On their high horses

BMJ 2006; 333 doi: (Published 14 December 2006) Cite this as: BMJ 2006;333:1277

On their high horses eating fish and chips


Loefler debates the basis of society’s preoccupation with risk
reduction [1]. Unfortunately, the waters of his debate are muddied with
regard to several issues.

Inequalities in the socioeconomic framework of our society means that
health promotion is most beneficial to those of higher socioeconomic
status, who forgo short-term self-gratification as they realise that the
impact of adopting health-promoting traits will have a beneficial effect
in the longer term.

Risk taking may indeed be an attribute of the successful, but this
need not apply to all facets of their lives. Indeed the more successful
one is, the higher the socioeconomic group they are in, and the less
likely they may be to take part in risky health behaviours.

Loefler wonders why mountaineering and horse riding are not vilified
in a similar fashion to eating fish and chips in front of the television.
Eating fish and chips is an adaptive response to a sedentary environment
that we have created. It should be criticised because of its risk on
cardiovascular and overall health. Although mountaineering has its
dangers, these will be partly offset by its health-promoting attributes. A
solution to this might be to make mountaineering an adaptive response by
plunging ourselves into the hills on a regular basis. I would certainly
advocate this approach, but then again, I am no horse-rider!

[1] Loefler, I. Soundings: On their high horses. BMJ 2006;333:1277

Competing interests:
None declared

Competing interests: No competing interests

17 December 2006
Michael V Holmes
SHO in A&E
Royal Free Hospital, London, NW3 2QG