KEY POINTS:
Peter Snell has picked up two honours on his trip from his home in Dallas, Texas to New Zealand without running a step. He's in Opunake, the Taranaki town of his birth, for the unveiling this morning of a statue commemorating his Olympic successes.
As a middle-distance runner, Snell won three Olympic gold medals in the 1960s and was consequently voted New Zealand's athlete of the century.
But it's his work as a scientist with a special interest in health and aging where he has since made his name.
Massey University last week conferred on him an honorary doctorate in science. For the past year he's collaborated with the university's projects on health, nutrition and fitness. A special focus has been the impact of diabetes on Polynesians.
"We live in an era where the infectious diseases have been conquered and now it's the degenerative diseases [that confront us]. With those, we can't see what's going on until there's an event - a heart attack or a stroke."
Adult-onset diabetes is prominent among them. Its incidence is steadily rising compared with cancer (flat) and heart disease and stroke which are slowly declining owing to recent emphasis on prevention.
Snell is dedicated to pushing the prevention message, emphasising how to limit the risk of diseases such as adult-onset diabetes. It's a global problem of particular concern to New Zealanders, especially Polynesians who are genetically prone to the disease. Maori, for example, didn't have the genetics to enable them to handle foods such as sugar.
The fast-food culture is a stumbling block, says Snell, but you can greatly improve your chance of avoiding adult-onset diabetes, and other degenerative diseases through diet and exercise. Reducing consumption of saturated fats and carbohydrates and getting more exercise counters obesity and improves insulin sensitivity.
Lean meats and seafood - especially the traditional Maori fare of eel - which are high in omega 3 fatty acids are recommended. Snell says New Zealand has a natural advantage over the United States in that beef here is fed grass rather than grain and so has a higher content of fatty acids.
Fatty acids and degenerative diseases may seem a long way from the world of elite athletics where a split second can be the difference between success and failure, but says Snell, science is an equally competitive, cut-throat environment. "It can be vicious," he said in a recent interview. "Scientists can be very territorial and there is a pecking order."
Snell, who has more than 60 published papers on his resume, is an associate professor at the University of Texas Southwestern Medical Centre, where his area of special interest has evolved into exploring how to be healthier, older; the so-called third age.
He began his academic career pursuing his interest in how to improve athletic performance but early on he was put in charge of a "wellness" programme (preventive medicine) for staff. "That involved educating them in lifestyle strategies aimed at preventing the onset of illnesses such as heart disease, things that are now standard - controlling blood pressure and keeping cholesterol down.
"You want to be in your third age not having to spend your retirement funds taking care of your health."
At 68, Snell, says he's old enough to walk the talk. One of his books, Use It or Lose It, is a guide to a healthy old age. "The title doesn't only refer to muscles. [The book] is about preventing some of these degenerative diseases and keeping your body and mind tuned up. I tried to lay out the rationale for that and to explain that you don't have to have the usual problems of old age. People over 70 can live pretty active, healthy lives. A goal I have is not to need to take medication. It's shocking to me to see the medicines people are having to take to control various conditions, many of which can be helped with good diet and exercise."
His academic career has been spent in a country that tops the list for obesity, pill-popping and quick-fix remedies that are no real fix at all. Disillusioned? "I think it's awful. Prevention is critical. Healthcare in the United States is very good but not everyone can afford it and it's getting more expensive."
As the cost of healthcare rises, employees' health becomes more financially relevant to companies that subsidise employees' health insurance and that may result in corporations taking measures to promote healthy lifestyles among staff.
Snell commends the New Zealand Government's initiative of "green prescriptions". Run by Sport and Recreation New Zealand (Sparc) and backed by Pharmac, it encourages doctors to write prescriptions (on a green form) for exercise. The rationale, says Snell, is that people tend to listen to their doctors and therefore may be more likely to do the exercise if it's prescribed by a medical practitioner.
Sparc senior health adviser Diana O'Neill says 86 per cent of doctors have written green prescriptions and in 75 per cent of cases walking is the activity prescribed. The main barriers to its success are limited time available to doctors and motivation on the part of patients. Many doctors are dealing with the first by assigning the task to practice nurses who have more time to build a rapport with patients, while once a prescription is written a regional sports trust is assigned to contact the patient monthly to monitor and encourage.
The scheme, which is 10 years old, has taken time to get buy-in from a mainstream health industry geared to reacting to sickness rather than promoting wellness.
Busy doctors get most of their information from drug companies and are therefore most likely to prescribe a drug, says Snell. With stomach ulcers, drug companies made a fortune selling antacids when it was a bacterial problem such drugs couldn't cure.
"The doctors where I am [Dallas] feel it's very difficult to get patients to change their lifestyles but doctors also don't have time to work with the patients and they'd rather prescribe something and get them out of their office. It's hard to say this without being critical but it seems to be a lost art for doctors to spend time with their patients. Some are employing nurses to do that which is a positive trend."
A greater barrier is the motivation for an individual to change their lifestyle. "When I give talks I try to emphasise the consequences because you don't notice anything going wrong even though your blood sugar and insulin are elevated. The damage is being done but you don't know it until you start to lose your eyesight or you need a toe cut off or your kidneys no longer function so well."
By then, changing to a healthier diet and adopting an exercise regime is a little too late, he says, whereas if you recognise the warning signals you can do something about it. "When you start to get organ damage the horse is out of the barn, as they say."
His own background as an athlete doesn't make it easy to maintain a healthy lifestyle, "I could be fat very easily. I have to work at it. I'm motivated by competitive activities and I see those as exercise opportunities." He plays squash, competes periodically in orienteering events and cycles. "I'm doing it because I know I've got to. Once you start to lose muscle mass and fitness, it's very hard to get it back."
While he's been fit all of his life and exercises to maintain that, it's those who have done little who stand to make the greatest relative gains.
"If you've done nothing for years then you can only benefit from even a modest amount of exercise."
He commends schemes such as Massey's 10,000 steps programme, where the university provides step counters as a motivational tool.
Snell cites his friend Auckland resident and author Garth Gilmour as an example of the benefits of exercise and a sensible diet. "Garth's in his 80s and he still rides his bike. He's very alert and he's helping me wrap up my biography."
Gilmour wrote No Bugles No Drums, which covered Snell's feats on the track.
The new book, to be published by Penguin later this year, details Snell's transition from athletics track to laboratory, from failing School Certificate at his first attempt to a 34-year career as an academic.
Phillip and Jackie Mills, owners of the Les Mills World of Fitness gyms, are other athletic Kiwis going into print (Fighting Globesity: A practical guide to personal health and global sustainability, in bookstores in July) with their health prescription. Like Snell, they don't advocate magic potions or crash diets but offer guidelines to developing good exercise and eating habits - what they term "energy out" and "energy in".
The Mills cite dramatic figures showing modern Western lifestyle creates obesity-related illnesses. We work more, exercise less, make poor food choices, get fat and sick. They quote a New York Times report that in some of that city's suburbs 50 per cent of residents had obesity-related type 2 diabetes. More than 30 per cent of Americans are clinically obese and New Zealand - traditionally regarded as an outdoorsy, healthy nation - is on a similar track. Adult obesity doubled to 21 per cent between 1989 and 2003.
As important as such messages are, those least at risk (the better-off and better-educated) may be paying most attention. "I'm hoping not," says Snell. To help get the message to where it's most needed, he involves people who at-risk groups will listen to. For the diabetes-prone Polynesian community, that means enlisting the help of surgeon Ra Durie, Ra's uncle Mason Durie, a psychiatrist who heads Massey University's Maori Studies department and, Snell hopes, golfer Phil Tataurangi.
"I agree that those who are better educated tend to think more about the consequences down the line but if they listen to us it is going to be possible to achieve some positive changes in behaviour."
