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Last Updated: Wednesday, 17 November, 2004, 15:33 GMT
Getting personal on lifestyles
Plans for individual NHS trainers may not have hogged the headlines in the same way as measures to combat smoking but they could soon be helping to change our lives.

Image of Tony Blair rowing
Ministers hope a personal trainer will help all of us get into shape

If the government's proposals are approved, those of us deemed to be unfit or overweight could soon find our GPs referring us to a personal lifestyle coach.

Dubbed "lifestyle gurus" by much of the media, the idea is that the trainers would offer advice about the little steps we, as individuals, can take to become healthier.

And, because the lifestyle plans are tailor-made for us, ministers hope we will find it easier to stick to the advice.

The Magazine decided to find out if it would work by following a patient's progress with a trainer over the next few months. Now all we needed someone who was overweight, unfit, stressed out... step forward old friend and our Rail Commuter's Champion Jon Yuill.

Jon Yuill
The patient
The BBC News website's commuter champion, Jon Yuill, has spent years making excuses for his lifestyle but believes the time has come for things to change and for him to learn to chill out.

Joanna Smith
The lifestyle guru
Lincoln City Council health and fitness development officer Joanna Smith runs the authority's health assessment programme - which offers a service similar to that planned by ministers.

JON YUILL

One of my early memories is hearing my parents say: "If you've got your health, you've got everything." Well guess what? On turning 44 this Sunday, I suddenly agree with them.

Waking up with a tongue like an old flip-flop and gazing down forlornly to where my stomach has been replaced with a space hopper, I realise that, just like my ageing Toyota, bits are beginning to fall off and it's time for a mind and body MOT.

I don't smoke (I've had mild asthma since childhood), but there are definitely areas which need looking at. Here's a brief synopsis.

Weight: If I were six feet tall, I'd be the perfect weight. At just over five feet six and weighing in at eleven and a half stone, I'm not. I tend to "graze" (workmates call me the snackmeister) and my wife is a superb cook, so it's fair to say I'm carrying a few extra pounds. My children, who affectionately call me gutbucket, confirm this.

Exercise: In a word, none - although for years I've been kidding myself that commuting to London each day is exercise enough. I do try and walk up the odd escalator, but I simply don't have the time to go jogging everywhere. Besides, the world's not ready to see me in a tracksuit. I do walk all the way to the pub and back. Beneath this lardy exterior is a thin man, screaming to stay there.

Drink: Mine's a pint. Yes, my biggest vice, I love real ale. Unfortunately, it comes with about 600 calories a throw. I average six to seven pints a week. I also enjoy both red and white wine, and my honest assessment is between three and four bottles a week. Honestly guv. I don't drink shorts. I also have about three teas or coffees (one sugar) a day.

Sleep: If I'm not in bed by 10.30 each night, I'm in trouble. I sleep fitfully and snore like a dry cork twisting in the neck of a bottle. Up at about whatever time four-year-old Martha decides - usually by launching herself on my stomach at about 6.30. Having kids is not conducive to a good night's sleep. Neither is a drink, as when you get to my age, the old washer begins to go a bit. Unsurprisingly, I hardly ever seem to wake with a spring in my step. More like the living dead. And who is it that sneaks in and puts ground glass under my eyelids?

Stress: WHADYAMEANSTRESS!? COURSE I'M NOT STRESSED! Anyone who has ever read my thoughts on commuting will know it really takes its toll. I've been doing it for some 25 years now, and I'm beginning to feel it.

Overall health: Reasonably stable. But like most of us, I creak a bit every so often.

So back to that MOT. OK, so my bodywork may be a bit flaky, but I'd still like an overhaul and get things running a bit smoother. And my wife would love to do something about my emissions.

JOANNA SMITH

What we try to do is offer suggestions that people can incorporate into their everyday life rather than telling them what they have to do such as go to the gym, which is not for everyone.

The first thing we do when someone comes to us is find out about their lives, their previous history and what they want to achieve - for instance a lot of people come to see us because they want to lose weight.

Some people are referred by their GP but the scheme is available free to everyone living in Lincoln.

Heart rate

During the first session, which would last about 45 minutes, we would find out as much as we could about a person's lifestyle and we would find out what they want from us.

We would assess their current health levels by checking blood pressure, heart rate, measure their height and weight, assess body composition, check their lung function by getting them to blow into a meter and measure grip strength - which can indicate their upper body strength.

All these will be entered into an individual's health diary so we can monitor changes.

We would then look at what improvements they could make - in Jon's case, it might be that he would improve his general health by cutting back the amount of alcohol he drinks and by introducing some physical activity into his daily routine.

Lunch-time walk

He's obviously quite a busy person so maybe he could get off the train a stop earlier on the way to work or he may be able to get away for a lunch-time walk rather than sitting at his desk.

Someone else may have previously enjoyed something like badminton or would like to try something new so we might look at how they could set about doing that - everyone is different.

After the initial visit we are available for follow up sessions. A lot of people tend to come back on a monthly basis but again it is up to them.

Since the launch of the scheme in March 2003, we have seen over 1,000 people and I think it's fair to say the majority have taken steps which have improved their health.

One recent case that comes to mind was a lady who lost one and a half stone. She said she didn't think she would have been able to do it without our help and support and, because she had not done this through a fad diet, she has a much better chance of staying at that weight.

As I say, it's all about looking at the individual involved and it can be a real buzz helping someone to achieve their aims.

Over the next few months we will be following Jon and Joanna's steep learning curve together. To add your comments to this story, use the form below.

Your comments so far:

People like Jon know exactly what they need to do, they just don't have the will power to do it. Eat/drink less and exercise more! Simple! If you ae bothered enough about your health you will find the time.
Jose (currently 2 stone overweight), London

It would be interesting to see if they use a pedometer in this regime . Although not overweight I was given one and have found for a number of valid reasons that is isn't easy to make 10,000 steps a day if you are office bound and have no way of walking to work.
Kieran O'Malley, Fareham , Hants

Most people *know* what they have to do; it's pretty clear-cut for the majority. Stop smoking, exercise more, eat less, cut down on the alcohol, increase the fruit n' veg/junk ratio. Trouble is, it's nowhere near as easy as it sounds for most. Lifestyles are actually very hard to change, and the constant pressure of having to think about what you do and how you to it, the sheer number of little things that have to change, can be extremely daunting. You have to really *want* to do it. In fact, you have to want to see the benefits more than you want to carry on in your own comfortable way, and the longer you've been living a particular way, the more inertia it will have. It's a fact that seeing a professional on a regular basis can help with the motivational aspects of hard-to-maintain lifestyle changes, and from the sound of things they could be of real use with practical suggestions too! So, best of luck Jon: it's a million-to-one shot, but it just might work!
Jarrad, Bristol, UK

Given Jon's detailed description of his lifestyle I am not encouraged by Joanna's initial advice, i.e. reduce alcohol consumption and walk more, even if it then takes longer getting to work and you arrive needing a shower! However, I am not surprised that there is no quick fix, us fat boys have been racking our brains for years. My best advice is for Jon to start exercising as a social activity and if he could encourage the family to play sport with him (or even go for walks) this would have obvious benefits for all of them. If Jon still remains overweight, so be it. Don't give up the beer, life's too short!!
Peter, Brighton, England

I can so relate to John's story. I do get some exercise, walking the dogs, but clearly not enough!
David , Llandovery, Wales

Just a technical point - there are only around 150-200 calories in a pint of beer. Unless a "throw" means a 3-pint jug? If so you should definitely cut down!
Kate, London

When I'd finally stopped hurting with laughter at Jon's self-diagnosis, I realised with a bit of a shock that not only am I almost exactly the same age as him, but I also have almost exactly the same problems, although I don't think I drink nearly as much - but in truth even that's only down to my daily disorganisation, not to my intentions or will-power..!! I really need a very similar body MOT, and a serious step-up in regular energetic exercise, but I've already pretty much decided it probably won't be a private gym - because I know I just won't go..! A regular session with a private trainer like Joanna sounds absolutely ideal - but I suspect once the real cost to the NHS becomes clear, it wouldn't last long - and still wouldn't be taken up by most of the people who really need it, because there just aren't enough hours in the day. But I also think it would work out much more expensive to the nation in public taxes than the standard cost of a private gym to those who want! it, followed by very regular weekly attendance to get their money - and health - back.
Craig, Birmingham, England

As someone who is in good shape, I encourage Jon whole heartedly to make the effort. Remember though, that any changes you make should be for life, and not just an 8 week dieting and exercise binge. Maintaining the positive effect, takes some effort...but it's well worth it.
Becquerel, Manchester,UK

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