On 19 November 2022, The Lancet published an article “Will the Qatar World Cup be good for health?” The editor posed a question, “As the 2022 FIFA World Cup in Qatar has been hailed by Tedros Adhanom Ghebreyesus, WHO Director-General as ‘a unique opportunity to show how sport can promote health’, does it really deliver the bill?” The answer given was… “not promising”. The article focused on migrant workers not given enough health protection, which is an important human rights issue. On the other hand, Qatar’s policy of not allowing LBGTQ+ people to campaign for their gender rights was criticised. I don’t dispute the significance of such issues, but I was a bit disappointed by the fact that Lancet had not put enough emphasis on the benefit of sports in health. How many football fans had been drinking and eating junk food during the excitement of the game? How many of them had lost hours of sleep watching the game? How many more cigarettes were being consumed when the games were on tie, and goals were missed? Yet, how many had learned that football is a good physical activity for our heart as well as the musculoskeletal system, if it is played (and not just watched) properly. 

Look at it from the positive side: football as well as any other sports activities, should be, and can be, an important thrust in our promotion of health. Sedentary lifestyle is linked to an increased risk of non-communicable diseases such as coronary heart disease, metabolic syndrome including obesity and diabetes, and even cancers. In fact, the benefit of exercise has more far-reaching effects. These include the protection of mental health, prevention of cognitive dysfunction and dementia, improvement of sleep, preventing falls and frailty and hence reduction of injuries. We have seen how the COVID-19 pandemic has brought not just physical illness, but made a global impact on mental health not least due to home confinement and restriction of physical activities. 

Promoting physical activity has long been a target of policies in health campaigns worldwide and the Ministry of Health of Singapore’s introduction of the Healthier SG programme is one such example. The importance of advancing from simply more physical activities to finding a healthy and balanced lifestyle and behaviour cannot be over-emphasised. However, very few successes have been seen around the world. Why do many health promotion campaigns fail so badly?  What makes health literacy so hard to achieve? 

Health literacy is vital to good health and wellbeing, especially for the silver-haired population. When the elderly start to exercise on a daily basis, they will enjoy improved muscle tone and cardiopulmonary function as well as enhanced mental and cognitive abilities. Good health and wellbeing is indeed one of the UN’s Sustainable Development Goals. People in both the developed world, as well as developing countries, need to know how to prevent diseases by changing their lifestyle (say, quit smoking and drinking) and increase the amount of physical activities. A whole-of-society approach to health literacy is needed to achieve this and it should start from our medical profession and allied health providers. Health literacy programmes should be part of the school curriculum. Health promotion should be launched more widely in schools and teachers must educate young kids and adolescents. Medical education should include health promotion and disease prevention instead of just treating illness when complications emerge. I think the Lee Kong Chian School of Medicine can take the lead in educating the public about a healthy lifestyle, balanced diet, avoidance of smoking and drinking, and of course, maintaining a healthy physical activity level. 

In 2023, we are going to work together with our students through engagement of the Medical Society in LKCMedicine on health promotion and education. Our annual Run It Forward – a virtual fundraising run that benefits disadvantaged communities through the President’s Challenge – is one example, highlighting the importance of mental and physical wellbeing through the adoption of enjoyable and healthy exercise.   Beyond this event, we have plans go to the community, shopping malls and transportation hubs, to explain the threat of non-communicable diseases such as diabetes, obesity, cardiovascular disorders and cancers. We will put our knowledge out there and  act on it. We should take our physical activities onto the jogging tracks, swimming pools and football fields. Let us exemplify good health and wellbeing through physical exercise to the general public, and illustrate the perils of a sedentary lifestyle. 

Football can be extremely good for health, but it can also bring detrimental effects, depending on whether you are a player or a fan merely watching. Let us put sports to good use by making it a population health endeavour. 

Editorial: Will the Qatar World Cup be good for health? Lancet 2022; 400: 1741

Dumuid D, Olds T, Sawyer S. Moving beyond more: towards a healthy balance of daily behaviours. Lancet 2021; doi: https://doi.org/10.1016/S0140-6736(21)01600-7

Editorial: Why is health literacy failing so many? Lancet 2022;400:1665