Author: Alessandro Demaio, MBBS MPH PhD

Launching a New Global Narrative for NCDs – from Melbourne, Australia


This past weekend, on the banks of the Yarra River in Melbourne, Australia, and to a packed audience at the Melbourne Convention and Exhibition Centre, NCDFREE was launched. A Saturday night event and part of the University of Melbourne’s Festival of Ideas, the theatrical and educational Global Health event aimed to inspire and engage a new generation to take action on the world’s leading cause of death – Non-Communicable Disease.

An event by, for and about young people, the audience had a full program including three short films from three continents, two interviews with NCD leaders and listened on as six inspiring young health change-makers took to the stage to share their ideas for a world free from preventable NCDs. The entire program was crowd-funded and streamed live to the world via webcast and soon – will be available through vodcast online for anyone who couldn’t be in the crowd.

The audience was sensational, interactive and inspired – watching a program packed of urban planners, design thinkers, economists, doctors, nutritionist and epidemiologists… Not to mention incredible young comedian duo Charlie Ranger and Michael Argus, and Melbourne rockstars Asta and Arowe.

More will be available over the coming days and weeks – but here a taste of the event, the first of three short films focusing on young health advocate Byambasuren Vanchin.

Watch this space for much more soon!


For more information, go to and @ncdfree.


The Conversation


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#GlobalHealth: an open letter to the Healthcare Students of the World.

This week, an open letter to the healthcare and public health students of the world – written by Harvard Fellow Dr Alessandro Demaio, for the 2013 Global Health Conference of the Australian Medical Students’ Association.


In his speech to the World Health Assembly this year, World Bank chief Dr Jim Kim boldly stated we are at a crossroads in global health.

“Together, we face a moment of decision,” he said, “The question is not whether the coming decades will bring sweeping change in global health, development and the fundamental conditions of our life on this planet. The only question is what direction that change will take.” And of course, who will lead us.


Well I believe there is no group better equipped to choose a healthier future and a fairer trajectory than you. Young, driven, intelligent, articulate and, most powerfully, informed. This is a big responsibility. Taking on the problems that were created and challenges unmet by the generations above you. But as young global health advocates and budding healthcare professionals, you are our white knight. Our secret weapon in global health. As I see it, for three key reasons.

Our White Knights.

First of all, because you can. You are a generation that is globally connected like never before – across time zones, borders and economic divides.  You are native to technologies that older generations will likely take years, maybe decades to master. You are driven and desperate for change and best of all, you combine the traditional knowledge of health and medicine, with a deep sense of social justice and an appreciation of non-health determinants.

ncd3Second, because you must – time is short. With the world rapidly speeding along deeply concerning environmental, economic and social trajectories, you must be the generation that rises above the rhetoric, moves beyond shallow, aspirational targets and political short-mindedness. Put simply, we have just a few more decades to get this right, and you are our best chance of realigning the direction the global community is heading in, to ensure a more sound, safe and sustainable future for our planet.

Finally, because no one else will. I am a realist and, having worked in global health for a few years now, I realise that change is not going to come in the form we need and in the timeframe that is crucial, from the generation you will replace. This is on you, like it or not. It might seen daunting, even unfair, but trust me – with your skills, your insights and your innovative thinking, a better world is well within reach.

Think Big.

This year, I co-founded a global social movement to address the world’s leading cause of death: non-communicable diseases. In a few months, NCDFREE crowd-funded more than US$60,000 and through crowd-sourcing, drew video from smart-phones around the world to encourage societal and political change through short films and personal narrative. Harvard, Oxford, ANU, the University of Melbourne, C3 Health, PLOS, BMJ and many others have come on board (financially and morally) and joined our movement, including the World Health Organization, who will host a specially-commissioned film at their July Ministerial Meeting. The success of this campaign, albeit it in its infancy still, has taught me a few key things I want you to hear.

The Support is There.

Although I outlined some pretty big challenges above, you have support to bring this change. The world is expecting big things from your generation, and they’re willing to back you in making them happen. They know what you’re capable of, and they’re poised to catalyse your solutions. Be bold, think big and don’t compromise. Others will be inspired by your passion and rally with you.

GHC2013I also stress the need to continue to look beyond the clinic. A classic flaw of us medical doctors is to lose sight of the world outside. Exams, patient lists, rounds… Don’t forget to look outside the window and remain globally connected and responsible. Being a public health or healthcare professional is noble and I commend you for dedicating your life to the health of others, but it is not enough. Remember the global challenges which may lay outside your daily routine, but for which your voice can be powerful – even game-changing.

Look Beyond Health.

Finally, I am going to use the “M word” – multidisciplinarity. Before you switch off or roll your eyes, I want to appeal to you – remember to have humility. Whether reflecting back or looking forward, the biggest gains in global health, and even healthcare within nations, have and will be made by innovations from outside the clinic and even medicine.

Ghana SunsetHIV, TB, NCDs… These are all driven by and interlinked with factors we call Social Determinants. The greatest gains in addressing these diseases will come from doctors working with other sectors, within other industries and ministries. Communicators, urban planners, lawyers, designers, anthropologists, economists – the list goes on. Inspire them and be inspired by them, work together and we will achieve much more for many more.

So once again, the challenges are large but there is no group better equipped to rise to meet them. Remember: don’t be afraid of thinking big. Don’t let fear stop you from getting off the conveyor-belt that is healthcare training and tackling some of the bigger picture issues.

Above all, don’t be afraid of failure. The only failure, would be to never try.


Dr Alessandro Demaio



Sandro_circleAlessandro is a Australian-trained Medical Doctor (MBBS, MPH) who has recently completed a PhD in Global Health and NCDs. He currently holds a Postdoctoral Fellowship at the Harvard Global Equity Initiative, Harvard Medical School and is Assistant Professor at the Copenhagen School of Global Health. Connect with Sandro on Twitter via @sandrodemaio.


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Global Health 2.0 – from the team at MPH@GW…

This week on TGH, we let the picture say a thousand words – literally. From the online Masters in Public Health program at The George Washington University is this innovative infographic! It explores how health care in the U.S. compares to 16 other countries around the world, using WHO data. 

Global Health needs more infographs like this – if you know of a great one, be sure to share it with us below!


US Health Care vs The World


This sensational example of innovative communications for Global Health, was brought to you by The George Washington University’s Online Masters in Public Health.

The data in the graphic is provided by the World Health Organization (WHO)’s World Health Statistics 2013 report – the annual compilation of world health data.  

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A changing climate & shifting epidemiology: shared risks and opportunities

Flickr /  USFWS HeadquartersI might be a doctor, but actually I wasn’t always medically-focused. In fact, in my final year of High School, I was captain for the environment. A young college leader, I was passionate about the sustainability of our waterways, oceans and forests – I believed strongly in protecting the integrity of our natural surrounds and the wider ecosystem we inhabit.

Jump forward more than a decade, and I am now a medical doctor focused instead on the shifts in epidemiology we are witnessing worldwide and the rapid rise in Non-Communicable Diseases.

From climate health, to human health.

For many, this transition may seem disjointed and unrelated. How could someone go from being so passionate about the environment to being passionate about human population health?

The answer is, nothing changed. There was no leap and it wasn’t a conscious transition – it was a gradual shift along a single continuum. You see, these two issues are not polar opposites, but in fact largely overlapping.

Human health and the environment are really two sides of the same coin.

A few stunning Lancet series later, much more accepted science and the fulminant effects of Climate Change playing out around the globe, people are awakening to the overlap of these two issues. People see the link between human health and a healthy environment, that if our natural environment is sick – we in turn are likely to become sick. That our health is reliant on the health of the natural surroundings – our oceans, our forests and our air.

But actually, this relationship goes a long way further. It is not only that a struggling planet makes for an unhealthy human race, but also that the process of becoming unwell as a population fuels the degradation of our planet. In fact this is an important concept to appreciate – because it is not our planet’s fault that we are in fact becoming unwell. Both are our fault, and each are fuelling the other.

Shares Risks.Flickr / shirokazan

Think of NCDs – or Non-Communicable Diseases. These are the leading cause of global deaths and present an enormous and time-critical challenge to the global community. Largely, these diseases are a reflection of the technological gains we have made in the past century, and the hyper-consumerist lifestyles many around the globe now lead. Mechanised lives lead to less and less caloric expenditure, cars replace our morning walk to work or school, we use electronics instead of being outdoors and largely, we have replaced manual labour with desk-bound work. At the same time, our diets which were once based on natural, seasonal, local, unprocessed foods are now calorie-dense, ultra-processed and served to us on a tray. Many of us eat meat most days whilst added sugar and fats have become ubiquitous ingredients in even our food staples.

But hang on a moment, they were some of the major drivers of the NCD epidemic. Or were they the drivers of climate change? Carbon-intensive, mechanised lifestyles; passive, fuel-reliant transport; ultra-processed foods; meat, sugar and oils.

The reality is, that these drivers of NCDs are also some of the major drivers of climate change. That in many regards, these two fundamental challenges for our global community this century are one and the same. Yes, an unhealthy world makes for an unhealthy population. Pollution and fragile eco-systems make populations more vulnerable to a range of disease outcomes, but furthermore, the drivers of both are actually shared!

9350882245_85d2f47454Shared Opportunities.

The exciting part, is that the reverse is also true. Mitigation for one, will lead to mitigation for both and actually, additional positive externalities. If we build cities which are conducive to the use of active or public transport – we could go a long way to addressing burdens of diabetes and lung conditions, but also cut our carbon emissions. If we encouraged a few more people to be weekday vegetarians and only enjoy meat on weekends, we would likely protect a few of them from a heart attack, but also reduce the methane emissions related to the production of that meat. If we could teach more of our children to connect with food, understand food and to cook wholesome food, we might find that they’re able to make healthier, more local and seasonal food choices – foods which don’t require carbon-intensive hot houses, long-distance transportation or high levels of processing.

We can have both.

I would argue that our two pressing Global Health challenges are in fact one. That environmental activists are public health activists and vice versa. A classic story of the whole being much more than the sum of the parts.

Climate health is human health, and human health is climate.


Connect with Sandro on Twitter via @SandroDemaio.


Dr Alessandro Demaio trained and worked as a medical doctor in Melbourne, Australia. While working as a doctor at The Alfred Hospital, he completed a Masters in Public Health including field work in Cambodia. In 2010, Alessandro relocated to Denmark and began a PhD fellowship in Global Health with the University of Copenhagen, focusing on Non-Communicable Diseases (NCDs). This year, Alessandro holds dual Postdoctoral Fellowships at the Harvard Global Equity Initiative, Harvard Medical School and the Copenhagen School of Global Health.

The Conversation


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A crowdsourced voice for the Ministers of Europe

Over the past months, as part of a global team of young people, we have been developing new ways to bring attention to the world’s leading cause of mortality and disability.

NCDs, or non-communicable diseases, kill more people than HIV, TB, malaria and all other causes combined. And contrary to popular understanding, the heaviest toll from this group of diseases – including diabetes, stroke, heart disease, cancers and lung disease – afflicts the world’s poorest nations.

NCDFREE aims to give a voice to young people who are actively engaged in, and passionate about addressing NCDs.

This week, we’ve travelled to Vienna to present our latest crowdsourced video commissioned by the World Health Organization, to their meeting of Health Ministers from 53 European nations.

We put a call out across the world, for young people to use their phones to send us their personal messages and calls for change on NCDs. A chance to talk directly to their Ministers & to global decision-makers.

Bright, engaged young NCD change-makers answered back, sending their own ideas and insights – and film clips representing them and their work.

Here are their voices and their messages – for the ministers, for the world and for you.

NCDFREE Europe Challenge Film

Please help us spread the word, by sharing this article. For more information on NCDFREE, visit the website at

Connect with Sandro on Twitter via @SandroDemaio.



The Conversation


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Big Soda – do you think we’re all stupid?

Flickr / YU-BinIn life, the dichotomy between ‘good’ and ‘bad’ is usually very blurred. When it comes to food, trying to decide whether something is ‘healthy’ or ‘unhealthy’, is even harder. Red meat, for example, is linked to disease – so is it unhealthy? But it is also a good source of iron and protein, so it is healthy? Cake is full of sugar and fat, but then again, the butter and flour also contain vitamins and calcium.

They are sources of calories, and calories cause us to gain weight, but they are also sources of nutrition.

It’s all very confusing!

But there is one item on our supermarket shelves, which contains nothing but calories. No nutrients, nothing helpful and nothing required for a healthy life.

Soft drink, or soda.

Empty calories

Simply sugar and flavours – sweetened, carbonated beverages are just plain unhealthy. They contribute nothing of value to our bodies and in fact can be downright harmful.

Science suggests that one can of soft drink per day increases your chances of diabetes by 22%.

Digest that one for a moment! Less than one can per day and your chances of diabetes may go up by one-fifth (relative to baseline risk).

It is also becoming clear that unlike calories from foods (even junk foods), calories from drinks are particularly good at evading your body’s receptors for satiety. In short, extra calories from drinking sugar-filled beverages don’t register with your brain – so you’ll go on to eat the same amount of food in addition, and therefore more overall.

Smoke and mirrors

So you can hardly blame me for being surprised when a certain red and white, global soda-company released enormously expensive advertisements this year to launch a “public health” campaign to reduce obesity!

The very company making these drinks, launches a challenge to the public to become healthy, lose weight and reverse the obesity epidemic.

Sorry, did I miss something? Does it sound like classic smoke and mirrors to anyone else?

Flickr / nicoleleecFirst, they market themselves as being healthy, caring about the community for many decades and taking initiative to reduce the sales of their own products. They promote their lucrative bottled water businesses as corporate social responsibility. They align themselves with national icons and pass-times. They sponsor the Olympics and high profile marathons.

Second, they capitalise on themes of happiness and friendship. Of caring and sharing. They bring out bottles with our names on the labels and urge us to share a drink with a mate or friend…

Third and most recently, they launch a multi-million dollar advertising campaign against sedentary lifestyles. In short, blaming a lack of exercise and not calorie-dense, sugar-filled beverages sold using sexy, predatory marketing as the cause of the obesity epidemic. In a subtle and quite subconscious way, they blame us for being fat because we don’t exercise and not because they have hooked us on caffeinated, liquid lollies and carefully crafted branding.

Happiness, friendship and now health promotion?

Is Big Soda serious? Do they think we’re all stupid?

Let me say it again, one can of soft drink per day may increase your chances of diabetes by 22% and sweetened drinks are linked to obesity. There is nothing “caring” about “sharing” the “happiness” of a soda!

Pernicious, predatory and purposeful

These ads are dishonest and frankly appalling. Big Soda has no place in providing health recommendations to the public, nor should it be allowed to. A company that sells sugar mixed with water and an addictive substance (caffeine) is not an organisation we want communicating information on health or how to lose weight!

It is already hard enough to navigate for a healthy life, without forces with such immense conflicts-of-interest getting involved too.

Flickr / ilovebutterPart of a concerning trend of strategies from beverage multi-nationals and alarmingly similar to tactics used by Big Tobacco in the past – let’s not be duped.

These companies are not interested in our health. They are interested in us drinking more of their liquefied treats. They’re not a public health organisation, and they should not be providing misleading, biased and incomplete information on health to the public.

Let’s not let our name printed on the label distract us from the truth, or a sleek and seductive advert lull us into confusing branding with health promotion.

These pernicious, predatory and purposeful advertising campaigns simply aim to divert us from the fact that these drinks contribute an enormous burden of disease to our society.

We know this Big Soda – because we’re not stupid.

Connect with Sandro via Twitter using @sandrodemaioThe ConversationThis article was originally published at The Conversation.


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A week filming in Mongolia: local change-maker to bring global change.

Wrapping-up after a sensational week in Mongolia. Here to film a short-film for our recently-launched health advocacy initiative, we have spent the days profiling a young, inspiring, local, health change-maker – Byambaa.

NCDFREE is a global social movement against the world’s leading cause of death: NCDs (or Non-Communicable Diseases). Founded earlier this year, NCDFREE sets out to change the way societies world-wide think about diabetes, heart disease, cancers, lung diseases and mental health (NCDs).

But also the way we communicate them.

As an academic, I traditionally communicate through scientific journals. As a branding and design expert, co-founder Giuseppe uses very different tools to connect with society. Our idea is to use the latter, to “rebrand” this global health challenge and paint an accurate face of the global epidemic.

You see, when people think of these diseases, they think of old, fat people in rich countries. Actually, 80% of disease occurs in the world’s poorest nations, where the burden is rapidly rising.

The true face of the global epidemic is in fact, likely to be Asian, below 70, female and impoverished.


The film follows a young female cardiology-trainee, who has seen the transition from communism to democracy in her lifetime. She has seen a city double in size and a GDP more than quadruple. But with this, she has also seen a change in the nation’s diet – in fact just this month the first KFC store opened in UB – and a change in the lifestyles of the populations as they replace the horse for an SUV. Transition from a ger to an apartment, and from the steppes to a dense, urban centre.

30% of the population may still live in poverty, but this is a 25% drop from 1 year earlier.

Rapid change is occuring.

“And although this all represents important and needed progress for Mongolia” describes Byambaa, “it has also brought major changes in the health of the population”. As infectious diseases and childhood illnesses dive – obesity, hypertension and NCDs have skyrocketed.

Through the story of this young community advocate and doctor from Ulaanbaatar, NCDFREE plans to change the way people think about these diseases. Connecting NCDs with the reality of poor, marginalised people – often facing a lack of health-promoting opportunities.


Byambaa is confident – in the future and in the health trajectory of her nation.

Spend much time with her, and you will be confident too.

She sees great potential in her colleagues and peers, and tells of a young generation that is very different from the one before. One that is globally connected, globally educated and passionate for change in their country.

Change that will not only see a continuation of economic prosperity and development, but one that will also empower and enable a population to live healthier and longer lives. Free from chronic, debilitating disease.


Well, we’ve been here a week and today we’re finishing up. Packing away the cameras and with it, footage of nomadic families, Ulaanbaatar’s poorest districts, the beautiful countryside, the generous locals, the rapidly transforming city and the optimism of a young generation.

Footage which will not only show a stunning and fascinating journey of a young leader and passionate health-promoter, but also rally a global community to action on a group of largely ignored, mostly-preventable yet highly deadly diseases.

Listen to a podcast interview focusing on NCDFREE and our trip to Mongolia, broadcasted live yesterday on ABC Radio Australia.

Connect with Sandro on Twitter via @SandroDemaio.

To follow our trip more closely this week, head to the NCDFREE Facebook page.


The Conversation
Dr Alessandro Demaio is a medical doctor, originally from Melbourne, Australia, with a Masters in Public Health. In 2010, Sandro began a PhD in Global Health with the University of Copenhagen, focusing on Non-Communicable Diseases (NCDs). His primary research project is based in Mongolia. As a Director for NCD Action, in 2013 Alessandro is a fellow at the Copenhagen School of Global Health and Harvard Medical School.

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Mongolia: a nation at a crossroads, with much to look forward to

A few weeks back, at the World Health Assembly, World Bank President Dr Jim Kim said the world is at a crossroads when it comes to health. A defining moment in history, from which our future trajectory will be decided.

Not many nations better embody this concept, than Mongolia.

Here this week to make a short film focusing on young, inspiring health change-makers working to address the leading cause of death (which might surprise you, is cardiovascular disease including stroke) I can see Mongolia is at a serious, but exciting moment in history.

In the midst of a mining boom, with economic growth eclipsing most nations, Mongolia is in the middle of rapid economic, social, cultural and health transitions. Once a small town, its capital Ulaanbaatar is one of the fastest growing urban centres in the world and now accounts for more than 60% of the nation’s 2.8 million population.

A bustling city overflowing with cars, their drivers not so long ago would have been on horseback.

As a foreigner, one senses the excitement of the potential opportunities which lay ahead for this landlocked nation. Having done my PhD here over the last years, I have seen the city literally transform. Sky-scrapers and high-rises where there were gers just a few years ago. Traffic jams and footpaths where there were neither less than a decade earlier.

The cost of living is rising rapidly, but so is the standard of living.

Speaking to two young Mongolian doctors, they explain the optimism held by the young generations. “As money floods in, so do opportunities for Mongolians. We are able to travel abroad to study, greater work opportunities and if the money is spent well – a promising future for our nation.”

Byambaa and Nara are both Mongolian born and raised. They lived through transition to a free-market economy after the collapse of the Soviet Union, they have seen their capital city double in size and their national infant mortality halve in the last 20 years.

They have such inspiration and vision for their country and its people. Part of a new generation determined to capitalise on the abundant natural resources of their nation, they’re committed to seeing change that affords all Mongolians greater opportunity and prosperity.

But they also acknowledge Mongolia faces big challenges – one such example is from the quickly rising burden of Non-Communicable Diseases (NCDs) including heart disease, diabetes, mental illness and cancers.

We are making a short film about one of these young doctors. Through her story, we hope to show the world that heart disease is not just a challenge faced by rich countries – and that many Low and Middle-Income Countries are facing a difficult double burden. NCDs and an unfinished agenda of maternal and child health challenges, infectious diseases and more.

A filmographic call for attention, action and investment toward this misunderstood global health issue.

But also, crucially, we will show that a young generation exists that is serious about changing the situation. Bringing health and health equity for their populations. Paving the way for a healthier future.

Profiling these motivated young people and capturing their narratives, including Byamba who has dedicated her life to becoming a cardiologist (in a country not linked with cardiovascular disease in the minds of many), we hope to rally global societal and political support for these young people, their quest and this neglected group of largely preventable diseases.

Inspired and inspiring young change-makers, they represent a global challenge, but also an untapped resource of vision and commitment.

Mongolia may be at a crossroads, but these young leaders promise to steward this nation to a healthy future.

It’s an exciting time.

To follow our trip more closely this week, head to the NCDFREE Facebook page.

Connect with Sandro on Twitter via @SandroDemaio.


The Conversation


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Lend your voice to NCDs for a chance to join NCDFREE in Vienna


Win a trip to Vienna to join NCDFREE at the WHO Ministerial Meeting on Non-Communicable Disease. (click on above to watch)


NCDFREE is a global social movement that aims to bring societal and political attention to NCDs (diabetes, heart disease, cancers, lung disease and mental health) through personal narratives focusing on inspiring, young change-makers.

Launched last week, in time for the World Health Assembly, NCDFREE has a new challenge for the global community.

You have one week left to submit 15 seconds of footage of yourself, and answer 3 questions via the NCDFREE website. All you need is a smartphone, camera or video camera and a passion for addressing NCDs!

Two contributors, passionate about Global Health, will get the chance to join the NCDFREE team in Vienna next month for the UN meeting!

Go to for more information and support this important Global Health cause today!


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Taking care of yourself is not very manly – but it should be!

Flickr / JD HancockIt is a sad fact that in modern day society, stigmas are still rife. Varied in nature, subject and conspicuousness they are still very real and very alive.

What is cool, what is not. Don’t wear this, never listen to that and definitely don’t be seen there… But one stigma I am really sick of (no pun intended), is the concept that being healthy – is not manly! Caring about your body, what you eat and how you live makes you less of a man.

If I want to be “manly” it seems I need to ignore my stresses and emotions. I need to take up smoking, drink hard alcohol and eat fried food. Ludicrous, as these are all risk factors for heart disease, diabetes, cancers and – ironically – impotence!

Even seeing your doctor is not ‘blokey’.

To be manly, I have to practically ignore everything my doctor told me and worst of all – I am only really manly if I don’t actually care!

Is the peak of manliness to be 6 feet under!?

Why is eating well and watching my weight “girly”?… Caring about my health, protecting my skin from the sun, avoiding tobacco smoke and sharing my stresses can only be done by women?

Males of all ages are more likely to practice more than 30 behaviours linked to higher mortality, than females, and less likely to take up protective behaviours – a US study showed.

But we have also all seen it ourselves – what is more manly, a burger or a tofu burger? A salad or a sausage? A light beer or a full-strength?

Masculinity should not be measured by poor health-behaviours and I should not risk being any less of a man because I choose to enjoy a lighter meal, moisturise each day or don’t feel the need to speed along on a two-wheeled death-trap!Flickr / dying regime

So let’s just take a step back for a moment and reflect on the effect this unhelpful, even harmful rhetoric has on the men in our society.

Not to mention the women who want to enjoy the odd burger.

Let’s lose the absurd associations we make between unhealthy practices and being “a man”. Being healthy, man or woman, should be encouraged, celebrated and congratulated. Particuarly given how hard maintaining health can be in today’s world.

To paraphrase Marie Antoinette, let them eat tofu.

It won’t kill us all to be a little less complacent with our language, but it might improve the health of one in two of us.

Connect with Sandro via Twitter using @sandrodemaio.

This article is dedicated to Dr Jess Nehme – for inspiring these words, but also her inspiring work this past year.



The Conversation

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