Should old people start wearing stilettos?


19th November 2014

It must, I sometimes think, be exhausting, if you actually take health advice from newspapers; diligently eating eggs one week but not the next, avoiding mobile phones in case they irradiate your gonads, avoiding all foreign-looking people in case they’ve got that Ebola. I thought this particularly the case this week when I read the Daily Mail saying that wearing heels into your 70s can ‘save you from deadly accidents’.

The hypothesis is a fairly straightforward use-it-or-lose-it thing: if you wear heels, you’re developing good balance, because heels require you to stand on a far smaller surface area than normal shoes; when you stop using them, your balance deteriorates, rendering you more likely to fall over. (The first line is ‘When should a woman stop wearing high heels?’ – but hey, if high heels really protect against falls, then surely the Mail should be encouraging the guys to strap on a pair of size 11 stilettos as well.)

It’s not based on any research, as far as I can see, simply the hunch of a couple of doctors; and while it is almost trivially true that exercising your balance will improve your balance, there’s an obvious trade-off in that while you’re wearing heels it is harder to stand up. Whether the net result is more or fewer falls is surely an empirical question. The only research I can find, from an Australian university, seems to suggest that wearing high heels (at any age) puts you at ‘higher risk for injury that leads to emergency department presentation’.

But that’s not really the point; I mean it should be obvious to anyone, really, that the simple headline advice of ‘wear heels to prevent falls’ (which are, by the way, a real danger to the elderly) is likely to be nonsense. What interests me is that a committed reader of the Health Journal of the Daily Mail would have to dust off the pair of six-inch Louboutins which he or she previously mothballed in 2008, having discovered that they caused ‘irreversible damage to leg tendons’, and before that been told, variously, that they are good, bad, and good for you again.

This won’t be news to anyone, really, and it’s almost unfair to pick on the poor old Daily Mail, who are simply the largest and most obvious target when it comes to this sort of thing (although they are the only newspaper to have a website dedicated to their campaign to divide the world up into things that cause and cure cancer). But there is a real, sort-of useful point underlying it, which is that health science, and in fact science in general, almost never advances in headline-friendly big leaps. A paper claiming that high heels, or carbohydrates, or whatever, is good for you isn’t a breakthrough that changes everything: it’s a few grains of rice to be piled on to one pan of a set of scales.

For what it’s worth, I won’t be going out advising any elderly relatives to clamber into the Jimmy Choos. My grandpa’s six foot tall already; he’d just look weird.