For ordinary office-bound men, the shots of bare-chested hunks on the front of the bestselling Men’s Health magazine can seem faintly ridiculous.
How do you get a torso that looks as if it’s been carved from a tablet of rock? Do the models care about anything other than honing their muscles?
But given that hundreds of men enter the cover model competition – the male equivalent of winning Miss World – it is obviously a very big deal.
Step forward Ben Mudge, one of five 2012 finalists and yet another example of masculine perfection. Or is he? The 22-year-old could not be more different from the other entrants.
Ben is now the poster boy – the new look, if you will – of cystic fibrosis (CF), the incurable life-threatening genetic condition.
He works as a physical trainer, and has biceps as hard as a python that has swallowed a cat. A long scar across his stomach from childhood surgery only enhances his abdomen, which lies so flat it would surely bulge if he ate so much as a crisp.
But vanity has not been Ben’s motivation. An obsessive drive to keep in peak physical condition, armed with the latest research in nutrition and science, goes hand in hand with his personal mission to educate others about CF.
And the healthier Ben keeps, he believes the less likely he is to succumb to an infection that could land him in hospital.
Hopefully, Ben is the new norm for CF – not the exception. Other inspirational figures include Aaron Brown, a 26-year-old surgeon at York Hospital who says that when he was born, his life expectancy was 30. It is now 40.
Then there’s Tim Wotton, a 41-year-old former England hockey player who is determined not to let CF beat him. ‘It is a horrible disease,’ he blogs, ‘and a daily battle to keep well.’
The photograph Ben keeps on his car dashboard shows his mother Karen, now 48, cradling him as a newborn, his limp little legs peeking out from under the blanket. It is a constant reminder, he says, of just how lucky he has been to survive.
The shot, taken hours before he underwent life-saving surgery to remove a bowel blockage, was followed by the devastating diagnosis of CF. Each week, five babies are born with CF and two young people die – 90 per cent from lung damage.
It is caused by a single defective gene and internal organs, especially the lungs and digestive system, become clogged with sticky mucus, resulting in chronic infections, inflammation of the lungs and digestion problems.
Of the 9,000 with CF in the UK, only half of those with the condition are likely to live past 41 – although improvements in treatment mean life expectancy is improving all the time.
The image of sufferers as weakly children lying flat on cushions as their backs are pummelled to shift mucus has become an old-fashioned one, according to Ben.
He tells of dozens of positive comments left on his Facebook page from parents of small children. ‘You are a light in what has been a very dark time,’ writes one mother whose child has been recently diagnosed.
left and in his mother Karen’s arms only eight days old ,
Given Ben coughed only once after a jog during a fitness session I take with him, it is easy to forget he is sick. But look beyond his mean triceps and signs of his CF do become apparent. He has been prescribed an antibiotic three times a week for a chest infection.
‘I can’t mix with other CF sufferers as we can pass on lung bugs peculiar to those with CF to one another. I don’t go in hot tubs either as they have germs that aren’t good for my lungs,’ he says.
He previously worked as an assistant film director but felt that long working hours without consistent breaks for food were not good for his health.
‘As a personal trainer, I work 20 hours a week,’ he says, ‘and in between times, I sleep. I get eight hours a night. I don’t go to bars because I don’t drink because of my health.’
Twice-daily hour-long workouts doing cardio are best for his lungs – and high-intensity training.
He shrugs off any suggestion that he must have been aware of his condition as a boy.
‘I never felt any different growing up. When I was no age, my dad used to make me do press-ups to give me good posture so my breathing would be clearer and I always found exercise made me feel better.
‘I never had physiotherapy and I’ve only been back in hospital twice,’ he says. ‘Once when I was eight to clear a bowel obstruction and the second time was in 2009, when I was 19 and admitted with a lung infection. I lost a stone in three weeks and was left with 60 per cent lung capacity.
‘I was determined to prove doctors wrong after they said I would never recover, so when I got tests results this year showing it was back up to 99 per cent, I cried.’
Lungs affected by Cystic Fibrosis produce mucus that contains less water than and bacteria can become more vulnerable to lung infections
When Ben did not respond to antibiotics in hospital, instead of allowing his condition to drag him further down, he took himself off to the hospital treadmill.
‘I started off with a kilometre at a light jog and it nearly killed me,’ he said. ‘I was scared. I’d been used to playing rugby and football. Doctors didn’t advise me to exercise – they told me not to go too hard but I felt if I wasn’t challenging myself, I wasn’t going to get better and slowly I built up my fitness.’
The fact that Ben fails to identify anything he felt held him back growing up – ‘apart from taking a gap year as I couldn’t travel round with all the pills I need’ – is testament to his parents, Karen, a retired nurse, and John, 49, who is in the Services.
The family live outside Belfast with Ben, their elder son Jamie, a business consultant, and daughter Lydia, 18. The couple were living in Dorset before Ben was born but moved to Belfast before the birth.
Arriving at a healthy 7lb 8oz, Ben’s condition deteriorated within hours as he failed to feed, because mucus was blocking his lungs and bowel. This is a classic sign of CF so doctors gave him the definitive heel-prick screening test.
Ben’s consultant is Stuart Elborn, professor of respiratory medicine at Queens’ University Belfast.
He helped developed cystic fibrosis centres for adults in Nottingham and Cardiff. In 1995, he started a new centre, providing care for adults with the condition in Northern Ireland.
The Belfast Centre has an active research programme in to the basic science of inflammation and infection and clinical research in airways clearance. ‘Screening is now mandatory across the UK using the heel-prick test,’ says Prof Elborn.
‘This is not diagnostic but screens for extremely high levels of an enzyme called IRP. If this is present, the second stage is a genetic test, then a sweat test as there are high levels of salt present in those with CF.’
However, it has only been since 2007, after a campaign by the Cystic Fibrosis Trust, that newborn babies in the British mainland have been screened at birth, so Ben’s mother doubts whether he would have survived if he had been born in Dorset. ‘It was only after the diagnosis,’ says Karen, ‘that my father said he must have been the carrier as his brother had three children with CF who later died.’
Although a carrier, Karen has no symptoms of the disease. Neither Jamie nor Lydia have the disease or are carriers. ‘When Ben was born, the wife of the consultant who looked after him sent me a magazine on CF and I scoured every page, looking for any articles about children that had lived to five or six to give us hope. I was a nurse but I knew so little about it,’ she says.
As a mother, Karen has battled other people’s ignorance. ‘I’ve had people say, “Oh, Ben must only have a mild case of CF” as he seems so fit.’
She encouraged him to play sports, which in turn kept his lungs healthy. Lungs affected by CF produce mucus that contains less water than it should and is stickier.
The movement of mucus in healthy lungs means bacteria can be kept ‘clean’ but in those with CF, bacteria can become more vulnerable to lung infections.
Dedication: Personal trainer Ben works out twice a day in one hour workouts in order to keep his lungs healthy
As ducts in the pancreas can become blocked by mucus in those with CF, the ability for the enzymes to break down food is affected. This means that because the body cannot digest essential nutrients, CF sufferers can find it difficult to maintain a healthy weight.
‘Exercise is good thing for those with CF, especially anything to strengthen chest muscles,’ says Prof Elborn. ‘Those with CF burn more calories due to infection in the lungs and the body having to work harder to breathe.
‘As a result they have to eat twice the average person’s daily intake of calories. Getting the right amount of nutrition and exercise is essential and keeping weight on can be an issue.
‘A second advantage to exercise is that it improves mucus clearance. How often have you seen a rugby or football player spit – it is because the body produces more mucus while exercising.’
Ben has worked out what leaves his stomach ‘sore’, such as broccoli and fizzy drinks. ‘I eat as sensibly as I can,’ he says over a steak. ‘Not much bread and six meals a day based around protein.’
He lines up his medication – four capsules of Creon 25,000, which he takes with every meal to assist the pancreas in digesting food. He also takes Forceval – vitamins and minerals – because his body does not absorb fat.
Sensing the inevitable awkward question on fertility, Ben pre-empts it by saying his girlfriend of nearly four years, Janice, 24, who works in insurance, is going to be tested to see if she is a carrier.
Although men with CF can have a normal sex life, they are usually infertile due to an absence of the vas deferens, the tube that carries sperm from the testes to the penis.
Sperm is produced, so in-vitro fertilisation is possible and has a success rate of between 30 and 50 per cent.
Females with CF are likely to have delayed puberty as a result of low weight and a higher incidence of amenorrhoea (missed or irregular periods).
Cervical mucus may be thicker than normal, which may cause problems with conception.
Pregnant women can have amniocentesis to test the embryo for CF so that if the baby has a bowel blockage it can be picked up on a scan.
When the charity Cystic Fibrosis Trust was formed in 1964, many children with CF did not live past five. It has so far spent more than £20 million on gene therapy, the aim of which is to add a copy of a healthy gene to do the job of a faulty one. If successful, it would prevent lung damage that kills 90 per cent of those with CF.
Jo Osmond, of the Cystic Fibrosis Trust, says: ‘Ben shows how beneficial physical activity can be to those with the condition. ‘Those with CF should be encouraged, if able, to exercise and to participate in sports as it can improve lung function, keep the lungs clear, and maintain physical fitness.’
Karen is defiant about her son’s longevity. ‘I’m convinced as long as Ben keeps fit and healthy, he will be well,’ she says. ‘He’s living well and hopefully that will inspire others, too.’