Five cities were in pursuit of the 2012 Olympics. At the heart of each application was the bid document, which has crucial chapters on health and the Game’s legacy. The Evaluation Committee of the International Olympic Committee (IOC) visited each city and interrogated their medical advisors, one of the current authors included, on every detail of the proposed health provisions.

With regard to the legacy, it is clear that the IOC’s increasing concern is to develop the benefits left by the staging of this elite, mass spectator, sporting event. A legacy of health gain is at the centre of many of the bids, although to generate one is not as straight forward as it might at first appear. The health equation of an Olympic games is by no means simple. Profound effects are felt by the communities in which mass events are staged, as well as by the populations viewing them, and these may not all be beneficial.

The benefits for non-participants may derive in two ways.

Populations viewing an event may be inspired to exercise. In a poll of nearly 900 adults, 26% stated that they had been inspired by British medal winning performances at the Olympic Games in Athens to play more sport, or to become more actively involved in sport in the future.¹ However, good data on how often these intentions result in lasting action remain wanting.

The link to a specific sport may be direct. After the British Olympic success in curling, the sales of related equipment escalated substantially. The consequent exercise will have brought measurable health gain to Scotland, a black spot for deaths from stroke and heart attack. If only its population exercised, cases could fall by over …