A giraffe in a plane

It is amazing how new learning’s come at the most unexpected times. Last Saturday I had a new lesson in relaxation, pillar 6 of DIY Health, at the local markets. Now Saturday can be fairly busy in our house.

There are two and sometimes three sports and most weeks it is the day for food shopping (unfortunately in Perth we are very restricted in when we can go shopping), as there is no time during the week.

Anyway we were due to start at 9am with basketball for my son. We arrived a bit before 9 and by the designated start time there were only three of our team and none of the other team and no referee.

This seemed odd. At five past I felt it was time to ask the question at the reception desk. Apparently the other team had forfeited at the last moment and the rest of our team who had arrived two minutes before us had been “headed off at the pass” and had gone off for a refreshment.

There are two choices one has in this situation. One is to get stressed, the other is to accept what is and move on to the next thing. We chose the latter.By late morning it was time for the weekly food run. We go to the local supermarket for non-perishables and to the local markets for fruit and veggies, bread and produce from the continental grocer. Now the markets are not flash (as my daughter reminds me) but the produce is good, fresh and actually cheaper than in the supermarkets.

Our last stop was to be the continental grocer as it was on the way back to the car. On the way we noticed the face painting for children was set up next to the grocer (it is usually at the other end) and you can guess what became the added stop.

Despite it being a busy lunchtime there were no takers for face painting. My daughter wanted a swan. One of the painters was trying to “sell” the idea of a painted giraffe in a plane. She had been practicing this but had no takers. “Dad “ she asked “would you like a small giraffe on a plane on your arm?” With a bit of encouragement I agreed.

On sitting down the painter said to me this is a good thing to relieve stress. This seemed an odd description of an adult having a picture painted on his arm. Then as I sat watching her paint, the penny dropped. I had been pretty much on the go all week and through Saturday. This was a chance to not only sit down but also watch an artist in action.

As the aviator giraffe formed on my forearm, I was relaxing as just watching her paint absorbed me and I stopped thinking about the other things that still needed to be done that day. It was also just “fun”. At what age did I become too old to have a fun painting on my arm? It was cute and colorful.

Watching a giraffe in a plane being painted on my arm had brought me into the present moment, allowed me to sit down and to be a kid for a while. I got up more relaxed than when I sat down. The opportunity to relax may present itself in unexpected ways. Be open to them and when they arise take the opportunity to do something that a serious adult would reject but a child would see as fun.

A Glass of Wine is OK

One of the reasons that public health messages struggle to get through is that they are presented as very black and white, a bit like in George Orwell’s Animal Farm -“four legs good - two legs bad”. Yet with virtually all matters of health it is not that simple. There is usually a right amount. Too little or too much is a problem.

Even essentials like air and water come under this rule. If you breathe too quickly you get anxious and light headed. There is a “right” amount of air that the body needs. Too much water can be a problem as is too little.

Most public health messages are based on the tobacco principle. Tell people its bad and don’t allow any wriggle room. It is fair to say that tobacco is not healthy in any amount (although like with all poisons less is better than more). However with foods and alcohol the situation is not as clear-cut.

Now the problems associated with alcohol abuse and misuse, dwarf the combined problems from all illicit drugs. The problems include violence, road trauma, relationship breakdowns and of course numerous health problems from liver disease through to dementia. These are problems from excessive consumption of alcohol.

Yet consumed in smaller quantities these problems do not occur. Furthermore it is likely that the consumption of red wine is actually good for our hearts. This idea has been around for a while but has struggled to get much coverage as the public health people are terrified that if the public are told that a glass or two of wine is healthy that they will drink much more than that.

The really interesting thing is that those who drink harmful amounts of alcohol are not wondering about the health effects of their behavior, be it good or bad, and no one who doesn’t like wine will suddenly start drinking it for medicinal purposes.

So lets just stick to the facts. It has long been observed that the French have lower rates of heart disease despite eating diets higher in fats compared to Anglo-Saxon countries. Attempts to explain this have always come back to the consumption of red wine. This has been documented many times. There are a few mechanisms-the main one being Resveratrol. There are some “cardio protective” effects from this including an increase in HDL or good cholesterol.

Resveratrol is now marketed as a supplement and this likely has some benefits. However, it is also likely that the benefits from red wine are not just due to Resveratrol and that there are other bio-active compounds working in with it. Reducing nature to one working part will generally mean something is left out.

So what is the take home message in all this? A glass or two (1-2 for men 1 for women) of red wine a few days a week is not only not bad for you but probably good for you. Is this a reason to take up wine? —No. Is more better? —No it’s worse.

Can you enjoy a glass of wine with your meal and not feel guilty? –absolutely.

If it wasn't a pill that caused it...

It is reported in The New York Times(see link) that 3 new diet drugs are lining up for regulatory approval. It is estimated that Americans spend $59 billion annually on a range of weight reduction measures from diet books to stomach surgery.Yet as the paper reports only a very small amount of this is spent on prescription drugs.

There are two main reasons for this. Number one is that they don’t work particularly well and secondly there is a track record of diet tablets being taken off the market due to safety concerns. The new drugs have shown some “positive” results over a one-year trial. This is not a long time though and the safety issues with previous drugs only became apparent after they were used by a much larger number of people.

Given the huge potential profits it is easy to see why the pharmaceutical industry may be keen to get involved (the drugs are owned by biotech firms looking for a pharma partner). This is despite sales of current weight loss pills being small and the safety/liability issues. There is also the FDA concern of them being used “recreationally” by people who are not overweight but say want to drop one clothes size.

Here is something to think about. If it wasn’t a pill, which made you put on weight why do you, need a pill to reverse the process. It is always interesting to hear when people say diets didn’t work. Diets have no moving parts .The only way it can “work” is if the individual sticks to it.

Now herein does lay the issue. Many “diets” are considerably removed from what people normally eat each day. Hence the change is too hard to sustain. Even when people stay the course for long enough to reduce weight, they then revert to the previous eating patterns, and not surprisingly this takes them right back to where they started.

Whilst this should not come as a surprise it usually does.

So is there a solution? Of course there is. It starts with taking personal responsibility. You must accept that it is your own actions, which have led you to this place, and that it is only your own actions that can take you to a different place.

The solution is to change your eating patterns. It is no use repeating the same thing and expecting a different result. You need to change the way you relate to food . For example, if you comfort eat then recognize this and deal with the underlying issue. If you have a sweet tooth (like I do) accept this and allow yourself some small treats rather than going without for so long that you end up binging.

Keep at the front of your mind this simple concept. The body stores energy it does not use up as fat. The only way to reduce weight is to use up more energy each day then you put in. This gives you two dials to adjust. Use more energy by being active and consume less energy(calories).

Do not go hungry. Choose foods, which provide nutrition without excess calories. In simplest terms this will be whole food. Food that till recently was moving around, or growing somewhere.

Cut down on processed and packaged foods. Drink mainly water. For sustainable change these must become what you do daily not just a “diet” for a few weeks.

It has been done, it can be done and you can do it if you so choose.

http://www.nytimes.com/2009/10/17/business/17obesity.html?_r=1&nl=todaysheadlines&emc=a6

Live Better for Longer

Two interesting pieces recently on longevity caught my eye. It was reported in The Lancet (link 1) that life expectancy is continuing to increase and that a large number of babies born this century will live to be a century.

I was first shown statistics like this in 2003 at an anti aging conference in Singapore run by The American Academy of Anti-Aging Medicine (A4M). The statistics showed that life expectancy in the developed world has been steadily increasing at the rate of one quarter of year per year (1 year each 4 years) since the late 1800s and that the graph was not plateauing. These latest findings confirm this.

Many reasons are cited and not surprisingly there will be many lining up to take the credit. It is due to a combination of many factors. One of the main ones is that average life expectancy is strongly influenced by childhood deaths. As these have bee reduced significantly the average has gone up. Better food, sanitation and living conditions have helped too. Modern medicine has had a role but less than it might claim.

Life expectancy still differs in different countries. Japan has one of the longest life spans and it is thought that half of its 80 year old women will make it to 90.It is also estimated that in very near future the number of people over 65 will exceed the number under 5.

The second article (link 2) looks at the effects of recession on life span and shows perhaps surprisingly that bad economic times correlate with greater increases in longevity. In other words health increases in bad times more than good. Again there are many reasons put forward. Less stress is a key factor .If people have less work to do they slow down, get more sleep and may make more time for exercise. Now there are downsides to recessions too so this effect is not across the board. However the overall effect on the health of the population is positive.

Averages reflect numbers on both sides of the “average”, the question then becomes what are the people who live longer than “average” doing and what can be learned from them. From my experience as a doctor talking to thousands of people over the years, those who live healthiest longest are looking after their bodies. They are putting in the right fuels, they are active on a regular basis, they get enough sleep and relaxation, they keep themselves hydrated, they have good relationships and they enjoy what they are doing. None of this is difficult or beyond the reach of anyone

What matters most is quality of life. Living more years if you are in pain or immobile or have lost your memory is not appealing to most people. The good news is that looking after your health means you enjoy a better life and it in turn makes it more likely that you will live longer and enjoy those years.

1

http://www.msnbc.msn.com/id/33121805/ns/health-aging/?ocid=twitter

2

http://www.msnbc.msn.com/id/33139622/ns/health-aging/?ocid=twitter

Let the Sun Shine

Without the sun there would be no life on earth. Yet somehow over the last 30 year the sun has become something evil to be feared and avoided at almost all costs. Lets be very clear up front -getting sunburnt is not a good idea and if you do it often enough there is an increased chance of you developing skin cancer

Much like there is a difference between your steak being raw medium rare or burnt; there is a difference between getting adequate sun exposure, too little and too much. In the rush to avoid the sun at all costs there have been an unexpected problem. Many (estimated up to 40%) are now deficient in vitamin D. -the active form of which (D3) is produced in the body under uv light exposure.

Classic vitamin D deficiency (rickets) was associated with underground miners in the late 1800’s. It was thought that in the modern era, such deficiencies of vitamins would be unheard of in the developed world.

European studies on trials involving 57,000 people published in the Archives of Internal Medicine, showed vitamin D had an important role in helping protect against colon and breast cancer as well as diabetes and heart disease. The trials found that those with adequate levels of vitamin D had a 7% lower overall death risk during the six year period of the trial. The results prompted Professor Edward Giovannucci from the Harvard School of Public Health to call for a debate on the merits of “moderate sun exposure”.

The Moore’s Cancer Centre at the University of California suggested that up to 600,000 breast and colorectal cancers could be prevented each year if vitamin D3 levels among populations worldwide were increased.

Inadequate vitamin D may also have a role in the development asthma, osteoarthritis and Alzheimer’s

So the obvious question becomes, how can one get the right amount of sunlight so as to get the benefits of adequate vitamin D in the body but not get excessive exposure .The exact amount of time doesn’t seem to have been determined yet, however, it is likely that something between 10-15 minutes per day on 4-6 days per week of sun exposure to the arms and face is likely to be enough for most people.

In other words, it is not about laying for three hours sunbaking. In particular, the best time to be out in the sunshine is before 10am or after 3pm. At this time, the risk of burning is reduced. The closer to sunrise and sunset, the longer one can stretch this out as the rays aren’t as strong and the risk of burning is lessened.

Unfortunately, the public health people are still paranoid about sunlight .For those doing DIY health the take home message is get the right amount of sun without getting burnt. This means getting a ”healthy” tan but not burning.

The Weekly Fitness Challenge

One of my great learning's this year has been social media in general and Twitter in particular. One of the interesting things to me has been the sense of community that develops in online gatherings. Whilst you may not personally have met the people,you certainly get a feel for who they are through the words and comments posted.

As in any gathering of people you tend to gravitate towards those who have similar interests and passions. With this in mind I find that I have “met up” with some wonderful people who are passionate about health and wellness and are doing something each day to make a difference.

One of my new Twitter buddies is Geoff Hampton who is the founder of The Weekly Fitness Challenge as well as being an author speaker and internationally respected business consultant. It is a great honor for me to have been appointed International Medical Director for The Weekly Fitness Challenge. There are a number of top people who have gotten involved on the board that Geoff has set up. (see link)

So what’s the big deal you may be asking? As I write in Dr Joes DIY Health-Putting You in Charge of your Health “The body is designed to be active and until recently, we didn’t have a choice as movement and physical activity were a normal part of life.
Our early forebears had to chase after food in order to survive and up until the industrial revolution most work was physical in nature.

Cars, labor-saving devices, escalators and remote controls have made for a very “easy” life. Collectively, the developed world is paying for its ability to automate simple everyday tasks and chores. The price is the growing rates of obesity and lower rates of fitness. It is worth noting that regular exercise is important at any weight and that being fit plays a role independent of weight in keeping you healthy.

Unfortunately, many people recoil in horror at this suggestion because exercise is seen as a chore. Furthermore, like many simple tasks where researchers and experts get involved, exercise has been portrayed as being far more complicated than it needs to be. “

Yet it doesn’t need to be hard. Exercise can be simple and most importantly fun.

This is why initiatives such as the weekly fitness challenge are so important. It is a program designed to get people who aren’t doing exercise to do so. It does this by encouraging those who do regular exercise to “reach out” to their family, friends or co-workers and get them active. There are 12-week cycles and each week there is a different activity. Each one is for group involvement emphasis is on fun and participation.

Geoff has designed the program to appeal to the unconverted. In other words it is fairly easy to get the message about exercise across to those who are exercising This is about reaching those who are not currently exercising regularly and helping them get started in a supportive environment.

The health benefits of regular activity are many. Whilst it may sound obvious, there is only benefit if you do it. Those who don’t exercise will get the benefits when they change behaviors and get active. The weekly fitness challenge is about getting people involved at a grass roots level and changing peoples lives for the better. I am very pleased to be able to contribute to this initiative.

http://perform-maxsystems.blogspot.com/2009/09/weekly-fitness-challenge-what-is-it.html

Smoke,mirrors and farm animals.

Two issues caught my eye this week. In my home of West Australia new legislation is being passed to make smoking in cars illegal when there are children present( link 1). This is as usual being hailed as a measure that will “save lives”.

Whilst this sounds great there are some unanswered “awkward” questions. Firstly how exactly is such a law to be enforced? Police are busy enough without trying to see whether cars contain someone smoking in the presence of a child under 17. Practically speaking unless a police car pulls up next to you at the lights your chances of being caught are minimal. Furthermore those who smoke in cars will also smoke at home. Given most people spend more time at home than in a car then how much less smoke are these children being exposed to?

Now the supporters of the bill will say that now that it is illegal, people wont do it because they don’t want to break the law. In other words they will do the right thing. This is the crux of the matter. Issues like this are a matter of personal judgment and not law enforcement. Those who want to smoke in their car will continue to do so, children present or not. Given the extremely low likelihood of penalty the behavior will not change. Those who wouldn’t do so already are doing the “right thing”. Legislating in areas of personal behavior (such as smoking) sends a message that it is the governments responsibility not that of the individual.

Lets be honest-Smoking is not good for you. No one who has started smoking in the last 35 years is not aware of this - yet choose to do so anyway. Petty laws will not change this. As I wrote on June 5 (link 2) the best way to stop smoking is to just stop smoking.

The other issue this week is our old friend the swine flu. Australian Health Department figures show that the spread in Australia is diminishing and that the virus is generally mild. Total deaths associated with H1N1 have been 150. This is significantly less than the usual flu toll in winter.

Despite this plans continue for a mass vaccine roll out. As I predicted on August 28, the government has stepped in to indemnify doctors who administer the vaccine. A special consent form will be used and its distribution will be under a legal clause that endorses its safety. We now have special immunity from damages claims for both manufacturers and doctors, a vaccine which has had little testing and is to be administered from multi dose vials which were effectively banned many years ago.

Public health officials worry that the row over indemnity may have damaged public confidence in the vaccine. If the vaccine is so safe why the need for special indemnity for the manufacturers and the doctors?

For unknown reasons and despite clear evidence to the contrary, public health officials continue to treat H1N1 like they were chicken little and claim the sky is falling. Is this some bizarre farm animal thing? Chicken little doesn’t like the pigs?? Memo to the powers that be -the sky isn’t falling.

Interestingly according to Australian Doctor magazine (Sept 4) a poll of UK doctors revealed 60% would refuse to be vaccinated and 71% of Australian doctors were either unsure or would refuse.

This tells you something. For the record I am in the group that will refuse a vaccine and I will not let my family have one either.

1 http://www.abc.net.au/news/stories/2009/09/11/2682811.htm

2 http://drjoesdiyhealth.blogspot.com/2009/06/stopping-smoking-made-simple.html