Blog Posts

Eat Less, exercise more

10/4/2013

The British Medical Journal has just published a research article documenting the improvement in the health of the Cuban population following the collapse of support by the Soviet Union. (it is well summarised with an interesting infographic in The Independent http://www.independent.co.uk/life-style/health-and-families/health-news/the-cuban-diet-eat-less-exercise-more--and-preventable-deaths-are-halved-8566603.html)

As a result of this loss of support, "food and fuel were in short supply in Cuba from 1990 resulting in millions going hungry and having to abandon their vehicles and walk.Cars and buses virtually disappeared from the roads as fuel supplies dried up, and farmers had to abandon motorised machines and work the fields manually. The Government issued one million bicycles to keep the population on the move.

Between 1990 and 1995, the average Cuban consumed fewer calories than they expended each day, leading to an average weight loss of 5kg.

Deaths from diabetes began to fall in 1996, five years after the start of the weight loss period, and remained low for six years. Deaths from heart disease and stroke which had been declining slowly since 1980 suddenly went into free fall from 1996."

But the message is contained in the four words "eat less, exercise more". We don't need to starve ourselves but we could all reduce our food intake a bit. We don't have to abandon the car completely, either, but perhaps walking a little more.......?

A simple message, but the benefits for health could be enormous.

Author: Michael Monk

0 Comments

"It's the knees that go first"

26/1/2013

0 Comments

We are living longer - life expectancy is increasing - but more of those extra years are lived with chronic and debilitating disease. According to figures from the US, in the last 10 years we have lost, on average, a full year of healthy life due to the rise of the major diseases that affect Western populations (diabetes, cancer, cardiovascular disease, obesity and arthritis).

We also spend less of our life fully mobile. Functional mobility has been defined as “the ability to walk up ten steps, walk a quarter of a mile, stand or sit for 2 hours, and stand, bend or kneel without using special equipment.”

Only ten years ago, the average 20-year-old man would spend 3.8 years of his life with impaired functional mobility. Today that number is 5.8 years. Women do even worse. Ten years ago, that number was 7.3 years and has since risen to 9.8 years.

Almost ten years of one’s life without basic mobility.

These numbers have not increased because of accidents or injuries. The increase is due to a broad and gradual systemic decline – the kind of impairment that is almost always preventable by effective and consistent lifestyle intervention.

Jokingly, we say “It’s the knees that go first”. But - many a truth in jest - if painful and stiff knees are starting to restrict your exercise and mobility you need to do something about it.

Now.

Author: Michael Monk

0 Comments

Lack of sleep is linked to weight gain

26/10/2012

0 Comments

Lack of sleep makes fat cells sluggish
You know that not enough shut-eye makes you irritable, but did you know that lack of sleep has also been linked to diabetes and weight gain? Researchers had not understood why, although one theory links it to a rise in the stress hormones, cortisol.
Some recent research, recently reported in New Scientist 20 October 2012, from the University of Chicago suggests another answer (Annals of Internal Medicine, DOI:10.7326/0003-4819-157-8-201210160-00005).
Matthew Brady and his team tested fat cells taken from the bellies of seven adults who slept for 4 nights for up to 8 and a half hours and then another 4 nights for only 4 and half hours.The team found that after sleep deprivation fat cells were 30 percent less responsive to insulin (a hormone that makes muscle, liver and fat cells take up glucose after a meal). This leads to higher blood glucose levels which are linked to diabetes. Fat cells also release the appetite regulating hormone leptin, and this mechanism may also be disrupted by lack of sleep.

The researchers were surprised by the strength of the response to lack of sleep. As they pointed out, four nights of sleep curtailment "represents a real world situation, such as sitting for final exams or having a newborn in the house".

Author: Michael Monk

0 Comments

Are your headache pills giving you a headache? Try acupuncture.

14/10/2012

0 Comments

Are your headache pills giving you a headache?
More than one million people in Britain may be suffering from constant, crippling headaches because they are taking too many painkillers, experts say.

The pills people take to relieve headaches and migraines may be making things much worse, according to the National Institute for Health and Clinical Excellence (NICE) in guidance to the health service for England and Wales.

So the tablets you take to relieve that awful headache may well be just making matters worse.

The problem begins with taking the odd painkiller for tension headaches or migraines, which usually works. But some people take the pills more and more often, until they are on tablets for more than half the days in a month. Nice says that if this goes on for more than three months the medication ends up causing the problem it is intended to cure.

At risk are those who are taking paracetamol, aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, for their headaches, either alone or in combination, for 15 days a month or more. (Bear in mind that long term use of paracetamol and NSAIDs also increases the risk of developing Alzheimer’s disease).

The risk of increasing the number of headaches or migraines is also carried by migraine sufferers taking triptans, opioids, ergots or combination analgesic medications for just 10 days a month or more.

“It may get worse before it gets better”
The solution is far from easy. Manjit Matharu, honorary Consultant Neurologist at the National Hospital for Neurology and Neurosurgery, said people needed to stop taking the painkillers completely.

"For the first two to three weeks, they are likely to have a severe rebound. They will have an awful two to three weeks. Patients understandably worry about how they are going to feel in the middle of a withdrawal," he said.

"What I do is make sure that anybody who is going through a withdrawal and [who] I know will be in a huge amount of pain does not have the usual responsibilities." He will write sick notes to excuse people from work and call relatives to make sure there is support. "We find if we do this, in a supportive manner, it is quite successful, 80% of patients successfully do it when you outline to them that there is an awful phase but you will feel much better after it."

What’s the alternative? Acupuncture is good, says NICE

The NICE guidelines on the management of headache published in September are a little confusing in that having recommended patients stop their medication and analgesics, doctors should then prescribe analgesics, such as NSAIDs, and triptans!

One positive statement though is that patients should be offered a course of acupuncture for tension type headaches. They recommend up to 10 treatments but our clinical experience has been that usually 5 or 6 treatments are enough.

The guidelines only talk of acupuncture for tension type headache, but our clinical experience,again, has been that it is very effective for migraines and hormonal and period related headaches too. There has been a very large study in Germany which showed the benefit of acupuncture for migraine and there was a British study demonstrating that acupuncture was more effective than conventional treatment, which was actually carried out at the National Hospital for Nervous Diseases (as it was then).

Other ways - exercise and osteopathy

Regular gentle exercise - yoga, pilates, swimming and walking, will almost certainly help to reduce tension type headaches. Many headaches are due to problems in the neck and these may well be helped by gentle osteopathy which looks to find the areas of tension and stiffness and then to relieve them by achieving more mobility and flexibility.

NB Any persistent or sudden severe headache should always be checked by your doctor first.

Author: Michael Monk

0 Comments

Bigger than the Olympics?

8/8/2012

0 Comments

Bigger than the Olympics?
London 2012 looks as though it will be the most successful Olympics of all time for Britain. Jessica Ennis, Bradley Wiggins, Ben Ainslie, Mo Farah, Andy Murray... the medals kept coming. But the Olympics are for youngsters – few will still be competitive beyond the age of 32.

Even the brilliant opening ceremony by Danny Boyle was a celebration of the young. The oldest participants (excluding the Royals) were Paul McCartney and the NHS, and Sir Paul looks in better shape.

Next year though is the World Masters Athletics (WMA) to be held in Brazil – 50,000 athletes are expected to take part. That's a lot more than the London Olympics. Although some will be older elite athletes, including some past Olympians, many of them will be newcomers to sport and exercise.

The WMA was founded to encourage sport in women over the age of 35 and men older than 40, but the message may be“You’re never too old”. Charlie Booth  the Australian sprinter won gold at the age of 99 (maybe because he was the only entrant in the 95+ age category). Another Australian, Vic Younger, aged 90, took 8 gold medals and 2 silver in weightlifting and athletics. He only took up exercise at the age of 60 when he retired from work.

Grow old disgracefully – down with ‘normal’ aging!
It’s easy to dismiss these as exceptional examples, as not normal. We may think that there are two separate races of humans; those that can and those that can’t. Perhaps this is nowhere more obvious than in the US where the country that has the highest rates of obesity in the world is top of the Olympic medal table. We seem to believe that getting older has to be accompanied by illness, infirmity, suffering and increasing reliance on medication. This is accepted as ‘normal’ aging.

But the research evidence of hundreds of studies on older adults and physical activity show that regular and moderate exercise can
cut age declines in half and reduce disease risk by 50%. Studies show that people feel better right away (less aches and pains, improved mood, better sleep, alertness, more energy, improved flexibility) and in time do better (get stronger, less breathlessness, lose weight, improve their memory, avoid diseases and reduce the risk of stroke, diabetes, cancer, premature heart
disease and early death). They are getting older but they are staying fitter and enjoying those extra years.

There are several reasons why older people choose not to exercise – fear of injuring themselves, fear of embarrassing themselves and looking foolish, the belief that older people just don’t run or jump or swim or whatever. But in developing countries and more primitive cultures physical exertion does not stop at age 60 or 65. Exercise is a necessary part of life and these societies do not suffer from the Diseases of Western Civilisation (cardiovascular disease, obesity, osteoporosis, diabetes type 2, some dementias).

Sitting still will kill you
Sedentary living (not exercising) leads to the same risks as those experienced by a 20 per day smoker. For thousands of generations humans needed to expend large amounts of energy simply to get their food (either hunting wild animals or scavenging and gathering nuts and berries). We still carry those genes within us. But modern lifestyles mean that we hardly exercise by comparison with our ancestors, and this lack of exercise is what leads to obvious disease.

Well-derly or ill-derly?
Fortunately we now know enough about the effects of exercise in the body to reverse much of the damage that inactivity brings. We
don’t actually need to do a great deal but what we do need to do should be brief, high intensity, and include resistance training (usually weight training). One study encouraged a group of 90 years olds (the oldest was 98!) to follow an 8 week programme of high-intensity resistance training. They registered an astonishing 174% increase in leg muscle strength, with an improvement in walking speed of 48%.

Because exercise has such a huge influence on whether or not we suffer from chronic disease, you can largely choose whether you will be well or ill in old age;" well-derly" or" ill-derly".

“Just do it”

Author: Michael Monk

0 Comments

Forward>>