When was the last time you took you car for a check? Most of us service our cars and do ‘MOT’ annually. It is surprising that with the human machine, we are less likely to make any effort. So where do you lie on the continuum, from one extreme characterised by “I can’t be bothered” or “you’ll die of something anyway” health belief, to the opposite hypochondriac who expects the worst from the least headache, cough or other symptom.
The building blocks for wellness are the basic needs of life, followed by healthy diet, regular physical activity, not smoking and a positive approach to life. The opposite habits when practised over time can result in chronic diseases such as obesity, diabetes, hypertension, stroke, heart and lung disease amongst other problems.
According to the World Health Organisation (WHO), the socio-economic environment, the physical environment we live in and an individual’s characteristics and behaviour determine our health. To be born with the right genes, ‘we have to choose our parents carefully!’ If the super powers never seem to agree on climate change, what can ordinary people do? Never a day passes without another economic-melt-down story.
The reality is that we cannot choose our genes; we have little or no control over the health service, the environment we live in or the state of our nation’s economy. However, we can take charge of our lifestyle. There is no quick fix but we can make slow and steady improvement.
Physical Activity is any bodily activity that results in the expenditure of energy. Anything that you do which makes you sweat, breathe faster and your heart to beat faster can be considered physical activity. We are all encouraged to be active for at least thirty minutes on five or more days every week. Less than 4 in 10 men and women meet these targets in the UK. Our bodies are made for movement – to walk, run, jump etc. not to hug the remote control, eat crisps and watch TV.
It is a fact that people take up the disease patterns of their inherited countries. A former university games gold medallist whose weight was steady at 75kg for more than five years immigrated to UK. A decade later, he weighed 95kg. During those years, as his weight crept up he joined fitness centres, bought a treadmill and exercise bike but never found the time to exercise. Knowledge is ‘knowing the right thing to do’; wisdom is ‘doing it’! Most people know they need to be more active, so what would it take to get them off the couch?
Healthy Eating is another sore point. You are what you eat. Fat, salt and sugar are the three main food items most likely to cause health problems when eaten without a thought.
The ‘5-a-day’ message has been around for some time now – 2 pieces of fruit + 3 portions of vegetables every day. From childhood, we appear to be programmed to avoid everything green in the plate. In reality, one cannot have too much vegetable as these form the bulk of faeces while supplying the micronutrients our bodies need to function. People who dislike vegetables and avoid them at meal time are more likely to have a longer transit time for food. They risk being constipated amongst other problems.
- Fat: Foods rich in fat invariably lead to elevated cholesterol in the body which over time makes the arteries narrow (blood vessel disease), can worsen the blood pressure and ultimately cause stroke and/or heart disease.
- Salt: Our bodies require salt to function but too much salt is bad. Research has shown that communities with low salt intake have lower blood pressure than those with higher salt intake. High salt intake especially amongst Africans is a recognisedrisk factor for high blood pressure.
- Sugar: The breakdown of sugar at the cellular level leads to the production of energy which the body requires for all its activities. Excess consumption of sugary foods as well as abnormalities in the pathway of glucose breakdown can contribute to diabetes, a multi-organ disease which is becoming more common as our lifestyles change.
The simple message is ‘do all things in moderation’. Our mothers taught us that the shortest route to a man’s heart is through his stomach. The time may have come for us to add that the fastest route to a man’s heart attack is also through his stomach. Remember, you are what you eat!
In the UK, alongside other health problems, stroke rate, diabetes and childhood obesity are commoner among people of African descent than the general population. Our illness behaviour and access to health services are quite different. There have always been issues of postcode lottery of care – the worried well are more likely to get prompt treatment. Social and political constraints are common and may be the fine line between excellent care and a fatal stroke.
Let us re-emphasise that you cannot choose your genes. The environment and the health services are largely beyond an individual’s control. It will take concerted efforts of well-meaning people shouting at the top of their lungs for many years to positively change the broad determinants of health. In the meantime, we can all start the journey to a healthier, perhaps happier life if we look after ourselves better.
You can be more active, eat healthier and stop smoking. The next step is to know your number. There are reference ranges for the following measurements:
- Weight
- Body fat and Body Mass Index (BMI)
- Abdominal circumference
- Blood Pressure
- Glucose
- Cholesterol (Total & ‘good’ cholesterol)
- Cardiovascular Risk Score
The advantage of knowing your number is that you can either be reassured that you are moving in the right direction and keep at it, or realize that you are heading towards an on-coming train and quickly change direction.
We make choices every day. Whether good or bad, they are our choices. Where our choices lead to disease, disability or death, the implications may be far-reaching. If you have husband/wife, parent, sibling or offspring, extended family, friends and other loved ones, this is an urgent wake-up call. It is not enough to blame the government, the health service, your doctor or nurse, or big businesses (the manufacturers of ill health) for your health problems or even the excess gain [‘spare tyre’]!
Take action about your health today – Know your number!
Dr Hector is a GP in Leeds, UK with keen interest in lifestyle intervention and community coalitions for health. He is a Director of KayHector Consulting Ltd, which coordinates health checks, second medical opinion and medical referrals for health tourists to UK and other countries.
