For many of us, the idea of lining up for a spot in a nursing home in our hundreds is staggeringly stupid. Until you get into ‘middle age’ when the alternative – carking it- don’t sound so good.  Then there’s a mad scramble to tidy up the health backyard and claw back an extra few years to watch those newly born grandkids hit school and even get married themselves. Suddenly the sheer fun of gaining a spare tyre and wrinkles doesn’t seem worth it.

For those wanting to turn back the clock, I have some tips;

1. Chose your parents wisely. Your genes hold a key to your longevity. A recent US study found that 75% of centenarians hold one of a small number of gene patterns that certainly put you in front of the goal posts for a long life. But given that most of us don’t get much of a say in that area, and also that only 10% with the genetic golden ticket actually make a century, you can still add years with some special lifestyle changes;
2. Eat less. I’m not advocating starving but countless studies have found that gluttony is the deadliest sin of all. Eat till you’re satisfied but not ‘FULL’ and you’ll add years to your life.
3. Exercise. I’d go for 30 minutes of moderate exercise 5 times a week. The good news is that if you are a career couch potato, all is not lost! Recent research from Duke University found that the benefits of exercise kick in whenever you start. I guess that’s tomorrow then.
4. Eat fish. Based on the fact that cultures where fish is the staple, especially Japan tend to yield long livers. Hardly conclusive because Japanese also love watching sumo wrestling and drinking sake and nobody’s advocating that. Given the price of fish to eat and the environmental costs of overfishing our waters, I reckon fish oil tablets could be a good alternative.
5. Eat olive oil. Round the globe to the Mediterranean where a high olive oil diet is credited with countless health benefits. Readily available and reasonably priced, cooking in olive oil is a reasonable idea.
6. Drink tea (and let’s add coffee as well). Packed with the plant based antioxidants, polyphenols, teas have lots of health benefits, longevity being one of them. Coffee has just as many polyphenols as tea and most studies on the stuff coming out now suggest it is as powerful as tea for fending off diseases.
7. Don’t teetotal. Don’t nurse a bottle of whisky in your handbag, but a glass a day of red wine also gives you a powerful dose of polyphenols and studies have found that drinking a small amount regularly prevents heart disease and might extend your innings. Hint 1 glass of red a day is not the same as 7 beers on a Friday night.
8. Go vego. My partner is devastated that his beloved steaks while delivering a great pack of iron do not do great things for your life expectancy. Vegetarians do much better!
9. Destress. It seems that people who can’t handle stressful situations meet their maker slightly earlier than the more chilled among us. Yoga and meditation are good tools for people who need a little assistance to ride life’s rollercoaster.

So tomorrow; a coffee, a good walk, a few fish oil tablets and a salad with olive oil dressing for dinner with a glass of red followed by green tea and yoga. Sound alright? See ya in the nursing home!

Red Bull villification

Reports that Turning Point Drug and Alcohol Centre’s director Professor Dan Lubman has called for Energy drinks containing caffeine, cleverly masked as the health-food-esque ‘guarana’ to be banned and blaming their mixture with alcohol for fueling violence among young people got me intrigued. That’s a euphemism for eye rolling.

These sorts of horror stories sure get headlines, but let’s look at the facts;

• A standard ‘V’ or ‘Red Bull’ contains 80mg of guarana (read caffeine). That compares to;
• A standard shot of Espresso coffee; 80mg
• A 600ml bottle of Diet Coke; 80mg
• A chocolate bar; 50mg
• A cup of tea; 30-50mg

Once we start knocking back 3 or 4 big cans of Energy Drinks, we’re looking at a reasonable caffeine dose to be sure, but banning them altogether is completely over the top and not based on science. There is no evidence that in low dose caffeine causes any harm to teenagers.

In fact as caffeine is a known performance enhancer in sport, a lot of the healthiest and sportiest kids are the ones downing Energy drinks pre-match and so are nervous students in the highest IQ centiles because caffeine helps you concentrate in an exam, especially after an allnighter studying. And many of my Italian and South American friends’ kids have grown up on coffee as have successive generations in their families with no discernable disastrous effects.

As for the Red Bull Vodka combo, there is also no evidence mixing energy drinks with alcohol causes a nasty interaction. But there is PLENTY of evidence alcohol with or without Energy Drink mixers is harmful to adolescents. And guess what? It’s already banned for sale to minors and we all know how much good that’s doing! So before vilifying a product without any evidence that they do harm, let’s concentrate on what we do know;

• Alcohol binges are bad and every effort should be made to curb this blight on our society.
• Illegal drugs cause mental health problems for adolescents and enforcement of this legitimate existing ban should be stepped up.
• Sugar in soft drinks makes kids fat- we have loads of research supporting this. Let’s tax the stuff to divert funds to obesity research and try to protect our kids’ health.
• Research needs to be done before we claim any harms from Energy Drinks.
• Everything in moderation.

I loved my mate, JT (Justin Tamsett’s) blog on workplace stress and its relationship to weight issues today. (Link below) I’m not sure too many board chairmen or women read my blog (I’m not that narcissistic) but I have to have a quick vent about toxic workplaces.

It all started with my patient – let’s call him Brett. A late 40s dad grinding away at getting rid of his mortgage and finding time to spend with his kids …… and slowly but surely developing a nice little (and eventually not so little) spare tyre and- OMG- diabetes. Yep, it showed up in his last set of blood tests to his (and his wife’s)HORROR.

His diet is not stellar but he has good home cooked dinners and a decent breakfast. But there is one trainsmash in his diet that we have to discuss. I’m going to name and shame here. His boss is QANTAS. Qantas gives ground staff at the airport UNLIMITED access to the softdrink vending machines for free while on shift. So like my patient, other Qantas ground crew are putting away litres of fructose-sweetened, artificially coloured and flavoured ROT into their bodies every day. How can Qantas do that? How can a company in which so many Australians have shares give their workers a short cut to heart disease, diabetes and blood pressure like that?

Another patient – let’s call her Jane is a nurse at a local Health Department run Public Hospital. Overworked and with no time for lunch as well as an endless supply of disgusting, cheap, highly processed, high fat, higher sugar, high carb, nutrient void biscuits has seen her head down the same path as Brett. She’s aware she’s stacking on the kilos, especially around the middle, but she’s so stressed, the biscuits make their way down the hatch faster than she can muster the strength to resist.

This is even MORE bizarre- this is a hospital. Sarah fixes overweight sick people for a living while slowly being turned into one of them by the very place she works in! Hello?

OK that’s too simplistic – we all have to take responsibility for ourselves and ‘just say no’ to drinks, biccies, doughnuts and the like. But surely the workplaces can get on board and stop adding to the problem? How about a water fountain, a fruit box delivery instead of a massive corporate biscuit box?

If you’ll indulge me a fantasy, I’d like to put in a word for employees getting employer funded health checks, bonuses for reaching and maintaining individualized health targets and gym memberships as well…. Sigh. I won’t hold my breath!

OK off my soap box. As you were….

JT’s blog… http://justintamsett.com/2010/07/02/where-you-work-makes-you-fat/

OMG I'm dying...........

Stomach cramps, headache, aches and pains and sore throat. That seems to be about the scope of the virus of the week. It’s a nasty one, for sure and I have the deepest sympathy for anyone struck down by it.

So this week I have had a higher than usual number of people coming in for ‘something to just get rid of it.’ Usually the something my patients have in mind is a script for antibiotics or perhaps a new medication slipped into the market while nobody was looking that can knock viruses on the head. By the way if such a breakthrough happened overnight while I was asleep, I want SHARES in the company and am prepare to pay up!

Viruses are still elusive to cure. Not only do they live inside a cell, making cell hari-kari part of the antiviral strategy, but they change so rapidly that as soon as you’ve nailed one, you have to nail three more. We have vaccines against influenza but not these other foul cold viruses.

Being told you have a virus is not being dismissed by your doctor. And in fact I have LOADS of advice for virus sufferers to nail the malady. Your immune system will sort you out eventually but you can give it a helping hand;

1. Sleep. An immediate AND long term immune booster. You know how when you have a virus you want to curl up and fall asleep? That’s a pretty loud press release from your body that you need to sleep- listen to it!
2. Stay home. No-one is indispensible and the more the viral pool at work grows by everyone bringing in and sharing their collective germs, the sicker everyone becomes exponentially.
3. Chicken soup. In almost every culture chicken soup is used to treat viruses. Scientific studies have now backed up the immune boosting properties of chicken soup- although not HIGH quality studies, they’ll do me.
4. Exercise. Rule of thumb- symptoms above the neck (headache, sore throat) go for it… below the neck (stomach cramps, cough) give it a rest. Regular exercise is an immune booster.
5. Zinc and Echinacea…. Studies are OK, far from conclusive. But not much to lose.

This advice is often greeted with glazed eyes, irritation or skepticism. Or more likely ‘Can I just have a script for antibiotics anyway?’

I am a leaf upon the water! ‘You know, I sense your frustration but that would just be doing the wrong thing by you.’

Can someone please just ask for a haemorrhoid check or toenail fungus examination?

Relax!! This won't hurt a bit....

Surviving your pap smear

Here in Australia, our Federal government send us a courtesy love letter to remind us to attend our biennial grease and oil check; the pap smear.

For reasons that hardly need expanding, women are often not overly keen to strip off and bare all for this fun little test. But it is necessary. The pap smear is trying to detect the red flags that suggest a cervical cancer might me on the way. The red flags on a pap smear are completely without symptoms so unless you have your tests, you’d never know they’re there.

The red flag changes come as a result of contracting Human Papilloma Virus, sexually. Don’t freak too much if that’s you because this virus is really common. In a recent US study, researchers found that around 27% of women test positive for the virus. That’s twice as common as herpes. I just got my stats back from the pathology company I use and 20% of my pap smears come back with a ‘low grade abnormality.’ So if you’ve had the dreaded call from your doc telling you all is not well with your pap smear, you’re in good company.

Very few of the pap smear red flag changes will go on to become cervical cancer and even if they do, we think there’s around a 20 year lag between the first abnormal pap smear and the cancer in earnest.

Once you’re convinced of the necessity of a pap smear, there’s the other business of surviving the process without making 100,000 excuses to be elsewhere.

Meanwhile here are 5 hot tips to make your pap smear less daunting;

1. Chocolate. Try having a piece while you’re in the waiting room. The stress busting ingredients in dark chocolate will take the edge off the event.
2. You can leave your socks on. Nothing makes you feel even more naked than being cold as well as stripped down. Leave your warm socks on.
3. Make a fist. In fact 2 fists under your bottom will tilt your pelvis forward and make it easier for your doc to find your cervix if it points backwards- as do the little womb necks in a third of women. Less digging and excavating makes it less painful for you!
4. Have a wash. Believe me this is more for you than for me. But being self conscious about smells etc makes it all worse. A quick 5 minute bathroom stop can make you feel more at ease.
5. Don’t rush. Coming in frazzled having left work 5 minutes late for the appointment is a nightmare. Allow yourself some time and arrive feeling calmer.

Hoping yours is only every 2 years!

Admin Aversion Disorder

Who are the grand poo bahs who decide what constitutes a mental illness? The writers of the DSM IV manual? Let me in because I want to create a new mental health category; Admin Aversion Disorder.

To get a diagnosis of AAD the patient must have four or more of the following clinical features;

1. At least 3 bills have been unpaid to the point of having a phone, Foxtel or gas cut off. This is because the bills were lost, somewhere in a pile of papers in one of 17 locations or because paying bills did not make it to the ‘To Do’ list.
2. What is a ‘To Do’ list?
3. The 17 piles of papers have become leaning towers of shredable mess that are now altogether too unwieldy to sort through.
4. Regularly a no-show at business meetings, social arrangements and dental appointments as either there is no diary, the diary exists but is not checked, the diary entries are sporadic in nature and often incorrect making the diary a useless resource.
5. Has a potential $5000 owing in Medicare or private health insurance rebates if the original receipts for medical expenses were discoverable in the paper piles and the patient in question could be bothered filling in and lodging forms.

The aversion to admin curiously overlaps with a particular kind of genius that ensures peculiar success in many arenas of life, especially in one’s career. Provided the AAD sufferer has the kind of personal assistant who does not think questions like ‘when is my wife’s birthday?’ and ‘what did you buy my mum for mother’s day’ to be crossing the line, he can appear to be reliable, punctual and efficient, fooling many intuitive colleagues.

On the other hand, for those afflicted without the benefit of said uber-assistant, the sufferers’ parents, partners and colleagues are often in need of support sessions, group therapy and several punching bags. I’m thinking of applying for a Government grant to set up a support group. Any lobbyists out there wanna help?

Easy for you to say!!

I still break out into a cold sweat when I see old video footage of ONJ in her leotard ‘getting physical’. No, not that sort of cold sweat; the kind that confirms my complete nausea and fear of a spin class or anything else that will force me into a gym.

So how happy was I to read the latest issue of the American Journal of Preventive Medicine?  A study published in the latest issue found that it’s not the volume of high intensity hard core work outs you do that kick your health along, but the amount of general activity. You know, passive stuff like walking around, without getting your heart rate up and your armpits saturated!

For every 1000 steps people take per day, the authors reported, there were huge reductions in waist circumference, triglycerides in the blood and boosts in good (HDL) cholesterol levels. Being moderately active (5000 steps a day) gave you a 40% lower risk of developing metabolic syndrome (spare tyre around the middle plus high blood pressure, high triglycerides, low HDLs and funny sugar metabolism) than people who were  total couch potatoes.

Gym junkies are often so exhausted after getting physical 80s style that they collapse in front of their computer screens for the rest of the day and end up with no net benefits in terms of steps taken than those of us who are gym avoiders.

So there you go. If the thought of heading out for a pump class or a fun 10k run makes you want to puke, it’s not all curtains for your health after all.  Just make sure that you get your steps in bit by bit!

GlaxoSmithKline PLC has pulled its trials of the miracle ingredient, Resveratrol (the 11 secret herbs and spices in red wine) over safety concerns. A Swedish study of over 35,000 women found that taking a multivitamin might GIVE you breast cancer, not prevent it.  Another study found that taking B vitamin supplements, the stuff in cure-all tonics, like Berocca ages you kidneys.

I know you’re thinking that I’m a doctor and that however apparently young and blonde I look on the outside, at the core of every health professional is a die-hard cynic awaiting an opportunity to stick the knives into ‘alternative therapies’. Nothing could be further from the truth.

But here’s your reality; We know people who eat lots of vitamins and minerals, via their diet are just healthier in every way you can name - heart disease, cancer, arthritis, mental health. But that logic does not extend to extracting the good stuff out of the red wine, fruit and veg and whacking it into a pill. Especially when you take a pill but continue to lead a high carb, highly processed, low activity lifestyle. In fact, as we’re starting to see, they can do more harm than good.

I’m not panning the vitamins. I’m just saying that you’re better off getting them the way nature intended rather than hitting up the local health food store to expunge your salary in the purchase of supplements.

Bonding at what cost?

This is one for all the pregnant ladies out there; I don’t mean to be too blunt, but we need to have a pretty frank conversation. And nobody else is going to have it with you, so here goes;

How have you pictured your labour? OK, specifically, where is your husband or boyfriend going to be situated during the process of bringing your precious baby into the world? Is he going to be the welcoming party ready to say g’day to the little emerging face? I want you to think about it carefully. Because lots of guys feel pressured to hang around at the business end of your body to usher his new offspring into its mum’s arms. And that might not be the best spot for poor dad.

Once down at ground zero he is likely to see his Holy of Holies, the temple of love where he used to worship being stretched into a grotesque and very large hole; possibly it will rip in a less than sexy way; chances are that mum will be adroit at pushing and push out a little poo as well, with or without some brand new shiny haemorrhoids; and the sight of a crowning head ain’t no aphrodisiac. The problem with seeing a birth is that once seen, it can’t be unseen and seeing it is often extremely traumatic.

No matter how extreme the joy of holding his precious, living, breathing baby in his arms for the first time and hearing his healthy cry fill the room, in the weeks and months after the birth, the vision of the vagina in full flight doing what nature intended can haunt men and kill their once thumping desire for you.

Right now, having your husband panting for your love might not be top of your agenda. But you and your baby need a strong partnership at the rock hard foundations of your new family. And your relationship with the father of your child, including your sexual relationship, will be the glue that holds your little family together.

I have no way of predicting who will adore the sight of an emerging baby and who will faint at the sheer ugliness of it all. But before everyone just assumes that ‘he’ll be right, mate’, it might be worth having the conversation that gives him permission to take up a tactical position at the human end of the process, holding your hand and kissing your forehead, instead of base camp watching it all unfold.

Good luck with it all!

Love driving? Hate being at home in the evenings? Then taking on extra activities for your kids could be for YOU!!

Hands up who gets to eat dinner as a family more than three times a week? It’s a noble aim to be sure with 3 being the magic number that sees kids have fewer brushes with the law as they get older, less obesity and less mental health issues. But from where I sit, the family dinner is becoming a threatened species. It’s not dad’s work or the intransigence of a 6pm tea time that is tearing apart the family tea time ritual in the 21^st century. No sir. Blame it on the after school activities.

I’ve flown the flag hard against the scourge of ballet lessons, tennis coaching and, especially extra Maths or English classes for years. I reckon Ian Thorpe’s mum deservers a medal for setting her alarm for 4:45am every single blinking day n the name of her son’s swimming career. As for the rest of us without sporting superheroes on our hands, the idea of spending the cash equivalent of a fabulous family holiday on extra classes and uniforms to sit in a car and ferry around the kids so they can move from below average to average in a tutu is anathema. Forget it. Pick one activity each and I’m in. Start talking piano and cricket and tuba and I’m leaving home.

I understand that children need to be socialized. That’s why I send mine to school. I understand they should do sport. But with a series of studies failing to find any benefit from anything less than an hour a day of sport (whether co-curricular or extra-curricular) for kids in terms of weight, blood pressure or other health measurable, I’m not prepared to spend hours of my life in a car. Not when I could be spending quality time in the laundry. Or with the kids chatting in our kitchen.

A quick straw poll of my friends and patients has found that most are spending less time together eating a meal as a family as their afternoon and evening time gets cannibalized by the children’s voracious appetite for after school activities. I was feeling very smug and superior until Sam, my eldest started driving. Unfortunately for me, the downside of Sam getting his own car is that all of a sudden, my boys are out doing their sport until 8pm or later each night 4 evenings a week. I can no longer say no. And our chances to eat dinner as a family have dwindled. I miss the boys terribly.

Given that so much research has found that it’s time spent sitting together as a family over a meal that yields massive dividends for the physical and emotional health of our kids (please note the TV was specifically excluded as a family member for all of this research), should we be stricter in limiting our children’s time with their coaches and tutors and demanding they come home while we still have the power to call the shots?

What do you think?