Prof Donal O’Shea: ‘The shocking fact is that most ill-health now comes from our lifestyle’

Since his return to Ireland in 1999, Prof Donal O'Shea has been the lead clinician for a hospital-based multi-disciplinary obesity service in St Vincent's University Hospital.

A regular commentator on the importance of preventing obesity, the professor has repeatedly spoken out against the marketing of junk food to children and promoted the importance of regular physical activity into everyday life.

In 2017, he took on the part-time role as clinical lead for obesity in the HSE, and chaired the health impact assessment group on the potential benefits and harms of a tax on sugar-sweetened drinks. He also co-chairs the Royal College of Physicians Policy Group on Obesity.

Prof O'Shea is a consultant endocrinologist at St Vincent's University Hospital and St Columcille's Hospital, Dublin. He lectures in endocrinology to medical students at University College Dublin and the Royal College of Surgeons in Ireland.

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Following his degree in medicine from UCD in 1989, he worked as a registrar in general medicine, cardiology and endocrinology and later as a senior registrar in the Department of Diabetes & Endocrinology in Hammersmith Hospital, London. In 1996, he became consultant physician/senior lecturer in diabetes and endocrinology at Charing Cross Hospital, London.

Prof O’Shea says he is not at all comfortable in being called a “Health Hero”.

1) What are you most proud of?

I am probably most proud of my involvement in policy matters such as the sugar tax and calories on menu boards – I didn't see that coming as part of my career. Its been a massive effort across many organisations (Department of Health, HSE, Royal College of Physicians, Food Safety Authority, Safefood, Operation Transformation etc) and strongly opposed by the food and drinks industry. I have become closely and publicly associated with that drive and am very pleased to see it getting over the line.

2) What motivates you in your work and life?

“Unmet need” motivates me in my work. I look at health services available for individuals with strokes, heart disease and some cancers and say to myself why are the same not available for patients with obesity and gender issues. In life, it’s all about finding a purpose or meaning.

3) What do you do to keep mind and body healthy and well?

I try to keep in mind the mantra of “everything in moderation – including moderation” . For physical health I try to get my 10,000 steps in every day (monitored on the health app on my phone) and about eight years ago I decided to start doing my age plus one in press-ups first thing when I get up five days a week. We often overlook the importance of a little bit of resistance work for long term health. I am now doing 53 every day!!

For mental health I try to spend at least 45 minutes every day in quiet time – reflection, meditation – call it what you will. If my day starts in St Vincents Hospital, that can be in Donnybrook Church – it opens at 6.30am and is a haven of quiet. Or if my day starts in St Columcilles it can be stopping the car and looking over the magnificent sunrise on the east coast as you come off the M50 at junction 17. I also have the privilege of regularly teaching the medical students in UCD and RCSI – and if you need any reminding of how fortunate you are in your job, then teaching people who are enthusiastic and idealistic at the start of their journey is just the trick.

So by the time I get to work most days, I will have done a bit of physical work and a bit of mental work.

4) What are the most important factors to maintain a healthy society?

It sounds clichéd but to make “the healthy choice the easy choice for all of us” is our major challenge as a society. We are all living longer than ever – but unfortunately with more years of chronic disease. That feeds in to a pharmaceutical industry that is delighted at what is ahead for its shareholders. We need a societal response to that – saying this is not acceptable and we must do better. We need safe active commuting, healthy eating in schools, better attitudes to breastfeeding . . . the list goes on. All of these things must become the new norm over the next 50 years, otherwise we will have failed and our currently overwhelmed health service will be submerged.

5) What needs to be done in Ireland to achieve this?

Backing the Healthy Ireland Framework is a pathway to achieve much of this. Healthy Ireland needs to be resourced and pushed. It is vital that it is not linked to a particular political party or government – it must be seen as bigger than that. We are five years into the 12 years of the Healthy Ireland Framework. It’s a long-term prize that we must keep our focus on.

6) What do you think is the most pressing health issue in Ireland today?

Cost – and because of that the rationing of health care that will inevitably follow. The cost of treatments is already prohibitive. The shocking fact is that most ill-health now comes from our lifestyle – food and drink consumption and physical inactivity. This presents an opportunity for society to have a different approach. If you live healthily into your 80s, the cost of your final illness is much less than if you have your final illness when you are in your 50s or 60s. That’s what we need, more people living longer with less chronic disease.

7) How do you think the Minister for Health needs to tackle this?

The Minister needs to realise that we cannot treat our way out of the obesity, cancer or cardiovascular disease crises. We simply must get a robust preventive strategy in place - to run alongside our treatment strategies.

8) What do you do to relax and unwind?

I find the 45 minutes of quiet time most days really helpful for keeping me relaxed. I don’t tend to get wound up or angry in general. I love walking and reading and we spend two weeks every year in a beachfront cottage in Inchydoney, Co Cork. For me, these two weeks of non-stop sea and west coast waves are hugely therapeutic. I also thoroughly enjoy following Italian rugby – a recent interest since my brother, Conor, took over there as head coach.

9) What makes you laugh?

Modern Family, my family, Mrs Brown and Mario Rosenstock.

10) Where would you like to live other than Ireland and why?

London. I spent a magnificent eight years there in the 1990s. I had difficulty leaving – it is such a bustling, buzzing, full of opportunity place that is really fair to the Irish.

[ irishtimes.com/healthheroes ]

Our Health Heroes
1 - Martin Nevin: Even unwashed and medicated up to my eyes, Martin makes me feel beautiful
2 - Maureen Durcan: That so many live on the poverty line in Ireland is incredibly sad
3 - John Burke: Managing mental health should not be like climbing a mountain
4 - Derek Devoy: The Kilkenny taxi man whose drive saves lives
5 - Sarah Fitzgibbon: Society has to stop treating the marginalised and disabled as charity cases
6 - Kathleen King: I wanted to make sure no one else would have to wait nine years for a diagnosis
7 - Caoimhe Bennett: The schoolgirl raising understanding about young carers
8 - Ann Norton: Our hospitals are a disgrace. We are letting down our doctors, nurses and whole society
9 - Una McNicholas: My proudest achievement is being able to help care for my sister
10 - Catherine Cox: Family carers are a hidden army of exceptional people fulfilling a role they did not ask for
11 - Prof Rose Anne Kenny: Good friendships make for a healthy life as much as regular exercise and healthy diet
12 - Dr Robert O'Connor: Within my lifetime we could eradicate cervical cancer with the HPV vaccine and screening
13 - Claire Cahill and Michelle Long: Scoliosis campaigners battling to reduce waiting times for children