The tyranny of health

In the 1990s, we are as obsessed with health as the Victorians were with death

In the 1990s, we are as obsessed with health as the Victorians were with death. Being healthy has been elevated to the status of moral achievement.

If your lifestyle isn't low-fat, high-fibre, sugar-free, organic, free-range, cold-pressed and extra virgin you are condemned to die before your time. People who get cancer or heart disease almost feel that it's their own fault. Those few stick-thin souls who manage to stick to a programme of rigorous exercise and diet are admired and extolled as the 1990s equivalent of the medieval, self-flagellating, religious ascetic. If one of them gets sick, we blame environmental pollution rather than lifestyle.

Many of us are turning neurotic, confused and chronically anxious, having been bombarded with contradictory health information from all kinds of sources - some accurate and some not. Health issues saturate the media. The average TV viewer has seen as much bloody surgery as a medical student. We even surf the Internet looking for medical websites to help us diagnose our own diseases. Irresponsible headline writers whip us into states of high anxiety by reporting the latest medical research paper as if it was the last word, when in fact you have to look at all the accumulated research in order to make a judgment.

We lap it all up and enjoy the hysteria. Remember the scare about antimony in baby cot mattresses? It turned out to be groundless. And the panic about the Pill? All nonsense.

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Yet we never learn; such scares merely whet our appetite for more. "We've become a hypochondriacal society," believes Dr James McCormick, retired professor in the department of community health, TCD. "It doesn't matter a damn what you eat unless you eat extremely bizarrely, and being plump is probably good for you." He asserts that, contrary to common belief, medical knowledge is insufficient to prevent, predict or screen reliably for diseases such as cancer and heart disease. His advice is to enjoy a life of "modified hedonism" and "keep your fingers crossed".

He admits his view is heretical in a climate in which the State leads us to believe that health is ultimately a matter of individual responsibility. The State preaches that cancer and heart disease are related to lifestyle factors such as diet and exercise, yet the State offers no screening programmes and condemns the worried-well and the truly-sick alike to waiting lists. The guilt that comes from passing the buck to the patient serves the State, since it is harder to complain on a waiting list if you think you put yourself there in the first place. The truth is that lifestyle is a secondary factor; we all have to die sometime and the clue to when and how is in the genetic hand of cards your parents gave you. Environmental factors - such as diet, smoking and exercise - may unmask or trigger genetic vulnerabilities which already exist. If your parents and grandparents lived into their 90s, you probably will too - if you're not struck by lightning first.

If medical science knew which people were prone to which diseases and conditions, we'd be a long way towards significantly extending life-spans through helping people to avoid the triggers, not to mention the holy grail of gene therapy. But we don't know who will die of what. Other than taking the sensible step of discussing your family medical history with your doctor and taking appropriate action, trying to protect yourself against all possible diseases is a waste of time.

Because we lack the scientific knowledge to pinpoint which specific individuals are predisposed to which particular diseases, State educators can merely give general advice which, they hope, will benefit enough people to cut health care costs for the State. Money is the bottom line. Mass health education programmes are intended for the benefit of the State, rather than the individual. All of us are made to feel anxious, in order to help only a few.

But why worry? Propaganda about exercise and diet would have you think that the Irish are among the least healthy in Europe, when the opposite is true. More Irish exercise regularly than any other nationality in Europe. Research by the Institute of European Food Studies at Trinity College Dublin, to be published by the EU shortly, (see bar charts) found that 47 per cent of the Irish maintain an exercise programme, compared to only 29 per cent of Europeans, on average, and 14 per cent of Greeks, in particular. For the 53 per cent of Irish people who are not exercising, the cure is easy. A beneficial exercise programme need consist of no more than four or five 20-minute walks per week. The news that should have us celebrating is that a mere 15 per cent of Irish people are total slobs, refusing even to consider exercise, compared to 27 per cent of Europeans.

As for the temptations of food - we're total hedonists. More than half (55 per cent) of Irish people have no intention of improving their diets; they think they're healthy enough, according to research by the Institute for European Food Studies. Fifty-two per cent of Europeans feel the same way.

"Here we are bombarded with information to increase fibre and reduce fat and eat more fruit and vegetables, and we don't use it," says Dr John Kearney, scientific director of the institute, whose research was commissioned by the EU.

"We found that people tend towards two extremes - the frenetic, frantic, diet-conscious type, and the others who are the ultimate slobs and couldn't care less. They hate exercise and have no intention of ever exercising."

The Irish and European pattern seems to be that we are overwhelmed, so that half of us feel anxious while the other half have turned off the issue completely. The State health information may well be back-firing because, combined with what we hear from advertisers, it creates a garbled picture of a universe in which every meal could decide our fates and the trip to the supermarket is more like a trip to the pharmacy.

We're encouraged to treat food as medicine, yet at the same time we're deceived into believing that we are informed, when in reality we may know very little of value. The things we think we are doing right are as likely to be useless and based on fallacies such as "sugar is bad for you" and "grapefruit makes you lose weight" or "you can't eat too much olive oil", according to Dr Mary McCreery, nutritionist at the Blackrock Clinic, Dublin. "I would thoroughly agree that because we are more knowledgeable we've become neurotic about our health, when in fact we're far healthier, we have fewer diseases and our food is safer than any time in past history. And yet people are fanatical about their health," she says. "You don't see nutritionists and doctors going around in a state of anxiety about their diets, and if anyone was to be interested, they would be," she adds.

"We don't suffer from malnutrition, we're over-nourished if anything. What's worrying is that people are going to extremes. "People worry too much about nutrition and deprive themselves of foods they may need so that diets are not balanced. The kind of thing I'm concerned about is mothers imposing strict rules on children's eating habits, which is completely unnecessary."

The State's role in the tyranny of health is to raise our anxieties, while not helping us do much about them. Dr McCreery thinks that it is "outrageous" that the State tells us to "be a healthy weight", while out-patients who need to see a nutritionist will find that private medical insurance does not cover this service, even if the patient has diabetes, coeliac disease or anorexia. We're all wound up with no place to go. It's no surprise, then, that one-third of Europeans feel the key factor in their health is not diet, or exercise, but stress, says the Institute for Food Studies. And what is causing the stress? The State, by not making quality of life a priority. Instead, it encourages us to "learn to handle stress". Forced to spend hours idling in traffic jams, we don't force the State to do something about the traffic - instead we go to stress counsellors.

I'm not saying that we should all surrender to fate and submit to sedentary lifestyles, but the truth is that we need to do very little to feel healthier. You don't have to spend precious time in the gym or out jogging. Instead, enjoy a 20-minute stroll, relax with a glass of wine, eat dessert. Life should feel good, not guilty.