The year of living a little less dangerously

 

No New Year's health resolution would be complete without a nod to smoking and drinking. Many smokers will be thinking of giving up now - if they didn't smoke their 'last' a minute to midnight on New Year's Eve and drinkers may intend to cut down on their favourite tipple. There are clear financial incentives in doing both. Putting your smoking or drinking money into a special holiday fund is one of the best motivators for change. Add this to the myriad health benefits, and you need not be short of motivation.

Exercise will not save you money, but equally it need not cost you to start. We used to recommend vigorous exercise as the only form that could bring about health change. This required some investment in track suits and gym subscriptions. More recent evidence suggests that less vigorous exercise, such as walking, is equally beneficial. Either five 30-minute or 10 15-minute periods of exercise per week will improve your health.

Let's take a look at the medical reasons why you should exercise more, drink less and give up smoking.

Exercise

The benefits of exercise, while undergoing somewhat of a renaissance in recent years, have long been recognised. Edward Stanley, during an address to Liverpool College in 1873, offered the following piece of wisdom: "Those who think they have no time for bodily exercise will sooner or later have to find time for illness."

The benefits are clear. Studies show that active adults live longer, have lower blood pressure, suffer less coronary heart disease, diabetes, osteoporosis and depression and have greater self-esteem. If a pharmaceutical company came up with a tablet that brought all these wonderful benefits, the whole country would have it for breakfast every morning.

Exercise and the heart

Looking at the specific figures, the relative risk of death from coronary heart disease is double for sedentary compared with active occupations. Furthermore, it is estimated that if more people exercised, strokes and heart attacks could be reduced. Exercise is good treatment for high blood pressure. Moderate amounts will reduce systolic blood pressure by 10 millimetres in patients with established hypertension. Exercise brings about a reduction in cholesterol levels independent of dietary intervention. It also helps to reduce one of the blood's principal clotting substances - an important consideration in heart attacks.

Exercise and other diseases

A large-scale ongoing study in the United States called the Nurses Health Study, which began in 1986, has just demonstrated the value of moderate exercise in the prevention of diabetes. The research found a direct relationship between the amount of walking women did and the development of diabetes. Even moderate exercise reduced the incidence of diabetes to a significant degree. The same study showed an hour of exercise a day could cut the risk of breast cancer by one fifth.

Exercise also improves mental alertness and elevates mood. The brain releases natural chemicals called endorphin and serotonin in response to exercise. These natural painkillers and mood enhancers are pumped directly into the blood-stream. Studies show a shift in people's mood profile from negative to positive when they have exercised. In addition, people with depression improve their mood scores with regular exercise.

Exercise and the elderly

Exercise is not just for younger people; there is substantial evidence to show that it is never too late to start. Adopting a more active lifestyle in later life delays the onset of coronary heart disease and improves a patient's outlook after a heart attack. Older people's reaction time, muscle strength and joint flexibility all improve with exercise.

Exercise is especially important in the prevention of osteoporosis, with increased bone strength resulting from even short-term exercise. Regular, moderate exercise reduces hip fractures by 50 per cent. It is particularly helpful in preventing osteoporosis when combined with dietary calcium supplements.

Anxiety is common in later life and, again, exercise has been shown to lower anxiety levels in the elderly.

Finding the time

The launch of the Sli na Slainte programme by the Irish Heart Foundation (IHF) has been of enormous benefit in helping us to incorporate exercise into our daily lives. Its most recent initiative leaves us with absolutely no excuse at all for not exercising at least moderately. Through the extension of the Sli programme to indoor work environments, the IHF is hoping to encourage all workers to include physical activity in their routine. In participating companies, you will be encouraged to use the stairs instead of the lift, walk at lunchtime and participate in weekend walks. Tallaght Hospital has the honour of being the country's first indoor Sli, to the benefit of staff, patients and their families.

Alcohol

If I had been writing this even five years ago, the advice about alcohol would have been quite different. It is fair to say that the "demon drink" has been rehabilitated of late. While heavy consumption of alcohol is still implicated in the development of cancer of the mouth, gullet and liver, as well as cirrhosis and damage to the muscle of the heart, the benefits of a lower intake are now proven beyond doubt.

Alcohol prevents coronary heart disease by lowering both cholesterol levels and the amount of stickiness cells (blood clotting agents) in the blood-stream. Drinking between one and three glasses of alcohol a day reduces the incidence of coronary heart disease, diabetes and strokes. Red wine leads the way as the beneficial drink of choice, with lesser benefits from beer.

Smoking

Smoking remains an absolute pariah in the field of health promotion. Its links with lung cancer, heart disease and strokes are well established, although you may not be aware that it also increases the risk of you getting cancer of the cervix and stomach. Thirty per cent of the Irish population smoke, equally divided between men and women, according to a recent survey. Department of Health figures show there were 60,000 smoking-related admissions to acute hospitals last year.

All in all

From the perspective of the medical evidence available to us, there is very strong evidence for stopping smoking. It's not easy, but there is now a range of products and programmes available from family doctors to help you in your efforts.

Teetotallers actually have a higher mortality from heart disease than those of us who drink in moderation. So you may wish to consider drinking a little if you currently abstain.

If there is a single health resolution every one of us should make, then it is to take regular, moderate exercise. Five 30-minute sessions a week or its equivalent is something we can all make time for.