Typically Irish


Mary Clarke is a 77-year-old widow. She lives alone, although two of her daughters live nearby. In the past year she has become fearful of going out of the house after an elderly neighbour was attacked on the road. Her daughters are concerned that she is not eating proper meals. She has some "wear and tear" arthritis in her joints, especially her knees. She had an early menopause at 42 years of age.

Mary is someone whose lack of exercise could cause health problems. Moderate activity would help keep her joints mobile within the constraints of her pre-existing arthritis. Exercise would also almost certainly help slow down the progression of the arthritis. Exercise will slow the progress of osteoporosis, which she undoubtedly has to some degree because of her early menopause. Her diet is also a concern in this regard. It is important that she drinks plenty of calcium-enriched milk, and eats fresh fruit and vegetables.

Her daughters could help in two ways: first, by ensuring she has a good supply of fresh rather than processed food; and second, taking the time to walk with her to the local shops and park would reinstate valuable exercise into Mary's weekly routine.

Jane Bowman is a 26-year-old marketing manager with a telecommunications company. She works 60 to 70 hours a week. She has a cup of coffee for breakfast and some- times does not get lunch until 3 p.m. This is often a snatched sandwich at her desk. She does not smoke but drinks two glasses of wine every evening to help her unwind. A two-year relationship has just broken up.

Jane is typical of the new generation. She needs to start the day with a good breakfast of fruit and cereal and must discipline herself and those around her that her lunch is sacrosanct. Forty minutes away from the desk, ideally incorporating a 15-minute brisk walk, is the least she deserves in the middle of the day.

Finding the time to go to a gym might be a problem, but she could decide to spend some of pay on home exercise equipment. Finally, Jane's alcohol intake level is fine, although if this has increased recently following the ending of her relationship, she needs to guard against using alcohol as an emotional crutch.

Brendan is a 20-year-old student from Longford. He shares a house with five others in Dublin while he attends UCD. This is his third year in college, and money is a bit tight. His main financial outlay is on pints of beer and cigarettes. He does not bother with breakfast, and most of his meals consist of coffee and snacks at the cafeteria in college. He has lost about 6 lbs in weight since September. He does not play sport. Brendan's lifestyle is fairly typical of the student living away from home. His habits and weight loss suggest he is not eating properly. Skipping breakfast is not a good idea - when added to exam stress and his intake of coffee, he is a likely candidate for stomach or ulcer problems. Ideally, he would give up cigarettes and cut back on his alcohol intake.

Brendan needs to ensure he has a good intake of fresh vegetables and fruit, as well as chicken and fish. A good idea - if he can get his flatmates' agreement - would be to nominate one night a week when they would all stay in and cook a fresh meal. Pooling resources to ensure a bowl full of fresh fruit at all times would help also. Finally, at his age some vigorous exercise - sporting or otherwise - is a must.

Sheila McGuire is a 34-year-old full-time mother of three children aged 18 months, two-and-a-half and five. She has no help at home, although the eldest is now at school, which is five minutes' drive away. Sheila's two younger children do not sleep - she is likely to get five hours of broken sleep every night. By the time she prepares several meals a day, she finds herself finishing the children's left-overs and then does not have the energy or interest to prepare a healthy meal for herself. Sheila has not been able to get her weight back to her normal level following the last baby. She misses adult company and admits to feeling stressed most of the time.

Sheila needs to do two things immediately. She needs more sleep and more exercise. The exercise will help with weight loss, stimulate her appetite and lower stress. A more normal sleep pattern will be a huge boost to her resilience and ability to combat stress.

Incorporating regular exercise into the day is the first move. This needs to be a brisk walk of 15 minutes twice a day, five days a week. Weather permitting, putting the younger ones in a push chair and walking the older child to school will achieve this goal. She could seek out other mothers in similar circumstances and maybe organise to mind each other's children for an hour or two a week. This would allow each of them to spend some time on themselves and lower her stress levels.

Her partner needs to share the sleepless nights, and ultimately they need to look at the reasons for the children's sleeplessness. Their doctor may recommend a sleep management programme to help overcome this difficult phase.

Martin Stewart is a 51-year-old managing director of a medium-sized company. He is married, with two teenage children. He entertains corporate clients up to three nights a week. Martin is currently two stone over- weight and has a family history of colorectal cancer. He has been experiencing chest pains while under stress at work. He smokes 30 cigarettes a day and plays golf irregularly.

Martin needs to see his GP urgently. He has several risk factors for coronary heart disease, which make the recent chest pain a worry. His blood pressure and cholesterol levels are likely to be elevated, and he may need some cardiac investigations.

Assuming there is nothing requiring acute treatment, Martin needs to address his lifestyle on several fronts. The cigarettes must go. He must either delegate the corporate entertainment or eat a minimal amount while dining out, choosing the healthiest options. He needs to exercise and lose weight. His diet should be aimed both at the risk factors for bowel cancer and heart disease. Depending on how close the relative with colon cancer is, he may need referral to a gastroenterology specialist for screening.

(Series concluded)