Thursday 26 November 2009

A green planet is a healthier world

We doctors were always taught about the various diseases as if they were separate, individual afflictions, with little interaction.
The fact that a multitude of other factors, including environmental ones, also strongly influence disease was rarely discussed.
If we have been a bit slow on the uptake, those heading the campaign on climate change certainly haven't.
Frustrated by the slow response from many of us to their pleas to make "green" changes to our lifestyles, they have sought new ways to bribe us into submission - and come up with the impact that climate change could have on our health as a topic that hopefully will get us listening.
Health Secretary
Andy Burnham has declared that health should now be at the centre of our fight against climate change and has called upon ministers and professionals across the world to recognise the danger that climate change poses to public health.
Wherever we live in the world the climate has powerful impacts on human life. We are brilliantly designed to live in many environments but there are limits.
Extremes of heat and cold can cause potentially fatal illnesses and research has shown that they can increase death rates from heart and respiratory diseases.
It's already happening. Heatwaves across Europe cause thousands of deaths and the recent flooding in
Cumbria disrupted many lives, significantly increasing the risk of disease.
The majority of people rely on safe drinking water, sufficient food, secure shelter and good social conditions to ensure their health.
A changing climate is likely to adversely affect all of these conditions.
It's clear to see how changing ecological systems may affect the prevalence and range of infectious diseases.
Vector-borne diseases such as malaria, dengue fever, yellow fever and encephalitis are currently among the largest global killers.
It has been predicted that the global population at risk from malaria will increase by between 220 million and 400 million in the next century.
While it is unlikely that climate change would cause malaria to become re-established in somewhere like London, the overall effects of a rapidly changing climate on health are likely to be overwhelmingly negative, particularly in the poorest communities - which ironically have contributed least to greenhouse gas emissions.
One reason we in the West have done so little about it is that most of these climate-related disasters occur in developing countries.
Perhaps if we started to suffer from them saving the environment would become more of a priority.
There are added benefits to getting greener. Cutting down on red meat consumption means livestock numbers can be reduced, lowering methane emissions but also improving our diets, particularly our saturated fat intake.
As is so often the case it's the elderly, the very young, the homeless and the poor who are especially vulnerable to increase risk of disease.
Darwin would certainly have something to say on this but only the fittest being able to survive is no longer acceptable.

Friday 20 November 2009

Stress has many causes and symptoms

We all need a certain amount of pressure in our lives to make our work satisfying and help us meet our deadlines.
But too much pressure without having the chance to let off steam causes stress. Of course, what is stressful for one person may not be stressful for another. Some thrive on it while others crumble.
If you feel that you are always rushing about, trying to be in too many places at once, missing meal breaks, for ever taking work home with you, and never seem to have enough time for exercise, relaxation or spending time with your family, then you may well be at risk of developing stress-related problems.
Stress is caused by a wide variety of different situations, and so can also have a wide range of symptoms. I tend to divide these into physiological, psychological and behavioural symptoms.
Physiological symptoms caused by stress include headaches, migraines, stomach disorders, raised blood pressure, changing sleep patterns, muscle spasms, back/shoulder/neck pain, general malaise and an unwillingness to work.
Psychological symptoms can cause you to grow resentful towards your work, making it a place of anxiety, tension and the cause of irritability, low self-esteem and forgetfulness. It can even lower your sex drive.
Finally, behavioural symptoms can cause sufferers to becoming irritable, aggressive and withdrawn, and to stop communicating.
An affected person may show signs of changes in eating and sleeping patterns; they may drink and smoke more, and even start excessively self-medicating.
Of course, these will also affect home life, making them more “difficult” outside work, less able to cope with their family and maybe even neglecting their hygiene and personal appearance.
There is rarely any one single cause of work-related stress.
While sudden, unexpected pressures can trigger it, it is often the result of a range of stressful factors that build up over time. If they are left undetected and untreated, they can reach boiling point and cause a full mental breakdown.

Friday 13 November 2009

Why sport is a vital goal for women

A local school in Lambeth, near to where I walk my dog, is the venue Sport England has chosen to announce the launch today of its new £10 million campaign targeted at getting women from disadvantaged communities to play more sport.
Even
Gordon Brown is urging a cultural change that allows girls to see sport and physical activity as aspirational - something that is most definitely not the case now.
Many girls enjoy games such as netball and hockey at school but as soon as they leave often all sporting activities stop. This is a shame.
The statistics show that campaigns of this sort really are needed.
There has been almost no change in the level of women's physical activity in the UK for the past 20 years, with 80 per cent of women doing too little exercise to benefit their health.
Twice as many men play competitive sports as women and six out of 10 women prefer exercising alone to team sports. Is this because sporty athletic girls are seen as unfeminine and female team sports a little too sweaty and "butch"?
I suspect that early experiences at school (don't we all have memories of terrifyingly masculine PE teachers hurling medicine balls at us?) have a greater impact on how girls perceive sport, and this is backed up by some evidence.
Research has shown that nearly a quarter of women say that PE at school put them off sport, two in five girls felt selfconscious about their bodies in PE lessons and a quarter of women hate the way they look when exercising or playing sport.
I remember having to play in "skins" (meaning top off) as one team colour as opposed to "shirts" (top on) and absolutely hating it, feeling terribly self-conscious, but I suspect getting small boys to run around with their tops off is forbidden now. I did go to a public school, after all.
This has got me thinking about the way we doctors sell the idea of exercise to our patients. I tend to say "join a gym" as an automatic response when discussing weight loss, as this is the
London thing to do.
Talking to my colleagues has confirmed that this seems to be the standard advice that most of them give. But is the gym quite the same, and does it have the same benefits as a team sport? I favour the mindless gym as my own choice of training.
I work out admittedly a little excessively and go about five times a week, which means I like to think I am pretty fit. But I suspect my speed, agility, balance and endurance are actually very poor.
I lift weights in the main which will make me strong but that's about it.
Playing sport would certainly redress this imbalance. So this idea has struck me as rather a good one, and perhaps something we should be suggesting more - and gym membership a little less.
The benefits of sport go far beyond simple weight loss.
We know that women who play sports do better academically; they have improved learning, memory, and concentration, giving active women an advantage.
Sport teaches teamwork and goal-setting skills; important in business where teaming up with others to meet goals can be the key to success.
Some benefits of sports are immediately obvious - such as improving fitness and maintaining a healthy weight, but women who play sports are less likely to smoke and have reduced chances of getting breast cancer and osteoporosis later in life.
We also know that women involved in athletics feel better about themselves, both physically and socially, and playing sports can help deal with stress and fight depression. I don't know why I didn't think of it before.