Mags GarganMags Gargan attends seminar offering advice on how to develop a healthy lifestyle
Exercise is medicine,” according to Prof. Mick Molloy, who said that low fitness is a bigger risk factor in causes of death in Ireland than obesity or even smoking. This eye-opening revelation was made at a free public meeting to discuss health and well-being at the Royal Irish College of Physicians of Ireland (RCPI) in Dublin.
To celebrate the feast of St Luke, the patron saint of doctors, the RCPI held a series of seminars last week under the title St Luke’s Symposium. The aim of the symposium is to celebrate the achievements of the members of the college, to share knowledge and engage with the wider public.
Most of the public lectures focused on teaching people how to take responsibility for their own health, and to improve it by making better lifestyle choices.
Prof. Mick Molloy, from the Faculty of Sports and Exercise in UCD, spoke about how to find ways to incorporate exercise into your daily life to improve your overall health and well-being.
He drove the point home that “any exercise will do”.
“Anything works: walking, running, cycling, weights. Walking around the kitchen cooking, gardening, it’s all positive. On the commute to work, walk or cycle instead of driving. At lunchtime go for a walk. Introduce exercise into your leisure time, and bring someone with you, like walking the dog.”
He said no matter how slow you walk or jog, “you are still lapping everyone on the couch!”
Prof. Molloy recommended 150 minutes per week of moderate activity or 75 minutes of vigorous exercise, but currently only one third of Irish people achieve this and 39% of the population are overweight.
Resistance
He said a combination of resistance (weights) and aerobic exercise is most effective in patients with type 2 diabetes, and resistance exercise is particularly important for the elderly.
“Resistance exercise builds up muscle strength and mobility, which can prevent falls and factures in the elderly,” he said.
Prof. Molloy recommended a GP exercise referral programme that has been operating in Ireland for some time (www.gpexercisereferral.ie). This offers a 12-week programme to help people develop a physically active lifestyle, and is run by qualified local coordinators from leisure facilities across Ireland.
“Exercise is as good as drugs for many diseases,” he said. “It will keep you alive longer and you feel better.”
As well as being beneficial to your physical health, exercise is as effective as drugs or cognitive therapy in treating mild or moderate depression, according to Dr Anne Jeffers, consultant psychiatrist, who offered solutions to stress management at the St Luke’s Symposium.
“In order to manage stress we need to understand it, identify the responses and reduce demands and build up our resources,” Dr Jeffers said.
“Stress is the difference between perceived demands on us and our resources for coping.”
She said stress occurs when pressure exceeds our perceived ability to cope, and our body enters ‘fight or flight’ mode. This was a beneficial coping mechanism for ancient man when he had to deal with dangers like wild animals. Chemicals such as adrenaline and cortisol are released into our bloodstream. Our respiratory rate increases. Blood is moved away from our digestive tract and directed into our muscles and limbs, which require extra energy to go into action. Sugar and fats flood into the system and our awareness intensifies, ready to fight or run away from the danger.
Stress
Under stress, we initially perform quite well because of our body’s response but this decreases under prolonged stress and, nowadays, we can’t run away from our problems. They are more likely to be exams or deadlines in school and college, a heavy workload in our job or financial or relationship problems at home.
“We may not be aware we are stressed,” Dr Jeffers said. “Others may recognise it before we do as we are more aware of signs of stress in our co-workers.”
Prolonged stress affects sleep, appetite, decision making, use of alcohol/drugs, blood pressure and metabolism of sugars/fats.
Dr Jeffers advised that we stay away from alcohol and high sugar foods when we are stressed because, although they may be tempting, they don’t help to deal with the problem.
She said relaxation is a skill and like any skill it takes practice to develop. “Children need to learn how to do it and practise it. You can get better at it over time.”
Participation activities like sport or volunteering are very good ways to reduce vulnerability to stress. “Support is so important for your mental health and it’s important to have different sources of support. Most of us rely on partners or family, it’s also good to have friends and activities outside of work.”
Dr Jeffers recommended that people develop a “toolbox of protective factors” – things that make you feel better like exercise, participation, meeting friends – which you can utilise when you are feeling stressed out. “It’s about understanding yourself and your environment in order to stay in control,” she said.
Cigarettes
Some people may turn to cigarettes when they are stressed but Dr Ross Morgan, consultant in respiratory medicine, Beaumont Hospital and chairman of ASH, would like to see Ireland tobacco free by 2025. “Smoking is the single largest preventable cause of death for both men and women,” he said.
While other things can be taken in moderation without affecting your health, like a glass of wine or a bag of chips, Dr Morgan said there is “no safe level of tobacco use”.
He said 100 Irish people will die this week from smoking, and five million people die every year globally from smoking-related diseases. This figure will double by 2030.
While 75% of smokers want to quit, less than 2% quit each year, which shows the strength of nicotine addiction. The younger you start to smoke, the more addicted you’ll be, and children are particularly vulnerable to second hand smoke.
However, Dr Morgan has some good news. Between 1998 and 2010, the number of 10-17-year-olds in Ireland who smoked fell from 21% to 12%. Since the workplace smoking ban came into effect in 2004, there has been a 32% fall in stroke admissions and a 38% reduction in chronic obstructive pulmonary disease (COPD) admissions.
Dr Morgan said nicotine replacement therapy doubles your chances of successfully quitting smoking but he does not recommend e-cigarettes. “They are very good at simulating smoking, but no one knows how to regulate them. Are they medicine or a tobacco product?”
He said there is no evidence that e-cigarettes help smokers to quit, and is concerned they are re-normalising smoking. “In the US last year, a study of 250,000 middle/high school students who had never smoked cigarettes [showed that students] had used e-cigarettes – three times as many as 2011,” he said
He also pointed out that advertising of e-cigarettes looks very like the advertising that was used for tobacco cigarettes before they were banned.
Advice
For those wanting to quit smoking Dr Morgan offered this advice: set a quit date, tell people, identify and avoid triggers, review past attempts and plan ahead for difficult times.
Within 48 hours of quitting, taste buds will begin to recover. Within one month of quitting smoking, skin will lose its grey pallor and wrinkles. Coughing may temporarily worsen, which puts some people off, but this is the lining of the lungs regenerating.
After a year, the risk of coronary heart disease is halved, after five years the risk of mouth, throat and bladder cancer is halved and the risk of cervical cancer and stroke also falls. After 10 years, the risk of dying from lung cancer is half that of smokers and, after 15 years, the risk of heart disease is the equivalent of non-smokers.
“You can quit, and the benefits can be seen at any age,” Dr Morgan said.