We seldom talk about health, which is really feeling good all over; physically, mentally & socially, without disease or disability. This is unfortunately incredibly rare currently in the U.K. where the threat from Covid 19 (a newly identified viral illness) is dominating all aspects of medical news headlines and drowning out the greater pandemic threat that is diseases of civilisation or non-communicable metabolic diseases.
This is a term unknown to most of us, that is responsible for vastly more deaths & poor health than the newly emerged virus. We nearly all recognise Obesity as being undesirable, but there are a huge number of other medical conditions are caused by subjecting our bodies to unhealthy lifestyle choices, poor diet, inactivity not to mention smoking or alcohol.
Most of us have heard of Insulin a hormone which is fundamental to our health, relating not only to Diabetes but having important effects throughout our bodies. Far fewer of us realise that fat, muscles & bones produce a further multitude of signalling compounds that are essential to the smooth running of the amazing creation that is human life. This is Metabolic health.
The past sixty years has seen a vast increase in diseases such as heart disease & stroke not to mention the epidemic of dementia & frailty that affects us as we age. Lung cancer is well recognised in smokers, but less attention is paid to the at least twelve cancers associated with being obese. Another aspect of metabolic ill health may well relate to childhood disorders acquired in the womb of metabolically unhealthy pregnant women which may partially explain the increase in Autism, ADHD & perhaps the Anxiety/ Depression unfortunately common in adolescence : brain development is only completed in ones’ early twenties.
Behaviour change is incredibly difficult to maintain for most of us. Life-long learning regarding a healthy lifestyle must start early and be continually reinforced throughout life.
Health is rarely considered or discussed until a problem has arisen. How often is someone described as “fit & well” prior to a medical catastrophe emerging! How can that be?
Because we have no idea who is actually healthy!
Metabolic health (involving such strange terms such as Insulin & Leptin resistance or low Adiponectin) are rarely if ever measured so we do not know whether our metabolic health is normal. Cardiorespiratory health (VO2 peak) Is occasionally known but usually only in elite athletes, despite probably being the best test available of current & future health it is a vital clinical sign.
The fact that these two facets of health are seldom recorded is a sad reflection of the NHS which is dominated by the Pharmaceutical industry “a pill for every ill” rather than catch-phrases associated with preventative medicine such as “food is medicine” & “activity a miracle drug!”
Pandemics
It is opportune to compare two current pandemics regarding behaviour change.
Covid 19 emerged throughout the world over a six-month period, which has resulted in incredible changes in our attitude & behaviour. Why?
It is a terrifying new disease, having caused over half a million deaths worldwide (July2020). Public behaviour has been radically altered by legislation – we are instructed by Government how to behave & this is reinforced in law by the police. Prevalence, incidence & death rates are widely broadcast. The NHS front-line services have been incredibly impressive with staff showing selfless dedication & immense expertise.
Metabolic diseases emergedworldwide slowly over sixty years; these have caused premature deaths with unmeasurable levels of morbidity for billions. Most of us regard ourselves as “Teflon-coated” regarding the risk of acquiring these conditions until it is possibly too late. The unhealthy lifestyle habits practiced by most of the population has not been changed & incidence, prevalence & death rates are rarely discussed even by healthcare providers. Government policy has not shown health leadership, allowing junk food to be highly affordable whilst real food comes at a much higher cost. How can a young family afford a healthy eating pattern- it can’t!!
Stop-press July
Government is tiptoeing into health advice: – targeting some aspects of “junk food advertising” & extolling the virtues of cycling, a good start?
Behavioural psychologists have recommended gentle nudging rather than inducing fear but the response to Covid 19 may suggest that this is in fact incorrect. There was certainly no targeted legislation or policing. Health services remain overwhelmed by the demand from chronic avoidable diseases with patchy awareness regarding prevention.
We do need to get serious about health
Obesity
Is a complex relapsing disease associated with an increased size or number of fat cells associated with ill health. It cannot be “fat shaming” to identify & discuss in an honest & supportive manner a condition that causes more premature deaths worldwide than smoking, alcohol or inactivity combined. Obese people overconsume food energy which they store as fat rather than lean tissue.
Globesity
Unbelievably over 2.5 billion people are overweight with currently 650 million recognised as obese as judged by the body mass index (BMI Weight in Kgs/ Height in Metres squared) These figures include S. Asians in whom normal values are lower. Only 14% of humans are actually a healthy weight.! Waist circumference which doesn’t require a maths degree, or a calculator is a simple measurement which helps to identify the dangerous inflammatory condition that is visceral obesity. (Fat deposited in & around such vital organs as the liver & heart)
Fat blindness
This term describes an interesting phenomenon that appears to be incredibly common in people afflicted with a weight problem. You do not wake up one morning suddenly having gained 20kgs overnight but the pinch test of old is rarely undertaken until damaging effect of weight gain is obvious. Two thirds of parents of fat (obese) children believe they are fine. Over half of overweight adults believe they are a normal weight & over half obese adults believe they may be a little overweight! As the general population has expanded in size the individual no longer appears to recognise or act on weight gain until the battle becomes virtually impossible to win.
A deadly disease
Being overweight reduces life expectancy by about three years, however significant obesity is associated with over twenty years of ill health prior to death which occurs six to eight years prematurely. Unfortunately, death occurs twelve to twenty years earlier than expected if obesity is complicated by Type 2 Diabetes.
It is common knowledge that being fat significantly increases the risk of heart disease & stroke, often with associated raised blood pressure causing kidney disease. Less commonly appreciated is the vastly increased cancer risk especially relating to Breast & Colorectal tumours amongst at least ten other cancer sites.
Most cancers require a period of around fifteen years of abnormal cell growth before the condition is revealed. This is particularly concerning regarding childhood obesity where a cancer may present in young adults rather than the current norm where it is regarded as a condition of older generations.
Arthritis affecting weight bearing joints is now found in young, obese children, unbelievably on occasions necessitating joint replacement in early teenage years.
Obesity also increases the risk of low self-esteem & depression & if present in middle age or associated with Diabetes doubles the risk of developing dementia.
An incurable disease for most?
Although virtually all diets work in the short term, the cure rate for the vast majority is abysmally poor with a five-year success rate in achieving an ideal body weight being as low as 5%.
Bariatric surgery & drug therapy may improve these depressing statistics for some but unfortunately not for all.
It is incredibly hard for the obese to lose weight, but unfortunately even more difficult subsequently to maintain a healthy size when feeling constantly hungry, weak & exhausted these are common symptoms amongst dieters.
Why did the world get fat?
To put on weight, one must overconsume food energy in excess of one’s body’s requirement.
A feature of obesity is a constant hunger. Why should this be when tens of thousands of food calories are stored as body fat? The obese infant has increased numbers of fat cells which enlarge in size during childhood syphoning off large amounts of energy after a meal leaving other cell types depleted hence the body requiring more food, a vicious cycle of hunger & weight gain often compounded by inactivity. However, if one adds Ultra-processed (Industrial) foods, beloved by us all, to the mix then most of the world’s population appears to be doomed! These high calorie nutrient depleted products do not satisfy hunger, compounding the Obesity crisis as an individual eating three large meals plus an equal number of snacks without activity is bound to put on weight.
Why is it so hard to lose weight?
As soon as we start to lose weight our body tries to protect us subconsciously from further reduction by reducing our metabolic rate (the burning of energy), increasing our appetite & ensuring that we move less. This is via an incredibly complex system of integrated messaging throughout the gut & the brain via multiple organs such as the pancreas, liver & muscles via various chemicals, hormones & nerves.
Obesity/ Metabolic Health & Covid 19
Obesity/Metabolic ill-health unfortunately vastly increases severity of symptoms & death rates amongst all the high-risk groups of people infected by Coronavirus 2019. Over 90% of patients who died due to Covid 19 had an underlying medical condition such as Obesity, Diabetes, Heart disease etc, etc!!!!
Although significant sustained weight loss takes time, rapid improvement in metabolic health can be achieved by adopting a diet that contains the essential nutrients to improve both immunity & well-being, which are found in real food, not expensive supplements. Combining changing the way we eat with starting to move a little more can rapidly reduce an individual’s future risk.
The Woodland Clinic Provides a safe clean environment, providing assessment of diet, activity, body composition, metabolic health, cardio respiratory fitness & muscular strength.
This allows a relaxed discussion and ongoing support regarding a personalised program to avoid or reduce metabolic illness. Vast benefits in one’s health include improved immunity against current infectious diseases including Covid 19.
Growing older is unavoidable but increasing one’s health span & avoiding the care home is feasible for most, if a healthy lifestyle is adopted & maintained.
Increase your Health-span
Eat real food but not too much
Move quite a lot
Sleep well
Love the sun but never burn!
Be happy & be kind
We can help!
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