Better Life Better Health - Lifestyle and Diet for a Healthy Future

Exercise

Exercise throughout life, especially in older age will help avoid osteopenia, osteoporosis and sarcopenia. Exercise of course has other benefits in general metabolism and cardiovascular function. ²

For many years, exercise and fitness have been recognized as important for health but recent dramatic developments in this area, ³ such as the ‘high intensity regimens’, shown on the TV Horizon programme by Michael Mosley, suggest that strenuous exercise for two minutes has very similar effects to two or three hours of jogging and even better effect in terms of metabolic change in reducing postprandial blood fat levels.

The finding that there are genetic types of human who will or will not respond to the benefits of exercise is also very important. If an individual is not an exercise responder it appears there is little point in them undergoing hours of fruitless activity, unless they really enjoyed it!

Swimming has particular benefits for postmenopausal women. A recent study showed after 24 weeks, a 15% reduction in body fat and 8% reduction in blood pressure. Swimming benefits ageing joints and for those with arthritis, water acts as a cushion to protect hips and knees, aqua activity improves overall body strength. ⁴

Sarcopenia, the reduction of muscle size by between 0.5% and 2% a year in older people, occurs as a normal part of ageing resulting in reduction of quality of life and lack of independence.

Oily fish such as mackerel (omega 3 DHA and EPA) is implicated in improving muscle strength in women in their late 60's by 20% with exercise, as compared with 10% in exercise only controls. ³

Practice points

Body mass index and abdominal circumference are underused in health and lifestyle advice; if the measurements are abnormal, their use is crucial to counselling and forecasting eventual outcomes. ²

When advising about hypertensive treatment it is important to point out that not taking the medication may cause cognitive impairment as well as the more obvious risks of heart attack and stroke.

Smoking, importantly is not generally perceived as being a risk for osteoporosis but is associated with other risks including cardiovascular disease, lung cancer and respiratory illness.

Vitamin D is important for reasons other than osteoporosis, including potential to reduce risks of malignancy and improve cognitive impairment; vitamin D levels should be checked on a regular basis. ²

Vitamin B₁₂ and folic acid levels should be estimated as deficiency is a serious risk for cognitive impairment. Recent findings from the Optima study in Oxford showed that B12/folic acid supplements reduced the progression of Alzheimer's by up to 40% and is the most productive intervention currently available.

Serum homocysteine levels are widely used in Europe as a predictive test for cognitive impairment, fracture and cardiovascular disease (a level of 12 μmol/L and above indicating risk), yet it is very rarely used in the UK.

Dietary issues

It is impossible within the scope of this article to go through all aspects of nutrition and diet in any detail but it goes without saying that a balanced diet is important; the appropriate five per day portions, vitamins, avoidance of excessive sugar and carbohydrate load and salt. Unfortunately the current problems with obesity and poor lifestyle are self-evident.

But other aspects of diet such as the use of oatmeal porridge on a daily basis and perhaps more excitingly potent antioxidants from blueberries, blackberries and probiotic yoghurts have important immunological benefits.

Tomatoes (lycopenes) are important for skin, cardiovascular and prostate health; indeed a full day international meeting was recently devoted purely to this topic at the Royal Society of Medicine.

Dark chocolate is an exciting area; cocoa solids are rich in antioxidants, such as polyphenols, which lower cholesterol, and flavonoids, which may have anticoagulant effects. The genetic code for cocoa, which was unraveled in 2010 is in the public domain. It is likely that genetic modification of the cocoa plant will be used to enhance the potent antioxidant effects of chocolate leading to specific types of chocolate to maximize health benefits especially in the area of cardiovascular disease. Most benefits arise from pure dark chocolate with above 70% cocoa content, the stronger the cocoa the better the health benefit. A small portion every day is to be recommended.

Certain types of red wine are recommended by Professor Roger Corder at the William Harvey Institute in his book The Red Wine Diet. ⁵ Types of traditionally made red wine have high levels of procyanidins (a type of flavonoid polyphenol, also present in cocoa and cranberries), which act on blood vessels rather like antihypertensive drugs and have health and longevity benefits.

The use of regular 24-hour fasting once a week, dramatically improves the individual's glucose metabolic profile after a number of weeks, apart from facilitating weight loss. ³ So the risk of metabolic syndrome and obesity can be reduced by the simple expedient of fasting one day a week. ⁶

In conclusion, lifelong education should start at school and we should all have a personal lifestyle plan at age 50. ⁷ National lifestyle policies should be pursued, such as free swimming for over 65 s; this policy was instituted in the UK by the last government then sadly withdrawn by the coalition government in 2010.

Health and lifestyle advice has always been a priority for the British Menopause Society, and its patient arm, Women's Health Concern. Detailed proposals were included in a consultation document to the coalition government. ⁷ To date there has been little or no government response; implementation of the BMS recommendations would surely lead to important ramifications for many individuals; improving their quality of life into older age and reducing long-term costs to the National Health Service by delaying or even avoiding the onset of chronic illness and disability.