The health ladder - tackling the big bad things first
By Joanna McMillan Price
I was once with a couple of friends when one of them offered to share her bag of peaches. “Are they organic?” asked my other friend and proceeded to tell us she would now eat only organic fruit and vegetables. Yet that same weekend we were all out for a drink and she casually lit up a cigarette. On seeing my surprise and obvious disapproval, she said, “Oh, I don’t really smoke, just socially when having a drink.”
It struck me that while most of us want to improve our health and do make changes in an attempt to do that, we don’t always make the change that will have the biggest impact first. Eating more fruit and vegetables cannot protect from the ravages of too much wine at night, while choosing low GI foods is not the best protection from diabetes if you only ever move from your car to your desk to your sofa! Think of it as climbing a ladder, with each change you make taking you closer to the top — a place where you have maximised your chances of good health, wellbeing and longevity. Make the big changes at the bottom of the ladder first and, as you climb, progress to the smaller ones.
1. Stop smoking
OK, so many of you are saying, “Who still smokes, for goodness sake?” Plenty of people do and they’re not just young girls. According to The Cancer Council NSW, in 2004, 18.6 per cent of Australian men and 16.3 per cent of women were smoking daily.
Certainly the highest rates were found to be among those in their 20s, so we do get wiser with age, but this age group accounted for less than one-quarter of the total numbers. Furthermore, these figures don’t take into account those social smokers such as my friend who classifies herself as a non-smoker. Don’t kid yourself. Every cigarette causes damage. In 1998, there were about 19,000 smoking-related deaths in Australia. There is no other change you could make that would have a bigger impact on your health, not to mention the way you look and the way you feel. Give up now.
2. If you drink, do it the French way: little and often
When my lovely hubby puts away a bottle of red wine after a stressful day at work, he looks at my raised eyebrows and says, “What? It’s red wine and you said that was good for me!” The trouble with alcohol is a little on a regular basis can be good and certainly red wine has good quantities of antioxidants thought to be beneficial to our health. But take the message too far, as is all too easy, and you tip the scale towards damage. If we look at a population level, the relationship between alcohol intake and mortality is what’s called a J-shaped curve. In other words, those who drink a little have the best health, particularly in relation to heart disease, even better than abstainers. Interestingly, this is the way the French (and people in many other European countries) tend to drink. But as you increase the number of drinks per day, the graph takes a sharp turn upwards and keeps climbing. A further problem is that alcohol affects people in different ways. If you have a family history of heart disease, a couple of drinks a day may be of benefit, but if breast cancer affects your family, you would do well to abstain. This is before even mentioning the health of your liver (and while France may be doing well on the heart disease front, it does have a relatively high rate of liver cirrhosis!). The Australian guidelines for men are no more than four standard drinks a day on average and no more than six standard drinks on any one day. For women, it’s no more than two standard drinks a day on average and no more than four standard drinks on any one day. Both men and women should also have one or two alcohol-free days a week. If you think this sounds like a lot, bear in mind that the glass of wine you pour at home is likely to be at least 1.5 standard drinks, perhaps even two. A standard drink of wine is 100ml, yet the usual serve in a restaurant is 180ml.
3. Move briskly for at least 30 minutes a day
We live in what the experts call an obesigenic environment. Modern life does not make it easy for us to do the exercise and activity our bodies need to be healthy, while making it all too easy to overeat. We need activity to survive.
It doesn’t matter how slim you are or how well you eat, if you are not moving, your body will suffer. You need movement to stimulate your gut to work effectively; to keep a good blood flow that enables the optimal delivery of oxygen and nutrients to all areas of the body, including the brain; to keep your heart and lungs working properly; to prevent back pain and other musculoskeletal disorders; and, of course, to manage weight.
If you now do very little, you have the most to gain. There are enormous advantages to health in moving from sedentary to moderately active. Thereafter, the gains diminish. It doesn’t take much — 30 minutes of moderate-intensity activity will reap the rewards. That means any activity that makes you feel warmer with a slight increase in your breathing. Brisk walking will do it for most, but gardening, golfing carrying your own clubs need not all be in one session — you can accumulate the 30 minutes in two or three slots: for example, a 10-minute walk to the train station in the morning, a 10-minute walk around the block at lunchtime and a final 10-minute walk home in the evening.
4. Eat more vegetables and fruit
While there is much controversy in the world of nutrition, this is the one consistent dietary message from (almost) all camps. Dr Atkins is the stand-out: in his bid to cut carbohydrates to impossible levels, he recommended restricting these foods. While he may have been right about some things, scientific and historical evidence shows this is not one of them. Modern scientific research has identified numerous phytonutrients in plant foods that are of potential benefit for human health. Future research is certain to uncover yet more. That means no supplement can match this array of nutrients.
Eating more vegetables and fruit is probably the most important dietary change you can make. There is compelling evidence that a diet rich in these foods cuts your risk of heart disease and stroke. It can help you to lower your blood pressure and cholesterol, prevent some types of cancer, keep your gut healthy, preventing illnesses such as diverticulitis, and even prevent vision loss caused by macular degeneration or cataract.
Most people find it easy to eat more fruit, but getting enough vegetables is more difficult. The national health promotion campaign of seven a day is not based on the ideal amount, rather the amount deemed achievable by most Australians. The latest US dietary guidelines promote up to 13 serves a day! Try to include vegetables whenever you can — they should make up half the plate for lunch and dinner meals. The more varieties you include, the better (but potatoes don’t count!), and go for an array of colours. The colours usually come from the antioxidants present, so the more colours, the broader your protection.
5. Move vigorously at least three times a week
Once you are active on most days, add a few sessions of vigorous exercise into your week. I often hear (from men particularly) “I don’t like exercising for exercise’s sake.” Well, in today’s world, you’re going to have to if you want the best health. In the past, physical labour was a part of most people’s daily chores, but that’s no longer true for most people. Yes, exercise can be hard work and tough to find the time, but the rewards are enormous. Vigorous means it should make you “huff and puff ”. Jogging, hard cycling (including indoor cycling), brisk rowing, circuit training, aerobics classes, some active yoga classes and participation in most sports all count. If you are overweight, getting fit is more important than losing weight. The founder of the famous Cooper Institute in Dallas, Texas, Dr Kenneth Cooper (who introduced “aerobics” to the world in the late 1960s), has shown with his research over the past three decades that being fat and fit is preferable to being thin and unfit. Throw out the scales and join the gym instead!
6. Chooser healthier fats, not less fat
The advice to eat a low-fat diet is out of date. The latest research shows it is not the total amount of fat in your diet that’s important but the type of fat. The worst kind of fat is trans fat. This fat occurs in only tiny amounts naturally but is created during the hydrogenation of vegetable oils in food processing. The first step in improving your fat intake is to avoid trans fats wherever you can. While margarines were a major source, most manufacturers have cleaned up their act and packaged foods are now the worst culprits — and it’s not required that the trans fat content be listed on the nutrition panel. Read the ingredient list and if the word “hydrogenated” appears, put it back. Deep-fat fryers are another common source of trans fats, so avoid deep- fried foods in restaurants. If you base your diet on mostly fresh, whole foods and very few packaged, processed foods, you can be assured of a low trans fat intake.
The second fats to cut down on are saturated fats. These tend to raise your blood cholesterol and may even be more readily stored as body fat compared with unsaturated fats. Primarily, these are animal fats, so you can reduce your intake by choosing lean meats and low-fat dairy products and by using less butter. Palm oil, used in many food products, is also highly saturated, so, again, consuming fewer processed foods is a major step in the right direction. However, not all saturated fats raise cholesterol. Those found in coconut fat and cocoa butter, used to make “proper” chocolate, are exceptions to the rule.
The fats to go for instead are those found in olive oil, avocado, nuts, seeds and oils made from them. The fats we need more of are the omega-3 fats found in oily fish, cod liver oil, seafood, omega-3-rich eggs and linseed. To get enough, you need to be eating oily fish at least twice a week and it seems that good old-fashioned cod liver oil may be the best supplement you can take after all.
7. Choose wholegrains and eat less white flour and refined sugar
Most of us know that too much sugar does us no favours, but white flour is probably even worse. The glycaemic index (GI), a ranking of how foods affect blood sugar levels, shows most products based on white flour have some of the highest GI values, which are mostly higher than for sugary products. The refining of flour also removes numerous nutrients as most are found in the bran part of the grain. Let’s not make the same mistake with carbohydrates that we have with fats — the quality is more important than the quantity.
Go organic
This is the top rung in the ladder, not because I don’t think it’s important or beneficial, but because I have no doubt that the other changes will make a bigger impact on your health. This is the icing on the cake.
We can argue about the nutritional and taste benefits, but there is no doubting the ethical and environmental value of its farming practices. It’s just a shame they can’t be made universal. I agree wholeheartedly with the organic philosophy, but the price differential is a barrier to most Australians. If you can afford it, go for it.
Joanna is a popular media spokesperson and is the resident nutrition expert for the Today show on the Nine Network. She is a health writer for Life etc magazine and writes a regular column “Ask the Food Doctor” for Slimming & Health. Joanna has authored or co-authored a number of books including the internationally published The Low GI Diet and The Low GI Diet Cookbook. Most recently Joanna teamed up with ‘The Food Coach’ Judy Davie and their joint book Star Foods (ABC Books) was released April 2008. Her next book is a must have guide for all women who want to look and feel their best, called Inner Health Outer Beauty. It will be released by Random House April 2009. www.joannamcmillanprice.com