Anatomy & Physiology

Be the one who skips across the finish line

There's good news: Life expectancy is steadily increasing. Modern medicine is so good now that it is possible to keep us alive for longer than ever. The bad news is: Healthy life expectancy is not increasing.

According to data published by Public Health England in July 2017, life expectancy in the UK is now 79.5 for men and 83.1 for women. Healthy life expectancy however, is 63.1 and 64.4 respectively. 19.0 years less for men and 16.1 years less for women. As life expectancy is increasing, but healthy life expectancy is not, we are spending more and more time of our life sick.

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By the time we hit 65, 40% of us are going to have at least one chronic illness: heart disease, stroke, type 2 diabetes, hypothyroidism, depression, dementia, arthritis, and cancer are just the most common ones. How thrilling is it to know that we’re going to live longer, but that we’ll spend a significant chunk of that time in pain?

The human body is an amazing thing. It takes a lot (a lot!) of punishment without complaining and works hard day and night – particularly at night though – to repair the damage we do to it and at least maintain us on a reasonably healthy level. That works really well for many, many years. But there is a point when that repair and maintenance begins to slow down. It is usually only then that we start noticing, and from my own observation I would say that that is at around age 40.

Most of my clients are over 40 and it’s not as if I wouldn’t be happy to see younger clients, it’s just that their diet and lifestyle hasn’t caught up with them yet. When you’re young, you can cope with short nights – whether that time was spent studying, partying, looking after a baby or working long-hours in a stressful job. Our body takes it all: junk food, eating on the run, smoking, drinking and even recreational drugs barely leave a mark (that we can tell). Injuries, like broken bones and torn ligaments, heal quickly and we get back on our feet in no time.

But once we hit our late 30s or early 40s the cracks are beginning to show: Suddenly there is a spare tyre around our middle that didn’t used to be there. Where did that come from? We haven’t changed anything! Anxiety, depression, insomnia, tinnitus, thyroid malfunction, high blood pressure, achy joints, hormonal imbalances, fertility problems, sexual dysfunction, and constant, leaden tiredness suddenly appear.

We’re feeling like cr*p, but at this point we are still looking at a good 20 or 25 years of a working life that is not going to let up. We are still expected to turn up at the same time every day and work hard, be efficient, be brilliant, make a contribution for at least 8 hours a day – as we always have. Once we get home, there is still housework to do, kids – or at this stage parents – to look after, bills to pay, friends to be seen, and just stuff to do. We simply do not have time to collapse on the sofa or crawl into bed to recover for another day.

Meds will help us through: anti-depressants, acid blockers, statins, beta blockers, thyroid hormone, HRT, metformin – once we hit 45, most of us are on at least one or two of those. While prescription drugs may be necessary, they are not going to fix anything, they’ll merely tide us over. All drugs come with side effects, which sometimes require another drug to deal with.

At retirement age, we have finally paid off the mortgage, the children have their own families, we’re not responsible for anyone but ourselves anymore. This is the time to spend the day just the way you like it: socialising with friends, cycling, gardening, volunteering, heck, you could even downsize, buy a camper van and go travelling.

However, if we even make it to retirement, 40% of us merely limp across the finish line, only to then collapse (statistically) and succumb to at least one chronic illness. We might not have the inclination or be in good enough shape to do any of the stuff we had planned.

But that’s old age for you, right? That’s what happens. It’s to be expected that by age 45 we’ve got to be on two or three meds. It’s normal to lay down extra fat and be achy in the morning and tired in the evening. That’s what happens when you age.

Well, actually no, it isn’t. We have come to accept all this as normal, because it is so common. It’s not inevitable though. It is our diet and lifestyle choices that have brought us to this point, and diet and lifestyle are what is going to turn it around for us. Obviously, the sooner you get into healthy habits the better, but it’s never too late!

So, what is it that makes us sick and old?

1. Stress

More than anything else lifelong stress sets us up for chronic illness. Over the time of our lives, most of us are exposed to a lot of psychological and physiological stress. For many, this starts even in childhood and while humans have remarkable resilience, it can catch up with us in middle age.

2. Diet

We still treat diet as an optional factor in health. Yeah, healthy eating is all well and good, but who has time or money for that? We’re busy people and shoving a burger into our mouths during a 15-minute lunch break is just going  to have to do. Or it could be a bag of Wotsits, or a stack of digestives. Anything is sustenance, right? Wrong. Do this for 20 years and you’ll no longer be able to ignore the consequences.

3. Alcohol, smoking and recreational drugs

Obviously.

4. Overweight and obesity

The most damaging thing excess body fat does for us is that it fuels inflammation. Temporary inflammation is a good thing and vital. When the immune system finds something wrong, it springs into action and deals with the problem. There will be redness, swelling and pain for a few days, but then we’ll get better. Chronic inflammation is silent and much less noticeable, but unfortunately chronic: It doesn’t stop. Fat cells, and particularly visceral fat (the fat on the inside) promote chronic inflammation, which is at the root of most chronic illness we experience when we are older.

Address these issues now – whatever your age – and make sure that you are going to be one of those people who skip across the finish line into retirement, ready to face their freedom!

What is the appendix for?

One of the most interesting fields of research for me right now is the microbiome. New research in the area comes out every day and the more we learn, the more scientists realise we don’t know.

Although not all bacteria and other microbes have yet been identified – let alone everything they do – we do now know that diversity is key to good health: the more different species there are, the healthier the individual. Hunter-gatherers have a much, much more microbiome than we do in the Western world, and we get many diseases that are unheard of in primitive cultures, e.g. Crohn’s disease.

appendix, appendicitis, microbiome, gut flora, immune system

Appendicitis - infection and inflammation of the appendix - is so common that everyone knows someone who has had it and has had an appendectomy as a result, an operation that probably saved their life.

For as long as we’ve known that this little dead end in our gut exists, doctors and researchers have been wondering what it is for. It was thought to be vestigial, like the coccyx (tailbone) or erector pili (the muscles that make hair stand on end) and body hair. In fact, if you google ‘vestigial organs’ you’ll find the appendix at the top of the list. It is thought not to do anything much, because no purpose has been found and, more than anything, people without one live on without suffering any negative consequences at all.

For other vestigial organs we can find out what there purpose might have been if we look back at our ancestors or closely related species, such as the great apes or monkeys. Our ear muscles, for example, don’t do much anymore, but monkeys use them to twist their ears in different directions, to pick up the sound of approaching danger sooner. Vestigial organs usually have shrunk and/or atrophied: they’re there, but unable to do anything anymore. When it comes to the appendix, however, it appears that apes and humans have a larger and better developed one than monkeys – which suggests that the appendix must be doing something useful.

Most people never get appendicitis, but 6% do, and that’s a lot of people. Of those who do get it, 50% survive it without an operation. Because it’s so common, appendectomy is now routine surgery. So without any medical help, 1 in every 32 people would be wiped out by appendicitis. If it was that dangerous an organ that doesn’t appear to serve any particular purpose, you would expect that over millennia evolution would have made us lose it, not promote it.

It wasn’t until 2005 that it crossed one American scientist’s mind, that perhaps the appendix was a reservoir for bacteria! In order to come up with this idea, there first had to have been knowledge of the gut flora and immunity. The appendix is filled with bacteria, antibodies and lymphatic tissue. Why?

We have more of the same all along the gut, but if we a struck down with infection and disease that causes severe diarrhoea, e. g. cholera, we will lose our gut flora and antibody protection in a very short space of time. Add to that these days enema before colonoscopy or antibiotic treatments. We’ll end up with a very clean gut indeed! But as we now know that is not a very good way to be.

The appendix appears to provide a save haven for bacteria during any such attack, and it is from here that bacteria emerge to recolonise the gut once the threat has passed. So, while we can live without an appendix, there is great benefit in having one. And by the way: appendicitis is another disease that is extremely rare in developing countries. Could the fact that we are so prone to it also have something to do with our Western lifestyle?

For further reading: Rob Dunn - The Wild Life of our Bodies, Harper Perennial, 2011.

Happy Gut - Happy You!

The digestive system is the least talked about and probably our most underrated organ, and yet it truly is the foundation of good health. While I cannot guarantee that a healthy gut will make all your troubles go away, I can safely say that true health will remain out of reach if the digestive system is not working well.

Eat for your skin!

Most of us have been plagued with acne at some point in our lives. In most cases, this was during puberty and it resolved itself once our hormones calmed down and normalised. For many, however, acne can continue into adulthood or even appear for the first time later in life. In adults, acne is not so likely to resolve itself and it is necessary to take a look at one's diet. Read on to find out how hormones and diet affect your skin. 

Stressed, fat, tired and depressed - because you're 50?

Is that how you feel? I speak to so many women around that age – not least because I am one of them – and am surprised and saddened by how many of us feel that way, have accepted it as a normal consequence of ageing and have given up. After all: Everyone else says the same.

Many of us have battled with their weight for our entire lives. We grew up surrounded by magazines that showed us what a woman should look like. A quick comparison between what we saw in the mirror and what was depicted in the magazine confirmed that we certainly didn’t fit the ideal. So we went on a diet. I was probably on my first one at around age 14. Looking back at the photographs now, I can’t really see what the problem was: OK, I wasn’t a stick insect, but I certainly wasn’t as fat as I thought I was (and as I was going to become!) by any stretch of the imagination.

 Me as a teenager in the early 80s.

Me as a teenager in the early 80s.

I wish I had known then what I know now: That going on diets is just a downward spiral – or upward, in terms of weight. Diets don’t work and serve only to make us feel miserable. After all, we keep failing at them. We eat less, move more, are starving all the time … and then fall off the wagon. Before we know it the weight we just lost is back and then some.

And then the exercise … We work all day and are lucky if we get away with 9-5 only, we’re commuting for 3-4 hours a day, braving London transport, do household chores when we get home and are still replying to work emails when we’re finally on the couch. Those of us who don’t work in London may be even worse off, stuck in traffic on the Southend Arterial Road twice a day, inching forward in the summer sun and losing the will to live. We pass the time by making mental lists of all the things we have to do when we get there. If we ever get there. We’re stressed, we’re tired, and hungry all the time. Where are we supposed to find the time and energy to exercise? Which is not even fun! Unwinding with a glass of wine and some chocolate in front of the telly sounds much more like it, and there’s barely even time for that.

Many of us around 50 are facing major life changes: The kids have left the nest, instead our parents are getting older and demand more of our time, maybe even need our care. There is a house to maintain, food shopping to be done, a social life to keep up with and a job to hold down for our contribution to the household income. The days never seem to be long enough.

And then that age … 50! Even that number alone! We’re officially middle-aged. It’s downhill from here. Yes, ok, there seem to be some of those annoying ‘healthy’ types who never seem to age, still run marathons with ease, keep their youthful figures, golden tresses and wrinkle-free faces apparently effortlessly. But that’s not us. We’ve acquired a spare tire around the middle, crow’s feet around our eyes, and no sooner do we get our roots dyed and they show again. The last thing we need are hot flushes and night sweats to rob us of that desperately needed beauty sleep, but, hey, things weren’t bad enough already, so why not add that to our misery and remind us that we’re now officially old. Thanks a bunch!

So what’s the answer? Is there even one? After all most of the women we know are in the same boat, going through similar things. It must be normal to be stressed, fat, tired and depressed at 50. Right?

Well, no. It depends on how to define normal: Is it how the majority of people feel? Then yes, it’s ‘normal’. Is it inevitable to feel like that at 50? I think not.

Given my profession, you’ll already know that food is going to come in here somewhere. And it is! You cannot underestimate the power of food. After all, everything that happens in our bodies is chemistry, and that requires chemicals, which in the food world are called nutrients: fat, protein, carbohydrates, vitamins, minerals, phytonutrients. That’s what you need for your body to work properly and it is fully capable of doing that even at 50 (and beyond).

You wouldn’t put diesel into a petrol car and expect the engine to run on that. And that’s just a machine. How is the human body – an intricate biological organism – supposed to function on artificial 'foods', laden with sugar, damaged fats, flavourings, thickeners, emulsifiers, preservatives, herbicides, pesticides, plasticisers, colourings and other questionable additives?

It won’t, and you already know that a) from experience and b) because you’re not stupid, but it’s near impossible to get away from the stuff! Fake foods are made for us to love them. The food industry spends billions on research to find that ‘bliss point’, that perfect combination of fat and sugar, that melt-in-the-mouth feeling, that will trigger our brain chemistry to release endorphins that will make us happy and keep coming back for more. It’s not you, it’s not a lack of willpower, it’s chemistry.

Knowing that is power. If you know what to do, you can take the reigns back and can get your health – and with it your life – back on track.

I didn’t mind turning 50, because … what’s the alternative? My father died from a heart attack when I was 4. He was only 39. When I was approaching 50 I was determined to celebrate my age, because I knew that he would have loved to turn 50. Getting older is nothing to complain about. It’s great!

And you know what? I’ve never felt better! And if I could achieve that, so can you!

Here’s me at 36 (left) and now. Need I say more?

50 stressed fat tired depressed menopausal