Staying Safe

Many of us will have experienced a time of emotional crisis. It could follow a break-up of a relationship, a bereavement, a traumatic event, financial worries or an adjustment to a big change.

We might feel inadequate, a failure, ashamed, angry, agitated, shocked or numb. These feelings may resolve with time, but they might instead be so intense that they either completely overwhelm us or we might even feel cut off from them. We might start to experience thoughts that we would be better off dead or that those we care about would be better off without us.

Such suicidal ideation is quite common. It is generally associated with depression and other mood disorders. However, it may also have associations with adverse life and family events, all of which can increase our risk of suicidal thoughts.

For many, these are fleeting thoughts that we get when we feel overwhelmed and want to escape the pain we are feeling at that moment in time. But for others, the feelings of distress, shame, guilt and low self-worth, are so devastating that these suicidal thoughts escalate and, without help, care and support can lead to disastrous consequences.

What can we do when we feel this way?

The first thing is to acknowledge that things are not going well. This may seem obvious, but when we are trapped in a situation, it is very easy to deny to ourselves and others that there is a problem. Or we might feel so hopeless, useless, numb and disconnected that we can’t see a positive way out.

Sometimes our suicidal thoughts become so frequent that we almost don’t recognise them as we can’t remember not having them. This happened to me when I was spiralling down. It was only when I stopped, took time out and talked to others that I recognised the thoughts and realised how bad things had become.

Reaching out for support

This is the next step. There are many barriers to seeking support such as guilt and shame, made worse by the negative judgements and lack of compassion shown by some to those who do disclose suicidal thoughts.

It can also be hard to open up. We might feel scared or embarrassed, but when we share how we are feeling, whether that be to a trusted friend, family member or colleague or to a trained health professional, we often find that others have gone through similar things and can understand what we are going through. Talking things through can help unburden a lot of the distressing feelings that we have kept bottled up inside and help us see things clearer.

Making a safety plan

Making a safety plan is a way that we can help ourselves. It is a resource developed by others who have been through similar situations and who use it themselves at times when they feel unsafe.

StayingSafe.net , a website set up by 4 Mental Health and the inspiring psychiatrist Dr Alys King Cole, has a free safety plan that can be downloaded onto your phone or printed out. This fantastic website offers support and advice on how to manage suicidal feelings, as well as videos and stories from others who have struggled including Jonny Benjamin MBE. Well worth checking this out for yourself or to help others that are struggling.

A safety plan includes:

What you can do to get through right now – the next few seconds, the next few minutes. These might be photos or videos of people or animals that you love and care about. It might be thinking about a particular place or memory that gives you joy.  It might be speaking to someone you trust and can open up to.

How to make your situation safer. Is there anything in the house that you could harm yourself with? Have you too many medications at home that could present a risk? Would organising a weekly collection of your meds from the pharmacy be a safer option for you? Are there people that make you feel worse or trigger bad memories? Should you avoid them at this time? There are many horrifying websites, chat rooms and blogs that can be really distressing when you are at your most desperate. Is there a way to limit your access online to avoid these?

Things to lift or calm your mood to help you get through tough times – activities such as going for a walk, watching an uplifting video or film, getting outside in nature or listening to music. Whatever helps you feel better. Or whatever allows you permission to hope, whether that be seeing friends, buying a lottery ticket or having a haircut.

Things to distract you when it feels like nothing will lift your mood or calm you. This might again be listening to music, watching a film or box set or getting outside. Or it might be cognitive things such as counting backwards in 7s from 100, counting things in the room that begin with a particular letter or visualising being in a pleasant surrounding. Again choose things that will really work for you.

People to support you. Include those that make you feel better just by hearing their voice without necessarily having to say how you are feeling. And those who perhaps know that you are feeling low or overwhelmed who allow you to feel comfortable without asking questions or having to talk. And those who you might want to open up to.

People you can talk to when you are distressed or thinking about self-harm or suicide. These might be friends, family, colleagues, a support worker – someone that you trust and feel comfortable talking to.

Emergency professional support. Keeping crisis numbers to hand in one safe place can be really helpful. The last thing you want to do when in crisis is spend time looking for numbers. These might be for the local mental health crisis line, your GP, your local safe haven or a helpline such as the Samaritans, Papyrus (for young people) or Childline.

Helping someone else who is in crisis.

Letting people know that you care and listening with kindness and compassion is key.

Both Mind and Staying safe have some really helpful practical ways that you can support someone who is struggling and having end of life thoughts.

As Staying Safe comment:

There IS hope – it is vital that people experiencing suicidal thoughts know that they are NOT alone and there are people who care about their situation.”

Resources

  1. StayingSafe.net
  2. Feeling overwhelmed – helping you to stay safe.
  3. Mind – suicidal feelings

Helplines and support

These are just a few

  1. Samaritans – Call 116 123 for free 24/7
  2. Papyrus – For people under 35 and those supporting them Papyrus HOPEline 0800 068 4141 (Mon-Fri 10am-10pm Sat-Sun 2pm-10pm and bank holidays 2pm–5pm text 07786 209 697
  3. Childline – Call 0800 1111 for free for anyone under 19 in the UK

4 Good Reasons to be Active

By Dr JULIET MCGRATTAN

We all know that doing exercise is good for us. Despite this, the Health Survey for England in 2016 tells us that 34% of men and 42% of women aren’t doing enough activity for good health. Why is it that exercise is so often seen as a chore and something that ends up on the bottom of our to do list?

Here are four great reasons to be active:

1. Better health. This might sound obvious but the power that exercise has to improve health is often hugely underestimated. Did you know that if you are regularly active throughout your life, you can reduce your risk of developing type 2 diabetes by 35 to 40%, your risk of Alzheimer’s disease by 20 to 30% and your risk of bowel cancer by as much as 50%? This means that we have the power to shape our own future health. When we’re young we tend not to think about these things but as we age, health issues do become more of a concern and it’s never too late to start becoming active and reaping some of these benefits.

2. Feel good factor. If you speak to someone who was previously inactive and became active, then you’ll find that one of the reasons they would never go back to a more sedentary lifestyle is simply because they feel so much better. You might think that you would feel more tired but your energy levels actually increase when you lead an active life. You sleep better, your concentration improves and you feel calmer. Stress and low mood are a common problem today and we know that exercise is a powerful tool for maintaining and improving mental health. You can expect a 20 to 30% reduction in your risk of depression if you keep active. Exercise helps both our physical and mental health.

3. Opens your world. Exercise can open up a whole new range of experiences and opportunities. From meeting new people and making new friends to exploring new areas and perhaps even travelling far and wide. You just never know where it will take you. Discovering a new path in your neighbourhood or feeling more a part of your local community can change how you feel about where you live. Learning what your body is capable of can change how you feel about yourself. Exercise can improve your self-esteem and self-confidence which then has a knock on effect to other areas of your life such as making you feel more empowered to take on challenges at work or within your family.

4. It’s fun. You might have grown up associating exercise with competitive sport at school and if you didn’t enjoy it then it can put you off for life. But there’s way more to exercise than feeling exhausted on a cross country run! Find something you like. If you want a new habit for life then it has to be enjoyable. Think back to when you were younger, what did you used to love doing? Chances are that if you can find a way to do it now, then you’ll love it all over again. Was it dance? Find an adult dance class or just crank up the stereo and dance around the kitchen. Was it football? There might be a local team, a walking football league or the opportunity to get active by coaching youngsters. Try new things and feel the boost that learning a new skill gives you. Above all, have fun with exercise.

Picture courtesy of PHE

These are four great reasons to be active and have you noticed they don’t include losing weight? We now understand that whilst some of the benefits of exercise are about any weight loss that it may cause in those who are overweight, lots of the benefits are entirely separate to what the scales tell you. You might not see your weight fall as you become more active but this doesn’t matter; it doesn’t mean it isn’t making you healthier. Exercise works by making you healthier from the inside out. It helps to reduce your visceral fat, this is the harmful fat around your internal organs. Visceral fat causes a slow inflammation in the body which we now know is one of the causes of the major diseases such as type 2 diabetes, cancer and depression. Exercise will work on this fat before it works on our spare tyres round our middle!

The other thing to bear in mind is that although each week we are aiming for 150 minutes of exercise that makes us feel out of breath, what we do the rest of the time is important too. Reducing how long we spend sitting is hugely important. We were designed to move and by breaking up our sitting time and moving around for a couple of minutes every half an hour, we can help to prevent the cells of our body being damaged by unspent energy.

So, keep moving, improve your health, feel better, open your world and above all, have FUN!

Dr Juliet McGrattan is a GP , mother and author of Sorted: The Active Woman’s Guide to Health. She works as a Clinical Champion for Physical Activity with PHE in the north-west of England and with 261 Fearless, a global women’s running network. 

Find out more about Juliet and follow her blog here.

Featured image supplied by Gratisography

Get Strong, Stay Strong

Most people appreciate that being active is important for our health and wellbeing.

Many are also aware that to really get the health benefits from cardiovascular exercise we need to be getting our heart rate and respiratory rate up to a moderate or vigorous intensity for at least 150 or 75 minutes a week respectively.

What many people are unfamiliar with, however, is the importance of balance and strength training from cradle to grave.

Evidence suggests that there are strong associations in middle and older age between poor balance, poor strength or poor physical function and mortality, and that lower strength in late adolescence and early adulthood link with increased vascular risk in later life.

Given that surveys in the UK report that 69% of men and 76% of women are not meeting the strength and balance guidelines (two or more sessions a week), this has implications for us all.


How does strength and balance change across the lifecourse?

Muscle strength, bone strength and balance ability increase in childhood and peak in early adulthood. A decline in muscle mass is seen from around the age of 30 years but this is more notable from the age of 50 years (0.5-1% loss a year) and after 75 years (2-4%).

Low muscle strength, also known as sarcopenia, is linked with frailty. It is more common in older adults but can occur at any point due to lifestyle factors such as sedentary behaviour.

Studies have shown that there is approximately a 50% decline in muscle strength between 25 to 85 years. This loss of muscle strength is seen as the primary limiting factor for functional independence. We need that muscle strength to be able to get out of a chair, climb stairs and to have the capacity to maintain balance when we trip.

Women statistically have less muscle mass than men and so reach the fall threshold earlier with age related loss. Evidence shows, for example, that 25% of women are at risk of not being able to get up from a low chair independently between 70-74 years compared to 7% of men.

Similarly, obese individuals will have a lower muscle strength in lower limbs compared to body weight which impacts negatively on performance too.

Bone density peaks around 20-40 years. After that there is progressive loss, which is accelerated in women after the menopause. So building that bone strength when we are young is important, as is engaging in activities that maintain bone strength as we age.

Not surprisingly, balance also declines as we age and is often affected by many other factors such as obesity, reduced sensitivity of skin receptors, reduced cognitive processing, visual impairment, joint problems, pain, poor coordination and vestibular dysfunction.


When should we focus on strength and balance activity?

Research has shown that there are specific times in the life cycle where strength and balance activities would be most beneficial to health.

  • 18-24 years to maximise bone and muscle strength gains
  • 40-50 years to maintain strength and reduce that downward spiral
  • Over 65 years to preserve balance and maintain strength and independence

Of note, there are certain transition periods in life which have been identified as being important too. These transitions represent times in our lives when we might become less active and / or more sedentary. They include pregnancy, the menopause, following a diagnosis or medical condition ie stroke, on retirement, becoming a carer or following a period of hospitalisation or prolonged illness.

These periods can result in accelerated loss of strength, balance and cardiovascular fitness, and thus represent optimum times to instigate strength and balance training. Women might experience more of these life changes than men (pregnancy, menopause and becoming a carer) on top of the already statistically lower muscle mass.

What should we be doing and which activities help the best?

According to a review by Public Health England and the Centre for Ageing Better, we should be doing strength activities twice a week which include “high intensity resistance training, some impact exercise (running , jumping, skipping etc) and balance training.

The table below shows the positive impact of different types of activity on muscle, bone and strength outcomes.

Those with established osteoporosis, history of vertebral fractures or frailer older people with or without significant cognitive impairment need to seek advice from a physiotherapist as there are some activities that they should avoid and some that they should only do supervised.

Type of Sport, Physical Activity or ExerciseImprovement in Muscle FunctionImprovement in Bone HealthImprovement in Balance
RunningXXXX
Resistance TrainingXXXXXXXX
Circuit trainingXXXXXXXX
Ball GamesXXXXXXXX
Racquet SportsXXXXXXXX
Yoga, Tai ChiXXX
DanceXXXX
WalkingXX0
Nordic walkingXXNKXX
CyclingXXX

XXX= Strong Effect; XX=Medium Effect; X= Low; 0= no effect; NK=Not Known

Assessment of the positive impact of different types of sport, physical activity or exercise on muscle, bone and balance outcomes (adapted from Heinonen & Kujala in Kokko et al 2011)

There are clearly many other activities not listed on the table such as swimming, skiing/snowboarding, hillwalking, climbing and martial arts other than tai chi that will improve muscle and bone strength and balance.

The important aspect, according to Health Survey England is that the effort of the activity is enough that “the muscles feel some tension, shake or feel warm” and ideally for this to be sustained for bouts of at least 10 minutes. With this is mind, many everyday activities could fall into strength and balance work such as climbing stairs, gardening and DIY. They don’t necessarily have to be planned extras. So this makes it easier when thinking of how we can integrate it into our ever busy schedules.


As you can see, getting strong and staying strong is important across the lifecourse and especially at particular periods of change, yet many of us are not doing enough. So how could we tackle this and start doing more?

First, we need to consider where we are currently and where we would like to be. We then need to break down our goals into realistic and achievable steps. #OneChange is a fun way to do this. It is about nudging or coaxing us to change our behaviour or to start a new healthy habit. An effective and simple way to do this can be to anchor the new habit with a current activity such as boiling the kettle or brushing your teeth.

So to kickstart this, my #OneChange is to stand on one leg whilst brushing my teeth.

What is yours?!

References

  1. “How do muscle and bone strengthening activities (MBSBA) vary across the lifecourse and are there particular ages where MBSBA are most important?” Dawn Skelton, Alexandra Manroeidi Journal of Frailty, Sarcopenia and Falls / June 2018 / Vol 3 No.2 / 74-84
  2. “What types of physical activities are effective in developing muscle and bone strength and balance? Charlie Foster, Miranda E.G Armstrong. Journal of Frailty, Sarcopenia and Falls / June 2018 / Vol 3 No 2 / 58-65
  3. Muscle and bone strengthening and balance activities for general health benefits for adults and older adults. Summary of a rapid evidence review of the UK Chief Medical Officer’s update of the physical activity guidelines. PHE and Centre for Ageing Better. July 2018.
  4. Health Survey for England 2016. Physical Activity in adults. NHS Digital.

Coping with bereavement

By MICHELLE SCOTT

It is a sad fact of life that at some point we all have to deal with the death of a friend, neighbour or loved one.

Coping with bereavement as an adult is a very traumatic and bewildering time but for a child coping with bereavement the emotional struggle can be even harder.

There are many helpful charities who you can turn to for support:

Charities supporting child bereavement:

Charities supporting adult bereavement:

There are many charities who can assist – a well-respected nationwide one is Cruse Bereavement Care.

Many of the adult bereavement charities are specific to the relationship with the person who died:

Some useful thoughts & resources

Winston’s Wish has a very helpful charter which is based on their conversations with thousands of children and their families following bereavement.

Simon Says – “ The death of someone important can have a devastating effect on a child or young person, however with appropriate support and information, children and young people can be helped to understand what has happened and can be helped to rebuild their lives.

Child Bereavement Charity – “Children need information and explanations that are honest, simple and in language they understand”. “Explain truthfully what has happened in words they can understand”. This charity recommends the use of real words such as “dead” and “died” as many young children can become confused if death is referred to as someone having “gone to sleep”.

Books

There are a great number of books that can be read to children to help them come to terms with their loss. Winston’s Wish has a detailed reading list broken down into books appropriate for children’s ages.

These are some of the books from the reading list for younger children:

Always and Forever – Alan Durrant

I Miss You: A First look at Death– Pat Thomas

Muddles, Puddle and Sunshine – Winston’s Wish

The Heart and the Bottle – Oliver Jeffers

The Huge Bag of Worries – Virginia Ironside

Water Bugs and Dragonflies – Doris Stickney

Michael Rosen’s Sad Book – Michael Rosen

Practical ideas to help children store memories

There are also many practical things that parents can do to assist children to store their memories of their special person-these are just a few examples:

  • Making a memory box
  • Sand sculpture jar of memories
  • Making a life book

“Bereavement is a land without a map”  

Christine Pentland (2002)

Mind full or Mindful?

By Dr Kate Little

All too often we are swept up in our busy lives, rushing from one activity to the next. We operate on autopilot; our thoughts taking control whilst we clean our teeth, brush our hair, take a shower; not really being aware of what we have just been doing.

In one of his talks, John Kabat-Zinn asks the audience an interesting question:

“How many people do you have with you in your shower?!”

I don’t know about you, but I for one, am rarely alone. My virtual notepad is always with me plotting and rehearsing my tasks for the day. Friends, family and colleagues frequently pop by as I think of all the conversations and messages they require. Or I revisit and agonise over an interaction with someone, which hasn’t gone as well as I would have liked. I am mind full.

Most of us spend much of our day absorbed in the personal narrative of our lives. We may worry about the future or obsess about the past. We rarely spend time actually enjoying and appreciating the now.

Mindfulness is about paying attention to the present moment. Feeling the drops of water on our heads as we take our shower. Noticing the tingle in our skin as we massage shampoo into our scalp.

It takes us outside our thoughts, outside that narrative that it is all too easy to get trapped in. And importantly, it allows us to gain some headspace to free up our thinking and perhaps think about some of our problems more creatively, or with a more positive mindset so that they feel less overwhelming.

What can mindfulness help us with?

There is a good evidence base for its use in depression and, more recently, anxiety. It is not a panacea for all problems – it is not appropriate for severe depression, alcohol and drug problems and psychosis. Some studies report it as being as effective as medication, with less side-effects.

Evidence also suggests that mindfulness might help us manage stress better at work.

In addition, research is being conducted into the benefits of mindfulness in schools, after reports from short-term studies of improved psychological wellbeing and attention.

How can I practise mindfulness?

Some people are put off by the thought that you have to sit still and meditate, but this is not necessarily the case.

In the many definitions of mindfulness, some highlight the importance of focussing internally, on our thoughts and body, and some on paying attention externally to what is going on around us, and some on both.

Focussing externally, by being curious, taking notice and appreciating the beauty of the things that surround us can really help us be in the moment. The vibrant colours and unexpected warmth of a sunny autumn day for example.

Or simple objects in everyday life that we normally would pay little attention to, that we sometimes see in a different light, marvelling at them in wonder as if noticing them for the first time.

The Book of Life’s chapter on Appreciation talks about a French writer from the 18th century, Xavier de Maistre, who was wounded in a duel and confined to his bedroom. He recorded a mock-serious journal “A voyage around my bedroom” in which he looked at familiar objects in his room such as a chair and the window as if they were “remarkable novelties”, and this brought him great joy. He came to realise that:

“The key to existence is not to seek out what is actually new. It is to bring a fresh mindset to what we already know but have – long ago – forgotten to notice.”

This focus externally to me represents a kind of mindfulness in action. It does not necessarily involve sitting on a mat or chair. You can be very much be awake and moving, but rather than doing on autopilot, you are fully aware and in the moment.

Focussing internally is about becoming aware of what is going on inside: the sensations in our body and our thoughts. Watching our thoughts as one might observe clouds passing – there’s planning, there’s worry, there’s the critic – helping us to see our thoughts as weather patterns that come and go. Accepting them, rather than fighting them. They, like our moods, will pass.

This can be done in a formal meditation sitting still, alert and aware, allowing the mind to focus internally, but can also be done moving in activities such as mindful walking, Qigong and yoga where the focus is on the breath and/or the body.

Integrating mindfulness into everyday life

This is my challenge. Mindfulness requires practice, like most things that we do. We know that to keep fit, it’s best to work out regularly, and this is the same for mindfulness. We need to practice regularly to train our mind like we would our muscles.

Ways we can do this are to:

PAUSE

Stop briefly for a few seconds throughout your day. Take a few breaths and notice what is present in your body and your mind.  Small coloured stickers placed on objects around your house/place of work act as cues to pause.

Take a three-step breathing space (3 minutes)

This is a quick meditation that can be done sitting or standing. I use it to unwind or if I am feeling overwhelmed by everything I need to get done, to re-energise and de-clutter.

Do formal practice (10 minutes)

Using an app such as those mentioned below, or some guided meditations such as those here. Some of these are seated. Some are moving.

Simply take notice.

Pay attention – what is here, now? Be curious. Like our French writer, we may start to appreciate those small things in life by seeing them differently. Practising #3 Good Things can help with this.

Mindful listening

Concentrate on listening and engaging rather than letting our minds wander or think ahead to what we are going to say next.

**************

There are many ways to become more mindful and less mind full. Writing this has inspired me to re-engage with my regular practice. I know that it makes a difference!

“Human beings, by changing the inner attitudes of their minds, can change the outer aspects of their lives.”

William James (American philosopher & psychologist)

 

Resources

Books

There are many books about mindfulness. Two that I have found useful are:

Finding peace in a frantic world by Mark Williams & Danny Penman. This has an 8 week course that you can do using a CD and the book. I have completed it and cannot recommend it highly enough.

Sitting still like a frog by Eline Snel (mindfulness for kids). I have tried this when teaching in schools and on my own children. They really love it, finding it very calming and relaxing. It starts to give children an awareness of their bodies and the changes that can happen depending how they feel. They learn to use the breath as a means of grounding themselves.

Apps

 


Could life be sweeter with less sugar?

By Dr Kate Little

Ever had that feeling that you really need to eat? Where you feel lightheaded and shaky?

This happened to me recently on my way to the shops after eating a bagel. It didn’t pass until I ate something. I looked at the sugar content of my bagel and was staggered to see that each bagel (even wholemeal) contained 6.6g sugars, four times the amount of a standard slice of wholemeal bread. Of course, a bagel weighs double a slice of bread, which explains some of this extra sweet stuff. And while, if I thought about it, I knew that bagels were an “unhealthy” food option, they had somehow slipped into our family staples without me really thinking about it.

Given the explosion of adult and childhood obesity (according to recent data from Public Health England, 1 in 3 children in the UK now leave primary school overweight or obese), the increase in cancer and Type 2 Diabetes globally, what we eat and the way we eat is clearly important, as well as how much or little we move.

Most of us know that if we want to lose weight, we need to reduce calories and exercise more. We know that reducing sugar is part of reducing calories, as sugar equals calories.

Many (but not all) are also aware that there are many hidden sugars, particularly in processed food, and that complex carbohydrates, such as rice, pasta and bread are all metabolised into sugar. So reducing our carb intake makes total sense.

Many high profile people, such as comedian Eddie Izzard and actress Gwyneth Paltrow, have given up sugar and claim to feel better for it. However, given the propensity of the rich and famous to make increasingly wild and wacky lifestyle decisions, is this just another celebrity fad?

And are not all calories in equal? If, for example, I ate a chocolate bar and skipped dinner, would that be enough to offset the chocolate?

 

“Sugar – the bitter truth”

For years, the focus has been on eating low-fat foods and reducing calories, yet in the last decade there has been more and more interest in and increasing evidence on the harms of sugar, in particular, fructose.

Table sugar (and most fruits that we eat) contain sucrose, which is made up of one glucose molecule and one fructose molecule joined together. High fructose corn syrup, commonly used in the States previously, has a ratio of 55% fructose to 45% glucose.

Fructose, unlike glucose, which can be metabolised almost anywhere in the body, can only be metabolised by the liver. Whilst the rest of the body burns the glucose, the liver works on any excess glucose and all the fructose, resulting in a high sugar load concentrated within the liver. Once the liver stores are full, the surplus gets converted to fat. Fatty liver then develops which then leads to type 2 diabetes and we all know the rest of the story.

High sugar diets have also been linked with poor behaviour in children, worsening seizures in epilepsy and Alzheimer’s dementia with some going as far as to call Alzheimer’s “Type 3 Diabetes“. Public Health England suggest that around one third of Alzheimer’s dementia might be attributable to lifestyle factors, including diet, exercise and smoking.

Armed with this information, the idea that all calories are equal can no longer hold sway. Perhaps we should be taking the harms of sugar more seriously.

So how do we start reducing sugar in our diet?

The first step we can all take, is not to add extra sugar to any food or drink, like tea or coffee, and to reduce our intake of sugary drinks and obvious sweet foods.

The next step, which is harder, is to limit processed foods, many of which have high concentrations of hidden sugars, often listed under different names such as glucose, dextrose, molasses, which many of us may not recognise as sugar. Many ready-made savoury sauces are very high in sugar for example. The Public Health collaboration has some excellent infographics here and here to help us to identify which foods are the worst offenders.

According to that reliable dietary resource, the Daily Mail, nearly half of all ready meals eaten in Europe last year were consumed in the UK.

On average, people in the UK consume at least one ready meal a week – twice as often as the French and six times the number consumed by the Spanish.

So if the Daily Mail is anything to go by, our fast food consumption is also something to be mindful of. If you prepare your own food from scratch, you can control the amount of sugar that goes into it. Another tip is to try to avoid food products that contain more than five ingredients.

“I’m a fat man in a thin person’s clothes”

This is what a friend’s husband told me once, after successfully losing weight and maintaining it.

And he’s right. According to Charles Duhigg, the author of “The Power of Habit”, bad habits don’t really disappear. We can ignore, change or replace them, but the pathways are “always lurking there, waiting for the right cues and rewards”. This is clearly beneficial for learned skills like driving and riding a bike, as we don’t need to re-learn them after a break, but not so good when we actually want to get rid of unhealthy habits. The slippery slope is a very real and risky path that is open to all of us.

Duhigg adds that “most people don’t set out to eat fast food on a regular basis. What happens is that a once-a-month pattern slowly becomes once-a-week, and then twice-a-week – as the cues and rewards create a habit – until the kids are consuming an unhealthy amount of hamburgers and fries.”

For me as a parent, this is really important information. It has made me sit up and consciously think about what we eat and how we eat at home and outside, to make sure that we keep treats as treats, and not allow them to creep into everyday life – like the bagels!

Given #Health is one of my #3 words this year, let’s hope this new habit lasts!

 


Resources

The Case Against Sugar by Gary Taubes chronicles “Americans’ history with sugar: its uses as a preservative, as an additive in cigarettes, the contemporary overuse of high-fructose corn syrup. He explains what research has shown about our addiction to sweets. He clarifies the arguments against sugar, corrects misconceptions about the relationship between sugar and weight loss; and provides the perspective necessary to make informed decisions about sugar as individuals and as a society.”

Sugar by Half – an Australian site with resources and ideas on how to make sugar swaps for healthier alternatives.

The Change 4 Life Sugar Smart App

You can download this for free from the app store. It scans the bar code of your product and tells you how much sugar equivalent there is.

Sugar – the Bitter Truth

A You-tube film of a lecture by Professor Robert Lustig, an American paediatrician. Not easy viewing as it does go right down to metabolic level in some depth, but if you like detail and have 90 minutes to spare, this video is amazing. As well as learning loads about the harms of high fructose corn syrup which has been introduced en masse in the States as an attempt to stabilise sugar prices in the 50’s, we learn how coca-cola has changed its recipe over the years to include more and more sugar to hide the added salt and caffeine to make us more thirsty.

The Diet doctor – a great resource on low carb diets

The 4 Pillar Plan by Dr Ragan Chaterjee – I will be writing more on this later

Preventing Alzheimer’s is easier than you think by Georgia Ede MD of Diagnosis Diet

The End of Alzheimer’s: The First Programme to Prevent and Reverse the Cognitive Decline of Dementia by Dr Dale Bredesen

Photo by Patrick Fore on Unsplash

Is sitting really the new smoking?

How and why being sedentary is harmful and what we can do about it.

We all know that exercise is good for our health and overall wellbeing, but what many of us don’t appreciate is that sitting for prolonged periods is actually harmful for our health even if we are optimally active the rest of the time.

According to Public Health England data, being inactive is linked for 1 in 6 UK deaths – at population level this is comparable to smoking. Hence, the saying “Sitting is the new smoking“. However, although sitting for prolonged periods is harmful, as we shall see below, at individual level, smoking is still far worse.

Evidence shows that sedentary behaviour increases our risk of heart disease and many cancers, and at least doubles our risk of developing type 2 diabetes. This clearly has great implications for those of us that have desk jobs,  use motorised transport or sit a lot when at home.

We know that when we are more active, we can help reduce the risk of many conditions including:

  • Cardiovascular disease, stroke and type 2 diabetes
  • Breast and colon cancer
  • Alzheimer’s dementia, depression, and musculoskeletal ill-health.

Being more active has also been shown to improve quality of life through better symptom control, as well as helping to treat over 20 conditions, including certain cancers, type 2 diabetes, heart disease, lower back pain, asthma, depression and anxiety. 

How does physical activity reduce our risk of disease?

Chronic low-grade inflammation is thought to be the root cause of many disease processes. Being active reduces our overall inflammation through two main paths.

  • Firstly, it reduces our visceral fat. This is that fat usually hidden around our organs and in our muscle tissue and is pro-inflammatory.  This visceral fat is lost preferentially over our subcutaneous fat (the fat we can see and feel) when we exercise and so reduces our overall inflammation.
  • Secondly, when we exercise, we increase our muscle bulk and in turn this releases more anti-inflammatory hormones which also reduce that inflammation.

Being sedentary increases the release of free radicals in our body. These damage our cells and promote that toxic inflammation which is linked to all those diseases. When we are active we limit that damage and actually protect our cells.

How often should we be getting up and moving?

There are no guidelines on this yet. The best thing to do is to get up often – every 20-30 minutes if you can or at least every hour and move about, stretch a little, before sitting back down again.

And thinking in energy terms:

Standing for 3 hours a day burns the same amount of calories as running 10 marathons over a year! 

Top tips for sitting less

My standing desk

At work consider:

  • Investing in or using a standing desk. I bought mine (above) from Healthy Home and Office * in Ripley. They have a great range there and are incredibly helpful.
  • Walking meetings with clients or peers – you might actually have more constructive conversations and better outcomes, a bit like when you are side to side in a car. One colleague I know does this particularly when stuck on a creative project. Another works as a mental health nurse and finds that it works really well for the clients too.
  • Standing meetings – sometimes used in the city to make decisions quicker, but great for our health too.
  • Walking or standing calls – watch Dr Muir Gray’s clip on this here.
  • Get up to chat to colleagues rather than pinging a text or e-mail.
  • Get outside for a walk or break when you can.
  • Use the stairs rather than the escalator or lift
  • Drink lots of water – as well as being good for your health (within reason of course), it might get you up to use the bathroom.

At home consider:

  • Doing your weekly or adhoc food shop in person. Or even better, walking to your local shops and supporting our local businesses at the same time!
  • Cooking from scratch – keeps you on your feet for longer than a take away or ready meal.
  • Having frequent breaks when you are watching TV or a film. What about going that one step further and using the breaks to do some quick strength building or cardio exercises?!
  • Setting rules on your screen time – read more on the benefits of unplugging here. 
  • Meeting friends or family for a walk to catch up rather than for a seated coffee or tea. You can always bring your coffee with you!

There are clearly many more ways that you can be less sedentary, the key thing is to find ways that resonate with you and that you will stick with.

“This whole life is an art of knowing when to sit and when to stand up!” 
Mehmet Murat Ildan 

What ways could you move more and sit less?


The Importance of Unplugging and why you should become a Digital Rebel

By Dr Kate Little

“Mummy, you’re not listening” my son says.

Mmmm. Sorry, I have just got to reply to this e-mail and I’ll be right with you…

Only I get side-tracked and the next thing I know, I am checking the WhatsApp and Facebook notifications on my phone. An argument breaks out at top volume around me.

Sound familiar?

The problem is that we all feel negative after this. And when I reflect back, the whole episode was my own doing. But what is it about our devices that makes them so compelling and addictive that we lose touch with real life going on around us?

The Digital Age and Inf-O-besity

We now live in a fast paced, information-overloaded digital world. It is an age of “Infobesity” with multiple competing demands on our time and attention.

More and more people are working flexibly or from home and with that, the boundaries between work and personal life have become increasingly blurred.

Research has shown that the average person checks their phone at least 150 times a day, an average user touches their phone 2500 times a day and a high user, well over 5000 times! It is perhaps no surprise based on these statistics that the average e-mail goes unread for a mere 6 seconds!

We get sucked in, often without realising it. But the design is intentional and it is based on slot machine psychology.

The Ludic Loop

Ludic is Latin for playful. The Ludic loop, coined by anthropologist Natasha Dow Schull, author of Addiction by Design, is a cycle of repeating the same activity, impelled by occasional random rewards.

Schull studied users of slot machines in Las Vegas. She found that users get drawn into a repeating cycle of inserting coins and pulling the handle in the hope of hitting the jackpot. Because the reward is not predictable, the gamer’s attention is grabbed and the behaviour becomes compulsive. They don’t want to miss that slim chance of a win.

We may not all be gamers and gamblers but we are all vulnerable to a similar loop in our use of e-mails and social media. Think about this scenario: You pick up your phone – it has been at least 5 minutes after all – you glance at Facebook, Twitter and Instagram, and then take a peek on your email. Once you have done that, a few more notifications appear on Facebook so you check that again. Before you know it, 30 minutes has passed. You return to what you were doing, but the lure is there at the back of your mind. What if someone has replied? So you start the cycle again. You are in the loop. The product designers are playing on our fear of missing something important and our need for social approval and reciprocity.

The Attention Economy

In his article, How Technology is Hijacking Your Mind – from a Magician and Google Design Ethicist”, Tristan Harris explains how product designers “play our psychological vulnerabilities (consciously and unconsciously) against us in the race to grab our attention.”

We think that we have free choice, but in reality it is the product designers who are controlling our choices. They do this upstream by designing the menu of options that we are offered.Our news feed, the Auto-play on You-tube and the suggested programmes on Netflix are all chosen for us.

According to Adam Alter, author of “Irrestible – Why we can’t stop checking, scrolling, clicking and watching, we enter a zone of “Flow” when we use these products, a zone where we become so immersed in the task at hand that we lose perspective of time.

The trouble is, there is no longer an end point. In his TED talk Why screens don’t make us happy,” Alter argues that it is because they “rob us of stopping cues,” that signal that it is time to move on to the next activity. Before the inception of “on demand TV”, we would watch a TV show, and when it ended, we would have to wait until the next week to watch the next episode. Now, we can stay up all night and watch the entire series in one go if we want to.

Why does this matter?

As Alter observes, much of our screen time is not making us happy. And the problem, as we have seen, is that we are on our devices a lot.

Digital natives (those born into the world of laptops and mobile phones) spend on average 8 ½ hours a day exposed to digital technology and brain scans are showing that this negatively affects emotional aptitudes such as empathy.

Our pocket slot machines are with most of us 24/7. Young people check their phones on average 10 times a night. We go to bed with them. We wake up to notifications that we check before we have even got out of bed.

We are constantly high alert and this has consequences.

Excessive screen time is linked with introspection, depression, anxiety and reduced sleep. Have you ever checked your e-mail late at night and then lost sleep afterwards? I certainly have.

Reduced sleep affects our mood and behaviour and the way we eat so that we make less healthy choices, and so a vicious cycle develops. There are effects on our productivity: people are distracted through the working day, when at home and through the night, further affecting sleep and performance.

To compound the problem, products like Facebook can fuel our insecurities further as we compare ourselves unfavourably to others who post images of their “perfect” lives. We see the parties and social events that we perhaps weren’t included in and this can exacerbate our already fragile egos.

Most of us are already aware of the addictive power of our screens, and of cyber-bullying and exclusion, particularly in young people, but perhaps less aware of the impact on those that we care for. A health visitor I know observed recently how more and more children are commenting that they wished that their parents weren’t on their phone so much. Perhaps it is not just our children’s use of screens that we should be monitoring, but our own too.

So what can we do about it?

 Here are some hacks to becoming a Digital Rebel:

#1 Unplug

  • Take regular breaks to go offline even for a minute or two.
  • Spend some time in nature every day, unplugged. Notice the colours. Listen to the sounds. Move about.
  • Actively connect with people face to face, unplugged.

#2 Set a Digital Sunset

  • Set a warm filter on screens in the evening.
  • Invest in amber glasses to reduce the blue light if you do have to use your screen.
  • Invest in an old fashioned alarm clock with no LED display.
  • Leave your phone outside your bedroom.
  • Stick to no screen time one hour before you go to bed.

#3 Alter the set-up of your phone

  • Create an essential home page screen, moving distracting apps like Facebook and e-mails to the second page.
  • Stop notifications or hide them in folders.
  • Launch your apps without unlocking your phone by swiping up the Control Centre like you would do for your camera. This way your phone remains locked, reducing the chance of distraction.

#4 Set rules

  • Set a timer on Internet browsing time.
  • Ban phones at the table and in the bedroom.
  • Delete the most time-consuming apps. Replace them with more productive ones.
  • Put your phone out of easy reach when working.
  • Schedule blocks of time at specific times of the day to check your e-mails and social media.
  • Set your phone on airplane mode when you don’t want to be distracted.

The Power of Unplugging

Our screens are miraculous inventions. But the way we use them does not always make us, or those around us, happy.

So, become a digital rebel. Step out. Unplug. Go outside. Feel the grass beneath your toes. Listen to the birds. Enjoy the sun on your back and take a deep breath in. Life will be richer.

“The present moment is filled with joy and happiness. If you are attentive, you will see it.”

Thich Nhat Hanh

 Appendix

How do you know if you are a high user?

On Apple, you can check your % usuage of apps and time since the last full charge in your Settings / Battery / Usage. You might be surprised by just how much you use it.

 Photo by Roberta Sorge on Unsplash