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Don’t Take My Wife, Please
Comedians have been getting cheap laughs at the expense of the old ball and chain for as long as there have been women and steel. The funny thing is that as much as we joke about women driving us to our graves, the fact is that they actually add years to our lives. Finding a mate and being happily married is about as good as, if not better for our health than, quitting smoking, maintaining healthy blood pressure, eating a low-fat diet, or exercising more than 60 minutes a day.
Marriage may also be the key to disease survival, say experts. When researchers at the Veterans Administration Medical Center in Miami checked the survival rates of 143,969 men with prostate cancer, they found that those who were married lived almost three years longer than those who either were never married or were separated or divorced. Marriage is even better for your health if you do it only once. Researchers found that the trauma of divorce can be bad enough to negate the benefits of being remarried.
«But the findings are pretty consistent that being married has plenty of health benefits for men,» says study author Joan Tucker, Ph.D., assistant professor of psychology at Brandeis University in Waltham, Massachusetts. «Women traditionally do things for men that have health benefits. Things like improving his diet, reducing his risky behavior, providing stress relief, and helping him remember to take medication are all strong health supports.»
You are what you eat
Remember the tired old «an apple a day» cliche? Well, a 20-some-year study of almost 10,000 people in Finland confirmed it. Those who ate the most flavonoids, which are natural antioxidants found in many fruits and vegetables, had lower risks for all cancers and half the risk for lung cancer than those who ate the least. The clear winner for lowering lung cancer rates? You guessed it: apples.
But apples aren’t the only fruit of paradise for your health. A study of more than 2,000 Welsh men demonstrated that those who ate the most of any kind of fruit had half the risk for all cancers compared to those who ate the least.
Hell, it’s becoming so hip to eat healthy that major-league ballpark stadiums are even hawking fruits and vegetables next to the weenies and fries these days. Busch Stadium, the Astrodome, Dodger Stadium, Jacobs Field, Oriole Park at Camden Yards, Riverfront Stadium, and Shea Stadium all offer vegetables, garden salads, or fruit and vegetable platters. Others, including Candlestick Park and Wrigley Field, offer garden burgers and other healthful stadium snacks.
Laughing in the Face of Death
Though Bobby McFerrin almost drove us all to an early grave in 1988, with his incessant and insipid «Don’t Worry, Be Happy,» his advice was scientifically sound. If you can laugh in the face of adversity, you can live better, longer.
A Japanese researcher studying 157 men and women ages 65 and older has found a strong connection between maintaining a general sense of well-being and having low levels of total cholesterol, low levels of artery-blocking low-density lipoprotein (LDL) cholesterol, and high levels of healthful high-density lipoprotein (HDL) cholesterol. Lifting your spirits, he concluded, is important in caring for your heart.
Any moves that men can make to relieve their stress and lighten their moods will probably decrease their risks for heart attack, says Dr. Ichiro Kawachi of the Harvard School of Public Health.
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It’s probably news you don’t want to hear, but coffee is not the best thing for your heart. Coffee affects our metabolism in several ways that place us at increased risk of heart disease. One way that coffee increases our risk of heart disease is by promoting inflammation in our body. A study done in Greece recruited 1514 men (aged 18-87 years) and 1528 women (aged 18-89 years); their blood levels of inflammatory chemicals were analyzed in relation to coffee consumption. When compared to men who drank no coffee at all, men who consumed more than 200mL per day had a 50 percent higher level of interleukin-6 (IL6), a 30 percent higher C-reactive protein level, 12 percent greater serum amyloid-A, 28 percent higher tumour necrosis factor (TNF)-alpha levels and three percent higher white blood cell counts. For women who consumed 200mL per day of coffee, these figures were even higher. All of these chemicals are indicators of inflammation in the body, and are directly linked to higher rates of heart disease.
Coffee also has the ability to raise blood pressure and damage our blood vessels. An Australian study was conducted on 18 healthy middle aged men and women who consumed 250mg of caffeine per day; this is roughly the amount found in two or three cups of coffee. The study showed that caffeine caused raised blood pressure and made the aorta less elastic and more rigid. The aorta is the largest artery in the body. People who drink coffee have higher amounts of the stress hormones Cortisol and ACTH in their bloodstream than people who don’t. These stress hormones can act as free radicals in our body and promote abdominal obesity.
Drinking unfiltered, boiled coffee can raise total cholesterol, LDL «bad» cholesterol and triglycerides if six or more cups are consumed per day. This effect is not present in filtered coffee, as it is the coffee oils found only in unfiltered or boiled coffee that are the culprit. Unfiltered coffee is more common in Europe; ground coffee is placed in a device that goes on the stovetop. Greek coffee is a type of unfiltered, boiled coffee. A more worrying fact is that coffee can raise homocysteine levels; four or more cups per day are required to have this effect. High homocysteine levels are a major risk factor for heart disease because homocysteine causes damage to artery walls and makes platelets stickier. Caffeine also promotes insulin resistance, meaning it makes us more likely to gain weight and develop diabetes. It is okay to enjoy coffee in moderation, approximately two to four cups a day.
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If you’ve ever wondered how, precisely, people die, we can tell you the one place you should not look for answers: television. On TV, sometimes folks die an agonizing death from the slightest case of sniffles. Other times, the helicopter slams into the bridge and the whole A-Team emerges unscathed.
«It’s hard to answer the question of whether death itself hurts because nobody really knows,» Dr. Iserson says. There can be pain and discomfort at the initial onset of a fatal event, especially with trauma or where a heart attack or a terminal illness is involved. «But it’s not likely that the final moments are very painful since the brain is shutting down. In fact, some dying processes, like drowning, can actually be quite peaceful,» says Dr. Iserson, a near-drowning victim himself. Here’s a quick look at how we die.
The big three. The three top causes of death-heart disease, cancer, and stroke-are also the easiest to understand. They cause death by shutting down vital organs. Most heart attacks occur because the heart is not getting enough oxygen through plaque-constricted coronary arteries. The heart stops, and the lights go out. Stroke is similar but occurs when the brain, not the heart, fails to get enough blood (which is why some doctors now refer to stroke as brain attack). And cancer kills by impairing the functions of the organs it invades.
Bang! You’re dead. Fatal events such as car crashes, falling from high places, or being shot cause trauma. More than half of the time, death in trauma cases is actually the result of injury to the heart, a major blood vessel, the brain, or the spinal cord, which causes blood loss and shock or massive injury to the brain or other vital organs. «That’s why the Safety Council folks are so adamant about people wearing seat belts, helmets, and other protective gear,» says Dr. Wecht. «Often if you can protect your head, you can stay alive.»
Bleeding to death. We tend to think of bleeding as something we do on the outside. But internal organs such as the spleen, liver, and lungs are like miniature blood banks. Rupturing such organs can cause massive internal bleeding, which takes precious amounts of blood out of circulation. A quick loss of 40 to 50 percent of your blood, which is approximately five to six pints in a 170-pound man or four to five pints in a 130-pound woman, is enough to cause coma and death. When too much blood is taken out of circulation, the heart speeds up to try to compensate for the loss. But once the pressure and volume get too low, the person falls into a coma, and the oxygen-deprived heart stops.
From gallows to swallows. Finally, there’s asphyxiation. One sure way to put your heart to rest and your brain to sleep for good is to cut off your air supply. When you can’t breathe, whether a chicken bone is lodged in your throat or cement shoes tied to your feet haul you down to drown, you experience asphyxia. During asphyxia, the pulse quickens, the blood pressure rises, and the amount of carbon dioxide in your blood shoots up due to the lack of new air coming in, or of old air being expelled. In a few minutes, the heartbeat becomes irregular from lack of oxygen and then stops.
Though death accounts are predictably grim, experts say that your final moments, if you are dying from a chronic, natural illness, probably aren’t all that bad-even if they aren’t exactly pretty. «In many cases, it’s just a slip out of consciousness,» Dr. Iserson says.
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Most people know that if they stopped smoking, drank very moderately, ate the right food, exercised regularly and got enough sleep they would live longer and be healthier. Yet most of us continue to do all or most of the things we know we shouldn’t. True, mortality rates for heart disease and strokes have been falling in the US (heart attack deaths have fallen by 30 per cent over the last 10 years), but the number of people having heart attacks has not fallen as dramatically. Clearly at least some of these improved statistics are the result of better medical care, once a heart condition is apparent.
In the face of unhealthy pressures all around us it would be surprising if self-help methods unfailingly succeeded in improving the health of the individual. But how reasonable is it to place the burden on the individual when cigarette and alcohol advertising continue to bombard him or her from all sides? Can children be brought up to take control of or responsibility for their health when they learn so soon that what they try to do has so little impact? And supposing our man described above did cut out all his vices, what would he do instead – and might it not be even more hazardous?
So if individuals often cannot help themselves, how about the State lending a hand? This only works if the public is ready for the legal restrictions. Prohibition in the US did not work because people weren’t ready for it, yet penalties for driving when under the influence of drink and for not wearing seat-belts are apparently acceptable in the UK and elsewhere. Increased taxation on illness-producing habits works at least to some extent but research shows that real devotees simply give up other things (a healthy diet perhaps) to fund their addictions. Anyway, how far does a government have the right to impose its will on the masses? In other words there is a considerable ethical dilemma involved in preventive medicine. Should 1 be allowed to behave in any way I want, even if it affects others adversely? We all want to see laws such as those that prevent drunken driving, but a balance must be struck between measures like this, which benefit us all, and the reasonable liberty of the individual And then there is the question of individual freedom to act in ways that don’t directly affect others. It could be argued that the man who smokes heavily in private is doing society a favour in several ways. First, he is relieving the society of the cost of the drugs that might otherwise be consumed if he were not smoking and being tranquillized by his cigarettes. Second, his habit will kill him younger, and relatively quickly, by lung cancer (the average lung cancer victim lives only eight months from the discovery of the tumour) or heart attacks-the other major smoking disease. Both kill very quickly, so reducing his capacity to be a burden on society and its medical facilities. Lastly, he will probably not live long enough to collect his old age pension-another saving to society.
Looked at coldly, then, a case could be made for allowing people to do what they want if it kills them quickly and prematurely, if only because we have so many old people and too large a burden of chronically ill already.
My approach to prevention, then, is not a dictatorial one, mainly because after fifteen years of preventive medical experience I know that forcing it on people does not work. In the last analysis everyone must be free to choose his or her way of death-and most of us will do so whatever governments or health educators do. Some kill themselves with overwork, some on the road, some through their hobbies, while others smoke themselves to death, and so on. What I as a health educator can do is to make them aware of the dangers of these harmful pursuits so that they have a choice. I never tell a patient to stop smoking. That’s his or her choice. I don’t expect patients to tell me to stop driving my car-and that could kill me. What I do is to lay before them the facts as they are currently understood about the harmful effects of smoking. The choice is then theirs.
The difficulties come when another person’s behaviour affects my life and health adversely, and most of us agree that the State should step in here. But here again the problems are formidable. Should the State, for example, pass laws to prevent any form of extramarital sexual activity on the basis that it harms innocent third parties? Such a suggestion seems preposterous yet we happily go along with similar laws that stop people polluting the air of innocent third parties with cigarette smoke on far flimsier evidence.
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For Kelly Jens, food was once an all-consuming passion.
«I was always thinking about what my next meal would be,» says the 28-year-old Glenwood, Iowa, native. «When I’d go out to eat, I’d try to pick places with the biggest portions or the most courses. I especially liked Quarter Pounders with Cheese, nachos, pizza with extra cheese, and anything with Alfredo sauce.»Always on the hefty side, Kelly couldn’t stop eating—or stop: gaining weight. By Christmas 1997, she had reached 220 pounds. «In a picture with my husband and my two kids, my little 1-year- old looks like a doll in my huge lap,» she recalls. «I thought to myself, ‘I don’t want my children to have a fat, unhealthy mother/»
It was time to change her life.
Using information she gathered from magazine and books by weight-loss guru Richard Simmons, Kelly determined that she would need to trim her daily calorie intake to 1,400 in order to achieve and maintain a healthy weight.
Obviously, that was far fewer calories than she had been consuming. To help herself stay on course, she began keeping a food diary. Kelly would write down every morsel she ate and every drop she drank—usually before she ate or drank it. She also noted the calorie and fat content of each item.
To help herself burn calories, Kelly started using a Health Walker, a nonimpact machine that allows the legs to swing back and forth to simulate striding. At first, she worked out for 15 minutes per session, then gradually built up to an hour a day—a schedule that she still maintains. She also does strength training twice a week, exercises to a kickboxing video, and jumps rope.
In 1 year, Kelly lost 95 pounds. And the weight hasn’t come back. For that, she credits her food diary. «I never really knew how much I was eating until I starting writing it down and reviewing it,» she explains. «Even though I’ve learned what I can eat and how much, I still keep a diary. It’s a good tool for helping me maintain my present weight.»
WINNING ACTION
Keep a diary. Buy a small spiral-bound notebook and carry it with you. Immediately after meals and snacks, write down what you’ve consumed, along with the food’s fat and calorie content. Studies show that people tend to be more true to their diets when they keep a record of what they eat. At first, you’ll probably be amazed at how much—and how often—you eat. Later, you’ll be proud of the positive choices that you’re making.
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