Over the last 50 years our health, and our understanding of what can threaten it, have dramatically improved. Perhaps it is now time to set our sights a little higher, to try to achieve a standard of health that comes closer to the World Health Organization defi-nition, which says that health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. In the Western World there is probably little scope for increasing longevity much beyond the biblical ‘three score years and ten’ which are now within most people’s grasp. Much more worthwhile will be efforts to stay healthy throughout this lifespan so that, in spite of the natural slowing down during middle and old age, we remain physically and mentally fit with a positive sense of well-being and our activities unrestricted by disease.
A good start in life
To begin at the beginning, we must make sure that children have the best possible start in life. This goes back before birth, even before conception. Couples who have a family history of inheritable disorders such as cystic fibrosis can seek genetic counselling, to help them assess their chances of a healthy baby even before conceiving. Wherever there is likelihood of a congenital abnormality, such as Down’s syndrome or spina bifida (perhaps because the mother is beyond the ‘safe’ age limit of around 35), screening tests can be given during pregnancy. These include chorionic villus sampling and amniocentesis. The former technique, which can be carried out in the first week of pregnancy, involves taking a small sample of cells from the chorion, the outer membrane surrounding the foetus. In amniocentesis, usually carried out at about the sixteenth week of pregnancy, a fine needle is used to extract a sample of amniotic fluid, the liquid in which the foetus ‘floats’ within the amniotic sac. In each case, the sample can be analysed to detect poss- ible genetic or chromosome abnormalities, and if necessary the mother offered the choice of an abortion. The mother’s health should also be monitored regularly. A healthy mother who has good antenatal care is more likely to produce a healthy child. A relatively trouble-free childhood with a happy family background is the best protection against future mental ill-health, and the foundations of future physi-cal health are also partly laid down in childhood. Habits and behaviour acquired in those early years have a lasting influence. Families are obese not so much because obesity is inherited in the genes, but because some parents set a pattern of overeating that their children inevitably follow and find it hard to shake off in later life. Habits of personal hygiene and dental care are formed at the same early age. And parents who do not smoke and moderate their drinking habits stand a reasonable chance of passing these behaviour patterns to their offspring. Not all illness is avoidable. But even if you have an inherited predisposition to a particular disease, this may become apparent only if it is aggravated or pre-cipitated by some other factor which is under your control. A ‘healthy constitution’ is far more the pro-duct of a healthy lifestyle than a piece of genetically-determined good luck.
A healthy lifestyle
So what constitutes a healthy lifestyle? Obviously people vary tremendously in their make-up, habits and requirements. Even so, it is possible to generalize four basic rules that medical experience shows make a contribution to the maintainance of good health and longevity. These are: Do not eat foods rich in animal fats. Do not smoke cigarettes or overindulge in alcoholic drinks. Do take regular exercise. And do not worry. The health-damaging agents involved are cholesterol in animal fats (which is implicated in cardiovascular disease), cancer-causing chemicals in tobacco smoke, alcohol (which can cause gastritis and cirrhosis of the liver) and continual stress, which can have psychological as well as physical manifestations. Regular exercise tones up the muscles and stimulates the heart, lungs and circulation, as well as creating a general fgeeling of well-being.
Programmes of health screening (examining apparently healthy people to detect disorders before symp-toms appear) have become popular with the health-conscious, especially in the United States, where it is almost part of a businessman’s routine to have an annual check-up. Such screening may give a person some peace of mind but it is probably not very effective. However it can be valuable if used to detect disorders such as hypertension (high blood pressure) or alcoholism, in which early diagnosis can affect treatment and the eventual outcome. Women can be taught to ‘screen’ themselves for early signs of possible breast cancer, for example, and encouraged to have a regular smear test for the early detection of cervical cancer.
Adapting to your environment
You cannot always control your environment, but you can adapt to it. For example, if you pursue a sedentary career you should take plenty of exercise to compensate for it, because fitness is largely deter-mined by the amount of physical exercise you take. If you have to spend much of your day sitting, make sure that your back is well supported in a firm, high-backed chair. In many Western countries more working days are lost through backache than any other single ailment.
There will be times when you have to account for a change in your environment, such as making sure you have the necessary vaccinations to travel to countries where infections diseases such as poliomyelitis and yellow fever are still endemic. Tablets to prevent malaria have te be taken before, during and even after a stay in a malarial area. Some people have a respon-sability to others, such as ensuring that elderly people and infants, who are especially vulnerable to heat loss, are kept warm when winter comes. Accidents in the everyday environment are a major cause of death and injury, so take adequate safety precautions in all areas of your life: in the home, on the roads, at work and during sport and leisure activities. The most common serious accident is a fall in the home, often cuased merely by tripping over.
Listening to the body
A person who feels healthy also needs to answer the question: do I feel happy? One cannot totally control happiness, but by living in a way which one likes and through maintaining a positive outlook on life one can contribute much towards this. This does not necess-iraly mean that one should live without stress. A certain form of stress may be experienced as being negative by one person, whereas it stimulates another person. Usually one knows best oneself how much stress one can handle. With too much stress one should try to find a way to decrease the inner tension. This is possible through, for instance, yoga, meditation, sports, or listening to relaxing music. The use of sleeping pills or tranquillisers does not offer any solution to the problems. Moreover, they may soon cause addiction. Therefore it is much better when one considers sleeping problems or a tense feeling to be signals from the body that there is something wrong; and that these symptoms should be suppressed as quickly as possible. Recognizing such symptoms of the body is, however, not easy. Therefore we really have to ‘learn’ to listen. Perhaps this will eventually be the most important thing we can do to stay healthy.