The World Health Organisation defines health as 'a state of total physical, mental and social well-being, not merely the absence of disease'. This definition is a recognition that we are integrated beings enjoying health in a number of inseparable dimensions each having a profound influence on the others. The Concise Oxford Dictionary is even more direct when it says that health is 'Physical soundness, mental soundness, spiritual soundness'. We can summarise these characteristics of healthy being as lifestyle factors in which soundness might be alternatively described as a quality of life.

 

Lifestyle

The role of lifestyle in determining our actual health status is being seen as of increasing importance. Current research shows that in all causes of death four factors are outstanding. Lifestyle is the leading factor accounting for fifty-three percent of deaths, a further twenty-one percent of deaths are attributed to environmental factors. If we consider that we are largely able to control lifestyle and environmental factors we can conclude that seventy-four percent, or nearly three quarters, of factors contributing to death lie pretty much within our ability to change them for the better. Sixteen percent of factors contributing to early death rests with our heredity. However, medical scientists tell us that even if we carry a genetic fault it is not inevitable that it will be manifested in our generation if we have minimised its appearance by adopting a healthy lifestyle. The remaining ten percent of factors lie in the realm of health-care itself. That may seem odd on the surface but is easily explainable. Accidents and turns for the worst occur even in hospitals. Science, even medical science, does not have all the answers to our problems. We may know what tablet A does, and even tablet B, when taken as prescribed. What we are not so sure about is what tablets A and B do when taken at the same time. Much of these insights come with more experimentation and the passing of time.

So the good news is that when we consider these factors together we see that our measure of control in all these areas is already very great and has the potential of getting better all the time.

We can only contribute to our health when we understand our bodies and their needs. This is not a new idea. The British philosopher Robert Boyle (1627-1691) said rather quaintly:

It is highly dishonourable for a Reasonable Soul to live in so Divinely built a Mansion as the Body she resides in, altogether unacquainted with the exquisite structure of it.

He is right of course. We ought to know our bodies and how to keep them in good health, not only by ensuring that we have a positive lifestyle but also what to do when things go wrong, and there is no guarantee that they will not as we do not live in an ideal world.

'Good' Health Habits

The current impetus for the interest in healthy living came about as a result of study into the health habits and health status of 7000 Californians in 1972 by the researchers Lester Breslow and N B Belloc.

In examining the physical condition of the men and women they concluded that people who practised a number of health habits were in better health than those who did not. In fact, seven 'good' health habits were prominent. The healthiest people in the group were people who:

never smoked drank less than four alcoholic drinks per week [better yet, none!] took breakfast every day rarely ate between meals slept 7-8 hours nightly often engaged in exercise were women less than ten percent overweight, or men less than twenty percent overweight

Correlations could also be demonstrated between even a few of these health habits and actual health status. The research gave rise to further studies conducted elsewhere around the world and with similar results.

A Balanced Life

Another dimension of health that has become very clear is the necessity to keep a balance to our lives, not just in the integration of being in the three areas already noted but even within those areas. Put simply, we are beginning to recognise that too little input may be as harmful as excessive input. If, for example, we take health problems with possible nutritional links, we see that there is in fact an optimal diet which provides the appropriate level of resource to maintain good health.

Hypertension (or high blood-pressure) may be related to a deficiency of potassium or calcium in the diet. On the other hand an excess of salt or fat might be a contributory factor. Dental caries may be due to a lack of fluoride in protecting the teeth or due to the presence of sugars attacking the teeth. The matter of balance is brought home further when we consider the difference that vitamins, minerals, and trace elements can make to our health, even in the relatively small amounts that they represent as part of our balanced diet.

In order for disease conditions to develop there has to be a causative agent and a susceptible person, although disease is not inevitable as, in spite of what is said above, there are reasonably wide margins of tolerance. However, if we adopt a positive lifestyle along the lines of the research cited, the risks can be reduced further as the individual becomes resistant. Likewise, it is not possible to guarantee absolute freedom from disease as, has already been stated, we do not live in a perfect world.

Diseases of Affluence

Studies in war-time Europe where rationing of food items was well established show that the general health of the population improved where the diet was restricted and fairly basic. Although we hear a lot about stress today as a cause of illness it did not have such a major impact on health during the war when stress was an everyday occurrence.

When rationing ceased and a wider variety of food-stuff was available (either natural or processed) the good health started to decline. As people ate more indiscriminately the disease statistics reflected the changes in lifestyle. Cancers and heart disease and other degenerative conditions leapt to the top of the list of causes of death and long-term ill-health. Since these changes were more often seen in Western countries with high standards of living doctors started to describe these conditions as 'diseases of affluence'. Where there is economic growth and the adoption of the Western style of living the diseases of affluence appear to follow. For example, breast and colon cancer rates remain low in countries where the diet is staple and fat intake is limited. When people emigrate to the affluent countries and adopt the lifestyle of their new country, and dietary habits in particular, the breast and colon cancer rates rise to the locally observed levels. However, if the migrants continue to follow their established dietary practices the cancer rates remain the same.

 

Reducing the Risks

Careful observations over a range of lifestyle factors indicate that positive changes can bring about a corresponding change in health status. This has led governmental health departments and other non-governmental agencies dealing with health to publish recommendations which they believe will help to lower overall and particular health risks such as cancer and heart disease.

The Europe Against Cancer organisation make ten such recommendations.

First of all they say 'Certain Cancers may be Avoided' if:

A person does not smoke; that smokers should stop as quickly as possible, and not smoke in the presence of others. That alcohol intake of beers, wines or spirits, should be more moderate (if used at all). Individuals would avoid excessive exposure to the sun, and protect themselves where this is unavoidable. Workers follow health and safety instructions at work, concerning production, handling or use of any substance which may cause cancer. Fresh fruits and vegetables and cereals with a high fibre content are eaten frequently. People avoid becoming overweight and also by limiting their intake of fatty foods. People noticing lumps, changes in 'moles' and pigmentation, or abnormal bleeding would report these to their doctor or medical centre. (Many cancers can be cured if detected early.) Persistent problems such as coughs, hoarseness, or changes in bladder or bowel habits, or unexplained weight loss occurs. Women have regular cervical smears. Breasts are checked regularly and, where possible, mammography (a special X-ray test) is undergone at regular intervals particularly above the age of fifty. Men are advised to check for testicular lumps regularly.

Specific dietary advice from various agencies showing that eating:

Fruits and vegetables containing vitamin A tend to protect against epithelial (skin) tissue cancers. Fruits containing vitamin C inhibit nitrosamine (a carcinogen or cancer causing agent) formation thus helping to reduce abdominal (stomach or colon) cancers. Green-leafed vegetables of the cruciferous (cabbage) family help to increase colon enzymes which deactivate carcinogens again helping to reduce colon cancers. Fats above twenty-four percent of total calorie intake increase a variety of cancer risks particularly that of breast cancer. Animal fats should be kept to a minimum in favour of vegetable fats/oils of which the mono- and polyunsaturated fats are beneficial. The polyunsaturated fatty acids should equal one third of a person's total fat intake. Less salt-cured, salt-pickled, and smoked foods help lower overall cancer risk.

All these dietary recommendations may be summarised in an easily remembered sentence: Eat at proper times a variety of natural foods in optimum quantities to maintain ideal weight.

Not only is this advice for would-be cancer risk reducers, it makes sound advice for people wishing to reduce the risk of heart disease. In fact heart risk reduction agencies worldwide say that we would all benefit if we

lowered our total fat intake, and reduced our intake of saturated fats (usually found in meat).

lowered our calorie intake to match our ideal weight, and avoided the use of refined sugars.

lowered our alcohol intake (where this is part of a lifestyle), and reduced our salt intake.

increased our vegetarian food intake, and in particular if we ate more complex carbohydrates (bread, pasta, legumes, cereals, and unpolished rice), and foods high in fibre such as fruits and vegetables.

Adopting these measures would help to reduce the diseases of affluence and strengthen our immune system. This would further help to protect against common seasonal infections, and the debilitating effects of newly recognised conditions such as AIDS. So instead of being susceptible people we could exercise our potential and become resistant people with a lower incidence of a wide range of disease.

 

The Food We Eat

We take great pleasure in selecting and preparing food items and are attracted by food taste, texture, smell and colour. That is as it should be. We should also be choosing foods which help us to enjoy good health, and may not realise just how food can affect our health and behaviour.

Recently, there has been a new focus on that relationship. A South Bank University (London) professor of nutrition, Dr J W T Dickerson, writes: 'It is now generally accepted that foods, or specific constituents of them, can make people ill.' He goes on to describe some of the clinical conditions associated with food-related illness.

Conversely, it is also fairly widely recognised that vitamins and minerals given to individuals who have a deficiency of such items can also remedy many of the physical, emotional and mental difficulties experienced. Unfortunately, many people do not have access either to good and varied food supplies, or to vitamins and minerals to help redress the problems associated with their lack. Where possible the best ingredients should be selected and, in any case, used to the best advantage.

Our eating habits are more important than we might think as food also plays a role in causing or relieving conditions have social implications. Dr Dickerson highlights, for example, attention deficiency, hyperactivity, disruptive behaviour, and violent and criminal behaviour. We might be surprised by this connection. In many instances these traits were significantly reversed when, 'The changes to the diets made in these trials resulted in an increase in nutrient density [more good food!] and were accomplished by replacing high fat and sugary foods, with fruits and vegetables and with whole grains …'

Fortunately, these food items form the basis of many staple diets and are enjoyed wherever they are eaten. They are the same items recommended by nutritionists promoting reduction of cancer and heart disease risk. The idea of food affecting behaviour is not new and is referred to in the writings of the Greek classics through to more recently written books such as Diet, Crime and Delinquency written by criminologist Alexander Schauss in 1981. In his book he quotes a pertinent statement by a famous physician from the Middle Ages, Moses Maimonides, who wrote, 'No illness which can be treated by diet should be treated by any other means.' We are just beginning to wake up to the implications of his statement.

Professor Dickerson comments on the food/crime connection citing a number of studies. He concludes, 'There now seems to be sufficient evidence to justify serious attention being given to a relationship between food, nutrition and truancy, explosion from school and anti-social or violent behaviour which may result in criminality.'

These statements coming alike from ancient philosophers, criminologists, and food scientists challenge us to look carefully at the food we eat and understand our choices so that our deepest needs may be met, and so that we can stay healthy in every respect.