Eating habits

There really is no secret to healthy eating – eat a balanced diet. Try not to eat any type of food too frequently, and eat a bit of everything. Research indicates the following list of do’s and don’ts.

• Do eat wholegrain in preference to white bread.
• Do include fish, especially oily fish, regularly within your diet.
• Do eat freshly prepared food frequently, and don’t eat too many ready meals and take-aways – not to mention that freshly prepared food is likely to be tastier and cheaper (retired people have more time to cook than the worker bees).
• Do eat at least five portions of fresh fruit or vegetables a day – if you have a garden you could even try growing them yourself.
• Don’t drink too much alcohol (less than 3 to 4 units of alcohol a day for men, and 2 to 3 units for women, where a unit is about half a pint of 4% ABV beer). And no, you cannot save them up for a binge!
• Don’t eat large amounts of red meat.
• Don’t eat too much processed food.
• Don’t eat excessive amounts of sugar. So you need to be sensible about the amount of confectionery you eat (yes, that does include chocolate!).
• Don’t overdo the amount of salt you eat.
• Don’t eat excessive amounts of saturated fat (sorry, that does include cheese).

If you have food intolerances or are a vegetarian then you should ask your doctor for advice on how best to maintain a balanced diet.

There is very little advice that applies specifically to older people. You should avoid fizzy drinks to lessen the risk of osteoporosis, which affects men as well as women. You should also be careful to avoid being overweight or eating too much refined sugar, to reduce the chances of developing late-onset diabetes. Other than that you should just stick to a balanced diet.

One of the advantages of eating a balanced diet is that you will be able to safely ignore most food-scare stories in the press.

Most of us at some point will wish we could lose a few pounds in weight, and some of us may even feel we need to lose a lot of weight. The medical benefits of keeping your weight under control are well proven. The most common measure used to determine if you are over- or underweight is the body mass index (BMI). You can calculate your BMI by measuring your weight in kilograms and dividing it by the square of your height in metres. Typically, if your BMI is in the range of 18.5 to 25 then you would not be considered as overweight or underweight. So, if you are overweight, you need to go on a diet – wrong – in my view this is not the best way to approach losing weight.

What you eat regularly has a certain number of calories, with a particular mix of protein, fat and carbohydrates and, together with the amount of exercise you take, has led to you stabilising at your current weight. If you change your eating and exercise habits permanently then you will stabilise at a different weight. The word dieting suggests a phase when you lose weight, but losing weight is easy, it is keeping it off that is hard.

The best thing to do is to focus on what your long-term eating habits are going to be. Indeed, there is evidence that extreme diets, either with very few calories or those that unbalance a diet (e.g. low carbohydrate), will lead to a situation where your steady-state weight for a particular long-term diet actually will increase. I recommend strongly that you avoid all extreme diets.

The good news is that short periods where you eat more, such as holidays and Christmas, will have only a temporary effect and, when you return to your normal eating habits, then your weight will return to the normal level.

Unsurprisingly, the key to your new eating habits, leading to a new, thinner body, is to reduce your calorie intake – permanently. By eating many different foodstuffs in moderation, you will not go far wrong.

There is a very substantial industry that has grown up around dieting. There are well-regarded clubs that recommend eating a balanced diet, which can provide valuable moral support. There are also some diet plans such as the fashionable GI diet that promote healthy eating habits.

You do not have to make a single large jump to your new eating regime. In fact there is a lot to be said for doing it in a few steps. Try not to be in a hurry.

Although there are some parts of the slimming industry that are best avoided, the industry has also produced lots of common-sense advice and good products to help you reduce calories and maintain a balanced diet, with the minimum impact on your lifestyle.

Take-aways should be treats not a regular part of your diet

Most take-aways are very fattening, as well as often being full of salt.

Do not cut naughty things out of your diet totally, just reduce them so that they become treats.

Alcohol

Once you no longer have the stresses of work it is much easier to reduce your alcohol consumption. Following the government’s advice on the maximum number of alcohol units that should be consumed a week obviously is best. Statistically there is a one in three chance that you the reader regularly drink more than the advised limits. From my own experience I found that reducing my consumption (by about a third) helped me lose weight, sleep better, have fewer headaches and, given that I really like the feeling of mild intoxication, I found that within a month I was getting the same buzz from the reduced consumption. It also helps the finances!

As you can see, nothing about improving your eating habits is rocket science. The potential benefits from an increased, good- quality lifespan, and a better self-image are very significant indeed.

Exercise

The benefits of regular exercise are well proven in terms of reduced mortality and morbidity. I probably do not have to convince you that you will look better, feel better and be able to do more without getting tired. In addition you may well find that you sleep better.

The key to a successful exercise regime is to build it in as a natural and regular part of your routine. Without the demands of work, retired people tend to find it much easier to take regular exercise than the worker bees. There is no best form of exercise, but here are three ideas for starters:

• Walking

  – It is very easy to build walking into your daily life.

  – There are no special skills or equipment required.

  – It is very cheap.

  – It can be pursued as a solitary or a social activity.

  – Aerobic exercise (where your heart rate speeds up) can be achieved easily by not taking lifts and escalators.

  – It is very safe.

  – It does not develop the muscles in the upper body.

  – It is excellent for building stamina.

  – It can help prevent problems such as osteoporosis.

• Swimming

  – Probably the safest form of exercise that develops muscles in the whole body, because the water takes the strain off your skeleton.

  – It is very good for people with bad backs.

  – Ear infections can be a problem.

  – A nearby pool may not be available.

  – In the UK it is now free for the over sixties.

  – Also it can be either a social or a solitary activity.

• Join a gym

  – Working out can develop the whole body, and can achieve the most marked improvement in your physical appearance.

  – Some people find it boring, although group activities such as aerobics can be more stimulating.

  – Minor injuries are quite common.

  – Membership varies from moderate to very expensive.

  – They tend to be available widely in towns.

  – It can be a social or a solitary activity.

In addition, hobbies such as gardening, dancing and golf can provide plenty of exercise, although gardening tends to be a seasonal activity.

If you start to take more exercise then build up your exercise routine gradually. Many health professionals give the sound advice that you should ‘listen to your body’. When exercising this is a very sensible approach.

Exercise can be a useful way of making friends. In addition, if exercise becomes a social activity you are much more likely to keep doing it regularly. Going to a gym or swimming pool at the same time each day makes it much likelier you will get to know other people.

Give up smoking

When writing this book in general, and this chapter in particular, I did not want to preach at you, but I am about to do exactly that. If you are a smoker then my medical adviser, Dr Margaret Grant, says I should tell you in the strongest possible terms to stop. Statistics about the dangers of smoking are simply dreadful. I used to smoke, and I adored smoking, but in the end I just could not ignore the terrible dangers involved. Not only is smoking quite likely to kill or damage you, the ways it does so are not nice at all. For example, smoking is implicated strongly in cancers of the lung, oesophagus, tongue, throat and tonsils.

A non-smoker who retires at 50 is twice as likely to see their 60th birthday than someone who smokes 20 a day. If the thought of a premature, unpleasant death does not worry you, how about going blind? The most common cause of blindness in the over sixties is age-related macular degeneration (AMD). A smoker is three times as likely to develop AMD as a non-smoker.

If you give up smoking, some residual risk from past smoking remains, but your life expectancy and chance of encountering other smoking-related health problems declines very quickly. After you have retired is an excellent time to quit. You no longer need the nicotine to help cope with the pressures of work, and withdrawal symptoms will not affect your performance at work. In addition your income probably has just gone down so the money saved is likely to be very welcome.

Apart from saving money there are numerous other benefits in giving up. Your sense of taste will get much better. You will no longer be setting a bad example to grandchildren and/or nieces and nephews. You will not subject others to the not inconsiderable dangers of passive smoking. Some benefits, such as increased fertility, probably do not interest you personally but, by helping set a good example to the younger generations, you may have a better chance of having a lot more youngsters to spoil.

Apart from withdrawal symptoms, the main downside to giving up smoking is that you probably will put on weight. For this reason it can be a good idea to combine quitting smoking with the move to a healthier, lower calorie diet.

In those countries where smoking is banned in restaurants, pubs and bars it is certainly easier to quit smoking than it used to be. The urge to light up after a meal or with a drink used to cause many a lapse, and those situations are now much less common. Indeed the whole social aspect of smoking has virtually disappeared in many countries.

There is clear evidence that seeking help from your doctor greatly increases the chances of quitting successfully. The use of nicotine patches or gum can be very effective indeed.

Why not put the book down and make an appointment to see your doctor now – and if you do, I may have just saved you from a long and lingering death (how many authors can say that!).

Giving up smoking is the most obvious positive action you can take to live longer. Diet and exercise have already been mentioned, but what other things should you do to promote a long and happy life?

A study in 2009, led by the Centers for Disease Control and Prevention in Atlanta, USA, measured the benefit of combining weight control, not smoking, eating a healthy diet and taking regular exercise. Their figures show a 93 per cent reduction in diabetes, 81 per cent reduction in heart attacks, 50 per cent reduction in strokes and a reduction in cancer of 36 per cent.

Proactive health management

Before discussing what to do it is worth saying what you should not do – do not become obsessed with your health. Your purpose in living longer should be to have more enjoyment, fulfilment, friendship and love. People who are obsessed with their health usually do not have much fun and are not much fun to be around. However, there is quite a lot you can do apart from eating healthily, controlling your weight, exercising and not smoking.

Most doctors’ surgeries in most countries will run ‘well person’ clinics, which will give you regular blood tests, blood pressure checks and general lifestyle advice. It is a very good idea to attend such clinics, particularly because they will ensure you get regular cholesterol and blood pressure checks. This is important because high cholesterol and high blood pressure increase the risk of heart disease and strokes significantly, and given that there are now effective drug treatments that can easily solve these problems it is well worth the effort.

You should attend all regular screenings – for example, women should attend their regular mammogram and cervical smear appointments. Some tests are not yet part of screening programmes but you can ask for them. For example, there is now an excellent screening test for bowel cancer, and catching it early dramatically improves survival rates. My medical adviser says she thinks men should ask for a prostate-specific antigen test (PSA test) to screen for possible prostate cancer. The PSA test produces a numeric result, which you will need to discuss with your doctor to determine what, if any, further tests are necessary. You should also do self-screening: women should check their breasts regularly and men should check their testes.

Many conditions, such as diabetes, high cholesterol, high blood pressure and glaucoma, can be inherited from your parents and grandparents. If you know you are susceptible to any inherited conditions obviously it makes sense to act appropriately to minimise the risk to yourself.

Do not worry about having to take drugs to control cholesterol, blood pressure (or other dangerous conditions) for the rest of your life. They are a major factor in increased longevity.

On the other hand do be careful not to become dependent on over-the-counter medication, such as painkillers. Taken too regularly such medication can have unpleasant or dangerous side effects.

When receiving medical treatment or drugs – do as you are instructed. Many people do themselves harm by not following directions.

See your dentist and your optician regularly. A good optician can detect:

• the early onset of glaucoma (high pressure in the eye, which is highly treatable but will blind you if left untreated)
• age-related macular degeneration (which is not yet curable, but can be managed partially if detected early)
• diabetes (which if not treated can blind you)
• high blood pressure.

A good dentist not only looks after your teeth and gums, but will also look for other abnormalities, such as cancer of the tongue.

You need to be aware of your body and see your doctor if you think you may need tests or treatment. Some of the symptoms that should not be ignored include:

• chest pains
• shortness of breath
• persistent cough
• unexplained weight loss
• dizziness
• changes in your bowel habits
• unexplained feelings of extreme tiredness
• new skin lesions that do not heal
• impotence
• blood in your excretions.

Try not to be obsessed about cancer. Most symptoms will not turn out to be cancer, so do not put off going to the doctor. Even if it is cancer, the survival rates for many cancers are now excellent, especially if detected early. Treatments for cancer are improving all the time.

It is worth saying when you should not visit your doctor. If you have the flu or one of the bugs that is doing the rounds (such as diarrhoea and vomiting) just self medicate, take painkillers and lots of fluids. Your pharmacist can be very helpful in managing the symptoms of common bugs. Only if symptoms persist because you have, say, developed a chest infection, should you visit your doctor.

NHS versus private health care

Many countries have a state-funded health care system (which I will refer to by the UK name of the National Health Service, or NHS for short), as well as a range of private health care providers. But when is it worth using a private health care provider?

Dr Grant believes that if you have an acute or life-threatening problem you are best to stick with the NHS. However, all national health systems have to ration care (usually through waiting lists) and, although treatment for acute and life-threatening conditions is usually excellent, you cannot be confident that the NHS is going to provide convenient and timely care for conditions that are not urgent or life threatening. As an example, if you have back, neck, leg, shoulder or foot pain, then the supply of physiotherapists, osteopaths, chiropractors and chiropodists available through the NHS is so limited you may do best to pay if you can afford it.

For other problems such as cataracts and joint replacements, you may want to be able to specify when you are treated, or want the confidence that you know precisely who will be operating on you. Some people may want to avoid the lack of privacy and perceptions about the prevalence of superbug infections in NHS hospitals. If you can afford it, you may want to either have medical insurance, or pay as you go, for such treatments. Apart from the cost, the main downsides of private medical care are that many private hospitals do not have facilities for critical care nursing and resident medical cover – which means that if something goes seriously wrong you may need to be taken by ambulance to an NHS hospital.

What about alternative therapies, such as aromatherapy, reflexology, herbalists, acupuncture, hypnotherapy and homeopathy? While these can work as a complement to your doctor’s care, I would warn against using such therapies in place of conventional medical treatments. Therapies such as aromatherapy, reflexology, acupuncture and homeopathy are unlikely to have dangerous side effects and, if you can afford them and they help you, why not use them? But be careful of those therapies that have a powerful effect, but are not scientifically understood, such as herbal preparations.

In a similar vein, should you take diet supplements? Dr Grant says that if you eat a balanced diet you do not need supplements. She also warns strongly against taking large doses of any supplements. However, moderate doses will harm only your wallet and if you find them helpful there is no reason to avoid them.

Scientific facts and falsehoods

I have already alerted the reader to beware of the latest food scares, which are often based on very dubious statistics. There are, however, some statistics that are definitely worth reporting.

There is a very close correlation between the number of people you are close to and your health. The larger your social network, the healthier you are likely to be and the longer you will live. I think that this may be linked to another finding: people who say they are ‘satisfied’ and ‘active’ are likely to be healthier and live longer.

There is a well-publicised untruth, which is that the average person loses 10,000 brain neurons a day. In tests on rats it has been shown that if elderly rats are kept in the company of other rats, in surroundings with toys that give them lots of stimulation, their brains enlarge. On the other hand, the brains of elderly rats kept in isolation deteriorate. Obviously these tests cannot prove that the same thing happens in humans, but there were ethical difficulties in persuading the authorities to allow the scientists to cut live people’s heads open!

My interpretation of these results suggests that happy, active people, with lots of friends and relatives, will make considerable use of their mental and physical faculties, which will have a significant benefit on their health. Or, to repeat the old adage, ‘use it, or lose it’. You also seem to have the circular effect, that being healthy makes you happy and being happy makes you healthy.

Researchers into aging frequently make the point that people are not just blessed or cursed by their genes. Certainly, some people are naturally more active, less anxious and have a more positive attitude than other people with less sunny dispositions. Research does seem to show that people can use their free will to become more active, less anxious and more outgoing.

Starting retirement can be a major shock to your system. It is likely that you will be adjusting to lower levels of adrenaline as the stress of work ceases. Do not be alarmed by the fact that temporarily you may suffer mood swings, depression, sleep problems, etc. My advice is not to be in a great hurry to make significant changes to your life immediately after you retire – wait until you feel you have established a new, stable routine in your life.

Handling common ailments

It is not possible to fully disentangle all the challenges that retired people face from the problems that you will have to manage as you get older. However, let’s take a look at the most common health issues highlighted in my research.

Sleep problems

If you put the two words sleep and problems into a search engine such as Google you will get a wealth of well-researched advice from organisations such as the Royal College of Psychiatrists. All the reputable sites give very similar advice.

The internet can be a source of excellent medical information and advice. However, be careful to check whether the source of the advice is trustworthy. Check numerous reputable sites to ensure that facts or advice are repeated by more than one reliable source. Beware of taking advice from newsgroups, chat rooms and the like.

The medical profession don’t always give you accurate or full information. The internet is one of the best ways of checking whether you need to ask for a second opinion.

Common advice to manage sleep problems includes:

• Beware taking prescribed sleeping pills for anything other than a short period. Even the latest sleeping pills are addictive, lose their effectiveness over time and can leave you feeling dopey during the day. Many over the counter preparations suffer similar, but less severe, problems. If homeopathic remedies work for you then these are ideal because they seem to have no unpleasant side effects. If you are taking prescription sleeping pills regularly, the advice of experts is to discuss with your doctor how you can safely wean yourself off them.
• Create a good sleeping environment.
• Avoid taking naps during the day.
• Take plenty of exercise.
• Do not use alcohol to get to sleep; you will probably wake up in the night and find it harder to get back to sleep.
• Do not get obsessed about not sleeping; you are retired so do not have to go to work in the morning.

The last point can be so significant that if you are getting very uptight about sleep problems then it may be worth seeking the services of a trained counsellor/therapist.

Bones and joint problems

If you are unlucky enough to suffer from fractures or joints wearing out, then you will benefit from the fact that orthopaedic surgery is now very well advanced. You should consult your ‘well person’ clinic about the best preventative measures, such as weight loss, diet and regular exercise. You can also take care when walking down stairs or in slippery conditions – but unfortunately this is one of the risks of getting old.

Likewise there are a number of nasty forms of rheumatism and arthritis that can, at best, be managed. However, at the time of writing, progress on treating such problems offers hope for the future.

The best way to cope well with such problems is to have a positive attitude of mind. They can ruin your life – if you let them.

If you have a chronic health problem then you should rule it – do not let it rule you!

Beware the potentially fatal vicious circle where you take life too easy, so you eat less or put on weight, become unfit, and feel permanently tired and hence feel even less like doing anything.

Some final advice

Do not wrap yourself in cotton wool. Although I have no research to back it up, I suspect members of extreme sports clubs have a longer than average life expectancy – and if they do not, they will have packed more experiences into their shorter lives. I was there when a member of the UK’s special forces was asked what the death rate was in the SAS. He replied, ‘Exactly the same as the rest of the population: one person, one death.’ There is only one end to retirement, which is death, so you should concentrate on maximising the amount of quality life you have before then.