Tips on how to change your diet to improve your health

A new book examines what to eat to cut the chances of suffering illnesses linked to western diets

A new book examines what to eat to cut the chances of suffering illnesses linked to western diets

A century ago, the vast majority of deaths were caused by infectious diseases. In the developed world that is no longer the case, thanks to antibiotics, sanitation and clean water. Unfortunately, the main causes of death now are lifestyle related, due especially to the western diet.

Cardiovascular disease is the number one killer in the US and Britain. As recently as the 1940s, however, doctors could not find a single case of heart disease in Uganda, which at the time was a relatively undeveloped country. The probable reason?

A diet with far more fibre, fresh fruit and vegetables than we in the west eat.

I have been reading a fascinating new book with the morbid title of How Not to Die by Michael Greger, a doctor in Washington who seems to devote every waking moment to reading thousands of research studies on diet and nutrition.

The book is a distillation of his work for, a website on which Dr Greger passes on diet research. For those who roll their eyes when the media trumpet the latest health news, this is the website to turn to.

The book looks at the 15 main causes of death — heart, lung and brain disease, digestive cancer, infections, diabetes, high blood pressure, liver disease, blood cancer, kidney disease, breast cancer, suicidal depression, prostate cancer, Parkinson’s disease and being killed by medical treatment — and examines how they relate to what we eat and drink. The second half of the book is devoted to how diet can help prevent some of these issues.

Dr Greger advocates a diet that includes a lot of unprocessed fruits and vegetables as the answer to many of humankind’s ills but he says the book is not just for vegetarians. “The book is for anyone wanting to eat healthier,” he tells me. “I didn’t know any of this stuff before I saw the research.”

For example, many people eat cruciferous vegetables — broccoli, cabbage and Brussels sprouts — for their cancer-preventing properties; did you know, though, that both frozen and cooked broccoli cannot make sulforaphane, a key anti-cancer agent? If you add a little mustard powder to these vegetables after cooking, it restores the enzyme myrosinase, which is needed to make sulforaphane.

Similarly, if you eat oatmeal porridge, adding a pinch of cloves increases the antioxidant benefits and, even better, a small amount of Indian gooseberries, sold as a powder called amla, can reduce blood sugar and bad cholesterol.

Unlike many so-called experts on the internet, Dr Greger is not a fan of supplements, preferring whole foods to pill popping.

In one interesting note, he relates how many older people, especially women after the menopause, have been told to take calcium supplements for their bones. Recent research cited by Dr Greger has shown that supplements can cause a spike in blood calcium, which raises the risk of stroke and heart attacks.

This book brims with valuable insights. Dr Greger tends to rely on the gold standard of medical research — randomised controlled trials — rather than the latest fads. Vegetarian or not, this book is a great way to improve your diet.

Sense of meaning and purpose in life linked to longer lifespan

Sense of meaning and purpose in life linked to longer lifespan

Sense of meaning and purpose in life linked to longer lifespan

A UCL-led study of 9,050 English people with an average age of 65 found that the people with the greatest wellbeing were 30% less likely to die during the average eight and a half year follow-up period than those with the least wellbeing.
Older person

The study, published in The Lancet as part of a special series on ageing, was conducted by researchers from UCL, Princeton University and Stony Brook University. It used questionnaire answers to measure a type of wellbeing called ëeudemonic wellbeingí, which relates to your sense of control, feeling that what you do is worthwhile, and your sense of purpose in life. People were divided into four categories based on their answers, ranked from highest wellbeing to lowest wellbeing.

The results were adjusted for age, sex, socio-economic status, physical health, depression, smoking, physical activity and alcohol intake, to rule out as many factors as possible that could influence both health and wellbeing. For example, terminal illnesses could reduce both wellbeing and life expectancy.

Over the next eight and a half years, 9% of people in the highest wellbeing category had died, compared with 29% in the lowest category. Once all the other factors had been taken into account, people with the highest wellbeing were 30% less likely to die over the study period, living on average two years longer than those in the lowest wellbeing group.

It has previously been found that happiness is associated with a lower risk of death. These analyses show that the meaningfulness and sense of purpose that older people have in their lives are also related to survival. We cannot be sure that higher wellbeing necessarily causes lower risk of death, since the relationship may not be causal. But the findings raise the intriguing possibility that increasing wellbeing could help to improve physical health. There are several biological mechanisms that may link wellbeing to improved health, for example through hormonal changes or reduced blood pressure. Further research is now needed to see if such changes might contribute to the links between wellbeing and life expectancy in older people.

The findings raise the intriguing possibility that increasing wellbeing could help to improve physical health.

Professor Andrew Steptoe

Sense of meaning and purpose in life linked to longer lifespan

As part of the Lancet paper, the researchers also examined data on ‘evaluative wellbeing’, a measure of life satisfaction, and ‘hedonic wellbeing’, related to feelings of happiness, sadness, anger, stress and pain. International data from the Gallup World Poll confirmed that in high-income English speaking countries, life satisfaction dips around middle age and rises in older age, but the pattern varied across the world.

In the former Soviet Union and Eastern European countries, older residents reported very low rankings of life satisfaction compared with younger residents in those regions. This same pattern is seen in Latin America and Caribbean countries, though life satisfaction does not decrease as sharply as in the Eastern European countries. And in sub-Saharan Africa, life satisfaction is very low at all ages.

Economic theory can predict a dip in wellbeing among the middle age in high-income, English-speaking countries. This is the period at which wage rates typically peak and is the best time to work and earn the most, even at the expense of present well-being, so as to have increased wealth and well-being later in life. What is interesting is that this pattern is not universal. Other regions, like the former Soviet Union, have been affected by the collapse of communism and other systems. Such events have affected the elderly who have lost a system that, however imperfect, gave meaning to their lives, and, in some cases, their pensions and health care.”
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Can you die from a broken heart?

Can you die from a broken heart?

Can you die from a broken heart?

The poignancy is enough to make anyone weep. Just a day after a beloved daughter dies, the mother passes away. It is a tragedy with a hint of sweetness – the two who lived each other’s lives, end those lives together.

And it is not uncommon. We do not know the cause of Debbie Reynolds’ death but there are more instances of two people who love each other dying in short proximity than you might think. There are medical reasons why it is possible to die of a broken heart.

There was once a joint funeral in Wales of a couple who died within a week of each other. Then a man in California who died hours after his wife. It makes people wonder how often this happens – and what could be the reason.

In the first case, the widower selected a poem to be read at his wife’s funeral – it talked of “two lovers entwined” and a journey “to the end of time’s end”. But before that funeral took place, the husband, Edmund Williams, also died. He and his wife, Margaret, had been married for 60 years and their love had endured. In their late 80s, they would still go into their garden holding hands. Parting broke his heart.


 Can you die from a broken heart?

Image caption Edmund and Margaret Williams died a week apart, after 60 years of marriage

And about the same time Don and Maxine Simpson died in Bakersfield in California. He was 90 and she was 87, and they were as inseparable as they had always been after meeting at a bowling alley in 1952 and marrying that same year. Maxine died first and four hours later, by her side, Don followed.

It looks like a pattern, and perhaps it is.

Research published two years ago in the journal JAMA Internal Medicine found that, while it happened rarely, the number of people who had a heart attack or a stroke in the month after a loved-one died was double that of a matched control group who were not grieving (50 out of 30,447 in the bereaved group, or 0.16%, compared with 67 out of 83,588 in the non-bereaved group, or 0.08%).

Drs often use the term a ‘broken heart’ to signify the pain of losing a loved-one and our study shows that bereavement can have a direct effect on the health of the heart.

 Can you die from a broken heart?

Image caption Coloured chest x-ray of patient suffering from cardiomyopathy

Some people talk about “broken heart syndrome”, known more formally as stress cardiomyopathy or takotsubo cardiomyopathy. According to the British Heart Foundation, it is a “temporary condition where your heart muscle becomes suddenly weakened or stunned. The left ventricle, one of the heart’s chambers, changes shape.”

It can be brought on by a shock. About three quarters of people diagnosed with takotsubo cardiomyopathy have experienced significant emotional or physical stress prior to becoming unwell. This stress might be bereavement but it could be a shock of another kind.

There are documented cases of people suffering the condition after being frightened by colleagues pulling a prank, or suffering the stress of speaking to a large group of people. It’s speculated that the sudden release of hormones – in particular, adrenaline – causes the stunning of the heart muscle.

This is different from a heart attack, which is a stopping of the heart because the blood supply is constricted, perhaps by clogged arteries.

Most heart attacks occur due to blockages and blood clots forming in the coronary arteries, the arteries that supply the heart with blood.

What becomes of the broken-hearted

“Broken heart” is referred to in the 1611 King James Version of the Bible: “The Lord is nigh unto them that are of a broken heart; and saveth such as be of a contrite spirit.” (Psalms 34:18)
Shakespeare features several characters who expire for love – King Lear perishes shortly after discovering the murder of his daughter Cordelia, and in Romeo and Juliet, Lady Montague is reported by her husband to have died of a broken heart: “Grief of my son’s exile hath stopp’d her breath”
Alfred Lord Tennyson’s 1842 poem, The Lady of Shalott, relates how the tragic damsel of Arthurian legend lay down in a boat to die and be discovered by Lancelot, the knight she loved: “For ere she reach’d upon the tide/ The first house by the water-side,/ Singing in her song she died,/ The Lady of Shalott.”

By contrast, most patients who suffer from cardiomyopathy have fairly normal coronary arteries and do not have severe blockages or clots.

Many people simply recover – the stress goes away and the heart returns to its normal shape. But in some, like the old or those with a heart condition, the change in the shape of the heart can prompt a fatal heart attack.

The scientific name, takotsubo cardiomyopathy comes from the Japanese word for a type of round-bottomed, narrow-necked vessel used for catching octopuses. The sudden stress causes the left ventricle of the heart – the one that does the pumping – to balloon out into the shape of the pot.

 Can you die from a broken heart?

“What will survive of us is love,” wrote Philip Larkin, referring to the Arundel tomb in Chichester Cathedral

There is also evidence of an increased risk of death after the hospitalisation of a partner, according to a study published in 2006 in the New England Journal of Medicine. Other research published in 2011, meanwhile, suggests that the odds of the surviving partner dying are increased for six months after their partner’s death.

The researchers pointed out that a mutually supportive marriage acts as a buffer against stress. Partners also monitor each other and encourage healthy behaviour – reminding each other to take their daily tablets, for example, and checking they don’t drink too much.

Whatever the science behind “broken heart syndrome”, the results are bitter-sweet. There is, of course, the grief of a bereaved family who have lost two people they love. But there is also often a relief that a couple deeply in love should have exited life together.

Edmund Williams’ poem for his wife Margaret talked about “two lovers entwined” and a journey “to the end of time’s end”.

If there is a benevolent heart condition, surely takotsubo cardiomyopathy is the one – but “dying of a broken heart” puts it better.