The body is 70% water by composition. Much like a river, to sustain healthy life the water needs to be flowing. For us this means drinking enough water each day to keep our body hydrated and stop our cells from drying out.

Some of the roles of water and hydration in the body are, transportation of nutrients, elimination of wastes, lubricating the joints and tissues, facilitating digestion, aiding concentration, keeping the skin looking younger and more vitality.

When we get low on water we can get headaches, dizzy, tired and even our thinking can go fuzzy. We are just not quite right!

We all know this but that does not mean we all drink as much water as our body needs. We get busy, we forget, we may not even be sure how much water we need.

There are different recommendations as to how much water we need each day. The most useful guide is 30ml/kilogram body weight per day.

If you are doing any physical activity or it is hot, then you need more water.   People who work outdoors on hot days may require four, five or six litres of water per day.

One way of gauging our hydration status is the color of our urine. The darker the color the more concentrated it is. This means the body is hanging on to water to preserve what it has. Urine should be clear or pale straw yellow and is so when we have enough water on board.

The upgraded i health coach app lets you assess your hydration status with the urine color chart and lets you know how much water you need. Plus you can set the app to remind you when it is next time to drink some water.

Some say they do not like the taste of water of are just not used to drinking it. Here are some tips to overcome this.

1)   Squeeze lemon or orange juice into the water.

2)   To start more gradually, have an extra half glass when you have one full glass of water and build it up from there.The aim is to get this to a stage where you actually miss your water if you don’t have it.

3)   Add a water filter to your kitchen tap, it does make water taste better and you will be more likely to drink it.

4)  When you feel hungry between meals, first have a glass of water.

It is much better for all the cells in your body  for you to be one step ahead with your water intake rather than playing catch up. You may even be surprised how much better you feel when you are adequately hydrated. Some people are in a constant state of slight dehydration without even realizing it.

Stay healthy and hydrated with the I health coach app.

Just in time for Easter comes new research, which show, wait for it, that people who regularly eat some chocolate have a lower BMI than those who do not.  Whilst the reason was not determined, the link withstood allowance for a host of other variables.

This has got to be good news for lovers of chocolate – which is most of us.

Easter Sunday is the day when everyone can indulge his or her love of chocolate without feeling guilty – and rightly so.  Chocolate is universal.  It is said that nine out of ten people say they like chocolate and the tenth is lying.

So why is there guilt about chocolate, and do we need to feel guilty?  The simple answer is NO. Chocolate is not intrinsically bad for us.  At levels of cocoa of 70% it is actually good for us.  What applies to you will depend on how much you eat and the quality of the chocolate

So lets look at some other “health benefits” of chocolate. The good feeling you get is not imagined.  Chocolate contains a phyto-nutrient, which is an endorphin.  The “high” from eating chocolate can be similar to the high runners get.  It comes from the endorphins (the bodies natural happy hormone).  Chocolate is virtually an antidepressant.  Is it any wonder people turn to chocolate when they feel down? A Swiss study showed that eating 40g a day of dark chocolate lowered stress hormones in the bloodstream making people more resilient to stress.

A Swedish study showed that after a heart attack, those who ate chocolate at least twice a week had a three fold increase in survival over an eight-year period. Meanwhile a Canadian study showed a decreased risk of stroke in those who ate chocolate once a week compared to those who do not.

The benefits come from the flavinoids in cocoa, which are a potent anti oxidant. These flavinoids have also been shown to protect our genes (DNA) from oxidative damage. This potentially makes chocolate an anti-aging compound.

Chocolate is viewed with suspicion because it tastes so good.  As a “pleasure” it has been seen as sinful.  There are also linkages between chocolate and that other great “sin” of humanity – sex. Hence, the association of guilt.

Dark chocolate has lots of minerals including potassium, zinc, copper, chromium and magnesium.  Many women turn to chocolate if they have pre menstrual symptoms.  This is related to low magnesium.  Again the body knows what it needs.

Cocoa is rich in antioxidants (10g dark chocolate has the same amount as a cup of green tea).  The glycaemic index (GI) of chocolate is 40.  Polyphenols in cocoa can reduce LDL, which is the “ bad cholesterol.  There are also good fats in chocolate.

Now this is all well and good, you may say, but you can get the most of the same minerals and antioxidants from other sources. This is where the extra dimension of chocolate comes in. Fun is one of the pillars of DIY Health. Apart from providing goodness for us, our food needs to give us joy.  Chocolate scores ten out of ten on this one.

So there is no need to feel guilty about eating chocolate on Easter or on any other day.  This does not mean a block a day and yes you can get all the above nutrients from other sources, perhaps without the same amount of enjoyment.  The best is 70% cocoa and organic is great if you can get it.

As part of a balanced DIY health program chocolate hits the spot.

What is the one thing we spend more of our lives doing than any other single thing?  It is something that we do every day and we largely take for granted.

The answer, is of course, sleep.

In the hierarchy of the body’s needs, sleep is number three after air and water. The body can go much longer without food than it can go without sleep.  Whilst it is very rare for people not to eat when they are hungry, it is fairly common for people to not go to bed when they are tired.

Over the course of the twentieth century the average number of hours slept per night fell from over nine to under eight.  One of the main reasons people tend to sleep less is actually because they can.  The advent of electricity has meant that we can stay in well-lit environments 24 hours per day.  Today there is much to keep us entertained after dark whereas, a century ago, there were not too many options after dark other than to go to sleep.

One of the commonest complaints I hear as a doctor, is tiredness and the commonest reason for this, is lack of sleep.  A person, who needs eight hours sleep a night and gets seven, will by the end of one week, be a whole nights sleep in arrears.  This continues to accumulate over time but it won’t be until, perhaps months down the track that symptoms begin.  The body is remarkable at compensating for the less than ideal ways in which we sometimes treat it.

Sleep patterns are also influenced by societal attitudes.  We tend to judge our success by our busyness and number of things we have to do.  With this mindset, sleep is seen as expendable. Sleep time is “cribbed “ from, to do other things, which are seen as more important.

Various studies have shown the importance of sleep.  At UCLA, it was demonstrated that there was an increase in silent inflammation of the body in people who did not get an adequate amount of sleep.  Slow or silent inflammation is a critical component in the development of heart disease, stroke and various autoimmune conditions.  A Japanese study showed lack of sleep as a separate risk factor for heart disease.

People who get adequate sleep tend to eat less junk food and it has also been shown that lack of sleep correlates with higher rates of obesity. On top of this inadequate sleep impacts on our immune system making us more susceptible to viruses.

Our children need sleep too. Teenagers who do not want to get out of bed may not be as lazy as we like to portray them as. It is likely they do need the sleep. Most interestingly was an American study which showed that when a county in Kentucky decided to push back the start of middle and high school by an hour, traffic crash rates for drivers aged 17 to 19 dropped 16.5% and of course, the students reported getting more sleep.

For adults NASA tests have shown that after 20 hours continuously awake, an adult’s reaction time is comparable to a blood alcohol reading of 0.05, which is the cut off for drink driving in most countries.

The case is clear. You would not dream of deliberately not breathing enough air or not drinking if thirsty. Sleep needs to be seen in the same light. Sleep is not something to relegate to the “I will do it after everything else is done pile”. It is a pillar of health and needs to be treated with respect. In simplest terms this means you need to set aside the eight hours that your body needs for sleep – for sleep and not anything else.

An FDA panel has recommended that approval be given to a new weight loss pill. If Qnexa gets final approval it will be the first new “diet” pill approved in over a decade. The move has surprised many as within the last two years three drugs including the one now recommended for approval had been rejected. The original rejection of this drug was due to side effects.

The reversal comes as the panel was apparently impressed by the amount of weight loss, despite its concern about cardiovascular (heart) side effects. Previous diet pills were taken off the market after heart related deaths!

It is estimated that Americans spend $59 billion annually on a range of weight reduction measures from diet books to stomach surgery.

Yet only a very small amount of this is spent on prescription drugs.

There are two main reasons for this. Number one is that they don’t work particularly well and secondly there is a track record of diet tablets being taken off the market due to safety concerns.

All three new drugs had shown some “positive” results over a one-year trial. This is not a long time though and the safety issues with previous weight loss drugs only became apparent after they were used by a much larger number of people.

Given the huge potential profits it is easy to see why the pharmaceutical industry may be keen to get involved (the drugs are owned by biotech firms looking for a pharma partner). This is despite sales of current weight loss pills being small and the safety/liability issues. There is also the FDA concern of them being used “recreationally” by people who are not overweight but say want to drop one clothes size.

Here is something to think about. If it wasn’t a pill, which made you put on weight why do you, need a pill to reverse the process. It is always interesting to hear when people say diets didn’t work. Diets have no moving parts. The only way it can “work” is if the individual sticks to it.

Now herein does lay the issue. Many “diets” are considerably removed from what people normally eat each day. Hence the change is too hard to sustain. Even when people stay the course for long enough to reduce weight, they then revert to their previous eating patterns, and not surprisingly this takes them right back to where they started.

Whilst this should not come as a surprise it usually does.

So is there a solution? Of course there is.  It starts with taking personal responsibility. You must accept that it is your own actions, which have led you to this place, and that it is only your own actions that can take you to a different place.

The solution is to change your eating patterns. It is no use repeating the same thing and expecting a different result. You need to change the way you relate to food. For example, if you comfort eat then recognize this and deal with the underlying issue. If you have a sweet tooth (like I do) accept this and allow yourself some small treats rather than going without for so long that you end up binging.

Keep at the front of your mind this simple concept. The body stores energy it does not use up as fat. The only way to reduce weight is to use up more energy each day then you put in. This gives you two dials to adjust. Use more energy by being active and consume less energy (calories). Do not go hungry. Choose foods, which provide nutrition without excess calories. In simplest terms this will be whole food. Food that until recently, was moving around, or growing somewhere.

Cut down on processed and packaged foods. Drink mainly water. For sustainable change these must become what you do daily not just a “diet” for a few weeks.

It has been done, it can be done and you can do it if you so choose.

It is little wonder that people get confused about health. The messages are often contradictory. Worse than that, the messages may reflect vested interest, which is not declared. Many “news” stories are pushed by those who may have a product to sell or an agenda to push.

So it was that a survey reported that long-term smokers could take up to seven goes before successfully quitting. Around 75% of poll responders reported two unsuccessful attempts to quit. This prompted an expert to opine that nicotine addiction was as powerful as heroin addiction. Strong words and not likely to inspire smokers that they could quit unaided. The thrust of the report was to encourage smokers to seek help in quitting. In particular it referenced pharmaceutical aids, which could help smokers.

A pharmaceutical company commissioned the survey.

However, an earlier report showed that stopping smoking is not actually that difficult and that the vast majority did so without any assistance or stop smoking aid. This was shown in over 500 studies. The authors wondered why those in public health do not promote such information more. They noted that 91% of studies focused on interventions and assistance, yet 70% of quitters did so unaided.

Unless you have been living under a rock for the last 40 years you will know that smoking is not good for your health.

Smoking has been medicalized. It is not an illness and as such does not require “treatment”. Some people may need some support, to quit smoking but smoking aids like patches and tablets have not been shown to make any difference long term.

It is also worth noting that the biggest reductions in cigarette smoking occurred during the 1960s and 70s when there were no “stop smoking aids”.

In my view the problem is that people in public health like to portray the individual as helpless and hence in need of public health people. They have a strong aversion to telling people that the choices they make are their own responsibility. They see it as  “nicer” to blame cigarette manufacturers rather than say the reason some people smoke is a choice they make. It is also then easier to portray smokers as victims of tobacco rather than individuals who have the power to choose.

Seeing yourself as a victim is disempowering. Hence if you are led to believe that you cannot quit by yourself, you are more likely to fail. In the studies on successful quitters many remarked that it was easier than they expected. The main reason they would have thought it hard, is because of messages telling them that.

Also the fact that it may take a few goes to succeed is not a problem. It is said that Thomas Edison had 10,000 failures before inventing the light bulb. There is no issue with not succeeding if you learn the lessons and apply them next time. Eventually you will succeed.

So to those of you who want to stop smoking, the news is actually good. You can do it if you want to, even if it takes a few goes. It will almost certainly be easier than you have been led to believe.

I have previously written about problems with long-term use of medications particularly those used for lifestyle related conditions. It looks like The American Medical Association agrees with me. The Association’s Archives of Internal Medicine Journal has highlighted the often-unpublicized downside of tests and treatments in a recent edition.

In an editorial titled “Less is more: How Less Health Care Can Result In Better Health” the spotlight has been turned on how extra tests and unnecessary treatments not only do not help but can cause significant harm. The fractures and diarrheal illnesses associated with long-term proton pump inhibitors (used for heartburn) were one of the cases highlighted. According to Dr Deborah Grady of the University of California, San Francisco “There just seems to be this assumption that the more health care you get, the better”.

This is an incredibly important issue. The Archives Journal will have a regular “Less is More” feature looking at where treatments have expanded to the point where harm outweighs benefit. Doctors and patients have become conditioned to the notion that if tests are good, more are better and that pills are the answer for just about everything. Yet there is never such a thing as a free lunch. All pills have side effects. These can be justified when the benefits outweigh the risks and when no other treatment is available. When simple changes in lifestyle will have the same effect though they cannot be justified. The issue of cost is a whole other component of this.

Tests are also seen as wonderful because of their capacity to find “unexpected” serious illness such as cancer. Tests are fallible though and many people go through further tests and even surgery because of a finding in a test which may in fact be meaningless but “once found must be acted on”. Mass screenings add to this problem. Issues with PSA testing led the tests inventor to describe PSA testing for cancer as being like flipping a coin. The benefits of mammography screening have also been significantly overstated.

So what drives the test and pop agenda? There are two main drivers. One is litigation and the use of defensive medicine. Ordering unnecessary tests on 1000 people will not get a doctor sued, regardless the cost and inconvenience but the one person where a diagnosis is missed may well sue. The other is commercial and vested interest.

Obviously the pharmaceutical industry has a legitimate interest in selling its products and is clever at marketing. It also drives a lot of research. If a study is done looking for a use for a drug there is a fair chance it will be found. Extending the number of people classified as needing treatment (for example by lowering cholesterol target levels) boosts sales.

Whole industries have sprung up behind screening too. Those involved in the mammography business dismiss any criticism of mammography, usually as an attack on women. Unnecessary surgery on breasts is not seen in the same light.

There is no point saying that there is an across the board clear-cut answer. And herein lies the real issue. One size fits all models do not fit all. Attempts to screen or treat everyone the same has led to this problem. Over emphasis on guidelines and protocols stop doctors (and patients) considering the individual circumstances of each case. Well meaning scare campaigns convert everyday bodily functions into danger signs of cancer leading to a race to exclude what was never there.

The answer then is in fact simple. Focus on being healthy rather than enter the obstacle course of avoiding disease. Have faith in your own body and what it is telling you. It knows more than most tests. Ask your doctor about the downside of tests and side effects of medications. Take the non-pharmaceutical option first.

Do not buy into scare campaigns or disease mongering.

Whilst the search goes on to find new “scientific” ways of living better for longer, there are two very simple things that you can do today to achieve exactly this. And there are two bonuses.

Last year Australian research showed, that there was a direct correlation between time spent being sedentary, and risk of dying. In fact there was a 10% increased risk of death for every hour beyond two per day that you spent continuously sitting down.

Just in case we needed more scientific proof, an American study of 120,000 people over 14 years showed that women who sat for six hours per day had a 37% higher risk of death than those who spent less than three hours a day sitting. For men the difference was 17%.

For those who did no exercise the death risk rates were increased by 94% for women and 48% for men.

Doing even a little exercise helped reduce this risk but prolonged periods of sitting is an issue in itself which is not totally offset by exercise even though exercise makes a big difference as seen above.

Yet the answer here is very simple. Just get up out of your chair on a regular basis and move around. Consider standing at your desk or standing whilst you read the paper. The simple act of standing instead of sitting causes a whole set of stabilizer muscles to be active which does not happen whilst you are sitting.

The simple act of standing instead of sitting for part of the day or at least getting up from your desk to stand, stretch or walk significantly impacts on health.

The other long established way to live longer is to eat less. Caloric restriction, time and again has been shown to correlate with reducing disease of all forms and with longer life in animals and humans. This is not about going hungry. It is as simple as eating (as the Japanese recommend) to 80% and leaving the table feeling that you could eat more.

This is helped by eating slowly, which allows the brain to keep up with the stomach. People who eat slowly are at least 30% less likely to be obese than those who eat quickly and 50% less likely than those who eat quickly till full.

So living longer and being healthier is as simple as eating a bit less and moving a bit more.

Now for the two bonuses. Firstly losing body fat and getting to a good weight helps the immune system so you will get sick less often. The second bonus is that being unhealthy and overweight affects your sex life. French (who else) researchers found that for both men and women who are overweight have less sex and more sexual problems than those of healthy weight.

So if living longer, and avoiding diseases like heart disease, cancer and diabetes does not provide motivation, maybe the prospect of a better sex life will.

The universe goes in seasons and cycles. The earth goes around the sun. The moon goes around the earth. The seasons follow in order; summer after spring and winter after autumn (fall). Night follows day and the month’s click around to December, which is followed by January and the start of a new year.

People’s behavior also has cycles.

The start of the year is typically the time when resolutions to change are made. Yet it is worth noting that you can resolve to make changes at any time of year. Birthdays are another time when the passing of a year can lead to reflection on how we do things and can we do them differently.

Our goal is indeed to do things differently than we have done them before. When smoking was more prevalent, quitting smoking was the most popular new years resolution. Today losing weight or getting fit are the most common.

The problem is that after a week or two things are usually “back to normal”. Why is this the case? We all know what to do. There is no shortage of information available about eating and exercise. There is no shortage of products or programs available to help us.

The problem is that we are creatures of habit. We do things a certain way. When we focus we can go against our habits but as soon as our minds are on other things (e.g. work or the family) we subconsciously revert to our default behaviors – the ones we have been doing for years. We reach for the biscuit instead of the fruit. We drink the soda instead of water.

Habits can be changed and the reversion to our default can become a positive not a negative. It is also known that it takes three months for new habits to become firmly established.

To help you achieve your new years goals here are five tips.

1) Before you start – make a plan. Setting goals without having a plan is like trying to build a house without a plan. The bricks won’t put themselves together and in the pattern you want. Neither will your new eating plan or exercise regimes just create itself. Write your plan down and consult it regularly. You can adjust it as you go too.

2) Do simple mathematics. Count and measure what you eat. With any change in eating patterns you need to measure calories and portion sizes till you start to intuitively “get” how many calories are in different foods. With exercise you need to count the minutes and do your exercise at set times so it becomes ingrained in your schedule and not something on the “to do” list. Find out how many minutes of exercise are needed to burn off a biscuit – you may be surprised and it will help you resist the temptation.

3) Enhance your willpower. It has been shown that those who believe they have willpower have more. It is not something that “other people have” and it can be learned. Even simple affirmations can get you started. Things like “I exercise regularly”. Believe you have willpower and you have more of it. As Henry Ford said, “whether you believe you can or you cannot – you will be right”.

4) Focus and discipline. When aiming to change aspects of the body you need to train the brain too as it needs to develop new neural pathways for your new behaviors. Meditation helps people focus better.

5) When you fall off the horse get back on. Thomas Edison failed 10,000 times before inventing the light bulb. So what if you have a day when you overdid the chocolate. You will lapse. What matters is what you do next. Do you use this as an excuse to say I failed or do you see it as a temporary setback and a learning opportunity?  Draw a line in the sand at midnight and start a new the next day.

This is not is difficult. You do not require three tertiary degrees. You will not need thousands of dollars nor months worth of spare time. Changing our behavior is a matter of changing your mindset, creating a plan, actioning it and most importantly staying the course.

Follow the five steps outlined above and you can turn your resolutions (new years or otherwise) into reality.

OK its now “official” – being sedentary does actually kill you. The negative impact of a sedentary lifestyle on our health has been observed for many years but it has now been clearly shown and quantified.

An Australian study of 8800 people over six years found those who spent four hours or more watching TV each day had a 46% higher chance of dying and were 80% more likely to die of cardiovascular (heart) disease than those watching two hours or less per day. There was a steady increase in risk of death of 11% per hour spent in front of the TV. A study of 123,000 Americans over 14 years showed a 20% (for men) and 40% for women, difference in death rates between those who sat for over six hours per day versus those sitting for less than three.

Another American study showed people who were sedentary found it harder to lose weight even when taking in the same amount of calories. Small incidental movement (not formal exercise) like taking the stairs had a significant effect. In this study the groups did the same amount of “exercise”. It was the group that did more movement in their daily life, which had fewer problems with weight.

No doubt the studies can be criticized but the key findings confirm what we have really known for a long time.

The human body is designed to be active. Until fairly recent times this was not optional. To eat you needed to catch or gather food. To get from place to place you needed to walk. Most work was physical. Today we have so many labor saving devices that most of the “incidental” movement and exercise we got even one generation ago is gone.

Thirty years ago you needed to get out of the car to open your garage door and, dare I say it, get up off the couch to change the TV channel. Now it is important to note that sitting in front of a computer or video game or even sitting reading is still being sedentary so it is not the TV as such that is the issue.

Interestingly, and this is a new finding, even those who did some regular exercise were still affected by being sedentary for long periods. There are metabolic changes that occur in our bodies whilst we are “still”, that amongst other things, slow down the burning of fat.  Sugar and cholesterol metabolism is also affected.

So whilst regular exercise remains vital for your health, being sedentary for long periods is a separate risk factor in poor health. The two do not seem to cancel each other out. “Exercise is not a perfect antidote for sitting” says Marc Hamilton an inactivity researcher at Pennington Biomedical Research Centre (quoted in The New York Times).

The good news then is that the answer to prolonged inactivity is fairly simple. Here are some simple ideas to incorporate into your life.

1 Take the stairs instead of the escalator or lift.

2 Park in the furthest rather than nearest spot at the mall.

3 When working at your computer, get up and wander around for a minute every  30 minutes.

4 Limit your TV time to two hours per day maximum. Get up and wander around the room during the ads. Get up to change the channel.

5 Do some housework each day. Chores like ironing, hanging out the washing, even cutting vegetables are being “active.”

6 See what you can do standing instead of sitting. The simple act of standing uses muscles that sitting doesn’t.

It is great when medical science catches up with what we all really know anyway.  Movement is a bit like medicine but without side effects or cost.

The human body needs sleep. Over the last century the amount of sleep people get has declined by over an hour. It is estimated that at the turn of the twentieth century we averaged nine hours per night. Today the average is under eight hours per night.

It is fair to say that life has changed. The invention of the electric light has allowed us to be active after the sun goes down. For most people before this invention there was not a lot to do after dark except go to sleep. Furthermore people in most instances were tired after a hard days work.

Today we have a 24/7 society where the electric light allows for a multitude of activities to be done after dark. Even sports that were once played only during the day can now be played under lights. Many people continue to work after dark. Of course electronics allow us to be entertained when the sun goes down too.

Nobody wants to turn back the clock, yet there also is no such thing as a free lunch. Tiredness is one of the commonest complaints I hear from patients. In turn, lack of sleep is the commonest reason for this. There are many health issues associated with lack of sleep. Even our chances of becoming obese or getting high blood pressure are influenced by our sleep patterns.

Many people complain of the difficulty getting to sleep or staying asleep.

Whilst asleep every part of the body is “active” except the conscious mind. The lungs breathe, the heart pumps, the kidneys filter the blood and so on. To get to sleep means we need to slow the mind down. We need to reduce external and internal stimuli. It is the “chatter “ of the mind the keeps many awake.

So what can you do to sleep better?

There are two categories here. The first group is what you do during the day to help you sleep better at night.

1) Do regular exercise.

2) Take up meditation yoga or tai chi.

3) Eat more fruit and vegetables and less refined processed carbohydrates.

4) Manage your stress.

The second group is things you do in the lead up to, and the time of going to bed. Not everything works for everybody, so use what works for you.

1) Have a routine. Go to bed around the same time each night.

2) Switch of screens, be it TV or computer at least 45 minutes before bed time.

3) Burn some fragrant candles with a calming scent.

4) Do not drink caffeine after 6pm.

5) Listen to calming forest music or play a guided relaxation.

6) Have a comfortable mattress and pillow.

7) Make the bedroom dark and quiet.

8 ) Drink a calming tea like chamomile tea.

This sounds so obvious but when you are tired in the evening-go to bed. We would not dream of not having a drink when you are thirsty so why do we not sleep when we are tired Changing sleep patterns also takes time. Sleeping tablets, other than for VERY occasional use, are not the answer and can even make the situation worse. You need to allow three months to establish a new sleep pattern.

The first step to sleeping better is making it a priority in your life rather than something you do when everything else is finished. You will be amazed at how much better you will look and feel when you get enough sleep.