ITV This Morning’s Dr Chris Steele talks to Chris Jenkins about the importance of diet and exercise, the implications of longer life expectancy, health treatment for women and the future of medicine.
Q. We’re all becoming more aware of what we eat, how it affects our long-term health and the effects it can have on the planet. Do you think people have a good understanding of the importance of diet and options such as vegetarianism, or are they perhaps misled by fads?
Chris Steele: The biggest killers—heart attacks, strokes and cancer—have a major common cause, and that is ‘lifestyle’. Our lifestyle strongly influences our ‘death style’. The major factors in our modern lifestyles today are what we eat, our activity and our unhealthy habits... i.e. diet, exercise and drugs of leisure (tobacco, alcohol).
The evidence is convincing that we eat too much red meat and processed meats, which are linked to heart disease and various cancers. We consume too much sugar in our food and drinks. Most people must now have a basic understanding of how important diet is, yet change is slow to occur.
I’m not a vegetarian, but I do eat more than my five portions of fruit and vegetable every day—especially the deeply coloured and bright coloured foods... I always have a rainbow on my plate!
Vegetarians and vegans make a personal choice, and to be honest I fully respect their decision and in particular how disciplined they can be. They will know that they may have to supplement their diet because of the absence of certain vitamins etc. Fad diets, I am very wary of, especially those endorsed by non-expert celebrities, who may know very little about nutrition yet pontificate widely across their huge social platforms!
Q. As we are living longer, and perhaps suffering more from the conditions brought about by old age, is medical science keeping up? Are conditions such as sight loss, prostate problems, incontinence and Type 2 diabetes being better cared for?
CS: We are living longer, as life expectancy increases in most of the Western world. As a result, our ageing bodies suffer more from those diseases brought about by degeneration of the various bodily systems. Fading sight, becoming hard of hearing, osteoarthritis, poor mobility and balance and of course one of the worst consequences of ageing—dementia.
Cancer becomes more common as we age, but there have been huge dramatic steps in curing many cancers, due to new surgical techniques, radiotherapy, chemotherapy and the ‘new kid on the block’, immunotherapy.
Medical science is trying to keep up and it’s fighting a valiant battle to ease these problems and even delay their downward progression. I keep an eye on health headlines in the press and medical journals, and nearly every day some new breakthrough research is published—we live in an exciting time!
Q. Do women get a fair deal in health treatment? Are treatments for conditions such as endometriosis limited because they are under-researched? What can be done to eliminate any gender bias in treatments?
CS: Overall, I don’t think women get the best deal in some areas of healthcare. Latest research showed that when men present at A&E with chest pain, the immediate potential diagnosis is heart attack, whereas this was not in the case in female patients, where other factors such as indigestion, acid reflux and muscular pain were considered first. Now, there could be a genuine reason for this, because it’s been found that women experiencing a heart attack do not always suffer the ‘male’ symptoms of tight or heavy chest pain, radiating down the left arm or up into jaw.
Other female disorders such as endometriosis and ovarian cancer need a lot more research and as every disease area is underfunded, progress often depends on funds raised by the charities that support these disorders and the sufferers.
Q. Do we need to think about caring for the elderly in different ways, such as using technology in the home rather than taking people into residential care?
CS: The size of the elderly population is increasing year by year. I strongly believe we need to try and keep as many old people in their own homes, if they can manage or be helped by family and our care systems.
Independence is vital to these proud old folks, and it’s so important that they remain in their familiar surroundings, rather than being placed in the strange surroundings of a care home.
Of course, the cruel disorder of dementia takes away their thinking powers, their memory and ability to perform even the simplest of tasks and then the only answer for the distressed family and the patient is professional attention in a residential care home.
Modern technology, with in-home cameras, alarms, light and cooker switches etc. already makes a huge difference if the elderly person has not lost any of their mental facilities and is fairly mobile within their home. However, who knows what advances we will see in this rapid technology revolution in coming years?
Q. There’s been a worrying rise in the incidence of skin cancer—is this entirely down to the sunbed industry, or to climate change, or are there other factors? What can we do to be aware of the risks and so improve our skin health?
CS: More and more cases of skin cancer are being detected each year, mainly because it is increasing in the general population but also because people have become more aware of the early signs and are therefore seeing their doctor earlier.
Skin cancer results from exposure to ultraviolet rays from the sun or even sun bed use. I’ve had skin cancer three times, basically as a result of being a sun lover and sun bed user 40 years ago, when we weren’t really aware of the dangers. Luckily my skin cancers were not the most serious type, which is malignant melanoma.
The rise in skin cancer results a lot from cheap air travel and holidays in the sun. Soon after arriving at our holiday destination, we rush to the poolside or beach to soak up the sun aiming to develop that healthy tan to show off once we get back home! It’s not easy, but you should start with short periods in the sun and then gradually increase your expose yourself to the sun over your holiday period.
The important message is DO NOT BURN! This applies particularly to children and teenagers. I burnt badly as a teenager and developed skin cancer 40 years later!
Always apply high factor sun creams that give protection against UVA and UVB rays and keep reapplying them throughout the day.
Q. This year’s World Health Day celebrates the 70th anniversary of the World Health Organisation, with the theme ‘Everyone, Everywhere’. With at least half the world’s population unable to access full healthcare, do you think Universal Health Coverage by 2030 is a practical goal?
CS: The World Health Organisation has been remarkably successful in improving health, especially in Third World countries. I believe its most successful interventions have been in supplying clean water to millions across the African continent, plus the advances it has made in its vaccination programmes in preventing many communicable killer diseases.
Its theme this year is ‘Everyone, Everywhere’ and the target is to really improve healthcare to the millions who just do not have the basic healthcare facilities.The WHO states that at least half of the world’s population are unable to access full healthcare. This is truly shocking, considering the excessive wealth (and waste) enjoyed by ‘civilised’ countries.
I only hope they achieve, or get close to, their goal of ‘Universal Health Coverage’ by 2030.
Q. The NHS has a comprehensive calendar of health campaigns ranging from Epilepsy Awareness Day to Stress Awareness Month, Action on Stroke Month and even National Stop Snoring Week. Do you think these campaigns do any long-term good, or are they just a bit of fun and fund-raising?
CS: There are so many campaigns designed by the NHS aimed at stopping smoking, awareness of epilepsy, strokes, stress etc. I think they all do some good, purely by raising the awareness of these conditions and educating people more about these disorders and what is available as help to those who need it.
One important aspect of such campaigns is raising money for the cause—money is often much needed by those doing research in these areas. Campaigns really form part of a much wider front when attacking problems in the healthcare arena, for example the ‘Stop Smoking’ campaign, added to the banning smoking in public areas, placing shock images on cigarette packets, concealing cigarettes at the point of sale etc. Basically, a campaign on its own is not enough—it has to form part of a multi-factorial extensive public education programme. But every little bit helps!
Q. How can we all do our bit to promote our own better health in old age? Are holidays, exercise and activities as beneficial to our mental and physical well-being as medical treatment? What would be a sensible exercise regime for the older reader?
CS: To improve one’s health at any age, here’s a simple piece of advice: Eat less - move more. Many of us are over-eating, and over-eating unhealthy foods, such as high fat and high sugar items. Not many are over-eating fruit and veg!
Many of us are too inactive—sedentary jobs, then sitting for hours watching TV in the evenings. The consequence of this is the epidemic of obesity prevalent even among our children.
To achieve old age and especially better health in old age, it’s imperative that we modify our lifestyles by changing our diet and getting active. Such measures will reduce our chances of heart disease, strokes, cancers, dementia, arthritis and the vast array of diseases brought on by diabetes (Type 2)
It’s never too late to make changes, and recent research shows that even 10 minutes of mild to moderate exercise twice a week has huge benefits. For the older person this could just be a walk to the shops or pottering around in the garden. Any exercise/activity is better than none, as is any improvement in your diet... it ain’t rocket science!
Of course, holidays and activities that involve meeting other people do improve our mental and physical well-being. Social contact amongst the elderly is valuable, as so many are left alone in their homes seeing no-one day in and day out. In my practice we used to visit our elderly patients every month, and for many, the doctor and the meals-on-wheels person were the only people they’d see. Isolation and loneliness are a big problem with many of our elderly folk—they just need a bit of company and a chat!