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Health boost

Population Health

Health boost

From eating healthily to getting more sleep, resolutions to improve our health and wellbeing are commonplace at this time of year. But how can customers stick with their best intentions? 

Just as indulging in food and drink is a staple part of the festive season, making healthy changes is often at the forefront of people’s minds come the New Year. And although many start with the best of intentions, making healthy changes can be daunting or unsustainable, meaning most of us haved ditched them by February.

But a healthier lifestyle doesn’t necessarily have to mean a strict diet or intimidating gym membership. Small, achievable changes can be introduced and pharmacy teams are perfectly placed to offer customers support, advice and encouragement along the way.

Eat healthily

Diets are the focus of many people’s New Year weight loss regimens, but when it comes to losing weight, all or nothing solutions rarely achieve long-term results. Instead, encourage customers to make simple changes that can have a positive, long-term impact on how they look and feel. These include eating:

  • Five portions of fruit and vegetables per day
  • Less sugar – swap sugary drinks and snacks for low sugar versions or alternatives such as eating fruit instead of biscuits
  • Less salt – salt raises blood pressure and increases the risk of heart disease and stroke. Adults should eat no more than six grams a day
  • Whole grains – these are digested more slowly, making us feel full for longer
  • Breakfast – it’s the most important meal of the day as it helps increase energy levels, boost concentration and reduce snacking
  • Regular meals to maintain blood sugar levels and reduce low mood, irritability and fatigue
  • Food cooked from scratch so you know exactly what’s in it
  • Smaller portions – weighing or measuring out staples such as pasta and rice means staying in control of portion sizes. Even eating from a smaller plate can help
  • More slowly – it takes about 20 minutes for the stomach to tell the brain it’s full.

Drinking three to four pints of beverages low in sugar and calories is also key to a balanced diet and keeping well hydrated.

Gul Root, lead pharmacist, Health and Wellbeing Directorate, Public Health England, says: “Generally we set rules to help us to meet goals, such as ‘I will eat a banana for my afternoon snack rather than a chocolate bar’. If we break these rules we can become vulnerable to overindulging and abandoning our resolution.” It’s therefore important to advise customers how best to manage these situations.

Measuring success is one way to achieve this. For example, advise customers to keep a food diary or do a weekly weigh in or waist measurement to track their weight loss over time. Support and encouragement can also be useful, such as the Change4Life Fruit & Veg Boost, which Gul explains “is a great tool for those trying to eat more healthily. It sends hints and tips via email every Friday and a free recipe to help you stick with your chosen plan.”

Drink less

One in five UK adults regularly drink above the Government guidelines, putting their health in danger. Just this month, the Department of Health altered the alcohol guidelines for men to 14 units a week, bringing them in line with those for women. Dr Sarah Jarvis, GP and medical advisor for Drinkaware, says that the health benefits of drinking less are extensive and can be categorised into three groups:

Short term

  • Better sleep
  • Increased alertness
  • Better concentration
  • Less irritability
  • Brighter skin
  • Fewer headaches.

Medium term

  • Weight loss
  • Higher energy levels.

Long term

  • Protects the liver
  • Improves fertility
  • Reduces the risk of heart disease and various forms of cancer.

In terms of targets, Dr Jarvis recommends “a couple of alcohol-free days per week as this reduces the likelihood of dependency developing”. Facing the challenge with a friend can also be helpful for some people, as can making a list of the motivations for doing it and a tally of the money saved.

Drinkaware and Public Health England’s Change4Life campaign both offer apps which customers can use to track alcohol intake, set self targets within the Government’s guidelines and receive regular, personalised advice, motivation and feedback.

As for resisting the urge to slip back into old habits, Dr Jarvis says: “It all depends on personal triggers. For example, if you always drink with your friends then say for one month that you won’t go around to their house unless you’re driving. People tend to be very good at not drinking and driving so it’s a good way to not be tempted.”

Get fit

Adults should get 150 minutes of moderate exercise each week. Moderate activity will raise the heart rate, make breathing faster and warm up the body.

Achieving this level of physical activity will not only help people lose or maintain a healthy weight, it also helps keep the heart healthy, strengthen muscles and bones and boost mental health. It can also reduce the risk of heart disease, stroke, type 2 diabetes and some types of cancer by up to 50 per cent and lower risk of early death by up to 30 per cent.

Physical activity can easily be included in people’s everyday routine, such as:

  • Taking the stairs instead of a lift
  • Walking or cycling to work
  • Getting off the bus or tube a stop early and walking the rest of the way
  • Using plenty of elbow grease when doing housework
  • Starting a hobby such as gardening, dancing, swimming or bowling. With a fun activity, getting active is less likely to feel like a chore.

It can be difficult bringing up the subject of drinking habits with customers, but as Dr Jarvis explains: “Anything that might be affected by alcohol, like medications, indigestion, sleeping and stress can all be starting points for conversation.”

If high alcohol consumption is suspected then a screening tool such as Public Health England’s AUDIT-C screening tool can be used to flag up whether or not further action is required. 

“Just a few minutes of alcohol advice, following identification through the use of a validated screening tool, can cut a patient’s alcohol consumption by between 15 and 34 per cent,” says Gul.

Improve posture

The body can become used to bad posture, but this can be damaging and cause muscles to weaken and not provide sufficient support to the body. Tim Hutchful, chiropractor and British Chiropractic Association (BCA) spokesperson, says: “Bad posture is cumulative so it won’t cause problems straight away, but stress is put on our neck and back and over time they’ll weaken. Pain is the last symptom to appear, so when it’s experienced, the damage has been done.”

But what is good posture? According to Tim, “if you stand someone up straight, there should be a plumb line from the ear, through the shoulder, hip, knee and down to the ankle.” This means our bodies are balanced and the more neutral we are, the less we have to work.

Improving posture ensures any pain is kept to a minimum and keeps the joints in good condition. It also means more air gets into the lungs, making breathing easier.

Tim’s top tips for improving posture include:

  • Become more active and use your muscles. Walk with arms free by your sides
  • Look at how you’re standing in the mirror and see what you can change to get that ideal line
  • Think about whether you’re achieving an ideal line from your ear though the shoulder and hip while sitting. If customers work in an office, advise them to talk to HR about an ergonomic workspace
  • About 70 per cent of women wear the wrong sized bra and this can cause slouching and back pain – get measured and wear the right size
  • The BCA’s ‘Straighten Up UK’ programme is a good start too. It’s designed to improve posture and prevent back pain by promoting balance, strength and flexibility in the spine with simple, three-minute exercises.

Make and attend health appointments

Many people are guilty of putting off making or attending health appointments. But keeping on top of these can, in some cases, be the difference between life and death.

Smear tests, for instance, screen for abnormal changes in the cells in a woman’s cervix. Any affected cells can then be removed, if necessary, to prevent them from becoming cancerous. Rather than a test for cancer, a smear test is a preventative measure. For around one in 20 women, the test shows some abnormal changes in the cells of the cervix.

Regular dental appointments are also important for keeping teeth and gums free from tooth decay, gum disease and bad breath. Toothache is often the last thing to be experienced, so a regular check up means that potential problems can be detected and prevented.

“Making and attending health appointments is so important,” says Dr Jarvis. “I suggest setting self targets for dealing with things like that, like people do at work. For example, if a letter comes in saying you’re due a check up then commit to making an appointment within a week.”

Manage stress

Stress can affect people in a number of ways and it can become harder to overcome if it’s not addressed quickly. Rachel Boyd, information manager at the mental health charity Mind, says: “Stress has quite a few forms and it’s usually the physical signs you notice first – that includes sleeplessness, breathlessness, tightness of the chest and stomach upsets.

“But there’s also the emotional and behavioural side, so people can find it hard to concentrate, they can get irritable and snappy, they find their head is full and can’t switch off and they generally worry more and get overly nervous about things.”

Taking a step back and understanding personal triggers can help someone prevent and manage stress, as can having a support network and making realistic aims. For example, advise customers to work out when their most productive part of the day is and plan to do important jobs in that time, and relax in between stressful activities to provide a balance.

Exercise can also be beneficial, as Rachel explains: “Exercise helps the body to eliminate the hormones that are produced when stressed. That can be anything from walking to yoga or Pilates classes. If possible, exercising with a friend or in a group is ideal as social contact can help massively when stressed.”

There’s no medication to help, however. “OTC or prescription medicines are available for things like anxiety, high blood pressure and sleep problems, which can all occur as a result of stress,” says Rachel. “But even if these are appropriate, they won’t address the root cause.”

Stop smoking

According to stop smoking charity QUIT, for every year a person smokes after the age of 40, their life expectancy reduces by three months. However, people who stop smoking before the age of 50 cut their risk of dying in the next 15 years in half, compared with those who keep smoking.

What’s more, the body starts to experience the benefits of stopping smoking straight away, no matter how long the person has smoked for. This includes blood pressure, pulse and oxygen levels returning to normal, and breathing, circulation and the ability to taste and smell greatly improving. People will also notice healthier looking skin and teeth, more energy and better physical fitness. Longer-term, quitters will also increase their lung function and halve their risk of heart disease.

Despite this, only three per cent of people successfully quit by willpower alone. Pharmacy therefore has an important role to play in offering advice and recommending nicotine replacement therapies. “Pharmacy teams can advise on the range of nicotine products which can help withdrawal symptoms and help prevent relapse,” explains Gul.

It can also be useful for people to remove smoking cues or triggers, such as ashtrays and lighters and stay away from places or situations that they associate with smoking.

Be sleep smart

One in three people say they don’t sleep properly and the effect of this can be broader than just feeling tired. Jessica Alexander from the Sleep Council says: “From a short-term point of view, we all certainly know how debilitating being overtired can be, even if it’s just from one bad night. The brain doesn’t work as quickly as usual and there’s an overriding feeling of exhaustion. The long-term effects are wide ranging, including obesity, diabetes, heart problems and issues with digestion.”

In terms of the recommended amount of sleep, Jessica says that to talk in absolute hours is difficult as we’re all programmed slightly differently. “For adults, sleeping more than nine hours could indicate depression and sleeping fewer than six can be physically and mentally debilitating. But research suggests that seven hours of undisturbed sleep is a good aim.” Jessica’s reference to ‘undisturbed sleep’ is particularly important, as quality is usually more critical than quantity.

Sleep hygiene has a predominant focus on bedtime routine and environment in order to establish quality sleep. “The bedroom should be cool, quiet, dark, very relaxing and comfortable,” says Jessica. “It’s also important to think about the wind down routine before going to bed. It’s not for nothing that we encourage this in our children with bath time and a bedtime story, and the same should apply for adults,” she adds.

To this end, listening to music, reading or making a list of things to do the next day can all help to neutralise the mind and aid relaxation. Daytime habits are also interrelated with sleep, so limiting caffeine intake, eating a healthy diet and getting plenty of exercise can all be conducive to a good night’s rest.

“When it comes to sleep problems, there is no quick fix”, says Jessica. “People have to be kind to themselves and work out how to get over it. It’ll often be a combination of solutions that’s needed and people should be advised to experiment to see what works for them.”

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