MEDICAL MATTERS:Trying to pursue goals can increase stress levels, writes MUIRIS HOUSTON
SO HOW are your new year health resolutions going? Swimmingly, I hope. Inevitably, however, many readers will be struggling and some of you may have already abandoned diets and exercise regimes.
This brings a feeling of failure and even self-loathing for some. And the sometimes pressurising role of columns and supplements such as this one must also be acknowledged.
How about turning all the well-intentioned advice on its head and adopting a new approach? Stop worrying about your health. It’s an approach advocated by Dr Susan Love, a professor of surgery at the University of California, Los Angeles.
Co-author of Live a Little! Breaking the Rules Won’t Break Your Health, Love makes the case that perfect health is a myth and that most of us are living healthier lives than we realise. “Is the goal to live forever?” she asks. “I would contend it’s not. It’s to live as long as you can with the best quality of life you can.”
Her thesis is based on the U-shaped curve. Rather than aiming for perfection at one or other end of the curve, maybe the best place to be is in the middle. It’s something borne out by research published late last year on salt in the diet (and also in Prof Eoin O’Brien’s column on these pages). Prof Martin O’Donnell of NUIG and Canadian colleagues found a J-shaped relationship between salt intake and death from cardiovascular disease.
In other words, by showing harm among people whose salt intake was less than 3g per day, O’Donnell and his co-authors have strengthened the evidence in favour of some daily minimum level of sodium intake. And they also reinforced the argument for the association between high sodium intake and increased risk of cardiac disease and stroke in patients with established cardiovascular disease.
All of which means that for the majority of people, the best place to be is right in the middle at the base of the J curve.
Love highlights the growing tendency to obsess about sleep and questions the results of studies carried out in the unreal surroundings of a sleep laboratory – which coincidentally were discussed in last week’s Medical Matters.
A study published in the Archives of General Psychiatry found that people who slept seven hours a night were the least likely to die during the six-year study period. But sleeping for more than seven hours or less than five increased mortality risk.
This may have been due to underlying health problems affecting the participants’ sleep rather than a direct link with amounts of sleep. Still it could be seen as an argument for being happy to be in the middle zone for sleep consumption.
The same arguments can be made for exercise and weight loss. It is now well established that people who are obese or underweight have higher death rates, while people who are overweight are just as healthy as those of normal weight. And maybe we don’t place enough value on the fitness we gain from lifting, walking and cleaning.
There is also an issue around the stress we feel under when trying to pursue health resolutions. It has emerged that the sensation of being highly stressed can rewire the brain in ways that enable the stress to persist.
Parts of the brain devoted to executive functioning shrivel under persistent stress while those concerned with habit formation increase in size. The research could help explain why some people who are in a rut seem to keep on digging deeper into that rut.
The good news is the anatomical changes can be reversed. But if they persist, they enable the negative effects of the flight or fright response to continue. High levels of the stress hormone, cortisol, cause blood pressure to increase and remain elevated; the same occurs as the heart races and the intestines constrict.
Obsessively pursuing health goals can mean stress hormones remain switched on, thus negating some of the very benefits a person is striving to achieve. Maybe it’s time to seek out that middle ground: make use of your body, have some fun and live life.