Lifestyle illnesses and the NHS: what would really make you be healthier?

"Illnesses associated with lifestyle cost the NHS £11bn," shouts the BBC headline this week.Apparently Public Health England (PHE) say that health problems related to poor diet, obesity, drinking and smoking are costing the NHS in England more than £11bn each year, and 40% of all deaths in England are related to behaviour.

It's not particularly obvious, either on BBC news or the PHE website, where these stats have come from. PHE quoted them when they launched the "One you" campaign in March this year, aimed at promoting a healthier lifestyle in the interests of trying to reduce preventable disease. Such as type 2 diabetesheart attacksstrokes and lung cancer I assume, although they don't specify.

The numbers sound impressive, but to you and me what probably seems more relevant is all the misery those illnesses will bring to us and our nearest and dearest if we get them.

Lots of lifestyle choices affect health in a good or bad way, and most of them we choose anyway. We take the risk of injury when we take up a sport. We take the risk of a car crash every time we get in our cars. We take the risk of stress when we apply for a job.

But perhaps some lifestyle factors are worth us thinking about as a society to make some efforts to do some damage limitation. So many people have suffered needlessly from smoking-related illness over the years, and many of them smoked before it was really known how much harm it could do. It is somewhat shameful that we are giving money to people in the world who are dying from famine and malnutrition, whilst simultaneously killing ourselves off through over-eating.

Health promotion is part of our job as GPs, and we spend a lot of time telling people they might want to consider quitting smoking, drinking less or losing some weight. I'm always rather surprised if anyone ever does that just because I say so, but a patient said to me just last week, "I'd give up smoking if you told me I had to, Doc."

So let me take the opportunity to say (just in case there is anyone out there from a bygone age when people took their doctors' advice):"Please, please, try to quit smoking; it's pretty unlikely that you will get away without some kind of hideous health misery if you don't. If you're vastly outside a normal BMI, let's think about how you could lose some weight. If you can manage to do some regular exercise it will help keep type 2 diabetes, heart attacks and strokes at bay. And try to drink less than I do."

Most of us however, need a more positive strategy. Tobacco, alcohol, sugar and laziness are addictive and need clever tactics to keep under control. The solution is going to be different for everyone, and in various areas of the country.

I'm loving the campaign that same BBC article tells us is going on in Fleetwood, one Lancashire town trying to improve its own health and quality of life. We can't really sit back and criticise the government as they debate increasing the minimum price of alcohol, and putting Maltesers® in smaller packets; to have an impact we all have to be involved. We need collective plans and ideas (like Fleetwood, which can help a whole community) or individual plans and ideas. We have to think outside the box. Here are just a few thoughts:

Exercise has to be fun rather than a chore. Dancing classes when the latest series of Strictly is on and we're all inspired. Tennis lessons in Wimbledon season. Pokémon Go; the Just Dance Wii game or aqua aerobics. Information about taking up sports was streamed to us with the Rio Olympics this year - a great opportunity to enthuse people.

Healthy eating is hard to see as enjoyable. Join a slimming club if you want the company of fellow strugglers. Form your own club, similar to a book club, but sharing recipes or get together for meals and healthy eating ideas. Or you could set up a website where people could post easy-to-cook delicious healthy recipes so eating healthily is as appealing as…well…not. Lots of healthy food is and can look completely yumlicious; it's about the presentation and convincing your brain. Keep the tempting sugary stuff out of your cupboards and the fridge.

How about smoking? Various strategies over the years have led to a reduction in smoking; awareness of the damage it can do, taxes, bans on smoking in public places. Something has changed in our country's mentality and even most of the dedicated smokers would stop if they could.

Different plans work for different people. Save the money you would have spent on cigarettes and do something awesome with it. Put a chart on the wall and cut down by one cigarette each week. Visit your GP for medicinal help with the nicotine replacement or cravings; there are several options. Consider changing to the more socially acceptable e-cigs. But be warned it's not really known yet how much safer they are.

And, finally, there's alcohol. If we all tried to stick to the advised limits we could enjoy drinking without it being any kind of health problem. Do as I say and not as I do.

Nobody has got all the answers, but maybe if lots of people had a small idea it would be a start.

You have to run with the ideas that work for you personally as it's you personally who could be unwell and unhappy down the line if you bury your head in the sand.

Shall we start a brainstorming session? All ideas to the comments box below…


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