The most causes of death it e been changed, mostly by better health measures. T if you die before your natural life span it will most likely be from an illness caused by your lifestyle. Despite advances in public health, Australians are generally not very healthy and this appears to be getting worse amongst young Australians. Making healthy changes to your lifestyle can help you both to avoid premature death and to enjoy your life more fully.

`Your good health!’ It’s one of our most common toasts. If it does not always accompany the healthiest of drinks, that doesn’t deny the fact that good health is something we often wish for each other and for ourselves. Later we will explain how you can enjoy some very good drinking, if that’s to your taste, as a part of a healthy lifestyle. That’s a point we would like to make early and will repeat often: living a healthy lifestyle does not mean going without all the things you like and putting up with things that no one in his right mind could ever like. It does mean enjoying the good things in life and coping with a few healthy demands in moderation.

In recent years there has been a growing interest in health and the factors that affect it. The clearest evidence of this is the massive growth of the ‘health’ industry — ‘health food’ shops,’ health and fitness’ centers, ‘health’ magazines, `health’-giving gadgets, potions, and pills. If you’ll forgive the pun, we think this interest is healthy because, as we will explain, you are the single most important influence over your health. Unfortunately, your interest may sometimes be attracted to a part of the ‘health’ industry that seems to offer magical solution for good health. No need to make much change to how you live or what you eat or drink. Certainly no need for all that unpleasant and sweaty exercise. Just swallow one of these vitamin pills a day or let our machine do the exercise for you or eat lots of oat bran. As you will learn, these magical solutions for good health are magical only in their capacity to earn money for their marketers.

For most of us, enjoying good health will involve making some moderate changes to several aspects of our lifestyles. Although they will cost a bit more effort from you than the magical solutions require, those changes need not cost you anymore money than you already spend on daily living.

The ‘health’ services in our community are one of our biggest costs. Doctors, nurses, paramedical and support staff, hospitals, health centers, equipment and drugs, all cost us amino. Each year they gobble up a major share of the budget at national, state and local government levels, not to mention affair slice of most family budgets. Even if you rarely need to consult a doctor, you probably pay a compulsory ‘health’ insurance levy to Medicare and may well pay an additional `health’ insurance premium to a private ‘health’ fund.

With all of this interest, activity and expenditure, you might assume we would all know about and enjoy good health. The truth is sadly otherwise. It is true that fewer babies or children die and people live longer than they used to. Some diseases that often killed or crippled have largely disappeared. But many of these health gains are due more to improved public health measures such as sewerage, drains, clean water supplies and better food handling than to advances in medical science.

The ‘wonder drugs’ of the 20th century have in fact been admixed blessing. They certainly saved many lives, but that has sometimes prompted an over-use which has spawned the growing threat of drug-resistant strains of diseases. The widely

Reported advances in medical technology, such as transplants, artificial body parts and in-vitro fertilization, are welcomed by their successful recipients but these are comparatively few and the costs are comparatively high.

Many people have misunderstood the promise of medical science to be: ‘No matter what goes wrong with your body –or why it went wrong — we will fix it for you’ although medical scientists would be the first to say they have never made such sweeping promises. They are, like most scientists, cautious in their public statements. But the way in which their activities are reported in the popular media when another ‘breakthrough’s announced carries such a message. Medical scientists are usually enthusiastic about their work and understandably wanton have it reported favorably, especially in times of dwindling financial support for research.

Although the public image of medical practitioners has taken a battering lately, there are still vestiges of the old attitude that the family doctor will have an answer for every-thing. This attitude, coupled with the unduly optimistic expectations of what medical science can deliver, has led many people to an irresponsible approach to personal health that has served them ill indeed.

For all the gains in public health, we are not a very healthy lot. We may like to think of ourselves as a sun-bronzed, outdoorsy, sporty bunch, but the only truth in that stereotypes our high incidence of skin cancer from excessive exposure tithe sun. Our most popular recreation is watching television; our most popular outdoor recreations would be eating and drinking (usually unwisely); and our usual involvement in sport is watching it. A survey released in 1984 by the Australian Bureau of States-tics found that 70 per cent of the population had taken some

Sort of health-related action in the two weeks before the survey. Of that group, 94 per cent had taken some sort of medicine, 25 per cent had consulted a doctor or specialist, 9 per cent had consulted some other sort of health professional, and 8 per cent had taken off one or more days from work. And that was just in a typical fortnight! Not exactly a national picture of glowing health.

Not only do we seem to have a high rate of health problems, but the situation may be getting worse. A report from the Australian Medical Association in 1984 concluded that teenagers today are far less healthy than those of thirty years ago. Dr David Bennett, said it was myth that teenagers today led fit, healthy lives. Instead they had higher rates of suicide, accidents, alcohol and drug abuse, sexually transmitted disease and psychological problems than any previous generation. One survey found that 9 per cent of teenage boys and 18 per cent of teenage girls were moderately obese (10 per cent overweight), while 4 per cent of boys and9 per cent of girls were seriously obese (20 per cent over-weight). Although parents were understandably worried about their teenage children using illegal drugs, the drugs most used by teenagers were alcohol, painkillers and tobacco. Dr Bennett said that two thirds of secondary school students used alcohol and painkillers, and a half were smoking tobacco, although these of other drugs was comparatively rare.

Atherosclerosis is a build-up of fatty deposits on artery walls, and it is a major underlying cause of heart disease.

R Fred Epstein, Professor of Epidemiology at the University of North Carolina, addressing the Seventh International Sym-podium on Atherosclerosis in 1985, said: ‘Atherosclerosis is basically a childhood disease, both because undesirable habits are formed in childhood and because the disease itself starts in

Youth.’ Those undesirable habits were smoking, lack of exercise, and eating habits that led to high levels of blood cholesterol and excess weight. There is a message there, if you are apparent or a teacher. But the message applies as well to all of us: our health reflects our lifestyle.

In a 1985 report by Mrs. Ruth English, principal nutritionist with the Commonwealth Department of Health, diet-related diseases were claimed to be responsible for 60 per cent of our deaths. She said that heart disease, hypertension (high blood pressure), stroke, some cancers, diabetes, and liver and gallbladder ailments were associated with excessive eating and drinking, especially of too much fat, refined sugar, alcohol and salt.

Further, her report said Australians are getting fatter. In1980, 41.3 per cent of men and 31.5 per cent of women were overweight. By 1983, 42.6 per cent of men (an increase of 1.3per cent in only three years) and 35.1 per cent of women (an increase of 3.6 per cent in the same period!) were overweight.

She had some other bad health news for us. One in six men and one in eight women had high blood pressure. Of men and women, 20 per cent had dangerously high levels of cholesterol and triglycerides in their blood. Thirty-two per cent of men and 25 per cent of women smoked regularly, the men averaging 21 and the women 16 cigarettes a day. Other health workers have reported that, although growing numbers of adults are quitting smoking, the public health benefit of thesis being canceled out by the growing number of younger people, particularly girls and women, who are taking it up. Airport to the Victorian government in 1985 predicted that the incidence of cancer in that state would rise by 20 per cent over the next ten years. Although some of that increase would reflect the aging population, the major contributor would be raising rates of lung cancer in women.

Finally, Mrs. English reported that only one in ten men and only one in twenty women were exercising at least three times week, the number of workouts recommended by the National Heart Foundation.

Part of the explanation for our not being as healthy as we could be is that many of us don’t know the facts about good health. In the past much health education has been conducted in over-simple or over-negative ways which fail to reach or impress many people.

The frauds, quacks and gimmick-merchants loudly push very simple and often wrong ideas about health to try to get your consumer dollar. The defensive tobacco and junk food industries try to cloud the issues for their selfish benefit. The sugar industry is currently running a very dishonest series of television commercials all pushing the claim that white refined sugar is a ‘natural’ food. The very Australian character in these ads, standing in a sugar cane field, proclaims: ‘You won’t find any NutraSweet trees out here.’ What he doesn’t add is that you also won’t find any crystals of white refined sugar growing anywhere other than in the very artificial sugar refineries. It’s no wonder that many people are misinformed about health.

In late 1989 the Saul wick Age Poll conducted a telephone survey of Australians’ health knowledge and found some alarming gaps. Sizable numbers of people had the wrong idea about suntan protecting you from sunburn (12 per cent wrongly believed it did); about food eaten during childhood contributing to heart disease in middle age (20 per cent wrongly believed it didn’t); about successful friendships con-attributing to good health (13 per cent wrongly believed they don’t); and about the accuracy with which people can judge how much their drinking will interfere with their driving safely (33 per cent wrongly believed drinkers could judge this accurately). The majority of people surveyed had the wrong idea about the desirable frequency of exercise (71 per cent wrongly believed that twice a week was enough), and about the possibility that moderate alcohol use may reduce your risk of heart disease (59 per cent wrongly believed that it wouldn’t).

A 1990 report in the Medical Journal of Australia also con-clouded that too few Australians understand how to reduce

Their risk of heart disease. This survey, for the University of Sydney’s Department of Public Health and the Prince of Wales Hospital, found that few people knew they should reduce the amount of fat in their diet or that they could reduce their risky doing exercise or learning to manage stress better. Al-though most had had their blood pressure tested, less than half had ever had their cholesterol levels measured and only5 per cent knew they had high cholesterol levels. Since other surveys suggest that 20 per cent of Australians have high cholesterol levels, the researchers concluded that three out of four people with high cholesterol did not even know it.

`But I’m going to die of something, sooner or later, so why not enjoy myself now?’ How often have you heard that justification for an unhealthy lifestyle? Maybe you have used it yourself, like the peasant in the Wizard of Id cartoon. The idea was expressed a little more technically, if just as misleadingly, by leading cardiologist. At a European Society of Cardiology con-grass in 1985: ‘What is the use of preventing death from coronary disease if you die from cancer two years later?’ We will refrain from predicting that cardiologist’s answer if, when about to die of a heart attack, he were offered a two- year extension to his life.

Healthy life styling is not about preventing death, because no one can do that. Although the average life span has tripled since Roman times, the maximum life span has not increased much, if at all. Some researchers in aging speculate that in the future it may be possible to extend the maximum life span. Butte research focus today is on how to reduce age-related disease and decline, so that more people achieve their maxi-mum life span, and enjoy doing so because of their good health. That is, healthy life styling is about preventing preamp- true, unnecessary death, with the bonuses of also preventing other, non-fatal illnesses and enhancing our participation inland enjoyment of life. Let us emphasize that point again: healthy life styling is about enjoying life to the maximum.

According to the 1989 figures from the Australian Bureau of Statistics, heart disease was still our number one killer, but it was declining as a cause of death while cancer was increasing. In 1988 heart disease, caused by blockages in the arteries, accounted for 27.3 per cent of all male deaths (down from 28.3 per cent in 1987) and 25.3 per cent of female deaths(down from 26.3 per cent in 1987). Other forms of heart disease had also fallen slightly. Heart disease is very much lifestyle illness and, as such, a postponement of a cause of death.

Cancer was our second major killer, accounting for 23.2 percent of female deaths (up from 22.7 per cent) and 25.9 percent of male deaths (up from 25.3 per cent). Dr Oliver Alabaster, Director of Cancer Research at the George Washington University, has concluded that 60 per cent of cancer in women and 40 per cent of cancer in men is caused by our eating and drinking habits. Cancer in the lungs and airways was the biggest group of fatal cancers and continues to increase, especially in women, reflecting their increasing smoking habits. The incidence of skin cancer (including melanoma), reflecting unwise exposure to the sun, showed a small decrease in this survey but is still much higher than five years before. Even though the incidence of our third major killer, stroke has fallen in recent years it still accounts for 14.4 per cent of female deaths and 8.1 per cent of male deaths. It, too, reflects lifestyle factors like diet. To varying extents, all of our major causes of death today can be postponed by moderate changes in our lifestyles.

Healthy life styling is not only about living longer by avoid-in premature death. It is also about enjoying your life more. A popular joke that is a variation on the Wizard of Id cartoon has a doctor advising her patient to give up all of the things he enjoys. The patient then asks if he will live longer, and the doctor replies, ‘No, it will only seem longer.’ It’s a moderately funny joke but, like many jokes, it’s simply wrong. Leading healthy lifestyle is just not about going without all of the enjoyable things in life, while forcing you to eat dry lettuce leaves arid suffer endless exercise, because few of us would be dedicated or silly enough to do that. Sensible healthy lifestyles enjoyable in itself, places no unreasonable demands or- restrictions on you, and increase your ability to enjoy life. Have you ever imagined how an obese person feels in summer, wearing a 10 or 20 kilogram overcoat of fat that he can’t takeoff? Have you ever listened to a smoker coughing up half her lungs in the morning? Have you ever watched a hung- over person, a delicate shade of grey, twitch as the family cat stamps down the hall? Have you ever found yourself too short of wind to play with your kids or friends? Who is really enjoying life?

If the bad news is that our self-inflicted attack on health begins in childhood, the good news is that it’s not too late to turn that

Into an attack on illness in adulthood. Recent research 11, shown that, even when begun in middle age, gradual reductions in calories consumed and in body weight can prolong healthy life. In studies with non-human animals, these moderate changes delayed age-related declines in immunity, held cancer, kidney and auto-immune diseases at bay and led to prolonged vigor. Evidence from humans goes in the same direction. In 1984 Dr Raymond Harris, President of the Center for the Study of Aging in Albany, USA, reported that exercise can retard some of the functional declines that accompany aging, such as the loss of muscle tissue, flexibility, endurance, bone strength, capacity for physical effort and efficiency of the heart and lungs. Not only that, but he also suggested exercise may help to normalize blood pressure and blood levels of sugar and cholesterol, and to ward off depression and dependency.

Similarly encouraging results have been obtained in Australia, showing that it is possible to improve your health by changing some of your health-related behavior. In 1987 Dragnets Dodson, a Newcastle medical researcher reported that death rates from heart disease fell by more than 40 percent between 1966 and 1983. She estimated that changes in smoking and other health- related behavior accounted for more than half of this reduction. She also found reductions in average blood pressure and blood cholesterol levels, consistent-with changing eating habits in the community.

So what’s gone wrong? Despite the advances of medical science this century and despite the proven possibility of improving our health even if we start late in life, nationally our health is poor and even declining amongst young Australians. We suggest the problem is that most people have been missing-formed about health. We find that many people are unaware of what health really is, of how much they can personally do to improve their health, and of the benefits to be enjoyed as result of that effort.