New Year a good time to make health resolutions
Experts' recommendations include exercise, managing stress, making end-of-life decisions
'Tis the season for resolutions. And many of us are already busy pledging that come Jan. 1 we will do more of some things, less of others or stop doing still other things altogether.
But what if experts made your health-related resolutions for you? What changes might they try to persuade you to make in your life?
We asked a number of doctors, health organizations and public health experts whose expertise we draw on from time to time to name the one health-related resolution they wish people would make for 2013.
There is some predictable common ground, as well as some surprising suggestions.
Get some exercise
It doesn't have to be a lot — just some, and on a regular basis. With an increasing number of studies suggesting that prolonged sitting is unhealthy and that even short bursts of exercise are beneficial, it's no wonder this was the most suggested resolution to come forward from our experts.
Dr. Mike Evans, a family physician and health information advocate at St. Michael's Hospital in Toronto, puts it this way:
"There are 24 hours in a day, and you might spend most of it caring for family, sitting at work, couch surfing, obviously sleeping and eating," Evans said.
"The evidence shows that the best thing you can do for your health is being active for half an hour each day and that, if you can do it, you can realize great health benefits."
The Canadian Cancer Society, diabetes expert Dr. Hertzel Gerstein, Dr. Perry Kendall, who is B.C.'s chief medical officer of health, and a number of others are telling people to make a point of getting regular but moderate exercise.
"It doesn't have to be extreme," said Dr. Michael Gardam, an infectious diseases expert at Toronto's University Health Network, who suggests starting slow and gradually building up your endurance.
"A lot of people go crazy in the New Year and ultimately fail because they start too fast and try to do too much."
Choose better foods
Several of our experts suggested variations on this theme. The Heart and Stroke Foundation would like people to resolve to eat five to 10 portions of vegetables and fruit a day for a heart-healthy 2013.
Dr. Tiffany Chow, a senior clinician-scientist at Baycrest Health Sciences' Ross Memory Clinic in Toronto, suggests people organize their meals so that produce is the main attraction and meat is more of a side dish.
Dr. Yoni Freedhoff, an Ottawa-based weight loss expert, would like to see people cook more meals from fresh ingredients and eat them, as a family, around a table.
"The corollary to that resolution would be markedly reducing purchased, convenient and heavily processed meals," Freedhoff said.
And the University of Calgary's Dr. Norm Campbell, who specializes in the treatment of high blood pressure, wishes Canadians would push the federal government to put consumers' interests over those of the food industry.
Campbell says good food policy could prevent a substantial portion of chronic disease in Canada.
"But our politicians introduce solutions that maintain the status quo and then blame us for making poor dietary choices," he said.
"If we want to stay healthy, it is likely our most critical health choice is in voting and advocating to politicians to introduce effective health policy."
Make the tough decisions
Perhaps the recent Supreme Court of Canada hearing on the Hassan Rasouli case, which centres on end-of-life decisions, put some of our experts in a pensive mood. But several suggested Canadians should give serious thought to the degree of medical intervention they want when their time comes.
"Without being too macabre, I think too many folks do not address how they wish to exit this world and leave it to others to try and figure it out," said University of Alberta cardiologist Dr. Paul Armstrong.
Do you want doctors to try everything possible to keep you alive under any circumstances? Or would you prefer health workers not use heroic measures, if you are near the end?
Armstrong suggests people should make these decisions and communicate their wishes verbally and in writing to their loved ones.
Dr. Ross Upshur, an ethicist and primary-care physician, agrees.
If you haven't designated a surrogate decision maker — someone who has the legal right to make choices about your care if you cannot — or haven't given someone power of attorney, set those things up, Upshur suggests, adding that you need to talk through your choices with the people you ask to fill those roles.
"We are all mortal and technology is increasingly powerful. We leave the discussions too late and then the situation is usually too fraught with exigency and emotion," said Upshur, who practises at Toronto's Sunnybrook Health Sciences Centre, which is the hospital caring for Rasouli.
Dr. Rob Fowler, who is Rasouli's physician, is even more to the point: "While eating turkey on the holidays, 'Talk turkey' with your family about your wishes for end-of-life care."
Learn to manage stress levels
"Decrease stress by not overcommitting yourself, and finding the right balance between work and leisure," said Dr. Jean-Pierre Chanoine, head of the endocrinology and diabetes unit at B.C. Children's Hospital in Vancouver.
Chow offers similar advice. The Baycrest doctor cheated a little and offered two resolutions under the umbrella of taking care of your brain health and lowering your risk of developing dementia.
People should recognize sooner when their stress level is unsustainable, Chow said, and ask earlier "Do I really need to do this (or) take responsibility for this by myself?"
"The answer is usually No!"
Drink less, and other suggestions
Resolve to drink less alcohol, suggests Dr. Joel Ray of St. Michael's Hospital in Toronto.
"Give the money to someone else to buy food."
Ensure your vaccinations, and those of your family, are up to date, said Dr. Bonnie Henry, medical director for communicable disease prevention and control services at the B.C. Centre for Disease Control.
Give your kids a healthy start, said Dr. David McKeown, medical officer of health for Toronto.
"Feed breakfast to your kids, walk your kids to school, teach them to wash their hands properly, teach them to swim, talk and read to them, hug them. Small lessons learned early last a lifetime and makes a healthy community."
Resist the urge to seek or take medicine, advises Dr. David Juurlink, head of clinical pharmacology and toxicology at Toronto's Sunnybrook Hospital. He said people are too quick to take prescription drugs or over-the-counter medications, suggesting they should be used sparingly and only when the likelihood of benefit is real.
Learn to engage in informed decision making with your physician, said Dr. Gordon Guyatt, a professor of clinical epidemiology and biostatistics at McMaster University in Hamilton.
And finally, from Canada's chief medical officer of health comes some poignant advice.
Dr. David Butler-Jones is working his way back from a stroke he had earlier in the year.
"Do not let anyone else limit your expectations of how much you can recover or become as you are more likely to get what you expect," he suggests.