The Health Blog

If you think putting on runners and taking a high-intensity jog around the block is a good way to lose weight, you’re wrong. It will increase your fitness and tone muscle, but it is not the most effective way of liquidating unwanted fat.

The old theory that the harder you exercise the more fat you burn has been replaced by a newer theory that requires less exertion but more planning. The new theory turns the old truth on its head. Basically, you don’t have to huff and puff to use up fat. The key is to change the intensity halfway through the exercise.

It’s all about burn rate. After 40 minutes of intense exercise you will be sweating, exhausted and congratulating yourself on a good workout, but you will have burnt very little fat. Had you spent that time differently you could have burnt much more.

In simple terms, it would have been more efficient to do 20 minutes of fairly intense exercise followed by 20 or even as much as 30 minutes of moderate exercise. In that moderate phase, fat would have begun to burn.

During exercise the body draws energy primarily from two sources: glucose and fat. The two are different fuels and the way the body burns them is analogous to the way a fire burns paper and wood.

Glucose is like paper. In a fire paper is quick to ignite, burns at high intensity and is used up rapidly. Fat is like wood, slow to get going but more effective as fuel over a long period. In the initial stages of an exercise session the body uses both glucose and fat.

As the duration of the exercise increases, a greater proportion of fat is used. During a sprint, for example, the body uses 80 per cent glucose and 20 per cent fat. During a 2-hour walk, the proportions are reversed and 80 per cent fat is burnt.

Glucose, which is stored in the liver and muscles as glycogen, is essential for the brain and the nervous system. For this reason it is always readily available and, to some degree, protected. Rather than allowing glucose stores to diminish, the body switches to using fat.

It is best to exercise first thing in the morning, before glycogen stores have been replenished by breakfast. Exercise then will result in a greater proportion of fat being used as fuel. While the amount of intense exercise necessary to burn fat varies depending on a person’s fitness, exercise history and metabolic rate, it is generally true that fat burns best during long periods of moderate exercise.

An easy way to plan exercise is to use the ‘perceived exertion scale’. This is a subjective measure of effort from one to 20, with 20 being the equivalent of running uphill at full speed with the wind against you. The glycogen depletion method suggests that the first 20 minutes of exercise be done at a personal 14 or 15 on the perceived exertion scale. For many people this would be a light jog or a power walk.

For the next 20 or 30 minutes, the method suggests a drop to an 11 or 12. This might be a walk that is determined enough to qualify as exercise but relaxed enough for you to be able to talk at the same time.

The program also focuses on raising metabolic rate. Metabolism is the ‘engine room’ of the body, and at rest, the average person has a metabolic rate that burns about a calorie a minute. The beauty of exercise is that it not only stokes up the metabolic rate, but it also keeps it partially raised for the next 14 hours.

Some take a slightly different view and suggest that the entire exercise session should be at a moderate intensity, which would be a 12 or 14 on the exertion scale. Long periods of slow movement, whether continuous or accumulated, are likely to be most effective in burning fat.

Overall, the message to those who want to burn fat is ‘keep moving’.

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It’s a puzzle: why are men in suits who spend all day seated at a desk more likely to develop cancer in their testicles than blue-collar workers? No-one knows for sure, but some researchers have a theory based on keeping cool.

They say that to be healthy and function efficiently testes need to be kept cool. To this end, the human scrotum acts like a natural airconditioning unit and keeps them about 3°C cooler than the rest of the body. If, however, testes fail to descend into the scrotum and remain in the warm abdomen, they may begin to malfunction. They may make mistakes with sperm production and are more liable to become malignant.

The major risk factor for testicular malignancy is maldescent of the testis. The higher the testis remains in its migration from the abdomen to the scrotum, the greater the risk of later malignancy. They say the dress and work habits of the professional classes often recreate the environment of a warm abdomen. Wearing tight-fitting underwear under suit pants and sitting with legs crossed under a desk raises the temperature in the scrotum.

In contrast, blue-collar workers who wear loose-fitting clothes and stand with legs apart at a work bench all day keep cool.

There are other possible explanations for testicular cancer being more prevalent among the professional classes. One may be that their lifestyle is more sedentary. By studying a map of a city, it is possible to predict where the highest rates of testicular cancer will be found.

When this exercise was done in Melbourne, the lowest incidence was found in the poorer suburbs of Sunshine, Port Melbourne and Broadmeadows. The incidence was three times as high in the affluent suburbs of Kew, Malvern and Brighton.

When incidence and occupation were examined, it was found that men in professional and administrative occupations were three times more likely to develop testicular cancer than tradesmen or labourers.

A British study into the causes of this cancer published in the British Medical Journal found that men who sit at a desk all day are more likely to develop it than those who take more exercise.

In Australia today, the lifetime risk of men developing testicular cancer is one in 300, and the incidence is increasing. In Victoria alone it trebled between 1950 and 1990. Throughout the world the incidence rose dramatically between the end of World War II and the 1980s. This puzzling phenomenon could be due to a change in clothing habits or a change in diet caused by cattle being fed large quantities of hormones. It is certainly not due to the population ageing, because testicular cancer is a young man’s disease.

There are two basic types of this cancer: seminomas, which arise mostly in men aged 18 to 45, and the more aggressive non-seminomas, which arise in the 16-to-35 age group. Both can occur in older men, but only rarely.

Young men should examine their testicles regularly and have any abnormality checked by a doctor. If there is a lump present, about 98 per cent of the time they will feel it. It is possible to live with a lump the size of the yolk of a hard-boiled egg and not realise it is there until it is found during self-examination. It may or may not be painful.

Men should not disregard a mass that does not subside after injury. As abnormal testes are more susceptible to damage or haemorrhage after minor trauma, a history of recent injury should not be accepted as the sole explanation for swelling and discomfort.

Modern treatment for testicular cancer is excellent. Although advanced cases of seminoma are difficult to manage, doctors can now achieve close to 100 per cent survival for many years, with only a few late recurrences. Early detection can almost guarantee a cure.

During the past three decades the 5-year survival rate for patients diagnosed with nonseminomas has risen from 50-60 per cent to 90 per cent.

Men who have a testicle removed because of cancer need not be concerned about their sexuality or fertility. The remaining healthy testicle can provide enough testosterone to drive a healthy libido and enough sperm to father a nation.

(It wasn’t always widely known that men could remain fertile after losing a testicle. In a celebrated case in the fifties, an Australian man sued his wife for adultery. A well-meaning but ignorant doctor advised him after the operation that he would never be able to have children. When his wife became pregnant, he accused her of infidelity and successfully dragged her through the divorce courts.)

There is no cause, either, for men to worry about emotional problems following the removal of a testicle: a recent British survey into the psychological after-effects of such an operation found nothing significant. All the men seemed to cope very well.

If the cosmetic appearance following surgery is a problem, a plastic prosthesis that looks just like the missing testis can be inserted into the scrotum.

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Here is the bad news: since the age of 10 your brain has been shrinking. At 10 it fitted snugly into your head and there was little room for anything else. By the time you are 90 it will have shrivelled and begun resembling a walnut with plenty of space-between it and the walls of your head.

But don’t worry, because here is the good news: size is not everything. A big brain does not necessarily work better than a small one. There is no correlation between brain size and 1Q. Males have heavier, bigger brains than females, so you would think they would be smarter, but they’re not.

Humans arc born with redundant brain cells. They have more neurones than they can possibly put to profitable use, and up until the age of 10, the brain organises and streamlines itself. Connections that are well used become entrenched and neurons that are not used are allowed to die. During this design process, the brain adapts and remodels itself for the future.

Around the age of 10, you have the brain you will have for life in terms of its bulk and the number of neurones operating.

Later you do a little more remodelling based on experience, but you will have less ability to adapt and you won’t get any more neurones.

From the age of 10 to the age of 15, people experience top neural function. They are not at their wisest, but their brains are at peak function for learning new things. It’s the kind of function that many at the peak of their careers wish they had. In their 40s and early 50s, men commonly begin worrying about their brains.

Overloaded at work, they are anxious about losing memory. Now, more than ever before, they have difficulty remembering names, words are on the tip of their tongues and their recollections are not as sharp as they once were.

The ageing process appears to affect memory. Memory does not go – it is just that sometimes recall is slower.

As we age, it becomes more difficult to keep many balls in air. Younger people can concentrate on several things at the same time. Older people cannot divide their attention as well. While speaking on the phone, I hey cannot talk to someone else and be pencilling in something at the same time.

Anxiety and depression can also affect memory. Distracted by their feelings, men who are anxious or depressed don’t pay attention to what they are doing. In order to lay down a memory you have to attend to the task in hand. It is simple: you have to attend and record it. Only then can you can recall it. If you never attended properly in the first place, you didn’t make the memory and you can’t recall it. Ageing and depression erode your ability to attend.

Men in mid-life, concerned about their brains, might be comforted to know that reaction times actually peak in their mid-40s.

The ability of a 40-something man to react physically in a situation that requires hand-eye coordination is marginally faster than it is in young men. This motor ability is, of course, tied to mental processes.

Although slowing is a major feature of the ageing brain, if older people are given more time, they usually compensate quite successfully and achieve equal accuracy. While a younger brain is better at some creative tasks, such as theoretical physics, other kinds of brain function show tremendous stability into the mid-to-late 70s.

Older men compensate by using stored experience. They will retrace a step to solve a problem that they solved years earlier. Younger people will take a problem they have never seen before, manipulate it and make adjustments. Older people are more likely to use previously learnt rules to attack the problem. If they have never seen it before, it is going to take them longer to deal with, but by their age they’ve usually had considerable experience and this speeds up their performance.

As long as you were healthy, you could still be President of the United States in your late 70s or early 80s. In fact, the average age of US senators is close to 70.

Men in their 60s often feel they are at their intellectual or creative peak. It’s all about focus. By that age, distractions such as child-rearing, career-building and social concerns are usually out of the way, and generally they are enjoying emotional stability. In such situations, men can clarify their priorities and focus on them.

Although there is a strong link between the brain’s ageing process and genetics, it is believed that intellectual activity can slow degeneration. Older men are advised to keep their brain stimulated by taking on intellectual challenges and remaining socially active.

It is known that the progression of dementia is slower in people living in a lively family environment compared to those who are more isolated.

When it comes to brain function, it can be a matter of ‘use it or lose it’.

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There seems to be a very simple activity men can engage in to reduce their risk of discomfort later in life: walking!

Research shows that 2 to 3 hours of walking a week may reduce by 25 per cent a man’s risk of developing common prostate problems. The longer a man lives, the more likely he is to develop these problems. As the years pass, hair thins, muscle wastes and his prostate grows plump with age.

A prostate in a healthy 20-year-old man is the size and shape of a walnut and weighs around 10 grams. A seriously enlarged prostate in a 60-year-old man can be the size of a lemon and weigh 40 grams.

Some men live happily with an enlarged prostate and are never inconvenienced, some bear the discomfort stoically and some find the condition intolerable.

The way a man reacts depends on the extent to which the enlarged prostate interferes with the flow of urine. The lube that carries urine from the bladder to the outside world passes through the centre of the prostate. As the prostate grows, it can constrict the tube with its increased mass, its increased muscle tone or both.

Researchers say that, while it cannot reduce the mass of the prostate, walking can help to reduce its muscle tone. The smooth muscles of the prostate are controlled by the sympathetic nervous system, which regulates the body’s involuntary functions.

The researchers suggest that there is a mechanism by which physical activity causes the sympathetic nervous system to reduce prostatic muscle tone. They base their findings on the experiences of 30 000 men aged between 40 and 75 who are part of an ongoing US prospective study called the Health Professionals Follow-Up Study.

The findings show that those men who are more physically active have fewer symptoms. Inactivity, gauged by the number of hours spent watching television and videos, is associated with more symptoms. While the study shows activity is good for all ages, younger men appear to derive more benefit from high-intensity exercise than from walking.

The prostate has been described as a time bomb ticking away deep in the plumbing of every male. Three main things can go wrong with it: it can become inflamed due to infection, it can become cancerous or it can become enlarged and obstruct the flow of urine. The latter is the most common prostate complaint.

Symptoms caused by enlargement often begin appearing when a man is in his 40s. By the age of 60, most men will have developed some signs of it. Common symptoms include difficulty starting to urinate, a weak urine flow, a urine flow that stops and starts midstream, the need to strain in order to urinate, dribbling, incontinence and water retention.

If the bladder muscles have to work harder to overcome constriction of the urethra, other symptoms may arise, such as discomfort when urinating, urgency, frequency, a need to get up at night to urinate and a feeling of not having emptied the bladder fully.

Drugs that help relax prostate muscle are available in Australia. There is also a drug that can reduce prostate size.

Some say the US research may have been compromised by the placebo effect. (Other studies have shown a placebo response of almost 30 per cent to any treatment for urinary symptoms.) There is also a natural fluctuation in symptoms such as those outlined earlier, and this must be taken into account when considering the effectiveness of treatment.

Many men recover spontaneously. They may, for example, go through a period of dribbling and having to get up at night but find, 3 months later, that their symptoms have resolved themselves without their having taken any action whatsoever.

Perhaps those in the American study who undertook exercise felt better about themselves and this made their prostate symptoms seem less distressing. Perhaps the ones sitting and watching television drank more glasses of beer or cups of tea and as a result had to rush to the toilet more often. There are many possible explanations.

But even if the science is not perfect, it is slill worth doing the walking. Walking confers innumerable other health benefits and, if practised safely and by consenting adults, causes little harm.

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There are men who are needle phobic. They just cannot bring themselves to self-inject anywhere, let alone into their penises. They would rather be impotent, for these men there is a gentle alternative. They can achieve the same effect by inserting a tiny gel pellet into the eye of the penis. This transparent white pellet looks like a grain of rice and, depending on the dosage, is either 3 mm or 6 mm long.

After the pellet has been inserted with a small, lightweight applicator, an erection usually begins building within 7 to 12 minutes. The duration that the resulting erection lasts varies among individuals but is usually between 30 minutes and an hour.

This system is called MUSE, which is an acronym formed from Medical Urethral System for Erections.

Using pellets is, apparently, not difficult, and only in rare cases does a narrowing in the urethra prevent insertion. When this happens, force should never be applied.

Common side effects of MUSE are relatively minor and include burning and aching in the penis and groin, redness in the penis due to increased blood flow and blood spotting due to improper administration.

It uses a single drug called prostaglandin, which is now considered the gold standard for treatment of erectile difficulties and is a well-tested, safe drug.

One thing most men want to know is if it will hurt. At first there may be some discomfort using MUSE, but with repeated use administration usually becomes easier. There are techniques for reducing discomfort.

Men also want to know if it is safe for their partners. During the trials, about 6 per cent of women complained of vaginal burning or itching. It was unclear whether this was caused by MUSI! or by resuming sexual intercourse after a prolonged interval.

MUSE cannot be used with safety more than twice a day.

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A check-up for cancer requires a thorough examination. This must include the skin, the rectum, the genital organs, and the internal organs of the chest and abdomen. Examination of the breasts and the vagina is essential for women.

Everyone should have routine examinations periodically (see Chapter 9). When there is a danger signal or any doubt concerning a possible danger signal, be sure to have an immediate examination.

X-rays

It is advisable to have a chest X-ray made every year, since early lung cancers, as well as tuberculosis and some diseases of the heart, can sometimes be detected in this way.

For examination of the stomach and intestines, the X-ray involves special techniques that seem fairly complicated, including the use of barium sulphate that is either swallowed or inserted through the rectum. When barium is in the stomach or large intestine, the organ is revealed as a silhouette on the X-ray film.

Special examinations

Your doctor has available highly specialized instruments that are extremely valuable in studying the internal organs and locating small cancers in their early, curable stages. These instruments work on the principle of a periscope. A slender, usually flexible, tube is inserted into the region to be studied. A tiny bulb at the end lights up the area of the body that is being examined.

Radioisotopes

These are used widely in diagnosing cancer in certain organs, such as the thyroid gland and the liver. Radio-active forms of iodine, phosphorus, gold, iron, or cobalt tend to concentrate in certain organs, making it easier for doctors to diagnose the state of the organ.

Biopsy

This is the definite way of determining whether or not even a tiny growth is cancerous or precancerous. A bit of tissue is removed and examined under the microscope. This examination is made by a pathologist, a doctor who specializes in determining from the appearance of tissue whether it is normal or shows signs of a tumour or other disease.

Sometimes it is not possible to perform a biopsy until the time of the actual operation on a rumour. In such a case, a small piece of tissue is removed during the operation and given to the waiting pathologist, who freezes it immediately, examines it under the microscope, and gives the report to the surgeon. This procedure is called the frozen section technique.

Papanicolaou (Pap) smear test

This simple test is used in detecting cancers of the lung, the stomach, and, particularly, the cervix (the mouth of the uterus). Fluid from one of these parts of the body is put on a slide and placed under the microscope.

Blood test

The blood is tested chemically for cancer of the prostate and for a rare malignancy of the bone marrow called multiple myeloma. A blood smear and blood count help in the diagnosis of leukaemias, but this is not a chemical test.

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I describe worm (more properly called intestinal parasite) infections at this point because parents so often blame them for convulsions in children. It is a safe rule that convulsions are never caused by worms.

Another misconception about intestinal parasites is that they are contracted from an infected household pet or other animal. The chief worm infections of children are contracted from human beings.

Roundworm infection (ascariasis)

These worms look like earthworms and may sometimes be seen in the bowel movements or in the child’s bed. Occasionally, one may be vomited. The worm should be saved to show the doctor.

A child infected with roundworms may become irritable and restless at night; he will probably develop an erratic or poor appetite.

The worms can be discharged from the intestine by special medicines that must be administered under a doctor’s care. Do not try to treat worms by getting medicines at a pharmacy.

Pinworm infection

The pinworm, also called the seatworm, is the most common worm to infect children. Pinworm infections occur in the intestine. The tiny worms measure less than a half inch in length. They do not debilitate a child as do heavy infestations of roundworms. But they cause trouble by their habit of coming out around the anal region during sleep. The worms irritate the region around the anus, leading to painful scratching and restless sleep. Occasionally, a pinworm will migrate into the tiny vaginal opening in a female child, where it will cause intense itching. Do not treat pinworm infections yourself.

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Women who have the following disorders should avoid becoming pregnant unless they have their doctor’s approval:

Heart disease

Kidney disease, especially Bright’s disease and chronic pyelitis

High blood-pressure

Diabetes

Tuberculosis

Venereal disease

Some of these illnesses can be cured completely. Others, if they are not too severe or can be controlled, will not necessarily endanger the life of the mother or baby. Even heart disease does not, in many instances, constitute too serious a problem if proper care is taken. But only a doctor can decide whether pregnancy will be dangerous in each individual case.

Other disorders

I feel it is most unfair to bring a child into the world if the mother is mentally ill. In most cases, it is scarcely less unfair to do so if the father is suffering from serious emotional illness. Also, I very much doubt the wisdom of having children if they are apt to inherit a disease that may make their lives miserable. Fortunately, such diseases are very rare, and there is, of course, the possibility that a cure will be found for them. I am thinking, for example, of haemophilia, the bleeding disease that is disabling and often fatal.

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A vacation should not be considered a luxury. Getting away from the regular routine is a necessity for both physical and mental health.

Tell your doctor not only where you plan to go, but also how you plan to get there, whether by train, plane, ship, or car. Your doctor has medicines to help prevent most cases of motion sickness. He will advise you to avoid places at certain seasons if you have a tendency to hay fever. He will tell you what inoculations you need if you are going abroad. The following items are suggested as a medical kit for all vacationers:

Aspirin, for headache, fever, muscle aches and pains Antiseptic, such as hydrogen peroxide, tincture of iodine or

benzalkonium chloride Skin lotion, to protect you against sunburn and windburn Anti-nauseant, for motion sickness Antacid, for mild stomach upset

Sedative, for emotional upset, overstimulation or nervous upset Broadband antibiotic, effective against a wide range of bacteria,

in case of serious illness; to be selected by your doctor and

used precisely as he instructs you A container of small bandages Sterilized gauze squares Roll of adhesive tape, one half inch wide Pectin-kaolin compound for diarrhoea Decongestants, for the common cold

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The eye is like a camera. The front part consists of the cornea— the transparent area in the centre—surrounded by the sclera, as the white of the eye is called. Behind the cornea is the coloured part, or iris, in the middle of which is the pupil, which grows larger or smaller to control the amount of light let into the ‘camera.’ The clear, transparent lens, located slightly behind the front surface, focuses the image on the retina, which is about three quarters of an inch behind it. The optic nerve carries the picture from the retina to the brain. The eye also contains muscles to do this work and fluid to keep the parts in working condition.

If I asked you whether you would mind being blind, you would call it a ridiculous question. Most people consider blindness the worst thing that could happen to them. But you would never guess it from the way they treat their eyes!

Probably some of you who are reading this have to squint to do so, or hold the book close to your nose, or wish your arms were longer so you could hold it farther away. You know you should have your eyes examined—but you put it off because it can wait, or because you do not want to be told you have to wear glasses. Even some serious eye conditions have been neglected, with tragic consequences, for these foolish reasons.

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