Obese children now from lower-income households

In bygone times having large children were prized. It was a sign that you were rich, had the wealth to feed your children and that they ate well. Unlike those skinny people who had no food to eat. Larger children were a mark of status, coming from higher income households where there was more disposale wealth.

This trend appears to be reversing. A study of obese children in England found that many of them were of poorer socio-economic backgrounds.

How has this happened? It is easy to point the finger at an abundance of high fat, high calorie, cheap food. In short, fast food.

Take a walk down your high street. Start by counting how many chip shops you can see, or shops selling fried chicken. You would probably see a fair few. And see what happens when the kids are dismissed after school. You will see many crowding around these shops, getting their fill of fried chicken and chips.

To top that all off: to quench their thirst after consuming the oily, high sodium food, many opt for sugary fizzy drinks.

The high fat, high calorie, high sugar diet is repeated over many days and weeks. We may talk of the social responsibility in allowing fast food places to target school children but that is what happens because fast food shops know where the bulk of their clients lie. To make matters worse, some children assume that eating fried chicken gives them protein to grow big, which is what they want. Chicken is a source of protein, but when fried it is high in fat and the combination of caloric drinks does not help either.

The consumption of such a high fat diet is a ticking time bomb for the NHS. In two or three decades from now many people will increasingly be obese, and there will be a higher population of middle-aged obese that threatens to burden the NHS.

The NHS should encourage exercise, but unfortunately many of the measures – such as to take 10,000 steps a day – are ill conceived. You could do 10,000 steps a day, but if that is done at a slow pace that hardly taxes your heart rate, you are not burning fat. In addition, fat burning only takes place after the body has been active for at least twenty minutes, at a heart rate of at least 60% MHR (Maximal Heart Rate).

The overabundance of cheap fast food has meant that lower income families see it as a cheap affordable way to feed their children. And when their children get obese, they are viewed as being “big” which many think is good for them.

We are at a point of disconnect, but what we have to address is this. Better, nutritional food costs more. And it doesn’t taste as good at the same price. Unless we can introduce subsidies on healthy food, we will only evolve into a society that increasingly consumes junk food. The price we pay for promoting healthy eating through subsidies will go a longer way towards reducing the ticking time bomb of poor social health.

Going herbal? Switch with caution

Do you use herbal remedies rather than traditional medicines? If you belong to the former group, you may find yourself part of a growing number of individuals who may be increasingly opting for the herbal medicine route in favour of the traditional medicine route.

What makes people resort to traditional medicine? There are many reasons. One may be that they have been on a particular type of medication for a long period of time, and have seen no improvement, and are keen to try something that might bring about change. For example, if you have been suffering from migraines for quite a long time, and the medication does not appear to alleviate the severity of the frequency of the headaches, then would you not be tempted into trying something else that might work? After all, you might think that if you do not try, you might miss out of the potential benefits. Hence, the search for a better treatment might be a motivating reason for going herbal.

But seeking products that might work better because they are more naturally occurring and possibly more readily adopted by the body may only be one reason for switching to or trying herbal remedies. Traditional medicine also carries risks of adaptation and addiction, which is why some individuals consider switching.

Take for example pain relief medicines such as ibuprofen. If taken consistently for a long period of time, the body adapts to this increased level and the benefit of ibuprofen is gradually neutralised and minimised. It does not bring pain relief if taken on a prolonged basis because the body has adapted. But because the body has acclimatised or become accustomed to this, it now depends on this level of ibuprofen. The medicine has now bred dependency, and an individual is now addicted to it. It is possible that something more potent in terms of pain relief may be prescribed by doctors but again with prolonged use there is the danger of adaptation and addiction, but this time to a higher dose.

Medicines also produce side effects if used for long term. We have already examined for example the effect of aspirin in the elderly – it can cause bleeding and other complications.

Hence it is unsurprising that individuals look to the herbal medicine route as a means of avoiding greater dependency on drugs, to avoid tampering with the body’s natural ability to heal itself, and in the hope that herbal remedies could provide a quick alternative resolution to medical issues that they have had long term treatment for.

The herbal medicine world is not as regulated as the traditional medicine world although there is increasingly a tightening on the controls, especially on the advertising and promotion of products to make sure that products cannot make claims to curing certain illnesses.

While some may protest into the regulation of the herbal medicine market as the clamping down on civic liberties by an over protectionist nanny state, there are actually valid medical reasons for these interventions.

Herbal remedies may interact with traditional medicines and cause conflicts. They may either neutralise the potency of the traditional drug, or enhance it to dangerous levels above recommended limits.

The most often reported drugs that can come into conflict with traditional drugs include the blood-thinning drug warfarin, cholesterol-lowering statins, anti-cancer drugs, antidepressants, immunosuppressant drugs for organ transplants and antiretroviral drugs for people with HIV. The most common result of a drug herb interference was that of cardiovascular disease, involving medicine such as statins and warfarin. Other unwanted spheres of influence include cancer, kidney transplants, depression, schizophrenia, anxiety disorders and seizures.

The most commonly used herbal remedies included ginkgo biloba, St John’s wort, ginseng, sage, flaxseed, cranberry, goji juice, green tea, chamomile and turmeric, while those most likely to cause interactions with drugs appear to be sage, flaxseed, St John’s wort, cranberry, goji juice, green tea and chamomile.

In some cases herbal remedies can lead to death or secondary death. One man died after a herbal remedy prevented his anti-seizure medication from working properly, resulting in him drowning.

These facts highlight the need for patients to inform their doctors if they are taking other forms of herbal medication apart from the medication that the doctors are prescribing, so that the doctors can examine if there might be interference in the interactions. This need is particularly important if among the drugs are those that have been identified as being likely to be affected by herbal remedies.

But what stops people from mentioning they are trying herbal remedies? One main reason is embarrassment. Alternative remedies still have a reputation for being outside the periphery of the mainstream and carry with them the stigma of being unconventional, flaky and based on superstitious beliefs. Some might question their unscientific basis as a whole load of quackery, akin to snake oil or elephant powder. Subscribing to herbal remedies in some circles in seen as being illogical. And no one wants to be perceived as a nutter.

There is also the perception of owning up to being a failure for whom traditional medicine has not worked for.

The crossover group is the one most at risk as they are most likely to continue taking the doctor’s medication while trying herbal remedies at their prescribed doseages. In other words, they are most likely to take double of what is recommended in a bid to get the best of both worlds.

Herbal remedies may prove their worth in time. But in the meantime, while we move towards a scientific study, regulation and understanding of non-pharmaceutical medicines, it is best to be cautious of interference and their crossover effect.

The higher cost of body embarrassment

If you were a bloke, would you avoid going to the doctor’s if it meant you had to strip off for the doctor to examine an area of your body you had concern about? Chances are men who have found a lump in their testicles might put off going to the doctor’s for a couple of days, drinking lots of water in the hope that it would go down, and if the lump remained, then work up the courage to make an appointment to see a doctor about it. Why put it off for a few days? It is probably down to the fact that it is slightly awkward and embarrassing to strip off to your private areas in front of someone else, despite the fact that doctors are professional and the health concerns are pressing. Despite the risk that the lumps may need to be operated on, some leave it late – and even a bit too late – because of the embarrassment.

But the embarrassment is not just down to men. Women put off going for tests and checkups because of the awkwardness around their perceived bodies. The BBC News website reported that women were avoiding smear tests to detect cervical cancer, with some either delaying making an appointment, or skipping screening altogether.

Cervical cancer accounts for an average of more than two deaths a day. Over 900 women die annually from it. Each day an average of nine women a day are diagnosed with it. All women aged 25 to 49 are invited for a screening test every three years. From the ages of fifty to sixty-four, this is reduced to once every five years.

Among those aged 25 to 29, more than one in three skip the cervical screening, a statistic that is worrying as the women more likely to get such cancer is the age group most likely to avoid the screening tests meant to catch it.

For what reasons do women avoid such tests?

One survey of around 2000 women found that their embarrssment about body shape was the most largely quoted reason for not attending. In other words, women were not comfortable with their own bodies in front of others. Other women also thought that they were healthy, being regulars of exercise or the gym, and thought that they were of a lower risk than others. A third did not believe that cervical screening reduces the risk of cancer at all. The results of the survey suggest that more importance needs to be placed on educating women of the benefits of screening.

The test only takes five minutes but perhaps one of the biggest barriers facing women was the awkardness if a male doctor or nurse was the one conducting the cervical screening. But women do have the option of asking in advance for a female to carry out the test, and many already do.

Jo’s Cervical Cancer Turst, the only charity in the UK dedicated to women suffers of this form of cancer, is working to improve detection rates and hence reduce the emotional impact of cancer on women and their families. The current screening is the greatest form of protection against such cancer, and helps save the NHS money by preventing the need for later surgery. The treatment of early stage cancer iis estimated by the charity to cost less than a tenth of later stage cancer.

It is not clear from the survery whether the women were representative of different regions, beliefs, or socio-economic groups. Women from certain cultures may find it more socially unacceptable to be naked in front of other individuals, let alone male doctors, and hence not attend screening for such reasons and are likely not to.

Appearance of the body shape and the vulva accounted for 84% or cervical smear absentees. Of these, 38% were also concerned that they might not smell normal, while 31% would not have gone had they not shaved or waxed their bikini area.

A senior nurse mentioned that nurses are aware of the awkwardness of showing an intimate part of the body to someone else but are sensitive to make the procedure less embarrassing so that women continue to have acceptable experiences that do not put them off screening for cancer. A chaperone is always offered and if women prefer to take a friend or partner with them that is fine too. It would be a great shame if women were put off seeking medical advice because of their embarrassment – it would be too great a price to pay for a small period of minimal inconvenience. The same goes for men and visits to their doctors too.

Your daily sausage roll may exact its revenge on you in good time

Ever wonder why people go on a vegetarian or a vegan diet? There are many reasons I can think of.

The most common one is that people are very much against animal cruelty. People who avoid eating animal-based products are against the farming of animals, because they are convinced that animals are treated inhumanely. For example, battery hens are kept in small cages in large densities. Imagine if you and your fellow co-workers were put together in a small room, without any desks, and told to make the most of it. You’d all be up in arms about the way you were treated. The only difference between you and hens is that hens can’t protest about it.

The transition to a vegan diet is not just about not eating animals, although this can be a factor too. Vegans are against the eating of animal meat because of the way farm animals are killed. Cows, pigs and chickens, the main farm animals that are killed to provide the common English foods such as the English breakfast comprising sausages, bacon and eggs, are – in the opinion of vegans – inhumanely killed, despite the best of measures.

Do you know how a chicken is killed before it ends up deep fried in bread crumbs and served with your chips and bottle of cola? There are two main ways. The first is by electric methods. First of all, the birds are shackled to a conveyor belt by their legs, upside down. Needless to say, they don’t willingly walk to the machine and pick their positions. There is a lot of fluttering about, human exasperation, and rough handling of the birds which may result in broken bones – who cares, right? After all, the bird is going to be dead soon – before the conveyor belt brings the birds upside down into a water bath primed with an electric circuit. The moment the bird’s head touches the water, it is electrocuted to death.

The second method involves gassing to death. Birds are transported in their crates and exposed to suffocation. This method is arguably more humane, supporters say, because the birds are not manhandled. But don’t be fooled into thinking the bird’s welfare is under consideration. It is a faster, less human-intensive way of killing the birds. Sling them in the box and gas them to death. No messing around trying to catch the flapping things. Avoiding the need to shackle them also saves time.

There is a third reason often quoted for going further in being a vegan. Cows produce vast amounts of methane and if everyone stopped eating beef, it would be better for the enviroment. In this instance, it is not so much for the animal’s welfare, but more for the sake of avoiding the environmental pollution by the animal.

There may soon be another fourth reason for avoiding meat. Processed meats – which have been preserved using methods such as salting, curing, smoking or adding preservatives – have been linked with cancer.

A study involving 262,195 UK women showed links of breast cancer and processed meat. Postmenopausal women who ate processed meat had a 9% higher chance of getting breast cancer than women who ate no processed meat. Those who consumed more than 9g of processed meat had a 21% chance of getting cancer in comparison to those who avoided it altogether.

The study is significant because the sample size is large – not just 100 women, or a small negligible figure whose results may bias findings, but over 250,000 women; more than enough to be taken seriously.

The women were all between the ages of 40-69 and free of cancer when they were recruited for the study before 2010. They were followed for a period of seven years and the results examined.

Process meats are thought to possibly cause cancer because the methods involved in processing the meat may lead to the formation of cancer-causing compounds called carcinogens.

What is not so clear is whether it was the eating of processed meats in isolation that caused the development of cancer. There are other factors that should be taken into account, of course, such as alcohol, exercise, work stress, lifestyle factors and body mass index. Certain ethnicities may also be prone to developing cancer because of other dietary factors such as cooking with oil, ghee or lard.

The results also did not suggest that the findings would be equally applicable to men.

Nevertheless, it would be a good idea, if you were an older woman, to avoid eating processed meat every day. Instead the consumption could be limited to once every other day, or eating it as an occasional treat. Or cut out the meat completely – a switch to a vegetarian or a vegan diet would not only be good for your health. You would be considering the environment too.

The bigger issues that come with preventing hearing loss

Is there cause for optimism when it comes to preventing hearing loss? Certainly the latest research into this suggests that if positive effects experienced by mice could be transferred to humans and maintained for the long term, then hereditary hearing loss could be a thing of the past.

It has always been assumed that hearing loss is always down to old age. The commonly held view is that as people grow older, their muscles and body functions deteriorate with time to the point that muscle function is impaired and eventually lost. But hearing loss is not necessarily down to age, although there are cases where constant exposure to loud noise, over time, causes reduced sensitivity to aural stimuli. Over half of hearing loss cases are actually due to inheriting faulty genetic mutations from parents.

How do we hear? The hair cells of the inner ear called the cochlea respond to vibrations and these signals are sent to the brain to interpret. The brain processes these signals in terms of frequency, duration and timbre in order to translate them into signals we know.

For example, if we hear a high frequency sound of short duration that is shrill, our brain interprets these characteristics and then runs through a database of audio sounds, an audio library in the brain, and may come up with the suggestion that it has come from a whistle and may signify a call for attention.

What happens when you have a genetic hearing loss gene? The hairs on the inner ear do not grow back and consequently sound vibration from external stimuli do not get passed on to the brain.

With progressive hearing loss too, the characteristics of sound also get distorted. We may hear sounds differently to how they are produced, thereby misinterpreting their meaning. Sounds of higher and lower frequency may be less audible too.

How does that cause a problem? Imagine an alarm. It is set on a high frequency so that it attracts attention. If your ability to hear high frequencies is gradually dulled then you may not be able to detect the sound of an alarm going off.

As hearing gradually deteriorates, the timbre of a sound changes. Sharper sounds become duller, and in the case of the alarm, you may hear it, but it may sound more muted and the brain may not be able to recognise that it is an alarm being heard.

Another problem with hearing loss is the loss of perception of volume. You may be crossing the road and a car might sound its horn if you suddenly encroach into its path. But if you cannot hear that the volume is loud, you may perceive it to be from a car far away and may not realise you are in danger.

The loss of the hairs in the inner ear is a cause of deafness in humans, particularly those for whom hearing loss is genetic. Humans suffering from hereditary hearing loss lose the hairs of the inner ear, which result in the difficulties mentioned above. But there is hope. In a research experiment, scientists successfully delayed the loss of the hairs in the inner ear for mice using a technique that edited away the genetic mutation that causes the loss of the hairs in the cochlea.

Mice were bred with the faulty gene that caused hearing loss. But using a technology known as Crispr, the faulty gene was replaced with a healthy normal one. After about eight weeks, the hairs in the inner ears of mice with genetic predisposition to hearing loss flourished, compared to similar mice which had not been treated. The genetic editing technique had removed the faulty gene which caused hearing loss. The treated mice were assessed for responsiveness to stimuli and showed positive gains.

We could be optimistic about the results but it is important to stress the need to be cautious.

Firstly, the research was conducted on mice and not humans. It is important to state that certain experiments that have been successful in animals have not necessarily had similar success when tried on humans.

Secondly, while the benefits in mice were seen in eight weeks, it may take longer in humans, if at all successful.

Thirdly, we should remember that the experiment worked for the mice which had the genetic mutation that would eventually cause deafness. In other words, they had their hearing at birth but were susceptible to losing it. The technique prevented degeneration in hearing in mice but would not help mice that were deaf at birth from gaining hearing they never had.

Every research carries ethical issues and this one was no different. Firstly, one ethical issue is the recurring one of whether animals should ever be used for research. Should mice be bred for the purposes of research? Are all the mice used? Are they accounted for? Is there someone from Health and Safety going around with a clipboard accounting for the mice? And what happens to the mice when the research has ceased? Are they put down, or released into the ecosystem? “Don’t be silly,” I hear you say, “it’s only mice.” That’s the problem. The devaluation of life, despite the fact that it belongs to another, is what eventually leads to a disregard for other life and human life in general. Would research scientists, in the quest for answers, eventually take to conducting research on beggars, those who sleep rough, or criminals? Would they experiment on orphans or unwanted babies?

The second, when it comes to genetics, is whether genetic experimentation furthers good or promotes misuse. The answer, I suppose, is that the knowledge empowers, but one cannot govern its control. The knowledge that genetic mutation can be edited is good news, perhaps, because it means we can genetically alter, perhaps, disabilities or life-threatening diseases from the onset by removing them. But this, on the other hand, may promote the rise of designer babies, where mothers genetically select features such as blue eyes for their unborn child to enhance their features from birth, and this would promote misuse in the medical community.

Would the use of what is probably best termed genetic surgery be more prominent in the future? One can only suppose so. Once procedures have become more widespread it is certain to conclude that more of such surgeons will become available, to cater for the rich and famous. It may be possible to delay the aging process by genetic surgery, perhaps by removing the gene that causes skin to age, instead of using botox and other external surgical procedures.

Would such genetic surgery ever be available on the NHS? For example, if the cancer gene were identified and could be genetically snipped off, would patients request this instead of medical tablets and other external surgical processes? One way of looking at it is that the NHS is so cash-strapped that under QALY rules, where the cost of a procedure is weighed against the number of quality life years it adds, the cost of genetic surgery would only be limited to more serious illnesses, and certainly not for those down the rung. But perhaps for younger individuals suffering from serious illnesses, such as depression, the cost of a surgical procedure may far outweigh a lifetime’s cost of medication of anti-depressant, anti-psychotics or antibiotics. If you could pinpoint a gene that causes a specific pain response, you might alter it to the point you may not need aspirin, too much of which causes bleeds. And if you could genetically locate what causes dementia in another person, would you not be considered unethical if you let the gene remain, thereby denying others the chance to live a quality life in their latter years?

Genetic editing may be a new technique for the moment but if there is sufficient investment into infrastructure and the corpus of genetic surgery information widens, don’t be surprised if we start seeing more of that in the next century. The cost of genetic editing may outweigh the cost of lifelong medication and side effects, and may prove to be not just more sustainable for the environment but more agreeable to the limited NHS budget.

Most of us won’t be around by then, of course. That is unless we’ve managed to remove the sickness and death genes.

Ethically spending a million pounds on useful research

Does offering financial incentives encourage mothers of newborns to breastfeed? While this may seem incredulous, a study actually was implemented in parts of England to see if this would be the case.

More than 10,000 mothers across regions such as South Yorkshire, Derbyshire and north Nottinghamshire took part in the trial, where mothers were given a hundred and twenty pounds if they breastfed their babies, and a further eighty pounds if they continued up to the point the babies were six months old. That is to say mothers received two hundred pounds if their babies were breastfed up to the age of six months.

But why was this implemented in the first place? One of the reasons the study was done was to see if financial incentives would help raise the rate of breastfeeding in the UK. In some parts of the UK, only one in eight babies are breastfed past eight weeks. The early suspension of breastfeeding causes later problems in life for babies, and this was a study to see if it would be possible to save a reported seventeen million pounds in annual hospital admissions or GP visits.

How were these women chosen? They were picked from areas which were reportedly low-income ones. There was a suggestion that in low-income areas, mothers feel obliged to return to work quickly and breastfeeding is inconvenient and a reason why mothers stop it.

The financial incentive did result in a rise of six percentage points, from 32% to 38%. This meant that over six hundred more mothers in the ten thousand breastfed their babies for up to six months instead of the hypothetical eight week line.

Should we get excited about these results? Caution is to be exercised.

As a few leading academics noted, there was no way to monitor a reported increase. The mother’s word was taken at face value but there was no way to monitor that a prolonged breastfeeding period actually took place. It would not be inaccurate to say that of these six hundred mothers, some merely reported they had breastfed for longer but without actually doing it. If you live in an income-deprived area, and were offered two hundred pounds of shopping at a time when you needed it, without having to do much apart from saying “Yes, I breastfed”, wouldn’t you take the easy money?

It was mentioned that if the results did have a high percentage of trustworthiness to them, in other words, if mothers breastfed as they said they had done, it would help normalise breastfeeding in regions where it might cause embarrassment to the mother. Why might breastfeeding cause embarrassment? For example, in some social situations it might be slightly awkward to reveal normally covered parts of the body in public.

How much did the scheme cost? If we assume that 38% of 10000 mothers breastfed and claimed these financial vouchers, that’s around 4000 mothers each claiming two hundred pounds, at a cost of eight hundred thousand pounds.

Wow. Eight hundred thousand pounds of free shopping for which an outcome cannot be undisputably proven. Where does all the money come from?

The Medical Research Council was funded to the tune of up to seven hundred and fifty-five million pounds in 2016/17, or which nearly half was provided as grants to researchers. But while all that may sound as a lot of money, surely there should be more accountability in how the money is used. Using up nearly a million pounds of that money for a trial whose results cannot be justified is not a good use of money.

But perhaps the babies’ height, weight and other factors pertaining to breastfeeding could have been taken? For example, if we know that breastfeeding has benefits in certain areas, such as in growth charts, perhaps the babies that were breastfed in that study could have been measured against babies who had not been breastfed to see if there had been any positive gain, and something that could correlate to breastfeeding over the six month period?

Imagine if this had been a study about literacy. Imagine that mothers who read two stories to their child up to the age of four years would receive two hundred pounds. Surely, at the end of the period, the research scientists would not merely be going to the mothers and saying “Did you read to your child? Yes? Here’s two hundred pounds.” They would try to assess the child, perhaps by means of a literacy test of some form, to see if any reading had actually taken place.

Otherwise it is just money down the drain for results which cannot be proven and cannot be relied on. In that case, what is the purpose of spending money on hearsay?

Did giving eight hundred thousand pounds encourage mothers in income-deprived areas to breastfeed for longer periods? Who knows? The only thing we can be sure of is that eight hundred thousand pounds made them say they did it.

Set aside time and space for your own mental health

Work places huge demands on modern living. It goes without saying that over generations work demands have increased. For example, generations ago the concept of a traditional job for most people was a five-day working working week. The song “9 to 5” by Dolly Parton more or less captured the essence of work at the time. (Unfortunately, it is still fairly often played, to the point that people in non-Western societies assume we still only work eight hour days, five times a week, and spend our free time sunning ourselves on the beach.) Nowadays people have to work longer hours, and travel further for work. The total time spent each day traveling and working each day could easily amount to twelve hours, and it is not like the commute is down time – we still have to catch up on emails, admin, and type away busily on the laptop. We could easily spend sixty hours doing work-related things.

And the weekends? Forget the weekends. These days there is no distinction between a weekday and a weekend. Work has steadily grown its talons and where an hourly-rated individual used to get 1.5 or two times the normal rate for working on a weekend, these days it is the same. Employers realise that in an economy with job shortages, they can get away with offering less rates but will not be short of takers.

The problem with all this is that we don’t really have much of a choice when it comes to establishing our work boundaries or exercise or rights when we realise we are being pushed beyond our work boundaries. We’re made to feel that in these times, we are lucky to hold down a job, and if we complain about the increasing demands of it, and how higher managers try to force more work on us without increasing our pay, we might get told to take a hike and end up in a more difficult situation of having no job, commitments to uphold and having to start out again. There are lots of people trapped in jobs where they have to take on more and more as the years go by, and have every ounce of work and free hour extracted from them for little pay. This places increasing mental demands on the individual not just in having to cope with work demands, but the possibility of being made redundant if he or she shows weakness by having to admit an inability to cope any more. It is a no win situation.

Is it a surprising statistic that mental health illness is on the rise? Hardly.

Nowadays people are working more to live and living to work more.

What can you do to preserve some semblance of mental health?

The first thing you can do for yourself is to establish boundaries within the home. Establish a space where work does not intrude. A good idea is often the bedroom, or even have a rule that you will not work on the bed. If you end up working on your laptop in the bed, it will not do you any good – keep at least a certain physical space for yourself.

Also try to set aside a time each day for yourself if possible. It is possibly unrealistic to say an hour each day in the modern life climate, but something like twenty minutes to half an hour would be a good idea. Use this time to wind down in your personal space doing something you enjoy, that is different from work. You may think you cannot really afford that time, but it is important to disassociate yourself from work for the sake of your long-term longevity. Think of it as enforced rest. If it works better for you, take your enforced in the middle part of the working day. You don’t necessarily have to be doing something, use it to rest or catch a power nap.

Every now again, such as on a weekend, do something different from work. Do a yoga class, learn an instrument like the piano, or play a game of tennis. The possibilities for leisure are endless. But don’t bring your work approach to your leisure. Don’t start charting your tennis serve percentage, or do anything that makes your leisure activity appear like work in a different form. The only thing you must do with a businesslike approach is to meet this leisure appointment so that your life does not revolve around a continuous stretch of work.

We can moan about it but the nature of work will never revert back to how it was in the past. Those of us who long for the good old days will only make our own lives miserable with wishful thinking. Those of us who insist on working five-day weeks will find it is insufficient to maintain modern living in the twenty-first century. We will all end up working longer and harder in the current economic climate, and even if times improve, employers will be unlikely to go back to pre-existing forms of remuneration if workers have already been accustomed and conditioned to work at a certain level, because it is more cost effective to hire fewer employees who do more work than have the same work done by more employees. Employees have to recognise that adapting to increasing work loads are a working life skill, and that taking steps to negate increasing pressures will also be an essential part to maintaining our own mental health and well-being.