It is that time again. New Year’s resolutions galore. Some about personal matters and some about professional behaviour. The commonest resolutions though are about some aspect of health. And in health it comes down to three basic types. About stopping some undesirable behaviour, taking up some desirable behaviour, and losing weight.

In the category of stopping things, the commonest resolution is probably to give up cigarettes. Without expending too much space on this question, it is enough to say that smoking cigarettes is bad. Even cutting down the number of cigarettes smoked does not eliminate the medical risks from smoking. However, there is some evidence that switching to e-cigarettes (vaping) does eliminate many of the major medical risks associated with cigarettes. The final medical decision in this matter though is still not in.

The second commonest issue is about drinking alcoholic beverages. Religious reason to avoid alcohol stands in its place. However, there seems to be some evidence that moderate alcohol consumption especially of red wine is not harmful and might even be beneficial. Moderate means two glasses of wine for men and one glass of wine for women in one day. The unfortunate fact is that most imbibers of alcoholic beverages are into ‘binge drinking’. Binge drinking is having more than three drinks at one time and that also more often than once or twice in a week. Once the line is crossed from moderate drinking to binge or heavy drinking, the risks multiply.

The third thing that people often think of giving up is a particular type of food, usually red meat. Many think about becoming vegetarians. There are good social reasons to give up meat. However, from a medical point of view vegan diets are no better than other diets as long as all foods are consumed in moderation and ‘processed’ foods (precooked-prepackaged) and ‘fast foods’ are avoided. It is entirely possible to have a healthy diet that does not include meat in any form.

Now to things that most people resolve to take up in a new year. Of these the most common resolution is about starting an exercise programme. Exercise is good. Inactivity is bad. That said how much exercise is good for you? The answer is a simple one. Whatever you can do and as much as you can do is good. From a medical point of view a brisk fifteen minute walk five times a week provides most medical benefits. However, more strenuous exercise has other benefits that include for instance better brain function in older people. Exercise is even thought to decrease the incidence of many, if not most, adult cancers.

It is important to remember that exercise by itself is usually not enough to lose weight. Also regular strenuous exercise is difficult to keep up for most people that have not exercised vigorously in the past. An important point for people that are getting along in years and want to start off a vigorous exercise programme, go get checked by a doctor to make sure that you can actually get involved in different types of exercise. Worry about the heart, knee joints, the back and other such stuff.

One of the major new trends or perhaps a recurrent trend is about yoga and meditation. If you can do it, good for you but yoga can be a problem for those of us that are not as ‘supple’ as we used to be. As far as meditation is concerned, it is now called being mindful. A bit more than forty years ago, yoga, meditation and The Beatles were all very popular. But mind altering drugs were also quite popular in those ‘heady days’. Times change but some things do keep coming back. One thing though. Taking time to relax and think of things besides work is good even if done for just a few minutes every day. However, this last bit of advice is definitely not meant for our ‘civil servants’. They, if reports are correct, spend more time in a day thinking of other things rather than their official duties and responsibilities.

Perhaps the most frequent New Year’s resolution is to lose weight. Through most of my life, personally as well as professionally, the desire to lose weight is overwhelmingly common. From a medical perspective, weight loss can be divided into two broad categories. First one is for cosmetic reasons. The second one is for medical reasons. I will treat these two separately. The old adage that you will lose weight if you eat less still stands, but with many caveats. Most commercial diets out there are effective in producing a weight loss but in most cases the weight comes back on once the diet is stopped.

First then to the problem of the very overweight or the obese. This sort of weight problem is a major health issue. Such people are prone to getting Diabetes (sugar) at an early age and also develop problems like high blood pressure and heart problems. Besides these, obesity also increases the risk for many different cancers. For people in this category, most weight loss programmes are effective but only for a short time. Evidently the body has reset itself at the higher weight and will return to it once a particular diet is stopped.

For the obese, medical help is often needed besides diet and exercise. However, the one type of treatment that is most effective in not only decreasing weight but also keeping it off is ‘bariatric’ surgery. This sort of surgery essentially removes most of the stomach and bypasses food almost directly into the small intestine. Most medical studies done on such people suggest that the weight loss is relatively permanent and is accompanied with a change for the desire for food. Such operations can even reverse high blood sugar as well as high blood pressure. The major problem with these operations is that they cannot be reversed.

For people who think that they are overweight but have just put on a few kilos over a period of time, weight loss is much easier. The important thing even in such people is that weight loss can be achieved rapidly with low calorie diets but to keep the weight off, some life style change is needed. The first thing is to start eating ‘healthy’. This means eating more fruits and vegetables and less meat and starchy and sugary things. And a certain level of physical activity above the normal must also be included. Even losing a few kilos in people of a certain age can delay or even prevent the onset of Diabetes, high blood pressure and heart disease.

Medical data suggests that being a little overweight is protective during major illness. So getting too thin is definitely not a good idea. And as we get older, both men and women might benefit from taking dietary supplements like different vitamins and other micronutrients, but only after discussing it with a doctor. And one resolution if you haven’t made it yet. Find a good doctor and have him check you out at least once a year especially if you have crossed the big four oh.