Health & Wellbeing with Dr Caroline West

Dr Caroline West is a busy woman. She’s been a GP and director of a medical practice for over 25 years. In addition to that she’s mother to three teenage children, and has had a long and extensive media career – from her days as a science reporter on Beyond 2000 to being the resident health expert on Nine’s Mornings.

When she joined her King’s Cross practice in the 1980s, the area was, and possibly still is, the epicentre of drugs, alcohol and violence in Sydney. Dr West says 70% of the health issues her patients list are directly linked to lifestyle – yes, drugs and alcohol – but also bad diet, lack of sleep and not exercising.

In fact, Dr West says the three major factors that affect stress management are “exercise, nutrition and your mindset”.

You control your health destiny

The two things Dr West constantly hears from her patients when discussing strategies for combatting stress are, ‘I’m really tired’ and ‘I don’t have much time’. When people say they don’t have enough time to exercise, what they’re really saying is that they haven’t created the time. You should plan for your exercise – just as you would plan to have meals tomorrow.

“You need the planned exercise, which has the intensity, but you also need the general background movement to stay healthy. If you don’t make time for good health now, you’ll have to make a whole lot of time at the other end for bad health. There is so much evidence that you are controlling your health destiny by how you live your life along the way.”

“Sitting is the new smoking”

“You may have heard the expression ‘sitting is the new smoking’, but it’s so true. Going to the gym for an hour a day means nothing if you sit on your bum for the rest of it,” she says. Dr West has a rule of thumb, which is “sitting for 20 mins, shuffling for two”.

This doesn’t necessarily mean sprinting up the stairs at your workplace – it could be walking to the photocopier, or even just standing during a phone call. If you get up to move around at regular intervals it will increase concentration, mood and the ability to remember information.

“Think of exercise as an opportunity, not an inconvenience”

For example, if you’re taking the bus to work and it breaks down – can you walk the rest of the way to work? If you’ve taken the car to go shopping, instead of spending 20 minutes attempting to find a car park, why not simply park on the outskirts and walk to the supermarket?

Dr West recommends that you track your activity as much as possible, with a pedometer or an exercise tracker, such as a ‘Fitbit’ watch. 10,000 steps per day is generally recommended, yet Caroline says 12,000 is better if you’re interested in weight loss.

“80% diet and 20% exercise”

Dr West says our diet has changed quite a bit over the years, with portions becoming bigger and more lavish. At the same time, innovations in medicine and changes in socio-economic conditions have extended our life span. “So we’re living longer, but with more years of poor health,” she says.

Dr West says many people don’t realise some foods we consider ‘healthy’ are actually full of calories. For example, if you start your morning with a breakfast muffin and a coffee, you are essentially having the same amount of calories as a Big Mac and a small Coke – that’s 530 calories!

This may come as a shock, but when it comes to weight loss, Dr West says it’s “80% diet and 20% exercise”. So if you’re thinking about weight loss, obviously watch your portions, but also make sure half your plate is always fruit and vegetables. Besides being very low in calories, they’re full of fibre and antioxidants.

Sleep Patterns

Lack of sleep can be traced back to the invention of the light-bulb, says Dr West. We didn’t have to go sleep at nightfall. This has only become worse with television and the internet. This has a knock-on effect, driving behaviours such as appetite and satiation hormones.

“Anyone who has been sleep-deprived with a young child will know how that in itself can lead to a low mood – and grumpiness too”, she adds laughing.

Self-medication

Dr West says one of the things she often sees in her practice is ‘self-medication’. She uses the example of going straight home from work, skipping the gym as you’re too tired, only to walk in the door and having a big glass or two of wine. So it’s about becoming self-aware, observing these behaviours and asking yourself, “Am I becoming too stressed?”

Fight or flight

Our environment has changed over thousands of years, and yet from an evolutionary perspective, we as humans are essentially the same. So when feeling threatened we are still hard-wired to react in that same ‘fight or flight’ response. Cortisol and adrenaline are released, making you tense and anxious. As you may already know, it’s usually felt most around your neck and shoulders.

Dr West says the problem is that it becomes ‘chronic stress’ when this response is constantly triggered on a day-to-day basis. This feeling might not be generated from an immediate threat, such as a predator, but simply from a hostile email or a word you’ve misconstrued from a colleague.

“They could be thoughts that aren’t linked to the present moment, but something that’s already happened – or a catastrophic thought about what might happen in the future,” she says.

Stress and your immune system

“Chronic stress is all about a constant wearing out of the engine; where it’s being revved at a high rate, without any respite. The consequences on our health are quite profound,” Dr West says.

“When it comes to stress we have a great capacity for denial and soldiering on. So the important thing about stress management is to bring our awareness into our bodies and to start observing what it is we might be experiencing.”

Dr West says you’re compromising your immune system when under constant stress. There’s a much higher rate of colds, flus – lasting longer, and with more intensity. This chronic stress can in some cases lead to a more serious chronic inflammation, which has been linked to diabetes, heart disease, stroke and depression.

How stress affects work

Dr West says we generally don’t think about the behavioural signs of stress, such as ‘black and white thinking’. When you’re highly stressed, it’s easy to go back to what you know best, which is “yes/no”, or “right/wrong”. In this headspace you’re less likely to be creative, intuitive and relaxed. You’re far more likely to make mistakes, be rigid and critical of yourself and others.

If you’re constantly running late for meetings, it could be a sign that you’re stressed, Dr West explains. “If your heart is racing, you might think that everyone can tell you’re anxious and agitated, but really it’s just internal. But to everyone else – all they’ll know is you’re running late and slow at making decisions.”