The World Values Survey Wave 6 2010-14 asked people from many different world countries what mattered the most to them. The topics that they said were grouped into six categories and these were ranked for the countries.
These were ranked in the world overall as being in order: Family, Work, Friends, Leisure Time, Religion and then Politics. How would you have answered?
There were some interesting differences. Almost all countries said that Family was the most important thing to them. Those in the Netherlands said Friends. People from Ghana said Work. Quatar, Egypt and Algeria all said Religion. All of these countries put Family in second place, so Family is still extremely close to people’s hearts all over the world.
Work and Friends seemed to be the most popular second choices.
Work was the next highest priority in Brasil, Ecuador, Peru, Romania, Azerberjan, India, Kyrgystan, Armenia, Thailand, Zimbabwe, Columbia, Mexico, and Uruguay.
Friends were the second highest priority in Argentina, Belarus, Cyprus, Kazakhstan, Poland, Rwanda, Slovenia, Taiwan, Australia, Estonia, Germany, Hong Kong, Japan, New Zealand, Sweden, Russia, Singapore, Spain, Ukraine, USA, China, South Korea, Lebanon, Uzbekistan, Turkey, and Georgia.
When it came to lowest priorities almost all countries agreed that Politics was what they cared about least. The Netherlands, Australia, Estonia, Germany, Hong Kong, Japan, New Zealand, Sweden, China and South Korea all put Religion last.
Leisure Time tended to be on the low end of priority too, but never the lowest.
If you are looking for the most fun, I think that the Netherlands is the place. They ranked Friends, Family and Leisure Time way above Work, Politics and Religion. I don’t know that they would be keen on overtime though!
Other fun prioritising countries are Australia, Estonia, Germany, Hong Kong, Japan, New Zealand, Sweden, Russia, Singapore, Spain, Ukraine, and the USA.
The least fun countries from this survey seem to be Algeria and Ghana. They both rank Work, Religion, and Family ahead of either Friends or Leisure Time.
When comparing my priorities with those in other countries it would seem that the clear winner for me is Uruguay.
Nature Medicine has published the results of the use of the Zoe METHOD study on 347 people.
They were allocated either general advice on cardiometabolic health or were trained and supported to use the Zoe app for 18 weeks. The Zoe users are trained to individualise their diet with feedback on their gut microbiome and post meal blood glucose and triglyceride levels.
What improved: Triglycerides reduced, weight lowered, waist circumference reduced, energy levels improved, and sleep improved.
What didn’t change: LDL-C concentration, hip circumference, blood pressure and glucose levels.
My comment: I only know one woman who used the Zoe app. She said that as a result she increased the variety and amount of fruit and vegetables she was eating and reduced sugar and starch intake. She had lost weight and felt more energetic. When I answered the Zoe questions myself I was advised that it wasn’t a suitable programme for me due to my irritable bowel syndrome and wheat intolerance as these foods are encouraged as a major part of the diet. It seemed reasonably priced to me and could be a good help for people to understand the effect food has on their metabolism.
The risk of death from delays in cancer treatment is rising in the UK. Treatment has been delayed twice as often in 2023 compared to 2022. Workforce shortages are the main reason.
The Royal College of Radiologists say that almost half of cancer treatment centres are experiencing weekly delays. Figures for delay in radiotherapy treatments were 22% in 2022 compared to 43% in 2023.
Cancer Research UK says that 382,000 patients in England missed target treatment rates of 85% within 62 days of an urgent referral since 2015.
97% of Clinical Directors said that workforce shortages were the problem. A delay of a month in treatment raises mortality rate by 10%.
The NHS is short of 1,962 Consultant Radiologists meaning that the workforce is only two thirds of what it need to be. There is a shortage of 185 Clinical Oncologists. There are 15 out of a hundred posts unfilled. It is predicted that the shortages will be 40% and 21% by 2028 if nothing is done to address the problem.
Demand for chemotherapy increased by 6-8%, but the consultant workforce only increased 3.5%. Some regions of the country are much more affected than others.
Cancer Research UK said that health boards had finally caught up with the COVID backlog. Shortages of staff and equipment remain and in April 24 only two thirds of cancer patients began treatment within 62 days of referral.
The NHS is treating a record number of cancer patients. 30% more people with cancer are being treated compared to 2015 figures.
Attention Deficit Hyperactivity Disorder now affects 2-5% of people across western populations.
Becker P et al focussed their research on things that people affected could do to lessen the impact of the problem on their lives. Inattention, lack of concentration and impulsivity are the main features of the diagnosis. Rather than use medication, these things can be effective.
Gain self awareness.
Be responsible and learn from the effects of your actions.
Stay active during the day.
Have a schedule to follow.
Remove distractions or move yourself away from them.
Schedule activities for the time of day that suits you best.
To stay organised and on time set alarms and reminders on your phone.
Have supportive relationships with your family and friends.
Consider medication if you are not managing.
Becker P. Self care strategies shown to be useful in daily life for adults diagnosed with ADHD. A systematic review. Issues in Mental Health Nursing. 2023.
The incidence of peanut allergy has tripled in recent decades and now affects 2% of the population. Researchers from Southampton University and King’s College London found that peanut allergy could be cut by 77% if peanut products are added to baby’s diets.
They suggest that babies with eczema are started at 4 months and other babies at 6 months. The effectiveness of allergy prevention reduced with every month that peanut introduction was delayed.
Most peanut allergies had developed by the age of one. Professor Gideon Lack said, “there is a narrow window of opportunity to prevent allergy developing.
Mary Feeney, paediatric dietician at King’s College London says, “Breast feeding should still continue. The baby should be developmentally able to take solids. Small amounts of pureed vegetable, fruit or cereals such as baby rice should be introduced first. Once this is established then add peanut butter which has been loosened with a little baby milk. Whole or chopped peanuts should not be used. A heaped teaspoon of peanut butter three times a week is good.”
Frequent or persistent crying in babies after three months of age, and sleeping and feeding problems after six months of age, are associated with an increase in mood disorders in young adulthood.
The affected adults also report less likelihood of social support from friends and contemporaries.
This association was found in data from Finnish and German longitudinal studies. (BMC Psychiatry 2023).
My comment: Looking after a new baby is spectacularly boring, demanding, and relentless. Time seems to slow down to a snail’s pace. Night after night you hope for a better night than the last one, only to face a long day ahead and another long, long night. We don’t know why some babies are easier or worse than others.
Is it personality differences due to genetics? Parenting problems? The wrong milk? Breastfeeding problems? Colic? Heartburn? Why do such miserable babies have a higher chance of becoming miserable adults? Does the fractured sleep of the parents affect how they react to the baby? Does this affect future childhood interactions? Are miserable people just born miserable?
Localised shock wave treatment has been used to treat patients with tendinitis, non-healing bone fractures, chronic leg ulcers, soft tissue wounds, post-stroke spasticity and spinal cord injury.
Now, Austrian researchers have found a small, but definite effect, in heart muscle regeneration in patients who have coronary artery bypass surgery.
An electric current is applied to electrodes in water, not the patient, so they get a sonic shock rather than an electrical shock. The sonic wave cannot be heard by humans. They say that this, “activates the innate immune system of treated cells, leading to increased DNA accessibility and cellular plasticity, together with the secretion of angiogenic cytokines and growth factors. This induces angiogenesis in the hibernating myocardium. Newly formed vessels then support the recruitment of chronically under-supplied myocardium.”
In a trial of 63 patients undergoing CABG surgery, some had the sonic treatment and others had sham treatment. After a year, left ventricular ejection fraction in the shockwave group increased by 11.3% compared to 6.3% in the control group. The treated group could walk further in six minutes compared to the untreated group and also reported a better quality of life.
Lead researcher Johannes Holfield said, ” for the first time, we are seeing the heart muscle regenerate in a clinical setting, which could help millions of people.” Larger trials are now planned for chronic ischaemia patients.
In the cathedrals of our minds resides the quality of our lives.
In this inner sanctum, we experience every moment and memory of our lives.
Whatever the duration of our lives or the degree of physical or cognitive quality we possess, it is how we experience our lives that matter most.
Fundamentally, the quality of our minds dictates the quality of our lives.
What Is Health?
In my view, health is the optimisation of three factors:
Lifespan – How long you live.
Health Span – The quality of your movement and cognition.
Soul Span – The quality of the experience of your life.
We are all too familiar with examples of those who have excelled in the domains of lifespan and health span but have seriously struggled in the domain of soul span.
When I speak of Soul Span, I am not referring to organic mental illness.
This is an entirely different matter that requires the input of trained medical personnel and often the use of mood-altering medications.
I am referring to our felt experience of the world.
Whether we feel engaged in a life that is meaningful?
Whether we experience periods of joy or happiness?
Because as Cicero once said:
“Diseases of the soul are more dangerous and more numerous than those of the body.”
The Formula
There are very clear formulas to optimise the domains of lifespan and health span.
I have covered these in detail over the last 100-plus articles here.
What these factors consist of have been discovered through the application of hard science.
Science can tell us a lot about the factors that determine our life experiences, but many of the answers reside in the domain of philosophy, art, and literature.
I do not profess to have the answer to this issue.
Minds far greater have struggled with the question for thousands of years, and no consensus has yet been reached.
Anything I say here is based on my own experience and reading.
The journey here is one you must traverse.
You and you alone.
As Rumi once said, “It’s your road, and yours alone, others may walk it with you, but no one can walk it for you.“
The question is whether there is a formula for optimising soul span similar to lifespan and health span.
Maybe there isn’t an exact formula, but the following are three key ideas I believe make a major difference to the factor of soul span and the quality of your life.
You Are Not Your Thoughts.
Each and every one of us has an internal dialogue in our heads.
All day.
Every day.
It’s probably chattering away right now.
“What is this guy talking about? I wonder, should I have a coffee now or later? Damn, I feel tired. I must not have slept well last night.”
If you spoke that internal dialogue out loud all the time, people would start avoiding you pretty quickly.
And yet, that dialogue is constantly pecking away inside your head.
And in the heads of everyone you meet.
But as Joseph Nguyen says, “Don’t believe everything you think”.
It does not take long for us to become identified with the chatter in our minds.
Without realising it, we become our thoughts.
They define who we are.
But those thoughts rarely glitter in praise of who we are and are more commonly an endless stream of low-grade negativity.
And we wonder why we are not happy.
We have no idea where our thoughts come from.
None.
We do not control our thoughts.
But…
We can control how we react to them.
We can learn to observe them.
Non-judgmentally and view them at a distance.
We can detach ourselves from our endless stream of thoughts and watch them.
Like we would a squirrel in our garden.
And when we learn how to do that we free ourselves from the negative chatter.
This is the purpose of meditation.
It is not to rid yourself of thoughts.
It is to stand at arm’s length from them.
And observe them.
For the strange and mysterious things that they are.
But in doing so, we free ourselves from being emotionally whipsawed around by them and can add some peace to our lives.
You are not your thoughts.
If you want to free yourself of them, learning to meditate is a must.
The Meaning Of Life.
Like so many others before me, I have spent years reading and learning in an attempt to discover the answer to the question:
What is the meaning of life?
The answer is…
There is no answer.
And that searching for one may not be helpful.
And might even be harmful.
As Albert Camus once said, “You will never be happy if you continue to search for what happiness consists of. You will never live if you are looking for the meaning of life.”
But do not confuse this with the idea that you cannot live a meaningful life.
Just because there may not be a precise answer to this question or we may never know what the ‘meaning of life is’ does not mean we cannot live a life that is imbued with meaning and purpose.
These are similar but, importantly, different concepts.
One is a definitive end-point answer.
The other is a process of discovery and experience.
We can live incredibly meaningful lives without knowing the specific answer to the question, “What is the meaning of life?”
Understanding this has been incredibly liberating for me.
We live in a time when the grander narratives of myth and religion have lost their foothold. This freedom has left many adrift without an answer to foundational questions we have as humans.
I do, however, believe we must all feel connected to something greater than ourselves.
As Carl Jung says, “The decisive question for man is: Is he related to something infinite or not? That is the telling question of his life.“
There is no doubt that this world is full of mysteries.
Why are we here?
Where did we come from?
Did we exist before birth?
What happens after we die?
Are we alone in the universe?
And so many other dizzying questions.
Simply staring up at the stars at night provides us with an immense sense of awe and beauty.
It connects us to the numinous, a sense that is ‘inexpressible, mysterious, terrifying”.
I know that life can be meaningful.
For me, that is enough.
Do Not Lie.
The opening scene of the HBO series Chernobyl starts with a question.
“What is the cost of lies? It’s not that we’ll mistake them for the truth.
The real danger is that if we hear enough lies, then we no longer recognise the truth at all. What can we do then?
What else is left but to abandon even the hope of truth and content ourselves instead with stories?
In these stories, it doesn’t matter who the heroes are. All we want to know is: “Who is to blame?”“
When I say, ‘Do not lie,’ most of all, I mean that we must not lie to ourselves.
We are the easiest to fool with our own lies.
And when we do, we often also look for someone to blame.
We are also the ones who will pay the greatest price for those lies.
What I have learned is the greatest lie is to not live the life you know that you truly should.
When asked on their deathbeds, this is people’s number one regret.
Above working too hard is the regret of not having the courage to live the life they knew they should have.
But didn’t.
Their greatest regret was lying.
Lying to themselves.
That they were someone different to who they knew they really were and convincing themselves to live a life aligned with the values of someone who they were not.
In the deepest recesses of our minds, we know who we really are.
But as Nietzsche says, “They fear their higher self because when it speaks, it speaks demandingly.”
We fear what our deepest selves tell us.
We fear the pain that pursuing that path would lead to.
But we forget the greater pain that will result if we do not.
We lie. To ourselves.
As Abraham Maslow says, “What one can be, one must be”.
To not become who you are is to lie.
And as the HBO Chernobyl series finishes, the protagonist who asked about the cost of lies refrains:
“Every lie we tell incurs a debt to the truth. Sooner or later, that debt is paid.”
You know what to do.
You know when you are lying.
We all do.
The question is whether you realise the cost of those lies.
Because sooner or later that debt will be paid.
A life well lived.
The journey of optimising soul span is fundamentally about a life well lived.
We can take guidance and counsel from greater minds that have reflected on this topic but in the end we must walk our own paths.
Maybe we can never know precisely what our destination may be, but I am confident that each and every one of us knows when we are on the right path.
When we are moving towards the manifestation of our highest selves we feel a sense of meaning.
A meaning that makes this life worthwhile.
But when we track away from what represents our highest selves, we suffer.
The goal, then, must be to identify your highest goals and then have the courage to move towards them.
Doing so will undoubtedly bring pain and suffering.
But not doing so will likely bring even more.
At least the pain and suffering we endure on the path to our highest selves will be worthwhile.
This life is short.
Lifespan and health span matter.
But for me, soul span matters most of all.
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As with all the material on this site it is not medical advice and is for general informational purposes only. None of the information provided constitutes the practice of medicine, or any professional healthcare services. No doctor patient relationship has been formed. Information contained on this platform is used at the readers own risk. Readers of this information should not delay or disregard in obtaining professional medical advice or treatment for any health related issue. The information presented is in no way a substitute for medical advice.
Adapted from BMJ 23 April 2023 and Medscape 20% of patients with Diabetes in Drug Free Remission with Low Carb Program by Becky McCall Nov 21 2022.
Diabetes UK say that the number of people with diabetes in the UK has reached 5 million for the first time. They say there is ” a rapidly escalating diabetes crisis”. They want the government to limit junk food advertising to children. 90% of those diagnosed have type two diabetes. The major risk factor for this is overweight and obesity. 64% of the adult population have this risk factor.
148,000 people under the age of 40 have been diagnosed with type two diabetes. The rate has increased by 23% over the last five years. Diabetes UK think that more people need to be referred to the NHS Diabetes Prevention Problem to reduce the year on year increase in the disease.
My comment: It is a pity that Diabetes UK did not heed the advice to ignore the detrimental Food Standards Agency so called “Eat Well Plate” recommendations decades ago. We are suffering the effects of pushing high starch, high fruit/juice diets that contain refined vegetable and seed oils and not enough protein and full fat dairy on the general population. With the increase in food prices, energy and housing in the last few years, that wages have not kept pace with, we are seeing more people sink into poverty. This means that they work longer hours to compensate, with less time to make healthy, non processed meals, and to undertake physical activity, and get sufficient restful sleep. I can’t see the situation being reversed for the foreseeable future.
At the Diabetes Professional Care Conference in 2022, Dr David Unwin presented the results of the low carbohydrate approach. 20% of his diabetic patients have gone into remission and no longer need any glucose lowering medication. His practice is in Southport. He has found that 50% of his patients will go into remission if they adopt a low carb diet. He has saved £68,000 on these drugs a year.
Weight dropped 10.3%, HA1c dropped by 33%, and blood pressure by 8.6%. Blood lipids also improved.
Remission was achieved in 77% if they started the diet in the first year after diagnosis. Rates after this fell, probably due to declining beta cell function, but 11% still went into remission even after 6 to 15 years after diagnosis.
Dr Unwin’s practice had 57 patients with type two diabetes in 1986 out of a list of 9,000. This is now 530, a tenfold increase. (Some of this could be due to better case finding). The UK spends around £10 billion a year on diabetes, 80% of this is to treat complications, and this is 10% of the health budget, similar to the budget for treating cancer.
Dr Unwin has been using the low carb approach since 2012, I was using it in my own practice about eight years before that. Without any extra funding, he has been educating his patients about this approach. He has found that the higher the person’s blood sugars, the more they improve on a low carb diet. He has had patient stay in remission for over ten years now. His oldest patient in remission is 92 years old. To his surprise, he has often found that older people do better on the diet, because they are organised, have time, and know how to cook.
His wife Jen Unwin, a psychologist says, “Older people are motivated to stay well. They don’t want to be ill. Their memory, energy and sleep, all improve remarkably. Some young people understand the diet and can implement it without too much trouble. But for others carbohydrate addiction really gets in the way. They are markedly affected by the obesogenic environment that has changed dramatically since the 70s. If you are really addicted to bread, as many people are, you can’t moderate it. Same for chocolate. Some people can’t have one biscuit. They have to eat the whole packet. They only way for these people is abstinence.
Jen continues, “Eating carbohydrates makes you hungrier. It also raises your blood sugar. When patients understand this they can sometimes make great improvements but teaching and learning takes effort and resources.”
The Public Health Collaboration have an online course that teaches the fundamentals of a healthy food approach. There is a link to the programme in a previous article in this blog site.
Adapted from JAMA Cardiology/ Original Investigation
Association of Lipid, Inflammatory and Metabolic Biomarkers With Age at Onset of Incident Coronary Heart Disease in Women. Sagar B. Dugani MD PhD et al. 2021.
A prospective group of US women health professionals, in the Women’s Health Study was conducted over 21 years. At the start over 28,000 women aged 45 years or older without known cardiovascular disease were recruited between 1993 and 1996. Data from over 50 biomarkers were tracked. Data was grouped from the under 55s, 55-65s, 65-75s and over 75s.
Results showed that diabetes and insulin resistance, hypertension, obesity and smoking were the strongest risk factors to cause premature onset cardiovascular disease. Risk factors became less important as later ages approached.
The relative risks for the various factors were:
Diabetes 10.7 in under 55s and 3.47 in the over 75s.
Metabolic syndrome 6.09 in under 55
Hypertension 4.58
Obesity 4.33
Smoking 3.92
Myocardial infarction in a parent before the age of 60 gave a 1.5-2 factor risk of a heart attack up till the age of 75.
Blood results (not all of these are tested for in the UK)
Lipoprotein insulin resistance 6.4
LDL cholesterol 1.38
Apoliprotein B 1.89
Triglycerides 2.14
Inflammatory biomarkers 1.2-1.8
For the group of women under 55, the average age was 48. Almost all were white. The mean BMI was 28.9. 38% of them were smokers. The average systolic blood pressure was 135. 57% were physically inactive. 30% reported that a parent had had a myocardial infarction under the age of 60. Of the 24 women who were post-menopausal, 17 were on HRT.
My comment: I’m surprised that even in the mid-1990s so many of this group of educated, white, female health professionals, were considerably overweight, physically inactive smokers! I wonder what a similar group would be like now?
Looking at the group over the age of 75, the average BMI had dropped a little to 26.1. Smoking was less at 12.8%. Physical inactivity was still high at 46.5% despite all of these women being retired. All would be post -menopausal and 35% of them were on HRT.
Premature coronary heart disease generally refers to the age under 65 in women and 55 in men. Mortality rates in this group reduced by 5.5% in men and 4.6% in women between 1979 and 1989. But over the next 20 years mortality for women went unchanged. Between 2010 and 2015 in the USA CHD mortality declined in all groups except for those aged between 55 and 65.
In Western Australia from 1996 to 2007 the yearly heart attack rate for women aged 35 to 54 increased by 2.3%. In British Columbia, Canada there was a yearly increase in acute MI of 1.7% in women aged 20 to 55. This increase was not seen in men. In the UK cardiac deaths also showed none or minimal improvement from 1985 to 2005.
Favourable factors that reduced cardiac risk were increased levels of HDL and higher levels of particle HDL size. Lower creatinine levels were also favourable. This is a measure of renal function.
The strongest associations for LDL were seen for small LDL particles, total LDL particles and smaller average LDL size. Large and medium LDL particles had almost no correlation to cardiovascular risk (1.02 and 1.13) . LDL particle average size indicated reduced risk at 0.64. Small HDL particles were associated with higher cardiovascular risk (1.60) and average to larger particles were associated with reduced cardiovascular risk (0.65 and 0.74).
Diabetes Diet 