I had a stick of CareFree gum, but it didn’t work. I felt pretty good while I was blowing that bubble, but as soon as the gum lost its flavor, I was back to pondering my mortality.

At some point(s) in our lives, the idea of our own mortality strikes us and we may be forced to ask ourselves some pretty intimidating questions like:

What have I done in my life? How will I be remembered? Has my life stood for something?

And perhaps we aren’t prepared with the right answer. Perhaps we shoulder the weight and continue on with more awareness of how precious our life is and the time that we have to truly live it.

This second installment on aspects of human thinking when faced with mortality is on a few more common expressions of some who were sadly forced to recognize death as a fast-approaching outcome, but who were fortunate to have a sympathetic ear to talk to before the end. These voices are the patients of Bronnie Ware, former palliative care nurse and writer of the blog Inspiration and Chai.

I wish I had the courage to express my feelings.

Relationships –marriages in particular– can cause one to habitually suppress the way he/she feels in order to maintain a modicum of peace. Unfortunately this may cause one to develop heavy emotions of bitterness and resentment, perhaps even eventually leading to illness. In 1971, a research team from the University of Michigan recruited 192 couples aged 35-69 years from Tecumseh, Michigan and followed them closely over 17 years. Each couple was individually interviewed about their methods for dealing with anger in marriage. Asked to imagine their mate shouting at them for something that they thought was not their fault, they were to describe how the would normally respond.

Based on whether they communicated their anger and resolved conflicts, the couples were placed into four groups: Group 1, where both spouses affectively communicated their anger when they felt unfairly accused by the other; Groups 2 and 3, where one mate communicated and the other suppressed anger; Group 4, where both partners suppressed their anger and sulked. The researchers discovered that early death was twice as likely to occur in Group 4 where both partners suppressed their anger, compared to Groups 1-3.

Affective communication is crucial in maintaining healthy relationships, and allowing yourself the freedom to express your emotions in a constructive and reasonable manner will contribute greatly to a healthy mind, meaningful relationships, and by extension your longevity.

I wish I stayed in touch with my friends.

“It is common for anyone in a busy lifestyle to let friendships slip. But when you are faced with your approaching death, the physical details of life fall away,” writes Bronnie Ware.

Because of the typically hectic Western lifestyle so many of us are accustomed to, friendships often fade over shorter and shorter periods of time. We get so wrapped up with our own lives that we tend to overlook the most loyal, admirable, best people we know. According to Ms. Ware, many had “deep regrets about not giving friendships the time and effort that they deserved”, and in the face of death, many suffered to fully comprehend the loss.

“It is all comes down to love and relationships in the end. That is all that remains in the final weeks: love and relationships.”

I wish I had let myself be happier.

“This is a surprisingly common one. Many did not realise until the end that happiness is a choice. They had stayed stuck in old patterns and habits.”

Studies on what makes people happy conclude that material possessions and high achievements actually don’t have much to contribute to the state of happiness. When you break it down, it’s all about your outlook on life and the quality of your relationships.
Human beings are inherently creatures of habit; most acquire and stay within a pretty narrow pattern or set of habits. Fear of change leaves many pretending, to themselves and others, that they are content with the way things are when deep down there may be hidden longings for a different way of life. Unfortunately, those that reach the end of their lives with a true sense of satisfaction for the life they led have become a rarity.

Ms. Ware summarizes it all with these simple words: Life is a choice. It is YOUR life. Choose consciously, choose wisely, choose honestly. Choose happiness.

References:

Paddock, Catherine. “Suppressing Anger in Marriage Linked to Shorter Life.” Medical News Today. MediLexicon International Ltd., 28 Jan. 2008. Web. 30 June 2011.
http://www.medicalnewstoday.com/articles/95322.php.

If you were faced with your own mortality, if you found out that you had a short time to live, what would you wish could have been different in your life? What regrets might you have? All too often, you might find yourself engulfed – drowning, even – in the minutiae of life without pausing every now and then to contemplate where you really are and more importantly, who you’ve become. Are you brave enough to strive to get to a point of feeling fulfilled with both?

Bronnie Ware, writer of the blog Inspiration and Chai, seems to be one of those eternally sunlit figures that seeks nothing but the good for others. After years of working in palliative care with patients sent home to live out their last days in peace, Bronnie found herself asking the same questions of the individuals she cared for. She noted reoccurring themes in responses over the years.

I wish I had the courage to live a life true to myself, not the life others expected of me.

“When people realise that their life is almost over and look back clearly on it, it is easy to see how many dreams have gone unfulfilled.”

Remarkably this was the most common regret her patients expressed to her. Expectations from our family, friends, colleagues, and even the expectations we perceive from society that continue to oppose the concept of contentment in life may cause us to swerve from what truly brings us happiness. Battling against our own ideas of what we should be: wealthy, prominent, “successful” may be one of the most difficult hurdles to overcome in this pursuit as well.

“It is very important to try and honour at least some of your dreams along the way. From the moment that you lose your health, it is too late. Health brings a freedom very few realise, until they no longer have it.”

I wish I didn’t work so hard.

Sadly, all of Ms. Ware’s male patients felt deep regret for living so much of their lives in the hamster wheel of work, having been part of a generation where most female patients were not the family breadwinners.

Interestingly, a worldwide survey of happiness reveals that beyond a certain income level (that which covers your basic needs), happiness is not contingent on money. According to the research, happiness in wealthier countries is now far more dependant on closer personal relationships, good health and job satisfaction. “We always think if we just had a little bit more money, we’d be happier,” says Catherine Sanderson, a psychology professor at Amherst College, “but when we get there, we’re not.” “Once you get basic human needs met, a lot more money doesn’t make a lot more happiness,” notes Dan Gilbert, a psychology professor at Harvard University and the author of the book Stumbling on Happiness.

Indeed, the more you make, the more you want. The more you have, the less effective it is at bringing you joy, and that seeming paradox has long bedeviled economists.

Simplifying your lifestyle will free you of a lot of time and money spent in maintaining a lifestyle that the world deems as “successful”. It is entirely possible to not require the income that you may think you need. By doing this, more time and energy can be focused on new experiences, opportunities, and the relationships you want to cultivate. And it’s the relationships that matter.

(To be continued…)




References:

Futrelle, David. “Can Money Buy Happiness?” CNNMoney. Cable News Network, 18 July 2006. Web. 23 June 2011. http://money.cnn.com/magazines/moneymag/moneymag_archive/2006/08/01/8382225/index.htm.

Karoshi is the Japanese term for “death from overwork”, literal occupational sudden death– the major medical causes being heart attack and stroke due to stress at work and often without previous signs of illness. In a country where employees were known to work 12+ hours a day six or seven days of the week and often working unpaid overtime hours, it doesn’t come as a surprise that Japan is one of the few countries that reports Karoshi as a separate category in national statistics. Japan broke a record in the financial year of 2006-07 when around 355 workers fell ill from overwork, and of them, 147 typically died of heart attack or stroke. The statistic was Japan’s highest figure, a 7.6% increase from the previous year in spite of government efforts to cut hours. But with Japanese employees putting in an average of 1,780 hours annually, not including unpaid overtime, the campaign to pre-empt karoshi would have to overcome some big obstacles.

Kenichi Uchino, a 30 year old Toyota employee, shortly before he died, collapsed at work at 4 am after more than 80 hours of overtime a month for six months, told his wife he was happiest when asleep.

From the Scientific American under the article “Can Work Kill?”:

“A 1998 survey of 526 Japanese men, aged 30 to 69, supported the idea that long working hours can be hazardous to a man’s health. The subjects of the study included men who had been hospitalized with a heart attack as well as healthy men of similar ages and occupations. The results were striking: Men from both groups who put in more than 11 hours of work on an average day were 2.4 times more likely to have a heart attack than were men who worked “just” seven to nine hours a day.”

Let’s take Sweden: In 1996 a Swedish study explored not just working hours and its correlation to health, but working conditions. More than 12,500 employed men over a period of 14 years were observed and evaluated by the psychological and physical demands of each individual man’s occupation. Age, exercise habits, smoking history, medical history, educational level and social class of each were collected. The results? Those with low control over the demands of their jobs were 1.8 times more likely to die from heart disease than those with more control were. Those with low-level social support from co-workers were 2.6 times more vulnerable to cardiovascular death.

2,465 Danish bus drivers were observed in an earlier study. The intensity of traffic on the drivers’ routes were linked to a two-fold increase in the risk of heart attack and death. Lack of social support only served to compound the problem. A seven-year study of 500 Swedish men implicated job strain as a predictor of mortality–high demands and low control combined to explain this effect. A related Italian study of 99,029 railway workers found that the particular combination of high job responsibility and minimal physical activity was associated with an increased risk of heart attack.

An American study assessed stress, personality, and psychological strain by questionnaire among 73 males with a mean age of 23 years old, 73% of whom worked full-time. Anxiety was positively associated with role ambiguity in the work place, as well as depression and resentment. Anxiety was also positively related to heart rate, the relationship between anxiety and work load greatest among Type A personalities.

High mental demands, low personal control and inadequate social support are the particularly worrisome factors of how overwork exacts its toll on the mind and body, and by extension, longevity.

Though more research is required to verify these observations, we do know that mental stress heightens adrenaline and cortisone blood levels, two of the so-called stress hormones while psychological stress raises heart rate and blood pressure. It can also induce arrhythmia, or abnormal heart pumping rhythm. Platelets in the blood can also be activated by stress, triggering clots that can block diseased coronary arteries.

Perhaps one of the better approaches to work can be found in France, where despite comparatively short workweeks, French employees regularly top productivity surveys. Though less time is spent at the office than their American and Japanese counterparts, when they are in the office, their time is used more efficiently. Perhaps cutting the number of hours you give yourself to complete tasks will help you get them done in a more timely manner, getting you home to your family, friends and mental “happy place” faster. As the French say: À Votre Santé!




References:

Heart attacks and strokes, once thought to be the plague of wealthy countries, have become the burden of developing nations worldwide. The aim of polypill is to change that. The first international polypill study published on the 25th of May suggests the extreme effectiveness of a pill that could significantly reduce the burden of cardiovascular disease, taken with an ease that is as “automatic as brushing your teeth”.

This super pill contains 75mg aspirin, 20mg simvastatin, 10mg lisinopril and 12.5mg hydrochlorothiazide. Aspirin prevents blood from becoming too coagulated, which can lead to clots that cause heart attacks; statins lower cholesterol and the latter two drugs lower blood pressure. Data was analyzed from 378 people with a raised risk of cardiovascular disease. Half were given the polypill and half a placebo. About a third of the participants were British, a third Dutch and a third Indian. Specifically, overall systolic blood pressure was reduced from a pre-trial average of 134 mmHg to 124; while ‘bad’ LDL cholesterol came down from 3.7 mmol/L to 2.9.

Professor Anthony Rodgers of the George Institute for Global Health in Australia, who led the study, said:

“The results show a halving in heart disease and stroke can be expected for people taking this polypill long-term… We are really excited about this – it is a step closer to providing the polypill to patients.”

The polypill concept has actually been around for decades but news from the 2009 American College of Cardiology annual conference forced the medical community and the public to sit up and take notice. One of the pioneers of the polypill, Professor Malcolm Law of the Wolfson Institute of Preventive Medicine in London states: “We have long advocated the polypill as a safe and effective way of greatly reducing the incidence of heart attacks and strokes in the population… This study shows that it’s possible to make such a product that is effective and doesn’t have adverse side effects.”

The polypill such as the one used in The Indian Polycap Study would be easily affordable and reduce the cost of doctor’s appointments, blood and cholesterol tests, and treatments greatly, making it ideal for the developing world where risk of heart attack and stroke abound and where proper medication may not be in supply or are too heavy a financial burden. “These drugs are off-patent and cost pennies,” says Law. “You might be talking in terms of 50p a day. There’s no way it’s going to drain resources.”

The co-principal investigator on a 2011 study from the National Heart and Lung Institute at Imperial College London states: “The polypill idea is really simple: make it easier for people to get the medication they need by giving them just one polypill to take each day, rather than lots of different pills that may need to be taken at different times. It’s likely that combining medications in one polypill could enable people in low-income countries to have easy access to cheap preventive medication.”

A Department of Health spokesman said: “We welcome any evidence that contributes to providing the best treatment for people with cardiovascular disease.”

“It is also important to remember that changes made to a person’s lifestyle such as stopping smoking, eating healthily and taking regular exercise have far reaching health benefits that will not be reaped from medication, including reduction in the risk of developing diabetes and cancer.”

Though the benefits are substantial, Associate Professor Anushka Patel, of The George Institute for Global Health noted, “Previous studies could not measure polypill side effects reliably, which is really important…This trial was reassuring in that we did not see unexpected problems. We did show previous studies had underestimated polypill side effects considerably – in the short-term about 1 in 6 people have a side effect. Most were mild but about 1 in 20 overall stopped treatment due to side effects.”

Evidently, the benefits are not as massive as researchers initially suggested; side effects were also not as rare as what was first thought. This indicates that treatment is best targeted to those at higher risk. “This heralds a more balanced, measured approach than the initial hype around the polypill,” said Professor Otavio Berwanger, Hospital do Coração, Sao Paolo. “It is not a panacea. It is a really promising part of an overall package that should include measures to tackle the major causes of heart disease and cancer ie. smoking, poor diet and physical inactivity.”

References:

Boseley, Sarah. “New Trials Launch of a Daily Polypill Which Could Potentially save Millions of Lives.” Sarah Boseley’s Global Health Blog. Guardian News and Media, 17 May 2010. Web. 6 June 2011. http://www.guardian.co.uk/society/sarah-boseley-global-health/2010/may/17/heart-attack-stroke-prevention.

When you think about vitamins and minerals deficiency, you may think about undeveloped or third world countries where food might be scarce. You may think about those who suffer from eating disorders such as anorexia nervosa or bulimia. But did you think that a modest deficiency could ever threaten your longevity? Modest deficiency in vitamins and minerals are all too common in developed nations. In countries such as the U.S. that are known for its availability of food and soaring obesity statistics, this fact is much overlooked and largely ignored.

But as a new study published in the Federation of the American Societies for Experimental Biology (FASEB) Journal reveals, moderate selenium and vitamin K deficiency over time may lead to age-related diseases including cancer, heart disease, and loss of immune or brain function.

Sounds a little serious now, doesn’t it?

“Understanding how best to define and measure optimum nutrition will make the application of new technologies to allow each person to optimize their own nutrition a much more realistic possibility than it is today,” says Joyce C. McCann, study co-author. “If the principles of the theory, as demonstrated for vitamin K and selenium can be generalized to other vitamins and minerals, this may provide the foundation needed.”

McCann and research colleagues of the Nutrition and Metabolism Center at Children’s Hospital Oakland Research Institute in Oakland, California compiled and assessed several general types of scientific evidence. Testing whether selenium-dependant proteins that are essential from an evolutionary perspective are more resistant to selenium deficiency than those less essential, they discovered an astoundingly sophisticated array of mechanisms at cellular and tissue levels. In instances where selenium was limited, these mechanisms protected essential selenium-dependant proteins at the expense of those nonessential. Fascinating, too, was how mutations in selenium-dependant proteins lost on modest selenium deficiency result in traits shared by age-related diseases that include heart disease, cancer, and loss of immune or brain function.

Selenium plays a role in the functioning of the thyroid gland and in every cell requiring thyroid hormone. Dietary selenium stems from nuts, cereals, meat, mushrooms, fish, and eggs, with high levels also founding Brazil nuts, kidney, tuna, crab, and lobster. However, the report supports the daily intake of a multi-vitamin that includes selenium.

Gerald Weissmann, M.D, Editor-in-Chief of the FASEB Journal had this to say: “This paper should settle any debate about the importance of taking a good, complete, multivitamin every day… As this report shows, taking a multivitamin that contains selenium is a good way to prevent deficiencies that, over time, can cause harm in ways that we are just beginning to understand.”

Partial to a particular multivitamin, Methuselites? Comment below!

Reference:

“How Vitamins and Minerals May Prevent Age-Related Diseases.” Science Daily. Science Daily LLC, 31 May 2011. Web. 31 May 2011. http://www.sciencedaily.com/releases/2011/05/110531115323.htm.