Wednesday 13 December 2017

Vintage medicine - Ireland on the naughty step when it comes to obesity

With waistbands expanding and no sign of self-regulation in sight, Maurice Gueret ponders a tarrif on doctors' cars

There are a number of reasons to explain why a person gains weight
There are a number of reasons to explain why a person gains weight
Dr Maurice Gueret

In the run up to the Budget, the noise has been deafening from the slim-down brigade to bring in sugar taxes - now postponed - fat tariffs and extra VAT on long belts. When Robert Emmet spoke about his country taking her place among the nations of the earth, I'm not sure he had girth in mind.

A statistic you will see bandied about a lot is the one which says Ireland is on track to become the fattest country in Europe by 2030. This claim is attributed to the World Health Organisation, but my understanding is that this was merely an estimate last year from a modelling project displayed at an obesity congress in Prague. The forecast is that 91pc of our men and 83pc of our women will be overweight or obese in just over a decade. With the exception of Holland, there was bad news for all Europeans. But the highest naughty steps were reserved for Ireland, Uzbekistan and Greece. We are often told that we should be following a Mediterranean diet. Many folks in Ireland do. Our problem is that it's battered sausages with chips,  12in pizzas and buckets of creamy gelato.

* We can theorise until the cows come home about why Ireland has this serious weight problem in our midst. In truth there may be lots of reasons. Perhaps we drink too much milk in childhood and too much alcohol in later life. Did we buy too much into the myth that sugar is better for you than fat? Should we go back to a main meal at lunchtime instead of bedtime? Have we simply stopped cooking for ourselves? Is it all to do with portion sizes? I watched a family of lean Belgians having their evening meal in Connemara this summer. Surrounded by Irish diners who were all on the five-course special, each member of the family ordered a solitary main course. And they all opted for the least popular options on the menu, namely the fish and the game. They drank water and retired as merry as anyone. The next morning they were at breakfast. While local guests tucked into cereal and croissants followed by the enormous full Irish, the Belgians ate fruit and drank orange juice. One let the hair down and ordered kippers. Food for thought.

* I was writing recently about a new-fangled illness described in Manchester as Bagpipe Lung. Courtesy of some fungal spores deep in his bagpipes, a musical hobbyist went to an early grave with an inflammatory lung disease. Well, a reader has been in touch with me to ask if he may have the first case in the world of Kazoo Lung. He has been struggling with a sore throat on and off for years. His family doctor and an ear, nose and throat specialist reassured him that all is well. He has been playing the kazoo as a comical instrument for many years. The kazoo is a small membrane-based musical instrument that was popular in lurid colours during the 1970s. Rather than blow into one, you hum a tune and the vibrating membrane gives off a buzzing sound. I'm not convinced of a new syndrome, but I'd say a kazoo is easier to rinse once a week than a set of bagpipes.

* While we are on the subject of blowing, a gentleman in Cork has written to me with some interesting observations on vacuum cleaners in hospitals. Over the past 15 years he has been an inpatient in no fewer than four hospitals in the south and south-east. One common feature he noticed of cleaners in all hospitals is that they use ordinary domestic type vacuum cleaners. He tells me that these suck in dirt and air and bugs in one end and then blow the air and bugs out the other end. He rightly wonders if this is good enough in these times of MRSA and other hospital superbugs. He may be on to something here. One manufacturer of a high-grade filtration machine says that one of the very best ways of creating an indoor airborne health hazard is to suck all the bacteria, spores, dust mites and faecal particles off a floor covering and then blow them liberally into the surrounding air where they travel easily from room to room contaminating a whole building. This could make an excellent research study for a student doctor or nurse. My informant tells me that there are new vacuum cleaners that are designed for hospital use which kill many bugs with ultraviolet light and don't blow them all back out the rear of the machine. Hiqa has been informed of his excellent observations. I wonder what they will say.

* Doctors have to disclose almost everything these days bar their means of transport. So I was interested to read of one medic, a former minister for health no less, who put his 10 Jaguars, three Daimlers, Triumph Spitfire and Mitsubishi Pajero on the open market and received plenty of media coverage for them. Another doctor disclosed to the High Court that he was getting rid of his Ferrari in part exchange for a McLaren MP4 sports car during a case he was taking against a car dealer. There are fears in the guild of motoring medics that our finance minister may introduce a special Rolls-Royce tax on our profession. Lest some readers think that all doctors inhabit the luxury-car market, I think it only fair that all of us declare a full motoring, mileage and service history. Since 2011, I have been the proud owner of a single Honda CRV diesel model. It's going well with over 100,000km on the clock. In a driving career that began in the mid 1980s, my previous house-call vehicles include a VW Polo, VW Jetta, Nissan Primera and Audi A4, followed by three consecutive Honda CRVs. With a full no-claims bonus, only the treatment is high powered and vintage!

Dr Maurice Gueret is editor of the Irish Medical Directory

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