Dr Naomi is a GP in an NHS practice. She is also a busy mum of five.
Check out our top FAQs on Health…
I have lots of social events over the party season and always end up catching a virus at this busy time. How can I stay well this Christmas?
Winter is notorious for cold and flu, but also vomiting viruses such as norovirus. Late nights, close contact with people and buffet-style meals at parties can make you more susceptible to them, but here things you can do to help.
If you’re in a confined space with a crowd (hello, drinks party!) remember that some viruses are spread by droplet from the nose or mouth and can live outside the body (on a door handle, for instance) for hours, so wash your hands with soap regularly, and avoid touching your nose or mouth. Also, don’t eat food that’s been on a buffet table all evening (food can be contaminated by a sneeze or cough too), open a window to get some fresh air, and if someone has a cold, swerve their kiss under the mistletoe.
Norovirus is very contagious but short-lived, so if you catch it, rest and drink lots of water. To keep it contained, stay at home for 48 hours after the last episode of vomiting or diarrhoea, clean surfaces with disinfectant and wash towels and sheets you’ve used on a hot setting.
Recovery from upper respiratory viruses which cause a runny nose, cough and feeling unwell can take up to two weeks. So, get plenty of rest, throw away used tissues immediately, and stay hydrated.
When you’re not out partying this Christmas, make sure you eat healthily and stay active to keep your immune system in good shape.
I’m a nurse and work lots of odd shifts. Is it true that people who do shiftwork are more likely to put on weight? If so, how can I avoid it?
It’s generally thought that people who work shifts are at greater risk of health problems such as cardiovascular disease and diabetes – particularly those working rotating shifts. It is also thought that shiftwork can cause weight gain, but the reason for this is not fully understood.
It might be the result of interference with the body’s circadian rhythm, which cause us to store fat, or that tiredness leads to mindless eating. Another possibility is that shiftwork affects our ability to form eating habits. For example, if you get home exhausted after a long night shift, instead of preparing a healthy meal from scratch, you’re more likely to grab something that’s quick, easy and less nutritious.
Hospitals, funnily enough, can be unhealthy places too, with chocolates and biscuits all too easy to find in the middle of the night when you feel tired and really fancy a quick pick-me-up.
I advise you to avoid grazing and definitely skip sugary drinks. Instead, take one healthy snack to work with you plus a substantial, healthy meal to have during your break. Or prep one in advance, so it’s ready for when you get home.
Take time to analyse what you eat at work too, and compare it to non-work days, then try to close up the gap.
I suffer with insomnia and take prescription Amitriptyline which helps, but I constantly battle fatigue and often turn to junk food. Help!
Insomnia can be caused by a number of underlying factors including anxiety, depression, an overactive thyroid, or poor sleep hygiene.
Unfortunately, people who become dependent on prescription medication for sleep, or take sleeping pills, often have the most difficulty overcoming insomnia, so it’s a good idea to adjust your lifestyle habits before resorting to medication.
A bad night’s sleep can tempt you to spend longer in bed the following morning or have a nap later in the day, which could make it difficult to sleep the following night – creating a vicious cycle.
When you’re not getting enough sleep, it can also become difficult to focus on a healthy-eating plan. So make sure you have nutritious food and plenty of water on hand each day – take healthy snacks out with you, batch cook healthy meals and freeze them, and keep a fruit bowl on show to remind you to eat well as often as possible.
Create a calm, relaxing sleeping environment by making sure your room is clean, tidy and smelling lovely. You could sprinkle a few drops of lavender essential oil onto your pillow or use a diffuser – lavender’s known to have a mild sedative effect.
You may also be a candidate for cognitive behavioural therapy (CBT) so chat to your GP.
I’m trying to eat well, exercise regularly and get plenty of sleep but I feel more exhausted than ever! Where am I going wrong?
Being tired all the time can simply be a symptom of a very busy life! Juggling work and childcare commitments, or feeling stressed can all take a toll, so be honest with yourself and see whether there are any healthy lifestyle changes you could make.
However, if you feel you are inexplicably tired despite good sleep, a healthy diet and regular exercise, it’s worth visiting your GP. They’ll be able to go through your medical history with you and are likely to ask about your sleep quality. For example, they might ask whether you snore, as difficulty breathing could mean you wake throughout the night, which would explain your exhaustion the next day.
Your GP is also likely to order a blood test, to find out whether any health issues are the cause of your tiredness. If there is a medical cause, it can often be easily remedied.
One of the most common medical reasons for feeling run down is iron deficiency anaemia (typically, you feel you can’t be bothered to do anything, your muscles feel heavy, and you get tired quickly). Other causes could be an under-active thyroid, diabetes or a vitamin deficiency. For example, people who have a low level of vitamin D can feel tired, however this can be easily alleviated by taking a simple vitamin D supplement.
I’m adventurous and love trying new foods when I’m abroad, but I’m always nervous about food poisoning. Is there a way to avoid it, and what should I do if I fall ill?
For the best chance of staying well on holiday, avoid any restaurants that look dirty, or have unclean crockery or glasses. If dishes are poorly washed, they will harbour bacteria, which could make you unwell.
Buffets are notoriously hazardous as the food is typically unrefrigerated or gently warmed for lengthy periods, which causes bacteria to multiply. If you do eat at a buffet, choose food that’s been cooked thoroughly, and avoid sushi, rare meat and shellfish. If the tap water isn’t safe to drink where you are, only eat fruits that need to be peeled, unless you can wash them yourself.
Restaurants that have a fast turnover of customers are likely to be safe options, because the food won’t be hanging around for long. They’re also likely to be popular for a reason!
If you’re unlucky enough to suffer from an upset tummy, make sure you stay hydrated. Take very small sips of water for the first few hours after you’ve been sick or had diarrhoea, and then gradually increase the volume as you feel able to.
If you stop passing urine or if it becomes very dark, you will need to seek medical help, as this is a sign of advanced dehydration.
When you start to feel like eating again, try small portions of bland, easily digestible food first, such as dry toast or plain rice, and again, build up slowly.
I have sensitive skin, and am prone to eczema and rashes, which can be difficult, especially during the summer. Is there anything I can do – or avoid – that might help?
Eczema can occur when the immune system reacts to an irritant in products like soap, washing powder and shampoo. Food can also be a trigger if our antibodies mistakenly target protein, for example in egg, peanuts or milk, and attack it as it would do invading bacteria.
Try to work out if there’s something you do differently in summer that might explain why you’re more affected at this time of year. Keep a diary of when you get a flare-up and record the foods and drinks you consumed in the hours before you noticed it, and make a note of anything that you have changed recently, such as switching to a new brand of washing powder or trying a new soap or moisturiser for the first time.
If you’re still puzzled by the cause, and it’s very troublesome, your GP can arrange for you to have a blood test to check for allergy to pollen, animal hair, peanuts, egg, milk and other potential allergens. The NHS also offers skin-prick testing, which involves observing the reaction to various proteins when introduced to the skin of the arm.
If you have sun-sensitive skin, protect it using an appropriate hypoallergenic sunscreen (particularly for rosacea, as this condition can often worsen in the sun). It’s worth noting that, while the sun can improve some skin conditions, such as eczema, it can also aggravate skin, especially if you suffer from prickly heat.
I know I should exercise to help me lose weight, but I have high blood pressure and worry it will get worse as I’m working out. How can I exercise safely?
It’s true that exercise temporarily raises blood pressure, because your heart is working harder to deliver oxygen to your muscles. However, regular moderate-intensity exercise usually improves high blood pressure – called hypertension – as well as helping weight-loss, which also lowers blood pressure, thereby reducing the strain on coronary arteries. Other things you can do to improve your condition include cutting down on alcohol and salt, quitting smoking and minimising stress.
First, though, visit your GP, who can re-check your blood pressure and calculate your cardiovascular risk score, which is a measure of the likelihood of developing a heart or circulation problem, such as heart disease, over the next 10 years. Depending on how high your blood pressure is, your GP may want to start you on medication before you begin an exercise programme.
If your risk score is high (common in smokers who are very overweight or obese) your GP might suggest you start with 20-minute walks that make you slightly breathless and sweaty. Once you manage those, without chest pain or feeling faint, you could push yourself a little harder every week, in steady increments.
I know that exercise will help me to lose weight and look better, but I need more motivation to do it. What other benefits will I get from exercise?
Exercise is the single biggest thing you can do to improve physical health, but I‘ve also heard of GP’s referring patients for activities such as golf lessons to help them manage depression. Personally, I’ve recommended taking up gym memberships to patients with a variety of physical and mental illnesses, and have seen it work brilliantly.
Studies indicate being physically active can reduce your risk of developing coronary artery disease and stroke by up to 35 per cent, and can cut your risk of type 2 diabetes and colon cancer by around 50 per cent. And, if you keep active, you’re also 30 per cent less likely to suffer from depression, more likely to sleep well, and even have a better chance of successfully giving up smoking.
Exercise improves heart and lung function, burns calories, strengthens muscles and bones, and produces feel-good brain chemicals called endorphins, which is why we often feel better after a workout, even if it was a struggle to accomplish.
If you’re finding it hard to get to a gym or exercise class, plan activity into your day, such as walking part of the way to work, so it becomes part of your regular routine.
My weight means I’m classified obese, and my mum’s the same. Could it be inherited, or is it only caused by diet and lifestyle?
Obesity is considered to be the result of lifestyle choices, in most cases. However, genetics and some medical factors, such as an endocrine disorder (where there’s an imbalance of metabolism-regulating hormones) and some prescription drugs are also linked to weight gain. At its simplest level though, obesity occurs when people take in more energy – through food and drink – than they need.
The energy we expend in our daily lives has dropped considerably (in other words, we don’t move as much as we used to), while it’s also become easier than ever to consume more calories than we need.
The most likely explanation, for you, is a combination of lifestyle and genetics. Family members tend to share certain lifestyle habits and be predisposed to some illnesses. If your mother struggles to lose weight, you’re more likely to as well.
However, having a family member in the same boat could help you both to lose weight, as you can empathise with each other.
Studies suggests that losing weight in a group is more effective than attempting it alone, so come up with joint targets and support and encourage one another.
I don’t have much energy and get lots of headaches – could it be dehydration? What are the effects of not drinking enough water?
Yes, mild dehydration can cause headaches and sap your energy levels, but these symptoms are normally short-lived once you’ve taken in enough fluid. Mood can be also affected by short-term under-hydration. And prolonged dehydration can cause kidney stones. The feeling of thirst cannot be relied on to ensure we remain hydrated, because this sensation doesn’t kick-in until we are one or two per cent under-hydrated.
Adults should consume around two litres of water a day, from food and drinks, which can include tea and coffee in moderation. If you suspect you’re not drinking enough, try having an additional couple of glasses of water each day to see if this makes a positive difference to your energy levels.
Air travel, especially on longer flights, and excess alcohol consumption can also make you more susceptible to dehydration, so be sure to increase your fluid intake in these situations.
The symptom that you’re describing can also be a sign of some other conditions, including diabetes and thyroid problems, so visit your GP to have these ruled out.
I'm just starting my weight-loss journey and people keep telling me I'll feel healthier - but how and when can I expect to feel the results?
You may feel more energetic as soon as your diet changes to a healthier one and you start exercising regularly – even before there’s a noticeable weight loss.
Once the weight really starts to shift, perhaps after losing just 7lb, you may feel the difference physically. Your heart and lungs won’t have to work as hard, so you may find you are less breathless when moving around or walking. You may even feel ready to start regular exercise sessions. Your joints will be under less pressure too, so any joint pains you have could start to ease. The closer you get to your healthy weight, the better you will feel.
When it comes to meals, cutting back on sugary and fatty foods, and replacing them with nutritious alternatives will help you feel better. Fizzy drinks, sweets, cakes and biscuits might cause a spike in blood sugar levels, which could then be followed by a rapid drop, leaving you feeling low in energy, Planning meals and including foods with a medium glycaemic index (GI) – such as brown rice and sweet potato – will help keep your blood sugar level steady, and power you through the day. Also, having large servings of vegetables helps to fill and nourish.
I find it hard to say no to a glass of festive fizz and often feel ropey the next day. How can I avoid a hangover?
Firstly, don’t beat yourself up if you overindulge at Christmas, as it’s what you eat on a regular basis that affects your long-term health.
Alcohol dehydrates you, and this can result in low mood and energy levels, as well as a sluggish digestive system. The simplest way to reduce or prevent a hangover is to drink a pint of water before drinking any alcohol, so you’re ‘pre-hydrated’ before you begin. Then drink a glass of water for every alcoholic drink you have, plus another before bed.
Eat a meal before going out, as it will slow the absorption of alcohol and can help prevent you from drinking too much. It also helps combat hypoglycaemia (low blood sugar, another side effect), which makes you shaky and hungry the next day.
Slowly digested complex carbohydrates are most effective, so go for pasta, potatoes or rice. Don’t skip meals the next day, either – regular, healthy food will provide your body with essential nutrients.
I’ve had lower-back pain lately and I’m not sure how to manage it – what would you suggest?
In terms of lifestyle, carrying excess weight puts pressure on the musculoskeletal system, so slimming down can certainly help; you’re on the right track by eating healthily and exercising more.
Avoid the temptation to lie flat for too long or stay sedentary, as research shows inactivity tends to make things worse. With most back pain, it’s vital to keep moving to prevent muscle spasm and to speed recovery – so keeping your back happy is just another great reason to fit in some light exercise that won’t strain muscles, tendons and ligaments.
Walking and swimming are both good. There’s evidence to show that regular yoga sessions can be beneficial for people with aches and pains, including lower-back pain, and Pilates can provide pain relief, too.
Check your posture, especially if you have a desk hob involving computers. Assess your chair height and support, and ensure your computer is at the right level; often a simple adjustment to a workstation can make a big difference, if you’ve had back pain for a while, though, and over-the counter painkillers don’t help, it’s worth a trip to your GP.
I’m finding it harder to lose weight since starting my perimenopause. Why is this and what can I do to get back on track?
As we age, it’s often harder to shed those stubborn pounds. The reason is that we tend to be less active, lose muscle mass and our metabolic rate naturally slows down as we move forward into later life. And you’re right, the onset of menopause (caused by a change in the balance of the body’s sex hormones, usually at around the age of 45 to 55) can affect weight loss. Going through this natural part of the aging process can make you feel more tired and affect your mood, resulting in less of a drive to be active. The night sweats associated with menopause can affect sleep quality, meaning you’re more tired in the day and therefore less likely to feel like exercising (and less likely to make healthy food choices, too). Although it can be difficult to motivate yourself, keeping to your fitness plans will help maintain your muscle mass and thus maintain your metabolic rate. Even if it’s a brisk stroll rather than anything more strenuous, exercise tones muscle, burns calories and promotes wellbeing. Consult your doctor for help if you are having troublesome menopausal symptoms.
My kids are getting ready to go back to school – do you have any advice for avoiding picking up bugs?
It’s hard to steer clear of bugs in a close environment. Both respiratory viruses and vomiting viruses (which are particularly virulent) spread via the droplet route, so just being near to someone and inhaling droplets when they sneeze, cough or even talk will put you at risk of infection.
Getting enough sleep, exercising and eating healthily will help to keep you fighting fit – and proper hand washing is key. Any soap is fine, but if you use a pump dispenser, ensure the pump itself is kept clean. Antibacterial hand gels won’t remove dirt; however, they will kill most bugs. Don’t overuse them as their alcohol content can dry your hands.
Some argue we can be a bit too keen to disinfect, and that exposure to bugs, especially as children, is good for the immune system, helping to prevent conditions such as eczema and asthma (it’s thought the immune system in a child needs to be introduced to a variety of viruses and bacteria in order to develop properly). Keeping yourself and your home clean without being too overzealous is probably the healthiest balance.
I’m trying to eat more healthily, but are there any supplements I should take to help boost my weight loss?
There aren’t really any supplements I’d recommend for weight loss. However, vitamin D is important in winter, as our major source, sunlight, is weak. A deficiency can cause tiredness, aches and pains, which can all hinder your weight-loss efforts.
Even a low-fat, low-calorie regime will provide enough essential vitamins and minerals, if you balance it with fruit and vegetables, and good-quality unprocessed protein such as fish, meat, eggs and soya. However, if you are following a very low-fat diet, you may need to supplement it with certain vitamins. Most notably, the fat-soluble ones: vitamin A, D, E and K. And if you aren’t eating much dairy, you could supplement your calcium intake.
For general health, the B vitamins are a group with a variety of functions, so these are also important. Vitamin B12 is vital in making red blood cells and for nervous-system health (it’s found in meat, eggs, fish, dairy and fortified breakfast cereals). However, if taken in excess, all these vitamins can be toxic. So I would advise you to discuss vitamin supplementation with your GP or dietitian first.
I’m trying to stop smoking, but I seem to want to eat more! Why is this and how can I give up for good?
Well done for stopping – it is the change that can have the single biggest positive impact on your health! You want to eat more because, firstly, smoking is an appetite suppressant, so when you stop, your appetite reverts to normal.
Secondly, when you stop, you look to do other things with your hands and mouth, and food is an easy substitute. The evidence is that joining a stop-smoking group is highly effective in helping you stop for good. If your partner smokes, try to give up together – it’s very difficult to stop with someone smoking around you. Using nicotine-replacement gum, patches and inhalers are all good at helping with cravings – and gym also helps by keeping your mouth ‘busy’.
When it comes to stopping smoking, there is little evidence as to the long-term safety and effectiveness of e-cigarettes. But if you think using them is preventing you from smoking cigarettes, then use them as little as you need.
Finally, there is a prescription drug, which has been shown to help people stop smoking, but visit your GP to see if it is suitable for you.
I know how important proper sleep is for my weight loss and general health, but I often have disrupted sleep. What can I do?
You’re right that a lack of sleep could affect your weight loss – studies suggest that getting too little sleep is linked to larger appetite and increased storage of body fat. What’s more, tiredness can affect your focus, so you might be less likely to stick to your get-healthy plans.
To sleep better, make your bedroom as conducive to sleep as possible. Ensure your bedroom is dark and install blackout blinds if you need them. If noise is the problem, invest in good-quality earplugs – they may take a few nights to get used to, but can greatly improve sleep quality. Avoid tea, coffee, alcohol and exercise just before bed. A good routine, such as having a hot drink and warm bath before going to bed at the same time every night, will help a lot. Most importantly, try not to nap in the day, no matter how tired you are.
These steps should hopefully keep you from waking in the night. If you do wake up, avoid activity that will make falling asleep harder. Don’t play with your phone; instead, listen to relaxing music and have a hot milky drink. A lavender pillow spray could help promote sleepiness, too.
What kind of regular checks should I be having to maintain good health in my 40s and 50s?
You’re wise to stay on top of medical checks – as well as catching any health issues early, you’ll get to know your own body and health better! Firstly, it is essential to keep up with regular cervical screening (for all women aged 25 to 64) and breast screening (for those over 50, but this age might be lowered to 47), which you should be invited to when due by your GP.
Don’t forget your dental health – this is very important, as poor oral hygiene (which can lead to gum disease and in turn, affect your bloodstream) is linked to many health conditions, including heart disease, stroke, diabetes and even some cancers. So, have a check-up with your dentist at least annually.
In addition, I’d also recommend that if high blood pressure or diabetes run in your family, make an appointment to visit your GP for weight, blood pressure, glucose checks and cholesterol, and take their lead on how often to have these tests. Finally, it you take medication, it is important to have an annual review, which should be requested by your doctor, in case your requirements change over time.
What causes high cholesterol? How can I bring my cholesterol level down and then keep it that way?
Good question! Your cholesterol level will be affected by your genetic make-up, diet, weight and alcohol consumption. Cholesterol is a waxy substance that’s made by the liver, but is also found in some foods. It plays a vital role in the function of every cell; however, too much of it can increase your risk of developing heart and circulatory diseases.
In general, eating a low-fat diet and combining this with exercise may be enough to keep your cholesterol within normal range, but if you’re over 50, it’s worth asking your GP to check it for you. Some people are predisposed to high cholesterol, as they have a condition known as familial hypercholesterolemia. Those affected tend to run a higher cholesterol than is desirable, even if they have a good diet and exercise regularly. So, if you have relatives who have suffered heart attacks and strokes at a young age, it’s a good idea to ask your GP to test you before the age of 50.
If a low-fat diet and exercise fail to bring your cholesterol level into the normal range, then taking a drug called a statin is very effective at doing so.
What would you advise your patients to be more mindful of when it comes to staying healthy on holiday?
Although we know the dangers, we still underestimate the sun’s strength (it’s vital to cover up babies and children, as the risk of melanoma is higher if you suffer five serious burns before you’re 20). Stay out of direct sunlight and reapply sunscreen regularly, particularly after swimming.
Another thing people forget? It’s easy to become dehydrated without realising, particularly when sun is combined with wind, which makes you feel cooler. Often, the thirst comes too late and, because heatstroke causes vomiting, it can be hard to get rehydrated in time. So, drink plenty of water, being careful about ice and water that may not be purified – if in doubt, drink bottled. Keep an eye on your urine output, as well, because if you aren’t urinating or your urine is dark, you aren’t drinking enough. Finally, be aware that food hygiene in holiday destinations can be of a lower standard than at home.
Wash your hands before eating and try to eat fruit and vegetables that have been either peeled or cooked. Make sure shellfish and meats and cooked through, too.
I’m trying to cut down on alcohol, but am finding it difficult. Can drinking a little bit be good for you?
Drinking alcohol when you’re on a weight-loss journey can pose a few unique problems. For one, it means you’re consuming empty calories. Plus, after a drink, you may not have as much willpower as you’d like for eating healthily, and the low blood sugar you get as a result of drinking could have you reaching for high-calorie snacks.
It goes without saying that it’s better not to drink excess, but small amounts of alcohol aren’t thought to be harmful. There’s evidence that the Mediterranean diet, which includes a little red wine, is beneficial to health. The reason for this isn’t clear, but while antioxidants in wine could help protect the lining of your heart’s blood vessels, it’s possible we benefit because alcohol acts as a relaxant. So, drinking a small amount can help to lower blood pressure. But beware – too much booze tends to raise blood pressure!
As with most things, moderation is key! Keep below 14 units per week, and have several alcohol-free days, too. When you’re drinking, keep tract of units – they can easily creep up, especially if you’re on holiday, and have a drink at lunchtime, too.
I have a busy lifestyle and seem to catch everything going to this time of year. How can I boost my immunity?
We might be at the tail end of winter, but we often feel run-down and prone to catching bugs around this time. There’s no scientific proof that immunity can be improved by changes in lifestyle alone. However, sticking to good-health guidelines is the single best step you can take towards keeping your immune system strong.
Plenty of sleep and a well-balanced diet certainly help the body fight infection. Plus, there are ways to help prevent catching wintry ailments. Respiratory viruses live in droplets spread by coughs and sneezes and they settle on surfaces. So, hand washing is key – before you eat, drink, or touch your face – especially after being in public places.
Keep your desk clean, and be aware that handbags, mobile phones and remote controls can harbor bacteria: clean them with alcohol-free disinfectant wipes. Plus, a humidifier can help keep the mucous membranes in your nose from frying out (the moisture traps invading microbes).
Finally, if you smoke, quit; the smoke can inflame the nasal lining, making you more susceptible to infection.