Q: I am a 45 year-old with a sedentary job. Can you give me any advice on how to generally get some energy back, and to get rid of my beer belly? I work five or six 10-hour shifts each week, driving a taxi. At the moment, I play five-a-side once a week. I am looking for results long term and would be willing to try anything. My diet is not bad but could be better.
Leonard M, by email
A: Sara Stanner writes
Many people with jobs such as yours that require you to sit most of the day, find themselves putting on weight, particularly around the middle — something we are all prone to with age.
Even if you regularly hit the gym or play a sport each week, sitting for most of the day can lead to a gradual increase in unwanted pounds. But it is great that you are thinking about the long term as this suggests that your motivation for trying to lose weight is primarily your health.
A large middle increases your risk of high cholesterol, high blood pressure, heart disease and Type 2 diabetes. But crash diets are not the answer for anyone who needs to keep their concentration sharp at work: they will leave you tired, lacking in energy and irritable. At the end of the day, the only way to lose weight, including around your stomach, is to burn more calories than you consume. But this is difficult for people in sedentary jobs where there is little opportunity to be physically active and it is easy to be tempted by high fat/sugar snacks.
There are some good apps now that make calorie counting much easier and you may find these useful, especially initially to get a good view of how much you are eating and the number of calories you need to cut down to achieve a steady rate of weight loss.
Starting the day with a healthy breakfast is an important strategy for losing weight and keeping it off.
To control your appetite during the morning opt for foods containing high levels of fibre and protein, which will keep you feeling fuller for longer. You can get lots of “on the go” breakfasts now like porridge pots (you only need to add hot water), ready-to-eat muesli with fruit and low fat yogurt and a variety of cereal pots — try to opt for whole-grain breakfast cereals or read the food labels to look for those higher in fibre and low in sugar.
As it can be difficult to eat healthily while on the road, be prepared and pack healthy meals, snacks and drinks. Make sure you have some healthier snacks to hand to keep your energy levels topped up, such as whole-grain crackers with a small portion of cheese, fresh fruits like bananas, apples or grapes, dried fruit or a small bag of unsalted nuts.
And watch what you drink — always have water to hand, use lower fat milk for tea/coffee and cut back on sugar-containing drinks including fruit juice as these are an added source of calories.
Look for ways to be as active as possible when you are on breaks — even a short walk will burn excess calories.
A: Tony Gallagher writes
For someone in your occupation immobility is the enemy, in the sense that it diminishes energy levels and retains body fat. Additionally, London taxi driving is particularly demanding on memory as demonstrated in a study led by the University College of London. Exercising your body will help keep your brain alert as well as counteracting the back, neck, shoulder pain, general muscle strain and the lack of energy you describe.
Ideally it would be very useful if you could get up and move about for five minutes or so of every hour.
We should be taking inspiration from New York, where there is an appreciation of the challenge that cab drivers face, given the long stretch of immobility they endure. “Taxi yoga” classes are in place, geared specifically to them. The aim is to promote exercises and breathing techniques for the body and mind with a focus on the lower back, neck, and shoulders. Relaxation techniques, a healthy diet and general body awareness are also emphasised. If you can manage to find a bit of time during your shift, doing simple mobility exercises in a slow, controlled manner will re-energize you.
Starting with your neck, slowly look up and look down 10 times. Follow this by slowly looking to the left then back to the centre and then look to the right. Repeat this five times. Drop your head to the side, trying to touch your shoulder with your ear, then repeat on the other side.
Moving to your shoulders, rotate them forward and then backwards (in a controlled manner) five times. Stretch your chest by pulling both shoulders backwards and holding this position.
Stretch your back by bringing both your arms to the front, crossing them and then pushing them away from you.
If sitting down (but not in the driving seat), slowly kick one leg out in front of you and back in again. Repeat this 10 times, then do the other leg. To rotate your trunk while sitting down, looking behind you, return to centre and then look the other way. Repeat five times.
Rotate your wrists clockwise and anticlockwise several times.
If you can get out of the taxi, hold on to the door handle and place yourself in a squatting position: hold this pose for a few seconds, then return to standing. Repeat several times. This is a great release for your lower back.
Finally, stand with hands on your hips and bend the upper torso backwards as far as is comfortable — this counteracts the effects of sitting with your back bending slightly forward at the steering wheel for most of the day. Try and keep the exercises flowing so you are constantly moving. You will feel the tension abate as you do them.
As regards weight loss, it is not possible to “spot reduce” fat from one area only, so your beer belly is best tackled by a combination of better diet, as Sara says, and an overall increase in exercise. You’ll probably find that if you move more generally, even gently, during the day, you’ll have more energy for a vigorous workout at other times in the week. Can you play five-a-side more than once a week? Or go for a jog when you’re off duty? The more weight you lose, the more energy you will have and it will have a snowball effect.
Nausea with no cause
Q: My daughter is 12 years old and has been feeling nauseous for a year now. For the last six weeks she has been feeling worse. It’s just the constant terrible nausea and we don’t know what it is. I was wondering if you have heard of this before? The GPs we’ve seen don’t know what it is. She has been for blood tests and to see a specialist but still has the constant nausea.
A: Dr Dan Rutherford writes:
Persistent nausea over months, in the absence of vomiting or any other symptom of ill health, is unusual. Nausea and abdominal discomfort, particularly in children, do not always have a physical cause and this makes diagnosis more difficult. A short course of an effective anti-acid medicine like omeprazole should clarify if stomach acid reflux is the problem, as response to treatment is swift. Gallstones are not unknown in children and are easily detected with an ultrasound scan. There are some rare causes such as hormone deficiencies but there would usually be a pointer to them from the blood tests, so these are less likely.
Chronic anxiety should be quite high up the list of potential explanations. Could there be bullying happening, or undue worry over some aspect of schoolwork or home life? Given the length of time this has been going on it may help to now get an opinion from a child psychiatrist. If this points away from a psychological cause then one needs to reconsider the diagnosis, possibly with the help of other paediatric specialists.
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