Q I have high blood pressure. With the Jewish new year fast approaching, I am keen to start a new diet and exercise regime to improve my all-round health. What do you recommend to help me achieve this?
This is a great idea. Unfortunately, the Jewish new year may not be the easiest time to start a health plan, given all the sweet foods we tend to eat during Rosh Hashanah – but it’s definitely worth having a go.
Exercise in any form will improve your health in particular your blood pressure control.
There are so many different types of exercise that each have huge benefits, but even simply walking for 30 minutes a day for four or five days a week will reap significant benefits.
Exercise itself, no matter what your weight might be, is a protective factor against many diseases – including cancer and heart disease.
It is also good for mental health, so you really can’t go wrong. Do something you enjoy so you are more likely to maintain the regime.
Dieting for high blood pressure really has two main aims: to reduce salt and to reduce weight.
Cutting salt from your diet is a proven way to reduce your blood pressure: you should be having less than 6g a day.
That may seem hard to work out but start looking at food packaging at the sodium levels; you will quickly become familiar with what you can eat.
Second, a diet following the EatWell guide, which cuts sugar and processed food down to a minimum will help you lose weight.
Q My son is starting university this month and has been offered a new meningitis vaccination. Does he need it if he was fully vaccinated as a small child?
Yes, absolutely. This is actually a new programme introduced this year particularly for young adults starting university or college, as well as 17-18 year olds.
The Department of Health have introduced the vaccination, as in the last 5 years there has been a 400% rise in the number of cases of meningitis W – a specific strain we see in teenagers. There are a few different strains of meningitis, and meningitis W seems to be increasingly prevalent in the UK.
The vaccination is not new as it has been used for a long time as a travel vaccine because W has always been prevalent in parts of the Middle East. You are right that your son is already vaccinated against meningitis having had his childhood vaccinations, but they are only against certain strains. He will have had a meningitis C vaccination as a child as well as MMR and Hib vaccinations which protect against some types of meningitis but not all.
Because of the way students socialize and live closely together in groups, infections spread easily between them which is why we sometimes see outbreaks of disease in student halls.
It’s certainly a good idea for all new students. While he’s at the GP it’s also worth making sure he’s up to date with any repeat prescriptions he may need to take with him.
Q I find this time of year very stressful preparing for all the chagim and the family meals. I feel I have headaches all the time until it’s over: are they real or just from the stress?
Even if your headaches are from the stress they are still very much real. Our mental and physical wellbeing are very closely connected and often people feel mental upset through physical symptoms.
This happens the whole way through our lives: it’s the same phenomenon that gave you butterflies on your first day of school or stopped you eating when you were nervous before a job interview.
Commonly in practice I see physical signs in patients as a result of their mental state – typically this would be headaches, tummy pain, irritable bowels, fatigue and even irritable bladders.
Whether your headache is coming from sinusitis or stress it is still genuinely there rather than being imagined as some people wrongly think. When people experience pain, they have nerves firing not only where the pain is but also in the brain – what doctors call central pain – and this is likely the mechanism of how stress-induced headaches occur, although it is not entirely understood.
The fact that your headaches go after the chagim is reassuring – obviously headaches are not a symptom to ignore usually but if they are so closely connected to a specific time or event it is less of a concern. You must look at ways to reduce your stress: mindfulness, exercise and asking for help would all be valuable.