People gain on average five pounds (two kilograms) in the four-week Christmas period, according to the British Nutrition Foundation. This is because they tend to increase their food intake by about 500 calories every day. And on Christmas Day itself, many people can consume up to 6,000 calories – that’s three times the recommended daily intake for women and more than twice the recommended level for men.
Many people focus on the short-term effects of overindulgence during the festive season, but there is a risk that a longer-term change in regular lifestyle habits can lead to more serious health problems too. According to the British Heart Foundation, the build up to Christmas can be stressful, not to mention the festive season itself, causing people to slip back into unhealthy behaviours, such as smoking and drinking more alcohol, in the New Year.
Overindulging in rich foods can trigger digestive symptoms such as heartburn, indigestion and diarrhoea. Dr Anton Emmanuel, medical director of the digestive charity CORE, says that people tend to eat larger quantities of food more often when they are eating with friends and family. “The western diet tends to be high in fat, especially at Christmas time,” he says. “The gut can only absorb a certain amount of fat, so if the capacity is exceeded, people are likely to develop fatty diarrhoea. Pharmacy customers should be advised to take a small amount of loperamide for short-term diarrhoea or try antacids to ease any heartburn and indigestion. But they should seek medical advice if their symptoms persist after their eating habits have returned to normal or if they experience red flag symptoms like weight loss or blood loss.”
Unfortunately, bad habits can be hard to break. “Over the festive season, most people eat a high-fat, high-sugar diet and consume bigger portions of food than they normally would,” says Debra Williams, registered freelance dietitian at Eat Well Now and spokesperson for the British Dietetic Association. “The food may also be richer and spicier than usual. The liver may have to work harder too. In the longterm, overindulgence can lead to an increased body mass index (BMI) and obesity, raising the risk of a fatty liver, diabetes and heart disease.”
Overindulgence doesn’t have to mean going up a clothes size in the New Year. But it’s important to plan meals carefully not just over the festive period but also once the celebrations are over. Debra says that some people do find it hard to get back into a healthy routine.
“There is a great app called myfitnesspal, which helps you log what you eat and drink, so you think about what food and drink you are having,” she says. “People should make sure their plate is balanced – half vegetables/salad, a quarter starchy foods and a quarter protein. Find a buddy to eat a healthy diet with and exercise with friends for motivation. They shouldn’t try fad diets, as these won’t work in the long term.”
Keeping active is as important as healthy eating in helping to reverse some of the festive damage. In December 2013, research published in The Journal of Physiology revealed that just one week of overeating can lead to poor blood sugar control and other physiological changes. Yet 45 minutes of exercise a day over the festive season can stop most of these negative changes from taking place, even if people are still gaining weight.
Unfortunately, fitness regimens often take a back seat during the festive season. When people relax and spend time with family, they tend to watch TV or play computer games, rather than take regular exercise. Yet according to Dr Andrew Blannin, an expert in exercise metabolism at the University of Birmingham, exercise is the best strategy for keeping weight off in the long term. “Gradual weight gain over our adult years is mainly due to small daily energy imbalances which are individually trivial, but when they accumulate over months and years cause us to very gradually gain weight,” he says. “Most studies show that dieting is more beneficial in the short term, while exercise is better as a long-term strategy. Regular walking is as good as any, and – as a general rule of thumb – you expend approximately 100 calories per mile covered.”
If customers don’t have time to follow their usual exercise pattern during the festive period, they should still try to build some physical activity into their daily routine, to keep the momentum going. For example, rather than watching TV after Christmas lunch, they could go for a brisk walk or a gentle bike ride. Exercise can also help to prevent indigestion and constipation caused by overindulgence, as it keeps the digestive system moving, and clears the head so people feel more refreshed.
Going for a brisk walk after Christmas lunch can help to offset the effects of overeating
Just one week of overeating can lead to poor blood sugar control and other physio-logical changes
At Christmas and New Year parties, it’s common for people to drink more than the recommended three to four units of alcohol per day for men and one to two units per day for women. In December 2013, Drinkaware research revealed that over half of the British people surveyed said they planned to drink more in December than at any other time of the year.
Alcohol not only stimulates the appetite, but also weakens the resolve not to overindulge. In the short term, it may help people nod off more quickly, but even just a few drinks can affect their quality of sleep. Alcohol is a diuretic, so drinking excess increases the risk of dehydration and hangover symptoms (e.g. headaches). Alcohol can cause acid reflux too. And research shows that combining alcohol and energy drinks (which are usually high in caffeine) can lead to more physical and psychological effects than drinking alcohol on its own.
“Drinking too much can lead to alcohol poisoning and a trip to A&E,” says Lauren Booker, Alcohol Concern workplace programme manager. “Many people underestimate the potential for harm from one night. There’s an increased risk of accidents and violent situations, and many people don’t think about how they are going to get home safely. There’s also the issue of one-night stands, so pharmacies should promote the importance of contraception and emergency contraception to customers well in advance of the festive season.”
Alcohol Concern’s Dry January campaign aims to help people think about their drinking and get support in breaking bad habits. “Dry January encourages people to have a month off the booze – they can save money and lose weight,” says Lauren.
“Regular drinkers may benefit from taking vitamin B complex supplements, as alcohol interferes with the absorption of these vitamins. Key advice for pharmacy customers is try not to drink on two nights in a row. If you are not used to drinking, have an alcohol-free drink between the alcoholic ones and use mixers with spirits. Take it easy the next day and drink lots of water to rehydrate and help to reduce the effects of a hangover.”
Not all traditional festive foods are fattening. In fact, many of them can be nutritious if they are prepared in a healthy way, and others can be an occasional tasty treat. Turkey is a low-fat source of protein, as long as the fat-laden skin is removed, while light meat has slightly fewer calories than dark meat.
Serve a variety of seasonal vegetables, using herbs for flavour rather than a layer of butter; Brussels sprouts and carrots are actually good sources of vitamin C. Replace sausage meat stuffing with a low-fat chestnut version and serve Christmas pudding with custard made with lower fat milk or low-fat Greek yogurt rather than double cream or brandy butter.
In December 2013, TV food psychologist Dr David Lewis, of Channel 4’s Secret Eaters, and eating expert Dr Margaret Yufera-Leitch, revealed the perfect Christmas dinner to leave people satisfied rather than stuffed. They suggested: 150g of white roast turkey meat; 110g of chestnut stuffing; 100g of gravy; 15g of cranberry sauce; one chipolata; 80g of roast potatoes; 155g of steamed sprouts; 160g of steamed carrots and 150g of red cabbage. After the main course, they suggested a 28g slice of Christmas pudding, a mince pie and a fresh clementine.
During the winter months, many people feel a little tired and run down, sleep a bit more than usual and maybe gain some weight. But for around 20 per cent of the UK population, these symptoms affect their daily life – a condition known as the ‘winter blues’. For around two per cent of the UK population, these symptoms are particularly severe, and sometimes disabling, and are accompanied by depression and anxiety – this is called Seasonal Affective Disorder (SAD) or ‘recurrent winter depression’.
SAD seems to be triggered by a lack of daylight in the winter months. It starts in the autumn or winter and stops in the spring and summer regularly each year. Many of its symptoms are the same as those of normal nonseasonal depression, but people with SAD sleep more and eat more, rather than less. The condition is usually diagnosed over three or more winters, so that the pattern of symptoms becomes clear.
The treatment of SAD largely depends on the severity of the symptoms. Mild symptoms may be eased with simple lifestyle changes, such as going outdoors as much as possible during the darker months. For more severe cases, however, the treatments are usually a light-box or antidepressants, or a combination of the two, often with psychotherapy, cognitive behavioural therapy (CBT) and/or counselling.
“Some people choose to take antidepressants every winter, while others need these all year round and just adjust the dose at different times of the year,” says Jenny Scott-Thompson, media officer at the SAD Association. “Some don’t use any medication at all, but rely on light-boxes and lifestyle changes. Pharmacies can stock light-boxes and dawn simulators. A light-box must be an official medical device, offering high enough levels of light and UV screening to reduce the risk of damage to the eyes. Dawn simulators are similar, but have a timer so they turn on during specific hours.”
The winter is a key time for colds and flu and other viral infections. Keeping healthy with a balanced diet rich in fruit and vegetables should help to keep the immune system in tip-top shape. However, many people also like to take a dietary supplement or herbal remedy (e.g. echinacea, zinc, vitamin C, probiotics, etc) as an extra precaution over the winter months.
Norovirus – the winter vomiting bug – is the most common stomach bug in the UK. Common symptoms include a sudden onset of nausea, followed by projectile vomiting, watery diarrhoea and fever. Most people make a full recovery within a couple of days, but the virus can be dangerous for the very young and the elderly.
Norovirus spreads easily from person to person. In June 2014, research published in The Lancet Infectious Diseases Journal revealed that norovirus is responsible for almost a fifth of all cases of acute gastroenteritis worldwide. And, according to NHS Choices, it is estimated that between 600,000 and one million people in the UK catch norovirus each year.
Currently, there is no vaccine or treatment for norovirus. But there are ways to reduce the chances of catching the infection and ease the symptoms (and the risk of complications) if they do occur. Good hand hygiene is essential to stop the spread of all viruses (not just norovirus), as is avoiding direct contact with other people until at least 48 hours after the symptoms have disappeared.
“It’s important to wash the hands regularly with soap and water or use alcohol-based hand gels,” says Dr Emmanuel. “If people do contract norovirus, they should avoid food for the first 24 hours and then limit fatty and starchy calories. The biggest risk is dehydration though, so drink 1.5 litres a day plus the equivalent of whatever has been lost in the stools. It’s important to drink more than you think you need. Over-the-counter rehydration therapy products are useful to keep at home, just in case a member of the household develops the symptoms.”