I have often thought about how much time and effort each human being needs to spend to stay healthy. It came to me again today.

     I often attend Grand Rounds at Columbia Hospital even though I am a retired physician, because I like to keep up with my old profession and I also like to exercise my brain a little bit. Today's talk was by a cardiologist at the hospital talking about reducing salt in our diet, what that will accomplish and whether indeed it would be possible to achieve that in this country of fast food and prepared foods in boxes. It is known that indeed we would need the full cooperation of our food industry to reduce salt. Studies have shown that there are remarkable reductions in hypertension -- reducing salt can lower systolic blood pressure by 10 to 13 mm of mercury which is what each individual blood pressure medication can do. This means that a significant salt reduction in our diet will allow us to drop one blood pressure medication. Our high salt diet has been linked not only to hypertension but to gastric cancer, osteoporosis, kidney failure, obesity, strokes and heart attacks. Finland, later Japan and then England have made national moves to force the food industry to lower salt intake. In the English study for example, heart attacks were reduced by 80% and it is calculated that the average person in England with this salt reduction will live 5-6 years longer. Pretty impressive numbers! It is estimated that in this country there are 100,000 deaths per year by cardiovascular events that could be prevented by lowering sodium in the diet. This is the equivalent of 2 jet liners crashing every day for a year. Now if a single jet liner crashed daily for 3 days, don't you think that all planes would be grounded and there would be a huge shake up to improve safety and figure out why such an awful thing was happening? Yet that equivalent of people die each year from the salt in our diet, and so far very little is being done to help the situation. Needless to say it was a very interesting talk and following discussion. But this prompted me to try harder to reduce salt in my own diet and avoid the snacks and other foods that unfortunately I love so much. Therefore I am back to reading the ingredient lists on foods I have in my pantry and when shopping at the store. This all takes a lot of effort and I can't even venture the amount of extra time it takes.
     In general, we eat way too much fast food and deli food with its salt and with too many calories in the form of fat and sugars. If we each really try to buy less of this kind of food and prepare food from scratch at home we will invest a very large amount of time. I can only guess that we cooks would be spending at least 2 more hours a day to prepare these healthier meals.

      I also recently went to the dentist. After such a visit I am always inspired to floss better and brush better and try to keep up with my teeth. Add maybe -- oh let's say 20 minutes a day to brush better and floss at least once.

     Then of course there is my recent encounter with skin cancer. So I am being very faithful about wearing sunscreen. Of course, I now put it on whenever I go out in my garden or go for a walk. But I have recently learned that I should be putting it on just when I drive to run errands. Did you know that the majority of skin cancers occur on the left side of the body, usually the arm, side of neck or shoulder, or face. This is especially true in men. Why would this be? Well, it is postulated that it is because men usually drive the car and hang their left arm out the window. But even if you don't hang your arm out the window, significant UV light can come through your cars windows unless they are made to block UV light. Even if they are, they may not block UVA light and that can over years of time cause skin cancer. So now when I am driving I am conscious of what part of my body is in the sun and am now putting on sunscreen even if I am just off running errands. It doesn't take much time but it is another obligation I am trying to meet. My exercise patterns which you will read about below involves water aerobics. In the summer, there is lots of sun exposure so now I have sent for sun protection swimwear with long sleeves on the top and longer pants on the bottoms. Cost: $130. Time to put on sunscreen: 10 - 20 minutes per day depending how much you are out in the sun.

     What about your exercise plan? You are supposed to exercise aerobicly for at least 30 minutes every day. If you are not in too good a fitness shape then you will have to exercise at a slower rate and maybe are just going to go for a walk. Then you will have to spend more time at that exercise to get the same benefit -- probably spending 50 minutes or so with that slower paced exercise.

     How many of you women spend a lot of money on skin products for your face and skin elsewhere on the body. I usually don't use too many of these products but as I get older my skin on my legs is getting dryer and with the water aerobics that I do, I need to put lotion on my legs to keep the skin moisturized. It is recommended that you apply this moisturizer after showering to trap the moisture into the skin. Extra time -- maybe 5 minutes.

     How much sleep do you get? We all know the touted 8 hours per night.

     I am a very spiritual person! I try to meditate daily. There are many studies that show that regular meditation lowers blood pressure, lowers pulse rate, calms anxiety, prevents and even treats depression, lengthens life. The usual minimum for meditation is about 20 minutes a day, but more frequent practice can only help more. Though some of the benefits from meditation are seen after regular practice for only 4 days. But one would assume those benefits are lost if these practices are not kept up. If you do not meditate and instead obtain your spiritual practice from  church attendance you are investing time there as well. Membership in a church also is membership in a community which requires other responsibilities and volunteering time and effort as well as money to the community. Difficult to estimate this time and money, but let me venture an average of 2 hours per week minimum.

     What about you ladies with your hairdresser. Do you go once a week for a wash and styling? If you do your hair yourself, you are investing more time than that a week. I would estimate at least 15 minutes per day.

     Do you get regular manicures or pedicures? I have never had one of these so I can't estimate the time and money spent on such luxuries. But it must be about an hour per week. Is this a reasonable estimate?

     I have read that if we don't exercise our brain regularly we may be more at risk for dementia in later life. We can't just sit in front of the TV. We must actually learn something new each day whether it is studying a new language, doing crosswords, or word puzzles, or taking a class. Let's figure at least an hour per day with these endeavors.

     It has been shown that those who live longest and healthiest are those with the largest and most effective support group. Support group equals friends. So for our health we need to maintain a healthy group of people around us who care about us a great deal. Those people are not going to be there for us unless we contribute to the maintainence of these friendships. This maintenance takes time as well. Let's figure at least 2 hours a week to keep friends as close as we need them for this purpose. I suspect that it would take a lot longer.

     What else do we need to do to keep ourselves happy and healthy? Any other ideas?

I think we are up to about 4.5 hours per day without your required sleep. Just do some math and you will find where that 5-6 years you saved watching your salt intake went. Yup, reading ingredients, and doing all the other things listed above. It's a wash!