In January we contemplate what we want to achieve in the upcoming year. New year’s resolutions are great for those who stick to them but many make similar resolutions each year because we didn’t quite achieve last years.

What we lack is a plan. For example, “I resolve to get fit” is a great aim but how is it going to happen? “I resolve to exercise three times a week by going to the gym” or “I resolve to walk five times a week for 30 minutes” puts specifics into the resolution that makes change far more likely.

“I resolve to lose five kilos is a fine intention but won’t happen without changes to eating patterns. “I resolve to cut down on refined carbohydrates, eliminate soft drinks and fruit juice and reduce my portion sizes by 10% puts a plan into the goal.

On a broader front there are some things that it would be great to see in the health arena in Australia this year. The following six items are not resolutions and realistically won’t be achieved in one year. However, at an individual, community and government level we could resolve to make a start.

  • Legalising Vaping

Australia has historically done well in reducing rates of smoking. Yet between 2013 and 2016 there was actually a small increase in the total number of smokers. Norway has halved smoking rates in a decade. In Scandinavia, alternate mechanisms for delivering nicotine are legal. In the UK smoking rates are dropping as they support smokers switching to vaping which allows delivery of nicotine without smoke. Research has shown that vaping is up to 95% less harmful (note nothing is harm free) than smoking. Europe Japan, the USA and New Zealand all allow and to varying degrees promote vaping as a way for smokers to reduce harm. Australia remains an outlier preferring to congratulate itself on past glories. This issue will get increasing attention in 2018 and legislative change will come one day.

  • Overhaul dietary guidelines

As has been clearly documented, the rise in rates of obesity and type two diabetes has coincided with the introduction of low fat dietary guidelines and increased consumption of refined grains. The official response so far has been to blame the public for doing what they are advised and to pillory those who point out the flaws in our current approach (including the relatively useless star system). Many individuals have had great success in improving their wellbeing and often losing weight (and for some with diabetes reducing their need for medication) by going back to the future and eating like their grandparents did up till the late 1970’s. Again, there will be no change at a government level this year as there is too much vested interest involved. However, many individuals will make the change and communities of these people are growing.

  • Simplify access to Medicinal Cannabis

In November 2016, Australia joined a growing number of countries recognising that medicinal cannabis has clinical benefits to a number of patients with certain conditions. Yet a year later access remains difficult for most patients. Both the AMA and RACGP have recently acknowledged that prescribing medicinal cannabis is difficult for doctors and that there needs to be a framework for doctors and patients, that whilst maximising safety, it does not unduly impair legitimate access. This is one where we may see movement in 2018 especially as Australian produced product becomes available for the first time.

  • Embrace technology

For all the negative talk about addictions to smart phones, they can also help our health.

There are literally hundreds of thousands of health and wellness apps. Some are not that useful but many are. Knowledge is power and our ability to measure aspects of our health is growing almost exponentially. With measurements we can measure the effects of any changes we make. Fitness, stress and sleep apps have helped millions of people with their exercise regimes, to improve their sleep patterns and to manage their stress. Monitoring of blood pressure, lung function and blood sugar (to name but three) at home also helps with medical management of numerous conditions.

  • Avoid fads

This is the eternal chestnut. Whether it is the latest eat lemons on Tuesday diet or a you-beaut fitness class we can be drawn to the newest trend for no other reason than it is new. There is nothing intrinsically wrong with new trends, humanity does not progress without new thinking. However, with exercise, there are only two key components to success. Find an exercise regime that you like and then stick to it long term. If you find something new that you like change your regime and then stick to that. With eating, the key remains eating mainly real (rather than processed) food and not eating more than your body uses.

  • Talk about the future

The Medicare system was introduced when the Commodore 64 was the latest technology. It serves us well. However, over the last five years it has become impossible to ask how it may work in the future without being accused of “attacking Medicare”. An aging population and higher rates of chronic illness means it (like health systems worldwide) can’t realistically survive without change till its 50th birthday in 2034. Currently the solutions are not known, but never will be if we cannot discuss them.

Advancing these big picture items will be slow. That doesn’t matter. What we need is to make a start.

 

Declaration: Dr Joe Kosterich is Medical Advisor to Medicinal Cannabis company Little Green Pharma and sits on the board of Australian Tobacco Harm Reduction Association(ATHRA)

This article first appeared on WAtoday.com.au