Diet over the Festive Season

The festive season is a time when we get together with family and friends, and often have more social gatherings than at other times of the year. Invariably getting together involves eating, and sometimes consuming excessive amounts of food or excessive amounts of unhealthy foods. Many of the foods served at parties (e.g. chips, salted nuts, cakes) are unhealthy if consumed in large quantities. Dinners served at restaurants may have higher quantities of fat and salt than those prepared at home, and many restaurants also offer very large portion sizes, meaning more calories. We tend to drink a lot more alcohol?too, and this can contribute significantly to our daily calorie requirement.

The festive season is therefore a time of year when there are many challenges to maintaining a healthy diet. There are definitely guidelines to help remember what and how much we should be eating every day. With a bit of effort we can incorporate healthy food into our diet during the silly season.

To maintain our weight, we should be having the same amount of energy from food and drink (measured in calories) as we use up to perform bodily functions and do exercise. So if we're eating and drinking far more calories than we are using, we can put on a lot of weight. Eventually this can lead to much more serious problems.

The festive season is hectic so people tend to skip exercise and go to a lot more parties. Therefore it's often at this time Australians can gain weight.

It is important that you eat a balanced diet, rich in vitamins and minerals and including each food group in appropriate proportions. Women should eat the following quantities each day:

Fruit: 2 servings (one serving is a medium piece of fruit or equivalent);Vegetables: 5 servings (one serving is 75 g of cooked vegetables or a cup of raw salad vegetables);Cereals: 4–9 servings (one serving is two slices of bread; one cup of cooked rice or equivalent);Dairy products: 2 servings (one serving is 250 mL of milk, 40 g of cheese, or?200 g of yoghurt);Lean meat, poultry, fish and legumes: 1 serving (one serving is 65–100 g of cooked meat or equivalent);Fats and sugars: In small quantities, occasionally.?

Men should eat the following quantities each day:

Fruit: 2 servings (one serving is a medium piece of fruit or equivalent);Vegetables: 5 servings (one serving is 75 g of cooked vegetables or a cup of raw salad vegetables);Cereals: 6–12 servings (one serving is two slices of bread; one cup of cooked rice or equivalent);Dairy products: 2 servings (one serving is 250 mL of milk, 40 g of cheese, or?200 g of yoghurt);Lean meat, poultry, fish and legumes: 1 serving (one serving is 65–100 g of cooked meat or equivalent);Fats and sugars: In small quantities, occasionally.

Eat plenty of fruit and vegetables

Fruit and vegetables provide essential nutrients which against many chronic health conditions. Eating at least 2 servings of fruit and 5 servings of vegetables per day is important for maintaining good health. Many Australians do not get enough fruit and vegetables and, in the busy festive period, we may be even less likely to do so.

Perhaps try the following:

Add fresh, tinned or thawed-frozen fruits to breakfast cereal;Try a banana, tomatoes, mushrooms, avocado, corn or capsicum for toast topping;Serve plenty of vegetables with every meal, including the traditional Christmas feast;Enjoy more exotic seasonal fruits such as cherries and pineapples;Snack on vegetable sticks with low fat dip at social gatherings and on Christmas day;Eat a variety of vegetables, of different colours (e.g. leafy greens, root vegetables);Add fruits to a cheese platter, salad, or couscous;Serve fruit salad for dessert on Christmas day (or other days), instead of the traditional pudding.

Avoid unhealthy snacks

Snack foods (e.g. chips, sweets, cakes, salted nuts) are unhealthy because they have a high fat, salt or sugar content. Eating a lot can therefore contribute substantially to your daily calorie intake, creating a risk for overweight and obesity. This can lead to diabetes or heart problems. So try the following snacks in moderation:

Try preparing healthy dips from fruits and vegetables (e.g. tomatoes, avocado) or low fat yoghurt;Serve vegetable sticks or toasted wholemeal bread with dip, instead of chips and crackers;Remove the skin and trim fat from meat before cooking it.

Consume alcohol in moderation

Consuming excessive amounts of alcohol increases the risk of many chronic health conditions, but also involves immediate risks such as trauma and the morning after hangover. There are guidelines to know how much is safe.

Eat a good breakfast, even on Christmas day

Breakfast provides the body with energy to get going for the day, and also fills the stomach so we are less likely to snack on unhealthy foods in the morning. Eating a wholesome breakfast every day is important, however, in the busy festive season, we might be more likely to skip breakfast, for example because we feel we are too busy. This might be particularly so on days like Christmas, when there are presents to open, visitors to look after and lunch to prepare. You may really benefit from the following tips:

Eating a good breakfast on Christmas day will fill the stomach and reduce your desire to snack on unhealthy food throughout the day;Add fresh, tinned or frozen fruit to breakfast cereal gives breakfast a nutrient boost. Adding traditional Christmas fruits such as cherries can give it a Christmas feel;Use a banana or tomato for toast topping;Add grated apple or pear to pancake mix;Have a fresh fruit smoothie, prepared from favourite fruits, skim milk and low fat yoghurt, to add some calcium to the first meal of the day.

Don't overeat in the festive period

Overeating in a single sitting can lead to an uncomfortable feeling of being overfull, while regular overeating can cause excessive calorie intake and weight gain. Even eating many high-fat or high-sugar snacks throughout the day, or if meals are high in fat or protein, can lead to weight gain.

So try the following during the festive season:

Stop eating when you begin feeling full;Eat slowly to get a better sense of when you begin feeling full;Be aware of portion sizes in restaurants and that they are often very large.Choose light meals from the menu;Drink water rather than sugary drinks;Keep track of how many calories you consume (e.g. using a calorie counter) and aim to eat no more than you expend;Avoid or consume in moderation high calorie snacks like chips, nuts and sweets. Snack on fruits and vegetables instead;When eating out, choose healthy, low calorie options such as salads and low fat meats;When cooking at home, cut potatoes and other vegetables into larger chunks for roasting, as they will absorb less fat and ultimately contain less calories when cooked. Remove the skin and trim fat from meat before cooking it;Get plenty of exercise to burn off calories. Take a walk after eating, or get some exercise playing with the kids and their new Christmas toys.

Prepare and store food and leftovers hygienically

Preparing and cooking poultry

Raw poultry and some other meats?contain harmful bacteria that can cause food poisoning. Cooking naturally eliminates these bacteria, so it is important to ensure that poultry is cooked thoroughly, and that it does not come into contact with other meats while it is raw. To protect against this:

Ensure that the turkey or other Christmas meats are fully defrosted before baking. Stick a fork into the thickest part of the meat to test whether or not it feels frozen;Defrost frozen meat in the fridge if possible. If there is not sufficient space in the fridge, meat should be defrosted in a sealed container, in a clean, cool spot, out of reach of pets and children;Check the packaging to find out how long the turkey or other meat will take to defrost, and ensure that it is removed from the freezer early enough to allow sufficient time to thoroughly defrost. As a rough guide, turkeys take on average: 10–12 hours per kg to defrost in a refrigerator (4oC);3–4 hours per kg to defrost in a cool room (17.5oC); and2 hours to defrost at room temperature (20oC). Ensure that raw poultry or other meat does not come into contact with other foods by: Washing hands thoroughly after touching poultry;Cleaning benches, chopping boards and other utensils thoroughly after using them to prepare raw poultry;Don't wash the turkey as it is unnecessary and can spread bacteria;Store turkey away from fresh foods, including other meats, and ensure that juice from the meat does not drip onto other foods;Allow sufficient time to cook the turkey or other meat thoroughly. Cooking times for turkey vary depending on the weight of the bird. As a rough guide, allow the following times for cooking turkeys of varying weights in a 180oC oven: < 4.5 kg: 45 minutes per kg + 20 mins;4.5–6.5 kg: 40 minutes per kilo;> 6.5 kg: 35 minutes per kilo;Ensure the turkey or other meat is thoroughly cooked by: Checking that the meat is steaming hot all the way through;Cutting the turkey open at the thickest part;Sticking a fork into the turkey and checking that the juices run clear;Checking the temperature of the thickest flesh of the bird (between the breast and the thigh) with a thermometer. The flesh should be ? 70oC for 2 minutes or more when taken out of the oven;Waiting for the pop-up timer to pop-up. Some birds come with built-in pop-up thermometers that indicate when the bird is cooked.

Leftovers

There is invariably some food left over after the Christmas feast, so to avoid food poisoning remember to:

Cool leftovers as quickly as possible after cooking, ideally in less than two hours;Store leftovers in the fridge after they have cooled;When using leftovers, take out of the fridge only the portion that will be reused, and leave the rest in the fridge;Do not leave plates of left over turkey or other meat (e.g. on a platter) outside of the fridge for more than one hour;Always reheat leftovers thoroughly so that they are steaming hot all the way through. Leftovers should not be reheated more than once;Consume leftovers within 48 hours.?
For more information on health during the festive season, including sleep, diet, exercise and stress, see?Festive Health.
For more information on nutrition, including information on?types and composition of food, nutrition and people, conditions related to nutrition, and diets and recipes, as well as some useful videos and tools, see Nutrition.? Healthy eating over the jolly season [online]. Glebe, NSW: Diabetes Australia NSW;?2008 [cited 14 December 2009]. Available from: URL linkDiet and lifestyle recommendations [online]. Dallas, TX: American Heart Foundation; 2009 [cited 13 December 2009]. Available from: URL linkDietary guidelines for Australian adults [online]. Canberra, ACT: National Health and Medical Research Council; 10 April 2003 [cited 13 December 2009]. Available from: URL link?Risk factors:?Low fruit and vegetable consumption [online]. Bruce, ACT: Australian Institute of Health and Welfare; 2001 [cited 14 December 2009]. Available from: URL link Healthy Christmas eating [online]. London: Food Standards Agency UK; 2009 [cited 11 December 2009]. Available from: URL linkTips to get 2&5 in your day?[online]. Canberra, ACT:?Australian Government Department of Health and Ageing; 2009 [cited 14 December 2009]. Available from: URL link?Healthy eating for a healthy weight [online]. Atlanta, GA: Centres for Disease?Control and Prevention; 27 January 2009 [cited 13 December 2009]. Available from: URL linkKellett E, Smith A, Schmerlaib Y. The Australian guide to healthy eating [online]. Canberra, ACT: Australian Government Department of Health and Ageing; 1998 [cited 13 December 2009]. Available from: URL link Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein and amino acids. Chapter 5: Energy [online]. Washington, DC: National Academies Press; 2005 [cited 6 June 2009]. Available from: URL link

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Exercise During the Festive Season

A regular exercise regime is essential for a healthy and happy lifestyle. Physical activity helps maintain a healthy weight range, improves body strength and fitness, and has positive psychological effects. People who exercise regularly generally live happier lives and are less stressed than those who do not. Often described as the cheaper non-pharmacotherapeutic treatment alternative, or "exercise therapy", the benefits of exercise are widespread throughout the body system.

Once festive season parties and celebrations begin it is all too easy to swap 30 minutes of exercise for an extra drink at the bar. While letting your hair down for a couple of days will not do your health or fitness any harm (within reason!) when this extends from the beginning of the Christmas parties in early December to well into the New Year it becomes a problem. Furthermore, the more time you spend out of your regular habit the harder it will be to restart your regular regime.

It is not difficult to list valid reasons that exercise and nutritional regimes are interrupted during the holiday period. Long distance travel and the associated jet lag,?interference with usual routines, entertaining visitors, additional responsibilities as well as the general holiday atmosphere all make it very difficult to stay motivated and keep exercise a priority.

There is a well documented tendency for people to overindulge during the festive season which commonly leading to substantial weight gain over the holiday period. Studies have shown that people generally gain as much as 500% more weight per week during holiday weeks compared with non-holiday weeks. This highlights the importance of being aware of how much and what you are eating and to make sure you continue to achieve 30 mins of exercise a day over this period.

The terms "Merry Christmas Coronary" and "Happy New Year Heart Attack" were coined after analysis found that there is a significant raise in cardiac events that has been observed during the festive season. Doctors have suggested that the accumulation of stress and overindulgence during the festive season is responsible for this incidence.

Diet and alcohol overindulgence, especially in predisposed people, is a risky mix and should be avoided. While exercise will not eliminate the risk for cardiac events, it is an avenue to minimise the risk factors; decreasing stress and reducing the net kilojoule count at the end of the day.

Christmas can be a very stressful time and for many people it can also be a very depressing time of the year, especially those with broken homes or those who have lost loved ones. Accumulating evidence suggests that exercise has "antidepressant" qualities; significantly decreasing stress and anxiety and combating the harmful consequences of stress on emotions, physical and mental health.

The relationship between exercise and depression is complex and as yet the mechanism underlying the therapeutic effects has not been established. Exercise has been shown to improve depressive symptoms and a lack of exercise has been shown to increase depression. Additionally, individuals that adopt a physically active lifestyle are less likely to develop depressive symptoms. A vicious cycle effect may exist between the two where an initial lack of physical activity can promote feelings of laziness, guilt and unattractiveness which can predispose a person to become more depressed which in turn affects motivation to begin an exercise program and so on and so forth. This could explain why it is so difficult to restart an exercise regime after taking a break over the festive period and highlights the importance of maintaining good habits over this time.?

Still not motivated to engage in physical activity during the holiday period? It is not unusual to come to the end of the year and believe you need a well deserved break from all the hard work you have been doing all year, and this is understandable. But who says that you need to wake up at 6am and do weights at the gym? During the festive season it is wise to change our exercise goals. Not only will this help you to keep motivated but will expose different muscles to a work out.

The festive season is a time for family and friends. Try changing your normal exercise routine to fun activities the whole family can enjoy. Encourage a game of street or beach cricket with the kids, a backyard game of ‘chasey' or a swim at the beach.? Social exercise does not feel like the regular "work out" and it gives everyone a chance to participate.

Christmas can be a very stressful time so taking some time out to participate in yoga, tai chi or pilates will be a beneficial exercise to combat stress while also keeping up with an active lifestyle.

Remember!?

It is natural to lose enthusiasm for exercise over the holiday period but try not to let this discourage you. Modifying your routine slightly will keep you active and you will be more likely to be motivated in the New Year.

?For more information on fitness and exercise, including stretches, types of exercise, exercise recovery and exercise with health conditions, as well as some useful videos, see Fitness.

Suija K, Pechter U, Kalda R, Tahepold H, Maaroos J, Maroos HI. Physical activity of depressed patients and their motivation to exercise: Nordic Walking in family practice. Int J Rehab Res. 2009; 32: 132-8.Greve P, Wanderley FS, Rebelatto JR. The effects of periodic interruptions of physical activities on the physical capacities of adult active women. Archives of Gerontology & Geriatrics. 2009; 49(2):268-71.Meltzer S, Fuller C. The Complete Book of Sports Nutrition: A Practical Guide to Eating for Sport New Holland Publishers (UK) Ltd. London; 2005.Baker RC, Kirschenbaum DS. Weight control during the holidays: highly consistent self-monitoring as a potentially useful coping mechanism. Health Psychology. 1998; 17(4):367-70.Kloner RA. The "Merry Christmas Coronary" and "Happy New Year Heart Attack" Phenomenon. Circulation 2004; 110: 3744-3745.Salmon P. Effects of physical exercise on anxiety, depression, and sensitivity to stress: a unifying theory. Clinical Psychology Review. 2001 ; 21(1): 33-61. Anonymous. Grief takes no holiday. For people who have lost loved ones, the holidays may elicit dread and apprehension. Here are some ideas that may help, now and year-round. Harvard Women's Health Watch. 2002; 10(4):1-3.Thorsen L, Nystad W, Stigum H, et al. The association between self-reported physical activity and prevalence of depression and anxiety disorder in long-term survivors of testicular cancer and men in a general population sample. Supportive Care in Cancer. 2005; 13(8): 637-46.Skapinakis P, Lewis G, Mavreas V. Temporal Relations Between Unexplained Fatigue and Depression: Longitudinal Data From an International Study in Primary Care. Psychosomatic Medicine. 2004; 66: 330-5.

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Drinking Alcohol Safely in the Festive Season

The festive season in Australia is a time when people gather amongst family and friends and many enjoy a few alcoholic drinks around the barbeque or at the beach. However, at this time of year there are many social gatherings and it can be easy to over-indulge.

Social time is important and can have many health benefits, such as enjoyment and stress relief. However, people who consume too much alcohol can endanger their health both in the immediate and long term. It is therefore an important time for people to be informed about how to consume alcohol safely and be careful to avoid consuming alcohol in quantities that put their health at risk.

The National Health and Medical Research Council (NHMRC) recommends that men and women drink no more than two standard drinks on any given day in order to reduce the long term risks of alcohol consumption. These risks include an increased likelihood of developing cardiovascular problems, diabetes, cancer?and liver disorders.

There are also a number of immediate risks associated with alcohol consumption, which arise because alcohol reduces motor and sensory skills, and also inhibitions. In the immediate term, excessive alcohol consumption increases the risk of trauma and death (for example,?if someone is very drunk and passes out, they may stop breathing or choke). To reduce these immediate risks, it is recommended that individuals do not drink more than four standard drinks in any one sitting.

If a person is intending to drive a motor vehicle or operate other machinery, their blood alcohol level should not exceed 0.05 g ethanol per 100 mL of blood (0.05%). This is the equivalent of consuming one standard drink per hour.

There is evidence that alcohol consumption increases in the festive season. A study conducted in Spain reported increased alcohol and substance abuse at work Christmas parties compared to other times of the year. A study from Finland reported increased alcohol sales (and an increased incidence of fatal alcohol poisonings) on weekends and at times of celebration such as Christmas and May Day.

It is important for people who drink alcohol to be aware how much alcohol can be consumed safely, and to develop strategies to ensure that they don't drink too much. The following tips for safe alcohol consumption apply to any time of year, but may be particularly useful in the pre-Christmas period when people tend to drink alcohol more frequently and in larger quantities.

Remember the difference between a standard drink and a serving of alcohol

Remember that a standard drink is not always equivalent to a serving of alcohol. In Australia, a standard drink is one containing the equivalent of 10 g of ethanol. However, in many cases a single serving of alcohol (e.g. a glass of wine, a bottle of beer) is more than one standard drink or 10 g of ethanol.?A standard drink is the equivalent of:

100 mL of wine (9.5–13% alcohol);250 mL of full strength beer (4.9% alcohol);375 mL of mid-strength beer (3.5% alcohol);470 mL of light beer (2.7% alcohol);30 mL of spirits (37–40%).

Standard serving sizes often contain more than one standard drink. For example:

In restaurants, wine is often served in 150 mL glasses (1.4–1.6 standard drinks);Standard cans and bottles of beer contain 375 mL of alcohol (1.4 standard drinks);Cans of pre-mixed spirits can contain up to 2.1 standard drinks.Reference: Australian guidelines to reduce health risks from drinking alcohol [online]. Canberra, ACT: National Health and Medical Research Council; 2009 [cited 11 January 2011]. Available from: URL link

This information will be collected for educational purposes, however it will remain anonymous.

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Keep track of how much you drink

It is often difficult to keep track of the amount of alcohol consumed, because the concentration of alcohol varies between alcoholic beverages, and because drinks are served in glasses that can hold more than one standard drink. When keeping track of alcohol consumption, it is important to consider both the serving size and concentration of alcohol. Monitoring alcohol consumption on a daily and weekly basis is also important. To make monitoring alcohol consumption easier:

Avoid refilling a half empty glass: It is much harder to keep track of how much is being consumed if a half empty glass?is refilled, compared to when the drinker waits and refills their glass only when it is empty;Keep track of the serving size of drinks: Convert them to standard drinks. Don't assume that a single serving is equivalent of a standard drink;Check how much alcohol the beverage contains: Read the label, which in Australia must state the?percentage of alcohol in the beverage. The more alcohol a drink contains, the lower the quantity that is equivalent to a standard drink.How much alcohol do you have in your system?

Most of us would have been?given a random breath test at least once but how does the reading this test gives actually relate to how many drinks you've had? Use this tool to estimate how much alcohol you have in your blood and how long it might take to sober up.

Click here to calculate your BAC

Set a limit and say no when you've had enough

Aim to limit alcohol consumption to the quantity recommended by the NHMRC for safe consumption. Stop drinking alcohol before or once you have reached the daily limit of four standard drinks. Some people may choose to drink in excess of these guidelines despite the health risks involved. However, these people should still set a limit at which they will stop drinking. It may be difficult to stop drinking sometimes (e.g. if everybody else is having another drink), so it is also important to be assertive and resist the peer pressure to continue drinking.

Space alcoholic drinks and drink in moderation

To avoid getting drunk, space alcoholic drinks throughout the day or evening, for example by:

Starting with a soft drink, fruit juice or glass of water;Drinking a glass of water after each alcoholic drink. This will help to rehydrate the body and also lengthen the period of time between alcoholic drinks;Use a small glass for alcoholic beverages;Drink slowly, taking sips not gulps;Avoid 'shouts' or 'rounds' of drinks or drinking competitions. These may encourage people to drink too quickly to keep up with the rounds;Only have one alcoholic drink at a time;Keep busy while drinking, for example by playing pool or talking with friends;When planning a party, ensure there are plenty of alcohol-free and low alcohol options available.

Choose low-alcohol options

The amount of alcohol contained in various alcoholic drinks varies considerably. For example, full strength beer contains approximately 5% alcohol (compared to 2.7% for light beer) while wine contains 9–13% alcohol and spirits 37–40% alcohol. Because there are many social gatherings in the pre-Christmas period, individuals are more likely to drink more often and may risk exceeding their recommended daily or weekly alcohol consumption. Choosing beverages containing no alcohol or lower concentrations of alcohol (e.g. light beer) or adding non-alcoholic mixers to spirits and wine to reduce the amount of alcohol consumed per glass can play an important role in reducing the total amount of alcohol consumed in the festive season.

Don't forget to eat

Having food in the stomach reduces the absorption of alcohol into the bloodstream and reduces the intoxicating effects of alcohol. It is very important to eat before or while consuming alcohol, and to eat enough food to fill the stomach. If you're planning a party, ensure there is plenty of food available for guests.

Don't drink and drive

Never drive a car if you've had more than one standard drink in an hour! When consumed, alcohol enters the bloodstream and affects the functioning of the drinker's brain, reducing their ability to think and coordinate their actions. Drinking alcohol therefore reduces an individual's ability to perform tasks such as driving a car. Driving under the influence of excessive amounts of alcohol is a major contributor to road accidents in Australia, particularly amongst young people and men. Over half of all alcohol-related road deaths and injuries in the country occur amongst young people aged 15–24 years, while 25% of all road accident deaths amongst men and 41% of all injuries are alcohol related (compared to 11% of deaths and 11% of injuries for women).

In Australia it is illegal to drive with a blood alcohol content of 0.05 g ethanol per 100 mL of blood (0.05%). This is the equivalent of drinking a single standard drink (10 g alcohol) in a one hour period, and is?the level at which an individual's sensory and motor skills remain adequate for performing complex tasks. It is therefore important to avoid driving a car after consuming more than one standard drink per hour. People planning to drink more than one standard drink in an hour should:

Go out with friends and designate a driver who will avoid alcohol, or organise a non-drinking friend to give them a lift;Use public transport (e.g. bus or?taxi) and ensure they have budgeted for the cost of getting home;At a house party, make sure there is extra bedding available for guests who are unable to drive home;Encourage friends who have been drinking not to drive.?
For more information on drinking alcohol, including drinking disorders and alcohol's effect on the body, as well as some useful tools, see Alcohol.?
For more information on health during the festive season, including sleep, diet, exercise and stress, see?Festive Health.Australian Drug Foundation. Ensure this Christmas isn't silly season [online]. 2009 [cited 14 December 2009]. Available from URL: http://www.adf.org.au Australian Drug Foundation. Safe partying for all ages [online]. 2008 [cited 13 December 2009]. Available from URL: http://www.druginfo.adf.org.auNational Health and Medical Research Centre. Australian guidelines to reduce health risks from drinking [online]. 6 March?2009 [cited 22 August 2009]. Available from URL: http://www.nhmrc.gov.au/ publications/ synopses/ ds10syn.htmState Government of Victoria. Tips for a safe night out drinking [online]. 2009 [cited 13 December 2009]. Available from URL: http://www.vic.gov.au/ news-detail/ alcohol-campaign-urges-responsible-drinking.htmlPublic Health Agency for Northern Ireland. Celebrating Christmas by drinking responsibly [online]. 27 November 2009. [cited 13 December 2009]. Available from URL: http://www.publichealth.hscni.net/ lnews/ 49 Press release - Celebrating Christmas by drinking sensibly - 27 November 2009.htmlVidal-Infer A, Tomas-Dols S, Aguilar-Moya R, Samper-Gras T, Zarza MJ, Aguilar-Serrano J. [Christmas work dinners. A pattern of recreational use of alcohol and other drugs?] [Article in Spanish]. Adicciones. 2009; 21(2): 133-42.Poikolainen K, Leppanen K, Vuori E. Alcohol sales and fatal alcohol poisonings:?A time-series analysis. Addiction. 2002. 97(8): 1037-40.

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Avoiding Stress over the Festive Season

Stress is the feeling people experience when they are under too much pressure. When an individual feels stressed, a number of changes occur in their body, for example the heart rate increases, blood pressure rises and stress hormones are released. Feeling stressed can also adversely affect an individual's behaviour (e.g. a stressed person might be irritable and have difficulty getting along with family members and work colleagues). In the long term, stress increases the risk of chronic health conditions such as cardiovascular disorders.

The festive season is a time when many people are busy enjoying time with friends and family, however it can also be a stressful time for many people (remember the year the in-laws arrived on the doorstep unannounced?). Some 20% of Australians experience stress at this time of year. The same proportion of the population also experience health-related stress and stress because of relationship problems, meaning that the festive season is a major cause of stress in Australia.

People may be more likely to experience stress over the festive season because they are busier than usual or because they have many additional expenses at this time of year and more commitments than usual (e.g. family and other social gatherings). Individuals that have high expectations for the festive season may become stressed if the period does not live up to their expectations. Others may experience stress because they are feeling lonely or isolated. While the festive season can be a stressful time, there are many ways individuals can avoid stress and also ways in which they can help their loved ones to remain stress-free.

The festive season is an expensive time of year and covering the additional associated expenses can be stressful. There are however many ways in which financial stress can be reduced with good planning and sensible spending.

Budget and save to avoid credit card spending

Many Australians love to give presents to loved ones on Christmas day, however many also dread the thought of footing the Christmas shopping bill, running up their credit card balance and can become stressed about Christmas-related finances. Preparing a budget early in the year and saving for expenses throughout the year is a key way to avoid financial stress at Christmas time. Having money put aside for expenses will also reduce the need for credit card spending, which can create significant additional expenses because of interest payments and stress related to paying credit card bills in the New Year.

To avoid financial stress and credit card bills this festive season try:

Preparing a Christmas budget early in the year- it should include an amount for forgotten or unexpected presents and extras;Put aside money on a regular basis throughout the year, starting early in the year;Leave your credit card at home when you go Christmas shopping;Set limits on the amount you spend, for example by: Limiting the number of people you buy gifts for;Limiting the cost of each present;Suggesting to your family that each family member buys a present for just one other person, rather than for everyone (e.g. Secret Santa);Suggesting to your family that you only buy gifts for the children.

Stick to your budget and avoid extravagance

A budget is only as good as the individual's ability to stick to it, and there are many temptations to overspend on the festive season shopping. To avoid blowing the budget, remember to:

Avoid extravagance and buy meaningful presents instead of expensive ones;Try making gifts instead of buying them.

Many people dread the thought of shopping in the busy festive season and may become stressed just thinking about it! Planning what you need to buy before you get to the shops, for example by writing a list of presents, can help avoid stress whilst shopping. Starting the Christmas shopping early, before the shops are busy, is also a great way to avoid shopping-related stress. Some people buy presents online or from mail order catalogues to beat the festive season shopping queues.

Health problems cause considerable stress and maintaining good mental and physical health in the festive season is therefore an important factor in reducing stress. Taking time out from the busy festive season to relax, get plenty of exercise and eat a healthy nutritious diet is essential for maintaining good health.

Relax

The festive season is a busy time of year when many people have hectic work schedules (e.g. because they are preparing for holidays), busy social lives and additional demands (e.g. Christmas shopping and entertaining) which may mean they have little time to relax. However, it is important to put time aside for relaxation, including in preparation for Christmas day celebrations. It is also important to get plenty of sleep and quiet time, for example to meditate, perform yoga, read or do other relaxing things.

Get plenty of exercise

Exercise can add fun and energy to the festive season and is important for maintaining good health. However, over the festive season when schedules are disrupted (e.g. because of holidays) and people are often very busy, exercise may be neglected. But the holiday period provides many opportunities for recreational exercise for the entire family. For example, days at the beach, bushwalking holidays and playing with outdoor Christmas presents with the kids are great opportunities to get some exercise. All people should aim to get at least 30 minutes of moderate intensity exercise everyday- even when they are busy during the festive season.

More information on exercise during the festive season.

Eat a healthy nutritious diet

One of the great things about the festive season is all the good food- eating out at work functions, yummy snacks and parties and of course the Christmas feast. Eating a healthy nutritious diet is essential for good health in the immediate and long term. During the festive season it is important to remember the difference between eating plenty and maintaining good nutritional health. At this time of year many individuals are busy and may eat take away or snack food because they are too busy to prepare healthy meals at home. There are also lots of opportunities to over-indulge on unhealthy foods at Christmas parties or dinners. However, maintaining good nutrition whilst enjoying the festivities is possible.

The festive season is an important time of year to spend time with family and friends and time spent with friends is an opportunity to chat, relax and reduce stress. However, organising festive meals can also be time consuming and stressful, and getting together with family members may also create stress for some. Getting everyone involved in organising the Christmas feast or a social gathering (e.g. by bringing a plate of food to contribute) can reduce stress on the day and ensure there is more meaningful time for friends and family.

It is also important to remember:

That spending time is more important than spending money. Children will be just as happy with a small number of gifts and lots of personal attention from their parents, as they will be with lots of presents and little love;That family gatherings are often less than perfect- don't expect them to be, but take time to clear the air prior to gathering, if there are any issues between members of the family;To drink alcohol in moderation.

Organising who will take custody of the children can be a stressful exercise at any time of year. Working out custody arrangements for Christmas day may be even more difficult especially if one or both of the parents have found a new partner, as this will mean there are more people trying to coordinate their Christmas day schedules. It is important for parents who share custody of their children to make advance arrangements about where the children will spend their time on Christmas day, in order to avoid stress on the day and to protect their children from stress.

To reduce the stress associated with making Christmas day custody arrangements remember:

To be flexible and willing to compromise with your child's other parent;Put the needs of the child first- it is unlikely that everyone will be pleased with the arrangements, so making sure they suit the needs of the children is most important;Set aside or resolve differences for Christmas day;Support children to spend time with their other parent;Give lots of love and make children feel special, whatever arrangements are made.

While enjoying the festive season, remember that not everyone is happy and festive at this time of year. In fact the festive season might be a particularly difficult period of the year for some people, for example individuals:

with financial problems;who relate Christmas to a tragic event such as the death of a family member;who have recently experienced a tragic event such as divorce or death; orwho are isolated.

Take time out over the festive season for loved ones who may be experiencing difficulties. Showing them love and care can reduce their stress and also help you feel good about yourself. For example, you may wish to:

Be aware of the signs of stress (including irritability, loss of appetite and tiredness) and be ready to limit your activities, or advise your loved ones to limit theirs, if you notice signs of stress;Invite someone who is lonely to share Christmas lunch;Be prepared to support loved ones who are feeling stress, for example by being available to chat to them when they need someone to talk to;Be prepared to refer loved ones to professional support if you notice they are not coping.

There are many ways of managing or reducing stress should it occur. If you or a loved one are feeling stressed out about the festive season why not try:

Talking to a friend or family member or lending someone your ear;Taking time out to relax and do something you enjoy when you feel stressed;Remaining calm and focussed and not making rush decisions;Having a plan for dealing with stressful situations, for example to go for a walk or sit alone and practice relaxed breathing for a few minutes;Seeking professional help if things get too stressful and coping is difficult.

And remember,?don't be tempted to smoke, drink or gamble to relieve stress. These behaviours are only likely to increase stress in the long term!

?For more information on health during the festive season, including sleep, diet, exercise and stress, see?Festive Health.National Health Service. Introduction to stress. 2008. [cited 2009, December 13]. Available from: http://www.nhs.uk/conditions/Stress/Pages/Introduction.aspx?url=Pages/what-is-it.aspx Torpy, J. Burke, A. Glass, R. Acute emotional stress and the heart. J Am Med Assoc. 2007;298(3):360.American Psychological Association. Managing your stress in tough economic times. 2008. [cited 2009, December 13]. Available from: http://www.apa.org/news/press/releases/managing-stress.pdf Family Relationship Services Australia. Protect children from stress during the festive season. 2007. [cited 2009, December 13]. Available from: http://www.frsa.org.au/UserFiles/Protect children from stress during the festive season(1).pdf NSW Health. Support those who suffer Christmas Stress. 2008. [cited 2009, Decmber 13]. Available from: http://www.hnehealth.nsw.gov.au/news/media_releases/Dec_08/support_for_those_who_suffer_christmas_stressLifeline. Staying balanced over the Christmas period. 2009 [cited 2009, December 13]. Available from: http://www.lifeline.org.au/learn_more/publications/articles/staying_balanced_over_the_christmas_periodBetter Health Channel. Christmas- tips to reduce the stress. 2009. [cited 2009, December 13]. Available from: http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Christmas_tips_to_reduce_the_stressSalvation Army. Stress-free Christmas. 2009. [cited 2009, December 13]. Available from: http://salvos.org.au/christmas/helpful-tips/stress-free-christmas.phpFood Standards Agency- UK Government. Healthy Christmas eating. 2009 [cited 2009 December 11]. Available from: http://www.eatwell.gov.uk/healthydiet/seasonsandcelebrations/winter/healthychristmaseating/Australia Government Department of Health. Fun ways to get moving. 2008. [cited 2009, December 13]. Available from: http://www.health.gov.au/internet/healthyactive/publishing.nsf/Content/fun

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Taking Your Medication over the Festive Season

Christmas can be a busy time of the year for most families. While squeezing in those last minute jobs, it is important not to forget our daily routines and importantly remembering to take your medication.?

Some strategies to help you remember to take your medication include:

Take your medication at the same time every day;Link taking your medication with another activity in your day. For example, take?your medication?before or after breakfast, before or after brushing your teeth, etc;Store your medications where they are easily visible, although out of reach of children;Set reminders on your mobile phone;Include taking your medication on your to-do list?for the day;Make use of pill boxes or Webster packages which have medications grouped into days and times. That way you will know if you have missed a dose;Write a reminder note and stick it on the back of the bathroom, front door or another place where you are likely to see it.

If you do forget to take your medication, it is best to continue with your medication as prescribed and seek advice from your prescribing doctor or an alternative doctor as soon as possible. Depending on what medication you are taking and how many doses you missed, you may need increased subsequent doses, blood tests, or no action at all. Do NOT double up on your next dose unless you have been advised to do so by your doctor. This is important as some drugs are toxic if you take more than your prescribed dose.

If you are going away for the holidays, remember to take enough medications to last you while you are away. It may be helpful to take the medication packaging with your prescription details with you, or a list of your medications and the dose, in case you do require more. This way the doctor will know exactly which medications you are taking and the dose to prescribe.

If changing time zones, speak to your doctor or pharmacist before travelling for advice on how to manage your medications.

If travelling out of Australia, be sure to keep your medicines in their original packaging with your prescription and a letter from your doctor outlining these medications and what they are for.

Most medications need to be stored in cool conditions away from heat and direct sunlight. The storage requirements of most medications are written on their packaging, or on the?information leaflet enclosed within. Alternatively, ask your pharmacist for advice. If your medication needs to be kept cool, refrigerated bags are a great idea while travelling.

Like most other professions, doctors take time off over Christmas and New Year too. So it is important to ring your doctor and find out if they will be practising over the holidays. It is also important to check the days and times that the doctors' offices are open, as these may change over the holiday period. You local chemist may also change its opening hours over the holiday period.

If you take regular medications, make sure you have enough to last you over the holiday period. If not, see your doctor earlier rather than later for a new or repeat prescription. For most drugs, these?are valid for 12 months from the date of issue.

Generally the post-holiday period is very busy and doctor appointments can be scarce. If you require an appointment with your doctor in the post-holiday period for repeat prescriptions or other reasons, it is best to book this appointment early, before the festive season, to ensure one is available for you.

Be aware of alternative forms of health care advice:

Health Direct, a free 24 hour health information service: 1800 022 222After hours GP clinicsEmergency departments

The festive season is a time when many people like to indulge in a little alcohol. If you are?thinking about having a celebratory drink, check with your doctor to make sure it will not interact with your medications.

?For more information on health during the festive season, including sleep, diet, exercise and stress, see?Festive Health.

(Kindly reviewed by Dr Joe Kosterich MBBS, General Practitioner and member of the Virtual Medical Centre GP Editorial Advisory Board.)

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