So how do we intend to postpone pushing up daisies, delay our inevitable demise and remain fit in mind body and wit?

Since I retired 2 years ago I’ve seen a doctor twice. Once for a medical for Bomaid, a rather cursory assessment, and secondly for a medical for an over 70 driving licence. Even cursoryer. I’m taking no medication for anything, I haven’t needed so much as a brufen. I bought a bottle of cryotherapy spray for a suspicious mole and a basal cell carcinoma on my neck. But our Jack Russel has some little warty skin lesions too, so the cryotherapy is a good investment.

So how do we stay fit and healthy as we get older?

A friend of mine Chris White about 10 years ago told me he had worked out how to make a small fortune in Uganda. Start with a large one. So rule number 1. Start fit and healthy. Get thin and fit in your 40’s and 50’s. Then it’s a lot easier to stay thin and fit when you retire.

We have always known obesity is bad for your health. Most diabetics, strokes, heart failure and hypertension are obese. The proportion of obese keeps going up, so developed countries quickly improved that statistic by redefining obese! So now obese is BMI over 30 in some countries or over 35 in others. So that means fewer people are obese, problem solved! And to add to confusion, heavily muscled people can be world-class athletes with BMI in the 30’s. So let’s just use the F word instead and say being fat is the biggest factor in poor health and early deaths worldwide. Being fat increases risk of diabetes, cardiovascular disease, cancer, even severe infections.

Almost everyone in icu with covid was fat, 75% of deaths were over bmi 26. Get thin. Eat a lot less, exercise a lot more. Yes it can be hard. I prefer chocolate to cucumber too but Rosie gives me both, so on average I eat well.

I used to run 10 km to work and back twice a week and cycle 2 days as well, so I was running 40km every week rain or shine and cycling 40 km too, though preferred the shine. But then running on the streets was forbidden as “attempted murder,” so I stopped the habit of 20 years and just cycled instead. I’ve never really got back into it.

Kampala was a beautiful climate for jogging, usually cool enough, lots of shade, nice hills. Here is flat flat flat, no hill for about 500 km, and it’s either dry and very hot or chucking it down in a deluge this time of year, so I haven’t had a morning jog for a month. However from now on its getting cold again, it can even freeze overnight in July, so the intention to start jogging again is there. You don’t have to jog. Some play tennis, some ride bikes, sail, go to the gym or swim. It’s not so much how much artificial exercise we do that keeps us fit, it’s the opposite: how much time do you spend sitting. I do a lot ofgardening. I’ve never ached so much in years but turning kalahari acacia bush into “a well watered garden in a desert land” is an excellent fat burner. There is a lot of dangerous nonsense out there, but I notice the careful use of clever language to provide plausible deniability. I rather scorn all diets but I believe the evidence that most processed food is bad for our health is true. Trans fats, preservatives, smoked or cured meats, the evidence is pretty clear. And they are expensive. (Rosie found some roll mop herring recently I just love it. I avoided reading the label just in case.)

I think it’s true though: we should avoid eating from packets and jars. Eat real food, as fresh as possible, nothing processed. Doesn’t living in Africa make eating real food so much easier! We try and eat it fresh as it comes, even better grow it yourself. Meat from the butcher, fish from the fishmonger, fruit and veg recognisable as what it looked like when it was growing. I’m sure those of us who avoid processed food and eat fresh have a much lower risk of cancer.

I gave up salt too, when I was a medical student. I have never added salt, even when running on the equator, and my blood pressure is still under 120. Elephants apparently go looking for extra salt, cattle use salt licks, but humans do not need it. Studies that show reducing salt doesn’t drop blood pressure is because they are reducing from 4 x more than you need to twice. I see mounting acceptance that adding salt to food is a bad practice, we don’t need any more salt then we get in normal food. Why not try giving it up? Food will eventually taste better as you get used to it, your blood pressure will come down, and one side effect you’ll not read in any text book is you will recognise an Islay single malt from a highland or Spey side from the salty taste.

• Keep your mind alert My memory is shot. I was forgetting names long before I retired, now I have to stop and concentrate to remember all sorts of words that I just can’t find. So if you are sitting, then do crosswords, sudoku, read books, anything to keep your mind active. Of course, losing your memory keeps you fit. If I go out I go upstairs to get my phone, see something I need and go back down. Then I realise I didn’t get my phone so go up again. Then I remember I need the car keys and have left them upstairs too. So I go up and down 3 times instead of once. Those who live in 2 story houses live longer, even though falling downstairs is a common cause of death. All that climbing is a great way of staying fit.So in case I forget, you’re all invited to my 80th in 2033.

• Don’t ignore symptoms or delay seeing a doctor. If you think something’s wrong go and see a doctor on time. Waiting and hoping it will go away is a great way of getting a delayed diagnosis of something that might have been curable. All around me I see people with cancer or heart disease and I wonder was it because of delay. Doctors themselves are the worst and I know I’ll struggle to admit it when I need to see a doctor. Even the BCC on my neck I’m treating myself with the cryo.

Which brings me on to: Don’t self medicate.

When I was working everyone was on vitamins or supplements. The fashion went from vitamin C to D to zinc. What for? I believe God created everything we need for long healthy lives and put it in our food. It seems some people think He forgot to put in enough vitamins in a banana so he created pharmaceutical companies to put right his mistake. It really is true that supplements just give you expensive urine. Remember the vitamin D hysteria that was exposed years ago. It was all a bit of a puzzle at first: no one could make money from D supplements. Then it became clear: they made it from testing. Scare people into getting tested and selling tests for vitamin D assay became a nice little earner. The tests  didn’t even measure vitamin D, only a marker. I had patients coming in who were told they had low D levels from their home countries, when they are out in the sun playing golf in short sleeves on the equator twice a week. The publications promoting supplements stood truth on its head. The truth is some illnesses cause low D, but it doesn’t follow that low D caused the disease. I just refused to test, the scam was so blatant.

Remember omega 3? Get a fish, smash it into a pulp, squeeze out the oil, isolate the omega 3, put it in a capsule sell it in a pharmacy. Why not just eat the fish? It will move on. Like a number 63 bus, another health fashion is always coming.

So those who live to extreme old age, what do they say?

I never read that any of them credit their supplements. Madame Calvert who lived to be 122 said it was because she took a glass of red wine every night. Others credit keeping on working. At best supplements are just plain silly, at worse they might even cause poor health. Excess vitamins and minerals have to be pee’d out and our kidneys must give a groan every time they see us taking them. Take a look at those celebrating their centenary. They are thin, they are active, they mostly live in the country and eat fresh food, often that they grow themselves. They are usually part of a tight-knit community that look after each other, with friends and family all around. I heard of one island full of centenarians where there are no roads: so they walk a mile or 2 to the local hostelry for their tipple every night.

I intend to enjoy being retired for 30 years: see if I can beat Prince Philip by a year. If you disagree with how I’m doing it, ask me in 20 years. Or if I’m wrong ask my heirs.