09 July 2018

Are you doing your best in the 4 M's of health?

When it comes to understanding what it means to have good general health, most patients have random facts that they've pulled from the web, their families and friends, according to Associate Professor and Cardiologist Dr Edward Barin of Macquarie Heart and Macquarie University Hospital.

To clear the confusion, Dr Barin's 4-M framework distils advice into bite-sized segments: movement, meals, measurement and mental state. 

The aim is to do your best within each of these four sectors of health.

The 4Ms: A snapshot


"The exercise we choose, like our diet, should change with the decades," Dr Barin said.

For those in their 20s, 30s and 40s, cardiovascular exercise can help discourage the extra abdominal fat that can come with a desk job.

"Another benefit of movement is to counter the muscle loss (sarcopenia) and bone loss (osteoporosis) that starts at about 50 and accelerates with lack of exercise," Dr Barin said. 

Resistive exercise - with resistance bands, weights, or one's own body weight - is the best exercise to counter sarcopenia, he said. ?Achieving and retaining strength is the aim."

"Impact exercise, something that puts a load on your bones - running, walking, dancing "will help build bone," so is important for reducing osteoporosis risk or progression." 

"Gardening is another great one. Swimming is great aerobic exercise but doesn't do much for bone strength."

"If your movement needs more attention, expert advice can be gained from personal trainers, exercise physiologists, and group exercise programs, including rehabilitation services," Dr Barin said.


While in-vogue, restrictive diets like paleo and low carb can help achieve goals, they can be hard to stick to, Dr Barin said. "It's good eating habits that sustain health."

"To counter confusion about which specific food items are 'allowed' or not, the safest approach is moderation. Fats may be good or bad depending on their origin and carbohydrates are a critical source of energy, but in excess will cause major problems."

"The classic dietary mistake these days is underestimating the amount of added sugar in the diet. And beer should be thought of as a portion of a meal because of the energy content."

Salt is a problem "only if it's excessive and if you've got high blood pressure or heart disease, then we recommend reduction."


"A measurement provides a snapshot of [one's health status, and a] benchmark for future assessment and progress. It can motivate us to do better," Barin said. 

"Blood tests can detect things such as early kidney malfunction, thyroid failure and iron loss, and precise scans can also pick up the amount of hardening of one?s arteries by x-rays." 

A scale can also be a handy at-home tool for someone trying to lose or gain weight for health reasons, encouraging them to stay on track.

Mental State

"Think of the brain as a muscle,? Barin said. ?Exercise it in any way you can." Sudoku, bridge and crosswords are great for cognitive (brain) health, provided you practise more than one of them.

"Otherwise it's like plucking just one string of a guitar. Every part of the brain has a different function."

Implementing the 4Ms approach

"Improving one's health may require attention in only one or several 4M areas for any individual," Dr Barin said "which means the tailored 'health overhaul' process will be less daunting than anticipated. Speak to your GP or specialist about how to get started."

First published via Healthshare and Fairfax Media. Healthshare is a joint venture with Fairfax Media

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