Eat, drink and be healthy!

Want to know a health prescription that's (a) tasty, (b) simple, (c) affordable, (d) thought to protect against cancer, heart disease, depression, dementia and infertility (among others!) and (e) stood the test of time? Look no further: it's the Mediterranean diet!

The traditional Mediterranean diet has garnered much academic and media attention in recent years, but it's no fad diet - in fact, it's been around for millennia. It is rich in protective plant foods, healthy fats and fish and eschews the refined carbohydrates, industrial fats and large quantities of red and processed meat that characterize the typical Western diet.

Over and above merely biochemical considerations, the Mediterranean diet embodies freshness, diversity, simplicity, conviviality and joie de vivre. As a nutritionist, I believe that healthy food should be enjoyable; if it feels like a chore, we won't persist eating that way for long. As a hedonist, the Mediterranean diet pushes all my pleasure buttons - and not just mine, as the huge popularity of Italian and French cuisines around the world illustrates.

From a purely biological perspective, the traditional Mediterranean way of eating is probably the closest thing to the perfect anti-cancer diet. For almost every food that is thought to have anti-cancer properties - such as garlic, onions, tomatoes, leeks, citrus fruit, cabbage, berries, green tea, mushrooms, olive oil, oily fish, nuts, seeds, lentils, beans, aromatic herbs and spices - is an integral part of the traditional Mediterranean diet.

In addition, the region has given birth to a rich food culture that celebrates conviviality, diversity and freshness - all of which boost the healthiness of the food we eat. (Incidentally, when I refer to the ‘traditional' Mediterranean diet, I mean a style of eating that prevailed until the 1950's, after which western eating patterns began making inroads into the Mediterranean way of eating - with regrettable consequences, as we shall see in a separate post.)

In relation to cancer, it is unclear whether the Mediterranean diet actually prevents the formation of tumors, or whether its protective role lies in hindering micro-tumors from developing into full-blown, life-threatening cancer. Whatever the mechanism, scientists estimate that up to 25% of colorectal cancers, 15% of breast cancers and 10% of prostate, pancreas, and endometrial cancers could be prevented if the populations of highly developed Western countries did nothing more than adopt a Mediterranean diet.

The more closely people adhere to the Mediterranean diet, the greater its anti-cancer effect. According to a study conducted in Greece, strict adherence to two elements of the Mediterranean diet - for example, a high consumption of vegetables and a low intake of meat - causes a 12% reduction in the incidence of all cancers. The study shows that the more elements of the Mediterranean diet are incorporated, the greater the protection; thus, simply adhering to four elements of the Mediterranean diet - for instance, by adding a high intake of fruits and legumes to the two measures described above - may reduce cancer incidence by up to 24%.

When combined with other healthy life-style habits, the Mediterranean style of eating can confer even greater protection. A large-scale European study found that people eating a Mediterranean diet who hadn't smoked for 15 years or longer, had regular physical activity and drank a moderate amount of alcohol, were 65% more likely to outlive their peers who had none of these healthy habits, and were 60% less likely to die of cancer.

You might be wondering how to adopt a Mediterranean diet without moving to Greece or Italy (albeit perhaps a tempting thought...). The good news is: you can eat this way wherever you live! Based on ingredients that are easily available everywhere, simple to prepare and delicious, Mediterranean-style eating can be transported to any part of the globe and adapted to local conditions.

During the Anti-Cancer Challenge, I have decided to adopt a traditional Mediterranean Diet following these principles:

The Mediterranean Diet: My Top-10 Tips

1. High intake of vegetables and fruits
2. High intake of olive oil, moderate intake of saturated animal fats
3. High intake of legumes
4. High intake of whole grains
5. Frequent use of aromatic herbs and spices
6. Moderate-to-high intake of fish
7. Moderate consumption of dairy products, mostly as cheese and yoghurt
8. Low consumption of meat and meat products, especially red meat
9. Moderate red wine consumption with meals
10. Enjoyment: taking time to prepare meals and sharing food and drink with others in a convivial atmosphere

Although I do not plan to turn this into a cooking blog, I do hope, over the coming months, to share my passion for Mediterranean food and cooking with you and plan to offer some practical suggestions that may inspire you to adopt Mediterranean eating habits. (If you are interested in Mediterranean-diet-inspired recipes, check out my website, where I publish a tasty new recipe every month.)

WCRF to advise on Anti-Cancer Challenge

Good news: the World Cancer Research Fund (WCRF) has agreed to act as scientific adviser to my Anti-Cancer Challenge. With the help of this highly respected and well-resourced organization, I will be even better equipped to provide reliable and useful information to readers wishing to improve their chances of preventing or overcoming cancer through simple lifestyle changes.

“We are pleased to advise Conner throughout her Challenge,” says Dr Rachel Thompson, science programme manager in charge of nutrition at the WCRF.  “A third of the most common cancers could be prevented by eating healthily, being physically active and maintaining a healthy weight. Unfortunately many people are not aware this. This is why we are pleased that Conner has launched the Anti-Cancer Challenge. We hope her initiative can help raise public awareness about the links between diet and cancer and show how our recommendations can be incorporated into everyday life.”

Regular readers of my blog will have noticed that I frequently refer to the WCRF for information and recommendations. That’s because I consider this organization to set the gold standard for cancer prevention.

WCRF International, founded in 1982, is a not-for-profit umbrella association unifying a global network of cancer charities dedicated to funding research and education programmes into the link between food, nutrition, physical activity, weight maintenance and cancer risk. The national charities under WCRF International’s umbrella are based in the US (American Institute for Cancer Research), the UK (World Cancer Research Fund UK), the Netherlands (Wereld Kanker Onderzoek Fonds), Hong Kong (World Cancer Research Fund Hong Kong) and France (Fonds Mondial de Recherche contre le Cancer).

The WCRF is best known for its landmark Expert Report “Food, Nutrition, Physical Activity, and the Prevention of Cancer: a global perspective” (WCRF/AICR 2007), preceded by “Food, Nutrition and the Prevention of Cancer: a global perspective” in 1997.  The 2007 report is the most comprehensive investigation published to date on the links between food, nutrition, physical activity and cancer prevention and is based on the in-depth analysis of over 7,000 scientific studies published on cancer prevention over the last 50 years. A panel of 21 renowned scientists reviewed the research evidence and drew conclusions that led to the WCRF’s recommendations for cancer prevention, which in turn underlie my own Anti-Cancer Challenge exercise and diet plans.

In February 2009 the WCRF/AICR published “Policy and Action for Cancer Prevention,” a companion publication to the 2007 Expert Report that provides advice and guidance for key groups, such as governments and employers, on what can be done to influence and change people’s lifestyle choices, as they relate to their risk of cancer. All three reports are rather voluminous but quite accessible to lay readers with an interest in health and public policy.

Somewhat less visibly, the WCRF also funds research into cancer prevention; to date, the WCRF global network has funded over £64 million (some $97 million) of research. To see the studies the WCRF has helped fund, click here.

For people seeking hands-on practical advice, the WCRF network supplies a wealth of information free of charge on its websites. The content varies from one country’s website to another, but all the material is equally useful so do consult them all regularly. On the UK website, for instance, you can find an informative blog, tasty recipes and useful information booklets. The US website also offers a frequently-updated blog and research updates you can subscribe to, and more recipes. It may take more than one rainy afternoon to digest all the information available!

For those who do not have any rainy afternoons to spare, I aim to condense some of that information, supplemented with material of my own, on this blog by posting practical advice on healthy eating and exercise. For my Anti-Cancer Challenge, I have put together diet, fitness and sleep guidelines that I plan to follow for a year; to join me in the Challenge, simply click to download these guidelines, print them out, stick them on your refrigerator and off you go!

Do share your thoughts, ideas, suggestions or general feedback with the rest of us – if we all chip in, this blog can become a valuable resource helping people around the world keep themselves and their loved ones healthy.

My Anti-Cancer Eating Plan

Our media rarely stop buzzing with reports about anti-cancer foods. Each time a study suggests that a particular berry, nut or spice may have anti-cancer properties, journalists hail it as a new wonderfood and everyone rushes out to buy it.

As a nutritionist, I welcome information that heightens the public’s awareness about healthy eating. However, when recommendations are contradictory they can become counterproductive.

After years of being told to eat five fruits and vegetables each day, health-conscious eaters were stunned to learn recently that these foods apparently offer only scant protection from cancer. (I will address this in a separate post.) Similarly, while some research suggests that soy food has a cancer-protective effect, other investigations haven’t backed this up. Indeed, some observers warn that soy foods, which contain estrogen-like compounds, may actually stimulate estrogen-sensitive tissues and could thereby promote, rather than prevent, cancer.

It’s not surprising, therefore, that many people feel overwhelmed when trying to figure out what they should eat to help prevent – or recover from – cancer. Indeed, some are so confused by contradictory reports that they stop believing anything they read in the press and revert to their old eating habits, as a recent survey showed.

When putting together my Anti-Cancer Eating Plan, therefore, I decided to base my program on the most unambiguous and reliable data I could find: the World Cancer Research Fund’s Expert Report published in 2007, which analyzes tens of thousands of studies into the food-cancer link and offers practical recommendations based on the findings.

At first sight, the WCRF’s recommendations may seem a little conservative. For instance, their researchers could not find clear evidence that soy, green tea or turmeric – widely touted as anti-cancer foods – are in fact cancer-protective. At best, the WCRF concluded, “there is limited evidence suggesting that pulses, including soy and soya products, protect against stomach cancer and prostate cancer”. Green tea and turmeric were mentioned only in passing. Note: the WCRF report does not say that we should not consume these foods; it simply notes that there is not enough evidence to say that they offer protection from cancer.

What appeals to me about the WCRF’s recommendations, however, is that they are realistic and achievable for almost anyone. For whilst anti-cancer diets involving exotic, unfamiliar or expensive ingredients may suit some people, most of us when faced with excessively challenging dietary change give up and go back to our previous eating habits. Smaller but realistic steps in the right direction may be more effective and sustainable than drastic changes that don’t last. Besides – to some people, implementing just one or two of the WCRF’s recommendations (below) will feel plenty drastic!

My Anti-Cancer Challenge Eating Plan will thus be based on the following dietary recommendations issued by the WCRF:

• Avoid sugary drinks and limit consumption of energy-dense foods (particularly processed foods high in added sugar, or low in fiber, or high in fat)
• Eat more of a variety of vegetables, fruits, whole grains, and pulses such as beans
• Limit consumption of red meats (such as beef, pork and lamb) to no more than 500 g (cooked weight) per week, and avoid processed meats
• If consumed at all, limit alcoholic drinks to 2 for men and 1 for women a day
• Limit consumption of salty foods and foods processed with salt (sodium); do not eat more than 6 g salt per day (about 1 teaspoon)
• Don’t use supplements to protect against cancer (exceptions being women planning to conceive (folic acid); vitamin-D-deficient people, and people whose low appetite (illness) or low calorie needs (the elderly) restrict their nutrient intake (a good multivitamin).

Other suggestions and practical tips from the WCRF include:

• Balance your plate: 2/3 of your plate should be of plant origin and 1/3 of animal origin.
• Fish is a healthy alternative to red meat; eat it regularly. Some limited evidence has shown it may help to protect against bowel cancer. 
• Poultry (chicken, turkey, duck – skinless where possible) and other lean meats such as rabbit and venison are healthy alternatives to red meat.
• Cooking methods: baking, boiling and steaming are healthy cooking methods; other high-temperature cooking methods may alter the make-up of foods, especially meat. It is prudent not to consume burned or charred foods frequently or in large amounts.

In order to tailor the Anti-Cancer Challenge Eating Plan to my family’s needs I added a few more items:

• Dairy foods: The calcium in milk may protect against bowel cancer, but milk consumption has been linked to an increased risk of prostate cancer. Moreover, my daughter is allergic to cow’s milk. Therefore I limit cow’s dairy and consume only goat’s and ewe’s milk cheese and yoghurt.
• Foods rich in omega-3: This essential fatty acid is thought to have anti-inflammatory and anti-cancer properties. I eat omega-3-rich foods daily; these include oily fish (sardines, mackerel, salmon, anchovies, herring), ground flax seed, green leafy vegetables, and eggs, meat and dairy from animals fed an omega-3-rich diet. I avoid large fish (tuna, shark, swordfish) because of their potential contamination by mercury or other marine pollutants.  
• Green and white tea: epidemiological studies and laboratory studies in animals and on human cancer cells suggest that green tea may protect against cancer. Since I enjoy its taste, I drink two to three large cups of green or white tea daily.
• Vegetables and fruits: I eat a wide variety of vegetables and fruits, including all members of the cabbage and onion families, mushrooms, red and blue berries, citrus fruit, sea vegetables and carotene-rich vegetables & fruits (e.g. tomatoes, carrots, melon, winter squash, etc). I eat at least 5 portions a day, but I'd like to increase that to 8 a day in the course of the Anti-Cancer Challenge.
• Herbs and spices: I make copious use of fresh kitchen herbs that I grow in my garden or buy at the market (parsley, thyme, coriander, chives, basil, rosemary, oregano) and which are rich in anti-oxidants. I use many different spices such as turmeric, pepper, chili, cinnamon, coriander, cumin, cardamom, paprika, saffron and ginger. The copious use of herbs and spices is a great way of boosting the flavor of many dishes without needing to use salt.  
• I eat seasonal, locally-grown foods: In order to obtain the freshest produce, protect the environment and support the local economy, I buy most of my food (about 75%) at the nearby farmers’ market and directly from local producers. If it’s not in season (e.g. tomatoes in January, cabbage in July) I don’t eat it. I grow some vegetables in my own vegetable patch.
• About 80% of the meals I eat are prepared at home, from scratch: I do not buy prepared meals or processed ingredients except for plain vegetables in jars or cans (e.g. tomatoes, lentils, beans) and occasional condiments (e.g. pesto, ). All meals are eaten at a table, with all family members sharing the same meal. The television is off while we eat and I do not eat in front of the computer or while driving.

Overall, I am happy to say that I already do most of these things. I rarely eat red meat (about 150 g per week at most) and consume lots of vegetables and fruits and small amounts of whole grains. I drink only red wine (a glass with dinner on weekends), and use very little salt in my cooking. 

Not taking supplements will be interesting; for the past 10 years I have taken a pretty high-dose multivitamin supplement and fish oil capsules, and I am curious to see whether not taking these will make any noticeable difference to my health and well-being. No longer being able to rely on the "health-insurance effect" of my supplements will make it imperative that everything that enters my mouth is as nutritious as possible - no room for "empty calories". 

Do you have any dietary cancer-prevention advice that you would like to share with readers? All suggestions welcome!

Food for Life

A keen cook and a self-confessed glutton, I have always been passionate about the selection, preparation and enjoyment of food, though for a long time, the accent was on "pleasure" rather than on "health".

My brush with cancer 10 years ago made me realize that a healthy diet isn't an optional extra but a vital necessity. And so I began eating as though my life depended on it.

While my health has indeed improved, I have been particularly pleasantly surprised to discover how enjoyable a healthy diet can be! To me, fresh, natural food, simply prepared, is incomparably more satisfying and pleasurable than the fatty, crispy, gooey treats I used to delight in. Hold the onion rings - I'll have some crunchy spears of asparagus drizzled with olive oil and lemon juice and dusted with light parmesan shavings, thank you. (What's more, I'll save on antacids!)

Most people, when they think of cancer, rarely think about food. Many hold the fatalistic belief that cancer is largely programmed by our genes and that there's nothing we can do about it (in fact, at most 15% of cancers can be attributed to genetic causes). Even those of us who are aware that life-style plays a critical role in cancer usually think of smoking, alcohol consumption or sun exposure as the main risk factors.

But few consider food as a factor that may contribute to causing cancer. And yet, it is increasingly understood that diets rich in sugar and refined carbohydrates, unhealthy fats, red and processed meat and deficient in nutrient-rich vegetables, fruits, nuts, seeds, herbs and spices, may increase our cancer risk.

Once cancer has been diagnosed, most people embark on the recommended medical treatment: surgery, chemotherapy, radiation therapy or a combination thereof. Very few doctors recommend dietary measures as part of conventional cancer treatments. Medical students are taught only the bare essentials of nutritional science.

Nevertheless, nutrition plays a crucial role, both in preventing and in overcoming cancer. In its landmark Expert Report, the most comprehensive report ever produced on the links between lifestyle and cancer risk, the World Cancer Research Fund (WCRF) estimates that up to 30% of all cancers could be prevented by eating an optimal diet, getting regular physical activity and maintaining a healthy body weight.

Some experts even suggest that some of the commonest forms of cancer, such as breast-, colorectal and prostate cancer, could be reduced by 60-70% and lung cancers by 40-50% if people ate an anti-cancer diet. Even cancer patients undergoing treatment may find this type of diet helpful, some studies suggest.

A healthy diet is certainly not a stand-alone treatment for cancer, nor is it a fool-proof tool for prevention. Modern medical approaches are an essential part of any cancer therapy. Nonetheless, what and how you eat before, during and after cancer treatment can have a crucial impact on its outcome.

Meanwhile, for those of us who are healthy but worry about becoming ill - without prevention, about one in three women and one in two men will develop some form of cancer during their lifetime, the U.S. National Cancer Institute predicts - it's important to know that changes in diet can very much tip the odds in our favor.

By the way, healthy eating isn't just for cancer patients. There are benefits to everyone in a diet that boosts general health and well-being. Thus, an "anti-cancer" diet can potentially help prevent or relieve a long list of other medical conditions, including diabetes, heart disease, dementia, arthritis and even depression.

In addition to helping improve overall health, the anti-cancer diet I follow has no known negative side-effects. In my experience, if there are any "side-effects," they are increased energy, fewer colds and sore throats, clearer skin, better digestion and a happier disposition. Fine with me!

In my next post I will unveil my Anti-Cancer Challenge eating plan for the remaining 11 months of this project, so watch this space.

Month One : Progress Report

It’s been just over a month since I began the Anti-Cancer Challenge. Here’s my first progress report.

(If you have recently joined the Challenge, you can consult my Fitness Plan here and my Sleep Plan here; there are also links to these pdf documents in the right-hand column. I plan to post my Diet Plan this week.)

1.    Exercise 

As planned, I have been exercising every day for about 30 minutes. On some days I have done shorter, more intense workouts, and have thrown in other additional activities such as lawn mowing (very tiring when you don’t know how your new lawnmower’s automatic traction works… My 12-year-old showed me after I had nearly finished mowing our rather expansive lawn!). The only interruption to my exercise routine (past two days) came from stepping on a rusty nail and driving it through my shoe and foot while lawn-mowing (ouch!).

I still struggle to make time for my workouts at the start of the day – I often get distracted by other seemingly important and urgent matters (work, housework, phone calls and other procrastination techniques) and don’t get around to exercising much later in the day, at which point I feel much less energetic. Over the next month, I aim to exercise first thing in the morning, no matter what my house or e-mail cue look like, so I can shower and move on to other things without a guilty exercise deficit hanging over my head.

What has come as a very pleasant surprise is discovering just how invigorating even short spurt of physical activity can be! Not only do I feel proud of myself whenever I have managed to overcome my resistance and moved my body. At a physical level, too, I feel more energetic, more bouncy and resilient. Instead of increasing my desire for food, as I had expected, I’ve noticed that my appetite seems to be curbed for at least 2-3 hours after exercising – quite unusual for a habitual snacker like myself. (Perhaps also because I feel good about myself and don’t need to boost my morale with the help of chocolate…)

Another positive surprise is the fact that little exercise can go a long way. A mere 20-30 minutes’ activity each day (indoor rowing, jogging, weights exercises – all done at moderate intensity) has made a palpable difference to my body shape: certain clothes that felt very snug no longer do so, and I feel stronger and less easily winded. My arms, especially, feel stronger, and the wobbly under-arms I was beginning to fret about as the t-shirt season approached (my son recently called them “Mama’s jelly-arms”) have firmed up. Phew!

2.    Sleep

Writing down all my good intentions was the easy part; now I have to actually put them into practice! I have found it very challenging to get seven hours’ sleep this last month for two reasons:  overwork (I have an exceptionally heavy workload and it will take at least another three months until this abates…) and my children’s two-week school vacation. With more work to do in less time, I have been playing catch-up at night.

I have, however, managed to push my bedtime forward slightly from 1 or 2 a.m. closer to midnight, and the extra 1-2 hours’ sleep have already made a noticeable difference. I have noticed, for instance, that I drink less coffee (1 cup a day instead of 2-3) and have fewer starch- and sugar-cravings. I have also felt a little more mentally organized which I attribute to the mind-soothing effects of sleep.

Alas, I have been waking up quite frequently in the early morning hours to do a spot of nocturnal pondering (mostly work-related). Over the next month, I will try to get a better handle on managing my thoughts and to-do lists during daytime hours to give my mind a break at night (see this post).

3.    Diet

As I haven’t yet published my Anti-Cancer Diet Plan there’s little to report on this front. However, I have been enjoying daily doses of delicious spring vegetables (crisp asparagus, squeaky spring onions, spicy young carrots, tender spinach, pungent garlic shoots) these last two weeks which has felt invigorating and cleansing. I love coming out of winter and eating fresh spring greens; to me, their emergence from the wintry soil symbolizes hope, vigor and resilience.

More details about anti-cancer eating will feature in my Anti-Cancer Challenge Diet Plan, which I will unveil later this week.

My Anti-Cancer Sleep Plan (I'm yawning already...!)

As I sit here at 11.37 p.m., writing, nibbling on a square of dark chocolate and enjoying the peace and quiet of my hushed home, I know that getting regular, restorative sleep will be a formidable challenge for me - harder than exercising daily or eating healthily. Yet, only this morning, when I awoke grumpy and bleary-eyed after yet another late-night work session, I swore that something had to change, and fast.

Having spent the last few posts discussing the importance of sleep for cancer-prevention, it’s about time I stopped talking and started acting! So here’s my Sleep Plan for the remainder of the Anti-Cancer Challenge (330 days to go):  

• I will sleep for seven hours each night. That seems realistic, and is “only” two more hours than I usually accord myself – I should be able to squeeze those out of my busy schedule!  If I still feel groggy on seven hours’ sleep, I will try to extend my sleep duration.
• To make sure that I actually get these seven hours, I will count backwards from my planned wake-up time; thus, if the alarm is set for 6.25 a.m. (my usual weekday wake-up time), I have to switch off my light at 11.30 p.m. (Actually, that doesn’t sound quite as draconian as I had feared!)
• I will give myself 60 minutes’ winding-down time before lights-out. This may include reading in bed for half an hour – nothing work-related, but instead, relaxing fiction or poetry to help me “get out of my head”.
• Some of that winding-down time may also be spent jotting down any items on my “small stuff” list so they don’t keep me up during the night.
• I keep a Sleep Journal for the first few weeks to help me keep track of my sleep hygiene until my new betimes become a habit.
• I will not check emails after dinner (last week an annoying email that arrived at 11 pm kept me up most of the night!); I can read or shop on-line when the kids are in bed, but I commit to switching off my computer at 10.30 p.m. at the latest.  
• I will go straight to bed when I feel tired. Often, when I start to yawn of feel heavy-lidded, I override my body’s cues and push through the fatigue (frequently with the help of chocolate and bread…), making it doubly hard to get to sleep later. 
• I will spend 30-60 minutes daily under open skies and exposed to unfiltered daylight to stimulate adequate melatonin secretion at night (see this post). Outdoors activities such as gardening, exercising, playing with my kids or sitting on the terrace doing nothing (gasp!!) will feature more often in my otherwise house- and car-bound life.  
• I will exercise daily. I don't know whether these is scientific proof that exercise promotes sleep, but I have noticed that it helps reduce my stress levels and shouldern tension, which may make me feel more relaxed when it’s time to go to bed.
• I will avoid heavy meals in the evening, and when I drink wine, I will limit it to one glass (alcohol consumed before bedtime can distrupt sleep). 
• I keep potentially sleep-disrupting stimulants and sugar to a minimum (no coffee after lunch).
• If I am about to “fall off the wagon”, I remind myself that regular sleep allows me to be a happier, healthier woman with fewer wrinkles and stable weight, a more patient, energetic and resourceful mother and a congruent health practitioner who practices what she preaches.
• And if I do stray occasionally, I won't lose sleep over it. Slips happen.

There – that should get me started! I'd love to hear how some of you make sure that you get the sleep you need - any suggestions?

Next week I will unveil my anti-cancer eating plan, the third cornerstone of the Anti-Cancer Challenge. Meanwhile, have a restful weekend!

Lie back and think of -- nothing!

When I go to bed at night I switch off my light, lower my head on my pillow and wait for Morpheus to cradle me in his sweet embrace. (No, not my husband – this is Morpheus, the Greek god of dreams.)

But while my body is willing, my head won’t follow. For as soon as I want to let go of the day’s cares, I am assailed by half-finished thoughts and an army of to-do-list items marching through my weary mind.

First, I pass review of the Small Stuff: for instance, rescheduling the cat’s vet appointment. This reminds me that I have to make a doctor’s appointment for my son. And book dental check-ups for the twins. Since I’m on appointments, I make a mental note to confirm a birthday-party invitation for my daughter, which in turn reminds me that I have to buy a birthday present for her little friend. Oh, and order that DVD my older son wants for his birthday. For the next five minutes I reel off a list of dozens of things I need to do in the next few days. I grow increasingly tense wondering whether I’ll be able to remember them all by the time the alarm rings the next morning.

This leads on to Medium Stuff: my book that awaits publication, blog posts requiring writing, cooking classes demanding preparation, recipes that want testing, tax declarations, work and family administrivia (and not-so-trivia) that are running late. By now, I’m feeling downright anxious.

From here, it doesn’t take a big step to get to the Big Stuff: the state of the economy, my children’s future, my ageing parents, climate change, and eventually – inevitably – Life, Death and Forgiveness. The script is depressingly familiar, and yet each time it fills me with fear and loathing.

At this point, sleep has become an entirely unrealistic proposition. I get up, pad downstairs and read a boring book to lull myself to sleep. This can take up to an hour. The next morning I’m so tired I feel I need a coffee just to find the coffee!

I have one or two nights like this each week; either my thoughts prevent me from getting to sleep in the first place, or I awake in the middle of the night and the unrelenting cycle of nocturnal ponderings begins anew.

I don’t consider myself to be a particularly tormented soul; it’s mostly a function of having a very busy life and not sorting out my mental clutter before I go to bed. As part of my sleep challenge, therefore, I want to find ways of calming my pointless night-time chatter. Because, let’s face it, night-time ruminations aren’t Quality Thinking Time: I rarely get any real problem-solving or creative thinking done, and in the bright light of day many of the concerns that kept me up at night seem ridiculously small and perfectly manageable. So here’s what I’ll do.

Small Stuff first: I will keep a note pad next to my bed, and before settling in for the night, I will write down any niggling concerns that I haven’t been able to attend to during the day. When I can think of no more items to add to my list, I tell myself: “That’s all for today. You can stop thinking now.”

Medium Stuff: I will keep a comprehensive list on my computer (Microsoft Outlook has a to-do-list-function that includes deadlines and reminders) of the important and/or urgent jobs that need doing and consult it every morning when I begin work, aiming to deal with at least two items before attending to anything else. (I already do this – kind of. For while I often add items to my list, I rarely get around to doing them – just writing them down feels like they’ve been taken care of...)

Big Stuff: this is the most complex nighttime cogitation-fodder, and that which has no Easy Answers. Here’s where taking quiet time to think – and to “not-think” (i.e. meditate) – may help bring some peace.

Talking to loved ones about unresolved conflicts or worries is also important – something I keep putting off, but that keeps coming back to haunt me. So I will schedule time to talk with them, trying to say what needs to be said in the hope of bringing greater clarity and peace to our relationship and to my frazzled mind. And in case my approaches fall on deaf ears, learning to accept things I can’t change and not dwelling on them also strikes me as useful.

Liberating snatches of Quiet Time during the day to “let dangle the soul” (“die Seele baumeln lassen”), as German writer Kurt Tucholsky put it so evocatively, will be a challenge. But my mind has a way of getting what it needs, and if I don’t give it time during the day, it will steal it from me at night.