In the 2007 film The Bucket List Jack Nicholson and Morgan Freeman play two main characters who respond to their terminal cancer diagnoses by rejecting experimental treatment. Instead, they go on a range of energetic, overseas escapades.

Since then, the term “bucket list” – a list of experiences or achievements to complete before you “kick the bucket” or die – has become common.

You can read articles listing the seven cities you must visit before you die or the 100 Australian bucket-list travel experiences. https://www.youtube.com/embed/UvdTpywTmQg?wmode=transparent&start=0

But there is a more serious side to the idea behind bucket lists. One of the key forms of suffering at the end of life is regret for things left unsaid or undone. So bucket lists can serve as a form of insurance against this potential regret.

The bucket-list search for adventure, memories and meaning takes on a life of its own with a diagnosis of life-limiting illness.

In a study published this week, we spoke to 54 people living with cancer, and 28 of their friends and family. For many, a key bucket list item was travel.

Why is travel so important?

There are lots of reasons why travel plays such a central role in our ideas about a “life well-lived”. Travel is often linked to important life transitions: the youthful gap year, the journey to self-discovery in the 2010 film Eat Pray Love, or the popular figure of the “grey nomad”.

The significance of travel is not merely in the destination, nor even in the journey. For many people, planning the travel is just as important. A cancer diagnosis affects people’s sense of control over their future, throwing into question their ability to write their own life story or plan their travel dreams.

Mark, the recently retired husband of a woman with cancer, told us about their stalled travel plans:

We’re just in that part of our lives where we were going to jump in the caravan and do the big trip and all this sort of thing, and now [our plans are] on blocks in the shed.

For others, a cancer diagnosis brought an urgent need to “tick things off” their bucket list. Asha, a woman living with breast cancer, told us she’d always been driven to “get things done” but the cancer diagnosis made this worse:

So, I had to do all the travel, I had to empty my bucket list now, which has kind of driven my partner round the bend.

People’s travel dreams ranged from whale watching in Queensland to seeing polar bears in the Arctic, and from driving a caravan across the Nullarbor Plain to skiing in Switzerland.

Nadia, who was 38 years old when we spoke to her, said travelling with her family had made important memories and given her a sense of vitality, despite her health struggles. She told us how being diagnosed with cancer had given her the chance to live her life at a younger age, rather than waiting for retirement:

In the last three years, I think I’ve lived more than a lot of 80-year-olds.

But travel is expensive

Of course, travel is expensive. It’s not by chance Nicholson’s character in The Bucket List is a billionaire.

Some people we spoke to had emptied their savings, assuming they would no longer need to provide for aged care or retirement. Others had used insurance payouts or charity to make their bucket-list dreams come true.

But not everyone can do this. Jim, a 60-year-old whose wife had been diagnosed with cancer, told us:

We’ve actually bought a new car and [been] talking about getting a new caravan […] But I’ve got to work. It’d be nice if there was a little money tree out the back but never mind.

Not everyone’s bucket list items were expensive. Some chose to spend more time with loved ones, take up a new hobby or get a pet.

Our study showed making plans to tick items off a list can give people a sense of self-determination and hope for the future. It was a way of exerting control in the face of an illness that can leave people feeling powerless. Asha said:

This disease is not going to control me. I am not going to sit still and do nothing. I want to go travel.

Something we ‘ought’ to do?

Bucket lists are also a symptom of a broader culture that emphasises conspicuous consumption and productivity, even into the end of life.

Indeed, people told us travelling could be exhausting, expensive and stressful, especially when they’re also living with the symptoms and side effects of treatment. Nevertheless, they felt travel was something they “ought” to do.

Travel can be deeply meaningful, as our study found. But a life well-lived need not be extravagant or adventurous. Finding what is meaningful is a deeply personal journey.

Names of study participants mentioned in this article are pseudonyms.

Leah Williams Veazey, ARC DECRA Research Fellow, University of Sydney; Alex Broom, Professor of Sociology & Director, Sydney Centre for Healthy Societies, University of Sydney, and Katherine Kenny, ARC DECRA Senior Research Fellow, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

If you’re one of the one in three Australians whose New Year’s resolution involved losing weight, it’s likely you’re now contemplating what weight-loss goal you should actually be working towards.

But type “setting a weight loss goal” into any online search engine and you’ll likely be left with more questions than answers.

Sure, the many weight-loss apps and calculators available will make setting this goal seem easy. They’ll typically use a body mass index (BMI) calculator to confirm a “healthy” weight and provide a goal weight based on this range.

Your screen will fill with trim-looking influencers touting diets that will help you drop ten kilos in a month, or ads for diets, pills and exercise regimens promising to help you effortlessly and rapidly lose weight.

Most sales pitches will suggest you need to lose substantial amounts of weight to be healthy – making weight loss seem an impossible task. But the research shows you don’t need to lose a lot of weight to achieve health benefits.

Using BMI to define our target weight is flawed

We’re a society fixated on numbers. So it’s no surprise we use measurements and equations to score our weight. The most popular is BMI, a measure of our body weight-to-height ratio.

BMI classifies bodies as underweight, normal (healthy) weight, overweight or obese and can be a useful tool for weight and health screening.

But it shouldn’t be used as the single measure of what it means to be a healthy weight when we set our weight-loss goals. This is because it:

• fails to consider two critical factors related to body weight and health – body fat percentage and distribution
• does not account for significant differences in body composition based on gender, ethnicity and age.

How does losing weight benefit our health?

Losing just 5–10% of our body weight – between 6 and 12kg for someone weighing 120kg – can significantly improve our health in four key ways.

1. Reducing cholesterol

Obesity increases the chances of having too much low-density lipoprotein (LDL) cholesterol – also known as bad cholesterol – because carrying excess weight changes how our bodies produce and manage lipoproteins and triglycerides, another fat molecule we use for energy.

Having too much bad cholesterol and high triglyceride levels is not good, narrowing our arteries and limiting blood flow, which increases the risk of heart disease, heart attack and stroke.

But research shows improvements in total cholesterol, LDL cholesterol and triglyceride levels are evident with just 5% weight loss.

2. Lowering blood pressure

Our blood pressure is considered high if it reads more than 140/90 on at least two occasions.

Excess weight is linked to high blood pressure in several ways, including changing how our sympathetic nervous system, blood vessels and hormones regulate our blood pressure.

Essentially, high blood pressure makes our heart and blood vessels work harder and less efficiently, damaging our arteries over time and increasing our risk of heart disease, heart attack and stroke.

Like the improvements in cholesterol, a 5% weight loss improves both systolic blood pressure (the first number in the reading) and diastolic blood pressure (the second number).

A meta-analysis of 25 trials on the influence of weight reduction on blood pressure also found every kilo of weight loss improved blood pressure by one point.

3. Reducing risk for type 2 diabetes

Excess body weight is the primary manageable risk factor for type 2 diabetes, particularly for people carrying a lot of visceral fat around the abdomen (belly fat).

Carrying this excess weight can cause fat cells to release pro-inflammatory chemicals that disrupt how our bodies regulate and use the insulin produced by our pancreas, leading to high blood sugar levels.

Type 2 diabetes can lead to serious medical conditions if it’s not carefully managed, including damaging our heart, blood vessels, major organs, eyes and nervous system.

Research shows just 7% weight loss reduces risk of developing type 2 diabetes by 58%.

4. Reducing joint pain and the risk of osteoarthritis

Carrying excess weight can cause our joints to become inflamed and damaged, making us more prone to osteoarthritis.

Observational studies show being overweight doubles a person’s risk of developing osteoarthritis, while obesity increases the risk fourfold.

Small amounts of weight loss alleviate this stress on our joints. In one study each kilogram of weight loss resulted in a fourfold decrease in the load exerted on the knee in each step taken during daily activities.

Focus on long-term habits

If you’ve ever tried to lose weight but found the kilos return almost as quickly as they left, you’re not alone.

An analysis of 29 long-term weight-loss studies found participants regained more than half of the weight lost within two years. Within five years, they regained more than 80%.

When we lose weight, we take our body out of its comfort zone and trigger its survival response. It then counteracts weight loss, triggering several physiological responses to defend our body weight and “survive” starvation.

Just as the problem is evolutionary, the solution is evolutionary too. Successfully losing weight long-term comes down to:

• losing weight in small manageable chunks you can sustain, specifically periods of weight loss, followed by periods of weight maintenance, and so on, until you achieve your goal weight

• making gradual changes to your lifestyle to ensure you form habits that last a lifetime.

Setting a goal to reach a healthy weight can feel daunting. But it doesn’t have to be a pre-defined weight according to a “healthy” BMI range. Losing 5–10% of our body weight will result in immediate health benefits.

At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can register here to express your interest.

Nick Fuller, Charles Perkins Centre Research Program Leader, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.