Genetics, healthy eating or just plain luck are among the factors thought to be behind living to see your 100th birthday.

But despite the uncertainty around how to reach this milestone, there are a record number of centenarians living in England and Wales, data for the Office for National Statistics revealed this week.

In 2021, nearly 14,000 people lived to 100 in England and Wales — up by more than  a quarter in just a decade.

Here, longevity experts and Britain’s centenarian’s share the secrets to living a long and healthy life. 

Staying active

Keeping fit and active has long been highlighted by experts as a way of keeping your muscles, joints and mind healthy.

But it could also be a way of boosting your life expectancy. 

‘Evidence shows that being more physically active can lower the risk of depression and dementia, heart disease, stroke, Parkinson’s and some cancers’, Caroline Abrahams, charity director at Age UK, told MailOnline. 

But it’s not just about lifting weights and running marathons.

Simply moving more, taking the stairs or carrying shopping counts. 

Ms Abrahams said: ‘It’s simply about moving more each day, in whatever way works, within our own capabilities.

‘Outdoors exercising is said to have more benefits, so you could try joining walking groups, a walk in the country or just walk to the shops instead of driving, any kind of activity is better than no activity at all.’

‘It’s never too late to get active, so try to boost your daily physical activity’, says Ruth Goss, senior cardiac nurse at the British Heart Foundation (BHF).

It not only improves blood pressure, it also lowers cholesterol, keeps weight under control and gives your mental health a boost, all ways of warding off diseases.

If you find an activity you enjoy, you are more likely to stick with it, advises Ms Goss.

Health chiefs recommend completing 150 minutes of moderate intensity activity a week, such as a brisk walk, swimming or cycling.

But our ability to keep up this amount of exercise can get trickier as we age. 

‘Where I live, I have plenty of stairs so even if I don’t go out, I’m active’, says Lauretta Boston, from London, who celebrated her 100th birthday in October 2022. 

Ms Boston, who told the ONS about her life and experience of being a centenarian, said: ‘There are things I find difficult to do because I am lumbered with a body that won’t do what I want it to do.’

But still driven to stay well and active Lauretta visits the shops. 

She said: ‘I have a little shopping trolley I can take to the shops and it’s nice to pick out what I want and go to the till.’

Living by the sea

Everyone enjoys the beach but moving to the sea-side could set you up to live to you’re 100th birthday, data suggests. 

Coastal areas have the highest proportion of centenarians, according to ONS data with a high proportion living on the south coast. 

But experts are not 100 per cent sure why.

It could be because centenarians living by the sea are ‘already healthy and wealthy people’ and choose to retire in coastal areas, a spokesperson the International Longevity Centre told MailOnline. 

It added that once in these areas, older people ‘are able to have a relatively high standard of living, heat their homes, have a good diet, exercise and have plenty of family and friends’.

Coastal environments are not only better for helping people get outside and be more active, but they also help to reduce stress, experts say. 

Spending time outside in nature can also improve your mood, reduce stress, improve physical health and improve self-esteem, according to mental health charity Mind. 

Getting enough sleep 

It’s not a mystery that getting enough shut-eye each night can improve your mood the next day. 

But good quality sleep could also add years to your life. 

Sleep is essential to helping memory and processing information, as well as removing waste products from brain cells, regulating your metabolism and maintaining the immune system.

Adults should be getting between six and eight hours a night, according to the NHS.

However, as we get older it can be hard to get enough sleep. 

‘Sleep patterns change as we get older and lack of sleep can directly affect the way we feel’, says Ms Abrahams.

She added: ‘If you’re having difficulty sleeping, try cutting back on daytime naps and reduce the amount of caffeine you drink. 

‘Try to make time to relax and unwind each evening, perhaps by reading a book, listening to the radio, or having a bath.’

Learning a new skill 

Keeping your mind sharp by learning a new skill could boost your brain power in old age. 

Whether it is learning to play an instrument or a new language, exercising your brain by stimulating the learning process can help improve your overall health. 

Knowledge has been shown to pay off in a 2014 study which found that learning two or more languages in adulthood can slow down age-related cognitive decline.  

‘Being positive and open, willing to try new things, and engaged with what’s going on around us have been shown to be important in sustaining our wellbeing as we get older’, says Ms Abrahams. 

She suggests learning something new or joining a new club can help you to ‘retain a sense of purpose’.

She said: ‘Volunteering to help others, joining a local group of some kind or learning a new skill like a language or musical instrument are just a few examples of things worth considering if you’re looking at how to retain a sense of purpose and get the most out of life.’

Staying social

Just like learning a new skill, staying social can also keep your mind active. 

It’s been shown that older people who socialise daily, weekly or monthly have a significantly greater chance of a longer life than those who socialised the least or not at all.

The long-term study by researchers from Sichuan University West China Hospital looked at data for 28,563 Chinese people who were asked about their socialising habits.

Experts say this could be because spending time with friends and family can relive stress and anxiety.

It also encourages people to get outside and be more physically active. 

Ms Abrahams said: ‘Spending time with others can help you feel more connected and less anxious. 

‘Spending time with family or friends can remind you of happy memories, while meeting new people gives you the chance to share different experiences, thoughts and ideas.’

Age UK encourages people to join clubs, volunteer in the community or even connect with others safely online. 

Ms Boston also puts her long life down to having plenty of friends and family around.

She said: ‘I live alone, but I never get lonely. I never seem to have enough time, because everything is a big effort and I’m so slow. It takes me time to do everything, so the days seem short. I also have my music and my family and friends.

‘My sister is 94 and I have had friends who also lived a long time. Two of them lived to 90 and one to 102, but unfortunately they have passed on. That’s what happens. 

‘Friends I have made more recently don’t know me as well as friends I knew when I was young. They can be very good friends but can only really see you as you are now.’

Eating well and stay hydrated  

Eating a healthy and balanced diet is a known way of slashing your risk of cancers and circulatory diseases.

More than 6million deaths globally could be avoided just by reducing the intake of processed foods, trans and saturated fats and added salt and sugar, according to Dr Xinyao Liu, from the Central South University, 

Dr Liu, who was the study author on research published in the European Heart Journal – Quality of Care and Clinical Outcomes, also told Diabetes UK that these heart-related disease deaths could also be reduced if people increased their intake of fish, fruits, vegetables, nuts and wholegrains.  

Ms Goss, of the BHF, also urges people to eat theses foods to help protect their heart and reduce their risk of a heart attack or stroke.

She told MailOnline: ‘Time and again the Mediterranean diet comes out on top, with studies linking it to longer life expectancy. 

‘This includes fish as well as plenty of fruit and vegetables, wholegrains, nuts, seeds, beans and lentils with fat from unsaturated sources.’

Experts say what we eat and drink gets even more important as we get older. 

Ms Abrahams said: ‘It’s good to remember that one person’s nutritional needs can be very different from another’s. Finding a balance that’s enjoyable, varied, manageable and sustainable for you is important.’

She added: ‘Sometimes we may find that we lose our appetite as we get older, unintentional weight loss can be harmful so it’s important that we continue to eat, something is better than nothing.

‘It’s important to drink enough to avoid dehydration and make sure our bodies function as they should. The official recommendations are to drink 6-8 cups of fluid a day – that’s about 1.5 litres or 2.5 pints. All hot and cold drinks count towards hydration.’

Have regular check ups 

Staying on top of eye tests, hearing check ups and dental appointments can help catch diseases and infections early on. 

As we age, our eyesight and hearing changes which can cause a loss of balance and affect quality of life. 

Ms Abrahams said: ‘Eyesight changes as we age and can lead to a trip or loss of balance. Get your eyes and glasses checked regularly, at least every two years to detect any vision problems early.

‘Problems with your ears can severely affect your balance, and the risk of hearing loss increases with age. Talk with your GP if you notice hearing changes are affecting your day-to-day living or social life.’

But these check ups will also flag early signs of cancer. 

Whether you have a full set of teeth or dentures its still important to go for regular check-ups at the dentist. 

‘Your dentist will help make sure there are no problems developing and help prevent future problems. At the dentist, you can also get checked for signs of mouth and neck cancer’, says Ms Abrahams. 

Ms Goss also stresses the importance of knowing your numbers and keeping on top of your blood pressure and cholesterol, if you want to live into old age. 

The nurse said: ‘Prioritising your heart health at every age is one of the best ways to increase your chances of living a long and healthy life. 

‘If you smoke, consider quitting as this is one of the best steps you can take for your overall health, and the earlier you quit the bigger the benefit. 

‘Knowing your numbers – blood pressure and cholesterol – can also help you to spot the early warning signs and take steps to ward off future problems including heart attacks and strokes.’

New York City is vibrant, exciting and fast-paced, but battle your way across it, jump on an Amtrak at Moynihan Train Hall, and 90 minutes later the blaring horns will be replaced with the serenity of New York State.

In the splendidly named town of Poughkeepsie, pick up a hire car for an adventure in an area packed with America’s rich colonial and early heritage, as well as spectacular views.

First stop is West Point, the oldest occupied military post in the US, which dates back to the War of Independence, and, nearby, General George Washington’s final HQ.

As the prime mover in the 18th Century battle for independence from the British, Washington knew his Continental Army would need a training school. 

He also realised the Patriots needed to stop the British from moving up and down the spectacular Hudson River. 

West Point, on a narrow bend, was a perfect place to achieve both, and a giant chain was made to float on log rafts across the river as a barrier. 

Today a ring of 13 remaining links – one for each founding state – stand in a loop in the training school grounds. It’s quite a sight.

High-roller mansions are another feature of the Hudson Valley, and near Poughkeepsie is Hyde Park, the home of Franklin Roosevelt, the president who saved America from economic collapse in the 1930s Depression. 

Artefacts abound, such as his ‘lucky’ hat, the wheelchair and leg irons he used after contracting polio, details of the New Deal to give relief and work to the unemployed, and his ‘four freedoms’ speech, emphasising freedom of speech, and of worship, freedom from want and from fear.

At the end of each of his presidential victories, FDR would give a speech from the porch of the ancient Beekman Arms in nearby Rhinebeck. 

The inn has been there since well before the American Revolution – and still looks like stage coaches will pull up out front on the old King’s Highway.

An hour north, in the state capital of Albany, you can change gear again. 

The commanding state Capitol building looks like a transplanted French chateau, in stark contrast to the ultra-modern concrete buildings lining the huge plaza outside.

Alongside all this is the New York State Museum. Next to depictions of the state’s history is a 9/11 exhibit. 

A burnt-out fire engine jolts hard, along with the testimonies from survivors. It’s powerful and moving.

Staying at Morgan State House is an experience. It’s an elegant three-storey brownstone facing Washington Park, which was once home to suffragette Alice M Wright, whose spell in jail in London for her activism meant she missed her journey back to the US on the Titanic.

Upstate New York offers excitement at every turn, but it’s a different kind of excitement. More than anything, it gives perspective, and that’s never a bad thing.

A woman who had a nasty hangover was left horrified after discovering her symptoms were actually a sign of cancer.

Amber Orr, from Ballymena in Northern Ireland, woke up with tummy pain and extreme nausea in March 2019 and assumed it was just due to heavy drinking with friends the night before.

However, when the 24-year-old was still suffering from ‘unbearable’ pain and throwing up days later, her mother rushed her to hospital.

There, doctors discovered the social work student’s appendix had ruptured and perform emergency surgery to remove it. 

But rather than her medical ordeal being over, further tests revealed that the rupture was triggered by a cancerous tumour in her abdomen. 

Amber had been partying with friends in Belfast in spring 2019, when she was 19-years-old.

Despite brushing-off her illness the next day as the after-effects of alcohol, her symptoms lasted for another two days.

She said: ‘When I woke up feeling sick, I blamed it on being hungover.

‘But as the day progressed, I realised it wasn’t a hangover.

‘I kept getting this unbearable pain in my side and I was throwing up.’

Her mother then took her to Antrim Area Hospital when she showed no signs of getting better. 

Medics monitored Amber overnight, suspecting that she had an UTI — an infection of the urinary tract that can cause pain in the lower tummy.

But after spending another 48 hours in hospital, she was rushed into surgery because her appendix — a finger-shaped organ with no known function — had burst. It’s usually not clear what causes an appendicitis. 

Amber underwent further tests and was sent home.

She assumed her health woes were over until two weeks later when she got a call from the hospital, asking her to come back in.

Once she arrived, medics sat her down and told her that test results showed she had a cancerous neuroendocrine mass — a rare tumour the can develop in many of the body’s organs.

Amber’s had been located in her appendix, before it was removed, and had also spread to her bowel.

Around 6,000 people in the UK and more than 12,000 in the US are diagnosed with the cancer every year.

Symptoms depend on where the tumour is located. Those in the bowel can trigger diarrhoea, constipation and tummy pains. 

Amber said she had ‘never thought’ that she had cancer.

She added: ‘I didn’t feel anything. It was more of a numbness. I didn’t properly digest the information until months later.

‘Cancer is a such a taboo word and subject and to hear it out loud is such a surreal thing.

‘My diagnosis also happened so fast that I honestly didn’t have time to even think about what was happening to me until the whole thing was over.’

Doctors told her that she would require surgery to remove the tumour and chemotherapy to kill any surviving cells.

But the procedure in May 2019, which removed half of her bowel, successfully cleared her of the cancer — meaning she didn’t require further treatment.

She has now been in remission for four years.

However, it continues to impact her mental health.

She said: ‘I can’t count the number of hours I’ve spent crying and breaking down because of how cancer has made me feel.

‘Whether that be physically, from the scars on my body, or mentally, from the anxiety and depression from treatment and fear of it returning.

‘You don’t realise just how much cancer impacts your mental health.

‘My mental health didn’t take a hit until after I was in remission.’

Amber is now using her experience to raise awareness of the long-term effects of cancer and the importance of early detection.

She said: ‘If my appendix hadn’t burst, I wouldn’t have found my cancer until it was terminal.

‘I try to use my story to encourage others to check themselves and listen to their bodies.

‘I also want to give them the confidence to book appointments and stand up for themselves when they feel something isn’t right.

‘Cancer doesn’t discriminate. It doesn’t matter your age, gender, or race.

‘I want to give back to the places that helped, like the Teenage Cancer Trust and Young Lives vs. Cancer, by fundraising, because without the help of their social workers and nurses, I know for a fact I couldn’t have made it out the other side.’

Amber will be starting her degree in social work this month.

She added: ‘I am looking forward to getting my degree and hopefully becoming a social worker for the NHS, working specifically with cancer patients.

‘If I can help even one person the way that they helped me, I know that I’ll be doing something right.

‘As much as cancer has changed my life, it doesn’t define who I am.

‘It shouldn’t get to take over my life and make me afraid to live.’

Most women going through menopause are not being given proper treatment, leaving millions to suffer in silence, a major review suggests.

Just 15 percent of women get effective drugs or therapies, and misinformation leads many to go down the route of unproven natural remedies, according to the review, which analyzed over 200 studies going back 70 years.

While only around a third of middle-aged women suffer noticeable menopause, the review said that many more go through silent changes in the body, such as loss of bone density that leaves them vulnerable to chronic disease down the line.

The study, conducted by researchers in the US, Italy, and Australia, found popular treatments like acupuncture and herbal supplements either just slightly improved menopause symptoms or didn’t work at all. 

And antidepressants, which are commonly prescribed for hallmark symptoms like hot flashes, may alleviate symptoms but come with a host of side effects that may add to women’s misery, including nausea, sexual dysfunction, and high blood pressure. 

‘The road to menopause is not difficult for all, but for some, symptoms may be severe or even disabling and disruptive to work and family,’ the study authors wrote. 

‘Recognition that menopause, for most women, is a natural biological event, does not exempt the use of interventions to alleviate symptoms.

‘Despite decades of research pertaining to menopause, more work is needed.’

Without effective, evidence-based treatment, the researchers cautioned menopausal women are left vulnerable to long-term ‘silent’ health consequences like bone loss, diabetes, and heart disease.

The review looked at more than 200 sources spanning 71 years to collect data on current menopause knowledge. 

They examined the effects of prescription drugs and homeopathic remedies, such as herbal treatments and acupuncture, on common side effects like hot flashes and night sweats.

They found ‘acupuncture appears no more effective than placebo,’ and herbal treatments only resulted in improvements in small, uncontrolled studies, so the evidence there is inconclusive.

However, cognitive-behavioral therapy did lead to some small improvements and boosted sleep and mood.  

Additionally, the study, published Wednesday in the journal Cell, evaluated the effects of several selective serotonin reuptake inhibitors (SSRIs), which are typically used to treat depression, on reducing hot flashes and night sweats. 

The researchers found SSRIs like citalopram, fluoxetine, and paroxetine reduced these symptoms by 25 to 70 percent.

However, patients who took these medications experienced a host of uncomfortable side effects, including nausea, insomnia, dry mouth, sexual dysfunction, headache, high blood pressure, constipation, and dizziness. 

Based on their findings, the team called for more individualized treatment approaches rather than recommending the same treatments to every woman.

‘Women with bothersome menopausal symptoms should be counseled on treatment options and offered evidence-based therapies,’ researchers wrote.

‘Therapy should be individualized depending on age and health risks, recognizing that health risks may increase with age.’

Menopause is a normal part of aging that occurs because the ovaries stop producing eggs. As a result, levels of the hormones that ovaries produce drop.

A hallmark sign of menopause is that affected women stop getting their period.  

Nearly nine in 10 women experience symptoms of menopause, including hot flashes, night sweats, changes in mood, sleep disturbances and cognitive difficulties, such as anxiety and low self-esteem, as well as memory or concentration problems.

Other signs include sexual issues, bladder problems and dryness of the vagina.

Symptoms usually arise before menopause officially begins, during a period called perimenopause. During this time, women’s periods become irregular, hot flashes start, and fertility decreases.

For some, this only lasts a few months, but it can stretch as long as four to eight years. 

The average age of onset for menopause in the US is 51. Those who undergo it between the ages of 40 and 45 have what doctors call ‘early menopause.’ 

After menopause, women enter post-menopause. This is when a woman hasn’t had a period in over a year, and symptoms like hot flashes, vaginal dryness, and changes in sex drive continue. 

This lasts for the rest of a woman’s life.  

The researchers noted doctors should focus on preventing and treating the ‘silent’ health consequences menopausal women are prone to, including osteoporosis, diabetes, and heart disease.

‘Comprehensive care of postmenopausal women involves lifestyle optimization,’ they wrote.

‘This includes optimizing nutrition, avoiding being sedentary and increasing physical activity, adding strength and resistance exercise or training, getting adequate sleep, reducing stress, decreasing alcohol consumption, and avoiding smoking.’ 

They also suggested menopause be characterized by ovarian function stopping rather than no longer having a menstrual cycle. 

This is because many women who are not menopausal stop having a menstrual cycle due to certain birth control or procedures like a hysterectomy. 

These approaches, the team argued, could help improve women’s long-term health.

Researchers added: ‘Optimizing health at menopause is the gateway to healthy aging for women.’

Depression can play a direct role in developing type 2 diabetes even if you’re not overweight, researchers have discovered. 

Experts have long known that people with diabetes are around twice as likely to suffer depression compared with those without the condition. 

It is also well established that people with depression have a higher risk of developing type 2 diabetes.

But new research, funded by the charity Diabetes UK, has found seven genetic variants that contribute to both type 2 diabetes and depression.

Leading experts and charities today labelled the findings ‘hugely important’ and urged health officials to consider depression as a risk factor for type 2 diabetes, alongside obesity, inactivity and a family history of the condition.

Researchers found, for the first time, that depression directly causes an increased risk of developing type 2 diabetes, but not that diabetes causes depression.

The study found that only 36.5 per cent of the effect of depression on type 2 diabetes could be explained by obesity.

Obese people are significantly more likely to have type 2 diabetes than those of normal weight.

The researchers also noted seven genetic variants that contribute to both type 2 diabetes and depression.

These shared genes play a role in insulin secretion or inflammation in the brain, pancreas or fat tissue, with changes in these biological processes potentially explaining how depression increases type 2, they suggested.

While a direct cause was not found for diabetes causing depression, experts still believe that the burden of living with type 2 diabetes can be a factor in developing depression.

Dr Elizabeth Robertson, director of research at Diabetes UK, said: ‘This hugely important study gives us new insights into the links between genetics, type 2 diabetes and depression, indicating that depression can contribute to the development of type 2 diabetes.

‘Type 2 diabetes is complex, with multiple risk factors – and previous research has shown that the condition is more common in people with depression.

‘This study gives us greater insight into why and indicates that depression should now be considered a risk factor for type 2.

‘This knowledge could help healthcare professionals to improve care and support for people with a history of depression and prevent more cases of type 2 diabetes.

‘We strongly encourage anyone with depression to know their risk of type 2 diabetes by completing Diabetes UK’s free online “know your risk” tool, so they can get the right support to reduce their risk and avoid type 2 diabetes.’

Inga Prokopenko, professor e-One Health and head of statistical multi-omics at the University of Surrey, who led the study, said: ‘Our discovery illuminates depression as a contributing cause of type 2 diabetes and could help to improve prevention efforts.

‘The findings are important for both individuals living with the conditions and healthcare providers, who should consider implementing additional examinations to help prevent type 2 diabetes onset in people suffering from depression.’

The study, published in Diabetes Care, used data from hundreds of thousands of people in the UK and Finland, including 19,344 people with type 2 diabetes, more than 5,000 people diagnosed with depression and 153,079 who self-reported depression.

Writing in the journal, researchers concluded: ‘Our results highlight the importance to prevent type 2 diabetes at the onset of depressive symptoms, and the need to maintain a healthy weight in the context of its effect on depression and type 2 diabetes comorbidity.’

Almost 4.3million people were living with diabetes in 2021/22, according to the latest figures for the UK.

And another 850,000 people have diabetes and are completely unaware of it.

This has concerned health officials as untreated type 2 diabetes can lead to complications including heart disease and strokes.

Approximately 90 per cent of diabetes cases are type 2 diabetes, which is linked with obesity and is typically diagnosed in middle age, rather than type 1 diabetes, a genetic condition usually identified early in life.

‘Are you off to Ricky’s house’ asked my taxi driver as he pulled up at the train station. It was clear from the local cab driver’s face that he was proud of Ricky Hatton’s association with Hyde.

During our short drive to the Manchurian’s house, I was inundated with stories about the Hitman and his involvement in the community. We spoke in great detail about Hatton’s five world titles and his unification bout with Carlos Maussa.

But, ask Hatton about his career and he will describe himself as a failure and highlight the depression, addiction and shame that followed his defeats to Floyd Mayweather and Manny Pacquiao.

After just 30 minutes in Hatton’s company, I learnt about his suicidal thoughts, the way in which his family grieved his defeat to Pacquiao and his concerns surrounding his son’s involvement in boxing.

Hatton’s story is certainly one of triumph over adversity. His widely publicised struggles with substance abuse didn’t stop him from becoming one of the most influential and beloved figures in British boxing. Now he hopes his son Campbell can enjoy success without the darkness that engulfed him. 

‘There’s a possibility Campbell could experience the same mental health problems as me. I have said to Campbell if there is anything on your mind, come to me. I nearly wasn’t here to enjoy the things that I am loving today. 

‘Spending time with my grandfather and seeing Campbell turn professional. Seeing my girls turning into the young ladies they are today. I nearly wasn’t here to experience that as I was suicidal. So I will hammer him every day asking if he’s okay.’

Hatton pinpointed his defeat to Mayweather as the moment his mental health spiralled out of control. He challenged for the WBC welterweight crown but was stopped for the first time in his career by the former five-weight world champion.

‘When I got beaten by Mayweather I was devastated. I told everyone I was going to win. I got my best pay day and I am fighting the best pound for pound fighter in the world but I didn’t go there just for that though.

‘I thought I was going to beat him. When I didn’t, after telling all those fans that went over I would, it put my head away.

‘After the fight, I couldn’t walk down the street I was so embarrassed. I didn’t want to show my face. I know that seems a bit strong but that’s what was in my mind.

‘I thought everyone was looking at me saying he told us he was going to beat Mayweather and he didn’t. It’s a shame really but was the start of my mental health struggles.’

That wasn’t the only loss Hatton struggled to deal with. Hatton’s aggressive style was no match for Pacquiao’s speed, accuracy, and power, resulting in a crushing second-round knockout. He described the scenes in the changing room after the fight as ‘heartbreaking’.

Hatton was used to basking in the euphoria of victory. There would be an intoxicating mix of elation, relief, and camaraderie. Loved ones would clutch onto his sweat-soaked body and fill the air with a round of applause.

But, not on May 2, 2009. The dressing room became a somber place, filled with silent stares and the occasional sigh following the Pacquiao defeat.

‘It was like a death in the family when we went back to the changing rooms. You don’t see many more brutal knockouts than that.

‘To see your mate or your loved one knocked out in that manor must have been very very hard. I think people were thinking Ricky needs to hang his gloves up now after being knocked out like that.

‘You know, he’s had his day. He’s had 45 fights. The way I was living my life and ballooning up and down in weight wouldn’t have done my body or mental health any good.’

Ricky, like many others, tried to hide his mental health issues from his family as he felt it was wrong to burden them with his problems. 

‘The thing is people never really knew how bad I was in terms of my mental health. I always shielded it from my family and my loved ones.

‘I didn’t want to tell them how bad it was because I didn’t want to worry them. I am certainly not going to go to my mates and say I am crying everyday. I want to kill myself. You just don’t do it. But, they knew I was in a bad place mentally. But, they didn’t know how bad it was.’

‘But, I went through a period where I didn’t care whether I lived or died. I thought to myself, f****ing hell Rick this is bad. You need to sort yourself out. I went and saw a psychiatrist in Manchester and said you need to tell me what to do otherwise I won’t be here next week, I’m going to kill myself.’ 

Ricky believes boxing as a sport needs to do more to protect its athletes.

‘Footballers have a club to look after them. They also have the PFA where they looked after. Promoters are like you’re making money great. Now who is the next prospect? The way that the sport is and the fact you intend on hurting your opponent, it’s hard. 

‘Don’t forget, boxers don’t come from Cambridge or Oxford either. They come from council estates. We don’t know how to deal with money or mental health. Promoters just move onto the next prospect. I think more should be done to help boxers.’

Despite his ongoing battle, Hatton has turned his life around and embraced a healthier lifestyle. That being said, there’s still a burning sense of injustice following referee Joe Cortez’s performance during his title fight with Mayweather.

When asked whether he felt cheated, Hatton said: ‘Yes, very much so. You have to remember Cortez was from Vegas. Mayweather was from Vegas. I’m not saying he was handed a brown envelope but I just think there was a bit of favouritism towards the hometown boy.’

Despite hanging up his gloves, Hatton’s love for the sport is still there. He found solace and purpose in the ring but made its clear boxers need more support.

‘Footballers have a club to look after them. They also have the PFA where they looked after. Footballers get testimonials, whereas in boxing they are on their own.

‘Promoters are like you’re making money great. Now who is the next prospect. It’s a shame but it’s always been like that boxing.

‘The way that the sport is and the way you have to go through with the intent of hurting your opponent, it’s hard. Don’t forget, boxers don’t come from Cambridge or Oxford either. They come from council estates.

‘We don’t know how to deal with money. We don’t know how to deal with mental health. The promoter just move onto the next prospect. I think more should be done to help boxers.

‘It’s a shame because how many times do you see boxers who win world titles, make their fortunes and then end up with nothing. We do need help, we’re not the brightest buttons in the box.’

Hatton is hoping those changes come into play sooner rather than later as his son Campbell continues to forge his own career in the sport.

‘There’s a possibility he could experience the same mental health problems as me. He was too young when I was going through my bad stage to actually realise what was going on. Now he knows the score and what I went through.

‘I have said to Campbell if there is anything on your mind, whether that’s a relationship problem or a problem at home, come to me.

‘Use my mistakes to benefit you. Just come and tell me. Speak to me and get it off your chest. I say that to everyone. We all have bad days, share it with someone you’ll be better for it.

‘I nearly wasn’t here to enjoy the things that I am loving today. Spending time with my grandfather and seeing Campbell turn professional. Seeing my girls turning into the young ladies they are today. I nearly wasn’t here to experience that.

‘So I will hammer him every day asking him if he has any problems. Whether it’s something I did right in the ring or something I did wrong out of the ring, I have the answer for you.

‘I think he’s proud when he sees what I’ve gone through and where I am now. I think he knows that if anything goes wrong, he has to come to me. I am confident he will do so.’

Our interview wasn’t all doom and gloom. Hatton highlighted his fight with Kostya Tszyu as the standout moment of his career.

Tszyu, a dominant force in the lightweight division, had not been defeated in over a decade until he stepped foot in the ring with Hatton.

The Hitman’s relentless pressure and attacking style saw the Russian boxer quit on his stall after the 11th round.

‘I had come back into the corner and I said to Billy Graham, I have nothing left. I have nothing left. He said, Ricky I don’t want to hear that.

‘He said remember all of those days sitting on the bottom step at the gym in Salford, having a cup of tea and you saying I want to be the best in the world. You saying I want to go to Vegas. I want to fight the best fighters in the world. I want to fight the best pound for pound fighters. He said this is your chance to become the best. This is the day we dreamed of.

‘You’ve got your nose in front now. I don’t want to hear any crap about you have nothing left. All you have to do is dig in and out the finishing touches on to make your dreams come true.

‘A good trainer knows the right words to say at the right time. He brought me back to when I was 16/17 years old sitting on that step. I went yep, yep he’s right. It had reached that stage in the fight where it didn’t matter about a certain punch, or a certain combination. We had gone past the tactic stage. All I needed was him to say something that would get those last couple of rounds from me.

‘I stood up and got off my stool. I looked around him and I saw the referee go like that. I thought, thank god for that. I started crying. I didn’t have much left in my but I would have gotten it out.’

Hatton is available to watch on Sky Documentaries and NOW 

I have been on the sleeping pill zopiclone for seven months and am wondering if I should come off it. I’m sleeping well but have started to get headaches. Do you have any advice?

Zopiclone is a Z drug – the other is zolpidem – and these should only be used for a short term, perhaps a few weeks.

Taking them for longer can lead to dependence. People may find they can’t sleep without them and suffer side-effects such as brain fog, poor memory, numbness and even anxiety and depression.

We also know that a tolerance builds up so that, in time, people need to use it more and more.

Anyone on a Z drug for more than a month or so should reduce their dose slowly due to the risk of withdrawal effects. These can include anxiety, the shakes, sweating and nausea.

Some patients tell me they feel their heart racing or that their old sleeping issue is coming back – but this is simply withdrawal. It’s important to speak to the GP to make a plan about how to stop.

We often do this over a period of weeks or months to make it as comfortable as possible. It can take more than one attempt.

For long-term sleeping problems, the recommended treatment is CBT-i, a specific form of cognitive behavioural therapy which tackles the thoughts and behaviours that cause and worsen insomnia.

For example, relaxation therapy or sleep restriction is used. Sleep restriction is where the patient is encouraged to limit their time in bed. They go to bed and get up at a set time, with a short window to begin with that’s increased.

It’s quite an involved process and a GP or therapist can help guide you through it. Or you can try an app such as Sleepio.

Sleep hygiene is often talked about. It means creating the best possible environment and mindset for sleeping with ideas like a tech-free room and not exercising before bed. This won’t cure your insomnia but is an important help alongside.

After tripping on a broken paving stone 18 months ago and fracturing my shoulder and arm I was diagnosed with moderate osteoporosis. I am 72 and have always eaten well and exercised. I’ve been recommended a drug called zoledronate but I’m worried as I’ve read it can cause some pretty nasty dental issues and I’ve had an extraction recently. What should I do?

Osteoporosis is a thinning of the bones that makes them weaker and more likely to break.

The aim of treatment is to prevent a fracture. Falls become more common as we age due to loss of muscle strength and stability and balance problems.

It can be quite serious. For example, hip fracture from osteoporosis will cause a permanent disability in around half of people who suffer one.

Osteoporosis is diagnosed with a DEXA scan. The result is given as a score which translates into various stages of bone thinning.

Whether treatment is recommended and what that treatment is depends on these results and a personal risk score calculated by a doctor, known as the fragility fracture score. Already having had a break will mean a higher score but it also depends on other factors such as age and family history. Treatment includes diet and exercise. Taking enough Vitamin D and calcium, both needed for healthy bones, is vital, as is adopting weight-bearing and muscle-strengthening exercises to support your bones.

The Royal Osteoporosis Society website (theros.org.uk) has helpful how-to exercise guides and diet advice.

Medication is important to strengthen the bones and there are a range, including HRT which may be suitable for some women in this case. All medications carry side effects and the dental complications of some osteoporosis drugs are important to weigh up if you need dental work. If you’ve had dental problems, it’s important to tell your doctor or nurse so they can work out the best treatment.

I have just returned from a holiday in Spain and suffered swelling in my feet and ankles after getting off the plane. This has been happening for years but tests show my circulation is fine. I am 71 and active. Is there any medication I could take? When it flares up it’s very sore and uncomfortable.

Swelling like this is known as oedema and though it can look unsightly, and feel uncomfortable, it’s generally harmless if all tests are normal.

When we sit for long periods, the movement of blood from the lower limbs back to the heart can slow. This allows fluid in the blood to leak out of the veins and into the surrounding tissues, which causes the swelling.

Movement of muscles in the legs and feet help to squeeze blood through the veins back to the heart more efficiently.

Oedema is worse for anyone with heart or vascular issues, so doctors do heart tests and other scans to check everything is ok. You may consider special socks for the plane. Compression stockings apply pressure to your legs, mimicking the muscles and aiding circulation. These are measured specifically for you and you can try different strengths and lengths to see what works and is comfortable.

We do sometimes prescribe water tablets – diuretics. It may be something that can be taken short-term to prevent these difficult symptoms on holiday.

Has hospital sent you home without care?

I heard an alarming story last week from the wife of a chap who was ‘turfed out’ of hospital after a horrific fall at home.

A few days after being admitted, despite the fact that he was practically unconscious having broken his hip, a hospital worker called claiming he said ‘he felt ready to come home’.

His wife agreed, of course. She asked if there would be any help. ‘Someone will come to assess,’ she was reassured. A care package – a bed downstairs, a commode and some help – would then be issued. But that never happened.

Luckily, she corralled friends to get a bed into the living room. After a few days of calling, the GP arranged a bedpan – but she still couldn’t get through to anyone from the hospital.

What a sorry tale. This scenario would fall under Discharge To Assess. Introduced in 2016, patients well enough to leave hospital but who need extra support are sent home and seen within days by an occupational health worker, who will then organise care. Clearly this doesn’t always happen.

If you’ve been in this situation, I’d like to hear from you. Write to me at the address above.

Heart attacks affect women too

I found myself irritated by an image that was posted on social media by the NHS’s Instagram account this week.

The picture was of an overweight man with hands clutching his chest, followed by part of a heart health campaign, designed to help people spot the signs of heart attacks. But we need to stop presenting heart attacks as a problem that only affects men.

It is well known that heart attacks often go hidden in women because there is an assumption – among patients and some doctors – that they are unique to men. It means women are slower to get vital treatment and are more likely to die from a heart attack.

Heart disease kills more than twice as many women in the UK as breast cancer. It may be time for the health campaign posters to reflect that.

The Food and Drug Administration has approved the first ever pill to treat postpartum depression (PPD) which is suffered by around one in seven new mothers. 

Zuranolone, which is an antidepressant, is a once-a-day pill, taken for two weeks. It will be sold under the brand name Zurzuvae.

Clinical trials showed it improved the symptoms of new mothers who were experiencing severe depression after having a baby. 

The only other medication on the market for PPD, Zulresso, needs to be administered via IV continuously for 60 hours and costs $34,000. 

Symptoms of PPD can be debilitating and range from deep despair and frequent crying to thoughts of hurting the baby, not feeling connected to the child, or feeling as if it is someone else’s.

In a statement on Friday, the FDA called Zuranolone ‘the first oral medication indicated to treat postpartum depression in adults’. 

It added: ‘Until now, treatment for PPD was only available as an IV injection given by a health care provider in certain health care facilities.’

The pill, specifically designed for PPD, has been shown to work faster than other antidepressants and is designed to be taken only over a short two-week period.

Trials of the pill showed its side effects were less severe than other antidepressants currently in use, which can lead to sudden loss of consciousness, weight gain or sexual dysfunction. 

It was developed by pharmaceutical companies Biogen and Sage Therapeutics. No price has yet been announced for the new pill.

Tiffany Farchione, head of psychiatry in the FDA’s Center for Drug Evaluation and Research, said PPD is ‘a serious and potentially life-threatening condition in which women experience sadness, guilt, worthlessness – even, in severe cases, thoughts of harming themselves or their child.’

‘Having access to an oral medication will be a beneficial option for many of these women coping with extreme, and sometimes life-threatening, feelings,’ she said.

Dr Asima Ahmad, chief medical officer at Carrot Fertility, a healthcare company in Menlo Park, California, said around 75 percent of moms reporting PPD symptoms go untreated.

‘These numbers are elevated for minority populations; 81 percent of Black women and 76 percent of Hispanic women said they would have liked to learn more about postpartum mental health before having children, compared to 70 percent of women overall,’ she said.

‘In a time when we are seeing rising maternal mortality rates, and significant racial disparities in maternal outcomes, we need to focus on solutions, and that includes addressing postpartum depression.’

Ahmad believes the new drug will reduce the stigma around using antidepressants.

‘Both the lower incidence of side effects and the short-term regimen, which could help some feel less stigma around having to use an antidepressant, could potentially improve compliance,’ she said. 

Zuranolone is one in a class of drugs that target GABA receptors in the brain using a substance called a neurosteroid.

It was designed to rapidly rebalance dysregulated brain networks responsible for functions such as mood, arousal, behavior, and cognition, to help reset brain function.

When a person is depressed, GABA and glutamate, both neurotransmitters, are thrown out of balance, affecting neuron activity.

Depression treatments typically aim to boost serotonin levels in the brain, but a growing body of research shows that the GABA pathway may be just as effective.

The drug companies sought approval based on the strength of their five trials in major depressive disorder and two trials in PPD.

In the Phase 3 SKYLARK randomized study, women receiving the drug at a 50mg dose felt measurably better after three days.

They measured women with PPD based on the 17-item Hamilton Rating Scale for Depression (HAMD-17).

A score of zero to seven is considered to be normal, while a score of 20 or higher (indicating at least moderate severity) is usually required for entry into a clinical trial.

Women were enrolled if they were less than six months postpartum and had a major depressive episode beginning during the third trimester or before four weeks postpartum.

Women who received Zuranolone each evening for two weeks experienced a greater reduction in HAMD scores than women receiving a placebo pill.

At day 15, the mean reduction in HAMD scores was 15.6 in women receiving Zuranolone vs. 11.6 in the placebo group.

At day 45, women treated with Zuranolone continued to show a greater reduction in HAMD scores than women receiving a placebo (down 17.9 points and 14.4 points, respectively).

Dr Kristina Deligiannidis, who led the study into the drug, told CBS Saturday Morning: ‘Women were reporting rapid improvement in their depression as early as day three.’

She added that the medication had side effects of feeling sleepy, sedation and headaches. 

One woman said Zuranolone helped her from day one. ‘I immediately just felt more like myself. It’s going to save so many women and families.’ 

Increased focus has been put on PDD after Boston mother Lindsay Clancy, 32, allegedly murdered her three children in January after suffering from an extreme form of postpartum depression.

In more extreme cases, a new mother may experience postpartum psychosis, the condition that Clancy is believed to have had when she committed the murders.

It’s a rare condition that usually develops within the first week after delivery. A new mother with psychosis will have an altered experience of reality which interferes with their ability to function normally.

Postpartum psychosis, which tends to include paranoia, dramatic mood changes, hallucinations, delusions, and suicidal and/or homicidal thoughts is treatable.

Mental health professionals have a full army of antidepressant drugs at their disposal. The medication does not have to be tailored to PPD symptoms to work. Talk therapy is also a useful tool for millions of women struggling post-pregnancy.

Cancer patients have told of having just months to live after facing long waits for treatment on the NHS.

Sufferers across England have been forced to endure delays of up to four months between vital checks, tests and treatments.

As a result, some say they are now dying prematurely, suffering depression and unable to plan for the future.

It comes as England’s burgeoning cancer crisis was today laid bare by MailOnline’s dossier of ‘disgraceful’ data.

The dire numbers – packaged into a searchable tool so you can see exactly how your NHS trust performs – come amid growing fears of a cancer timebomb.

Carol Fletcher

Carol Fletcher, from South Wales, had a routine screening appointment for breast cancer in June 2022.

The NHS offers the checks to women aged 50 to 71 every three years. It uses X-rays to look for cancers that are too small to see or feel.

It was not until eight weeks after her mammogram, that Carol was told there was something wrong.

She was then diagnosed with breast cancer and faced further waits for scans, tests, surgery and chemotherapy.

Carol told the BBC: ‘I was told that I might not get results back [quickly] after my mastectomy because they haven’t got enough pathologists, so there was another eight-week delay for chemotherapy.

‘I can’t plan for the future and it’s had a huge impact on my family.’

Kevin O’Hara

Kevin O’Hara, from County Durham, had a scan last November after a motorbike accident.

As well as showing that he had five broken ribs, a scan detected a shadow near one of his kidneys.

It was later diagnosed as kidney cancer.

Kevin was initially offered drugs to slow the growth of the tumour.

But medics informed him that he faced a three to four month wait for surgery.

He told the BBC: ‘Every day you are waiting and waiting and nothing changes.

‘I come home from work and go to the door and, when there’s no envelope that says NHS on the top, I just get so depressed.’

Charlotte Park

Charlotte Park, from North Yorkshire, booked GP appointment in June 2020 after finding a lump in her breast.

Her doctor made an urgent referral to her local breast clinic, which was supposed to see her within two weeks.

But when Charlotte called the clinic after not hearing from it, she was told there were delays due to a backlog.

She was eventually seen three-and-a-half weeks later — but only after going back to her GP who helped secure an earlier appointment. 

Scans showed she had an aggressive form of breast cancer. But it wasn’t until September that she began chemotherapy.

She is now in remission, which means there is no sign of cancer in her body. 

But she told the BBC: ‘It was so frustrating. I just felt like I was hitting my head against a brick wall. I felt under a massive amount of stress.

‘I thought I was going to die at one point. You worry so much when you are waiting. Sadly there are so many people out there is this position.’

Caroline Boulton 

Caroline Boulton, from Greater Manchester, was booked in for a mammogram — a routine breast cancer check — in March 2020.

But the appointment, and another for November 2020, were cancelled due to the Covid pandemic.

Then, in November 2021, she found a small pea-sized lump on her breast.

Caroline booked a GP appointment and was urgently referred to a specialist. 

However, she had to wait three weeks to see a consultant, rather than the two weeks set out in the NHS rule book.

By the time of her appointment, the lump had grown to the size of a tangerine.

Caroline was told it was a fast-growing cancer but that it would be an eight-week wait for surgery to remove her breast.

She then faced delays of four to eight weeks between each appointment and scan.

By the time she saw an oncologist, seven months after finding the lump, scans showed that the cancer had spread to her liver and there was no effective treatment available. 

Caroline said: ‘I’ve now got stage-four cancer that I shouldn’t have — and two years to live.’ 

My husband had an operation on his heart last year due to angina. He is on blood thinners, statins and medication for high blood pressure. But he also drinks a lot, most days, and I worry that he has a problem. Should I try to get him to stop?

This is a problem I often hear in my clinic. Alcohol is a huge health risk, particularly if a person drinks excessively.

On the other hand, not everyone who drinks a lot ends up unwell – it is all to do with an individual’s constitution and genetics.

People often worry about liver disease due to alcohol but this is by no means the only issue drink can cause. High blood pressure, heart disease and cancer, not to mention brain diseases such as dementia and depression, are all linked to alcohol intake. And it is very addictive – I often see people who can’t cut down for a sustained period of time, let alone stop.

My worry for someone drinking while on blood thinners and other heart drugs is the effect of alcohol on those medications. There’s also the chance of falling if drunk and then having a serious bleed from an injury due to bleeding a lot more than usual when on blood thinners. A head injury would be a particular concern.

Safe drinking for men and women is considered to be under 14 units a week – that’s about six pints or glasses of wine.

Sometimes there are very clear signs that someone drinks too much: opting to drink over other activities, not being able to say no or even hiding the habit. It can be hard to broach the subject with a loved one without being judgmental or confrontational.

Talking about your concern and being supportive – when they’re sober – is the best way, rather than using accusatory words such as alcoholic.

Drinkaware.co.uk has more advice on what to do if you’re worried about someone’s drinking, including tips on what to say and what not to say.

I am suffering from a dragging and pushing feeling in my pelvis, a swollen tummy and discomfort around my bottom. My GP checked for a prolapse but she said that wasn’t the problem. I then had an ultrasound and was told that they could see ‘congestion’ – which I’m not sure I understood. Could the doctor be missing something?

Dragging and pushing are classic features of a prolapse – when one of the organs within the pelvis, such as the womb, drops down into the vagina. It is normally caused by an issue with a weakened pelvic floor and often occurs after the menopause.

What the ultrasound revealed may be a condition called pelvic congestion syndrome. This can be identified on a scan as the blood vessels around the ovaries wider and different to normal.

It is usually seen in women before menopause and causes pelvic pain because the blood vessels are not working as efficiently as they should. It can cause a dull ache, a dragging type of pain, and piles which would cause discomfort in the anus. For proper diagnosis, you need a scan of the pelvic veins.

With no clear answer, it would be reasonable to ask for a further conversation with the doctor, another examination and even a referral to gynaecology. These are not symptoms to be ignored.

I’m on a drug called levothyroxine for my underactive thyroid. But when I take it, I get a feeling of pins and needles in my face and my ears feel blocked, as if I am on an aeroplane. It takes a few hours to wear off. The specialist I saw says it is not the drug, which I have been taking for 22 years, and until this year I have never had a problem. What do you think it could be?

An underactive thyroid gland, known as hypothyroidism, is where the thyroid, which is in the neck, does not produce enough hormones. These are important for maintaining energy levels, and symptoms of having insufficient amounts include tiredness, weight gain and feeling depressed.

Levothyroxine is a hormone tablet prescribed to treat these problems. It’s common for people with an underactive thyroid to also suffer nasal congestion, stuffiness, sinus issues and even impaired hearing – but they are not side effects of levothyroxine.

It is perfectly possible that these symptoms have nothing to do with the drug but that they occur first thing, before breakfast, which is coincidentally when you take your tablets – so you are wrongly associating the two.

It would not be unusual for your sinus and ear congestion symptoms to appear first thing in the morning. When we get up from lying down, it causes fluid to move within the ear or sinuses, which can cause these symptoms. If a medication has been taken long term – in this case 22 years – it’s possible these problems are a result of the condition not being controlled as well, and there may be a need for a dose adjustment.

It’s also possible the sinus problems are linked to an allergy, and a two-week trial of antihistamine tablets might be worth considering to see if this has any impact.

Tackling the nightmare of sleeping pill addiction 

UK health chiefs introduced a brilliant initiative which I want everyone to know about – a guide for patients who take sleeping tablets but want to reduce or come off their dose.

Sleeping pill dependence is a huge problem in the UK. About a million people take the pills – so-called z-drugs such as zopiclone and benzodiazepines – to help them sleep or tackle severe anxiety.

But they are not a long-term solution. They come with a serious risk of addiction – over time you have to keep taking more to get the same effect.

And after just a few weeks of use, my patients tell me that they suffer brain fog, struggle to concentrate and feel emotionally numb.

As a doctor, you worry that patients haven’t taken in the risks of these drugs, because they’re often prescribed in a time of crisis. But now they will have a simple guide to help weigh-up their pros and cons. It’ll also offer advice for those worried about going cold turkey.

I’ll be pointing my patients towards it, and other GPs should do the same. 

I was right about beta blocker

Earlier this month I answered a reader’s question about her husband’s heart condition, atrial fibrillation.

He was taking a medicine called bisoprolol and I mentioned that it was not often prescribed for the condition – it’s not what GPs would call first-line treatment. I suggested her husband ask the doctor why he was on it.

I’ve since received emails from other readers saying that they have atrial fibrillation and have been on bisoprolol for years without issue.

Bisoprolol is a beta blocker – it slows the heart beat – but it is only recommended for atrial fibrillation if the patient also has another medical condition, such as diabetes.

I suspect that the readers who say they are on bisoprolol for atrial fibrillation will also be suffering a concurrent problem.