Frank Sweeney is a 42 year old digger operator living in Dublin. His unhealthy lifestyle of chips, telly, cigarettes and drinking binges could be taking years off his life... but is he ready to completely change the way he lives?
He's got 8 weeks to change his bad habits and add years to his life.
Frank will undergo a thorough medical so Dr Mark Hamilton can access his health but one thing is immediately obvious . he's carrying too much weight and that's going to knock years off his life.
His daily diet at present consists of a fry for breakfast, something with chips at lunchtime and a takeaway or chip supper for dinner.
Frank's inactive lifestyle is also likely to be a major cause of his weight gain. He has a sedentary job, sitting in a digger cab all day. He takes no exercise - each evening he sits at home watching soaps on TV.
Dr Hamilton is extremely worried about Frank. His father died of a heart attack at the age of 55 and there's a serious risk that Frank is going to die early too - unless he takes action now.
His sister is also worried - for years the family have been pestering him to change his diet and to stop smoking.
The single biggest risk to Frank's life is smoking but it's going to be difficult to persuade him to kick a 20 a day habit that he's had for 30 years. It's estimated that as an obese man who smokes Frank is reducing his life expectancy by a whopping 13 years.
And smoking is already wreaking havoc with his health. His sense of taste and smell had been affected so Dr Hamilton decided to check how bad things were.
Taste test - Frank failed to recognize the taste of marmalade, lemon juice, or vinegar.
Dr Hamilton showed him a "Jar Of Tar" to demonstrate what he's putting into his lungs as he smokes. A 20 a day smoker puts 500 mg of tar into their lungs each day - that's half a litre of tar a year.
As well as the battering his body is taking from smoking it's not helped by a weekly binge down the pub. (Frank only drinks one night a week but he regularly drinks 10 pints and 20 vodkas and coke in one session).
Dr Mark Hamilton is worried Frank might not be far from a heart attack. (Frank meanwhile is worried that the doctor will ask him to give up smoking!)
At the end of the medical Dr Hamilton should be able to predict the health problems that could affect how long he lives.
The fat content of Frank's blood will be measured including cholesterol and triglycerides and a fasting blood sugar level will indicate if Frank is suffering from diabetes, a disease which could have major repercussions for his future health.
There's a history of heart problems in Frank's family so his heart is checked for any early signs of disease.
Heart disease is known as "the silent killer" because it often shows no symptoms before a heart attack. One in eight deaths caused by heart disease are due to smoking.
At the moment Frank's heart is not showing any obvious signs of disease but Dr Hamilton thinks it is likely that his smoking, lack of exercise and extra weight will be putting it under strain. and he needs to look at reducing this strain over the next 8 weeks.
By measuring Frank's height and weight his BMI is calculated (BMI - body mass index). Frank's BMI should be between 20 and 25. Frank's is a shocking 39 and a lot of it sits in the most dangerous risk area for diabetes - around his waist.
Men waistlines should be below 37 inches. Frank must try and reduce his from 49 inches and lower his BMI of 39 if he is going to reduce his risk of diabetes and other complications. His size will also be putting pressure on many of his organs.
A gallstone is found at the bottom of his gall bladder. Although a gallstone is not life threatening it is a clear indication that Frank's body is beginning to show the strain.
Fatty deposits found on his liver are a marker that he may develop diabetes and other complications in the future. (There is a genetic history of diabetes in his family).
There's more bad news on the way - after 30 years of smoking Frank's spirometry (or lung function) test showed that his lungs were severely impaired. Frank was in for a massive wake-up call. Frank has been diagnosed with the lung age of a 66 year old. (Frank's lung age is 24 years older than him, a scary thought.)
At 42 Frank is still 33 years younger than the average life expectancy of 75.
The screening and blood tests had confirmed what the doctor suspected - there were potential dangers ahead which could shorten Frank's life.
Armed with the results of the tests it was time to try to convince Frank to change his ways - before it's too late.
TRIGLYCERIDE 4.29 (significantly raised, a signpost that diabetes could be around the corner, a risk indicator)
Fatty deposits on liver
Good news - a lot of repair can be done.
Frank has no hesitation about diet and exercise but Frank is still not sure about stopping smoking as he fears he will gain weight. But Mark tells him that the benefits will outweigh any weigh gain.
Can he reverse years of damage?
Frank Sweeney is a 42 year old inactive heavy smoker who is medically obese.
A full health screening has revealed fats in the blood, fatty deposits in his liver, a gallstone and a lung age of 66. These are all indicators that if he doesn't change his ways it's very likely he could become seriously ill in the next ten years.
In order to increase Frank's life expectancy my plan over the next 8 weeks is to slowly increase Frank's activity levels, give Frank a low fat healthy eating plan and convince him to give up smoking.
In 8 weeks we will be retesting Frank and if he's going to add years to his life he's got a lot of work to do.
Week 1 - EXERCISE
In order to repair the damage Frank's done to his lungs he has to give up smoking but he's still not agreed to do this. In the meantime Mark is concentrating on helping him lose weight and the main way he can do this is by increasing his activity levels.
Frank takes a fitness test and by measuring his breath and blood lactate levels we can find his optimum and safe level of exercise.
His VO2 max score is 25.4 ml. Frank's result of just above 25 means he is classed as "deconditioned" - we have just 8 weeks to recondition Frank before we test him again.
Frank's plan will begin with 30 minutes exercise 3 times a week, slowly increasing over the 8 weeks but it's important that the exercise is fun. Operating the TV remote doesn't count so Mark persuades Frank to take up a sport he's always fancied - swimming.
By increasing his physical activity Frank reduces the risk of dying from heart disease or stroke and reduces the risk of developing Type II (or age related) diabetes by a massive 50%.
Mark hopes that swimming will form a large part of Frank's new regime.
And Mark is delighted that at last Frank's decided to give up smoking though it's going to be the hardest thing he's ever done.
Week 2 - DIET
Something else he's got to ditch is the chips so Mark sends round a nutritionist to help with his diet. A look at a couple of days from a typical week shows Dr Kathy Fulcher she's got her work cut out.
Frank's swimming will mean he is burning more energy but he is still taking far too much in. Someone of Frank's height and build should be eating about 2500 calories a day and 90g of fat - but on a typical day Frank is eating nearly double that with 4000 calories and 200g of fat.
Kathy explains that if fat is allowed to accumulate in the body it deposits itself in the arteries, narrowing the space that blood can travel in and puts a strain on the heart.
There are 350 calories in 2 pints of beer (roughly the same amount as found in a King Size Mars Bar). As Frank drinks 10 pints as a time that's the equivalent of 5 King Size Mars Bars.
Frank's idea of cooking is opening a box from the local takeaway. So Kathy decided to give him a quick lesson.
Eating fruit and vegetables can add years to your life by protecting against various cancers and filling up on low energy food will help Frank reduce his weight.
Kathy has given Frank a weekly diet sheet which includes stir-fries, salads, fruit instead of snacks and a daily breakfast of porridge which will replace his fry.
Frank announces he has taken on a ¤2,000 bet with a friend that he'll lose 2 stone in the 8 week period.
WEEK 3 - SMOKING
Dr Hamilton is impressed with the way Frank has embraced changing his eating and exercise habits but the biggest way Frank can increase his life expectancy is to give up smoking. He's begun to tackle his addiction by taking medication to reduce his cravings. At first Frank found he had dizzy spells in the morning but that quickly passed. He also tries hypnotherapy - it's a mental battle.
WEEKS 4 - 7
Over the next four weeks Frank knuckles down. He found it easier than he thought to change his diet. His sister is impressed by his new cooking skills, he cooks a mean stir fry.
He's continued with the swimming and bought a treadmill. He walks on the treadmill as he watches his favourite soaps.
The hardest change is giving up cigarettes.
It's the end of the 8 week plan and Mark is looking forward to catching up on Frank's progress.
8 weeks ago a medical highlighted a lot potential health problems and Mark was worried if he carried on as he was he could become seriously ill in the next ten years. Frank says he was especially surprised to be classified as obese - he thought that obese meant a person was really huge, enormous. He vows "he'll never call it to me again".
Frank's medical and fitness test were repeated a few days ago and Mark is amazed at his new results:
Lost 11 kg (he won his wager)
BMI now 36 (was 39)
Waist 44" (was 49")
Cholesterol 5.2 (was 5.9)
Triglyceride level 2.65 (was 4.29)
Lung age now 51 (was 66)
Mark has also calculated a new life expectancy for Frank. (Mark uses a life expectancy calculator - there are many examples of these on the internet).
He estimates a value of 19 added years.
The important thing is if Frank continues with his plan that these years hopefully should be free from chronic illness.