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The Lover

And then the lover, sighing like furnace with a woeful ballad

Hold on tight: the years between 15 and 25 are a roller-coaster ride of rapid physical, emotional and intellectual changes, as modern-day Romeos and Juliets seek to separate themselves emotionally and physically from parents, and young adults explore relationships and career choices.

Maintaining robust good health and vitality throughout these turbulent years can be a challenge. “I don’t do anything I think would jeopardize my health,” says Adam Nayman, 20, a second-year English major. But when you’re juggling courses, friends, dating and family, “it’s really easy for health to get lost in the shuffle,” he admits.

Jane LeMoyne (BA 1973, BEd 1975, MEd 1985), a Toronto teacher whose daughters, 18 and 19, are “more interested in health than I was when I was growing up,” believes young people today shoulder greater responsibility for certain health choices (such as managing their diet or stress levels) than kids in the ’50s, for example.

It’s important to establish healthy habits in the teens and 20s, says Dr. Miriam Kaufman, a specialist in adolescent health at the Hospital for Sick Children in Toronto. This can prevent the seeds of later problems, such as heart disease or osteoporosis, from taking root. Here are some health messages that young people – and their parents – should take seriously:

Understand the dangers of smoking

Twenty-five per cent of teens aged 15 to 19 smoke, as do 32 per cent of people aged 20 to 24, according to Health Canada. Smoking damages the lungs and heart, increases the risk of cancer, heart disease and stroke, and ultimately kills 45,000 Canadians each year.

Young people know that cigarettes are harmful, but there’s little motivation to quit since negative health effects take a long time to appear, says Dr. Edward Sellers, a professor in the departments of pharmacology, medicine and psychiatry.

Carolyn Kearns (BA 1972, MSc Pl 1974), says smoking is probably the biggest health concern she has for her two sons, 16 and 21, and her daughter, 19, who are all social smokers. “They do feel they’re invincible. And they all probably feel they will stop at some time,” says Kearns, a management consultant in Toronto.

Pay attention to mental health

Kearns says she’s surprised by her children’s emotional resilience: “They’ve learned to cope much better with pressures around exams [than I did], and they’re very good at multi-tasking.” She attributes these skills to a greater degree of life experience and knowledge than teens possessed even a generation ago.

Unfortunately, this is a time of life when mental health can be at risk: major depression, bipolar disorder, schizophrenia and substance-abuse disorders typically have their onset at this age. “Also, conditions that have been present for years may become clinically diagnosable – anxiety disorders, obsessive-compulsive behaviour, anorexia nervosa,” says psychiatry professor Dr. Anne Bassett, emphasizing that when detected early, many of these illnesses may respond better to treatment.

Dr. Kaufman, who is also the author of Helping Your Teen Overcome Depression: A Guide for Parents (Key Porter, 2000), says up to 20 per cent of teens will experience a diagnosable depression during adolescence.

In addition to the stress of term papers, exams, and the competition for limited spaces in graduate programs and professional faculties, some students must also work part-time to meet financial needs, and foreign students must adapt to a new culture, says Dr. Sara Taman (MD 1972, MBA 2000), physician-in-chief of the university’s Health Service clinic. Proper nutrition, exercise and adequate sleep are the first steps in managing stress and anxiety, she says.

Protect against unwanted pregnancy and sexually transmitted diseases

Last year, a survey of 7,800 students in 16 Canadian universities found that 57 per cent reported engaging in sexual activity in the three or four months after arriving on campus. No surprise, then, that “family planning” was the main reason students visited the university’s Health Service clinic last year.

According to Dr. Kaufman, the most worrisome STDs are HIV infection and HPV (human papilloma virus) infection. Several subtypes of HPV are linked to cervical cancer, so sexually active young women should be sure to have annual Pap smears.

Recognize the addictiveness of drugs

In the survey, 18 per cent of students reported having smoked marijuana since arriving on campus, while four per cent had used heroin, cocaine or other “hard” drugs. The subject of whether marijuana use leads to harder drugs remains controversial, but a recent New Zealand study found that teens who smoked pot at least 50 times in a given year were far more likely than non-smokers to use other illicit drugs. Warning signs of drug dependence include an overpowering desire to take a substance; using increasing amounts; needing it early in the day; having withdrawal symptoms; and having trouble quitting.

Watch unhealthy drinking habits

“The reality is that a lot of university students drink; it’s a major form of socialization,” says Adam Nayman. The survey revealed that 85 per cent of students had consumed alcohol since arriving on campus. Thirty-eight per cent had experienced a hangover, 13 per cent had done something they regretted while under the influence, and 11 per cent had missed classes because of a hangover. (Alcohol is also a known risk factor for unplanned or unwanted sexual activity.)

Eat nutritious food

Plenty of vegetables, fruit and whole-grain foods in the diet will lower the risk of heart disease and cancer later in life, as will cutting back on harmful fats in foods like potato chips, commercial baked goods and deep-fried fast foods. Plenty of calcium-rich foods, such as low-fat dairy products, help growing bones reach maximum density and lower the risk of osteoporosis in later life, a particular concern for women. Vegetarian teens need food combinations that provide complete proteins, such as grains with legumes, or grains with nuts.

Stay active

“I feel better when I move,” says first-year arts student Mariapia Pietropaolo, who likes to walk and bike. Regular physical activity boosts energy and stamina, strengthens the heart, lungs, muscles and bones, helps control weight and results in sounder sleep. According to Health Canada, even 10-minute bouts of activity throughout the day are helpful so long as they add up to between 30 and 60 minutes in total.

Visit your doctor regularly

Even the healthiest young person should visit a family doctor once a year, advises Dr. Kaufman. Regular visits give health professionals a chance to deliver health-promotion messages, and allow young people to raise issues they might not discuss with parents.

Quest for schizophrenia gene narrows

Imagine that the human genome is a map of the world, and the challenge – akin to searching for an individual house – is to find a specific gene for schizophrenia. Dr. Anne Bassett, a University of Toronto psychiatry professor, is zeroing in on that elusive target.

Family, twin and adoption studies suggest that schizophrenia is predominantly genetic. Often arising in the late teens or early 20s, the illness affects one per cent of the population, drastically affecting thinking, perception, mood and behaviour.

“Nobody has found a gene for schizophrenia, but we’re close,” says Dr. Bassett, also a staff psychiatrist at the Centre for Addiction and Mental Health. Last year, she and her colleagues reported finding a link between a region on chromosome 1 and this devastating illness. The discovery arose from a 12-year study of 300 people from 22 Canadian families with a high incidence of schizophrenia. Dr. Bassett speculates that, as in most complex medical conditions, not just one, but several genes may play a role in the development of schizophrenia.

Dr. Bassett was drawn to genetic research when, as an undergraduate, she met Canadian scientist Dr. Michael Smith, who later donated his Nobel Prize winnings to schizophrenia research. By identifying genes susceptible to schizophrenia, Dr. Bassett hopes for a better understanding of the basic brain mechanisms involved, which will lead to improved treatments.

What Mother Nature may know about HIV

HIV infection is rampant among female prostitutes in the east African city of Nairobi – yet some manage to escape infection by the deadly virus that causes AIDS.

Dr. Kelly MacDonald, director of the HIV Research Program in the department of medicine, is trying to unravel this immunological and genetic puzzle: why do some people have higher resistance to HIV infection than others? To that end, she spends three months of the year in Nairobi, Kenya, and the rest of the time directing the research program and working as a microbiologist at Mount Sinai Hospital in Toronto.

Dr. MacDonald’s work involves human leukocyte antigens (HLA), molecules that help the immune system recognize and kill cells infected with a particular virus. Using her findings that people with certain types of HLA are more resistant to HIV infection, she hopes to develop a vaccine that will heighten people’s immunity to HIV. “We’re asking, ‘What is Mother Nature trying to tell us about natural immunity to HIV?'” she says. “And how can we mimic that in a vaccine?”

Vaccines are urgently needed, she says, because behavioural-based strategies to prevent HIV infection – using condoms, selecting partners carefully, avoiding intravenous street drugs – haven’t been completely effective. “In spite of all our efforts, the number of new cases of HIV in Canada in 1999 was exactly the same as in 1996,” says Dr. MacDonald. And the total number of infected persons continues to rise.

Worldwide, AIDS has infected more people than all the military and civilian casualties of the Second World War. Today, 25 million Africans are infected with HIV. “But we think that in the next few years, there will be more cases of HIV in India than in all of sub- Saharan Africa, and the same may be true for China,” says Dr. MacDonald.

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