One hundred years ago, no one had any doubt that people had inherited most of their character, as well as much of their physical health, from their ancestors.

If someone suffered a stroke or heart attack at the top of the family stairs at the age of 48 and went tumbling down them as a result, it was assumed to be because of an inherited characteristic or gene. Until the second half of the twentieth century, people attributed their woes and vices to nature rather than nurture, to inherited genes rather than environment or upbringing.

After the 1950s, environmental factors were considered allimportant in the development of disease and the formation of a personality. It wasn’t any longer thought that great grandfather’s genes had caused the fatal tumble down the stairs, but his couch potato life, his smoking and his love of rich food. His aggressive personality with its mercurial temper and his obsessional nature were also considered important factors in the development of disease. The supporters of the nurture school in the debate are especially determined that so far as psychiatric disease and temperament are concerned, it is near hear say to suggest that inherited factors have much to do with how people behave.

The pendulum has now swung some way back. Most doctors, together with other workers in the medical field, believe that health is the result of both nature and nurture and the interaction between them. We now believe that many diseases, both physical and mental, are not necessarily inherited but that a predisposition to develop them is. If the genetic tendency is not too strong and we, for whatever reason, live our lives unwisely, we may suffer problems with our health. If on the other hand from an early age, possibly even from the time in our mother’s womb, we have every advantage, we may never show the signs of the condition.

Equally significantly, most doctors accept that however good someone’s early upbringing and however wise his or her adult life, the hereditary tendency is sometimes so strong that nothing will totally eradicate inherent problems, it they may well modify them. What is certain is that so far as inherited family health is concerned, to be forewarned is to be forearmed. Furthermore, if modifying lifestyle and supplementing diet are going to make a difference, the sooner someone starts the better.

The heart, even if it is not the source of life, is the engine which maintains it. If it begins to fail or the arterial system becomes so clogged with fat that they no longer deliver an adequate supply of oxygenated blood to reach vital organs, the length and quality of life will be severely curtailed.

Nothing is more important in the pursuit of health than preserving an efficient cardiovascular system and no aspect of this matters more than the correct diet. It is accepted that as well as a healthy diet those who are interested in their heart and arteries should not smoke and that they should take at least thirty minutes’ brisk walk every day. If someone is aware that his or her family has a history of heart disease or has other risk factors for developing heart disease, he or she should double the amount of daily exercise.

People’s fat intake should be less than 30 per cent of the total calories and less than a third of the total amount of fat should be saturated, the type in butter, meat and biscuits. Having five portions of fruit and vegetables a day is important. These don’t have to be boring old faithfuls like cabbage and broccoli, but can include exotic fruits and vegetables. The golden rule is that the more highly coloured the vegetable, the greater the likelihood that it has a high antioxidant content. Tomatoes, peas, beans, peppers - both green and red - delicious small carrots and tiny Scottish turnips - neeps - are all delicious. Lettuce is, as the Americans say, a nutritional weakling. Potatoes don’t count in the daily score. I always recommend a multi vitamin tablet with added trace elements such as zinc, selenium and magnesium daily to make up for any deficiencies in my diet or any failure of my body to absorb them.

I never fail to tell patients about the need to achieve an adequate intake of omega 3 and omega 6 and the correct balance between them. I suggest they have oily fish twice a week but so as not to take chances, they should also have fish oil capsules or cod liver oil with a reduced vitamin A content daily. I also recommend additional calcium and vitamin D to bolster the body’s defences against osteoporosis. Osteoporosis affects both sexes but doesn’t usually become apparent in men under 65. The tendency to osteoporosis is inherited. Women should start taking precautions against it before they reach the pre-menopausal years. As well as having a diet rich in calcium, vitamin D supplements are also recommended. This is especially important for those with an indoor job. Weight-bearing exercise, such as brisk walking, is also essential in the prevention of osteoporosis. Of the three recommended forms of exercise - brisk walking, swimming and bicycling - only walking is weight-bearing.

Some antioxidants are not only useful against possibly inherited heart disease but also may protect against some cancers. Experts believe that in a third of cases of cancer diet has played a factor and that the recommended daily intake of fruit and vegetables could dramatically reduce the incidence of some cancers, especially those of the gut and prostate. Among these is the lycopene found in tomatoes. It has been shown to be especially useful in reducing the incidence of cancer of the breast and prostate. Lycopene capsules daily, together with selenium, are important anti-cancer agents.

Diet and the correct waistband aren’t only important in the prevention of heart disease, strokes and cancer. There is good observational evidence that omega 3 and the correct balance with omega 6 help women to bear children who are brighter and certainly remain so to primary school. Omega 3 also seems to be beneficial for children who are hyperactive and even those who have ADHD. There is some evidence that omega 3 reduces the incidence of Alzheimer’s, but this may be a reflection of its effect on the arteries leading to the brain.

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