On working mornings, my selection of clothes is dictated first by the availability of clean items that may loosely be said to match and second by how easily they can be ironed. It is not often that I find myself steering clear of garments to avoid illness. Until now.

The British Medical Association recently decided that doctors should no longer wear “functionless” clothing such as ties. These, they decided, were nothing more than harbourers of MRSA. Fair enough, but it’s another cruel setback for the once harmless tie. It is not so long since they were accused of causing the eye condition glaucoma. To a wave of publicity in 2003, researchers from New York released results of eye pressure examinations in 40 patients. Half had glaucoma (where the pressure inside the eye is elevated) and half did not. They found that when the person was wearing a tight necktie, eye pressures were raised, whether or not the person had glaucoma.

Tie-wearing was either leading to inaccurate readings of eye pressure or, it was suggested, the tie itself might have been capable of causing the pressure rise.

Rather less publicity was given to another similarly small but contrary study published in the same journal (The British Journal of Ophthalmology) in 2004. Dutch researchers examined the eye pressures of 23 patients and found that tight neckties did not “significantly elevate” eye pressures.

Two things to note here: the study size was small and the conclusion on what to do about your tie far from definite. Still, the evidence for avoiding restrictive clothing keeps coming. A report from Canada tackles a subject rather too near to my heart – that of “mildly obese” young women attempting to wear fashionable jeans of the hip-hugging variety. These women, it was found, were wearing denims so tight that their lateral femoral cutaneous nerves were being compressed, resulting in tingling and burning sensations on the lateral aspect of the thigh.

If I am honest, I’d assumed this was one of the small sacrifices of having favourite jeans. My gloominess was compounded by the report’s recommendation of “loose-fitting dresses”. I’m all for comfort but the fat-compressing qualities of denim are, in my wardrobe at least, welcome.

My favourite recent scare story, for comedy value, was that high heels can “cause infertility”. Entirely seriously, one fitness expert told a newspaper: “If people value their health in any way at all, avoid these killer heels at all costs. They’re not worth the risk.” The suggestion was that wearing high heels causes increased pressure on the front of the foot, subsequently causing forward tilting of the pelvis. Apparently, “left unchecked, this can lead to menstrual dysfunction and increases in period pains as well as affecting the ability to conceive.”

A search on the enormous PubMed medical website (www.pubmedcentral.
nih.gov) reveals absolutely no evidence for this. I did come across a paper from Taiwan that asserts that the wearing of “higher heels results in decreased comfort” but did we really need a study to tell us this?

This kind of paranoia is all around us. In winter partygoers are told they must wear more clothes. It seems too much skin exposure on nights out can lead to hypothermia. In fact, the primary cause of hypothermia on nights out has surely to be alcohol or drugs. In summer we are also told we must wear more clothes so as not to let a tiny bit of sunlight near us – a philosophy that is rather too paranoid for my liking, given the benefits that some sun exposure can give us. My daughter even has tights that will allegedly change colour with the temperature so that I can detect whether or not she is too hot or cold.
I should emphasise that I bought these tights for the colour (a particularly princessy shade of pink) and not the thermometer function.

There are, on the horizon, clothes that could have a genuine and useful effect on one’s health. For example, if you have a problem with palpitations, dizziness and chest pain, you may have a cardiac monitor attached for a week. If, however, you only experience symptoms once every couple of months, the demand and expense of the equipment means you can’t just keep the monitor until you get symptoms. The solution could be biomedical clothing, where a small dry-electrode is built into clothing (such as a bra or belt) and can monitor heart rate or rhythm over long periods of time. Wireless technology can be used to relay the information for analysis by the cardiology department and, in serious life-threatening rhythm disturbances, local alarms can be raised, even via mobile phone networks.

For the moment, getting rid of uncomfortable clothes is, my waistline tells me, a good idea. But there are times when one is willing to suffer. Scuffing along in flat shoes might be acceptable during the day but come the evening and the weekend I’ll be in one of a selection of uncomfortable but far more glamorous heels. Indeed, clothes have a role in what I will broadly refer to as psychological health. Furthermore, I’d be willing to bet that not only do high heels have nothing to do with infertility but that the judicious wearing of a pair of black leather stilettos is more often responsible for an upward blip in the birth rate.

BJO paper 2003

BJO paper 2004

Margaret McCartney is a GP in Glasgow margaret.mccartney@ft.com

More columns and further reading at www.ft.com/mccartney

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