Wednesday, January 13, 2010

Have a happy and healthy new year

It's a new year, new decade and – perhaps – the beginning of a healthier, new you.

There's an endless amount of advice on how to achieve a healthy life, but the fundamentals are easy: eat well, exercise and great plenty of rest. It's the specifics of putting this advice to practice that can be more complicated. Here, Massachusetts General Hospital physicians weigh in on the steps to putting your healthiest foot forward this year.

Be proactive about prevention

It's important for adults of every age to be attentive to their health. This means taking preventative measures even when you are not experiencing symptoms.

"Certain tests have been found to be extremely effective at catching disease in early, treatable stages. People should communicate with their physicians about what screenings are recommended based on their age, gender and risk factors," says Elizabeth Roth, MD, a primary care physician with Mass General.

Some tests to consider are:

  • Cholesterol: Every five years if normal
  • Blood glucose: Every three years starting at age 45; If under 45, ask your physician if you are high-risk for diabetes
  • Pap test (cervical cancer screening): Every other year for women starting at age 21; every three years after age 30 if normal.
  • Mammogram: Every year for women starting at age 40. See an expert’s comments on new mammogram guidelines.
  • Colon cancer screening: Start testing at age 50. If under 50, ask your physician if you are at-risk for colon cancer
  • Vaccines: Ask your physician if you are up-to-date. Adults need a tetanus shot every 10 years.
  • Bone density: Beginning at age 65 for women without other risk factors for osteoporosis
  • Glaucoma: Talk to you doctor
  • Skin cancer screening: Depends on risk profile
  • Blood pressure screening
  • Testicular exam: For young men yearly beginning in their late teens
  • STD screening and counseling for appropriate patients

In addition to screening tests, Dr. Roth says she also talks to her patients about their alcohol, tobacco and drug use. Quitting smoking and drinking in moderation are central to a health lifestyle.

"These recommendations are set by various task forces and organizations, which sometimes come to different conclusions based on the data. Recommendations can also change over time as new research is presented," says Roth. "Your doctor can help you understand what screenings are most appropriate for you."

Know your numbers 

Heart disease is a growing epidemic, but one that is also preventable. During a check up, your doctor will take a look at your "numbers,” which can be important indicators of heart health. The four important numbers to keep in mind are:

  • Cholesterol
  • Blood pressure
  • Blood sugar
  • Body mass index

"Amazingly, two-thirds of patients are not at their cholesterol, blood pressure or blood sugar goals," says Randall Zusman, MD, director of the hypertension program at the Mass General Hospital Heart Center. "Be sure to know your targets; and know what your numbers are. Then you'll know what you have to work on to improve your cardiovascular risk profile."

Watch Dr. Sekar Katherisen, director of the Mass General Hospital Cardiovascular Disease Prevention Center, talk about the risk factors of heart disease.

Get exercise

Physical activity is one of the best things everyone can do for their health. Studies have found that both aerobic and muscle-strengthening exercises can benefit your health in numerous ways, including decreasing the risk of premature death, heart disease, type 2 diabetes, depression, some cancers, and cognitive decline. Increasing your daily physical activity can also have an immediate behavioral benefit, such as improved sleep and energy and an increased resiliency to stress, says Edward M. Phillips, MD, a physiatrist at Mass General and director of The Institute of Lifestyle Medicine at Harvard Medical School.

According to the U.S. Department of Health and Human Services, for optimal health benefits adults should strive to reach meet these guidelines for exercise:

  • at least 150 minutes a week of moderate-intensity, or 75 minutes a week of vigorous-intensity aerobic physical activity. Aerobic activity should be performed in episodes of at least 10 minutes, and preferably, it should be spread throughout the week. Additional health benefits can be gained by increasing the amount of aerobic physical activity
  • 2 or more sessions per week of muscle-strengthening activities that are moderate or high intensity and involve all major muscle groups

"While scheduled exercise sessions work for many people, consider engineering additional physical activity into your daily activities. Taking the stairs, getting off the T a stop early, parking at the back of the lot or having a walking meeting with a colleague are all efficient ways to truly multi-task and get some necessary physical activity throughout the day. Remember that even if you don't achieve the full 150 minutes per week some physical activity is better than nothing and more is better than less," says Phillips.

Get more sleep

Americans are notorious for pushing the limits of time, often to the detriment of their sleep. For optimal health, experts recommend getting seven to eight hours of good sleep per night. To make your sleep restful, cut down on caffeine and alcohol and avoid taking daytime naps.

"Almost everyone will experience short-term insomnia at some point, but chronic sleep loss is a serious problem that can contribute to a whole host of health problems, including cardiovascular disease, weight gain and mood disturbances," says Kenneth Sassower, MD, a neurologist with Division of Sleep Medicine. "Sleep deprivation can also diminish your immune system, making your body more susceptible to infection."

If you are having chronic sleeping problems – meaning a lingering source of sleep difficulty that occurs over several weeks – you may be suffering from a more serious health condition. Common sleep problems include insomnia, sleep apnea and restless leg syndrome, among others.

Dr. Sassower suggests seeing a doctor if your symptoms cause you to repeatedly wake up or keep you up for hours during the night. Such problems can affect your daytime functioning and quality of life, impacting your focus and performance at work or school and negatively impacting your relationships.

"We also see patients who are referred to sleep specialists for other medical conditions," says Sassower. "We find that patients who have trouble controlling their blood pressure or those with depression or other mood disturbances may benefit from help managing underlying sleep disorders."

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