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Contents

Introduction

Your Doctors and Nurses

Staying Healthy

Checkups, Tests, and Shots

More Resources for Good Health

Prevention Charts


2. Staying Healthy

How To Take Charge of Your Health


Every day, you have a chance to make good choices about your health. This section tells you how.


Choosing a Healthy Lifestyle

"I knew I wanted to lose weight, so I came up with a plan. I set my goals for a month at a time. The first month, I decided to trade my usual high-fat desserts for low-fat yogurt or a piece of fruit. I also set a goal of walking 30 minutes a day, 4 days a week. As the months went by, I improved my habits even further. I've lost 7 pounds, and I'm determined to keep going."

—Donna S.

You may ask yourself, "How do I begin to improve my health habits?" A good way to start is to set small goals instead of large ones that you won't be able to meet. For example, instead of setting a goal of losing 15 pounds in the next year, set some smaller goals for eating better and being more active. You may decide to trade your morning donut for a bowl of cereal or start taking the stairs instead of the elevator at work.

Reducing Your Risk for Heart Disease

Many of the sections in this guide have information to help you reduce your risk for heart disease.

Overall, you can reduce your risk for heart disease if you:

Should You Take Aspirin for a Healthy Heart?

For people who are at high risk for heart disease, taking aspirin every day or every other day can help reduce that risk.

For most people, taking aspirin is safe. But for some, aspirin increases the chance of bleeding in the stomach or intestines. And there is a small chance that aspirin will increase your risk for some kinds of stroke.

Talk to your doctor or nurse to find out if taking aspirin is right for you.

Watching Your Weight

Being overweight increases your risk for heart disease, diabetes, and high blood pressure. Your doctor can tell you what you should weigh for your height.

To stay at a healthy weight, you need to balance the number of calories you eat with the number you burn off by your activities. You can get to your healthy weight and stay there by doing two things: eating right and being physically active. The next two sections, "Eating Right" and "Keeping Active," provide some helpful hints.

Keep track of your weight. Use the Checkups and Tests Record (PDF File, 31 KB, PDF Help; Text Version).

Ask your doctor or nurse: What is a healthy weight for me? What are some ways I can control my weight?

Eating Right

Eating the right foods and the right amounts can help you live a longer, healthier life. Many illnesses and conditions—such as heart disease, obesity, high blood pressure, and type 2 diabetes—can be prevented or controlled by eating right. A healthy diet also provides the vitamins and minerals you need.

It is never too late to start eating right. Here are some helpful tips.

Eat a variety of foods, including:
  • Vegetables, especially dark-green leafy and deep-yellow vegetables, such as spinach or carrots, and legumes, such as lima beans or green peas.
  • Fruits, such as melons, berries, and citrus fruits, or juices, such as orange or grapefruit.
  • Meat, poultry, eggs, fish, and dried beans (for example, navy, kidney, or black), especially products low in fat, such as lean meat and poultry prepared without skin.
  • Dairy products, such as milk, yogurt, and cheese, especially low-fat or fat-free dairy products.
  • Grains, especially whole grains, such as oatmeal or whole grain breads.
Limit calories and saturated fat.

Foods high in saturated fats are high in calories, so they can cause weight gain. They also increase your cholesterol levels. Try to limit:

  • High-fat dairy products such as ice cream, butter, cheese, cream, and whole milk.
  • Meats high in fat, such as bacon or chicken with the skin on.
  • Palm and coconut oils and lard.

Unsaturated fats do not raise cholesterol levels. Foods with unsaturated fat include vegetable oils, fish, avocados, and many nuts.

Watch portion sizes.

Don't choose "super" or other oversized portions. Be aware of how much you eat.

Keeping Active

Physical activity can help prevent:

  • Heart disease.
  • Obesity.
  • High blood pressure.
  • Type 2 diabetes.
  • Osteoporosis (thinning bones).
  • Mental health problems such as depression.

Physical activity also helps you stay at a healthy weight, reduce stress, sleep better, and feel better overall.

What to Do

All kinds of physical activity, whether it is moderate or vigorous, will help you stay healthy. It's a good idea to aim for at least moderate activity—such as brisk walking, raking leaves, house cleaning—for 30 minutes most days of the week. Generally, the more active you are, the healthier you will become.

How to Get Started and Keep at It
  • If you have not been active, start slowly.
  • Choose something that fits into your daily life.
  • Choose an activity you like, or try a new one. Activities such as dancing, swimming, or biking can be fun.
  • Ask a friend to exercise with you, or join a group.
  • Make time in your day for physical activity.
  • If the weather is bad, try an exercise show on TV, watch an exercise tape, walk in the mall, or work around the house.

Ask you doctor or nurse: How do I get started with an exercise program?

Preventing Skin Cancer

Skin cancer is often preventable.

You can lower your risk for skin cancer by:
  • Limiting the time you spend in the sun, especially between the hours of 10:00 a.m. and 3:00 p.m.
  • Wearing sunglasses and clothing that protects against the sun—such as broad-brimmed hats, long-sleeved shirts, and long pants—when you are in the sun.
  • Using sunscreen when you are in the sun. (But, don't stay out in the sun longer just because you are wearing sunscreen.)

Preventing Injury

Following basic safety rules can prevent many serious injuries. Here are two checklists to follow to help keep you and your family safe.

To help protect yourself at home:
  • Use smoke detectors. Remember to check the batteries every month. Change the batteries every year. You may want to use a reminder. For example, change the batteries around your birthday or some holiday.
  • Lock up guns and ammunition, and store them separately.
  • Keep hallways and stairwells well lit.
  • Remove or repair things that someone could trip on, such as loose rugs, electrical cords, and toys.
To help protect yourself away from home:
  • Wear seat belts.
  • Never drive after drinking alcohol.
  • Always wear a safety helmet while riding a motorcycle or bicycle.
  • Be alert for hazards in your workplace. Follow workplace safety rules.

Taking Medicines Correctly

Always be sure you know everything about a medicine before you take it. This information will help you get the full benefits from your medicine. It will also help you avoid taking too much or too little of a medicine. Taking medicine in the wrong way can make you worse instead of better.

Ask your doctor, nurse, or pharmacist: What is the name of the medicine? Is there a generic form of this medicine? If so, should I consider it? What is the medicine supposed to do? How often and when do I take it--and for how long? Are there any foods, drinks, other medicines, dietary supplements, or activities I should avoid while taking this medicine? What are the possible side effects? What should I do if they occur? When should I see an improvement? What written information is available about the medicine?

To keep track of the medicines you are taking, fill in the Medicine Minder (PDF File, 31 KB, PDF Help; Text Version). You may want to bring the chart with you when you go to your doctor, nurse, or pharmacist.

Your Medicine: Play It Safe (AHRQ Publication No. 03-0019) gives practical tips on how to take medicines safely. To get a copy, call the Agency for Healthcare Research and Quality (AHRQ) Publications Clearinghouse at 1-800-358-9295 or E-mail at ahrqpubs@ahrq.gov.

Making Smart Choices About Sexual and Reproductive Health

"As I got closer to menopause, I worried about all the changes my body was going through. But after I talked to my doctor, I realized it was all perfectly normal. She had good advice for relieving symptoms, too."

—Lucy S.

This section offers information about sexually transmitted diseases and birth control. There are also tips for women about what to expect during and after menopause.

Sexually Transmitted Diseases

Sexually transmitted diseases (STDs), such as HIV infection, herpes, syphilis, gonorrhea, chlamydia, and hepatitis B, are passed easily from one person to another during sex.

Sexually transmitted diseases may cause serious health problems. For example, HIV causes AIDS. Hepatitis B can cause liver damage, including liver cancer.

If you have sex, you may be at risk for a sexually transmitted disease. Your risk is increased if:
  • You or your partner has or had other sexual partners.
  • You do not use condoms consistently and correctly.
  • Your partner has a sexually transmitted disease.
  • You use injection drugs.
  • You exchange sex for money or drugs.
  • You live in an area where a particular sexually transmitted disease is common.
  • You are a man and have sex with other men.

If you are at increased risk, talk to your doctor about whether you should be tested. This is especially important because serious health problems may develop before you realize you have a disease.

You can greatly lower your risk for sexually transmitted diseases by using a male latex condom every time you have sex. If you are allergic to latex, use a polyurethane (soft plastic) or synthetic condom.

Planning a Family

If you have sex and are not planning to have a child, you and your partner may want to use some form of birth control. Many birth control methods are available for men and women. Each has advantages and disadvantages.

The condom is the only birth control method that protects against most STDs, including HIV/AIDS.

Whichever birth control method you choose, remember that, for it to work, you must use it all the time and use it correctly.

Ask your doctor or nurse: Which method of birth control is best for me?

Menopause and Beyond

The time when a women's menstrual cycle stops for good is called menopause. Most women reach menopause in their late 40s or early 50s.

During the years leading up to menopause, levels of two female hormones, estrogen and progesterone, begin to change. These changes signal that your body is getting ready to stop menstruating. This time leading up to menopause is called perimenopause.

Perimenopause usually lasts around 5 to 7 years. You can still get pregnant during this time, so you may want to use some method of birth control.

Most women have begun perimenopause by the time they are 50 years old. Some may have reached menopause by then.

For many women, the shifting levels of hormones during perimenopause cause physical and emotional changes. Some of these changes may be uncomfortable, but there are many ways to relieve the discomfort.

The changes could include any of the following:
  • Skipped periods.
  • Irregular bleeding.
  • Hot flashes.
  • Mood swings.
  • Sleep problems.
  • Painful intercourse from vaginal dryness.

If you have not had a period for at least a year, you are likely to be in menopause. At this point, your hormone levels drop, so you are no longer producing eggs. Once this happens, there is no chance of becoming pregnant.

What happens after menopause?

Women are at higher risk for some diseases, such as osteoporosis (bone thinning, which causes bones to break easily). Their bodies no longer make the estrogen that may help protect them against such diseases. (Select for more information osteoporosis.)

Some women also continue to have symptoms such as hot flashes and vaginal dryness.

Hormone Therapy. Hormone therapy increases the levels of the hormones estrogen, progesterone, or both in your body. If you are approaching menopause or have gone through menopause, you may be considering hormone therapy to relieve symptoms of menopause or to reduce your risk for diseases such as osteoporosis.

Hormone therapy may reduce your risk for fracture, bone thinning, and colorectal cancer. On the other hand, there is evidence that some hormone therapies may increase your risk for breast cancer, heart disease, blood clots, stroke, and gall bladder disease. For women with mild or no symptoms of menopause, the potential harms of hormone therapy may outweigh the benefits.

If you are considering hormone therapy, it is important to be well informed about these benefits and harms and how they apply to you specifically. Your doctor can help you decide whether hormone therapy is right for you.

For more information about menopause and hormones, visit the U.S. Food and Drug Administration's Menopause and Hormones Web site at: http://www.fda.gov/womens/menopause/. Information is available in English and Spanish.

Ask your doctor or nurse: How can I relieve the symptoms of perimenopause and menopause? Is taking hormones right for me? If so, how long can I take hormones safely?

Overcoming Depression

"I started making excuses to avoid social occasions. I guess I knew something was wrong, but I felt too low to do anything about it. Luckily, my daughter pushed me to talk to my doctor about depression. The doctor recommended counseling and trying some medicines. Now it's hard to believe how depressed I was. I feel relieved every day."

—Rodney F.

Everybody feels "down" or "blue" sometimes. But, if these feelings are very strong or last for most of the day nearly every day for two weeks or longer, they may be due to a medical illness called depression.

The good news is that depression can be treated. You do not have to face this problem without help.

Warning Signs of Depression

Changes in the way you feel:
  • You feel sad, hopeless, or guilty most of the time.
  • You feel tired or lack energy.
  • You have thoughts of suicide or death.
Changes in sleeping and eating habits:
  • You sleep either too much or too little.
  • Your appetite has changed. You have gained or lost weight.
Changes in daily living:
  • You have lost interest and pleasure in daily activities.
  • You have problems making decisions or thinking clearly.

If you have had most of these symptoms for at least two weeks, you may be suffering from depression. Talk to your doctor about whether you are depressed and what you should do about it.

The sooner you get treatment for depression, the sooner you will begin to feel better. The longer you wait, the harder depression is to treat.

Depression usually is treated with counseling, medicine, or both. Medicines for depression are not addicting or habit forming. They work for people with severe depression and may be useful for people with mild to moderate depression.

Treatment works gradually over several weeks. If you do not start to feel better after this time, tell your doctor. It may take some time to find what works best for you.

Getting Help for Smoking and Alcohol or Drug Abuse

"I tried at least half a dozen times before I quit smoking for good. This time, I think I've licked it. But I know I have to be careful. Even after 6 months, I stay away from places where people are smoking."

—Jeff H.

Smoking

More than 430,000 Americans die each year from smoking. Smoking causes illnesses such as cancer, heart and lung disease, and stroke. When you quit, you lower your chances of getting sick from smoking. Quitting is hard. Most people try several times before they quit for good.

When you are getting ready to quit:
  • Make a plan and set a quit date.
  • Tell your doctor that you want to quit smoking, and get medicine to help you quit.
  • Tell your family, friends, and people you work with that you are going to quit. Ask for their support.
When you quit:
  • Get support and encouragement. You may want to join a quit-smoking program.
  • If you slip and smoke, don't give up. Set a new date to get back on track.
  • After you quit, don't smoke—not even a puff. Try to keep yourself away from all cigarettes.

The following tools from the U. S. Public Health Service can help you quit smoking:

To get free copies, call the AHRQ Publications Clearinghouse at 1-800-358-9295 or E-mail ahrqpubs@ahrq.gov.

Alcohol or Drug Abuse

Abusing alcohol or drugs can cause serious medical and personal problems. Alcohol and drug abuse can lead to accidents, depression, and problems with friends, family, and work.

Do You Have a Drinking Problem?

Ask yourself the questions below. A "yes" answer to any of them may be a sign that you have a drinking problem. Alcohol abuse and alcoholism are treatable with counseling, medicines, or both. Talk to your doctor or nurse.

  • Have you ever felt that you should cut down on your drinking?
  • Have people annoyed you by criticizing your drinking?
  • Have you ever felt bad or guilty about drinking?
  • Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover?

Drug use can cause heart and breathing problems.

Alcohol abuse can cause liver disease, heart problems, and several kinds of cancer.

Here are some suggestions about drugs and alcohol:
  • Don't use illegal (street) drugs of any kind, ever.
  • If you drink alcohol, limit the amount—no more than one drink a day for women and two drinks a day for men. One drink equals a 12-ounce bottle of beer or wine cooler, a 5-ounce glass of wine, or 1.5 ounces of 80-proof distilled spirits, such as gin, whiskey, or rum.
  • Don't drink alcohol before driving or operating heavy machinery.

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