Healthy living

Information
While maintaining good health habits cannot guarantee a longer life, it can certainly improve the quality of your life. The following are a few simple factors, if practiced regularly, that help minimize the risk of illness and enrich life:

     
  • Exercise regularly  
  • Avoid smoking and drug abuse  
  • Drink no more than a moderate amount alcohol, if any. (Don’t drink any alcohol if you have a history of alcoholism.)  
  • Control your weight  
  • Keep a balanced and healthy diet  
  • Take care of your teeth  
  • Control of high blood pressure  
  • Follow good safety practices

EXERCISE

Exercise is a key factor in staying healthy. The question is not should you exercise, but what kind of exercise is appropriate for you? Exercise strengthens the bones, heart, and lungs. Exercise also tones muscles and increases physical reserve and vitality. In addition, exercise prevents insomnia, helps relieve depression, and prevents constipation.

If you are just starting an exercise program and have any health concerns (such as obesity, hypertension or diabetes), see your doctor for an exercise tolerance test to help you establish safe limits for your exercise program.

Begin gradually (perhaps with brisk walking) and don’t expect to “get into shape” overnight. Your fitness should start to improve within 3 months provided a consistent regimen has been maintained.

You should work hard enough to sweat during each exercise period, but not so hard that you cannot carry on a conversation, unless you are training for certain sports.

In order to become fit, plan an exercise routine that will last 20 to 30 minutes and be done at least 3-5 days a week. Include stretching before and after your exercise. This will help avoid injury. Remember to start slowly and listen to your body’s pain messages. If it hurts badly, then you have probably overdone it.

While exercises such as weight lifting provide strength to the muscles, they do little for the fitness of the heart. Aerobic exercises strengthen the heart and lungs and should be part of the fitness routine. Examples of good aerobic exercises include walking, running, jogging, swimming, cross-country skiing, rowing, rope skipping, dancing, racket sports, and cycling.

The duration of your exercise routine should be at least 20 to 30 minutes, and for more dramatic fitness results 45 to 50 minutes. In addition, remember that aerobic exercise can’t be “start and stop” - it must be sustained for at least a 10- to 12-minute period.

Adjustments in exercise programs need to be made for children, pregnant women, obese adults, elderly people, disabled people, and heart-attack survivors. Programs should also be modified for high altitudes and extreme hot or cold conditions.

Use good equipment (including good shoes) for your fitness program and do some research into a new type of activity before launching a program.

No exercise program ever goes smoothly. There may be setbacks (such as illness or injury), but these should not change your overall motivation. If necessary, substitute one exercise activity for another (for example, switch from running to swimming). If you do have a setback, don’t start immediately at your previous level of activity. You should take about as long to get back to your previous level of activity as the time you were out of action.

Exercise can be fun - even though it may not seem fun at first. Don’t be afraid to vary both the duration and type of exercise activity if your present program becomes boring.

SMOKING

It is estimated that smoking kills over 300,000 people in the U.S. every year. Smoking is the largest preventable cause of premature death and disability in America. One out of every six deaths annually is either directly or indirectly attributable to cigarette smoking.

In the U.S., about 23 billion dollars is spent in medical costs related to smoking. Over 30 billion dollars are lost due to decreased productivity and absences from work linked to health problems related to smoking.

The serious diseases most frequently caused by smoking are:

     
  • lung cancer (the risk for smokers is 10 times greater than for nonsmokers)  
  • emphysema  
  • chronic bronchitis  
  • heart attack  
  • stroke (the risk for smokers is almost 3 times greater than for nonsmokers)  
  • heart pains as a result of coronary artery disease (angina)  
  • leg pains as a result of blockages in lower extremity arteries (claudication)

It is never too late to quit smoking. Two years after stopping, your risk of heart attack returns to average. After 2 years, there is a decrease in lung cancer risk by about one-third. After 10 years of quitting, your risk for lung cancer returns to near normal.

Low-yield cigarettes are not safe and probably do not decrease your risk of serious disease. Smokeless tobacco is also a serious threat to the health of its users and is not a safe alternative to smoking. With use, the risk of cancers of the larynx, pancreas, esophagus, and other diseases goes up significantly.

Four out of five smokers start smoking before age 21, when most people are not concerned with long-term health risks.

Smoking parents should stop if for no other reason than for the health of their children. The adverse health effects of second-hand smoke are well documented, resulting in most of the states in the U.S. enacting laws limiting smoking in public places. Smoking during pregnancy increases the risk of fetal or infant death, miscarriage, and of having a low-birth-weight baby.

While tension and irritability are common smoking withdrawal symptoms, the health benefits begin almost immediately upon stopping. In addition to the health benefits, food will taste better, your stamina will improve, and you will avoid the cost of cigarettes.

Combine your stop-smoking program with either the beginning of or an increased exercise program. Avoid prolonged use of nicotine chewing gum if possible - nicotine itself has negative health effects, though these are less severe than those associated with smoking cigarettes. The American Cancer Society has “stop-smoking” courses which can help you quit successfully.

Research shows that the more times you try to quit, the more likely you are to stop. Medications like Zyban and nicotine replacement therapies can dramatically increase your odds of stopping and staying stopped.

ALCOHOL USE

Researchers estimate that there are approximately 10 million alcoholics in the U.S. Another 20 million are alcohol abusers, most of whom are teenagers or college students. About 2 out of every 3 adults use alcohol. Over half of all suicides, homicides, and accidental deaths are alcohol related. Over 10,000 young people are killed and 40,000 more are injured annually in alcohol-related automobile accidents.

The annual cost of lost productivity and health expenses related to alcoholism is estimated to be over 100 billion dollars. While it is estimated that only 1 out of 10 people (about 1.5 million Americans) get help for their alcohol problem, the cost for such help is staggering.

Alcoholism is a type of drug dependence that is both psychological and physical. Danger signs of excessive drinking include:

     
  • alcohol related automobile citations or accidents  
  • blackouts  
  • concerns expressed by friends or spouse  
  • depression  
  • drinking excessively and often  
  • drinking to make problems go away  
  • loss of control  
  • making excuses for drinking  
  • medical problems such as gastritis or ulcers  
  • missed work days  
  • morning or solitary drinking  
  • preoccupation with drinking

Consumption of alcohol gradually depresses brain function. Emotions, thought processes, and judgment are first to be affected by alcohol consumption. With continued drinking, motor control becomes impaired, causing slurred speech, slower reactions, and poor balance. Both increased body fat and drinking on an empty stomach speed the rate of alcohol intoxication.

The diseases most frequently caused by alcoholism are:

     
  • acute and chronic pancreatitis  
  • cancer of larynx, esophagus, stomach and pancreas  
  • cardiomyopathy  
  • cirrhosis of the liver  
  • bleeding esophageal varices  
  • hepatitis  
  • impotence (in men)  
  • Mallory-Weiss tear  
  • menstrual irregularity (in women)  
  • sleep disorders  
  • Wernicke-Korsakoff syndrome (“wet brain”)

Although research suggests that most problem drinkers can learn to moderate their drinking, most American treatment programs treat all heavy drinkers as though they have the severe problems associated with alcoholism. The Institute of Medicine has called for expanded treatment options, but so far the treatment community has resisted providing them. For alcoholics, the best treatment goal is abstinence.
Common falsehoods about drinking and alcoholism include:

     
  • Only those who lack will power become alcoholics.  
  • Drinking can make you warm.  
  • Alcohol is a stimulant.  
  • Alcoholics Anonymous is the only effective treatment.  
  • Your true personality comes out when you are drunk.  
  • Old people do not become alcoholics.

Avoid alcohol consumption when pregnant. Health damage to the unborn child can be significant. Fetal alcohol syndrome is the most common known cause of mental retardation.

Parental responsibilities include:

     
  • Educate your children by example and by counseling about the dangerous effects of alcohol.  
  • Establish a trusting communication with your children so that sensitive issues can be discussed.  
  • Don’t allow your children to be guided completely by their peers. Your children need your firm and loving guidance as their parent much more than they need you as a friend.

For help, call your local Alcoholics Anonymous (AA) which offers a sober peer group as an effective example of how to achieve total abstinence from alcohol. (See alcoholism - support group). Other support groups for people with alcohol problems include SMART Recovery, LifeRing Recovery, and Moderation Management (for heavy drinkers, not alcoholics). Because approximately half of all alcoholics have a mental illness (such as depression) in addition to their alcoholism, it is important to get a psychiatric evaluation and treat the additional problem to prevent relapse.

DRUG ABUSE

Any drug taken for purposes other than as intended or in a manner or in quantities other than directed is considered drug abuse.

Addiction is defined as compulsive use of a substance despite continued negative consequences. Simply needing a drug (like a painkiller or antidepressant) and taking it as prescribed is not addiction.

The signs and symptoms of addiction are different for each person but may include: insomnia, unpredictable moods, agitation, personality changes, excessive sweating, unexplained weight loss, bloodshot eyes, flushed skin, persistent running nose, and dazed appearance. An increased need for money and extraordinary time spent away from home may also be signs of drug addiction. As with alcoholics, at least half of all addicts have an additional mental disorder which will need evaluation and treatment if the person is to recover successfully.

Abuse and addiction are not just associated with illegal “street” drugs. Legal drugs such as laxatives, painkillers, nasal sprays, diet pills, and cough medicines can also be misused, resulting in serious health problems.

Elderly people have to be particularly careful about drug-related problems caused by taking more than one medication (for treatment of different diseases) at the same time. The interaction of two or more drugs when taken simultaneously can have serious health consequences. Older people on multiple medications need to be monitored and have a written drug administration schedule. When going to more than one doctor for the treatment of different problems, always inform each doctor about all the drugs you are currently taking. In fact, it is often useful to bring a list of current medications to your healthcare provider.

Avoid drinking alcohol while on medications-this combination can be very dangerous, particularly with tranquilizers or painkillers.

Drugs that treat nervousness and tension (such as Valium) are often abused, as are painkillers (such as codeine and morphine). However, most people given painkillers for pain will never become drug addicts and it is important to fully treat pain symptoms. Ironically, undertreatment of pain is more likely to produce addiction than using appropriate doses of medication.

Signs of drug abuse in teenagers may include: apathy, temper tantrums, missing school, sloppy dress, lack of interest in school, excessive demands for privacy, secrecy, and a change in group of friends. However, some teens may show none of these symptoms and teens who do have drug problems need continued parental attention and love, not just punishment.


Mothers-to-be should avoid taking any drug during pregnancy-especially during the first trimester when the fetus is very sensitive to drugs in the mother’s body. If you have been taking any drugs just before becoming pregnant, inform your doctor.

See also chemical dependence - support group.

DEALING WITH STRESS

Stress is a normal and necessary part of life. It can be a great motivator, and in low doses can even improve health. However, excessive stress can produce symptoms such as insomnia, headaches, nausea, diarrhea, fatigue, irritability, aggression, and so on. If left unchecked, these symptoms can lead to illness and physical and emotional dysfunction.

Learn to recognize the things most likely to cause stress in your life. While you may not be able to avoid them, it will be reassuring to know they are the source of the stress and this will help you feel more in control. The more control you feel you have over your life, the less damaging stress will be.

Also, accept the fact that stress-related discomfort is normal.

Try different methods (there is not one that works for everyone) to relieve your stress until you find something that works. However, avoid using drugs (including alcohol and tobacco) to relieve stress.

Avoid worrying about things over which you have no control. Try to keep your immediate stressful situation in perspective with your long-term goals and with the things that are most important to you.

Exercise is a very effective way of coping with stress. Exercise will help to calm you, and if you are fit, your body will be better able to cope with stress.

If your stress is due to personality conflicts with other people - especially if there is a spouse or family conflict - seek counseling for guidance and support.

OBESITY

For most people, weight control is a difficult task that requires continual attention over a lifetime. Every weight control program should include exercise. If you consume 3,500 calories less than you burn, you will lose a pound. Conversely, if you consume 3,500 calories more than you burn, you will gain a pound. Exercise is even more critical to weight-maintenance (the hardest part) than it is to weight reduction.

Obesity adds stress to the heart, bones, and muscles. It also increases the risk for health problems such as varicose veins, breast cancer, gallbladder disease, high blood pressure, and strokes. Contributing factors to obesity include heredity, overeating, eating too much of the wrong foods, and inactivity. Try to provide support and encouragement to people who have a weight problem. Avoid criticizing and making jokes, which can prove devastating for an overweight person (especially a young person). (See eating disorders - support group.)

DIET

As a general rule, try to reduce fat, increase fiber, reduce sodium, and reduce calories and sugar. For details, refer to the section on nutrition.

TOOTH CARE

Good dental hygiene is essential in preserving your teeth for a lifetime. It is important for children to start young with good dental habits. Proper hygiene should include:

     
  • daily flossing and twice-daily brushing of the teeth  
  • use of fluoride toothpaste  
  • regular dental checkups  
  • limiting sugar intake  
  • using a toothbrush with soft bristles (replace the toothbrush with a new one as soon as the bristles become bent)  
  • having the dentist instruct you on proper brushing and flossing techniques  
  • being aware that “tartar-controlled” toothpastes have little or no effect on tartar below the gum line and, therefore, will not provide a safeguard against gum disease

Johns Hopkins patient information

Last revised: December 4, 2012
by Janet G. Derge, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.