Rules to Live By

The following suggestions are based on my experience over the past 35 years and supported by Evidence Based Medicine, the United States Preventive Services Task Force, Expert Opinion and the Center for Disease Control recommendations.

  1. Exercise aerobically for 150 minutes weekly.  Muscle strengthening two days per week for all major muscle groups.
  2. Do not smoke or use tobacco products.
  3. Limit alcohol intake to: two drinks per day for males and one drink per day for females.
  4. Try to control stress through regular exercise, yoga, counseling, Tai Chi or meditation.
  5. Maintain a body mass index (BMI) of between 19 and 25.
  6. Always report rectal bleeding. Many people assume rectal bleeding is from hemorrhoids when it is actually due to colon cancer.
  7. Wear a helmet when biking, snow skiing or skateboarding.
  8. Never text and drive! This has become the leading cause of death in teenagers.
  9. Never drink alcohol and drive!
  10. Always wear a seatbelt.
  11. Start getting screened for colon cancer at age 50 or earlier if you have risk factors for colon cancer.
  12. Women should get an annual PAP smear starting at age 21.  After 3 annual normal PAP smears they should get a PAP smear every 3 years.  At age 30 they can start getting a Human Papilloma virus (HPV) as well as a Pap smear and if normal can go to an every 5 year schedule for a PAP smear and HPV.  Women still need an annual yearly physical but a pelvic exam is not recommended.
  13. Influenza is a potentially serious illness and the chances of getting it can be reduced by getting a flu shot every year.  The CDC recommends getting the flu shots as soon as they come out usually in August for everyone 6 months or older.
  14. Females should have a mammogram every year or two starting at age 40 or earlier if they have specific risk factors for breast cancer.
  15. Have a Prevnar(PCV13) immunization at age 65 and a Pneumovax(PPSV23) one year after the Prevnar or earlier if you have risk factors such as diabetes, asthma, heart disease, lung disease or if you smoke.
  16. Become knowledgeable about sexually transmitted diseases.
  17. Discuss sleep apnea with your physician if you snore and your partner says you seem to have repetitive episodes of upper airway occlusion while sleeping. Excessive daytime sleepiness can be the only symptom of sleep apnea.
  18. Eat fish two or three times per week.  Cold water fish such as salmon and tuna are best. Studies have shown that this reduces your risk of heart disease by 30 percent.
  19. Try to get at least 30 grams of fiber every day.  One half cup of Fiber One Cereal contains 14 grams of fiber. Citrucel may cause less bloating than Metamucil.
  20. Avoid excessive amounts of sun exposure and use sunscreen.  Any moles that change should be evaluated.  New moles appearing after age 40 should be evaluated.
  21. Report any vaginal bleeding that occurs after menopause.
  22. Eat 5 servings of fruits and 5 servings of vegetables daily.  Taking vitamins is not a substitute for eating fruits and vegetables.
  23. Avoid excessive use of NSAID’s (ibuprofen, Aleve, Motrin and others). This is particularly important if you have diabetes or renal disease. They can cause gastric bleeding, increase in blood pressure, swelling of ankles and interfere with renal function.
  24. Consider taking a baby aspirin with food everyday if you are at high risk for heart disease or if you have diabetes.
  25. In general, I would avoid supplements as they are not regulated and studies have shown that many times they do not contain what they claim to contain.
  26. Limit the amount of red meat in your diet.
  27. Try to get 1200 mg of calcium/day either through diet and/or calcium tablets.
  28. Men should discuss getting a PSA (prostate specific antigen) blood test with their physician at age 50. The United States Preventive Services Task Force no longer recommends a routine PSA test because studies show they do more harm than good.
  29. Get a Tdap (tetanus, diphtheria and pertussis) shot every 10 years.
  30. Take folic acid 0.4 mg several months before you decide to become pregnant.  Taking a multivitamin daily satisfies this recommendation. This prevents neural tube defects in the infant.
  31. Avoid using new drugs on the market during the first year after they are introduced. Some adverse drug reactions are not discovered until the drug is released and has widespread use.
  32. Markedly limit saturated fats and omit trans fatty acids.
  33. Consider getting a hepatitis B immunization
  34. Take Vitamin D3 1000 IU daily if you are over age 64. This will help prevent falls in the elderly.
  35. Don’t take Vitamin E or beta carotene.
  36. Avoid taking supplements as they are not well regulated and have been shown to cause harm. See the article on my website about supplements “Supplements: Buyer beware!”

The information provided above is offered as a community service about health-care issues and is not a substitute for individual consultation. Advice on individual problems should be obtained from your personal physician. This information is based on research by the author and represents his interpretation of the literature.

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