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No one is born with an instruction manual, so staying alive from conception to 80 or so takes a lot of guesswork and luck. Nevertheless, some physicians say there are things we can do from start to finish to maintain basic health. The key is to start early. Doctors call this process screening or preventive medicine. Here are a few things people should do throughout their life to ensure safety: Wear seat belts and drive safely. Avoid harmful drugs and substances, legal or illegal. Avoid family violence and violence with strangers. It's unhealthy on several levels. "Nobody is invulnerable, and one of the single best health practices is to put seat belts on," said Dr. John Morley, director of geriatric medicine at the St. Louis University School of Medicine. All physicians, from pediatricians to geriatricians, say exercise remains the single most important element for leading a healthy life. It works for children, adults, older people, sick people and healthy people. Exercise can even lessen the severity of illnesses passed along the family tree, according to some doctors. This doesn't necessarily mean you have to join a gym or run a marathon. Simply walking 30 minutes a day, five days a week is reported to ward off most illnesses caused by sedentary lifestyles. Taking meat out of your diet and substituting fish three to four times a week will help keep the bloodstream cleaner and provide the vitamin D you need increasingly as you age. One caveat: Recent studies have found that some fish, eaten in large quantities, contain potentially harmful levels of mercury. Pregnant women and nursing mothers are cautioned to eat no more than 12 ounces of seafood a week. While getting enough calcium is good advice for everyone, it's especially important for girls and women. Women, especially white women, are at risk for bone problems later in life because inadequate calcium intake in their younger years can result in osteoporosis, a weakening of the skeleton when bone density decreases. Dr. Thomas De Fer, assistant professor of internal medicine at Washington University, says physicians want girls to have maximum skeletal mass so that when they reach menopause, they start from a higher level. Adequate calcium and a multiple vitamin with adequate vitamin D - which helps with the absorption of calcium and other minerals - are vital throughout a woman's life, doctors say. Smoking is the worst thing you can do to your body, other than hurl it into a solid object at high speed (see safety). Smoking causes its own problems, but also worsens other problems. Drinking has entered a "Twilight Zone" of information. A small amount of alcohol - one to two drinks a day for an adult male, half that for an adult female - may actually be beneficial for non-alcoholics. More than that and drinking can be harmful. Internally, overindulgence rots the organs. Externally, it makes you do stupid things (see safety). De Fer emphasizes selecting physicians who share your values about life and health. Seeing a physician whose instructions you'll ignore is a waste of time and money, he says. "We recommend; we cannot force," De Fer says. When doctor and patient are on the same wavelength, the success rate is higher for health, experts say. Get more mileage out of your body with regular maintenance. Here is a list of recommendations from the medical community for basic maintenance over a lifetime. Your physician may alter this schedule, depending on your risk factors - for example, whether you have a family history of a certain illness, or a condition that requires additional monitoring. Doctors may start regular blood pressure and prostate checks much earlier and more frequently for black men, for example, than for white men. Doctors will start checking for skin cancer in young white people as early as age 18. So your own regimen depends on a lot of variables. Prenatal Genetics: Dr. John Morley, director of geriatric medicine at the St. Louis University School of Medicine, emphasizes foremost - a bit tongue-in-cheek, but true nonetheless - to select good parents. Much of your health is determined by the genes that mom and dad pass on to you. Family history will have a tremendous influence when your physicians determine health regimens later in life. Know what plagued the folks, the grandparents and their parents and you'll know what's lurking in your future. Smoking: Moms-to-be shouldn't smoke or drink alcohol. They should also stay away from smoky areas to avoid secondhand smoke. Vitamins: Pregnant women should take prenatal vitamins that include folic acid, which helps prevent birth defects. Rest and exercise: These are essential for healthy pregnancy. Birth to 15 years old This is the time to develop habits that children will keep throughout their lives: exercise, eating right and safety precautions. Pediatricians check to see if kids are developing normally, so parents should be taking youngsters to the doctor regularly. Multivitamins: They won't hurt, and can help someone with a poor or marginal diet. Vaccinations: Be sure your child gets the recommended vaccinations. They protect children from the evil diseases that used to ravage populations. Keep a chart recording the date of each vaccination. 15 to 40 years old For the healthy person, this is the time of life when medical advice tends to be greatly generalized. It's the time of the fewest health problems, although it's also the time when poor lifestyle habits prepare the body for health problems after 40. The 15- to 18-year-old category is a gray zone. Family to family, this age group has varying amounts of adult responsibilities: health, social, stress, even parenthood. Mom and dad no longer dictate every move - and even when they do, the teens don't listen. Get pap smears: For most people, sexual activity starts somewhere in this age range. Sexually active women should start getting pap smears within three years of the first sexual intercourse or at 21 years old, says Dr. Thomas De Fer, assistant professor of internal medicine at Washington University. Although the American College of Obstetricians and Gynecologists recommends annual screenings earlier, that's a choice a woman needs to make. "But most of the women who die of cervical cancer never had a pap smear," says De Fer. Chlamydia check: Sexually active women should be checked regularly for chlamydia. Chlamydia is a sexually transmitted disease, often without symptoms, that can permanently damage a woman's reproductive system. It's very easy to cure once it's detected. HIV test: If you are sexually active or use drugs, consider getting an HIV test. This goes for men and women. Breast self-exams: At age 20, women should start monthly breast self-examinations. If your family has a history of breast cancer, talk to your doctor about other screenings. Avoid obesity: Often, this is the time when people who have been in shape start letting their weight creep up. "For some reason, after 25, people stop exercising," Morley said. Learn to deal with stress: Stress management now will save a lot of stress-related health problems in the future, says Morley. Screenings: Once you hit 30, start screening for conditions that begin to emerge after that age: high blood pressure, circulatory system anomalies and problems with bone density. Find a doctor who agrees with a regimen that suits your values. Identify bad habits: This is the time to get them under control. Many of the things that seem harmless now will manifest into problems - some catastrophic - after 40. Smoking, excessive drinking and a lack of exercise are the worst culprits. The next demon is eating a diet laden with sugar and highly processed fats and carbs. Beware the sun: Sun exposure can cause skin cancer. Skin cancer is easy to prevent - don't overexpose yourself to the sun - and it's easy to cure if you catch it early. Doctors are doing maps of young bodies, especially fair-skinned whites, on patients as young as 18 to keep an eye on changes in moles, color and texture of the skin. Tetanus shot: Get a tetanus shot every 10 years or when you step on a nail or get cut by something rusty. Double-check to see if you were vaccinated as a child. Discuss other vaccinations with your doctor: Some childhood illnesses can wreck an adult. Discuss hepatitis A and B vaccinations, which aren't part of the childhood group of shots. 40 to 60 years old Health screenings become more frequent. Doctors more intensely watch for signs of high blood pressure, rising cholesterol, diabetes and certain cancers. Doctors will screen for additional problems, depending on your risk factors and overall health. Check bone density: This is most important for women at this stage of life. The loss of bone minerals picks up as you approach menopause. Expect more strenuous testing if you're a smoker, sedentary, post-menopausal or otherwise low in estrogen. Hormone replacement therapy, which has been used as a treatment for low bone density, is controversial because it has been linked to an increased risk of breast cancer. Colonoscopy: This search for abnormal growths in the large intestine should start at age 50. With higher risk factors - smoking, family history, blood residue - screenings may be more frequent or earlier. Stay mentally active: Experts say that during this age range your brain is shifting into use-it-or-lose-it mode. So stay mentally as well as physically active. Pay closer attention to obesity: If you are obese, drop the weight through sensible eating and exercise. At this time of life, being obese can have more serious effects on your physiology than earlier in life. Many of the illnesses that doctors screen for are the result of obesity: blood pressure, clogged arteries, diabetes and some cancers. Also, joints are wearing down and extra weight accelerates the process. Avoid taking too many medicines: Morley says that if you're taking more than five prescription drugs, you need to question why and consider which drugs are necessary and which aren't. There's a saturation point at which the drugs interact poorly, or even cancel each other out - aspirin and ibuprofen, for example. This is more likely to happen if you're seeing specialists in addition to your primary-care doctor. Mammograms: Women should start getting a mammogram every one to two years, depending on their risk factors. Screenings: Monitor your blood pressure and check your cholesterol and glucose levels; how often depends on your personal and family history. Pap smears: Women should get pap smears every one to three years, depending on their risk factors. Prostate checks: Men, start getting prostate checks. At age 50, doctors begin checking for signs of certain cancers. The one that gets on men's nerves - so to speak - is the regular prostate cancer screening. But the enlarged prostate gland is the first sign of a problem. Ignoring it is the worst thing a man can do. A man with a family history of prostate cancer should get exams earlier, and black men, who are more prone to the illness, also should get earlier and more frequent screenings. Hormone replacement therapy: Men, consider hormone replacement therapy. Ask your doctor to check to see if your levels are normal and if therapy is in order. Hormone therapy for women is a controversial issue because of the associated risk of breast cancer; women should discuss their options with their doctor. Menopause: Women, be alert for signs of menopause and work with your doctor to deal with the symptoms, such as hot flashes. Calcium: Men and women should be sure they're getting adequate calcium. The National Institutes of Health recommends 1,000 mg a day for adult men and pre-menopausal women, and 1,500 mg a day for post-menopausal women and all adults age 65 and over. Physicians may order vitamin D as part of the regimen, which helps the body more easily use calcium and other minerals. 60 to 80 years old Regardless of how great you feel, your body is six decades old or more. How you've taken care of yourself will make this part of your life a pleasure or a pain. Some of your doctor's orders will change. For example: Don't lose weight - at least, don't lose it the wrong way. If you're sedentary, any weight you're dropping at this age is more likely muscle, not fat. Weight should be controlled through exercise and proper eating. So exercise, especially weight lifting and improving balance, is more important than ever. Keep track of medication: Keep an inventory of your medicines and don't take too many pills. If you hit five prescription drugs, talk it over with your physician. Vitamins: Along with your calcium, make sure you're getting daily doses of vitamin D. The National Institutes of Health says the recommended daily amount is 200 IU for men and women ages 19 to 50; 400 IU for people ages 51 to 69; and 600 IU for those 70 and over. Vaccinations: Get flu and pneumonia vaccinations. People this age who die after getting influenza tend to die from pneumonia. Consider safety-proofing: Start to safety-proof your house to prevent falls or other accidents. Keep your mind active: Mental activity is very important; the mind needs exercise just like the muscles. Over 80 After 80, do everything else here to maintain good health, but don't worry about it as much. Remember, says Morley, by now you've outlived most of your doctors. |
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