25 ways to make (or keep) your body the best it’s ever been

Posted by on Monday, April 30, 2012 in Features, May 2012.

Compiled by Wayne Wood
Thanks to Mary Yarbrough, Stacey Kendrick, Marilyn Holmes, Jim Kendall, Jay Groves and Lori Rolando

1. Protect your hearing

While we are all pretty much destined to need glasses as we get older, hearing loss is not as predictable. Some people reach old age with relatively intact hearing, and some don’t. But about 10 percent of the U.S. population has some degree of hearing loss.

The No. 1 risk factor for hearing loss is constant exposure to loud noise. People exposed to a continuous sound of about 85 decibels or above—a screaming child or a lawn mower may be noisier than that—could damage their hearing. Despite your experience at the grocery store, screaming children do stop after a while, and probably do no permanent damage. But someone who uses a lawn mower every day for a whole summer without ear protection could hurt his or her hearing.

Ron Eavey, M.D., chair of the Department of Otolaryngology, suggests wearing foam or silicone plugs while using a vacuum cleaner or hair dryer, because your hearing can even be damaged when you never feel it while it’s going on.

The type of hearing loss associated with aging is called presbycusis, and it tends to begin in the higher registers—meaning that one of the first truly noticeable signs for many people is that they have more trouble understanding the voices of women, which tend to be higher than men’s.

If you think you may have a hearing problem, an evaluation by an audiologist is the necessary first step to figuring out what’s going on and how to correct it. The vast majority of hearing loss is treatable and correctable.

2. Get regular eye exams; wear glasses if you need ‘em

Children: Either a pediatrician or ophthalmologist should do a screening exam before the age of 6. Some eye diseases, most notably amblyopia, must be caught early and treated or they can do permanent damage to vision.

Children with certain medical conditions, such as diabetes or neurofibromatosis, should have their vision closely monitored, because these conditions can cause vision damage.

And parents shouldn’t overlook one of the most common causes of vision loss in children—trauma. Children should wear safety glasses when playing sports such as racquetball, and remember all that stuff your parents told you about being careful with sticks and BB guns because they can put someone’s eye out? Doggone if it’s not true.

Young adults should have one comprehensive vision exam, to make sure everything is OK and to establish a baseline that can be useful to check against when middle age makes the vision start to change. Which it will.

From the 40s through the mid-60s, an eye exam every two to four years usually is fine, but after age 65, eye exams should be more frequent, every one or two years. The reason is that eye diseases such a glaucoma and macular degeneration are much more common at older ages, and should be caught as early as possible. Vision can be saved if these diseases are diagnosed early, but vision that is lost cannot be regained.

And, in that rare piece of medical advice that can help you look cool, it’s a good idea to wear sunglasses, because sunlight exposure can help bring about cataract formation and macular degeneration.

3. Take care of your teeth

Diseases of the teeth and gums are not a natural part of aging, and can pretty much be avoided altogether.

Brushing protocol: A lot of people brush their teeth just before bed. Well, that’s better than nothing, of course, but it’s way better to brush after eating. So, if you brush twice a day, brush after breakfast and after dinner, when you can remove the food particles that combine with saliva in the mouth to start the process of tooth decay. It’s even better to have a brush and some toothpaste at work, so you can brush after lunch as well.

A soft brush is better for your gums and more effective at cleaning the teeth.

The only important consideration about toothpaste is to use one with fluoride. Even for people middle aged and beyond, the root surfaces of teeth tend to become exposed with age, and it’s important to keep those areas strong. The way these root surfaces become exposed is that, unless you take good care of your teeth, gums can pull away from the base of the teeth, allowing bacteria to flourish. This can weaken the teeth and eventually lead to tooth loss.

Flossing is possibly the most boring activity known to humankind, with the possible exception of participating in other people’s children’s knock-knock jokes. But flossing is important to those of us who really, really like having teeth. So use your flossing time to imagine yourself on a nice beach or something.

To floss properly, go down the surface of one tooth to the gumline, then back up the other tooth, making sort of a “U.”

Seeing a dentist regularly for cleanings and a checkup can help stop tooth problems or gum disease, and therefore tooth loss, before they start, leaving you as an older person with one flashy set of your own choppers.

4. Protect the skin that protects you

If you want your skin to look beautiful, stay out of the sun. As an adult, you are likely thinking: NOW they tell us. It’s true—most people get a lot of their lifetime sun exposure before their 18th birthday.

In this battle against the sun and the damage it can do, sunscreen is your friend. Use at least SPF 30, and use it any time you are going to be in the sun for a half-hour or more, especially in the middle of the day.

Avoid tanning beds: More than a million people use a tanning bed on an average day in the U.S., and every one of them is voluntarily choosing to lie down and have their skin bombarded with radiation that increases their chances of getting skin cancer. In fact, there is a seven times greater risk of melanoma among tanning bed users.

Do a monthly self-skin exam: Nobody knows what your skin looks like better than you do, and that’s why it’s a good idea to do a monthly skin self-exam. Melanoma is the most severe form of skin cancer and can be fatal if not caught early and treated before spreading.

But if it’s caught early, it’s unlikely to be fatal.

While scrutinizing your hide, or that of a partner, the main thing you’re looking for are moles that are larger than a pencil eraser, asymmetrical, irregular, or having mixed colors.

Besides malignant melanoma, there are two other main types of skin cancer, squamous cell and basal cell. Neither of these are typically fatal, but should be dealt with promptly.

Get a full body skin exam yearly: Here’s the idea: have somebody who knows what skin problems look like—a dermatologist—check you over. This is what the American Academy of Dermatology and the American Cancer Society recommend, and it’s great for peace of mind.

5. Have a regular relationship with a health care provider

Your health care provider should be somebody with whom you are comfortable talking about any aspect of your life which can have impact on your health—which is to say, almost anything. Sometimes, especially in an age when the shifting alliances of health plans force us to find new providers, it is difficult to keep the same doctor or nurse practitioner for a long time. Still, it is worth the effort to find somebody you can connect with enough to trust, because that trust is what you rely on.

One lesson in this is, despite the difficulties and expense, it is a great idea to have the first visit to a new provider be for a routine checkup or a get-acquainted session. The first time a new doctor or nurse lays eyes on you, you should ideally not have a 101-degree temperature and feel generally as though you have been found on the floor of a bus station bathroom.

There are some things to look for in a provider’s office that should let you know if it is a well-run operation from a patient comfort point of view. Does the doctor or nurse talk to you before an examination, or when you meet for the first time are you already wearing one of those fashion-statement-for-exhibitionists gowns? On the medical history questionnaire, does it ask “Are you married?” or does it ask “With whom do you live?”—the latter is a more precise question medically and a more sensitive question for people who have a significant other to whom they are not married.

And finally, the gut question: are you comfortable with this person? This has nothing to do with clinical skill, knowledge, or even whether somebody is a nice person or not. Sometimes personalities click and sometimes they don’t, and your health care provider should be someone you click with.

6. Know your cholesterol level

Cholesterol is a white waxy fat. Yuck, you think. Well, the truth is, every cell in your body needs cholesterol to function, so it’s wrong to think that life would be better if we could just get rid of cholesterol.

But, the level of cholesterol in your blood may have a profound influence on your health, and that’s why it’s good to know.

Cholesterol has two main components, usually abbreviated as HDL and LDL. HDL is “good” cholesterol—it actually removes plaque from artery walls. LDL is the wears-black-leather-and-hangs-around-on-street-corners cholesterol, and builds up on artery walls, which can cause all kinds of problems, such as heart attack and stroke.

There are two main things you should know about cholesterol—the ratio between total cholesterol and HDL (it should be less than 4.5) and the LDL level, which should be lower than 130 milligrams.

But look—you don’t need to know all this stuff. All you need to know is that it’s important for you and your health care provider to look at these levels and make changes, such as weight loss, diet change, more physical activity, or cholesterol-lowering drugs, if need be.

7. Know your body mass index

The body mass index is a measurement of body fat based on your height and weight. It provides a pretty good quick snapshot of where you stand in relation to where you should be from a health point of view. It has some limitations—most obviously, for people who have a muscular build it may overestimate body fat. But it’s a good number to know and a good way to measure progress on an exercise and/or weight loss effort.

8. Have your blood pressure checked regularly

You can have a health care provider do this. You can drop by the Health Plus offices and have this done. There is a blood pressure kiosk in the Courtyard Café. There are machines at drug stores and supermarkets, and there are handy home blood pressure devices, including wristwatch versions. It may be that no health information is easier to come by than your blood pressure.

Quick primer: blood pressure is literally the measurement of the highest pressure attained by the blood when the heart pumps it into the arteries (the top number, systolic) and the lowest pressure to which the pressure drops at the bottom of the cardiac cycle (the bottom number, diastolic).

While low blood pressure troubles some people and can cause, for example, fainting spells, high blood pressure is the usual concern; it is defined as a measurement of 140/90 or above. But that measurement doesn’t mean you have a disease, because high blood pressure isn’t a disease—it’s a risk factor for disease. Among the problems known to be caused by high blood pressure are heart attack, stroke, renal failure, and heart failure, all as a result of the atherosclerosis caused by high blood pressure.

High blood pressure itself usually has no symptoms, so there are literally millions of people walking around with this major risk factor for nasty disease who have no idea. Which is why, to come full circle, you should have it checked or check it yourself, a couple of times a year.

High blood pressure can usually be controlled by a combination of smoking cessation, diet, exercise and medication. There’s no magic bullet, but there are a number of steps to take to bring blood pressure down, and the steps are well worth it because—well, read that list again of potential diseases.

The first step is knowledge.

9. Know your blood sugar level

Diabetes is a very serious disease that many people have without knowing they have it. Over time, it can lead to serious complications, such as blindness and amputation of limbs.

And it is so easy to test for. A couple of minutes, and you can have some information that can help you live a longer and better life, if it turns out you have diabetes.

10. Get a regular colon exam after age 50

Colon cancer is one of the most common cancers in the U.S.—only breast cancer and lung cancer are more common among the life-threatening malignancies—and is relatively easy to detect and easy to stop in its tracks when caught early enough.

People at the age of 50 or older should be checked for colon cancer regularly, as should people whose medical or family history place them at increased risk.

The simplest and most often used test for colon cancer is the fecal occult blood test, which looks for blood in bowel movements. Since not all precancerous polyps bleed and some things that are not life threatening, such as hemorrhoids, do bleed, this test is not perfect, but it is a quick and broad assessment tool that can point to problems.

Sigmoidoscopy is an examination of the lower part of the bowel, which is where most colon cancer begins, and this test is often recommended for people who are 50 or older.

But the most accurate screening exam is the colonoscopy, which examines the entire large intestine for polyps, and, at the same time, allows for their painless removal. A flexible tube with a light and camera is inserted into the rectum and a doctor can see the entire surface of the bowel. Since a polyp may take many years to develop into a deadly cancer, the exam in most people needs to be done only every 10 years.

11. Men: self-exams and screenings

Watch out for prostate cancer.

The prostate is a male sex gland that makes seminal fluid, and is about the size of a walnut. It is located just below the bladder and in front of the rectum, and surrounds part of the urethra, the tube that carries urine from the bladder to the outside of the body. Many men later in life will experience benign prostate enlargement, in which the gland grows larger and creates discomfort by reducing the flow of urine. But uncomfortable as it is, prostate enlargement is not life threatening. Prostate cancer is.

About one in five men will develop prostate cancer in his lifetime–and anything that can help detect it is important and necessary.

There are basically four methods of detection:

• The rectal exam, in which a gloved finger is inserted into the rectum to feel for lumps in the prostate.
• Ultrasound imaging.
• Needle biopsy, in which a small number of cells are removed and checked for evidence of cancer.
• A blood test for prostate specific antigen (PSA). The PSA test has become a common part of the physical exam for men since the 1980s.

For young men in particular, the rectal exam may be the only one of these that a health care provider routinely does, since the vast majority of prostate cancer strikes older men, with 80 percent of cases coming after the age of 65.

But the PSA in particular has created a revolution in the diagnosis of prostate cancer. PSA is a godsend for finding prostate cancer early, but—here’s the catch—a lot of the cancer it finds would not ever cause any harm, because it is too slow growing. It’s a medical question that almost becomes an existential question: if a cancer is found that will never cause any symptoms and never harm the person in whose body it’s found, was it worth finding in the first place?

Health care providers and their patients are still sorting that out, because right now when an early cancer is found, there’s no way to tell if it’s one of the slow moving ones that will probably never amount to much, or whether it’s a nasty aggressive variety that could pose a threat.

Some people are OK with “watchful waiting,” in which treatment is postponed and the cancer is closely monitored for signs of aggression. Other people want to get the cancer out by having the prostate removed, surgery which, if the cancer is confined to the prostate, is totally effective, but can in some cases have side effects such as impotence and urinary incontinence. Still others steer a middle course by opting for radiation treatment. A man with an elevated PSA needs to talk to his physician and assess all his options before making a decision.

Do monthly testicle self-exams

Testicular cancer is the most common cancer in men age 29 to 35. It is also one of the most curable types of cancer. If caught early, it is about 95 percent curable.

Testicular self-examination is the best way to detect the cancer early.

The examination is best performed after a shower or bath, because muscles in the scrotal skin are relaxed and make palpation easy to do.

Place the index and middle fingers behind the testes and palpate between the thumb and fingers. Then gently roll the testes between the thumb and fingers and feel all surfaces of the testes. Any change should be reported to your health care provider, but the main thing to look for is a hard, non-tender mass in the testicle. Occasionally testicular tumors may hemorrhage into themselves and appear as a hard, tender mass.

A testicular exam is also a part of a regular physical examination.

12. Women: self-exams and screenings

Get regular gynecological exams, including Pap tests

The American College of Obstetricians and Gynecologists recommends that a woman should begin getting Pap tests, which check for changes in the cervix that can be early indicators of cervical cancer, at age 21.

It’s important to remember that abnormal Pap tests are, well, sort-of normal. Most of the time, they show a change that isn’t cancerous or pre-cancerous. But still, if every woman would get a regular Pap test, cervical cancer would be virtually eliminated. That’s how important this is.

Other elements of a routine gynecological exam may include a bimanual exam, in which the health care provider palpated the uterus and ovaries to see if they are of normal size and contour; a breast exam; counseling concerning sexually-transmitted diseases and sometimes screening for STDs; and pre-conception counseling, if appropriate.

Also it’s important that women discuss the pros and cons of hormone replacement therapy with their health care provider.

Do monthly breast self-exam

As with many other cancers, identifying and treating breast cancer earlier is crucial—not only does it improve a woman’s odds for survival, it also means a wider choice of treatment options.

A clinical breast exam should be done by a health care provider starting in the late teens, and along with that exam, the young woman should be taught how to do a breast self-exam. One of the main reasons for this is so she can learn her own anatomy; month upon month of routinely knowing what feels normal can help her know if anything changes. One common way of accomplishing this task is to pick a day of the month and remember to do the exam in the shower on that date.

Get an annual mammogram after age 40

When a woman turns 40, the American Cancer Society recommends, she should continue to do a monthly breast self-examination, have a clinical examination every year, and have a screening mammogram every year.

As for preventing breast cancer completely, there are few hard and fast rules. Many of the factors that put a woman at higher risk for developing breast cancer do not lend themselves easily to change (if they can be altered at all). These include family history, age at first period, age at menopause, age at child-bearing and number of pregnancies. Some studies suggest regular exercise or limiting alcohol intake might reduce risk for breast cancer, but the research is not conclusive (though neither would probably do any harm).

Researchers have identified changes in certain genes that increase the risk for breast cancer—although inherited genetic mutations account for fewer than 10 percent of breast cancers. If a woman has a strong family history of breast cancer, she may decide, in consultation with her health care provider, to start screenings at an earlier age and/or undergo them more frequently than is recommended for the general population.

13. Drink alcohol in moderation, if at all

If you drink alcohol in moderation, especially in the form of red wine, there is good evidence that, especially if you are a middle aged person at risk of coronary artery disease, you may be doing something very good for your health.

Of course, with alcohol, nothing is simple. Because, while a lot of people enjoy drinking and suffer no ill effects, others can become addicted, make terrible decisions under the influence, or kill or injure others while driving after drinking.

So, let’s start with this: If you don’t drink and don’t want to, fine.

If you do drink, the best way to preserve your health is to make sure that your drinking is moderate, defined as two drinks or fewer a day for men and one drink or fewer a day for women. (And that’s really per day, not an average. You can’t skip drinking during the week and blow it out on weekends and get the same health benefits).

According to the National Institute of Alcohol Abuse and Alcoholism, drinking can be beneficial or harmful depending on age, health status, and amount consumed. A standard drink contains 0.6 fluid ounces of 14 grams of “pure” alcohol. This is amount is present in 12 fluid ounces of regular beer, 5 fluid ounces of wine, and a 1.5 fluid ounce shot of 80-proof spirits (hard liquor). Alcohol should be avoided if planning to drive a vehicle, taking medications that interact with alcohol, managing a medical condition made worse by drinking, or if pregnant or trying to become pregnant.

Strategies to control alcohol consumption include the following: (1) keeping track of consumption; (2) knowing “standard” drink sizes; (3) setting goals on how many days to drink and how much to drink on those days, (4) limiting to no more than 1 standard drink per hour and using “drink” spacers such as water or soda between drinks; (5) finding alternatives to drinking, e.g. hobbies, relationships, healthy activities; (6) avoiding triggers such as people and places that encourage drinking; (7) when triggers cannot be avoided, talking things through with a trusted person or seeking a distraction; and (8) planning a polite and convincing way to say “no.”

And if you have a problem controlling drinking, know that there are people who are willing to help you and stand by you, both in this community and on this campus.

14. If you smoke, stop.

This may be the single most important change you can make to give yourself a chance at long-term good health. There is no doubt about this—smoking is terrible for your body. It damages your lungs, it damages your heart, it increases your risk for stroke, which damages your brain. It can make your skin look older and can hurt your sex life.

And, if you are a smoker, chances are you know all of this, and have a hard time quitting anyway. The truth is, people don’t smoke because of some perverse death wish. Smoking can be nice—it relaxes your muscles, it stimulates your brain, you feel good and your appetite is somewhat controlled.

The problem is, the long-term effects either kill you or significantly diminish your quality of life. Day by day, a smoker is trading away life for a nicotine high.

Quitting is not easy but it is definitely worth the effort. Set a date. Design a plan. Develop a strategy. Establish a support network. Prepare to make changes. Involve your primary care provider. Purchase your appropriate medications. Celebrate your decision and then celebrate the fact that you no longer put dead leaves in your mouth and set them on fire.

15. Get an adequate amount of sleep most nights

We all understand. For not-fun reasons—being sick or taking care of a sick baby, for example—or fun reasons—fill in your own here—you will not get a full eight hours of sleep every night.

But it’s a good goal, because there is a link between adequate sleep and both physical and mental health. Some sleep experts say that two out of three Americans are sleep-deprived, and nobody doubts that sleep is essential not only to your physical health but also to your emotional well-being.

The average sleep-deprived person is less alert, less attentive and unable to concentrate effectively. They may experience irritability, diminished performance and daytime drowsiness. In addition, because sleep is linked to restorative processes in the immune system, sleep deprivation in a normal adult causes a biological reaction similar to the body combating an infection. Continual lack of sleep can even make you more susceptible to infection.

If being less productive, cranky, and sick aren’t enough, lack of sleep has also been discovered to promote serious illness and cause people to age prematurely. Sleep enables the mind and body to reenergize, rejuvenate and restore. It allows your body to rest while your mind sorts out past, present and future feelings and activities.

Sleep requirements differ from person to person. Most people require an average of six to eight hours of sleep per day.

If you have chronic insomnia, meaning you have trouble falling asleep for more than two weeks, you should see a doctor. Chronic insomnia could be a symptom of a deeper, underlying health issue.

Tip to follow if the sandman is eluding you:

• Exercise regularly. Not only is exercise good for you physically, it will help eliminate stress, which is often associated with insomnia.
• If you have trouble falling asleep, get out of bed and do something else. Lying in bed, worrying about not being able to sleep will most likely prolong your insomnia.
• Do your best to stick to a regular schedule by waking up and going to bed at the same time every day, even on weekends.
• Drinking caffeinated beverages too close to bedtime can cause difficulty falling asleep.
• Establish a pre-bed routine. By repeating a few calming activities, the body begins to recognize the routine and becomes more relaxed. Good pre-sleep practices include reading, listening to quiet music, or taking a warm bath.
• Don’t fill up before going to bed. If you’re hungry at bedtime, try eating a light snack.
• Be judicious about napping. A quick catnap can be a great way to reenergize, but a long afternoon snooze will often leave the napper groggy and sluggish.
• Don’t take work to bed with you. The body is less likely to connect the bed with sleep if the bed is used as a makeshift office.

16. Get help for depression

Transitions of life, illness, illness of a significant other, retirement—there is a reason why it seems like stress increases with age, because for most of us, it does.

Here are some general ideas to help:

• Talk to somebody. Find someone who has gone through similar things and talk to them. Find a support group or a therapist, if you think that might help.
• Break down problems into smaller parts, and deal with the parts.
• Begin with the end in mind. Think about what situation you want to bring about, and take steps to move toward that solution.
• Feeling out of control is stressful; don’t put your head down and pretend problems don’t exist. The problem is, many people go day-to-day putting out the fire in front of them, and putting out fires is not an effective plan for dealing with stress. Solving today’s problem today is not as effective as planning how to get the larger root problem solved. If, for example, there is a conflict between your work hours and a child’s transportation needs, improvising day-by-day will be a constant source of stress; forging a long-term solution may be more difficult and stressful in the short term, but vastly more helpful in the long term.

The bottom line is that people who are more efficient at managing stress are less likely to suffer depression.

But what if you do everything you can do to balance and manage your life and still feel like you’re pulling up short? Are you depressed?

There are some benchmarks to help you tell; among them are:

• A loss of enjoyment of things that you once found pleasurable
• A loss of motivation
• Sleep problems
• Feeling sad or down for an uninterrupted period of at least two weeks.

As for what you can do about it, there are several choices.

While some depression is treated at the primary care level, commonly with a prescription for an antidepressant, others may benefit more from therapy from a psychologist, clinical social worker, or psychiatrist.

And, of course, this discussion is about common, garden-variety clinical depression, not depression of a deeper and dangerous kind, which always requires the help of mental-health professionals.

But the main point is, depression is a treatable condition.

17. Remember Marilyn Holmes’ 11 Commandments to avoid weight gain

Marilyn Holmes, manager of Health Plus and a registered dietitian, says her experience has taught her some things. Here are her 11 commandments:

1. Plan meals and prepare shopping lists for upcoming meals. Keep meals interesting and healthy by using recipes from cookbooks with tasty nutritious foods.
2. Don’t bring temptation home from the grocery store. Bringing home healthy foods increases the chance that they make it to the mouth and down the hatch.
3. Break the fast with a “breakfast type meal.” No time? Mix Carnation Instant Breakfast with skim milk or wrap a tortilla around a cube of low fat cheese.
4. Eat “fast food” only every once in awhile. When doing so, order the small orders and grab or take a piece of fruit to eat with it. Have a salad and lowfat/light dressing with pizza.
5. When eating in a restaurant, eat only half the meal. Take the rest for later.
6. What we drink can add weight. Twenty-four ounces of cola has 304 calories. Often 1,000 calories or more are consumed in a day from non-nutritious drinks.
7. Alcoholic beverages can really add calories. Two glasses of wine or other alcoholic beverages = a rich dessert in calories.
8. Know portion sizes for foods to help control calories consumed. A serving of meat = a deck of cards; a serving of cooked fruits and veggies = ½ cup (1 cup raw); pasta, rice, grits = ½ cup; and bread = 1 slice; margarine/butter/oil about the size of 1 dice; milk/yogurt = 1 cup (For example: A gourmet bagel can equal as many as 4 servings of bread.)
9. Exercise at least 30 minutes a day. No time? Think of ways to add activity during the day like taking the stairs, walking instead of taking the shuttle. Can’t exercise due to bad joints? Exercising in a pool may be an option.
10. Did you overeat? Eat less the rest of the day or exercise more.
11. Weigh at least once a week and if you gain 1 or 2 pounds, work to remove it quickly.

18. Regularly exercise

Here’s what the experts at the CDC say: Every U.S. adult should accumulate 150 minutes or more of moderate-intensity physical activity, or 75 minutes of vigorous-intensity physical activity, per week.

Here are a few things exercise does:

• Improves self-esteem
• Gives you more energy
• Improves quality of sleep
• Helps control stress
• Helps you lose or maintain your weight
• Helps prevent heart disease
• Increases HDL cholesterol, reduces LDL cholesterol
• Provides a break and gives you time to think
• Helps you be more creative
• Increases your awareness of your body
• Builds strength, endurance and flexibility
• Helps control diabetes
• Lowers blood pressure
• Improves bone mass and helps prevent osteoporosis

And, maybe the most important one:

• It improves the overall quality of your life

So many of us are so busy–with a job and children and housework and volunteer activities–that it is important to take time to do things that are for ourselves. Even if it’s something simple, like a relaxing walk around the block at lunchtime or in the evening.

Swimming or running or aerobics, for example, will increase your cardiovascular endurance. But don’t defeat yourself by trying too much too fast. A lot of people begin an exercise program and try to do too much too fast, and they quit soon afterward because they want instant gratification. Here’s the CDC again: “Aerobic activity should be performed in episodes of at least 10 minutes, and preferably, it should be spread throughout the week.”

Children should start exercising at an early age, and one of the best ways to instill that habit in a child is to see parents make it a part of their lives.

It’s important to be careful, though. Marilyn Holmes, the manager at Health Plus, is a very healthy person, but she also injured herself exercising, and, by trying to work through the pain, made things worse.

Her three quick take-aways from the experience: Work all muscle groups; if you hurt, get help; it’s OK to take anti-inflammatory medications if you need to.

19. Wear a seat belt

No, you will not be thrown clear in a crash. No, the airbag is not all the protection you need. Two-thirds of the people who die in motor vehicle crashes are not wearing seat belts. There is no doubt about this: wearing a seat belt is one of the single most important things you can do to avoid being one of the 40,000 or so people a year who die in motor vehicle crashes.

And don’t forget about the people who are counting on you to protect them; it is also important that children be in age-appropriate car seats.

20. Have a smoke detector in your house

There are more than 2 million house fires every year in the U.S. House fires can be sudden and deadly, and this inexpensive piece of equipment could stand between survival and death for you and your family. Have at least one smoke detector on each level of your house, centrally located. Some fire experts advise a smoke detector outside each bedroom and in each corridor on every level.

And, just as important, make sure it has good batteries and actually functions by testing it and replacing the batteries as needed. A good strategy is to replace the batteries twice a year, at the spring and fall time changes.

Most of us have images of what a house fire would be like, and those images are often wrong. Fire is fast; a typical house can be engulfed in five minutes from the start of a fire. Fire is dark, not light; it’s easy to get confused in the smoke and darkness and get disoriented even in your own house. The heat is more intense than you can imagine and smokier than you expect. And fires most often kill at night; most fire deaths occur between 2 and 6 a.m.

21. Wear helmets if you bike, skateboard, etc.

The severity of head injuries from bikes, skateboards and scooters is reduced significantly by the consistent use of crash-tested helmets.

Let’s take bikes for example: Bicycle wrecks send a half million Americans to hospital emergency rooms each year, and about two-thirds of those injured are under the age of 15. About 1,000 bicyclists are killed each year in the United States. Three out of four bicycle-related deaths involve head injury and one-third of bicycle injuries are to the head and face. More than 40 percent of bicycle wrecks occur in low traffic areas.

Research indicates that bicycle helmets should be worn by all bike riders, regardless of age, experience or distance that they plan to ride. It is estimated that there would be an 85 percent decrease in bicycle-related head injuries if all riders wore bike helmets. Parents should model this good behavior in their children.

22. Be up to date on vaccines

Get a flu shot every year

Influenza is a lousy disease that can lay you low for a week or two. If you could avoid getting it with a shot, why wouldn’t you?

But influenza is also, to some people, a potentially deadly disease. For the elderly, for the very young, for people with compromised immune systems, the consequences are far worse than a week with a cloth on your head and reruns of Matlock blaring through the house in the middle of the day.

For those of us who work in a medical center, there is another, maybe even more important aspect to this: our patients. People can spread the flu virus for two days before they ever become sick, and we owe it to our patients to do everything we can not to infect them while they are under our care. Getting a flu shot is one simple way to do this.

Get vaccinated for Hepatitis B

This is an extremely serious—as in, it can kill you—disease that literally nobody should get. With a vaccination, it is totally preventable. Hepatitis B is a liver disease that is transmitted by the blood of infected individuals, which means if you have any potential exposure to blood or blood products, you should get this series of three shots over about six months.

Make sure your child is up to date on immunizations

The success of childhood immunizations is an underappreciated public health triumph. In addition to the elimination of polio, whose crippling specter haunted childhood summers through the mid-1950s, diseases that were common only a generation ago–mumps, measles, German measles–have been reduced by more than 99 percent in the U.S.

That progress has continued, with the introduction in the 1990s of a vaccine against the most common type of bacterial meningitis in children.

The bad news, if there can be said to be bad news in the midst of success as clear as this, is that as the memory of how bad these diseases are fades away, there is a tendency to become complacent about keeping up with vaccines. Forty percent of 2-year-olds are not up to date, leaving a gap in protection.

Stay up to date on your tetanus shot

Tetanus is the name of a bacteria that is found worldwide in dirt and manure, and is also the name of the neurological disease that the bacteria cause. The most common means of getting tetanus is through a puncture wound, like that caused by a rusty nail. The crippling muscle spasms caused by the disease can cause the jaws to lock, leading to the other name for tetanus, lockjaw.

Luckily, tetanus is easily preventable with a vaccine. The tetanus shot is usually combined with the vaccination for diphtheria in what’s called the Td vaccine.

You should get a Td booster every 10 years. Check with your health care provider to see when you had your last booster, and if it has been more than 10 years, catch up the next time you’re at the provider’s office.

23. Practice good hygiene habits

Wash your hands

Really. It would be hard to come up with something more low-tech than this, but soap and water are one of the best defenses against disease ever invented.

Much of the progress that humans have made in length and quality of life over the past 100 years is due to improvements in hygiene and public health, and much of the work left to be done in less developed parts of the world is as simple as seeing to it that everybody has clean water to drink and wash up in.

There would be vastly less communicable disease—including both respiratory infections and intestinal disorders—if everybody would just wash up.

If you wash your hands and instruct your children to do so, you reduce your chances of respiratory disease in winter and enteric disease in summer.

Handle food properly in the kitchen

At one time or another we’ve all eaten something that has made us sick. Most of the time a particular sensitivity to a certain food is the culprit. All too often, though, the reasons for these gastrointestinal misadventures are microscopic organisms, or their byproducts, hiding within the food.

The best news about food-borne pathogens and food poisoning itself is that with proper cooking or sanitary measures it can be prevented.

While fruits and vegetables can certainly be contaminated, the main culprits for contamination are meats, such as chicken and beef.

Chicken is also loaded with illness-causing bacteria, campylobacter and salmonella These organisms thrive naturally in the chicken’s gut. When chickens are slaughtered these organisms are spread throughout the meat.

If you prepare the chicken on a plate and then cook the chicken thoroughly and place the chicken back on that plate without cleaning it, the meat is recontaminated. Also beware of knives and cutting boards that have come in contact with raw meat.

Red meat, particularly hamburger, can be contaminated with the potentially fatal bacteria E-coli 0157:H7. Ground meats should always be cooked through. Having a hamburger with a pink center can possibly allow the bacteria in the center of the patty to survive the cooking process.

Salmonella is the bacteria that most commonly causes food poisoning. This organism can set up shop and multiply rapidly in the intestines causing a fever and an almost unstoppable diarrhea, which is a phrase that we’d just as soon not have to think about.

So: keep cold stuff, especially if it contains raw eggs, cold until it’s time to eat. Also, watch out for eggs in restaurants, where a lot of eggs may be pooled in the preparation process, increasing the chance that one bad egg can contaminate the whole batch.

24. Cultivate peace of mind by having a living will and a durable power of attorney for health care

A living will tells your loved ones and your health care providers what you would like done regarding your care if you are unable to communicate such decisions for yourself. A durable power of attorney for health care designates who you would like to make decisions for you if you are unable to do so.

Preparing both of these takes very little time, allows you to make these important decisions for yourself, and can save your loved ones much anguish later.

25. Make time for things you enjoy and connect with people

It’s easy in the course of taking care of all the things that you have to do to lose time for things that you want to do. But life is not about making deadlines or getting angry in traffic or hoping that a meteor hits your boss. Life is about finding out where your passions lie and living those passions. Life is about friends and love and laughing and trying to figure out as best you can how you fit into all this.

There are some very happy and long-lived loners, but in general, people who have friends, family and a community are more likely to stay healthy and active longer. Something about being around other people lets us know we are accepted and cared about, and it fosters good health. It also is an important support system when we pass through life’s storms.