Prevention wasn't always viewed as so important. In the past, maintaining good health took a backseat to disease treatment. Few visited the doctor for routine checkups or thought much about what could happen to their bodies -- until it did. But times are changing.
As an increasing number of studies show that lifestyle measures like eating healthfully, exercising, and reducing stress have an enormous impact on the development of disease, mainstream medical experts are starting to take prevention more seriously. "Our health-care system still focuses largely on treating disease, but that's begun to shift," says Tracy Gaudet, M.D., director of Duke Integrative Medicine at Duke University and a Body+Soul columnist. "It's becoming more apparent how important it is to be proactive with our health."
That's easier than you might think. Prevention doesn't call for a daily regimen of knocking back wheatgrass juice at dawn, running five miles at lunch, and meditating for an hour after a dinner of barley and raw kale (unless you want to). Protecting your heart, brain, breasts, bones, and the rest of your body can be as tasty as a bowl of blueberries, as enjoyable as hiking in the woods with a friend, and as easy as taking a deep breath. Here, our experts have helped us compile a guide to keep you in top shape, from head to toe.
The older you get, the more likely you are to experience a change of heart -- literally. With age, the walls of this organ begin to stiffen and your blood vessels become thicker and less elastic, which can lead to high blood pressure. If you have high cholesterol, deposits of plaque can further narrow arteries. And your blood may get "stickier" and form clots that block blood vessels, triggering a heart attack or stroke. But none of these changes is inevitable. "Your heart should stay strong throughout your life if you make the right choices about your health," says Jaime Moriguchi, M.D., codirector of the clinical heart-failure program at UCLA. Along with following heart-healthy diet and exercise plans and not smoking, these steps will help keep your ticker going strong.
Know Your Risk
Your odds of developing heart disease depend on whether you have risk factors for it, including smoking, diabetes, high blood pressure, high cholesterol, obesity, stress, and a family history of heart problems. Get your cholesterol and blood pressure checked regularly, and ask your doctor about other tests you might need, such as an electrocardiogram, a stress test, and blood tests of blood sugar and C-reactive protein, a marker of inflammation. Many of these risk factors are in your control. "You aren't fated to develop heart disease, even if you have a family history of it," says Moriguchi. "Keep your risks in mind as you make everyday decisions."
Brush and Floss
Some studies show that gum disease may harm the heart, possibly because this bacterial infection can trigger chronic inflammation, which has a heart-disease link. (Smoking may raise that risk even higher.) Brush and floss twice a day and get regular dental checkups.
Don't Skip Breakfast
Research suggests that eating in the a.m. helps stabilize blood sugar throughout the day, which helps keep LDL ("bad") cholesterol and triglycerides in check. What you eat is just as important: Quick-burning carbohydrates, such as cornflakes and bagels, raise blood sugar quickly, increasing your odds of developing diabetes and abdominal fat, both risk factors for heart disease. Instead, choose fruit, healthy proteins, and whole grains: A recent study in the American Journal of Clinical Nutrition found that people who ate whole grains shed more belly fat and lowered blood levels of C-reactive protein.
Take a Sip
It's not just what you eat that affects your heart; what you drink also counts. While too much alcohol can increase blood pressure and triglycerides, small amounts have been shown to raise HDL ("good") cholesterol and reduce the risk of developing and dying from heart disease. High in resveratrol, a compound linked to longevity, red wine may be particularly protective, says Moriguchi, who recommends that women stick to one drink or less a day. In some studies, the regular consumption of green or black tea was associated with fewer incidents of heart disease. Tea's antioxidant flavonoids seem to relax blood vessels and prevent clots.
Depression, anxiety, anger, grief, loneliness, and stress have been linked to an increased risk of cardiovascular problems. Combat these now by finding a relaxation technique that you enjoy -- like breathing exercises, yoga, or meditation -- and get into the habit of practicing it regularly.
A large review of studies published in November 2006 found that people who eat nuts more than four times a week have a 37 percent lower risk of heart disease than those who seldom eat them. That's likely because nuts like almonds and walnuts harbor high levels of heart-healthy fats, says Moriguchi. While not true nuts, peanuts contain resveratrol and therefore have heart-health benefits, too.
Some research suggests that humorless, antisocial personality types have higher rates of heart disease, while their more easily amused counterparts are less likely to have heart problems. For help in the humor department, rent comedies, watch stand-up or improv, and do whatever else it takes to elicit belly laughs. Still having trouble letting go? Fake it till you make it: It may sound odd, but even pretending to laugh or forcing a smile can eventually lead to real laughter.
People who cultivate social networks appear to have less heart disease and live longer than those who are more isolated, according to Nieca Goldberg, M.D., medical director of New York University's Women's Heart Program. In fact, a study on people nearing retirement age suggested that loneliness may harm the heart as much as smoking. No matter what your age, reach out -- and don't limit yourself, advises Goldberg. "Connecting with family, friends, social groups including church, and even pets can help."
A Healthy Heart Tonic
Herbalists have long relied on the berries, leaves, and flowers of the hawthorn plant to treat and prevent cardiovascular woes, and recent research confirms its benefits. A 2008 review of 14 studies, for example, found hawthorn as an adjunctive treatment can significantly improve the symptoms and outcome of congestive heart failure. Other evidence indicates hawthorn, which contains antioxidant compounds called procyanidins, may increase the integrity of blood vessel walls and improve blood flow to the heart. Talk to a health-care provider about the best dosage.
The specter of memory loss and Alzheimer's disease, on the rise in the United States, haunts many of us. Don't take every misplaced-key incident as a bad sign, though. It's true that our brains do decline with age. Over time, levels of chemical messengers fluctuate and the number of brain cells may slightly decrease, causing mild problems with memory. But we're able to form new connections between remaining cells, even in the later years. For help staying sharp, eat a healthy, whole-foods diet; get regular exercise; watch your blood pressure; and try the following steps.
Use it or Lose It
The magic bullet for good memory? It could be as close as the Times crossword puzzle. Studies have found that keeping your brain active -- by doing word games, playing an instrument, or having engaging conversations, for example -- may help ward off cognitive decline and Alzheimer's disease.
Spice Things Up
Turmeric does more than add flavor to curry dishes. Curcumin, one of the compounds in this spice, has antioxidant and anti-inflammatory properties. Some early research has linked it to a lower risk of cognitive decline. Preliminary animal studies suggest it may help prevent Alzheimer's disease, a condition that's rarer in India, where curry is a staple. Add turmeric to food regularly or mix 1/2 teaspoon with hot water and sip as a tea.
"Your brain will do what you ask of it," says David Rakel, M.D., director of the University of Wisconsin Integrative Medicine program. Instead of multitasking, he suggests taking a few minutes each day to focus on one positive thought, like the word "peace." Doing so, he explains, creates new neurological networks in your brain and helps you feel happy and compassionate more easily. On the flip side, harboring angry thoughts can create networks that make you feel more negative about life, more often.
Hit the Sack
Getting enough shut-eye doesn't just boost your energy -- it may increase brainpower as well. Research shows that a good night's sleep helps improve memory. In one recent study published in Nature Neuroscience, researchers found that sufficient sleep is also necessary to help retain episodic memory, your ability to remember times, places, and events. Although sleep needs vary, most of us require about eight hours a night.
Ditch the White Foods
White sugar, flour, and other refined carbohydrates are absorbed quickly as sugar into the bloodstream and can cause a spike in insulin levels. This promotes inflammation, which in turn has been linked to an increased risk of Alzheimer's disease. Keep blood sugar stable by choosing slower-burning carbohydrates like whole grains, says Rakel.
Brain Power in a Pill?
Could popping a pill boost your memory? Not necessarily, according to recent studies of the herb ginkgo biloba. Although early evidence suggested a link between ginkgo and better cognitive function, newer research shows less impressive results. A study published in February in the journal Neurology found that ginkgo didn't improve memory in elderly people, while a 2007 review of studies concluded that any benefits of the herb for dementia and cognitive impairment were "unconvincing." Vitamin E could prove more promising: Although more research is needed, some studies suggest that this antioxidant may reduce the risk of Alzheimer's disease and slow its progression.
If there's one supplement that could hold the answer to many chronic health problems, it's fish oil. A growing body of research suggests that the omega-3 fatty acids found in oily fish such as salmon, sardines, and herring can help the heart, brain, and joints. Studies show that fish oil may slightly lower blood pressure and help prevent heart disease, stroke, dementia, depression, and inflammatory bowel disease. Look for supplements labeled "purified," a sign that they're free of mercury and other pollutants. Common dosages range from 1 to 4 grams daily; discuss with your health-care provider.
Bones and Joints
Our bones tend to become less dense over time, particularly those in the hip, wrist, and spine. Known as osteoporosis, significantly decreased density means bones break more easily. The cartilage that cushions our joints also thins, making joints more susceptible to injury and osteoarthritis. But this deterioration isn't a foregone conclusion. "Our bones and joints are living tissue, like the rest of the body," says Peter Sharkey, M.D., a joint-replacement specialist at Thomas Jefferson University Hospital's Rothman Institute. By nurturing this tissue, you can keep your body's structure strong.
A Dual Energy X-ray Absorptiometry (DEXA) scan can give you an idea of the state of your bone health and risk of osteoporosis. Although the US Preventive Services Task Force recommends bone density testing at age 65 and older, other experts say it's a good idea to get screened earlier. "I recommend women get a DEXA scan around menopause," says Gaudet. "The results can encourage you to start making changes to prevent bone loss before it becomes severe."
Cover Your Bases
Calcium-rich foods such as yogurt and collard greens help you maintain bone mass, says Gaudet. Since most women don't get adequate calcium through their diet, she recommends supplementing with 600 mg of calcium citrate and 200 mg of magnesium twice daily. Evidence now shows that vitamin D may be equally essential for bone health -- helping with calcium absorption as well as osteoporosis and fracture prevention -- yet most of us don't get enough. Getting 15 minutes of sun exposure on your arms and legs twice a week helps your body produce D, says Rakel. Many health experts now recommend supplementing with 1,000 IU of vitamin D3 as well.
Exercise -- and Rest
Regular exercise, both aerobic and resistance training, is a must for healthy bones and joints. But you also need ample rest between workouts, says Sharkey. Because the body doesn't heal itself as quickly as we get older, constant activity can set the stage for injury. After about age 50, balance intense aerobic or resistance exercise with rest by allowing a day or two for joints to repair themselves, just as you would with your muscles.
Maintain a Healthy Weight
Your knees carry the brunt of your weight, and burdening them with extra pounds increases the risk of joint damage. But recent research suggests that low-level inflammation plays a role, too. "Fat cells contain substances that stimulate inflammation," Sharkey explains. "That may be why overweight people are also more likely to develop osteoarthritis in non-weight-bearing joints, such as those in the shoulder and hand." If you're overweight, losing just 10 pounds can significantly lower your risk of osteoarthritis.
Eat Your Antioxidants
A study published in July 2007 suggests that people who consume plenty of fruits high in vitamin C and vegetables high in the antioxidants lutein and zeaxanthin have fewer early signs of knee osteoarthritis and cartilage defects than those who eat less of these staples. Pile your plate with produce like dark leafy greens, bell peppers, and citrus fruits.
Breaking a bone is the biggest risk of osteoporosis. Prevent falls and stay on your feet by practicing exercises that test your stability. Studies show that people who do tai chi regularly improve their balance and reduce their risk of falls. Other good options include yoga (think Tree pose), qigong, and Pilates.
Breasts and Reproductive System
Changes that occur to our breasts and reproductive systems bring a measure of emotion and fear. After all, the hormonal shifts that accompany aging often result in hot flashes, mood swings, and other unpleasant symptoms. And menopause isn't the only change that comes with time: As our fertility wanes, our risk of cancers of the breast, cervix, and ovaries increases. Here's how to stay healthy.
Taking a proactive approach to your health means getting an annual exam that includes a Pap smear (official recommendations change with age, so consult your doctor) and, after age 40, a mammogram. Talk to your physician if you have a family history (particularly your mother or sister) of breast or ovarian cancer, as you may need more frequent testing. As for breast self-exams, some studies have shown no decreased risk of death from breast cancer in women who perform them. That said, they do often help reveal suspicious lumps, says Kristine Rinn, M.D., an oncologist specializing in breast cancer at Seattle's Swedish Medical Center.
Extra pounds have been linked to a higher risk of breast, ovarian, and cervical cancer, possibly because of excess weight's effects on the hormone estrogen. (Weight gain after menopause especially seems to raise the risk of breast cancer.) In addition, gaining a lot of weight affects your chances of getting pregnant. "Obesity interferes with fertility," explains Gaudet.
Be Sensible About Diet
Should you eat soy or avoid it? Does dietary fat cause cancer? What about red meat? Unfortunately, says Rinn, "there aren't any clear answers yet about the effects of diet on breast cancer risk." Indeed, a 2005 study of more than 90,000 women found no significant link between dietary patterns and breast cancer; other research is mixed.
Likewise, the relationship between food and gynecologic cancers also remains uncertain. So rather than obsess about what foods may cause or prevent breast cancer, stick with the basics of a whole-foods diet (see "A Menu for Good Health," page 106). One area in which diet may help is fertility: A large study in the November 2007 issue of Obstetrics and Gynecology showed that women who ate more monounsaturated fat, vegetable protein, dairy products, and low-glycemic carbs along with fewer trans fats and less animal protein boosted their odds of getting pregnant.
Drink with Caution
While moderate drinking can benefit heart health (see "Take a Sip," page 102), studies generally show the opposite when it comes to other conditions: Women who consume one to two alcoholic drinks a day have a 30 to 50 percent higher risk of breast cancer, and some research has linked regular alcohol consumption to a higher risk of infertility. But you don't need to abstain entirely, especially if you're looking to protect your heart. "There's no hard and fast rule," says Rinn, "but a drink every other day is reasonable."
Weigh Your Options
Once a standard approach to menopausal symptoms, supplemental hormone therapy came under fire in 2003, when the large Women's Health Initiative study linked the combination of estrogen and progestin to an increased risk of heart attack, stroke, and breast cancer. Yet hormone therapy has also been shown to lower the risk of colorectal cancer and osteoporosis. Oral contraceptives are also a mixed bag: "They do slightly increase the risk of breast cancer, but they decrease the risk of ovarian cancer," says Rinn. The bottom line? "Discuss the risks, benefits, and different forms of hormone therapy with your doctor," advises Gaudet.
Sure, regular physical activity boosts your reproductive and breast health (see "Your Exercise Prescription," page 110). But another type of exercise can also help: Regularly performing Kegel exercises to strengthen the pubococcygeus, or PC, muscles in your pelvis can help prevent urinary incontinence, improve sexual function, and ready your body for childbirth if you're pregnant. Locate your PC muscles by stopping the flow of urine when you go to the bathroom; then practice this squeezing motion when you're not urinating, up to 30 times a day.
With stress linked to infertility, sexual dysfunction, and breast and ovarian cancer, don't wait to get in touch with your feelings. "Many of us are very good at nurturing others without taking care of ourselves," says Gaudet. "But repressing emotions can be very unhealthy." Take some time to recognize and deal with feelings like sadness, anxiety, and anger, whether by keeping a journal, meditating, or talking with a close friend on a regular basis. "Our body speaks in whispers," explains Gaudet. "Don't wait until it screams to do something."
As you've probably heard by now, the biggest risk factor for cervical cancer is the human papilloma virus (HPV), a sexually transmitted infection that often has no symptoms. At least 50 percent of sexually active women and men acquire the infection at some point in their lives. Over time, HPV can trigger precancerous changes in the cervix usually identified with a Pap smear. Although they don't completely protect against HPV, condoms can lower the rate of infection by about 70 percent. (An HPV vaccine is available but is recommended for women and girls who have not yet had sex.)
Most age-related changes to the gastrointestinal (GI) tract go barely noticed, but two can create bothersome symptoms. Your production of stomach acid naturally decreases, making it more difficult to absorb nutrients like vitamin B12, iron, and calcium. And food tends to move through the large intestine more slowly, setting you up for constipation. In addition, colon cancer, the third most commonly diagnosed cancer in both women and men, becomes far more common after age 50. Making smart choices now can improve digestion and protect your long-term gut health.
Elimination is critical in detoxifying our bodies. Prevent constipation by staying hydrated, exercising regularly, and going when the urge strikes, says Rakel. When planning meals, "focus on foods that have vitality and function," says Gerard Mullin, M.D., director of integrative GI nutrition services at Johns Hopkins Hospital. Such super foods -- like broccoli, berries, and whole grains -- serve multiple purposes. They're rich in antioxidants and other
You might cringe at the idea of a colonoscopy, but this screening test can catch colorectal cancer early and even allows your doctor to remove suspicious tissue at the time of the test. The American Gastroenterological Association and other experts recommend a colonoscopy every 10 years starting at age 50; yours may suggest the test earlier or more often if you have a family history.
Go the Natural Route
Because stomach acid naturally decreases with age, it's important to maintain what you do have. "Acid-blocking drugs like Pepcid and Zantac are incredibly overprescribed," says Mullin. According to recent research, using these drugs for long periods of time might lead to cognitive decline; proton-pump inhibitor drugs such as AciPhex and Nexium may lead to nutrient deficiency. If you have acid reflux, try addressing your diet and stress levels rather than popping pills.
That feeling of butterflies in your stomach has a physiological basis. "There's a lot of cross talk between the brain and the gut," explains Mullin. Your GI tract has its own nervous system, which is why stress can cause digestive problems such as diarrhea, heartburn, and irritable bowel syndrome (IBS). Learn to manage stress -- and reduce GI problems -- by exploring massage, art therapy, breathing exercises, and other relaxation techniques.
Join the Culture Club
"Your digestive tract is a delicate ecosystem of both good and bad bacteria," says Rakel. When you eat a lot of processed food or take antibiotics, you can wipe out these "friendly" bacteria. This allows the bad guys to take over, leading to IBS, diarrhea, and other problems. Maintain a healthy balance of bacteria by eating a daily cup or two of yogurt labeled "contains active cultures." If you have digestive problems, Mullin recommends taking a probiotic supplement that includes good bacteria. Look for products with Lactobacillus GG, Bacillus coagulans, or those in the Bifidobacteria family.
Food sensitivities can trigger digestive problems, says Mullin; common culprits include soy, corn, eggs, wheat, and dairy. If you suspect certain foods are bothering you, consult with a nutritionist, who might have you eliminate them from your diet, then gradually add them back in. If your symptoms go away and then reappear, you may have an allergy or sensitivity and should avoid that food.
Regular physical activity has countless benefits, from head to toe.
Stimulates brain chemicals like endorphins, which boost mood and help prevent depression and anxiety; helps reduce stress; promotes better sleep; may improve memory and reduce the risk of Alzheimer's disease and dementia
Strengthens the heart; improves circulation; lowers blood pressure; reduces risk of heart disease, heart attacks, and stroke
Bones and Joints
Builds muscle tone and strength; increases bone mass; improves balance and joint flexibility
Improves digestion and prevents constipation; may help prevent colorectal cancer
Breasts and Reproductive System
Reduces the risk of breast cancer, endometrial (uterine) cancer, and ovarian cancer
For Optimal Benefits, Aim for:
- Thirty to 60 minutes of aerobic exercise (like brisk walking, swimming, dancing, cycling) most days of the week; be sure to build rest in, too, to avoid wear and tear on your joints
- Twenty minutes of strength training (lifting weights, using body bands, doing lunges and squats) at least twice a week
- Exercises that stretch your muscles and improve balance (Pilates, yoga, tai chi) twice a week or more
An impressive body of research links a healthy diet (and even specific foods) to a lower risk of a variety of conditions, including heart disease, cognitive decline, and several types of cancer. The key, say our experts, is to choose foods that help fight, not promote, inflammation, believed to be a root cause of illness. Here's what to eat -- and what to avoid.
- Fruits and vegetables; aim for five to nine servings a day
- Oily, cold-water fish like salmon, sardines, and black cod; aim for two servings a week
- Flaxseed; sprinkle freshly ground flaxseed on salads or add 1 tablespoon to smoothies daily
- Olive oil; make it your go-to cooking oil
- Whole grains and beans
Cut Back On
- Processed, snack, and junk foods
- Saturated fat (in red meat, full-fat dairy, and other animal foods)
- Refined grains and sugars
- Safflower, sunflower, corn, and other polyunsaturated oils