Dr Kevin McCarrollWe are all familiar with the adage in medicine that “prevention is better than cure,” a thought that should keep all of us focused on doing the right things to stay healthy.
While it may not be as easy as ‘eating an apple a day’ to keep the doctor away, optimising our health through lifestyle choices and identifying and addressing risk factors like high cholesterol or high blood pressure can help hugely to stave off several diseases. In fact, as simple as it may seem, regular exercise, a balanced diet and alcohol in moderation can substantially reduce the risk of several cancers, cardiovascular disease and dementia. In addition, early detection of some conditions by screening may allow for curative treatment or halt further damage due to disease. .
The importance of exercise as a factor in maintaining good health could not be over emphasized. Adults (including those over 65) should do at least 30 minutes of moderate intensity exercise five days a week or a total of 150 minutes per week.
This can include brisk walking, housework, dancing or gardening. For more health benefits and where possible this intensity of exercise can be doubled to up 300 minutes per week.
About one minute of more vigorous activity such as hill walking, playing football, jogging, cycling or swimming equates to two minutes of moderate activity and so may reduce the overall time spent exercising. It’s important to remember that any physical activity is better than none and can easily be incorporated into chores like carrying groceries or vacuuming, or taking a stairs instead of a lift or walking instead of using the car.
Keep an eye on your weight and be aware of your body mass index (which for most should ideally be below 25), as well as your waist measurement which should not exceed 37 inches for males and 32 inches for females. If you are overweight or need to maintain weight loss then you should try and do an exercise equivalent of at least 60 minutes of brisk walking per day.
Alcohol consumption should be limited to a maximum of 11 standard drinks per week for females and 17 for males (with a drink equating to half a pint of beer, a small glass of wine or a measure of spirits).
You also shouldn’t have more than five drinks in a short space of time.
To ensure a healthy and balanced diet you should eat at least five portions of fruit and vegetables each day, have an adequate intake of fibre and calcium and cut down on dietary salts and saturated fats.
From a medical perspective, several conditions should be screened for particularly if there is a strong family history. If you are over 30, you should have your blood pressure checked at least every five years and if borderline high every one to two years. Remember, up to half of Irish people with high blood pressure are not aware of it and it substantially increases of heart disease and stroke.
Cholesterol levels should be checked in early adult life and should be rechecked about every five years. About 70% of measured blood cholesterol is unrelated to diet and is also dependent on genetic factors. If you have a healthy diet to begin with, then modifying what you eat is not likely to have much impact on your level though exercise and weight loss may help.
The current recommended target (in mmol/l) is to have a total cholesterol of less than five, a bad cholesterol (LDL) of less than three and the good form (HDL) greater than one with stricter treatment targets in those with heart disease, stroke or diabetes. If your level is high despite lifestyle measures you may not necessarily need to go on tablets and should discuss with your GP.
Screening for diabetes by checking a fasting blood sugar should be considered in those aged over 45 or earlier if there is strong family history and /or you are overweight.
Checking for glaucoma in some people is important as it can be a silent cause of visual loss. If you over 40 and have a family history or are short sighted or have other risk factors like diabetes then getting your eyes examined is advised.
Brittle bones
As regards bone health, getting a DXA scan to look for brittle bones is recommended for all women aged over 65 and should also be considered in men over 70.
Screening for breast cancer with mammography is advised every three years for all women aged 50-64 and most aged between 25 -60 should also have regular cervical smears. Screening for prostate cancer with a PSA blood test and digital rectal exam is controversial as it may lead to further investigations in a significant proportion that prove negative. However, it should be considered in men aged 50-75 who have a life expectancy of least 10 years.
For this reason, the decision should be made on individual basis after discussion with your GP. In those with a strong family history of colorectal cancer, screening with colonoscopy is also available.
In summary, adopting a healthy lifestyle, checking for silent risk factors and screening for disease where appropriate can substantially reduce ill health and indeed prolong life.
As always, be vigilant for changes in your health and don’t be afraid to go to your GP if you’re concerned.