Ten Top Tips for Healthy Living

The great thing about the new year is it allows us to think about the next year and, in the case of this column, hopefully the next many years! We are, after all, interested in how to make these remaining years as healthy as possible.

I recently had the privilege of addressing this topic at the Charleston Chapter of the Daughters of the American Revolution (their name might make you wonder how they have lasted that long). And, mindful of efficient use of time, I thought it best to communicate my discussion with you, the loyal readers of this column.

The first table at the bottom of this page lists the ten things that are vitally important to healthy aging. There is nothing new on this top ten list; all of these topics have been written about before because they are the keys to healthy aging. This list is not in any rank order; all are important and every one adds its unique contribution to the goal. We will consider each briefly in the order listed in the table.

Whole columns have been written on various aspects of one's diet. It is important to your health. Fresh vegetables and fruits are important because they bring vital vitamins and minerals as well as essential fiber. All these things promote health and prevent disease. Meat should be eaten in moderation, since red meat has fats that are unhealthy for us, and red meat makes it difficult—along with all the fast food items—to keep cholesterol down where it needs to be to prevent heart disease and stroke. Grains should be consumed the most in our daily diet. Fish is good for us and fats and sweets are bad. Alcohol can be consumed in moderation and some even recommend a glass of red wine a day. Remember, no more than two drinks a day for men and one for the ladies.

Exercise is every bit as important to health as diet. In fact one benefit is that exercise allows one to enjoy the diet in larger servings. It is highly recommended that aerobic (oxygen consuming) exercise like jogging, walking, swimming, biking, playing racket sports, etc. be part of your weekly routine at least four times per week. The goal is to get one's heart rate up, break a sweat, and actually burn up some calories while keeping muscles and bones strong. The duration of these workouts should be at least 20 minutes and preferably up to an hour. Exercise has been proven over and over to combat many diseases that can broadly be grouped as cardiovascular and cancer. Exercise also helps with mental health, diabetes, and some immune diseases. Although exercise takes planning and execution, it is probably the best activity you can do to promote health.

Conflict of interest aside, it is strongly recommended that you have a personal physician (preferably a general internal medicine specialist) who knows your health status well and in whom you have full trust. This professional relationship is absolutely vital to your health. Your doctor will have you on a health maintenance regimen designed especially for you. He or she will also manage chronic diseases like hypertension or diabetes and make appropriate referrals to specialists when indicated. Your doctor will oversee your blood tests and prescriptions as well as any over-the-counter things you both agree are useful to you for health. Over the age of 65 it is recommended that you see your doctor twice a year if in good health and more frequently for chronic disease management or for specialty physician care.

I had the pleasure of talking to medical students today and wowed them with the fact that when I graduated from medical school all that was being done for people with heart attacks was keeping them quiet and sedated and praying for their survival. Today we have so many ways to delay or prevent heart disease with medicines that lower cholesterol, reduce blood pressure, and keep platelets from aggregating and causing heart attacks. The point is: Prescription medicines have become an essential part of modern medicine and add immeasurably to healthy aging. Your doctor will prescribe medicine for you that should help, but all medicines do have side effects in some patients, and if you encounter them, let your doctor know immediately. The other responsibility you must exercise with regard to medicines is to take them as directed (at the proper time and with or without food as your doctor and pharmacist instruct). The great number of medicines that we take can interact and it is important to note if adding a new medicine has any untoward effects. Fill the prescriptions at a "chain" drug dispensary so that when traveling, if you forget or run out of your medicine, you can get a refill.

Related to medicines, of course, are the immunizations that will keep you healthy. Most immunizations are by prescription and these are shingles (Herpes Zoster), pertussis (whooping cough), and pneumococcal pneumonia. Make sure that you are up to date with all these immunizations. The "flu" is an annual vaccination. It should be taken in the fall every year to ward off the winter flu season. (Don't skip the shot just because some fear it will not be as effective this year as it usually is.) The flu kills thousands of elderly people every year.

People are dependent on others. It has been proven with rigor that social interactions are healthful. Happy marriages, significant others, good family ties, close friends, and pets are all keys to healthy aging. It may be impossible to have all of these, but it is important to have at least one or more of these social relationships that sustain us in our effort to have a long and meaningful healthy life. Healthy relationships breed health—it is a proven fact of life.

One of our greatest fears is that as we maintain our physical health, our mind and the myriad of neurons and nerve synapses will no longer function as when we were young. We fear neurodegenerative diseases that cause progressive loss of normal neurocognition. Most of the diet fads have not proven helpful here. Physical exercise can help prevent the vascular causes of neuronal function. However, there is a body of evidence that fits into the "use it or lose it" category regarding brain function. Thus, it is important to exercise the old brain—don't sit in front of the mind-numbing TV for hours on end. It is important to do as many of the following as possible since these activities have proven useful in preserving function. Mental exercises include writing (even keeping a daily journal), reading a book and thinking about the content, solving puzzles, playing board games and card games that require memory, and taking adult education classes, bible studies, book clubs or other cognitive stimulating group activities. Finally, a test of progress is to write a list of things you need to get at the grocery store and then go to the store and try to remember all the items before resorting to the list!

Strength and balance exercises are different than the physical exercise designed to improve cardiovascular and other health. Strength exercises involve stationery lifting of dead weights and other exercise designed to improve muscular and tendon strength. Arm, leg, and waist muscles are the ones to address through a variety of lifts, bends, and squats. Weights should be five to 10 pounds for 10 to 12 sets of three when using the weights. Balance and stretching exercises are important to practice daily and before and after any kind of other exercise. These exercises prevent falls, which become a major problem as we age. I highly recommend that you view this wonderful guide to exercises, courtesy of the National Institute on Aging. It is very good and free!

We are constantly bombarded with opportunities to buy various vitamins, minerals, and supplements in hopes of staving off bad effects of aging. There is virtually no scientific support for most of the things some would have us buy. There are two things to do before putting any in your mouth. First, be certain you are eating a balanced diet which should contain what you need. Second, ask your physician if you need any vitamins and/or minerals like calcium or iron. He or she can look at your blood tests or listen to symptoms and tell if supplements are indicated.

It is crucial that you be aware of symptoms that require emergency attention. Table 2 below lists those symptoms that should alert you to an imminent emergency that requires an immediate call to your physician or to 911. Emergencies require prompt action since time is of the essence. For example, don't wait for that crushing chest pain to subside, it could be a heart attack that requires prompt care—call 911. Delaying the treatment of any of the many problems that cause the symptoms in the table can be life threatening.

Healthy aging requires constant attention. Nothing that we do is more important than thinking about whether it will positively or negatively affect our health. As we age we lose some of the margin for error we had when younger.

Ten Things that Contribute to Healthy Aging

1. Diet
2. Exercise
3. Doctor
4. Medications
5. Immunizations
6. Social Engagement
7. Mental Calisthenics
8. Strength and Balance Exercises
9. Supplemental Vitamins and Minerals
10. Recognizing Emergency Conditions

Warning Signs and Symptoms of a Medical Emergency

• Difficulty breathing, shortness of breath
• Chest or upper abdominal pain or pressure lasting two minutes or more
• Fainting, sudden dizziness, weakness
• Changes in vision
• Difficulty speaking
• Confusion or changes in mental status, unusual behavior, difficulty waking
• Sudden or severe pain
• Uncontrolled bleeding, severe bone fractures, and burns
• Severe or persistent vomiting or diarrhea
• Coughing or vomiting blood
• Drowning or near drowning
• Suicidal or homicidal feelings

From: American College of Emergency Physicians