The Ultimate Guide to Living Healthy

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Ready to Start Living Healthy in 2017?

[/fusion_text][fusion_text]The goal of this post is to provide a guideline for living healthy. We all struggle in implementing these lifestyle changes, but keep in mind that small steps in the right direction will produce results. As always, discuss with your doctor before implementing these recommendations.[/fusion_text][fusion_text]

Consume a Heart Healthy Diet

[/fusion_text][fusion_text]- Limit your total daily calories to maintain a desirable weight. Your goal should be a BMI of 21-25 kg/m2. BMI = (Weight in Pounds / (Height in inches x Height in inches)) x 703

– Don’t skip breakfast. Use moderate portions. Avoid eating after 8pm.

– Drink at least 8 glasses of water daily, about 64 ounces. If you have heart or kidney problems talk to your doctor first.

– Drink 2 cups daily of fat free or low fat milk, or equivalent milk products.

– Most fats should come from sources of polyunsaturated and monounsaturated fatty acids like fish, nuts, and vegetable oils (olive, canola, peanut, soybean, sunflower, safflower, and corn). Keep trans- fatty acids (partially hydrogenated vegetable oil shortening) consumption as low as possible. Total cholesterol intake should be no more than 300mg per day and total fat intake should be 20-53% of total daily calories. While saturated fat should be no more than 10% of total daily calories. Good sources of Omega 3 fatty acids are flaxseed, canola, soybean, walnuts, and fish oil capsules.

Living Healthy Fruits – Consume plenty of fiber, such as whole grains, fruits and choose a variety of fruit and vegetables each day. Be sure to select from all 5 vegetable subgroups: dark greens, orange, legumes, starchy vegetables, and other vegetables.

– Reduce intake of red meat, egg yolk, fried foods, and added sugars. Consume more fish (12 ounces/week), poultry, fruits (2 cups/day), vegetables (2 ½ cups/day) and whole grain products (3 or more ounces/day). When selecting and preparing meat, poultry, dry beans, milk and meat products, make choices that are lean, low fat, or fat free.

– When given a choice, select fish over red meat. The safest fish are flounder, farmed rainbow trout, sole, anchovies, and farmed clams and shrimp (low in Mercury and Polychlorinated Biphenyl (PCB)). Other fish are fine to eat in moderation -once a week- such as: cod, farmed cat fish, mahi-mahi, wild salmon, tilapia, and canned tuna. Do not eat shark, swordfish, king mackerel, or tile fish as they contain high levels of mercury. The highest levels of PCB are found in farmed salmon and fish caught in local lakes and ponds.

– Limit salt intake to 2300-5000 mg of sodium per day (1-2 teaspoon of salt/day). Those who exercise heavily may need more. Keep in mind that non salty foods may contain large amounts of sodium. Increased salt intake can increase your blood pressure.[/fusion_text][fusion_text]To learn more about our Prostate Cancer Screen as part of our Personalized Medical Care click here.[/fusion_text][fusion_text]

Benefit of Vegetables

[/fusion_text][fusion_text]- Limit your total daily calories to maintain a desirable weight. Your goal should be a BMI of 21-25 kg/m2. BMI = (Weight in Pounds / (Height in inches x Height in inches)) x 703

– Don’t skip breakfast. Use moderate portions. Avoid eating after 8pm.

– Drink at least 8 glasses of water daily, about 64 ounces. If you have heart or kidney problems talk to your doctor first.

– Drink 2 cups daily of fat free or low fat milk, or equivalent milk products.

– Most fats should come from sources of polyunsaturated and monounsaturated fatty acids like fish, nuts, and vegetable oils (olive, canola, peanut, soybean, sunflower, safflower, and corn). Keep trans- fatty acids (partially hydrogenated vegetable oil shortening) consumption as low as possible. Total cholesterol intake should be no more than 300mg per day and total fat intake should be 20-53% of total daily calories. While saturated fat should be no more than 10% of total daily calories. Good sources of Omega 3 fatty acids are flaxseed, canola, soybean, walnuts, and fish oil capsules.

– Consume plenty of fiber, such as whole grains, fruits and choose a variety of fruit and vegetables each day. Be sure to select from all 5 vegetable subgroups: dark greens, orange, legumes, starchy vegetables, and other vegetables.

– Reduce intake of red meat, egg yolk, fried foods, and added sugars. Consume more fish (12 ounces/week), poultry, fruits (2 cups/day), vegetables (2 ½ cups/day) and whole grain products (3 or more ounces/day). When selecting and preparing meat, poultry, dry beans, milk and meat products, make choices that are lean, low fat, or fat free.

– When given a choice, select fish over red meat. The safest fish are flounder, farmed rainbow trout, sole, anchovies, and farmed clams and shrimp (low in Mercury and Polychlorinated Biphenyl (PCB)). Other fish are fine to eat in moderation -once a week- such as: cod, farmed cat fish, mahi-mahi, wild salmon, tilapia, and canned tuna. Do not eat shark, swordfish, king mackerel, or tile fish as they contain high levels of mercury. The highest levels of PCB are found in farmed salmon and fish caught in local lakes and ponds.

– Limit salt intake to 2300-5000 mg of sodium per day (1-2 teaspoon of salt/day). Those who exercise heavily may need more. Keep in mind that non salty foods may contain large amounts of sodium. Increased salt intake can increase your blood pressure.[/fusion_text][fusion_text]

Exercise Regularly

[/fusion_text][fusion_text]Living Healthy Exercise – Engage daily in 30-60 minutes of physical activity that is moderate in intensity. Daily exercise can be broken up into 2 sessions.

– Start gradually. Stop and discuss with your doctor if you have pain.

– Achieve physical fitness by including cardiovascular conditioning, stretching exercises for flexibility, and resistance exercises for muscle strength and endurance.

– Please consult your physician prior to starting any exercise program.[/fusion_text][fusion_text]

Use Alcohol in Moderation

[/fusion_text][fusion_text]- Alcohol intake should not exceed 2 drinks per day for men and 1 drink per day for women. Keep in mind that 1 drink is equivalent to 1 oz. of alcohol or 12 oz. of beer. Alcohol intake should be reduced if you have hypertension or other chronic medical problems.

– Alcohol should not be consumed by pregnant and lactating women, children and adolescents, individuals taking medications that could interact with alcohol and those engaging in activities that require attention, skill or coordination, such as driving or operating machinery.[/fusion_text][fusion_text]

Reduce Stress

[/fusion_text][fusion_text]- Avoid stressful situations and learn new ways to cope with stress.

– Yoga and meditation are excellent options.

– Marry someone you love. Evidence shows that health and lifespan is improved by being in a committed relationship.

– Consider getting a pet.[/fusion_text][fusion_text]

Maintain Preventative Health

[/fusion_text][fusion_text]- Check your cholesterol, blood pressure, and blood sugar routinely and take appropriate actions if elevated. If abnormal, lifestyle modification or medications may be appropriate to prevent complications.

– Influenza vaccine: Annual flu vaccine is recommended for people over 6 months of age.

– Pneumonia vaccine: Two pneumococcal vaccines, PCV13 and PPSV23, are recommended for people over 65 years of age. For people less than 65 years of age with chronic medical conditions or who smoke, a single PPSV23 vaccine is recommended.

– Tetanus vaccine: Tetanus vaccine every 10 years and pertussis vaccine added to Tetanus once as an adult.

– Prostate cancer screening: Initiate prostate cancer screening discussions with your primary care physician at age 50, continue screening until age 75. If African American, begin discussion at age 45. Screening includes annual PSA and digital rectal exam. See your doctor if you are having urinary problems.

– Pelvic exam and Pap smear: Screening has become controversial and is no longer advised annually for routine screening. Discuss with your OB/GYN for the most up to date recommendations.

– STD’s: Be screened for STD’s if you are sexually active, especially between the ages of 15 to 29. Hepatitis C and HIV screening is recommended for people at high risk.

– Mammography: Every 2 to 3 years for women over 40 and annually for women over 50 to age 75. Women, know your breasts, perform breast self exams monthly. Notify your physician if you detect an abnormality.

– Colon cancer screening: Begin screening for blood in the stool at age 40. Begin colonoscopy screening at age 50. If African American, begin colonoscopy screening at age 45. Be familiar with the color and shape of your stool. Notify your doctor if stool is black, bloody, consistently pencil thin, or you experience a major change from your bowel movement routine.

– Abdominal Aortic Aneurysm (AAA): If you have ever smoked, be screened once for AAA at the age of 65. If you have hypertension or a family history of AAA you may need to be screened sooner.

– Vision/Hearing: Periodic hearing and vision screening every 3 to 5 years, sooner if abnormality is noted.[/fusion_text][fusion_text]

Sleep

[/fusion_text][fusion_text]- Get adequate sleep, at least 6 to 7 hours nightly.

– Practice good sleep hygiene. The bed should only be used for sleep or sex.

– Melatonin supplementation may help with insomnia.

– Limit caffeine intake, especially after 12 noon.

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Quite Smoking

[/fusion_text][fusion_text]- When trying to quit, talk to your doctor, you don’t have to do this alone.

– Medications are available to help you quit.

– Evidence shows that repeated attempts at quitting inceases likelihood of success. If you don’t succeede the first time, try, try, again.[/fusion_text][fusion_text]

Focus on Safety

[/fusion_text][fusion_text]- Always wear seat belts while driving a car.

– Always wear helmets while riding a bike.

– Do not drive after drinking.

– If you own a pool, make sure it is fenced.

– Learn to swim.

– Wear plenty of sunscreen to prevent sunburn.

– Install smoke detectors in the home and change batteries twice yearly. The best smoke detectors are those that are both photoelectric and ionization.

– Keep water heaters under 120 degrees Fahrenheit.

– Do not keep fire arms at home. If you do, ensure fire arms are locked and secure.

– Practice safe sex.

– Do not engage in illegal drug use.[/fusion_text][fusion_text]

Wear plenty of sunscreen to prevent sunburns

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Be Emotionally Aware

[/fusion_text][fusion_text]- Be an optimist. A pessimistic style of living is associated with increased death rate.

– Have faith in God or consider other spiritual practices.

– Be honest with others and yourself.

– Control your anger.

– Love your family.

– Help others in need.

– Always guide actions towards others by love, righteousness, and equality.[/fusion_text][fusion_text]I hope you enjoyed the Ultimate Guide to Living Health! At Buckhead Medicine in Atlanta, our goal is to help our patients live the happiest, healthiest lives possible. Take the time in 2017 to focus on yourself by improving your health.[/fusion_text][/one_full][button link=”#” color=”default” size=”” stretch=”” type=”” shape=”” target=”_self” title=”” gradient_colors=”|” gradient_hover_colors=”|” accent_color=”” accent_hover_color=”” bevel_color=”” border_width=”” icon=”” icon_position=”left” icon_divider=”no” modal=”” animation_type=”0″ animation_direction=”left” animation_speed=”1″ animation_offset=”” alignment=”center” class=”footer-button modal-trigger-one” id=””]Request Appointment[/button]

A Look at Vitamin D & Calcium Supplementation

[fusion_text]The topic of Vitamin D and Calcium supplementation seems to pop up quite frequently on the evening news. Recent reports on the benefits of Vitamin D have been closely followed by concerns over side effects of too much Vitamin D. Experts vary in the recommendation of supplementation from 500 units daily to 50,000 units weekly, depending on whether you are Vitamin D deficient or insufficient.  As far as Calcium goes, experts also have varying opinions that seem to change yearly. Some say you should take Calcium daily, others caution that we may be taking too much Calcium. So, what’s the big deal about Vitamin D and Calcium supplementation anyway?

In order to fully understand Vitamin D and Calcium supplementation, it’s important to understand why we supplement to begin with.  In a nutshell, as we get older the likelihood of bony fractures or falls leading to bony fractures increase because our bone density decreases.  Loss in bone density is called osteopenia and in more severe cases osteoporosis.

Osteoporosis is the most common bone disease in the U.S. and a major risk factor for fractures. In the U.S. there are more than 1.5 million osteoporotic fractures each year, attributing to an annual cost of $15 Billion in health care and disability expenses. Overall, osteoporosis affects women more than men, but it does affect men to a significant degree.

Fractures at a young age may at face value not seem so bad, but a fracture such as a hip fracture at an older age is much more significant and is associated with many other medical problems. Winter 2011 dealt Atlanta  a pretty significant snow storm (I would call it ice storm).  I can’t tell you how many people I came in contact with who slipped and fell or knew someone who slipped and fell.  I know it sounds odd, but one of my initial thoughts when I hear of a fall is, “I hope they have dense bones.”  I frequently see elderly patients who are hospitalized due to a fall that resulted in a hip fracture. They undergo surgery and post operatively develop worsening of their existing medical conditions such as tachycardia, or heart failure, or may develop new problems such as pneumonia or blood clots. Regardless, my point is that fractures at an older age can lead to many medical complications. The best strategy is prevention of osteopenia and osteoporosis and, consequently, avoidance of fractures. That’s the big deal about Vitamin D and Calcium Supplementation.

To be clear, it’s not just supplementation or the lack of supplementation that predisposes us to decreased bone density. A variety of genetic factors can predispose a person to low bone mass, such as gender, race, body build and family history.   Acquired factors also predispose us to low bone density including a diet low in Calcium or Vitamin D, early menopause, a sedentary lifestyle, and cigarette smoking.

Let’s initially discuss prevention and screening of decreased bone density. Everyone clearly agrees that prevention is key. The health habits of individuals in early and middle life play a role in their risk of osteoporosis as they age.  Adequate dietary intake of Calcium and Vitamin D, active physical exercise and avoidance of excess alcohol, tobacco and drugs known to cause osteopenia are all useful measures for the prevention of osteoporosis.  As far as screening goes, we usually screen people with multiple fractures, women in the perimenopausal time of their life, as well as people with medical conditions that may predispose them to osteoporosis, such as hyperparathyroidism or other endocrine problems. The most commonly used test for screening is the DEXA bone scan.  DEXA bone scans are available at most hospitals in Atlanta, including Piedmont and Northside Hospital.  DEXA bone scans assist physicinas in making the diagnosis of osteoporosis at guide us in determinining treatment stratagies. Ask your doctor if she or he recommends this test for you.

As with most medical topics there is some degree of disagreement among the experts.  How and who to supplement is what is usually debated. In November of 2010, the Institute of Medicine released their new recommendations for supplementation.  This report was good juicy material for journalists. It became news because it was somewhat of a change of opinion from the existing recommendations. In this report the IOM reviewed the existing data on Vitamin D and Calcium supplementation.  The report recommended specific individual daily requirements for optimum bone health that were slightly changed from the existing recommendations. The IOM underscored the importance of not over supplementing Vitamin D and Calcium in patients without deficiency.  A couple of additional important points that were made were based on the medical communities views that Vitamin D and Calcium may play key roles in the immune system as well as in supporting a person’s overall cardiovascular health. The IOM report concluded that current evidence does not support other benefits for Vitamin D or Calcium intake such as immune system or cardiovascular benefits.  The other key point they highlighted was the concern over measurement of Vitamin D.  In the medical community we have for some time expressed concern over how reliable the lab results are when measuring a person’s Vitamin D level in the blood. The IOM report raised concern in the reliability of laboratories performing serum Vitamin D levels as these may have high variability and may possibly be over estimating the number of Vitamin D deficient persons.   If you click on this link you will be directed to a pdf file that contains a summary of the IOM report, as well as my recommendations for supplementation.

As far as treatment goes, when people develop osteoporosis and associated fractures, separate from continued supplementation with Calcium and Vitamin D, there are treatments that help to prevent further excessive bone loss, promote bone formation, prevent fractures, reduce pain, and restore physical function. These medications, although somewhat controversial on their own, are available as a treatment strategy. These include: Estrogen Replacement, Selective Estrogen Receptor Modulators (SERMS), Bisponsphonates, and Calcitonin. If you have osteopenia or osteoporosis, I encourage you to speak with your primary care provider and/or endocrinologist to discuss these treatment options.[/fusion_text]