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Category Archives: health

Imported Jewelry Can Pose Danger

Foreign-made jewelry is a potential source of lead exposure, according to public health officials.

A 1-year-old boy living in New York City had a rapid increase in blood lead levels, and the likely source of the exposure was traced to a Cambodian amulet made from knotted string and metallic beads, according to researchers from the NYC Department of Health and Mental Hygiene and the CDC.

Testing revealed that the beads contained 45 percent lead, the researchers reported in Jan. 28 issue of Morbidity and Mortality Weekly Report.

The boy had worn the amulet — “something to protect him,” his father said — since he was 3 months old, and had been seen putting it in his mouth.

“Healthcare providers and public health workers should consider traditional customs when seeking sources of lead exposure in Southeast Asian populations,” the authors wrote.

Healthcare professionals should ask parents — particularly from Southeast Asian families — about the use of amulets, they added, noting that educational efforts about the risk of lead poisoning from jewelry are needed for immigrant families.

An accompanying editorial note pointed out that the CDC recommends blood lead testing for internationally adopted and refugee children and that the New York City health department recommends testing all children with recent travel to foreign countries.

Although the most common source of lead exposure in young children is paint, other sources have been increasingly identified.

That is particularly true in immigrant communities because of the use of lead-containing products from their country of origin, such as spices, food, candy, cosmetics, health remedies, ceramics or pottery, and jewelry.

For the case of the 1-year-old boy, routine lead testing showed an elevated blood lead level of 10 micrograms/dL.

According to the National Institutes of Health lead concentrations in blood should be less than 10 micrograms/dL in children and less than 20 micrograms/dL in adults.

Because he lived in a household with a cousin who had had lead poisoning, he had also been tested at 6 months. His blood lead level was just 1 microgram/dL then.

A risk assessor from the Environmental Protection Agency visited the home to look for potential sources of the lead exposure. The boy’s father denied using any imported products, and the assessor failed to find any potential sources of exposure.

Three months later, the boy’s blood level doubled to 20 micrograms/dL.

The boy’s father again denied that the child wore jewelry or charms, but eventually admitted that the child had worn an amulet acquired at a Cambodian market since he was 3 months old.

A second home inspection identified one area of paint with an elevated lead level, as well as imported spices and rice. Testing revealed that the food products did not have elevated lead content.

Within eight days of the amulet being removed from the home, the boy’s blood lead level decreased to 14 micrograms/dL.

About five weeks later — after the lead paint was reported to be removed — the boy’s blood lead level was 10 micrograms/dL, and five months after the amulet was removed, the level was down to 5 micrograms/dL.

“Although other factors might have contributed to the child’s overall lead burden,” the researchers wrote, “the most likely source identified was the amulet, based on its high lead content, statements that the child had been observed mouthing it, and the rapid decrease in the child’s blood lead level after its removal.”

Common Complication Delays Giffords’ Recovery

An accumulation of fluid in the brain, a condition called posttraumatic hydrocephalus, has delayed U.S. Rep. Gabrielle Giffords’ transfer to an inpatient rehabilitation facility.

Although the Arizona congresswoman was transferred last Friday to Memorial Hermann healthcare system in Houston, where she was scheduled to enter The Institute for Rehabilitation and Research (TIRR), she was admitted instead to the hospital’s neurological intensive care unit.

One of the doctors involved in her care in Houston, trauma surgeon John Holcomb, MD, said that a drain had been inserted to release a buildup of fluid. Until that drain is removed or a permanent shunt is implanted, Giffords must remain in the neuro ICU.

Reid Thompson, MD, chairman of neurological surgery at Vanderbilt University in Nashville, said in an e-mail to ABC News and MedPage Today that fluid buildup is a very common problem in neurosurgery.

“In the setting of a gunshot wound, and recent surgery, it would not be unusual to build up fluid and possibly have fluid leak out — raising the risk for an infection (meningitis),” wrote Thompson, who is not involved in Giffords’ care.

The timing of the drain placement, he said, suggests that Giffords has developed a fluid leak either from inflammation in the brain or an infection.

“This creates a plumbing problem as fluid can no longer circulate out,” he wrote.

According to a Houston Chronicle story, Holcomb said over the weekend that the fluid does not appear to be infected.

If the fluid buildup does not resolve within about two weeks, Thompson explained, the drain — a potential source of infection — would have to be replaced with a permanent shunt, which would divert spinal fluid from the ventricles of the brain to the abdomen, where it is absorbed.

“I don’t see it as a setback,” Thompson wrote in his e-mail. “Rather it is part of the process from her original injury. It will, however, keep her from progressing to a rehab environment quickly.”

Although Giffords’ transfer to the dedicated rehabilitation hospital has been delayed for an indeterminate amount of time, she will continue rehab in the ICU.

Another member of the medical team responsible for her care, neurosurgeon Dong Kim, MD, said the congresswoman “looked spectacular” when she arrived in Houston from University Medical Center in Tucson, Ariz., where she’d been cared for since being shot in the head at a public event on Jan. 8.

Kim said Giffords was alert, interactive, awake, calm, and comfortable.

He added that she had very good movement on the left side of her body and did not like it when doctors shined light in her eyes, both of which are considered good signs.

Kim noted that Giffords did not have much tone in her right arm and that over a period of about 30 minutes, she did not move it. The medical team in Tucson had reported seeing her move her right arm.

Overall, Kim said he expects Giffords to do “remarkably well,” adding that the entire process, including ICU care and inpatient and outpatient rehabilitation, will probably last four to six months, regardless of how quickly she recovers.

Although her doctors are optimistic, several physicians contacted by ABC News andMedPage Today cautioned that Giffords’ future function remains uncertain.

“Sadly, this is where the long-term reality of brain injury starts to hit home,” Gregory O’Shanick, MD, medical director of the Center for Neurorehabilitation Services in Richmond, Va., wrote in an e-mail.

“As she increases her efforts towards becoming more independent with rehabilitation,” he wrote, “the deficits will become ever more apparent and frustrating since there is no surgery, no single medication, and no artificial prosthesis to reverse the injury she sustained.”

Other physicians thought it unlikely that Giffords would recover without some physical or cognitive deficits.

“I think it would be too early to ask such a question without further testing, but the reality is, most people with this type of injury usually cannot return to their previous level of functioning, especially if it was at a high level,” wrote Inam Kureshi, MD, director of the head injury program at Hartford Hospital in Connecticut.

A statement from Memorial Hermann said the next update on Giffords’ condition will be provided when she is transferred to the rehabilitation facility.

Federal Judge Strikes Down Health Reform Law

A federal judge ruled Monday that the new U.S. health-care reform law is unconstitutional, saying the federal government has no authority to require citizens to buy health insurance.

That provision is a cornerstone of the new legislation, signed into law in March by President Barack Obama.

The judge’s decision was not unexpected, and both supports and opponents of the legislation anticipate the validity of the new health law ultimately will be decided by the U.S. Supreme Court.

The ruling was handed down by U.S. District Judge Henry E. Hudson, a Republican appointed by President George W. Bush who had seemed sympathetic to the state of Virginia’s case when oral arguments were heard in October, the Associated Press reported.

Last week, White House officials said a negative ruling would not affect the implementation of the law because its major provisions don’t take effect until 2014, the AP reported.

Virginia Attorney General Kenneth Cuccinelli, a Republican, had filed a lawsuit in defense of a new Virginia law barring the federal government from requiring state residents to buy health insurance. He argued that it is unconstitutional for the federal law to force citizens to buy health insurance and to assess a penalty if they don’t.

The U.S. Justice Department said the insurance mandate falls within the scope of the federal government’s authority under the Commerce Clause. But Cuccinelli said deciding not to buy insurance is an economic matter outside the government’s domain.

By 2019, the law will expand health insurance access to 94 percent of non-elderly Americans. Advocates say that between now and then, it will also provide Americans with many new rights and protections.

Key provisions include:

  • Health plans may no longer deny coverage to people based on pre-existing health conditions.
  • Health plans that cover dependents must permit children to stay on a parent’s family policy until age 26.
  • Insurers may no longer place lifetime dollar limits on essential benefits.
  • New health plans must offer preventive services such as mammogramsand colon cancer screenings without charging a deductible, co-payment or coinsurance. (This provision does not apply to existing plans that are “grandfathered.”)

Dangerous Bacteria Spreads Outside Hospitals

The dangerous bacteria Clostridium difficile spreads not only in hospitals but also in other health-care settings, causing infections and death rates to hit “historic highs,” U.S. health officials reported Tuesday.

C. difficile is a deadly diarrheal infection that poses a significant threat to U.S. health care patients,” Ileana Arias, principal deputy director at the U.S. Centers for Disease Control and Prevention, said during a morning news conference. “C. difficile is causing many Americans to suffer and die.”

The germ is linked to about 14,000 deaths in the United States every year. People most at risk from C. difficile are those who take antibiotics and also receive care in any medical facility.

“This failure is more difficult to accept because these are treatable, often preventable deaths,” Arias said. “We know what can be done to do a better job of protecting our patients.”

Much of the growth of this bacterial epidemic has been due to the overuse of antibiotics, the CDC noted in its March 6 report. Unlike healthy people, people in poor health are at high risk for C. difficile infection.

Almost 50 percent of infections are among people under 65, but more than 90 percent of deaths are among those aged 65 and older, according to the report.

Previous estimates found that about 337,000 people are hospitalized each year because of C. difficile infections. Those are historically high levels and add at least $1 billion in extra costs to the health care system, the CDC said.

However, these estimates might not completely reflect C. difficile’s overall impact.

According to the new report, 94 percent of C. difficile infections are related to medical care, with 25 percent among hospital patients and 75 percent among nursing home patients or people recently seen in doctors’ offices and clinics.

Although the proportion of infection is lowest in hospitals, they are at the core of prevention because many infected patients are transferred to hospitals for care, raising the risk of spreading the infection there, the CDC said.

Half of those with C. difficile infections were already infected when they were admitted to the hospital, often after getting care at another facility, the agency noted.

The other 50 percent of infections were related to care at the hospital where the infection was diagnosed.

The CDC said that these infections could be reduced if health care workers follow simple infection control precautions, such as prescribing fewer antibiotics, washing their hands more often and isolating infected patients.

These and other measures have reduced C. difficile infections by 20 percent in hospitals in Illinois, Massachusetts and New York, the CDC said.

In England, infections have been cut 50 percent in three years, the agency said.

Patients get C. difficile infections mostly after taking antibiotics, which can diminish the body’s “good” bacteria for several months.

That’s when patients can get sick from C. difficile, which can be picked up from contaminated surfaces or spread by health care providers.

The predominant sign of C. difficile infection is diarrhea, which can cause dehydration. If serious, the infection can become deadly. Other symptoms include fever, nausea and loss of appetite.

The CDC advises that if diarrhea occurs after a patient starts antibiotics, C. difficileshould be suspected and treatment continued with another antibiotic.

Commenting on the report, infectious disease expert Dr. Marc Siegel, an associate professor of medicine at New York University, said, “All these recommendations are fine; the problem is they are not going to work, you can’t stop these practices. This bug exists in a climate of overuse of antibiotics.”

It is hard to eradicate C. difficile because it buries itself in the colon, then recurs and testing isn’t always accurate, Siegel said. “It’s a pervasive problem in hospitals, and even in communities,” he said.

How Seat Belt Save Lives

It’s been proven time and again, on back roads and superhighways: A seat belt can save a life in a car accident. According to the National Highway Traffic Safety Administration (NHTSA), more than 15,000 lives are saved each year in the United States because drivers and their passengers were wearing seat belts when they were in accidents.

Seat Belt Safety: 5-Way Protection

“Seat belts prevent occupants of the vehicle from serious injury in five ways,” says Angela Osterhuber, director of the Pennsylvania Traffic Injury Prevention Project in Media, Pa. A seat belt:

  • Keeps the occupants of the vehicle inside. “It’s clearly a myth that people are better off being thrown clear from the crash,” Osterhuber says. “People thrown from a vehicle are four times more likely to be killed than those who remain inside.”
  • Restrains the strongest parts of the body. “Restraints are designed to contact your body at its strongest parts. For an older child and adult, these parts are the hips and shoulders, which is where the seat belt should be strapped,” Osterhuber says.
  • Spreads out any force from the collision. “Lap-and-shoulder belts spread the force of the crash over a wide area of the body. By putting less stress on any one area, they can help you avoid serious injury,” Osterhuber says. A shoulder strap also helps keep your head and upper body away from the dashboard, steering wheel, and other hard interior parts of the automobile should you stop suddenly or be hit by another vehicle.
  • Helps the body to slow down. “What is it that causes injury? A quick change in speed,” Osterhuber says. “Seat belts help extend the time it takes for you to slow down in a crash.”
  • Protects your brain and spinal cord. A seat belt is designed to protect these two critical areas. “Head injuries may be hard to see immediately, but they can be deadly,” Osterhuber says. Likewise, spinal cord injuries can have serious consequences.

Seat Belt Safety: Buckle Up Correctly

Adjusting your seat belt properly is a must: Getting the right fit is as important as wearing it. The strap that goes across your lap should fit snugly over your hips and upper thigh area. “If the belt rides up on the stomach, it could cause serious injuries in a crash,” Osterhuber says.

Shoulder belts should rest securely across your chest and shoulders between your breasts. Don’t ever let the strap fall across your neck or face and never place the strap under your arms or behind your back. “Any one of these positions can cause serious injury,” Osterhuber says.

Seat Belt Safety: Rules for Infants and Children

Children are not small adults — they need specialized protection in a moving vehicle. “Their skeletal structure is different,” Osterhuber says. Age, height, and weight determine the safest way for a child to travel.

According to the American Academy of Pediatrics, here’s how to select the right option for your child:

  • Rear-facing child safety seat. Children under age 1 and those who weigh less than 20 pounds should sit in rear-facing, child safety seats approved by the National Highway Traffic Safety Administration (NHTSA). The seats should be placed in the backseat of the car.
  • Forward-facing child safety seat. Children older than 1 who weigh more than 20 pounds should ride in forward-facing child safety seats. The seat should be placed in the rear of the vehicle until the child reaches the upper weight or height limit of the particular seat. Typically, a child will outgrow a safety seat around age 4 and once she reaches about 40 pounds.
  • Booster seat. Children age 4 and older who weigh more than 40 pounds should ride in booster seats. A child can safely progress to a seat belt when the belt fits properly across the upper thighs and chest. “This is usually at age 8 or when they are at least 4 feet 9 inches tall,” Osterhuber says.
  • Seat belt. When children outgrow their booster seats, they can use seat belts, but they still should sit in the back of the vehicle. “Really, all children should be riding in the backseat of the car until they are at least 13 years old,” Osterhuber says.

Seat Belt Safety: A Clear Message

The National Safety Council recently reported a drop in traffic fatalities for 2008, indicating a record low since the 1920s when it began publishing statistical reports. One reason given for the decline is the increased use of seat belts.

It takes only a few seconds to buckle up once you get in the car. Why wouldn’t you?

Medications Safety

The U.S. Food and Drug Administration (FDA) judges a drug to be safe enough to approve when the benefits of the medicine outweigh the known risks for the labeled use.

Doctors, physician assistants, nurses, pharmacists, and YOU make up your health care team. To reduce the risks from using medicines and to get the most benefit, you need to be an active member of the team.

To make medicine use SAFER:

  • Speak up
  • Ask questions
  • Find the facts
  • Evaluate your choices
  • Read the label and follow directions

The members of your team need to know your medical history, such as illnesses, medical conditions (like high blood pressure or diabetes), and operations you have had.

They also need to know all the medicines and treatments you use, whether all the time or only some of the time. Before you add something new, talk it over with your team. Your team can help you with what mixes well, and what doesn’t.

It helps to give a written list of all your medicines and treatments to all your doctors, pharmacists and other team members. Keep a copy of the list for yourself and give a copy to a loved one.

Be sure to include:

  • prescription medicines, including any samples your doctor may have given you
  • over-the-counter (OTC) medicines, or medicines you can buy without a prescription (such as antacids, laxatives, or pain, fever, and cough/cold medicines)
  • dietary supplements, including vitamins and herbs
  • any other treatments
  • any allergies, and any problems you may have had with a medicine
  • anything that could have an effect on your use of medicine, such as pregnancy, breast feeding, trouble swallowing, trouble remembering, or cost

Ask Questions

Your health care team can help you make the best choices, but you have to ask the right questions. When you meet with a team member, have your questions written down and take notes on the answers. You also may want to bring along a friend or relative to help you understand and remember.

Find the Facts

Before you and your team decide on a prescription or OTC medicine, learn and understand as much about it as you can, including:

  • brand and generic (chemical) names
  • active ingredients — to make sure that you aren’t using more than one medicine with the same active ingredient
  • inactive ingredients — if you have any problems with ingredients in medicines, such as colors, flavors, starches, sugars
  • uses (“indications” and “contraindications”) — why you will be using it, and when the medicine should/should not be used
  • warnings (“precautions”) — safety measures to make sure the medicine is used the right way, and to avoid harm
  • possible interactions — substances that should not be used while using the medicine. Find out if other prescription and OTC medicines, food, dietary supplements, or other things (like alcohol and tobacco) could cause problems with the medicine
  • side effects (“adverse reactions”) — unwanted effects that the medicine can cause, and what to do if you get them
  • possible tolerance, dependence, or addiction – problems that some medicines can cause, and what you can do to avoid them
  • overdose — what to do if you use too much
  • directions — usual dose; what to do if you miss a dose; special directions on how to use the medicine, such as whether to take it with or without food
  • storage instructions — how and where to keep the medicine
  • expiration — date after which the medicine may not work, or may be harmful to use

Your pharmacy, the library, the bookstore, the medicine maker, and the Internet have medicine information made for consumers. If you have questions, ask your health care team.

Evaluate your Choices — Weigh the Benefits and Risks

After you have all the information, think carefully about your choices. Think about the helpful effects as well as the possible unwanted effects. Decide which are most important to you. This is how you weigh the benefits and risks. The expert advice from your health care team and the information you give the team can help guide you and your team in making the decision that is right for you.

Read the Label and Follow Directions

Read the label to know what active ingredient(s) is (are) in the medicine. The active ingredient in a prescription or OTC medicine might be in other medicines you use. Using too much of any active ingredient may increase your chance of unwanted side effects.

Read the label each time you buy an OTC medicine or fill your prescription. When buying an OTC, read the “Drug Facts” label carefully to make sure it is the right medicine for you. Prescription and OTC medicines don’t always mix well with each other. Dietary supplements (like vitamins and herbals) and some foods and drinks can cause problems with your medicines too. Ask the pharmacist if you have questions.

Before you leave the pharmacy with your prescription, be sure you have the right medicine, know the right dose to use, and know how to use it. If you’ve bought the medicine before, make sure that this medicine has the same shape, color, size, and packaging. Anything different? Ask your pharmacist. If your medicine tastes different when you use it, tell your health care team.

Read and save all the information you get with your medicine.

Read the label each time before you use the medicine. Be sure it’s right in 5 ways:

  1. the right medicine
  2. for the right patient
  3. in the right amount
  4. at the right time
  5. in the right way (for example, swallow instead of chew a pill)

Follow directions on the label and from your health care team. When you are ready to use the medicine, make the most of the benefits and lower the risks by following the directions.

If you want to stop a medicine your doctor told you to use or to use it in a different way than directed, talk to a team member. Some medicines take longer to show that they are working. With some medicines, such as antibiotics, it is important to finish the whole prescription, even if you feel better sooner. When you stop using some medicines, you must reduce the dose little by little to prevent unwanted side effects.

6 Ways to Boost Women’s Health

To look and feel your best at every age, it’s important to make smart lifestyle and health choices. Here are six simple things that women can do every day (or with regularity) to ensure good health:

Health Tip #1: Eat a healthy diet. “You want to eat as close to a natural foods diet as you can,” says Donald Novey, MD, an integrative medicine physician with the Advocate Medical Group in Park Ridge, Ill. That means a variety of fresh fruits and vegetables and fewer processed foods. Eat whole grains and high-fiber foods and choose leaner cuts of meat, fish, and poultry. Include low-fat dairy products in your diet as well — depending on your age, you need between 800 and 1,500 milligrams of calcium daily to help avoid osteoporosis, Dr. Novey says. Avoid foods and beverages that are high in calories, sugar, salt, and fat.

Healthy eating will help you maintain a proper weight for your height, which is important because being overweight can lead to a number of illnesses. Looking for a healthy snack? Try some raw vegetables, such as celery, carrots, broccoli, cucumbers, or zucchini with dip made from low-fat yogurt.

If you’re not getting enough vitamins and nutrients in your diet, you might want to take a multivitamin and a calcium supplement to make sure you’re maintaining good health.

Health Tip #2: Exercise. Heart disease is the leading cause of death among women in America, but plenty of exercise can help keep your heart healthy. You want to exercise at least 30 minutes a day, five days a week, if not every day. Aerobic exercises (walking, swimming, jogging, bicycling, dancing) are good for women’s health in general and especially for your heart, says Sabrena Merrill, MS, of Lawrence, Kan., a certified personal trainer and group fitness instructor and a spokeswoman for the American Council on Exercise.

Health Tip #3: Avoid risky habits. Stay away from cigarettes and people who smoke. Don’t use drugs. If you drink alcohol, do so in moderation. Most women’s health studies show that women can safely consume one drink a day. A drink is considered to be about 12 to 14 grams of alcohol, which is equal to 12 ounces of beer (4.5 percent alcohol); 5 ounces of wine (12.9 percent alcohol); or 1.5 ounces of spirits (hard liquor such as gin or whiskey, 80-proof).

Health Tip #4: Manage stress. No matter what stage of her life — daughter, mother, grandmother — a woman often wears many hats and deals with a lot of pressure and stress. “Take a few minutes every day just to relax and get your perspective back again,” Novey says. “It doesn’t take long, and mental health is important to your physical well-being.” You also can manage stress with exercise, relaxation techniques, or meditation.

Health Tip #5: Sun safely. Excessive exposure to the sun’s harmful rays can cause skincancer, which can be deadly. To protect against skin cancer, wear sunscreen with a sun protection factor (SPF) of at least 15 if you are going to be outdoors for more than a few minutes. Even if you wear sunscreen faithfully, you should check regularly for signs of skin cancer. Warning signs include any changes in the size, shape, color, or feel of birthmarks, moles, or freckles, or new, enlarging, pigmented, or red skin areas. If you spot any changes or you find you have sores that are not healing, consult your doctor.

Health Tip #6: Check for breast cancer. The American Cancer Society no longer recommends monthly breast self-exams for women. However, it still suggests them as “an option” for women, starting in their 20s. You should be on the lookout for any changes in your breasts and report any concerns to your doctor. All women 40 and older should get a yearly mammogram as a mammogram is the most effective way of detecting cancer in its earliest stages, when it is most treatable.

A woman’s health needs change as she ages, but the basics of women’s health remain the same. If you follow these six simple healthy living tips, you will improve your quality of life for years to come.

7 Ways to Fit In Exercise

The benefits of regular exercise are unrivaled: Physical activity can help you lose weight and prevent a host of ailments, including heart disease, diabetes, and osteoporosis. Being fit also can help you stay mentally sharp.

While most people know they should exercise, you may not know where to start or how to fit it into a busy schedule. The American College of Sports Medicine (ACSM) and the American Heart Association (AHA) recommend that healthy adults get at least 150 minutes of moderate-intensity aerobic activity spread out over five days a week, or 20 minutes of vigorous-intensity aerobic activity on each of three days a week.

“This is something we recommend to all Americans,” says Gerald Fletcher, MD, a cardiologist at the Mayo Clinic in Jacksonville, Fla., and a spokesman for the AHA.

An ideal fitness routine also includes resistance or weight training to improve muscle strength and endurance. The ACSM and the AHA recommend that most adults engage in resistance training at least twice a week.

Finding Fitness: 10 Ways to Get in Exercise

Sometimes the problem isn’t motivation — it’s simply finding the time. But scheduling exercise isn’t as difficult as you might think. Here are 10 ways to get you moving more often:

  1. Be less efficient. People typically try to think of ways to make daily tasks easier. But if we make them harder, we can get more exercise, says Sabrena Merrill, MS, of Lawrence, Kan., a certified personal trainer, group fitness instructor, and spokeswoman for the American Council on Exercise (ACE). “Bring in the groceries from your car one bag at a time so you have to make several trips,” Merrill says. “Put the laundry away a few items at a time, rather than carrying it up in a basket.”
  2. Shun labor-saving devices. Wash the car by hand rather than taking it to the car wash. “It takes about an hour and a half to do a good job, and in the meantime you’ve gotten great exercise,” Merrill says. Use a push mower rather than a riding mower to groom your lawn.
  3. Going somewhere? Take the long way. Walking up or down a few flights of stairs each day can be good for your heart. Avoid elevators and escalators whenever possible. If you ride the bus or subway to work, get off a stop before your office and walk the extra distance. When you go to the mall or the grocery store, park furthest from the entrance, not as close to it as you can, and you’ll get a few extra minutes of walking — one of the best exercises there is, Dr. Fletcher says. “Walking is great because anyone can do it and you don’t need any special equipment other than a properly fitting pair of sneakers.”
  4. Be a morning person. Studies show that people who exercise in the morning are more likely to stick with it. As Merrill explains, “Are you going to feel like exercising at the end of a hard day? Probably not. If you do your workout in the morning, you’re not only more likely to do it, but you’ll also set a positive tone for the day.”
  5. Ink the deal. Whether morning, afternoon, or evening, pick the time that is most convenient for you to exercise and write it down in your daily planner. Keep your exercise routine as you would keep any appointment.
  6. Watch your step. Investing in a good pedometer can help you stay motivated. “If you have a pedometer attached to your waist and you can see how many steps you’ve taken, you’ll see it doesn’t take long to walk 5,000 steps and you will be inspired,” Merrill says. And building up to 10,000 steps a day won’t seem like such a daunting a task.
  7. Hire the right help. While weight training is important, if you don’t know what you’re doing, you run the risk of injuring yourself or not being effective, Merrill says. It’s best to get instructions from a personal trainer at the gym. You also can buy a weight-training DVD and follow along in your living room.

If you can’t fit 30 minutes a day into your schedule, get more exercise simply by being less efficient with your chores and adding a little extra walking distance everywhere you go. However, if you pick an activity you like, finding time for fitness will become effortless and the rewards enormous.

How to Eat a Healthy Diet

 If you are what you eat, it follows that you want to stick to a healthy diet that’s well balanced. “You want to eat a variety of foods,” says Stephen Bickston, MD, AGAF, professor of internal medicine and director of the Inflammatory Bowel Disease Center at Virginia Commonwealth University Health Center in Richmond. “You don’t want to be overly restrictive of any one food group or eat too much of another.”

Healthy Diet: The Building Blocks

The best source of meal planning for most Americans is the U.S. Department of Agriculture (USDA) and U.S. Department of Health and Human Services Food Pyramid. The pyramid, updated in 2005, suggests that for a healthy diet each day you should eat:

  • 6 to 8 servings of grains. These include bread, cereal, rice, and pasta, and at least 3 servings should be from whole grains. A serving of bread is one slice while a serving of cereal is 1/2 (cooked) to 1 cup (ready-to-eat). A serving of rice or pasta is 1/2 cup cooked (1 ounce dry). Save fat-laden baked goods such as croissants, muffins, and donuts for an occasional treat.
  • 2 to 4 servings of fruits and 4 to 6 servings of vegetables. Most fruits and vegetables are naturally low in fat, making them a great addition to your healthy diet. Fruits and vegetables also provide the fiber, vitamins, and minerals you need for your body’s systems to function at peak performance. Fruits and vegetables also will add flavor to a healthy diet. It’s best to serve them fresh, steamed, or cut up in salads. Be sure to skip the calorie-laden toppings, butter, and mayonnaise, except on occasion. A serving of raw or cooked vegetables is equal to 1/2 cup (1 cup for leafy greens); a serving of a fruit is 1/2 cup or a fresh fruit the size of a tennis ball.
  • 2 to 3 servings of milk, yogurt, and cheese. Choose dairy products wisely. Go for fat-free or reduced-fat milk or cheeses. Substitute yogurt for sour cream in many recipes and no one will notice the difference. A serving of dairy is equal to 1 cup of milk or yogurt or 1.5 to 2 ounces of cheese.
  • 2 to 3 servings of meat, poultry, fish, dry beans, eggs, and nuts. For a healthy diet, the best ways to prepare beef, pork, veal, lamb, poultry, and fish is to bake or broil them. Look for the words “loin” or “round” in cuts of meats because they’re the leanest. Remove all visible fat or skin before cooking, and season with herbs, spices, and fat-free marinades. A serving of meat, fish, or poultry is 2 to 3 ounces. Some crossover foods such as dried beans, lentils, and peanut butter can provide protein without the animal fat and cholesterol you get from meats. A ¼ cup cooked beans or 1 tablespoon of peanut butter is equal to 1 ounce of lean meat.
  • Use fats, oils, and sweets sparingly. No diet should totally eliminate any one food group, even fats, oils, and sweets. It’s fine to include them in your diet as long as it’s on occasion and in moderation, Bickston says.

Healthy Diet: Eat Right and the Right Amount

How many calories you need in a day depends on your sex, age, body type, and how active you are. Generally, active children ages 2 to 8 need between 1,400 and 2,000 calories a day. Active teenage girls and women can consume about 2,200 calories a day without gaining weight. Teenage boys and men who are very active should consume about 3,000 calories a day to maintain their weight. If you’re not active, you calorie needs drop by 400 to 600 calories a day.

The best way to know how much to eat is to listen to your body, says Donald Novey, MD, an integrative medicine physician with the Advocate Medical Group in Park Ridge, Ill. “Pull away from the table when you’re comfortable but not yet full. Wait about 20 minutes,” he says. “Usually your body says, ‘That’s good.’ If you’re still hungry after that, you might want to eat a little more.”

Healthy Diet: Exercise Is Part of the Plan

At the bottom of the new USDA food pyramid is a space for exercise. Exercise is an important component of a well-balanced diet and good nutrition. You can reap “fabulous rewards,” says Dr Novey, just by exercising and eating “a healthy diet of foods that nature provides.”

The Health Benefits of Water

 Did you know that your body weight is approximately 60 percent water? Your body uses water in all its cells, organs, and tissues to help regulate its temperature and maintain other bodily functions. Because your body loses water through breathing, sweating, and digestion, it’s important to rehydrate by drinking fluids and eating foods that contain water. The amount of water you need depends on a variety of factors, including the climate you live in, how physically active you are, and whether you’re experiencing an illness or have any other health problems.

Water Protects Your Tissues, Spinal Cord, and Joints

Water does more than just quench your thirst and regulate your body’s temperature; it also keeps the tissues in your body moist. You know how it feels when your eyes, nose, or mouth gets dry? Keeping your body hydrated helps it retain optimum levels of moisture in these sensitive areas, as well as in the blood, bones, and the brain. In addition, water helps protect the spinal cord, and it acts as a lubricant and cushion for your joints.

Water Helps Your Body Remove Waste

Adequate water intake enables your body to excrete waste through perspiration, urination, and defecation. The kidneys and liver use it to help flush out waste, as do your intestines. Water can also keep you from getting constipated by softening your stools and helping move the food you’ve eaten through your intestinal tract. However, it should be noted that there is no evidence to prove that increasing your fluid intake will cure constipation.

Water Aids in Digestion

Digestion starts with saliva, the basis of which is water. Digestion relies on enzymes that are found in saliva to help break down food and liquid and to dissolve minerals and other nutrients. Proper digestion makes minerals and nutrients more accessible to the body. Water is also necessary to help you digest soluble fiber. With the help of water, this fiber dissolves easily and benefits your bowel health by making well-formed, soft stools that are easy to pass.

Water Prevents You From Becoming Dehydrated

Your body loses fluids when you engage in vigorous exercise, sweat in high heat, or come down with a fever or contract an illness that causes vomiting or diarrhea. If you’re losing fluids for any of these reasons, it’s important to increase your fluid intake so that you can restore your body’s natural hydration levels. Your doctor may also recommend that you drink more fluids to help treat other health conditions, like bladder infections and urinary tract stones. If you’re pregnant or nursing, you may want to consult with your physician about your fluid intake because your body will be using more fluids than usual, especially if you’re breastfeeding.

How Much Water Do You Need?

There’s no hard and fast rule, and many individuals meet their daily hydration needs by simply drinking water when they’re thirsty, according to a report on nutrient recommendations from the Institute of Medicine of the National Academies. In fact, most people who are in good physical health get enough fluids by drinking water and other beverages when they’re thirsty, and also by drinking a beverage with each of their meals, according to the Centers for Disease Control and Prevention. If you’re not sure about your hydration level, look at your urine. If it’s clear, you’re in good shape. If it’s dark, you’re probably dehydrated.