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Posted: Thursday, December 15, 2005

ARTICLES
Publication Date: December 15, 2005

1. Focus your efforts on things that matter; inform yourself about possible risks.

The American Council on Science and Health (http://www.acsh.org) is dedicated to helping you set rational priorities for a healthy and long life. While it is tempting to focus our anxiety on mysterious threats that lie largely beyond our own control, such as a possible terrorist attack (see ACSH's terrorism preparedness report at http://www.acsh.org/publications/pubID.228/pub_detail.asp ), the truth is that when it comes to achieving long life and good health, we largely determine our own fate, through routine, everyday decisions.

One new health threat on the horizon that we would do well to avoid panicking about is avian flu, or "bird flu." Although the strain of influenza that has passed from birds to humans (mostly in Southeast Asia) seems quite virulent, thus far it has not demonstrated the ability to pass from one person to another?which would have to happen in order for a true pandemic to occur. Currently, individuals should be alert to news about this possible pandemic but should understand that the risk is still theoretical.

As we get ready to start a new year, instead of brooding over worst-case scenarios, a more effective plan would be to improve important health-related aspects of our lifestyles?by quitting smoking (or, better, not starting in the first place), engaging in regular exercise, and taking advantage of technology that protects us against health and safety hazards, such as bicycle helmets and appropriate immunizations. To make the best health choices, resolve to sift carefully through the health advice that surrounds us, and focus your efforts on the things that really matter.

2. Don't smoke.

If you don't smoke, don't start. If you do smoke, resolve to quit this year. Half of all adults who once smoked cigarettes have kicked the habit. You can, too. For more information on quitting, see ACSH's booklet Kicking Butts in the Twenty-First Century at http://www.acsh.org/publications/pubID.220/pub_detail.asp .

Unfortunately, while many adults are trying to kick the habit, many teens are getting hooked. Over 20 percent of high school student are current smokers, and will be prone to all the negative health consequences of the habit.(1) ACSH's teen-friendly site on the facts about smoking can be accessed at: http://thescooponsmoking.org/ .

This is our major New Year's resolution because cigarette smoking is the number one cause of preventable deaths in this country. Between 1997 and 2001, smoking was responsible for 438,000 deaths in the U.S. each year and more than $50 billion in medical expenditures. One in every five deaths in the United States is smoking-related, and half of all lifelong smokers die of a smoking-related disease.(2)

So don't let another year go up in smoke. Start the New Year smoke-free.

3. Achieve and maintain a healthy weight. Eat a balanced diet and handle foods safely.

Over half of Americans are overweight, and about a third are obese (meaning that they have a Body Mass Index of 30 or more).(3) The proportion of the population that is overweight has been increasing rapidly in the U.S. for the past 20 years in both the adult and the pediatric population.(4) Excess weight is associated with increased risks of heart disease, diabetes, high blood pressure, stroke, arthritis, gallbladder disease, and some types of cancer.(5) Obesity is hard to treat once established: prevention is a better route to take. To help reduce excess weight and to maintain a healthy weight, experts recommend that Americans eat a balanced diet, moderate total calorie intake and portion sizes, and exercise regularly.(6)

The keys to good nutrition are variety, moderation, and balance. There are no "good" or "bad" foods?but there certainly are "good" and "bad" diets.

In addition, many people worry too much about hypothetical hazards from traces of pesticides or other chemical residues in food while paying too little attention to more important food-related risks. For an informative look at the "carcinogenic" chemicals naturally present in food, see ACSH's Holiday Dinner Menu at: http://www.acsh.org/publications/pubID.103/pub_detail.asp .

One of the most important food-related risks is contamination by microorganisms (bacteria, viruses, and some parasites). Diseases caused by microorganisms in food cause an estimated 5,000 deaths, 325,000 serious illnesses, and 76 million cases of gastrointestinal illness in the U.S. each year.(7)

Be aware that foodborne illness can be contracted from any type of food: fruits and vegetables, as well as meat and poultry products can carry disease-causing microbes. keep foods safe, follow the four principles of the President's National Food Safety Initiative: 1) Clean: Wash hands and surfaces often. 2) Separate: Don't cross-contaminate. 3) Cook: Cook to proper temperatures. 4) Chill: Refrigerate promptly.(8)

For more information, read ACSH's booklet on food safety, Eating Safely: Avoiding Foodborne Illness at: http://www.acsh.org/publications/pubID.317/pub_detail.asp .

4. Exercise regularly?with caution.

Regular exercise will help you control your weight, improve your overall health, and reduce your risk of medical problems such as heart disease and osteoporosis. To get the most benefit, exercise for at least 30-45 minutes three to five times a week.(9)

When you exercise, make sure to take all the safety precautions that are recommended for the activities that you choose. It's especially important always to wear a helmet while cycling or skating. Wearing a bicycle helmet can reduce your risk of head injury by up to 85%.(10) Other safety equipment, such as kneepads and wrist guards, can also reduce your risk of injury.

Although exercise is beneficial for almost everyone, some people need to consult a doctor to find out what level and types of physical activities are safe for them. This precaution is especially important for heart disease patients, people who have a medical condition that might be aggravated by exercise, and people who are taking any type of medication (especially medicines for high blood pressure or heart disease).(11)

5. Separate drinking and driving.

Never drink and drive. Equally important, never ride as a passenger in a car driven by someone who has been drinking alcohol.

Forty percent of all traffic fatalities in the U.S. are alcohol-related.(12) One American is injured in an alcohol-related driving incident every two minutes.(13) Rates of fatal crashes have begun to rise after a decade of decline in alcohol-related crashes. Since 1999, they have increased slightly by 4% to 10% for all age groups except for ages 16 to 17 years,(14) so there's plenty of room for improvement. There are more than 120 million episodes of impaired driving in the U.S. every year.(15) Every one of these episodes puts people's lives at risk.

So if you plan to drink, make safe transportation arrangements. If no designated driver is available, use mass transit or call a taxi.

6. If you drink alcoholic beverages, keep your intake moderate.

Moderate drinking is OK for most adults (those without a family history of problematic drinking, for example). If you're middle-aged or older, it may even benefit your health by reducing your risk of heart disease. What's moderate? For men age 65 and under, the limit is two drinks per day; for men over 65 and women of all ages, it's one drink per day.(16)

Heavy drinking (that is, drinking that goes beyond the limits of moderation) is not healthful. The heavy drinking of alcohol is associated with increased risks of injury, liver disease, heart disease, high blood pressure, and several types of cancer. It's responsible for more than 100,000 deaths in the U.S. each year.(16)

For more information on the health effects of moderate drinking, see ACSH's booklet Moderate Alcohol Consumption and Health at: http://www.acsh.org/publications/pubID.391/pub_detail.asp .

7. Take your body to the shop for preventive maintenance.

Your car comes equipped with a maintenance schedule. So does your body. Health authorities recommend that all adults and children should have certain types of preventive care?such as screening tests and immunizations?on a regular schedule. The timing of these services depends on your body's "model" and "mileage" (that is, your gender, family history, and age).

Unfortunately, many Americans have fallen way behind on their maintenance schedules. For example, yearly mammograms and breast exams are recommended for women over the age of 40 (if not younger), but over 24% of women in this age group reported not having had these exams for the previous two years.(17) Everyone over the age of 65 should receive a single immunization against pneumococcal pneumonia and an annual flu shot?but more than a third of all Americans in this age group didn't get a flu shot last year, and more than 40% have never received the pneumococcal vaccine.(18) Influenza and pneumonia together killed over 60,000 Americans in 2002 (the 7th leading cause of death that year); appropriate vaccinations could substantially reduce this unnecessary death toll.(19)

If you haven't been taking routine care of your body (or your child's body), resolve to make an appointment with your doctor this year to find out what preventive services are recommended. And then follow up by getting the necessary tests and immunizations.

For more information on children's immunizations see ACSH's booklet Vaccinations: What Parents Need to Know at: http://www.acsh.org/publications/pubID.411/pub_detail.asp .

8. Protect yourself against AIDS and other sexually transmitted diseases.

The best ways to protect yourself against AIDS are to:

* Never use a non-sterile needle to inject anything into your body.
* Either abstain from sex or have sex only with an uninfected partner in a mutually monogamous relationship.

If you choose to have multiple sex partners (or your partner does), you can reduce your risk of AIDS and other sexually transmitted diseases in the following ways:

* Urge all prospective sexual partners to be tested for sexually transmitted infections.
* Use condoms properly and consistently.
* Avoid sexual intercourse with people who engage in high-risk behaviors such as unprotected sex or intravenous drug use.

9. Check "alternative" practices with your doctor.

More than 40% of Americans use some kind of "alternative" therapy,(20) such as herbal medicine, massage, chiropractic, or aromatherapy. Some people think that all alternative practices are harmless, but this isn't necessarily true?especially for people with special medical concerns. For example, people with Parkinson's disease should never take the herb kava-kava because it can worsen their disease symptoms.(21) People with osteoporosis should not receive chiropractic therapy because the manipulation could cause a fracture.(22) For more information on possible drug-supplement interactions, see ACSH's brochure What's the Story? Drug-Supplement Interaction at: http://www.acsh.org/publications/pubID.515/pub_detail.asp .

Even if an alternative therapy isn't dangerous in itself, it can hurt you if you use it as a substitute for proper medical care. Most alternatives have not been proven effective, and many don't work at all. If your problem turns out to be serious, you could endanger your health?or even your life?by experimenting with unproven therapies instead of seeing a physician promptly.

If you use alternative therapies, you should let your medical doctor know. However, more than 60% of Americans who use alternative methods don't do this.(23) To find out whether any alternative practices you would like to try are safe for you, resolve that you will always check out these methods with your doctor before you start.

10. Use automobile safety devices every time.

A recent survey showed that 82% of all Americans now buckle up?at this rate, seat belts prevent 15,700 deaths, 350,000 serious injuries, and $67 billion in economic costs associated with traffic injuries and deaths every year.(24) This year, resolve that everyone in your car will be buckled into the proper restraint every time. That means seat belts for adults, booster seats (in the rear seat) for older children, and properly installed safety seats (in the rear seat) for small children and infants.

11. Protect your dental health.

You can help keep your teeth healthy by brushing and flossing, getting regular dental care, using fluoride as recommended by your doctor or dentist, eating balanced meals, and limiting snacks. While most people know this, here's something you may not know: more than two million teeth are knocked out every year, many of them from sports-related injuries.(25) Many of these injuries could have been avoided if the person was wearing a mouth protector. So if you play sports that involve a risk of mouth injury, resolve to wear a mouth guard every time.

12. Install and maintain a working smoke detector.

Smoke detectors save lives. They're your best protection against death or injury in a nighttime fire in your home. But they won't protect you if they're not working. The American Red Cross recommends that you test your smoke detectors once a month, replace the batteries at least once a year, and replace the detectors themselves every ten years. You can also protect your family from fire by planning at least two escape routes from every room in your home and making sure that all family members know how to use them.(26)

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1. Centers for Disease Control and Prevention. Cigarette use among high school students ?United States, 1991-2003. MMWR. 2004: 53(23);499-502. Available at http://www.cdc.gov/mmwr/PDF/wk/mm5323.pdf .

 2. Centers for Disease Control and Prevention. Annual Smoking-Attributable Mortality, Years of Life Lost, and Productivity Losses?United States, 1997-2001.MMWR 2005:54(25):625-628.  Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5425a1.htm .

3. Hedley A, Ogden CL, Johnson CL, Carroll MD, Curtin LR, Flegal KM.  Prevalence of Overweight and Obesity Among U.S. Children, Adolescents, and Adults, 1999-2002.  JAMA 2004; 291: 2847-2850.

4. Ibid.

5. Must A, Spadano J, Coakley EH, Field AE, Colditz G, Dietz WH, The disease burden associated with overweight and obesity. JAMA 1999;282:1523-1529.

6. From a Surgeon General page entitled ?Choose a Healthy Weight for Life.?  Available at www.surgeongeneral.gov/topics/obesity/calltoaction/fact_advice.htm .

7. From a CDC press release dated Sept. 16, 1999 and titled ?CDC data provides the most complete estimate on foodborne disease in the United States.?  Available at www.cdc.gov/od/oc/media/pressrel/r990917.htm .

8. These principles are listed in many government documents. They came from an FSIS "food safety feature" dated July 1999 and titled "Cleanliness Helps Prevent Foodborne Illness." It's available at http://www.fsis.usda.gov/OA/pubs/cleanliness.htm .

9. The American College of Sports Medicine, available at www.acsm.org/pdf/Guidelines.pdf .

10. According to a Consumer Product Safety Commission press release dated April 21, 1999 and available at www.cpsc.gov/cpscpub/prerel/prhtml99/99099.html .

11. From the American Heart Association?s recommendations on physical activity, available at http://216.185.112.5/presenter.jhtml?identifier=4563 .

12. From the National Center for Injury Prevention and Control's "Quick Facts About Impaired Driving." http://www.cdc.gov/ncipc/duip/spotlite/3d.htm

13. Ibid.

14. Ibid.

15. Ibid.

16. References for this statement can be found in ACSH's report on moderate drinking.
http://www.acsh.org/publications/pubID.391/pub_detail.asp

17. From the National Center for Chronic Disease Prevention and Health Promotion?s Behavioral Risk Factor Surveillance System Prevalence Data, 2002. http://apps.nccd.cdc.gov/brfss/Trends/trendchart.asp?qkey=10060&state=US

18. This statistic comes from a Behavioral Risk Factor Surveillance System survey in 2002, which asked, "During the past 12 months, have you had a flu shot?" In the age group 65+, 35.1% said no. When asked if they?d received the pneumococcal pneumonia vaccine, 37.0% of people 65 or older said no. http://apps.nccd.cdc.gov/brfss/Trends/TrendData.asp

19. National Vital Statistics Reports, Vol. 53, No. 17, March 7, 2005. Available at tp://www.cdc.gov/nchs/data/dvs/nvsr53_17tableE2002.pdf .

20. Eisenberg DM et al, Trends in alternative medicine use in the United States, 1990-1997. JAMA 1998;280:1569-1575.

21. References for this statement can be found in our draft report on supplements and the elderly.

22. From a National Safety Council fact sheet called "Is Alternative Medicine Going Mainstream?" http://www.nsc.org/pubs/fsh/archive/spr99/altmed.htm

23. From the article by Eisenberg cited above.

24. National Highway Traffic Safety Administration  September, 2005. http://www.nhtsa.dot.gov/portal/site/nhtsa/template.MAXIMIZE/menuite
http://www-nrd.nhtsa.dot.gov/pdf/nrd-30/NCSA/RNotes/2005/809932.pdf

25. From an American Dental Association press release entitled "Mouth Protectors: Don't Play Without One." http://www.ada.org/public/topics/mouthguards.asp

26. From the American Red Cross fact sheet "Are You Ready for a Residential Fire?" http://www.redcross.org/services/disaster/0,1082,0_584_,00.html .

Resolutions updated by Ruth Kava, Ph.D., R.D.



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