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Vow to take care of yourself, for life

So you made your new year's resolutions, those self-imposed, holiday binge-inspired rules that usually dissipate by the end of January.

One of the major problems I experience in my medical practice is getting people to observe a few basic healthy habits, like maintaining a prudent diet, quitting smoking (and staying with it), exercising regularly, and monitoring blood pressure and blood sugar. So I was happy when Karl, who had had a heart attack the prior year, resolved to quit smoking on

Jan. 1.

"Why do you have to wait for Jan. 1? Why not quit now?" I asked.

"Well, you have to get ready to build up your willpower, pick a good day and psych yourself up to do it," he said with some gusto.

Maybe that is the prevailing sentiment everywhere _ that we can do these things only as part of a well-organized, rigid protocol, after long deliberation and calculation, and then pick an auspicious moment. There is nothing wrong with that as long as you make the right resolutions and stick with them. The latter is the more difficult part. According to one source, at least 70 percent of new year's resolutions are broken before the month is over.

Still, I encourage all my patients to take a few "healthy steps" every year.

As evidence accumulates that Americans are succumbing to many preventable and progressive diseases, it has become imperative to focus on achieving favorable levels of all risk factors simultaneously.

Following are my top 10 suggestions for the new year:

1. Quit smoking _ now. Smoking is deadly. It is the leading cause of preventable death in this country and a major risk factor for heart disease, strokes and many types of cancers. Even one cigarette a day can reduce your lifespan. Nicotine patches, gums and special medications can reduce the craving.

2. Check your blood pressure. Even slightly elevated blood pressure increases the risk of cardiovascular disease. beginning with a systolic/diastolic blood pressure of 115/75. Normal is 120/80, prehypertension is 120-139/80-89, and hypertension is 140/90 and above. The relation between blood pressure and the risk of cardiovascular disease is graded and continuous; even prehypertensives are at significant risk.

3. Check your blood sugar. Ideally, check fasting blood sugar, blood sugar after meals and hemoglobin A1c (HbA1c is a marker of diabetes). Latest studies show that elevated blood glucose level is a risk marker for cardiovascular disease, even in apparently healthy individuals who do not have diabetes.

4. Check your cholesterol level. It is common knowledge that high cholesterol, especially the combination of high LDL (bad cholesterol), low HDL (good cholesterol), and high triglycerides, is correlated with high prevalence of heart disease and strokes.

5. Eat healthier. With supersized meals, excessive alcohol intake and an increasingly sedentary lifestyle, Americans are constantly waging the battle of the bulge. Obesity now affects almost two-thirds of Americans and is rapidly rising among children. There are a zillion diets for sale but no quick fixes. A diet restricted in saturated fats and carbohydrates and high in proteins seems to be optimal. Appetite suppressants are variably effective, and some have fatal cardiac and other side effects. Stay away from them.

6. Get enough sleep. Sleep-deprived people have a greater chance of motor vehicle accidents, obesity, migraines, infections, and overuse of stimulants, among other things. Individual sleep requirements vary and are genetically predetermined; that is, you cannot "get used to less sleep." Eight hours is usually enough. Definitely not less than six hours.

7. For women, get a mammogram and Pap smear annually. Breast cancer affects one in eight U.S. women. Mammograms should be done annually in women older than 40. Cervical cancer is another underdiagnosed life-threatening condition. Women older than 18 (or earlier if sexually active) should have annual Pap smears.

8. Exercise regularly. Just 20 minutes a day, five days a week can go a long way to help your body. Ideally, the exercise should be something you enjoy as an activity, not just as a health benefit, so that it motivates you to stick with it. It helps to have an exercise buddy to keep you on track, especially on those lazy Sundays in February.

9. Spend a few minutes daily on meditation and prayer. This helps you to see your image and life in a positive light, bolster your personal energy and connect you with the divine presence in your life. Many studies have shown that prayers help healing.

10. Avoid stress. It may sound like a tall order in the current world, but you must try.

Taking care of your health involves lifelong self-education. Although the Internet has some great patient-friendly health information, not all sources are accurate. Discuss the aforementioned points with your family doctor or an internist. If you don't have one, make it your No. 1 resolution (and don't wait until January) to find one you trust.

The adage "If it ain't broke, don't fix it" is not true for your body. It's more like, "It is not what you know that kills you, but what you don't know."

With these 10 points in your arsenal, with hope you will be on your way to many healthy new years to come.

M.P. Ravindra Nathan is a Brooksville cardiologist.

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