Doctors' orders

 You think it’s going to be such an ordeal, this business of getting healthier and living better. You’ll have to trade in your sedan for a bike, give up your favorite TV shows, eschew the brew entirely, and in general become a bore. T’ain’t so!

You can improve your health one meal, one walk, or one laugh at a time.

Eat fresh foods and eat less of them, get outside and pump up your heart rate several times a week, and go light on yourself. We talked to six local doctors and despite their diverse areas of specialty, their advice generally boiled down to these points.

Attitude counts for a lot.

Approach your well-being positively and not as if you’re serving a term. It’s all about saying “Yes.”

But, there is one big No, and we’re talking to you, smokers. Sorry, but if you smoke and you want to boost your helath, then you have to quit. Sad but true: Neither carrots nor belly laughs can undo the damage caused by cigarettes.

Healthy Women

Tips from Claudia Sencer, CNM, Woman Care

1. Love. Having an ongoing emotional connection to another being is sustaining, affirming and health promoting. This does not need to be with another human; an animal friend can fulfill this basic human need. When we feel connected to another, we are drawn into life and health.

2. Laugh. We have all heard the adage “Laughter is the best medicine.” Laughter opens the heart and creates connections between people. There is even a study showing that people who laughed more had less heart disease than the group that simply was not amused.

3. Exercise. Not new news, but so important in the prevention of heart disease, diabetes and cancer, as well as improving mood and mind. You don’t have to run a marathon. If you do no exercise, just walking 15 minutes three to four times a week can have a significant positive impact on your mental and physical health. 

4. Moderation. You are what you eat, drink and smoke. It’s not rocket science. High sugar and high fat foods in large amounts cause heart disease and diabetes. If you exercise and eat healthfully, you can occasionally eat these tasty but less healthy foods and do fine. But they cannot be your main diet. 

5. Minimize medications. Take a good look at your medications and decide, with your health practitioner, what you could do/change in your life that could enable you not to need your meds. Consider this when you are looking at starting a new medication as well. Changing your lifestyle in order to avoid medications is always an excellent life sustaining choice.

6. Supplements. Food is your best supplement. Sometimes we cannot get the food we need and supplements help. For some folks with certain health concerns, there is an important place for supplements. For most everyone, Vitamin D is necessary at 2000 IU/day. 

7. Compassion. Love yourself as you would have others love you. We are all so hard on ourselves. Self-criticism is very destructive and has no redeeming quality. Reflect on your mistakes and learn and grow from them, then let them go. At times we all struggle with life and believe that other people have it more together than we do. It’s not true! Counseling can be very helpful if you get stuck and keep beating yourself up.

8. Eat well. How? Google The Harvard Food Pyramid and learn about the Healthy Eating Pyramid. Men eating closest to this diet had a 40 percent reduction in heart disease and women had a 30 percent reduction. The USDA pyramid conferred only an 11 percent improvement for men and 3 percent for women. 

9. Dedication. Create a health plan and carry it through. When you mess up, try to figure out why, then modify your plan to help support your goals—and your weaknesses—and do it again. When you mess up, forgive yourself and repeat the process. When you mess up again, refocus, recommit and repeat the process. A support person can be helpful to remind you about your path and help you strategize and stay the course.

10. Faith. Know you can create health in your life. Have faith in your ability to transform and heal yourself. For some, faith in external being helps, and in others, faith in themselves is what works. This is a difficult but very rewarding path and there are many roads that can get you there. Meditation, visualization, prayer and Qi Gong to name a few. Often guidance from a group or a professional is helpful.

Healthy Kids

Tips from Karyn Wolfe, MD, Pediatric Associates of Charlottesville

1. Get and stay active. Children should be physically active every day. Choose physical activities that you can do as a family, such as hiking and biking. Limit screen time. Children should spend less than two hours per day watching television or playing video/computer games. The AAP recommends that children under 2, not watch television. Remove TVs from children’s rooms. Minimize exposure to violence by monitoring the programs they watch, the video games they play and the websites they visit.

2. Healthy eating. Children should be taught to enjoy healthy foods from a very early age. Provide plenty of fruits and vegetables. Limit juice and high-fat, low-nutrient foods. Ensure that children are getting the appropriate amount of milk every day. The servings and amounts of food that children should have vary according to age, so talk with your pediatrician about these amounts. Be a good example of healthy eating for your children.

3. Safety. Make sure your children stay safe. This includes wearing helmets every time a child is on a bicycle, scooter, skateboard or skates. As soon as your child is learning to pedal a tricycle, he should wear a helmet. There are new recommendations on carseats and booster seats. Children should remain rear-facing until 2 years old. They should remain in a five-point harness carseat until they reach the weight limit of that carseat and they should remain in a booster seat until they are 4’ 9” tall. Teach your children to swim. Most children love the water, so make sure they are safe in it. Consider starting swimming lessons as early as 3 years old. 

4. Doctor visits. Children should stay up-to-date with their physicals and immunizations. A well-child visit allows the physician to assess your child’s physical health, as well as his development. It provides the physician with an opportunity to review age-appropriate safety issues and the most up-to-date recommendations. Immunizations prevent life-threatening diseases. Children should receive these on time. If you have concerns about particular immunizations discuss these openly with your physician.

5. Sunscreen. Children should wear sunscreen every time they are going to be outside. This includes cool, cloudy days. Children should wear at least 15-30 SPF and this should be reapplied every one to two hours. It is the sun exposure that we endure as children that puts us at risk for skin cancer as adults, so protect them now.

6. Insect repellant. The bugs are here! Lyme disease in Virginia has increased dramatically over the last two years. Children should wear insect repellent when playing outside. Use products with DEET concentrations 15 to 30 percent. Do not use products that are insect repellent/sunscreen combinations, as the sunscreen should be applied much more frequently than the insect repellant.

7. Read! Keep your child’s brains healthy too! Children should read or be read to at least 20 minutes daily. Start reading to your children early. Reading to children as early as 4 months of age has been shown to have positive effects on children’s language development.

8. Don’t forget your teeth! Children should brush their teeth at least twice daily, and after meals. They should floss daily. Visit your dentist every six months. 

9. Wash your hands. Children should be taught to wash their hands before they eat and after they use the restroom. They should also wash their hands upon coming home from school or outside play. Washing hands prevents illness.

10. Honesty and family time. Have open discussions with your children as they grow. Discuss high-risk behaviors at appropriate ages. Be open about the dangers of tobacco, alcohol and drugs. Don’t be afraid to talk about sex, STDs and pregnancy. Talk with them about their friends. Be aware of their social groups. Discuss bullying. Enjoy family activities with your children frequently. Model good behaviors, show them respect and affection every day!

Healthy Bones

Tips from Eric W. Carson, MD, UVA Department of Orthopaedic Surgery/Division of Sports Medicine

1.  Treat your muscles right. Keep in mind the importance of stretching and flexibility.

2.  Proceed step-by-step. Gradually ramp up your work out.

3. Get support. Novices at working out should consider supervision and guidance from a personal trainer (particularly with weight training).

4.  The work out’s not over until it’s over. Don’t neglect a warm up and cooling down post-work out.

5.  Work smart. The quality of your work out is more important than the quantity.

6.  Know your condition. Consider obtaining a good bill of health from your physician prior to starting workouts.

7.  Gear up. Wear proper fitting running shoes and equipment.

8.  Consider your surfaces. Avoid running too much on the pavement and streets or treadmill.

9.  Drink, drink, and drink some more. As you start working out, your requirements for hydration and water and caloric intake increase significantly.

10.  Don’t look for instant results. Set realistic goals with weight reduction and your work out schedule.

11.  Work out in your diet, too. Improve eating habits with fruits, vegetables and other nutrient-rich foods. Decrease your intake of alcohol and caffeine and eliminate tobacco and fast foods.

Healthy Elders

Tips from Mark Williams, MD, Professor of Geriatrics at UVA

1. Know the reality. There’re a lot of myths and misinformation out there for old people, but the point is, there’s reason to be optimistic rather than pessimistic.

2. Challenge your body. Regular exercise is critical.

3. Stimulate your intellect.

4. Manage your emotions. Get negative emotions out so they don’t eat away at you. Also, foster warm and effective relationships.

5. Nurture your spirit.

Healthy Hearts

Tips from Dr. Kwame Akosah, Professor of Internal Medicine, Cardiovascular Division, at UVA

1. Know your cardiovascular risk factors and control them. Fortunately, most of the cardiovascular risk factors are modifiable. You can’t change your gender, you can’t change your age, but the rest we can modify and they tend to be very important. 

2. Exercise. A simple way to exercise that is inexpensive is to just walk. Walking to stay healthy is very important. 

3. If you don’t smoke, don’t start. If you do, quit. 

4. Eat healthy. You want to have a good, healthy diet. An easy and inexpensive way to get there is to go to the American Heart Association website where there are a lot of suggestions for healthy eating. 

5. Know your cholesterol and control it. See your doctor to find out if you’re a candidate for medication to reduce it. Cholesterol can be managed by diet and exercise, although for moderate and high cholesterol elevations, people often need medications. But of course, we don’t think you should be taking medication without controlling your diet and exercise. They go hand-in-hand. 

6. Control your blood pressure. Your doctor may give you medication to control it. 

7. Take your medications as prescribed by your doctor. The medications that we prescribe when it comes to your heart are very important. For example, aspirin is prescribed for people who already had a heart attack; we do know that it will likely prolong their lives. 

8. Control your weight. Weight is very important. Obesity is a cause for Type 2 diabetes. People should know their risk for diabetes and manage it. Diabetes is very significant when it comes to heart disease and its complications. Many people who are prone to having diabetes may actually develop heart disease before we know that they have diabetes. 

As a nation, our population is getting larger. We do know that people with diabetes are at a high rate of developing heart disease and a higher rate of complications when they do develop heart disease. Knowing the risk is very important. 

9. Reduce and manage stress. Obviously we can’t take people out of their environment, but managing your stress is important. 

Healthy Mind

Tips from Susan C. Stone, Ph.D., Co-leader, Insight Meditation Community of Charlottesville 

1. Cultivate a healthy mind as well as a healthy body. Your mind and body are connected and both require your kind and thoughtful attention.

2. Wake up and notice when your actions are driven by habitual, unexamined judgments. Become mindful of how judgment creates unnecessary stress and prevents you from experiencing the moment fully.

3. Mindfulness means being present-minded, not absent minded. It means bringing your body and mind together in the same place at the same time rather than allowing your mind to run amok among regrets about the past or worries about the future while you distractedly go through the motions of daily life. 

4. Formally practice mindfulness for at least 20 minutes a day, watching your breath closely, experiencing how it changes moment by moment, and gently and repeatedly dropping thoughts when they arise. As a result of regular periods of formal practice, mindfulness will begin to enrich all areas of your life. 

5. Listen to your body; it is your teacher. Your mind can concoct all sorts of reasons, many of them contradictory, about why you should or should not take a particular action, but your body, when deeply heard, tells the truth.

6. Live from the inside out. Practice kindness toward yourself first; then it will flow naturally to others. This is commonsense, not selfishness. The habit of belittling and criticizing yourself while trying to love others clogs the gears of love. 

7. Forgive yourself; forgive others. Forgiveness doesn’t mean condoning your own or another person’s harmful actions. It means bringing a large-hearted understanding to the being who committed them, recognizing that we all want happiness but sometimes get confused about how to attain it. As long as you carry anger and unforgiveness in your heart, you cannot be happy and your health will likely suffer.

8. Balance and simplify. Too much of a good thing is not a good thing. Try to bring a wholesome balance to all aspects of your life.

9. Do your best and don’t expect perfection. It’s not in the cards for humans to be perfect. We are precious beings who try hard, fail sometimes, and can learn to hold it all with kindness.

10. Relax, laugh often, and enjoy your life now. Even the most difficult circumstances contain joyful aspects, if only you pay attention.