What concrete steps do you wish people took for their own health?
December 22, 2021 3:56 AM   Subscribe

You: a medical or fitness professional of some sort, whether a practitioner or researcher. Me: an author writing a book of practical tips. What specific things do you wish more people did to maintain or improve their own health and fitness?

FYI, I'm defining health and fitness in the broadest sense. If there's a thing you wish people did to maintain their toes or their scalp or anything in between, I'd love to know.

I would especially love concrete, actionable, and evidence-based suggestions -- for example, "Get 30 minutes of moderate exercise five times a week", instead of a more general "Stay in good shape." But if you are a professional and there's something you wish people knew about their own health and fitness, I'd rather you err on the side of sharing it, even if it is general.

Finally, just to be clear: nobody in this thread is my doctor, physical therapist, or coach. I will take any responses as ideas of general interest, rather than medical advice.
posted by yankeefog to Health & Fitness (14 answers total) 36 users marked this as a favorite
I work for a healthcare company and all I can say is break down the steps and don't sweat the small stuff. Most change is hard because it's seen as monumental. Starting with ten minutes of moderate exercise because that's all you can physically do is better than trying to do 30 minutes and feeling bad you only achieved 10 minutes. The impact of reflecting on your achievements is huge because it sets the stage for stable growth rather than frenzied action.
posted by parmanparman at 4:04 AM on December 22, 2021 [4 favorites]

Get your vaccines.
More specifically: Check your blood pressure a few times a year, because high blood pressure is both a symptom and cause of lots of things and doesn't usually have signs you can feel.
Have some professional look at the back of your eyes, because that's another area you won't perceive the damage in until it's too late to reverse well.
posted by cobaltnine at 4:52 AM on December 22, 2021 [3 favorites]

A few different thoughts:
  • If the effects of exercise were in a pill, it would be the biggest and most effective blockbuster drug ever seen. So get started small, build gradually, and make simple exercise a part of your life. (potential impact of 10 years of life)
  • Everybody says it, but I'll say it again anyway: don't smoke. If you can, however, you can - quit smoking. Use a patch or vape in order to transition away from tobacco smoke. However you accomplish it, stop smoking. (potential impact of 10 years of life)
  • Keep an eye on inflammation and visceral fat levels in your body ("central obesity"). You can gauge this through your basic lipids test by looking at the triglyceride:HDL ratio. Ideally this value should be lower than 2 (in US units). Talk to your doctor. (potential impact of 2 years of life and massive increase in quality of life)
  • Keep a close eye on blood insulin and blood sugar. Type 2 diabetes (T2D) and/or prediabetes forms a foundation for a whole host of progressive diseases and symptoms - heart disease, kidney disease, high blood pressure, and many others. A high fasting insulin (hyperinsulinemia) provides an early warning sign of disordered glucose metabolism and an elevated risk of future T2D. By the time that T2D or prediabetes is formally diagnosed via elevated blood sugars (e.g. via HbA1c test), it has probably been building for years or decades. The early warning sign of fasting hyperinsulinemia is often missed because it's an uncommon lab measurement.
  • Most diets work, sort of. The common ground between most "healthy diets" is that they cause a person to look closely at what they are eating and cut back hard on the very worst and most habit-forming foods (i.e. highly processed, packaged, non-nutritious, and energy dense - seed oils, refined grains, added sugars). The further you move away from the standard American diet (SAD) the better, whether that is as a vegan, a carnivore, a Mediterranean dieter, a Paleo dieter, or whatever you want. Shifting your diet to prioritize protein, vitamins/minerals, and fiber, and deprioritizing carbs and fat, will generally lead to body fat loss and generally help with the above bullet points about chronic disease (inflammation, and insulin/blood sugar).

posted by theorique at 5:41 AM on December 22, 2021 [20 favorites]

Limit health information to really reliable sources. Mayo Clinic, Harvard Health Newsletter, BBC, WebMD, choose whichever one you like, but not that guy on the Internet selling supplements. The Internet is awash in a few facts and a lot of fads and snakeoil, some if it just dumb, some quite harmful.

Eat way less junk food, chips, sweets, poptarts, sugared cereal, Doritos. Reduce sugar intake. Refined carbohydrate foods (white bread, pasta, white rice) are exercise fuel; eat less of it. Eat a lot more more vegetables and some fruit. When you plan what to eat, plan the vegetable 1st. Lots of green beans, maybe a little sauce, some spaetzle(yummy pasta), maybe some meat. Make then frozen beef & broccoli; add a bunch of extra broccoli that you keep in the freezer. Eat a lot more fiber; it really helps your body process carbs and sugar, has many health benefits. Make the chili with beans.

Build exercise in to your day, even walking from the farther end of the parking lot helps. Make exercise fun if you can, but exercise is critical to good health. Dance, walk, whatever.

Get enough sleep.

Build an active social life.

Alcohol is full of empty calories, is a mild carcinogen. If you choose to use it, be aware of the risk and moderate your use.

Get your vaccinations.
posted by theora55 at 7:13 AM on December 22, 2021 [5 favorites]

Take charge of your own healthcare. Keep track of the names of your clinicians, your medications, your allergies, surgery dates, etc. I often advise patients to keep a list in their wallet.

Take notes while at healthcare visits. I dislike it when people say, 'Can you write that down for me, because I'll never remember?' I provide educational resources, visit summaries, etc, but I also think it's important for patients to write things down in their own hand.

If you have trouble understanding or remembering things, bring a trusted friend or family member to your visits as a second pair of ears, or ask your clinician if you can have them on speakerphone during visits.

Ask questions if you don't understand something.
posted by aquamvidam at 7:15 AM on December 22, 2021 [1 favorite]

PCP here. If you're not willing to take a medication that your doctor is trying to prescribe, for any reason, firmly tell them, "I won't take that. What else can we do?" I so frequently have patients just say yes, knowing they're not going to do something, because they think there's no other option or they don't want to have a conversation.

Likewise, if you decide to stop a medication, for any reason, even if you don't have an appointment coming up, call or send a message to your doctor and let them know that you have and why. If it was due to a side effect they can almost always recommend something else. Often people self-discontinue medications due to misunderstandings (e.g. "I stopped my blood pressure medication because my blood pressure was low." "What was it?" "120/80, that's too low.")
posted by telegraph at 7:44 AM on December 22, 2021 [12 favorites]

Advocate for yourself with your doctor. If your doctor dismisses your concerns, see a different doctor. If your medical doctor prescribes something (medication or action) that is bad for your mental health, tell them, and ask for another option.
posted by tangosnail at 9:35 AM on December 22, 2021 [3 favorites]

See your PCP at least once a year, whether you feel like you need it or not. So many major health problems, if caught early, can be completely reversed or mitigated. And it maintains a baseline for your doctor to refer back to if she notices any changes.

If you have diabetes, please please please get your eyes checked every year - a retinal eye exam. Also your HbA1c and kidney monitoring tests. But it's the eye exam most diabetics skip, because it's a hassle - you have to do it at a separate appointment, it's not something your PCP can do for you. Diabetes can really screw with your vision if it's uncontrolled, so this is something your really shouldn't skip.

Also for diabetics: Wear socks, wear shoes, ALL THE TIME. Keep an eye on your feet. If you get a scratch or a cut that doesn't seem to be healing, see your doctor immediately to get it checked out and treated. Small wounds on your feet can be masked by peripheral neuropathy, and if they get infected you can lose toes or even the whole foot. I know this professionally but I've also seen it happen to my brother, who hated wearing shoes in the house and lost three toes and part of his foot as a result.

Anyone taking ongoing medications: If you find you have pills left over at the end of your prescription period, you're probably not taking it as prescribed whether you realize it or not. Refill your prescription, and consider adjusting your medication habits to make it impossible to forget to take your meds. There are so many tricks for this - put them on the counter next to your toothbrush, store them right in front of your coffee maker, keep them next to the TV remote, put a sticky note on your mirror, whatever works for you! But do keep up with them, because your health may seriously suffer without the medications your doctor thinks you need to stay healthy.
posted by invincible summer at 9:41 AM on December 22, 2021 [2 favorites]

Emphasize the need for quality sleep, and demystify CPAP and other machines used for Sleep Apnea.

As for Sleep Apnea, I'd increase screenings for this; when I was diagnosed and got my CPAP, it was basically life changing.

On a different topic, I'd also talk about exercises that one can do in a cramped apartment. I'm quarantining because of the Omicron variant, and I don't even feel safe using the Workout Room in my apartment building. Having a set of easy exercises that one can do would be great.
posted by spinifex23 at 12:04 PM on December 22, 2021 [3 favorites]

Regarding spinifex's point, when suggesting apartment exercises, also make sure they aren't too disturbing for neighbors (downstairs or next door) -- so no jumping jacks, for example.
posted by librarina at 12:26 PM on December 22, 2021 [1 favorite]

Also, wash your hands frequently and thoroughly; and even after the Pandemic ends (crosses fingers), wearing a mask and not going out a lot in peak flu and cold season helped a ton of people stay healthier.
posted by theora55 at 1:16 PM on December 22, 2021 [2 favorites]

A biggie that's missing and often disregarded because it is difficult for some people (including me) - social support. For good health you need a solid network of friends that understand and hear you. Folks you can be happy spending time with.

The challenge is to learn the habits and aptitudes that will get your social network (not online, please) in place and maintain it. Some tips:

Get rid of this label "introvert". Most people aren't true introverts, they are ambiverts. Introversion is often an excuse that shyer people use to avoid the angst of forming connections. But those connections are the treasure we need and are looking for.

Use your interests and hobbies to meet other people. Join a group where you practice social and speaking skills in a non-threatening environment (for instance, Toastmasters, improv and acting classes).

Realize that many people you meet will not fit into your network, accept and move on. A network takes years to build and the building never stops. You'll know the right ones the first time you share a laugh together, and the laughs keep coming.

Lastly and perhaps most important. Become a helpful person. The NYT in a recent article called this a neglected cure for loneliness. It's true - thinking about others breaks the loop of self-absorption and negativity. Look at all the people who need help. Make the world a better place and you too become better? What a deal.
posted by storybored at 8:00 AM on December 24, 2021 [4 favorites]

Don’t drink sugar. No sweet tea, no soft drinks, no coffee with sugar, regular Red Bull, apple juice, etc.

As an internist, this is the easiest and most effective step towards treating (or preventing) diabetes and weight gain that I’ve seen. Patients can make the change much more easily than other dietary changes, it’s widely accepted as a good practice regardless of your dietary beliefs, and patients see quick results. Not a panacea by any means, but… A+++
posted by phaedrus441 at 3:04 PM on December 24, 2021 [1 favorite]

Response by poster: Thank you everybody! Those are extremely useful tips -- for the book and, as a bonus, for my own health. I appreciate it!
posted by yankeefog at 1:40 AM on December 26, 2021

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