Getting healthy, staying healthy
Please don't smoke. Stopping smoking, and being a non-smoker, reduce your risks of developing cancer, heart disease, and lung disease. For smokers, the 'number one best thing' they can do for their health is to stop smoking.
GPs can help smokers with quitting by one or more of the following: Providing advice, discussing motivation, discussing behavioural strategies for quitting, referral, prescribing nicotine replacement therapy, and prescribing medication which helps with quitting.
An excellent resource is the Quit Program. This includes a phone helpline, the Quitline, 13 QUIT (13 7848)
Exercise has been shown to reduce the risks of developing obesity, diabetes, heart disease, and some cancers (eg bowel cancer). Exercise can improve mental health and general wellbeing, and it can help to reduce the effects of stress.
Exercising for health requires at least 30 minutes of moderate intensity exercise daily. With 'moderate intensity exercise', you should be breathless to a level where you can still talk normally, but cannot sing (try it!).
Another way to determine 'moderate intensity exercise' is to measure your heart rate or your pulse during exercise (not easy to do without a device). The 'target heart rate' (THR) for 'moderate intensity exercise' is obtained from the following calculation:
THR = (220 - your age)/2, beats per minute. So, for example, for a 40 year old person, THR = (220 - 40)/2 = 180/2 =90 beats per minute
This is based on a THR of 50% of your maximum heart rate (which is 220 - your age). For moderate intensity exercise, the THR can be up to 70% of your maximum heart rate - however, you should discuss your exercise with a health professional before aiming to exercise at greater than 50% of your maximum heart rate.
To measure your heart rate or your pulse rate, you can use a device (heart rate monitor, pulse monitor, or 'smartwatch'), or you can count the pulse at your wrist for 30 seconds:
Pulse rate = (2 x number of pulses counted) per minute
If you don't know how to check your pulse, ask a health professional to show you how to do this. There are plenty of online videos which demonstrate how to check one's pulse, but these are of variable quality.
Suitable activities for 'moderate intensity activity' include brisk walking, jogging, light running, cycling, and swimming. However, these activities are not exclusive, and there are many more activities which provide 'moderate intensity activity'.
Relaxation has been shown to improve mental health, to improve general wellbeing, and to reduce stress. Try to make time for 20-30 minutes of relaxation activities every day. Sitting and watching a screen probably doesn't count as a relaxation activity.
Relaxation techniques include controlled breathing, mindfulness, meditation, yoga, and 'progressive muscle relaxation'.
And - whatever you do that helps you relax.
Fun is a good thing in itself, but it's also good for mental health and physical health. It may be difficult to have fun due to stress, relationship problems, financial problems, employment problems, environmental problems, global problems, and more. If we can make time for fun, we'll benefit from this. Fun activities are personal - whatever you enjoy,
It's been shown that compared to social isolation, social connection improves mental health and wellbeing. It may reduce the risk of heart disease. 'Social connection' is about relationships and interactions with family and friends.
To reduce the risk of harm from alcohol-related disease or injury for healthy men and women, drink no more than 10 standard drinks per week and no more than 4 standard drinks on any one day. The less you choose to drink, the lower your risk of alcohol-related harm.
Alcohol-related harm includes heart disease, liver disease, increased risk of some cancers (mouth, throat, oesophagus, colon, liver, and breast), dementia, and damage to the nerves in the limbs.
A standard drink contains 10 grams of alcohol - the amount your body can process in one hour. 'Standard drinks' are also called 'units'. As a guide:
375mL of 5% beer = 1.5 standard drinks
150mL of 13% wine = 1.5 standard drinks
30mL of 40% spirits = 1 standard drink
Please refer to the Standard Drinks Guide for more detailed information
Diet is a controversial topic. What's not controversial is that the 'Mediterranean type' diet has been shown to be associated with reduced risk of heart disease, diabetes, and some cancers. The 'Mediterranean type' diet isn't a strict diet. It describes the principles of a healthy diet. A healthy diet is a varied diet based on these principles. The Australian Dietary Guidelines are based on the 'Mediterranean type' diet. In a healthy diet, there are five food groups:
Vegetables, and legumes and beans (legumes and beans are also 'protein' foods)
Lean protein (fish, poultry, lean red meat, eggs, legumes, beans, nuts, seeds)
3 serves of dairy meet the daily requirements for calcium (for healthy bones)
Water is an important component of a healthy diet. Adults should aim for 2.5 to 3 litres of water today, either as plain water (preferable) or as tea or coffee or juice (although juices may have high sugar content). To avoid excessive caffeine intake (which may be associated with increased risk for heart disease and some cancers), aim for no more than 4 standard cups of coffee per day.
We need some salt in our diet for good health. We get most of the salt we require in the foods that we eat. Excessive salt intake can lead to high blood pressure. It's recommended that we don't have more than 5g of salt per day (1 teaspoon of salt per day). It's advisable not to add salt to cooking, and not to add salt to food on the plate. Some foods have a high salt content, for example, bacon, sausages, processed and packaged foods, sauces, some breakfast cereals, and some canned foods. It's worth checking the food labels. These foods should be 'occasional' foods, not 'everyday' foods.
Unless you have a diagnosed deficiency, you won't get any benefit from taking vitamin supplements or mineral supplements. They are expensive, and unnecessary. Supplements for specific vitamins or minerals may be recommended by a GP, specialist, or dietitian for people who have nutritional disorders, some medical conditions, or proven deficiencies - for example, Vitamins B1, B3, B6, B12, D, Folic Acid, and Iron. Folic Acid 400 micrograms daily is also recommended for women who are planning to conceive and for women in the first trimester of pregnancy,
There is increasing interest and understanding in relation to the gastrointestinal microbiome ('the gut microbiome'). This refers to the population of microorganisms in the stomach and the bowel. The composition of the microbiome may have beneficial effects and/or adverse effects in relation to many aspects of health and disease.
Normal weight is associated with good health. Being overweight increases the risks of developing diabetes, heart disease, osteoarthritis, and some cancers (eg breast cancer and bowel cancer). Being underweight increases the risk of developing osteoporosis ('thin bones'), muscle weakness, lowered immunity, and infertility (in women).
For good health, you should aim to have normal weight. 'Medical' weight is assessed by 'Body Mass Index (BMI)' and by waist circumference. Please refer to 'Check-ups and screening' below for details about weight.
To maintain a steady weight, your energy expenditure (metabolism, activity, and exercise) needs to be the same as your energy intake (food and drink).
To lose weight, your energy expenditure (metabolism, activity, and exercise) needs to exceed your energy intake (food and drink).
For weight loss, you should initially aim to get to your 'target weight' (as determined by 'BMI'), or to lose 5% of your body weight, whichever is the lower weight loss. Don't overdo it.
The 'energy equation' underpins the approaches to weight loss. Aim to increase energy expenditure by increasing exercise. Aim to decrease energy intake by modifying your diet (food and drink). A Mediterranean type diet is ideal (see above). Quantities and portion size are important in determining the energy intake from your diet. Aim to eat less - this can make a big difference.
Many 'special diets' are promoted for weight loss. Some examples include: The 5:2 diet (fasting on two days per week); The Dukan Diet; The 'Low Carb High Fat' Diet; the DASH diet; and the Paleo diet. There are also many weight loss programs. Some examples are: Weight Watchers; and Lite n'Easy.
Some people lose weight with these special diets and/or with these weight loss programs. Some people don't lose weight with these special diets and/or weight loss programs. There is no evidence that any one of the special diets or weight loss programs is superior to any of the others. It's likely that any weight loss achieved with a special diet or with a weight loss program is because energy intake has been reduced.
There is increasing interest in pharmacologically assisted weight loss using 'Glucagon Like Peptide - 1' receptor agonist (GLP-1 RA) drugs, such as semaglutide. GLP-1 RA drugs were developed for the management of Type 2 Diabetes, but they have been found to help weight loss in people who do not have Type 2 Diabetes.
For a great way to lose weight, and to improve wellbeing and fitness:
have a portion-controlled Mediterranean type diet
do moderate intensity exercise for at least 30 minutes every day
drink no more than 10 units (standard drinks) of alcohol per week
Some medications can cause weight gain, for example, steroids, most antipsychotic medications, some antidepressant medications, and some medications that are used to treat diabetes. If weight is a problem, and you're taking one or more of these medications, please continue to take the medication, but discuss this with your doctor.
Rarely, overweight can be caused by hormone disorders, for example, underactive thyroid, and high cortisol. If you have difficulty losing weight despite attempts at weight-loss, then it may be necessary to do blood tests to check for hormone levels.
In the past, phentermine has been prescribed for patients for weight-loss. This may not be effective, and it is potentially harmful. Phentermine is an amphetamine-like drug (a sympathomimetic amine). If you wish to phentermine for weight loss, discuss this with your doctor.
safe sun exposure
Sun exposure is necessary for the body to make Vitamin D. Vitamin D is essential for healthy bones. Deficiency of Vitamin D can lead to thinning of bones, and an increased risk of fractures (osteoporosis). Vitamin D is also thought to be necessary for mental wellbeing and for a good immune system. However, excessive sun exposure increases the risk of getting skin cancer.
In winter, healthy sun exposure is no more than a total of 3 hours over a week. Sunscreen should be worn if the UV index is 3 or higher.
In summer, healthy sun exposure is no more than 10 minutes per day, avoiding 11am to 3pm, and wearing sunscreen if the UV index is 3 or higher.
check-ups and screening
Check-ups and screening are about identifying the risk factors for disease, and identifying the early stages of disease, so that interventions can be made that lead to better health. It's a good idea to 'check in' with your GP at least once a year, for a 'check up'.
This is assessed in two ways.
Body Mass Index (BMI). This is the ratio of your height (in metres) squared to your weight (in Kg). You can calculate your BMI here
Normal weight is a BMI between 19.5 and 25
Underweight is a BMI below 19.5
Overweight is a BMI between 25 and 30
Obese is a BMI between 30 and 35
Morbidly obese is a BMI over 35
A healthy waist circumference is less than 80cm for women, and less than 94cm for men. Waist circumference is measured around the abdomen at a level which is midway between the lower border of the rib cage, and the upper border of the pelvic bone.
Being overweight or obese are risk factors for developing diabetes, cardiovascular disease, and some cancers (eg bowel cancer)
A healthy 'systolic' pressure (the upper figure) is less than 140.
A healthy 'diastolic' pressure (the lower figure) is less than 90
So, a healthy blood pressure is less than 140/90 (140 over 90).
Systolic pressure is the pressure in the bloodstream when the heart beats
Diastolic pressure is the pressure in the bloodstream between heart beats
High blood pressure is a risk factor for cardiovascular disease (heart attack, angina, stroke). It is a risk factor for heart failure.
Depending on your age, your medical history, and your family history, it may be appropriate to have a blood test periodically (eg every 1 to 5 years) to check for cholesterol, diabetes, kidney function, iron level, and blood count.
This is an X-Ray examination of the breasts. It's a 2-yearly screening test for breast cancer for women aged 40 to 74. The Breastscreen Program invites women to start having screening mammograms from age 50, but women are eligible to have a screening mammogram, every two years, from age 40. Phone 13 20 50 or check breastscreen.org.au .
Different tests and screening intervals apply for women who have had breast cancer, and for some women who have a family history of breast cancer (this should be discussed with a GP)
Cervical Screening Test
This is a 5-yearly screening test for cervical cancer for women aged 25 to 74.
Bowel Cancer Screening Test
This is a 2-yearly screening test for bowel cancer for people aged 50 to 74.
For some people with a family history of bowel cancer, the screening test is 5-yearly colonoscopy. This should be discussed with a GP.
It's recommended that all children get immunised according to the National Immunisation Program.
Children get vaccinations at 6 weeks, 4 months, 6 months, 12 months, 18 months, and age 4. The vaccinations are primary courses and boosters for protection against the following diseases: hepatitis B, diphtheria, tetanus, whooping cough (pertussis), haemophilus, polio, pneumococcal disease, rotavirus, influenza, measles, mumps, rubella (German measles), chickenpox, and meningococcal disease types A, C, W, and Y. First Nations' children are also vaccinated against meningococcal disease type B.
It is recommended that all children get vaccinated against meningococcal disease type B.
Adolescents get vaccinations against the following diseases: human papilloma virus (HPV) disease, whooping cough (pertussis), diphtheria, tetanus, and meningococcal disease types A, C, W, and Y.
Pregnant women should get influenza vaccination and whooping cough vaccination in every pregnancy. The whooping cough vaccination is a combined vaccine providing protection against pertussis (whooping cough), diphtheria, and tetanus. There are two brands: Boostrix and Adacel. These vaccines are included in the National Immunisation Program.
COVID-19 vaccination is recommended for everyone aged 5 or older
Influenza vaccination is recommended annually for everyone from the age of 6 months.
Pneumococcal vaccination (the 'pneumonia' vaccination) is recommended for everyone at age 70 (unless they have received it previously)
The shingles vaccination (zostavax) is recommended for people at age 70 (it is contraindicated for people who are immunocompromised, or people who are taking immune suppressing drugs). Zostavax is funded under the National Immunisation Program.
People should also consider the following vaccinations which are not funded under the National Immunisation Program.
Shingles vaccination (shingrix) for people from age 50. Two doses, 2-6 months apart. It costs about $300 per dose
Whooping cough vaccine every 10 years, to protect yourself, and to protect children with whom you may be in contact. Whooping cough vaccination is a combined vaccine providing protection against pertussis (whooping cough), diphtheria, and tetanus. There are two brands: Boostrix and Adacel. Boostrix costs about $30, Adacel costs about $30.
Whooping cough vaccine is recommended in every pregnancy, in the third trimester
Influenza vaccination is recommended in every pregnancy, at any time in the pregnancy.
Hepatitis A vaccination
Hepatitis B vaccination (if not already vaccinated in childhood)
Travel vaccinations as appropriate for destinations: