Thursday, April 15, 2010

How Bad Are Your Health Vices?

Can you ever reverse the damage of a past smoking habit or the savage tans you sported into your 30s? Here, what's forgivable, what's regrettable, and how to get healthier.

OTC Diet Pills: Forgivable
The FDA continues to recall various OTC diet pills because of health and safety concerns.
Most recently, it pulled the plug on Hydroxycut because of liver injuries (complaints ranged from jaundice and elevated liver enzymes, an indicator of potential liver injury, to liver damage requiring liver transplant). Others may contain untested active pharmaceutical ingredients, including antiseizure meds and diuretics. Yet another substance found in some products (sibutramine) can cause high blood pressure, seizures, tachycardia (rapid heartbeat), palpitations, heart attack, or stroke, or interact with other medications that patients may be taking. A few years ago, the FDA banned ephedra after 16,000 reports of adverse events revealed two deaths, four heart attacks, nine strokes, and one seizure.
If you're concerned about whether you will experience longer-lasting effects from these drugs, ask your doctor. In many cases, the chemicals leave your system quickly so there's less of a long-term damage risk. For example: "Ephedra, like most stimulants, is out of your system after 12 hours," says Shari Midoneck, MD, an internist at Weill Medical College of Cornell University.

Fasting: Forgettable
If you've ever been suckered into a weekend detox fast at one of those high-priced spas where supermodels go to slim down for Fashion Week, relax.
The effects of fasting once or twice a year won't make you ill—and you won't lose bone mass the way you might with yo-yo dieting. On the downside, despite the claims, doctors say that fasting won't rid your body of toxins or result in lasting weight loss.

Yo-Yo Dieting: Forgivable
This is generally defined as gaining and losing 10 pounds at least five times in your life.
Though there's no definite evidence that this is harmful, "some studies have suggested it may be," says Sharonne Hayes, MD, director of the Women's Heart Clinic at the Mayo Clinic. One University of Michigan study found that people with a history of yo-yo dieting had reduced blood flow to the heart; another study suggested it may also lead to decreased bone mass. The potential upshot: heart and bone problems after menopause.
However, experts aren't sure whether the yo-yoing itself is the culprit or whether extreme diets lead to nutritional deficiencies that can affect long-term health. To break the cycle, set your sights on a realistic goal and try to maintain that weight. If you must diet, "aim to lose only a pound or two a month and try not to gain 10 pounds over the winter," says Hayes. Get yearly cholesterol and blood pressure checks to detect early signs of heart disease.

Alcohol: Forgivable
First, be honest about your drinking days: Did you occasionally overdo it on weekends? Or were you a problem drinker who downed up to four drinks a night, several times a week, for an extended period?
The former is repairable, says Robert M. Swift, MD, a professor of psychiatry and human behavior at Brown University, because the major organs affected by alcohol—the brain, liver, and pancreas—are fairly resilient. Moderate amounts, about one drink a day for women, may even prevent heart disease and certain cancers and could make you live longer. However, if you put yourself in the latter category, ask your primary care doctor for an ALT (alanine transaminase/aminotransferase) test, which detects liver damage. And make sure you watch your waistline. Scientific research has found that more than four drinks a day predisposes you to belly fat, which can increase your risk of heart disease; the same amount of alcohol can put you at risk of stroke.
Also, be sure to get an annual mammogram. In a study by researchers at the Fred Hutchinson Cancer Research Center in Seattle, older women who had consumed two or more drinks a day for 20 years—and were still drinking—had 3 times the risk of getting hormonally sensitive breast cancer than did abstainers. Finally, drinkers should know that one study found that just two drinks a week can raise the risk of certain types of cataracts by 13%, so visit an ophthalmologist every year.

Fast Food: Forgivable
Studies show that just hours after you've eaten a typical fast-food lunch, fat globules start to obstruct your blood vessels. Continued consumption of these unhealthy meals can trigger heart problems, obesity, and diabetes.
That's not to say that if you enjoyed regular drive-thru meals when your kids were young, you should check in to the hospital now. Much of the damage from a poor diet can be undone. "A general rule: As long as it took for you to get to an unhealthy state, that's about how long it takes to become disease free," says Merz. Research suggests that taking 1,200 IU of vitamin E and 500 mg of vitamin C before an unhealthy meal can help your heart by alleviating fat-induced inflammation. Over the long run, following either a low-fat vegetarian regimen or a Mediterranean diet that's rich in healthy fats, whole grains, and vegetables has been shown to reverse heart disease risk. Getting 30 minutes of aerobic exercise at least three times a week works, too.
"Women who eat a fast-food diet tend to miss out on calcium, which helps build healthy bones, because they don't drink milk," says Judith S. Stern, ScD, RD, a professor of nutrition and internal medicine at the University of California, Davis. Premenopausal women should be vigilant about getting 1,000 mg of calcium per day; older women need 1,200 mg. Weight-bearing exercise, such as walking, hiking, or lifting weights, also boosts bone density, and is a must for former junk-food junkies.

Loud Concerts: Regrettable
If you spent college weekends swaying to live Grateful Dead jams, don't blame your ringing ears and hearing loss on age.
One-third of the 28 million Americans with hearing loss can attribute the problem to noise exposure, according to the National Institute on Deafness and Other Communication Disorders. Loud sounds destroy the ear's sensory nerve cells, sometimes so gradually that you don't even notice it. Although you can't repair this damage, you can preserve what you have left. The golden rule: "If you're in a noisy room where you have to raise your voice to be heard by someone 3 feet away, then it's too loud," says Greg Flamme, PhD, an assistant professor in the department of speech pathology and audiology at Western Michigan University. Also, play your iPod on the lowest volume that's audible to protect against further damage. And if you return to the concert arena or climb onto the back of a roaring motorcycle, please do so sporting protective earmuffs or musicians' earplugs.

Sunburns: Regrettable
Although dermatologists know that ultraviolet (UV) radiation alters DNA, which can eventually cause cancer, they don't know how much UV exposure it takes to cause DNA damage.
They also can't say for sure who will get cancer, or how soon after a blistering burn cancer could develop. All the more reason for former sun worshippers to follow this four-point plan: 1) See a dermatologist every year for a skin cancer screening. 2) Wear SPF 15 sunscreen every day; use 30-plus when spending time outside. 3) Avoid being outdoors between 10 AM and 4 PM. 4) Try to cover yourself with a long-sleeved shirt, pants, and a broad-rimmed hat if you must be in the sun.

Too Much Coffee: Forgettable
Don't worry too much if you can't stop jonesing for java.
"There's no proven link between caffeine and heart disease or cancer as long as you stay under six cups of coffee per day," says C. Noel Bairey Merz, MD, director of the preventive and rehabilitative cardiac center at Cedars-Sinai Medical Center in Los Angeles. Even better, long-term coffee consumption may reduce your risk of type 2 diabetes. And an alkaloid in coffee may prevent cavities. However, more than 300 mg of caffeine a day combined with insufficient calcium could contribute to bone loss, so coffee, tea, and cola drinkers should compensate with a calcium supplement. The final word on caffeine from one bone-health and nutrition expert: "Stick to two cups a day, and add milk for the calcium," advises Jasminka Ilich-Ernst, PhD, an associate professor of nutrition at Florida State University.

Pot: Regrettable
Sorry, Cheech, but scientists have determined that this habit is as unwholesome as tobacco.
"We used to think that marijuana was safe, but it contains many of the same cancer-producing chemicals as cigarette smoke and has the same health-harming effects," says Diane Stover, MD, chief of pulmonary service at Memorial Sloan-Kettering Cancer Center in New York City. Ex-tokers would be wise to follow the same advice given above for ex-smokers.

Cigarettes: Regrettable
By Daryl Chen, Prevention
Lung cancer is the leading cause of cancer death in women. It turns out that the 4,000 chemicals in tobacco appear to be even more lethal when ingested by women than by men.

Lung damage from emphysema or bronchitis can't be reversed, but your cardiovascular system can bounce back. "Within 24 hours of stopping smoking, there is improvement in the function of the blood vessels. After 1 year, there's a 50% reduction in the risk of having a heart attack," says Sharonne Hayes, MD, director of the Women's Heart Clinic at the Mayo Clinic in Rochester, MN. Thirty minutes of exercise a day will speed the return to normal heart function.

Although everyone should eat at least 5 to 7 servings of fruits and vegetables a day, ex-smokers should consider making one or two of those servings strawberries or black or red raspberries, which may prevent the onset of esophageal cancer, according to research at Ohio State University. Getting one to two times the daily value of folate (found in whole grains and greens) and B12 (in meat and dairy products) can reduce cell damage that may lead to cancer.

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