Here are some simple and achievable ways you can help prevent long-term health problems.
The Dietary Guidelines for Australian Adults takes an evidence-based, whole-diet approach to disease prevention. There are few surprises in the guidelines, it's mostly things you already know, but maybe don't always choose to follow. Here's the main advice:
- Eat plenty of fruits, vegetables, legumes and wholegrain cereals
- Include lean protein and low-fat dairy foods
- Moderate total fat intake
- Limit saturated fat, salt, alcohol and sugar
The importance of plant foods can't be overstated. Studies of populations around the world have consistently found that people who have diets high in fruit, vegetables and legumes have substantially lower risks of coronary heart disease, stroke and several major cancers.
And if Atkins-type diets have scared you off all carbs, there's evidence that a diet rich in high-fibre, wholegrain cereals protects against coronary heart disease, obesity, type 2 diabetes and colorectal cancer.
Regular exercise works against coronary heart disease, stroke, high blood pressure, type 2 diabetes, colorectal and breast cancer, osteoporosis, obesity and high cholesterol. It's also good for psychological wellbeing, and can help prevent dementia.
A good starting point is 30 minutes or more of moderate exercise at least five days per week. Adding some more vigorous activity will improve fitness and burn more kilojoules. For stronger bones, make sure at least some of your exercise is weight-bearing, like walking, jogging or ball sports.
Strength or resistance training will help prevent loss of muscle mass - associated with decreased independence and increased risk of falls. Yoga can help with balance and suppleness.
You should also sit less: the amount of sitting a person does during the day can adversely affect health , regardless of whether they're otherwise healthy and regularly hit the gym or go for a run.
Keep a healthy body weight
With more than half of Australian women and about two-thirds of men overweight or obese, excess body weight has overtaken smoking as the leading cause of reduced life expectancy.
Obesity is associated with a range of diseases and conditions mediated through changed metabolic functioning and the physical burden of excess kilos. These include insulin resistance and type 2 diabetes, gall bladder disease, hypertension, high cholesterol, non-alcoholic fatty liver disease, coronary heart disease, stroke, gout, certain cancers, osteoarthritis, sleep apnoea and other respiratory issues.
Healthy eating and regular exercise will help maintain a healthy body weight, preventing obesity and the diseases it causes.
For more tips, see the federal government's healthy weight - and waist - campaign, Measure Up.
Current guidelines recommend drinking no more than two standard drinks per day for reduced long-term risks of alcohol-related disease or injury, and no more than four on any one occasion to reduce risks of injury.
Effects of excessive alcohol consumption include cardiovascular disease (high blood pressure, arrhythmias and other circulatory problems), some cancers; malnutrition; being overweight or obese due to added kilojoules, increased appetite and metabolic changes; liver diseases; long-term cognitive impairment and dementia; and depression, anxiety and self-harm. Alcohol is an addictive drug, and regular use can result in alcohol dependence.
Although there are some health benefits - including for mental health - from moderate alcohol consumption, it's important to weigh up the risks too.
Slip, slop, slap and wrap
Wear a hat, clothing and sunscreen to protect your skin against the ageing and cancer-causing effects of the sun, and sunglasses to help prevent eye damage and diseases such as cataracts. Two in three Australians will get skin cancer, and melanomas kill more than 1000 people each year.
The health risks associated with smoking are numerous and well-publicised. If you're ready to quit, see your doctor about your options, including subsidised nicotine patches.
Get a life
Studies of centenarians have revealed that social and mental activity is critical for health and longevity. This includes engaging in intellectual stimulation, learning new things, having good family ties, a supportive social network and community links.
Turn it down
It's estimated one in six people suffers some form of hearing loss, with exposure to noise partly responsible. Occupational health and safety requirements do much to ensure workers are protected against occupational noise. However, recreational noise, such as excessive music volumes at nightclubs and live music venues, still poses a problem.
Australian Hearing recommends you wear earplugs at concerts, motor races and fireworks displays.
Australian research found that 25% of people surveyed using music headphones are listening too loud for too long, so keep the volume low.
Get enough sleep
Sleep refreshes the mind and repairs the body, and adults need about 7 to 8 hours a day. Lack of sleep can result in short-term problems such as poor concentration, mood disturbances and accidents. Long-term sleep deprivation can cause physical illnesses such as heart disease and obesity, possible mental illness (it's not clear whether mental illness is a cause or result of lack of sleep), and maybe even some cancers.
Visit your dentist regularly
There is increasing evidence of the link between poor oral health and cardiovascular disease, diabetes, poor nutrition (if you're limited to eating certain foods) and oral cancer. There are life-threatening cases where dental infection has spread to the eye or brain or into the neck or chest cavity. The loss of teeth may also have psychological impacts because of reduced confidence and difficulties speaking.
Regular check-ups can prevent small problems becoming bigger and more expensive later.
Screening for better health
There are various targeted screenings and tests recommended for adults in middle age and beyond, in addition to regular tests and health screenings recommended for all adults such as skin cancer, dental health, cervical cancer (women) and body weight.
These are the most useful targeted tests:
45-49 year check-up
Once only, for eligible people aged 45-49.
GPs can conduct a comprehensive health and lifestyle check designed to detect risks for many of the chronic conditions affecting older adults, such as type 2 diabetes, osteoporosis and heart disease. They can then help patients to make the necessary lifestyle changes to prevent or delay the onset of chronic disease.
To be eligible for the check, the doctor must identify at least one risk factor, such as unhealthy lifestyle, biomedical risk factors (high cholesterol or high blood pressure for example) or family history. About 90% of people in this age group have at least one risk factor.
75 and older health assessment
Every year for people aged 75 and older.
A structured health assessment aimed at preventing or managing health issues and conditions, it also looks at factors that influence a person's physical, psychological and sociological functioning.
Bowel cancer: faecal occult blood test
Every two years for people over 50.
Bowel (or colorectal) cancer affects 4-5% of adults. The faecal occult blood test (FOBT) is available as a home-based screening kit from pharmacies or online. You take two samples from your stools and send them off for lab analysis. The kit and pathology lab analysis costs about $35-$40, though you may be eligible for Medicare or private health insurance rebates.
Breast cancer: mammogram
Every two years for women aged 50-69.
A woman's lifetime risk of breast cancer is about 10% (rare diagnosis in men), and a family history increases the risk. Warning signs include changes to the appearance of the breast and nipples, pain and/or a lump.
Mammography using low-dose X-ray can detect cancers too small to be felt, and early detection means a greater chance of recovery.
Cholesterol and triglycerides: blood lipid screening
Every two years after age 45; more frequently if there are other cardiovascular disease (CVD) risks.
Blood tests can detect total cholesterol levels and the levels of the main components, high-density lipoproteins (HDL) and low-density lipoproteins (LDL). HDL, also known as good cholesterol, protects against heart disease; it's the LDL (so-called bad cholesterol) that leads to fatty deposits that line the arteries. This causes the vessels to narrow. They may eventually become blocked, which can lead to angina, heart attack or stroke. Triglycerides are also measured, and high levels show increased risk of CVD.
Hypertension: blood pressure test
At least once a year, especially for over 50s (24-hour blood pressure monitoring may be recommended for people with high readings).
High blood pressure is usually caused by reduced elasticity and plaque build-up in arteries. It can lead to heart disease, heart attack and stroke. Lifestyle changes can successfully control high blood pressure in many cases, especially if addressed in the early stages.
Osteoporosis: bone mineral density (BMD) scan
For women at the start and after menopause, and for men according to risk.
Osteoporosis affects one in two women and one in three men over 60, and can lead to debilitating bone fractures, which in turn can lead to permanent disability and death. Low BMD levels are symptomless, but indicate increased risk of fracture. Detected early by BMD measurement, osteoporosis can be managed or treated with lifestyle changes, nutrition supplements and/or medication.
Prostate cancer: PSA and rectal examination
Every year for men aged 50-70.
A man's lifetime risk of prostate cancer is about 10%, and having a family history of prostate cancer increases personal risk. Early symptoms include a slow or stop-start urine stream, difficulty starting urination or increased need to urinate. For many men though, there are no symptoms, and regular screening is the best bet for early detection.
Prostate specific antigen (PSA) is a protein produced by the prostate gland, and men with prostate cancer will have higher than normal PSA in their blood. A blood test isn't fail-proof though, and a rectal examination by a doctor will help increase the detection rate.
Prostate cancer screening is controversial, because the harms associated with treatment may outweigh the benefits of diagnosis - many men die with, rather than from, prostate cancer.
Type 2 diabetes: blood glucose tests
Every one to three years, depending on risk.
Type 2 diabetes (T2D) is most common among people over 40 years, though more and more younger people are getting it these days too. Apart from age, the main risk factors include obesity, especially abdominal obesity (high waist circumference), existing cardiovascular disease and sedentary lifestyle. If caught in the early stages (by measuring high fasting glucose or impaired glucose tolerance), lifestyle changes can reduce the likelihood of pre-diabetes progressing to full-blown T2D by more than 90%.
Vaccination booster shots
Older people should be vaccinated against pneumococcal disease every five years and keep their tetanus shots up to date (you need a booster at age 50 if you haven't had one in the past 10 years). It's also a good idea to get an annual flu shot, which protects against the most serious and prevalent active strains.
Vision and eye health: testing by an optometrist
Every two years for adults over 40.
Older adults are susceptible to:
- cataracts - a clouding of the lens.
- macular degeneration - affecting the central area of the retina, resulting in the loss of central vision.
- glaucoma - a group of diseases where the optic nerve is gradually destroyed, usually due to raised pressure inside the eye, leading to loss of peripheral vision.
Your optometrist may also recommend reading or vision-correction glasses. As we age, the eye loses the ability to focus on nearby objects. This generally starts at around the age of 45, when you might notice that you need to hold small print items further and further away in order to focus on them - so-called "long arm syndrome"!
Magnifying glasses available from pharmacies and variety stores may help, but flaws, such as uneven lens centres, can cause eye strain or double vision. Try reading with them for a few minutes before buying them - if they're clear and comfortable they're probably OK.
Another issue for people with spectacles is the risk of falls when wearing bifocals or multifocals, where the lower part of the lens is for reading and the upper part for distance vision. A typical scenario is someone looking down as they're walking down stairs and misjudging the step because they're looking through the reading part of the lens. One solution is to have a pair of multifocals for around the home, and a set of single-focal distance glasses for when you're out and about.
Vitamin D deficiency: supplements and medication
Recommended for people at risk of deficiency.
Vitamin D increases calcium absorption from food, so a deficiency can lead to bone diseases including osteoporosis. Those at risk include people who are housebound, who cover skin for religious reasons, who have dark skin or who avoid the sun. If any of these apply to you, talk to your doctor about supplements and medication to reduce your risk of deficiency.