Kegel exercises strengthen the muscles under the uterus, bladder, and bowel (large intestine). At the bottom of your pelvis are layers of muscles known as your pelvic floor. They are shaped like a hammock and connect to the front, back, and sides of your pelvic bone. Your pelvic muscles support the bladder, rectum, and sexual organs. They hold them in place and help control the flow of urine.

For women, pregnancy and childbirth can weaken the pelvic muscles. For men, prostate surgery can weaken the pelvic muscles. Your risk also increases as you age and if you are overweight. Brain and nerve disorders can also lead to problems with urine leakage or bowel control.

Weak pelvic muscles can cause you to leak urine. Luckily, Kegel exercises can strengthen your pelvic muscles and help you regain bladder control.

Path to improved health

You can do Kegel exercises almost anywhere, at any time. People can’t see you do them. That’s because it involves tightening and releasing the muscles in your pelvis. It is easiest to start off doing them as you are lying down. As they become easier, you can do them while driving, working, or watching TV.

Before you start the exercises, you’ll need to locate your pelvic muscles. They are the same muscles you use to stop urine flow or hold in gas. To exercise, pull in (contract) or squeeze your pelvic muscles. Hold this for 3 to 5 seconds, then release and rest for 3 to 5 seconds. As you continue, you can increase the amount of time you hold and rest up to 10 seconds. Do 10 to 20 exercises 3 times per day. If you are doing the exercises correctly, the muscles in your thighs, bottom and stomach should remain relaxed.

You may not notice change in your muscles right away. As with other muscles in your body, it can take 4 to 8 weeks of daily exercise. Keep a log of your exercises to track your progress.

Things to consider

If you struggle with incontinence, try contracting your muscles after going to the bathroom. This can help ensure you have gotten all the urine out. Be careful though. Doing Kegel exercises mid-urination can cause a bladder infection.

You also should tighten your muscles before certain movements. This includes sneezing, coughing, laughing, jumping, or lifting a heavy object. The contraction can prevent pelvic muscle damage and urine leakage.

Talk to your doctor about Kegel exercises. They can help make sure you are doing them correctly. Keep them informed of your progress or if your problem isn’t improving. You may need another form of treatment, such as pelvic floor physical therapy or surgery.

Questions to ask your doctor

• Is a weak pelvic floor associated with other health issues?
• What does it mean to contract or tighten my pelvic floor muscles?
• Should Kegel exercises be painful?
• Will I always have to do Kegel exercises?

Resources

National Institutes of Health, MedlinePlus: Kegel exercises – self care

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People fall at every age. This is especially true of young babies learning to walk. However, as we age, we become more concerned about falling. A fall at an older age can have serious consequences to your health and independence.

Path to improved safety

Talk with your doctor to see if you are at a higher risk of falling. In addition to age, certain medical conditions put you at risk, including arthritis, cataracts, and hip problems. Diseases, such Parkinson’s disease, and multiple sclerosis (MS) also can affect your mobility and increase your fall risk.

Reduce your risk for falling by following these tips:

• Exercise regularly to keep your body, muscles, and bones healthy and strong. Exercise should focus on balance training and resistance training.
• Install good lighting in your home. A well-lit home will help you avoid tripping over objects that are not easy to see. Make sure your bedroom, hallways, stairs, and bathrooms are well lit.
• Fasten rugs firmly to the floor. Add nonskid backing so the rug doesn’t move, and tack down loose ends and corners.
• Install handrails in your bathroom for the bath, shower, and toilet. Add them to both sides of your stairs if you don’t already have them.
• Keep electrical cords away from high-traffic areas in your house.
• Store your most-used kitchen objects in easy-to-reach areas. This eliminates the need to reach high, bend over, or climb on a stool.
• Wear shoes with firm, nonskid soles. Avoid wearing loose-fitting shoes and slippers.
• Get regular eye exams.
• Keep your feet healthy, especially if you have diabetes.
• Be aware of medicine side effects. Some medicines can cause dizziness.
• Use a cane or walker if your doctor recommends it.
• Don’t smoke, and limit alcohol to no more than 2 drinks per day for men and 1 drink a day for women.
• Ease in and out of bed. Sit on the side of the bed for a few minutes with your feet on the ground before you stand. Getting up too quickly can cause dizziness.
• Don’t go outside in icy conditions. If you must go out, plan by having someone walk with you, treat the conditions with anti-icing materials, or have your walkways shoveled.

Things to consider

• Broken bones. Our bones become more brittle as we age. Broken bones take longer to heal as we age. Other breaks, such as hip fractures in the elderly, have been linked to health decline. This health decline can result in death in as soon as 6 months after the fall. Additionally, you lose your ability to be independent when you can’t walk.
• Traumatic brain injury (TBI). This is a serious injury to your brain. It can happen if you fall and hit your head on an object or on the floor.
• Cognitive decline. Alzheimer’s disease and other conditions that affect a person’s cognitive ability can increase the risk of falls.

Questions for your doctor

• At what age do falls lead to serious health problems?
• Do certain vitamin supplements and dietary changes strengthen aging bones?
• What physical activity and exercise is best for older persons trying to avoid a fall?
• Am I taking any medicines or combination of medicines that could increase my risk of falling?
• Is my diet appropriate enough to keep me strong to prevent falls?

Resources

Centers for Disease Control and Prevention: Older Adult Fall Prevention

National Institute of Arthritis and Musculoskeletal and Skin Diseases: Preventing Future Fractures

National Institute on Aging: Falls and Fractures in Older Adults

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Your cognitive health is determined by how well your brain can perform mental processes. These include remembering things, learning things, and using language. A healthy brain is just as important as a healthy body. Many of the things you do to keep your body healthy can also keep your brain healthy. It is also important to stay socially and mentally active.

What is cognitive decline?

Cognitive decline is when your brain doesn’t work as well as it used to. For example, a person who is experiencing cognitive decline may have trouble learning, using language, or remembering things.

Some cognitive decline is a normal part of growing older. Cognitive decline that happens quickly or that affects day-to-day activities is called dementia. A head injury, a stroke, or disease (for example, Alzheimer’s disease) can damage brain cells and lead to dementia.

As your body gets older, so does your brain. You can’t stop normal cognitive decline, just as you can’t stop other parts of normal aging. However, you do things to reduce your risk of decline. You can maintain your body and brain health by making healthy choices about your lifestyle, diet, and exercise. Healthy choices can also help prevent disease.

Path to improved health

There isn’t one specific diet that is best for brain health, but eating healthy is important for your overall health. Choosing foods that nourish your body and brain can help prevent or delay health problems, including conditions that increase your risks for dementia. There are many things you can do to nourish your body and brain.

Manage your weight. Studies show that obesity, diabetes, high blood pressure, and high cholesterol can all increase your risk for dementia. To lose weight and keep it off, avoid short-term or “fad” diets. Instead, adopt a healthy way of thinking about and eating food.

Eat fruits, vegetables, and whole grains. A diet that includes lots of fruits, vegetables, and whole grains can reduce your risk for chronic diseases, including heart disease, diabetes, and cancer. These same foods may also help protect brain function. The antioxidants in leafy greens, dark-skinned vegetables, and cruciferous vegetables (broccoli, cabbage, and turnips) may be especially protective. Vegetables including beets, broccoli, Brussels sprouts, cauliflower, eggplant, kale, red bell peppers, romaine lettuce, and spinach are good choices.

Avoid unhealthy fats. Try not to eat any trans fats. These are man-made fats that are bad for you. Trans fats are often used in processed foods and store-bought baked goods. Read food labels carefully to check for trans fats. They will appear in the ingredient list as “hydrogenated vegetable oil” or “partially hydrogenated vegetable oil.”

Foods that are high in saturated fats (for example, red meat) can contribute to high cholesterol levels. Over time, high cholesterol can increase your risk for heart attack and stroke. When you do eat red meat, reduce your portion size. Choose poultry and fish more often.

You can also avoid unhealthy fats by using olive oil or canola oil when you are sautéing foods. Bake, broil, or roast your food instead of frying it.

Get your omega-3 fatty acids. The most common source of omega-3 fatty acids is fatty fish (sardines, tuna, salmon, mackerel, and herring). Try to eat this type of fish once or twice a week.

Talk to your doctor about the risks and benefits of taking vitamins or supplements. Your doctor might suggest a dietary supplement based on your overall health and the vitamins or minerals your diet lacks. If you are interested in taking another type of supplement, talk to your doctor about why you want to take it and what you hope it will do for you. He or she can help you figure out if a dietary supplement will interact with any medical conditions you have or any prescription or over-the-counter (OTC) medicine you are taking.

Stay active physically, socially, and mentally. Physical activity helps prevent disease and maintain blood flow to the brain. If you don’t already exercise, try to work up to 30 minutes of moderate activity into your schedule 5 times a week. Moderate activities include anything that gets your heart rate up. Walking, hiking, bicycling, and swimming are all good options. Choose something you enjoy doing.

Any activity you do with other people helps to stimulate your brain. A social activity can be as simple as having lunch with a friend or walking around the block with a neighbor. Volunteer opportunities in your community or church are good ways to be social. Another option is finding a club or social group that focuses on a sport, hobby, or topic you enjoy.

To keep your brain cells strong and active, it’s important to stay mentally active. Challenge yourself to learn something new. Read to stay informed and for fun. Enroll in a class at a local community college or adult education center. Or, challenge yourself in a different way by playing games, completing puzzles, or trying memory exercises.

Things to consider

It is normal for your memory to lag as you get older. Forgetting where you put your keys, for example, is not a sign of Alzheimer’s disease. Being unable to retrace your steps to find the keys could be a sign. Other signs include losing track of the date or the season, or difficulty completing familiar tasks.

There is currently no known cure for Alzheimer’s disease. Researchers are working to find a way to delay or prevent Alzheimer’s disease. Until then, taking care of your body and brain are the best ways to prolong cognitive health.

Questions for your doctor

• What could be causing my memory loss?
• Is it possible that my medications could be making my memory worse?
• Are there any medications that can help with memory loss?
• Is it safe for someone with cognitive decline to drive?
• My parent could have dementia. How can I talk to them about it?

Resources

Centers for Disease Control and Prevention: Healthy Aging

National Institute on Aging: Assessing Risk for Alzheimer’s Disease

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Prostate cancer, the growth of abnormal cells in a man’s prostate gland, is a leading cause of death in men. Your doctor can perform a screening. The screening includes a prostate-specific antigen (PSA) test (blood test) to check the PSA level in your blood. PSA is a substance produced by the prostate gland. A high PSA level may indicate a prostate problem. A digital rectal exam (DRE) is still widely used by many physicians. This is a physical screening in which your doctor inserts their gloved finger into your rectum to feel the size of your prostate. If you doctor needs more information, they may use imaging tools, such as ultrasound or MRI to get a more detailed look of your prostate.

Path to improved health

The goal of prostate screenings is to find cancer early. Cancer is easier to treat and more likely to be cured if it is caught early.

However, most cases of prostate cancer are not aggressive. More men have a slow-growing form of prostate cancer. This means they may not have symptoms or even require treatment. This approach is called “watchful waiting” or “active surveillance.” Prostate cancer treatment can have long-term side effects. These include loss of bladder control and erectile dysfunction. There is a rare chance of problems occurring in surgery to get a biopsy. This is the only way to confirm a prostate cancer diagnosis.

PSA test results aren’t always accurate or are “false positives.” This means that the PSA test result suggests that you might have cancer when you do not. A false-positive test result can lead to unneeded tests, such as a biopsy, and side effects from testing. It also causes worry for you and your family.

For these reasons, the American Academy of Family Physicians and U.S. Preventive Services Task Force have issued clinical recommendations. For men 55 through 69 years of age, they do not recommend routine PSA screening. Instead, they recommend having a conversation with your doctor about the risks and benefits of periodic screening. They do not recommend PSA screening for prostate cancer in men 70 years of age and older.

Other organizations have different screening recommendations. These include the American Cancer Society and the American Urological Association. Their guidelines depend on your age and state of health.

Things to consider

Ultimately, the decision to be screened for prostate cancer is between you and your doctor. Talk to them about your specific concerns. They can weigh the pros and cons with your personal health and risk factors.

Doctors and scientists perform ongoing and new research. These studies, or clinical trials, help to learn more about the benefits and risks of prostate cancer screening. Ask your doctor about the most recent study results. Try to stay up to date on new progress in prostate cancer screening and treatment.

Questions to ask your doctor

• How do I know if prostate screening is right for me?
• What are the symptoms of prostate cancer?
• If I have a high level of PSA, what problems could I have?

Resources

American Academy of Family Physicians: Clinical Preventive Service Recommendation: Prostate Cancer

American Cancer Society: Recommendations for Prostate Cancer Early Detection

American Urological Association: Prostate Cancer Guidelines

National Cancer Institute: Prostate Cancer—Patient Version

National Institutes of Health, MedlinePlus: Prostate Cancer

U.S. Preventive Services Task Force: Prostate Cancer: Screening

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Testosterone is a sex hormone that your body makes. Normally, men produce more of it than women do. Some men may have low amounts of testosterone. This is known as hypogonadism. Your hormone level decreases as you get older. Certain medicines and health conditions may affect it as well, including:

• Cancer treatment, such as chemotherapy
• Testicular cancer
• Injury to your testicles
• Hypothyroidism (low thyroid levels)
• Problems with your nervous system
• Obesity
• Diabetes

Path to improved health

Low testosterone can affect your physical and mental behavior. Talk to your doctor if you have symptoms, such as:

• Low sex drive
• Low sperm count
• Infertility
• Erectile dysfunction
• Changes in mood
• Depression
• Muscle or bone loss
• Decreased strength
• Weight gain
• Hair loss
• Trouble sleeping
• Trouble focusing

These can also be caused by other health issues. Your doctor will likely perform a physical exam and review your lifestyle to determine the problem. In addition, they may run a blood test to check your levels. Men usually have between 300 and 1,000 nanograms (ng) of testosterone per deciliter (dL). If your test results show a low level, you may need to increase the hormone. This can be done naturally.

Testosterone replacement therapy (TRT) is most common. This involves using man-made hormones. There are several forms that your doctor can prescribe. They include gel, a patch, or an injection. TRT is not an option for men who have certain health issues, including prostate or breast cancer. TRT also may not help men who have low testosterone due to advanced age.

TRT often is done in combination with other lifestyle changes. These changes promote overall good health. If you are obese, you should lose weight. You can do this by eating better and getting more exercise. Aim to get 7 to 8 hours of sleep each night. Try to control your stress levels. This allows your body to focus its energy on testosterone production.

Men low in testosterone should eat foods with zinc and vitamin D. These can help balance your hormones and produce more testosterone. Adult men should get about 11 milligrams of zinc per day. Zinc is in meat, poultry, seafood, and shellfish. Beans, nuts, and whole grains are also good sources. These foods, plus dairy, also contain vitamin D. Adult men should get about 600 international units (IUs) of vitamin D per day. You also should eat less sugar and saturated fat.

Things to consider

Your doctor may want to perform other tests to find the cause of low testosterone. This will help them decide if you need other treatment, as well.

There are benefits and risks to TRT. The goal of therapy is to get rid of symptoms of low testosterone. The treatment has been known to improve men’s sexual drive and mood. However, studies show that it may increase your risk of plaque buildup and heart disease. Talk to your doctor more about specific concerns. Make sure they know if you are at risk of any other health conditions.

Questions to ask your doctor

• Will I always have low testosterone?
• How long does TRT last?
• Should I take a supplement to increase my testosterone?

Resources

Endocrine Society: Hypogonadism in Men

National Institutes of Health, MedlinePlus: Could You Have Low Testosterone?

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It’s common for runners to overdo it. In fact, up to 70% of runners develop injuries each year. They most often occur because of a training error. You may run too far, too fast, or too soon after an injury. As a runner, it’s important to take care of your body to avoid injuries.

Path to improved health

You can lower your risk of running injuries by doing the following:

• Start slow if you’re new to running. Alternate walking and running to ease into it.
• Don’t increase your running mileage by more than 10% per week.
• Don’t run more than 45 miles per week. There is little proof that running this much improves your performance. In fact, it can increase your risk of an overuse injury.
• Don’t run on slanted or uneven surfaces. The best running surface is soft, flat ground.
• Don’t “run through pain.” Pain is a sign that something is wrong. You shouldn’t ignore it.
• If you have pain when you run, rest for 2 to 3 days and use ice. See your doctor if the pain continues for 1 week.
• Alternate hard running or training days with easy days.
• Change your running shoes every 500 miles. At this distance, shoes can no longer absorb the shock of running.

Stretching and strengthening exercises can prevent injuries. Here are some exercises to try:

Stretching exercises

Hamstring stretch

Sit with your right leg straight in front of you and your left leg bent to the side. With your back straight and your head up, lean forward at your waist. Try to touch your toes. You should feel the stretch along the underside of your thigh. Hold the stretch for 10 to 15 seconds. Repeat and switch legs. This exercise may be helpful for people who have:

• Patellofemoral pain syndrome (PFPS or “runner’s knee”): Pain under and around the kneecap.
• Patellar tendinitis: Inflammation of the tendon that connects the knee and knee cap.
• Hamstring strain: Overstretching or tearing of the muscles on the back of the thigh.

Iliotibial (IT) band stretch

Sit with your right leg straight in front of you and your left leg crossed over it. Twist at your waist to the left and pull your left leg across your chest. You should feel the stretch along the side of your hip and IT band. Hold the stretch for 10 to 15 seconds. Repeat and switch legs. This exercise will be helpful for IT band injuries.

Groin stretch

Sit with your legs bent and knees open to the side. Hold your feet together. Keep your back straight, head up, and elbows on the inside of your knees. Push down on the inside of your knees with your elbows. You should feel the stretch along the inside of your thighs. You can lean forward over your legs to increase the stretch. Hold the stretch for 10 to 15 seconds. Repeat. This exercise may be helpful for adductor strains, which is overstretching of the groin muscles.

Quadriceps stretch

Quadriceps are the muscles that cover your thighs. Stand straight on both legs. Bend your right leg behind you and take hold of your foot. Pull your right heel toward your buttocks. You should feel the stretch in the front of your thigh. Hold the stretch for 10 to 15 seconds. Repeat and switch legs. This exercise may be helpful for PFPS, patellar tendinitis, and IT band injuries.

Calf stretch

Stand with your hands against a wall and your right leg behind your left leg. Keep your right leg straight, heel flat on the floor, and foot pointed straight ahead. Bend your left leg, making sure your knees are over your toes, and lean forward. You should feel the stretch in the middle of your calf. Hold the stretch for 10 to 15 seconds. Repeat and switch legs. This exercise may be helpful for:

• Achilles tendinitis: Inflammation of the Achilles tendon, the large tendon at the back of the ankle.
• Plantar fasciitis: Heel pain.
• Calcaneal apophysitis: Inflammation where the Achilles tendon attaches to the heel. This is more common in children.

Plantar fascia stretch

Stand straight with your hands against a wall and your right leg slightly behind your other leg. Keep your heels flat on the floor. Bend both knees, making sure your knees are over your toes. You should feel the stretch in your heel, arch, and lower part of your leg. Hold the stretch for 10 to 15 seconds. Repeat and switch legs. This exercise may be helpful for plantar fasciitis, calcaneal apophysitis, and Achilles tendinitis.

Strengthening exercises

Straight leg lift

Lie down on your back, then support your upper body on your elbows. Raise your right leg off the floor in 4 counts, hold for 2 counts, and lower it in 4 counts. This will engage the top of the thigh muscles in your right leg. Relax your leg and thigh muscles. Repeat and switch legs. This exercise may be helpful for PFPS and patellar tendinitis.

Side leg lift

Lie down on your right side. Raise your left leg off the floor in 4 counts, hold for 2 counts, and lower it in 4 counts. This will engage the thigh muscles of your left leg. Relax your leg and thigh muscles. Repeat and switch legs. This exercise may be helpful for IT band injuries.

Inner thigh lift

Lie down on your right side with your left leg crossed over the knee of your right leg. Raise your right leg about 6 to 8 inches off the floor. Hold for 2 seconds and then lower it back down. This will engage the inner thigh muscle of your right leg. Relax your leg and thigh muscles. Repeat and switch legs. This exercise may be helpful for adductor strains.

Lying leg lift

Lie down on your stomach. Raise your right leg off the floor in 4 counts, hold for 2 counts, and lower in 4 counts. This will engage the thigh muscles of your right leg. Relax your leg and thigh muscles. Repeat and switch legs. This exercise may be helpful for hamstring strains.

Standing wall slide

Stand with your back against the wall. Your feet should be slightly apart and 6 to 8 inches away from the wall. Bend your legs and lower your back and hips about one-third of the way down the wall. Make sure your knees are over your toes. Hold the position for about 10 seconds or until you feel your thigh muscles become tired. Straighten back up to standing. Repeat. This exercise may be helpful for PFPS and patellar tendinitis.

Lateral step-ups

Start with both legs on a stair or platform that is 4 to 6 inches high. Lower your right leg, putting your heel on the floor. Straighten the knee of your left leg, allowing the foot of your right leg to lift slightly off the floor. Repeat and switch legs. This exercise may be helpful for PFPS and patellar tendinitis.

Walking lunge

Stand straight on both legs. Step your right leg forward about a foot and keep your heels on the ground. Bend both legs, making sure your knees are in line with your toes. Hold for 2 seconds. Straighten your legs. Repeat and switch legs. This exercise may be helpful for PFPS and patellar tendinitis.

Now that you know the exercise to do, follow these rules to get the most benefit:

• Be consistent. Do 3 sets of each exercise with 10 repetitions in each set. You should hold each stretch until you feel tension but not pain.
• Never bounce with a stretch.
• Make sure you exercise both legs equally.
• Try not to favor a leg that is weaker or injured.
• You can add ankle weights as the exercises become easier for you.
• Stretch every day.
• Stretches also can be part of an injury recovery plan.

Things to consider

Some doctors suggest wearing orthotics or compression socks or sleeves when running. These can help prevent running injuries.

Orthotics are shoe inserts that can correct bad alignment between your foot and lower leg. You may need orthotics if your feet turn in, a problem called pronation. If you have bad alignment but don’t have pain or injuries from running, you probably don’t need orthotics.

Compression socks and sleeves help increase circulation. People who run a lot and have poor blood flow may need to wear these.

Questions to ask your doctor

• Should I do stretching and strengthening exercises before I run? After? Both?
• How do I treat a running injury?
• If I have an overuse injury, how long do I need to rest from running?
• How do I know if I need to wear orthotics or compression socks or sleeves?

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Awareness is an important part of making lasting changes for healthy living. For some people, keeping a journal is a good way to be more mindful. You can keep track of what, when, and how much you eat. You also can log what you do and how you feel.

Even if you are not losing weight, making diet and activity improvements can still significantly benefit your health.

Path to improved health

When you start a food and activity journal, try to capture everything. This means logging everything you eat and do throughout your day.

Nutrition

Write down what you eat and drink all day. Start when you wake up and end when you go to bed. Include how much you ate (portion sizes). If you’re not sure, use an estimate. This will give you an idea of how much you consume each day. If possible, record the number of calories you ate or drank. Record how much water you drink as well. It is important to stay hydrated throughout the day.

With each meal or entry, ask yourself, “Am I truly hungry?” You might be starving, need a snack, or not be hungry at all. Take note of this in your journal. It helps to write down your thoughts, feelings, and symptoms. They play a part in why you want to eat. Doing these things will help you make better choices in the future.

Activity

Write down your physical activity each day. Include the type and length of time. For instance, you ran for 30 minutes or bicycled for an hour. Be sure to include routine things, such as doing household chores and walking the dog. Add a note to capture your thoughts, feelings, and symptoms. This could be how you felt before and after, or if you had any pain.

Your thoughts

Jot down anything that you reflect on throughout the day. This could be emotions, insights, or goals. Be sure to include hobbies and time spent with others. You also should make note of any questions or concerns that you want to discuss with your doctor.

Things to consider

Here are some tips for using a food and activity journal:

• Commit to writing in it every day. Reflect on what you have learned.
• Keep track of times to help you see out your patterns or habits. This could be when you ate, how long you were active, or what you felt.
• Try to carry your journal with you, so you can write things down before you forget.
• If you don’t have your journal, write a note and add it in later.

Each day, look at what you wrote down in your journal. Compare it to other days to learn patterns and become more aware. For instance, did you eat from all five food groups? Did you skip a meal? This assessment will help you make healthy changes in your daily life. You may be surprised by what you find out and how helpful a journal can be. Whether you want to lose weight or simply improve your health, the choices you make each day make a difference.

If you find it hard to keep a paper journal, consider an online journal. There are many mobile apps that allow you to track food, drink, and activity. Try to find an app that has an emotional or mental component as well. Examples include My Fitness Pal, Yazio, and Lose It!

Questions to ask your doctor

• How much should I eat and drink each day?
• How much activity should I do each day?
• What do my feelings have to do with losing weight or living healthy?
• What kind of goals should I make when using a food and activity journal?

Resources

Food and Activity Journal — Blank (PDF)

Food and Activity Journal — Sample (PDF)

National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases: Changing Your Habits for Better Health

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“Use it or lose it” commonly refers to the importance of exercising your body and staying fit. Exercising your brain is just as important. Your brain needs a regular workout, especially as you age. After the age of 65, your risk of developing dementia doubles approximately every five years.

Dementia is not a disease. It’s a collection of symptoms resulting from damaged brain cells caused by other diseases. These cells affect your memory, personality, and decision-making abilities. Brain damage can occur from a head injury, stroke, or disease, such as Alzheimer’s dementia (the no. 1 form of dementia). Other diseases, such as uncontrolled type 2 diabetes, can cause another form of dementia known as vascular dementia (the 2nd most common form of the condition). Vascular dementia is caused by poor blood supply to the brain. It also affects memory, personality, and decision-making abilities.

While some forms of dementia cannot be cured and the brain damage cannot be reversed, research shows that keeping your brain active with activity, a healthy diet, and physical exercise may help delay the onset of dementia. It also may help prevent brain damage caused by injury or disease. The earlier you start brain-training activity, the better the benefits.

Path to improved health

If you are healthy and younger than 65, stimulating your brain with activities and games can keep your mind sharp later in life (unless you develop a dementia-related disease or have a stroke or a head injury). If you currently have some form of dementia, brain games and “active mind” activity can still help.

There are plenty of online games and apps available to play on the computer, your cell phone, or tablet. Some are free and some require a one-time or monthly fee. Don’t forget the benefits of playing simple board games, such as checkers, chess, matching games, or a jigsaw puzzle. Other puzzle games, such as Sudoku and crossword puzzles, are challenging, as well, and are often found in your local newspaper.

As you search for online games and apps, look for activities that stretch your short-term memory, listening, attention, language, logic, reaction time, hand-eye coordination, alphabetizing, and visual and special abilities. Consider adding brain-training activities that apply to your everyday life. For example:

• Write a to-do list and then memorize it.
• Listen to a new song and write down some of the lyrics.
• Draw a map from your home to the library.
• Research a new topic

Other ways to challenge your brain include:

• Changing the way you do something. If you are right-handed and stir your coffee with that hand, trying to stir with your left hand.
• Read a how-to book.
• Learn a new language.
• Try a new craft or hobby.
• Learn to play a musical instrument.
• Take a class at your local college or community center.

It’s important to supplement your brain activity with a healthy lifestyle, too.

• Maintain a healthy weight and eat healthy.
• Get moving with physical exercise.
• Don’t smoke.
• Limit your alcohol.
• Get adequate sleep.
• Do your best to avoid injuries.
• Lower your stress.
• Follow your doctor’s orders for managing your diseases or conditions.
• Focus on activities that support your mental health.
• Maintain an active social life by regularly spending time with friends, volunteering, or joining a club.

Things to consider

Brain training and lifestyle changes may be overwhelming. Don’t try to change everything at once. Start slow by choosing one brain game. If you can add more, that’s even better. If you find yourself getting bored with the same game, choose another one to stay active. Don’t give up. Change up your daily living routine, too. For example, if you always brush your teeth and then comb your hair, try reversing your routine. Do the same thing with your healthy living. Swap a fried food for the grilled version. Add five minutes to your exercise routine. Schedule your annual health exam and screenings. Make a date with a friend.

Unfortunately, there’s no guarantee that brain training and lifestyle changes will prevent all forms of dementia. It will not cure certain forms of dementia, such as Alzheimer’s disease. However, you can improve dementia that is tied directly to disease (such as uncontrolled type 2 diabetes) by managing the disease with medicine and healthy living.

Dementia may be difficult to spot on your own. Often, it takes a family member or close friend to notice changes. Unfortunately, there is not enough evidence to determine the pros and cons of physician screening for dementia, according to the American Academy of Family Physicians (AAFP). Certain medicines and depression can be tied to memory loss.

It is important to note that depression in the elderly often looks a lot like dementia to others, so supporting their mental health is critical.

When to see your doctor

Don’t be concerned about occasional memory loss. That is normal. However, memory loss related to dementia grows worse over time and progresses at a faster rate. Signs that you or a loved one may be suffering from dementia might include:

• Memory loss of recent events or information. This might be noticeable if you or a loved one repeats the same question and can’t remember the answer.
• Forgetting how to perform familiar tasks, such as driving, cooking, or bathing
• Language problems, such as not using the correct word
• Not remembering how to get somewhere familiar or how you got there
• Poor judgment for simple things, such as wearing a different shoe on each foot
• An inability to think in abstract ways, such as understanding the purpose of money
• Losing things and finding them in strange places, such as putting clothing in the refrigerator
• Mood and personality changes that can turn a usually happy person into an angry, rude person, or a confident person into a fearful, suspicious person
• Loss of interest in things that once mattered, such as time with friends and family or hobbies
• Difficulty making choices

Questions to ask your doctor

• How many hours a day should I spend playing brain games?
• Should I be concerned if I perform poorly on the brain games? Is that an indication of early dementia?
• What does it mean if I get tired after playing games?
• How can I tell if playing brain games is making a difference?
• Is it better to play brain games on your own or with a partner?
• How can I tell if my memory problems is normal aging versus dementia?

Resources

Alzheimer’s Association: Brain Health

Centers for Disease Control and Prevention: Healthy Brain Initiative

National Institute on Aging: Cognitive Health and Older Adults

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People who have diabetes are more likely to get heart disease. When you have diabetes, your blood sugar level is often much higher than it should be. Too much sugar in the blood can cause damage to many parts of the body, including blood vessels. Some lifestyle habits may also raise the risk of heart disease.

Diabetes, being overweight, high blood pressure, and heart disease are related. But there are things you can do to reduce the risks of all four conditions. Diet and exercise are good ways to control your blood sugar level, lower your blood pressure, and cut your risk of getting heart disease. When diet and exercise don’t help enough, medicines can help control blood sugar levels, lower cholesterol levels, and control blood pressure.

Controlling diabetes – Path to improved health

There are many things you can do to be proactive about your health. Taking care of yourself is especially important when you have diabetes. Some of the things you would do to control diabetes will also lower your risk for heart disease.

Keep your blood sugar level under control.

Controlling your blood sugar level will lower your risk of heart disease. Many people who have diabetes check their blood sugar level every day. This confirms their medicines and/or insulin, diet, and exercise are working to keep their blood sugar in a normal range.

Lose weight—and keep it off.

Losing weight helps a lot of health problems. For example, if you’ve been told your blood pressure is too high, losing weight can bring it down. If your blood sugar level has been hard to control, losing weight can help.

Weight loss is important if you have a lot of extra weight around your waist and abdominal area. People who tend to carry extra weight around their waist are more at risk for heart disease than people who have extra weight in the hips or thighs. Even losing just 10 pounds can help your blood pressure, sugars, and the risk for heart problems. If you need help losing weight, ask your family doctor for advice. He or she can help figure out a safe and healthy plan for you.

Lower your cholesterol level.

Cholesterol is a waxy substance your body uses to protect nerves, make cell tissues, and produce certain hormones. All the cholesterol your body needs is made by your liver. Cholesterol in the food you eat (such as eggs, meats, and dairy products) is extra. Too much cholesterol in your blood can clog your arteries.

There are two types of cholesterol. LDL (which stands for low-density lipoprotein) is the so-called “bad” cholesterol that can clog your arteries and lead to heart disease. HDL (which stands for high density lipoprotein), is the “good” cholesterol that carries unneeded cholesterol away from body tissues. This lowers your risk of heart disease.

If your doctor says your cholesterol level is too high, what can you do about it? It helps to lose weight and eat a healthy diet.

You should limit the amount of fatty and cholesterol-rich foods you eat. There are many cookbooks available that contain low-fat, low-cholesterol recipes and meal suggestions. If you need help figuring out how to change your diet, your doctor might refer you to a dietitian. A dietitian has special training in planning healthy diets.

If diet alone doesn’t lower your cholesterol, certain medicines can help do that. You and your doctor can talk about these medicines. The medicine that’s best for you depends on your special needs and medical condition.

Increase your physical activity.

Along with diet, exercise is very important for people who have diabetes. Diet and exercise work together to help your body work properly. If you’ve changed your diet to lose weight, exercising can help you lose weight faster. Even if you are not losing weight, do not get discouraged. Adding exercise to your routine will still make a positive impact on your health.

You and your doctor can plan exercises that will work best for you and are safe for you. You don’t need a gym or expensive equipment to get good exercise. Brisk walking is great exercise. Climbing stairs instead of taking an elevator is another good thing to do.

Like eating a healthy diet, exercise will help keep your blood sugar level normal and can lower your risk of heart disease.

Control your blood pressure.

People who have diabetes often also have high blood pressure. High blood pressure is a big risk factor for stroke. It also increases your risk for heart disease and kidney disease.

The same lifestyle changes that control blood sugar levels and lower your risk of heart disease may also keep your blood pressure at safe levels. Weight loss and exercise are important. The more weight you lose, the more you lower your blood pressure. It’s also important not to drink very much alcohol.

If your blood pressure doesn’t come down enough with diet and exercise, your doctor might have you take medicines to help.

If you smoke, stop smoking.

Smoking is bad for everyone, but it’s even worse for people who have diabetes. That’s because it damages the blood vessels. If you have diabetes and smoke, you double your risk of getting heart disease. If you keep smoking while you try to reduce other risks (such as losing weight), you won’t be able to exercise as much. This means you probably won’t lose the weight you need to.

Things to consider

The higher your blood sugar, the higher your risk for developing heart disease. This means if your blood sugar is left uncontrolled, it can really damage your heart. Other factors can increase your risk even more, including smoking or being overweight. Having these risk factors likely means you’ll develop heart problems sooner. And your heart problems will be more severe.

If you have diabetes, talk to your doctor about the best way to manage your blood sugar. Ask the doctor to recommend an exercise program for you. Ask your doctor to refer you to a dietician.

Questions for your doctor

• Do I have risk factors that increase my likelihood for developing heart disease?
• If I have type 2 diabetes, can I manage it with diet and exercise alone?
• If I take medicine to control my blood sugar, do I really need to diet and exercise?
• Should I also see a cardiologist if I have diabetes?

Resources

American Diabetes Association: Nutrition, Eating Doesn’t Have to Be Boring

American Heart Association: Healthy Eating

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Admitting you have an addiction is hard to do. But it’s the first step in getting help for your problem. The next step is getting help through treatment.

The purpose of addiction treatment is to help yourself or another person:

• Stop the addiction
• Keep the addiction stopped
• Be productive at home, at work, and in society

Path to improved health

There are several types of addiction treatment options available. These are some of the most common.

Inpatient/Residential

This is the most intensive type of treatment. It’s for people with severe addiction issues. For this type of care, you live at a specialized facility for an extended period of time. The amount of time depends on the facility and the type of treatment you need.

Some people may stay a few days at a hospital’s in-patient addiction recovery unit. Others may stay at an out-of-town facility for 30 days or more. Some private facilities offer programs that last 6 months or longer.

The most common programs typically last 30 days. These programs are good for people who have trouble staying addiction free on their own. They provide more structure and guidance. An inpatient program gives you a safe place to stay while you focus on yourself. While living there, you may attend individual therapy, group therapy, and classes. These teach you about addiction. They help you learn to live without your addiction.

Intensive Outpatient

An intensive outpatient (IOP) program provides the same therapy and education as inpatient treatment. But you stay at your own home for the duration of treatment. You take part in a program that lasts several hours a day. Some programs run during the day. Others run in the evening. If you have a family or commitments that prevent you from going away for treatment, IOP could be a good option for you.

Sober Living

Some people choose to live in houses or communities with people who are also in recovery. This gives them accountability and structure they may not have at home. There are usually rules that must be followed. Residents often have chores or responsibilities within the house. With this treatment, people get to live on their own but still have structure and support from peers.

Outpatient

In this treatment, you usually attend group therapy on a regular basis. Depending on the program, therapy may be once, twice, or more a week. Another form of outpatient treatment is individual therapy with a counselor. These forms of treatment are recommended for people who have been addiction free for some time.

Support groups

There are free support groups that help people with addictions. Some of these are called 12-step groups. They include, but are not limited to:

• Alcoholics Anonymous
• Narcotics Anonymous
• Overeaters Anonymous
• Gamblers Anonymous

Other groups that aren’t affiliated with the 12 steps include:

• Celebrate Recovery
• SMART Recovery
• Secular Sobriety

These groups are usually free to anyone with a problem. They can offer support for someone struggling with addiction. Because they’re peer groups, you can learn from the experiences of anyone in the group. You also gain a sense of community that can support you as you deal with your addiction.

Things to consider

There are a number of factors you will need to consider when choosing what type of addiction treatment is right for you. These include:

• The severity of your addiction. If you struggle with your addiction every day, you may need residential treatment.
• If you need to detox. Some substances are very difficult to stop, and medical detoxification is needed. These include alcohol and heroin. You’ll need to find out if the treatment option you are looking at involves detox.
• If you have a co-occurring condition. These are mental or behavioral disorders that you deal with in addition to your addiction. These could include depression, anxiety, PTSD, bipolar disorder, or schizophrenia.
• What you can afford. Medical insurance will usually cover some forms of addiction treatment. You need to find out what your insurance company will cover before you make your decision. If your insurance doesn’t cover the treatment you need, you’ll need to decide how much you can afford to spend. Some treatment programs are willing to work with you. They may offer discounts if you pay cash up-front. Some offer sliding scales. Some programs, like 12-step programs, are free.

Questions to ask your doctor

• How severe is my addiction?
• What kind of treatment will be best for me?
• How long should I be in treatment?
• Do I have any co-occurring conditions that I should be treated for, too?
• Can you refer me to a treatment facility?

Resources

National Institute on Drug Abuse, Treatment

U.S. Department of Health & Human Services, Substance Abuse and Mental Health Services Administration: Behavioral Health Treatment Services Locator

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