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Live Well, Live Long: A Lifetime of Healthy Living PDF

432 Pages·2004·2.27 MB·English
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Bh0573M00-PressProofs.QX5 17/12/03 2:38 PM Page i Live Well, Live Long Bh0573M00-PressProofs.QX5 17/12/03 2:38 PM Page ii KEEP UP TO DATE Visit the Live Well, Live Long website www.livewelllivelong.com The Live Well, Live Long website provides: • new medical information to help up-date the information provided in this book. • new information resources, including websites and publications. • information about how this book can be purchased. The Live Long, Live Well Preventative Health Clinic The preventative health practice of Dr Paul Goyen in Sydney. Visit the above website for contact details and further information. Bh0573M00-PressProofs.QX5 17/12/03 2:38 PM Page iii Live Well, Live Long A lifetime of healthy living l i v e w e l l , l i v e l o n g D R PA U L G O Y E N Bh0573M00-PressProofs.QX5 17/12/03 2:38 PM Page iv For my family, Robyn, Leigh and Anna and for all those who have suffered from the premature loss of loved ones. First published in 2003 Copyright © Dr Paul Goyen 2003 All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording or by any information storage and retrieval system, without prior permission in writing from the publisher. The Australian Copyright Act 1968 (the Act) allows a maximum of one chapter or 10 per cent of this book, whichever is the greater, to be photocopied by any educational institution for its educational purposes provided that the educational institution (or body that administers it) has given a remuneration notice to Copyright Agency Limited (CAL) under the Act. Allen & Unwin 83 Alexander Street Crows Nest NSW 2065 Australia Phone: (61 2) 8425 0100 Fax: (61 2) 9906 2218 Email: Bh0573M00-PressProofs.QX5 17/12/03 2:38 PM Page v Contents Contents l i v e w e l l , l i v e l o n g Foreword xi Acknowledgements xii Introduction xiii PART 1 PREVENTING ILLNESS—THE BASICS Identifying preventable adult illnesses 3 Burden of disease 4 The least you need to do 7 Choosing your family doctor 11 Identifying preventable childhood illnesses 12 Population groups with special health needs 19 Health in Indigenous people 19 Health in overseas-born people 21 Health in rural and remote communities 22 Health in socioeconomically disadvantaged groups 23 The problem—achieving change 25 Behavioural patterns that make change difficult 27 The stages involved in changing lifestyle behaviours 28 Assessing medical information 33 Can your practitioner provide quality treatment that works? 33 Conflict of interest 34 v Bh0573M00-PressProofs.QX5 17/12/03 2:38 PM Page vi vi Live Well, Live Long A reasonable fee for the consultation 34 What evidence is there that the treatment is beneficial? 35 Medication labels 36 PART 2 MENTAL HEALTH Functioning in our society 39 Relationships—an integral part of mental health 39 The art of ageing well—self-worth and achievement 46 Adolescent risk-taking 50 Sleep and tiredness 54 Stress 58 Mental illness 62 Anxiety disorders 63 Depression 68 Suicide prevention 75 Schizophrenia 78 Alcohol and illicit substance use and abuse 81 Harmful effects of alcohol 81 Illicit substance abuse 93 PART 3 NUTRITION AND ILLNESS PREVENTION What’s in your food? 105 Nutrient groups in your diet 105 Body energy imbalance—a major health dilemma 105 Fat—the danger in our diets 107 Carbohydrates and low-glycaemic index foods 117 Fibre in the diet 119 Micronutrients and other useful compounds 121 Vegetarian diets 124 Caffeine 125 Organic foods, pesticides and food additives 126 Herbal and natural remedies 127 Consumer food information 128 Diet and cancer prevention 130 Dietary recommendations to prevent cancer 130 Vegetables and cancer reduction 131 Food and bowel cancer 135 Food and prostrate cancer reduction 137 Other dietary influences on cancer 138 Bh0573M00-PressProofs.QX5 17/12/03 2:38 PM Page vii Contents vii PART 4 OBESITY AND PHYSICAL INACTIVITY Obesity 143 What is it and how does it affect us? 143 Prevention of obesity 148 Causes and principles of treatment 150 Diets—do they work and which is best? 157 Achieving change in eating habits 167 Childhood obesity 178 Causes of childhood obesity 179 Problems caused by obesity in children 180 A family problem, not a problem with the child 180 When weight loss goes too far—anorexia and bulimia 184 Physical inactivity 186 Benefits of physical activity 187 Preventing injury from exercise 188 Planning your exercise modification program 189 Commencing and maintaining a new physical activity program 194 Physical activity for children and the elderly 194 PART 5 PREVENTING HEART ATTACKS AND STROKES Vascular disease—an overview 199 An outline of the vascular system 199 What is vascular disease? 200 Heart attacks and angina 204 Risk factors for vascular disease 207 Strokes 214 Lowering blood cholesterol and other lipids 216 The causes of raised blood lipids 216 Investigating blood lipids 218 Reducing blood cholesterol and triglyceride levels 220 Hypertension (high blood pressure) 226 Prevention of hypertension 227 Treatment of hypertension 231 Diabetes 233 What is diabetes? 233 Diabetic complications 236 Prevention of type 2 diabetes 237 Bh0573M00-PressProofs.QX5 17/12/03 2:38 PM Page viii viii Live Well, Live Long Other influences on vascular disease 243 Raised homocysteine levels 243 Type A personality, stress and depression 244 Lipoprotein(a) 244 Antioxidants 244 Alcohol 245 Beneficial dietary influences on vascular disease 246 PART 6 CANCER PREVENTION Understanding how to prevent cancer 249 Death and disability from cancer 249 Preventing the initiation of cancer 251 Medical intervention 252 Cancer and diet 254 Prevention of lung and other smoking-related cancers 255 Death and disability from smoking 255 Genetic predisposition to nicotine addiction 258 Quitting smoking 259 Smoking prevention 265 Recognising possible lung cancer symptoms 266 The future—screening for lung cancer 266 Bowel cancer prevention 268 Diet and bowel cancer 268 Screening people at normal risk of bowel cancer 269 Screening people at higher risk of bowel cancer 271 Recognising possible bowel cancer symptoms 273 Breast cancer 275 Breast cancer initiation 275 Breast cancer genes 277 Breast cancer risk 278 Breast cancer prevention 278 Screening using mammograms 280 Cervical cancer 283 What causes cervical cancer? 284 Pap smears as prevention 284 Screening techniques for detecting HPV 287 Bh0573M00-PressProofs.QX5 17/12/03 2:38 PM Page ix Contents ix Skin Cancer prevention—melanomas 289 Types of skin cancer 289 Preventing skin cancers 291 Screening for melanomas (and other skin cancers) 294 UV light and sunglasses 294 Prostate cancer 296 Diet and prostate cancer 296 Screening for prostate cancer by Prostatic Specific Antigen testing 297 PART 7 OTHER PREVENTATIVE HEALTH ISSUES FOR WOMEN Preparation for pregnancy and screening in pregnancy 303 The decision to become a parent 303 The pre-pregnancy consultation 304 Foetal genetic abnormalities 305 Other preventative health issues 308 Older mothers 310 Urinary incontinence in women 311 Risk factors for incontinence 312 Prevention and treatment of incontinence 313 Menopause and hormone replacement therapy 318 Who needs HRT? 319 Additional health benefits of HRT 319 Disadvantages/health risks of HRT 319 Other treatments for menopause 323 PART 8 OSTEOPOROSIS, INJURIES, ASTHMA AND OTHER PREVENTATIVE HEALTH ISSUES Osteoporosis 327 Osteoporosis risk factors 329 Diagnosing osteoporosis 331 Prevention and treatment of osteoporosis 332 Fall prevention 336 Accidents and injuries 340 Childhood accidents and injuries 340 Adult accidents and injuries 346 Bh0573M00-PressProofs.QX5 17/12/03 2:38 PM Page x x Live Well, Live Long Respiratory diseases 350 Asthma 350 Smoking and chronic obstructive lung disease 356 Asbestos and other work-related causes of lung disease 356 Renal disease 358 Screening for kidney disease 358 Determining kidney function 359 Hearing and sight 361 Adult-onset hearing impairment 361 Preventing hearing loss 363 Chronic glaucoma—a silent cause of blindness 364 Infectious diseases 366 Immunisation 366 Sexually transmitted diseases 369 HIV/AIDS 370 Prevention of hepatitis B 371 Prevention of hepatitis C 372 Dental caries 373 APPENDICES 1 Qualifying the effects of illness—the ‘burden of disease’ 377 2 Evidence-based medicine 379 3 Major foods contributing to fat intake 382 4 Developmental milestones in children 386 5 Major foods contributing to iron and zinc intake 387 6 A list of low glycaemic index foods` 388 7 BMI weight chart 389 8 The evolution of vascular disease 390 9 Dietary and other factors that influence vascular lesion formation 391 10 Diagnosing diabetes by testing blood sugars 392 11 New Zealand cardiovascular disease risk calculator 393 12 Cholesterol in the body 396 13 Antioxidants in foods 397 14 Control of LDL levels by dietary fatty acids 398 Glossary 401 References 406 Index 409

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