Live Well, Live Long: A Lifetime of Healthy Living

432 Pages·2004·2.27 MB·English

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Live Well, Live Long
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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.
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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
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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: [phone]
Fax: [phone]
Email:
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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
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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
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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
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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
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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
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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