Many chronic illnesses have early warning signs. Here's how to recognize them-and turn your health around
"Good news! Your blood pressure is going up, your cholesterol is a little high, and your blood sugar is slightly above normal!"
No doctor would announce results of your latest medical tests this way, of course. But learning that these key measures of your health are drifting upward can be, if not good news, at least very useful information. Most people are surprised when they are diagnosed with a serious health problem-in one study, more than half the patients were shocked when their doctors told them that they had diabetes. But common conditions like heart disease and diabetes don't just appear overnight. They develop gradually, giving themselves away in "borderline" or "pre-" or "subclinical" stages that can show up years before you have the full-blown disease. Paying attention to not-quite conditions gives you the chance to take action. That starts with finding out what your numbers are-and then learning how little it may take to pull yourself back from the brink. Here are four major health preconditions-and the best ways to stop them.
PREHYPERTENSION
What it is A blood pressure reading anywhere from 120/80 to 139/89. Officially, true hypertension (high blood pressure) is diagnosed when either your systolic pressure (the upper number) is 140 or higher or your diastolic pressure (the lower number) is 90 or more.
Why it's a problem Rising blood pressure makes your heart work harder and damages the lining of your arteries, increasing your risk of a heart attack or stroke. "If your systolic blood pressure goes up by 20 points, your risk of dying from a heart attack or stroke increases 50 percent," says Lawrence Fine, M.D., of the National Heart, Lung, and Blood Institute. Research has shown that people in the "window"-above normal but below official hypertension-are significantly more likely to go on to have the full-blown disease and to need medication to bring their pressure down.
How to reverse your risk You can begin to dramatically lower blood pressure in as little as two weeks, a landmark federal study (DASH) reported. And the drop could be enough to get your pressure back to normal. The DASH plan stresses whole grains, fruits, vegetables, fat-free dairy, lean protein, nuts, and legumes. One key feature: eating less salt, which can raise blood pressure. Check food labels for high amounts of sodium (more than 400 milligrams per serving). Be especially vigilant about processed foods-they contribute 75 percent of the sodium in the typical diet. Some surprise culprits: salad dressing, pasta sauce, and instant hot cereal. You can also counterbalance the impact of sodium by getting more potassium and magnesium, which lower blood pressure (good sources include broccoli, spinach, lima beans, tomatoes, and sweet potatoes).
BORDERLINE HIGH CHOLESTEROL
What it is A total-cholesterol reading of 200 to 239, or LDL ("bad") cholesterol of 130 to 159. Your level is officially "high" when total cholesterol reaches 240 or LDL hits 160 (less if you have other risk factors).
Why it's a problem Too much LDL in the blood causes plaques to form in the walls of blood vessels, narrowing and clogging the arteries, which can eventually lead to a heart attack. "Your risk increases as your cholesterol goes up," says James Cleeman, M.D., of the National Cholesterol Education Program. And "borderline" should not be thought of as a precondition if you're already at higher risk of a heart attack because you have heart disease or diabetes or other risk factors, such as high blood pressure, smoking, age (55 or over for women), or a family history of early heart disease. "Then it could be a serious problem that requires aggressive treatment with lifestyle changes and medication," says Dr. Cleeman.
How to reverse your risk The more risk factors you have, the more you stand to gain from lowering your total and LDL cholesterol. That doesn't necessarily mean medication: "Lifestyle changes alone can reduce your risk of developing heart disease by 20 to 30 percent," says Dr. Cleeman-about the same amount you'd get from taking cholesterol-lowering medication. One easy change: walking briskly or doing some other form of moderate aerobic exercise for at least 30 minutes five days a week. Make it more vigorous-jogging, for example-and you need to work out only 20 minutes three days a week.
On the diet front, focus on lowering your consumption of saturated fat (found especially in butter, whole milk, and other high-fat dairy products, and in marbled red meat, bacon, sausage, and chicken with skin). "Saturated fat raises cholesterol more than anything else," says Dr. Cleeman. "Trans fats raise LDL just as much, so you should avoid them, too, but saturated fat is four to five times more common in the diet, making it a far bigger problem."
PREDIABETES
What it is Fasting blood sugar of 100 to 125 or a reading of 140 to 199 on a two-hour oral glucose tolerance test (GTT). Actual diabetes is defined as fasting blood sugar of 126 or higher or a two-hour GTT of 200. (If you're at risk of heart disease, ask for the GTT. Women are more likely to have a form of prediabetes known as impaired glucose tolerance, and this test is better at picking it up.)
Why it's a problem By the time people are diagnosed with type 2 diabetes or experience symptoms, such as constant thirst or frequent urination, it's often too late to cure the key problem: insulin resistance, a condition in which the body has trouble using the insulin it produces to convert carbohydrates (sugar) from food into energy. As a result, sugar accumulates in the blood. Prediabetes means you already have some degree of insulin resistance, though it hasn't driven your blood sugar high enough for an official diagnosis. But you may be on the way: People with prediabetes are five to 15 times more likely to develop the actual disease than those with normal blood sugar-and are also at higher risk of suffering from heart disease or stroke. That's why you need to be "very aggressive about changing your habits," says Richard Hellman, M.D., president of the American Association of Clinical Endocrinologists.
How to reverse your risk Dropping just 5 to 7 percent of your weight could do it. In a large National Institutes of Health study, men and women who lost that amount were 58 percent less likely to progress to diabetes-a dramatic turnaround that was far better than the results for a similar high-risk group who took medication. That means that if you weigh 150 now, losing just 7 to 10 pounds could keep you from becoming diabetic. But even if you're successful, keep exercising as well as watching your diet: You want your blood sugar to stay low, and studies have found that exercise is key.
OSTEOPENIA
What it is Bone-mineral density T-score of -1 to -2.49. T-scores of -2.5 or lower signal osteoporosis.
Why it's a problem Don't be put off by the math. Basically what you need to know is that osteopenia means you have a mild amount of bone thinning, which puts you at higher risk of developing the more severe condition, osteoporosis-or of suffering a fracture. Half of bone breaks after menopause occur in women with osteopenia, not osteoporosis, recent research shows. "Actual fracture risk is based on many factors besides T-score, such as your age, weight, and family history of osteoporosis," says Kathryn Diemer, M.D., clinical director of the Bone Health Program at Washington University in St. Louis. ...
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April 2008 Good Housekeeping, Tuesday, April 1, 2008 Byline: Richard Laliberte |
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