Who need excercises? - How muscle activity helps?

DO YOU NEED EXERCISE?

The chances are that, like most of us, you are getting too little daily exercise. If you need specific clues to the fact that you can benefit from more activity, here are some: heart pounding or hard breathing after relatively slight exertion; a long time required for your heartbeat to return to normal after heavy exertion (you can measure the heart rate by the wrist pulse); stiffening of legs and thighs after climbing stairs; aching muscles after such activities as gardening or furniture moving; waking up from sleep as tired as before; frequent restlessness. 

Your physician, as part of his preventive medicine program for you, will be glad to determine with you, on the basis of your specific present condition, daily activities, and other personal factors, whether you need more exercise, how much time you need to devote to it, what kinds of activities would be best suited for you.

OPPORTUNITIES FOR ACTIVITY

Undoubtedly you will benefit from a soundly planned regular exercise schedule, even if it occupies no more than just a few minutes a day- and more on this shortly. Along with such a schedule, you can, and should, find other opportunities for increasing your activity. For one thing, it is possible to find opportunities for physical recreation that can supplement scheduled exercises and provide enjoyment. The list is almost endless: fishing trips, family outings, evenings of dancing, bowling in an office or neighborhood league, walking, etc. 

For another thing, there are opportunities for stepping up daily activities-and little bits of action add up in their good effects. It's a matter of attitude, of recognizing that it is good to use the body As much as possible and of seeking chances to do so.

Walk up a flight Physical Activity in 85 or more of stairs instead of relying entirely upon the elevator; walk part III much or sometimes all the way to the market, to the office. Interrupt sedentary work with little bursts of activity, even if no more than getting lip out of the chair and bending, stretching, moving about, flexing the  squatting, imitating a few golf swings. 

Weight Loss - Causes and Food Control

 It took time to put on the excess weight you want to be rid of. Take time to reduce. Moderate loss, at the rate of one-half pound to one pound a week, is healthier loss and the fat lost is more likely to stay off than fat lost in a hurry. And a pound a week adds up to 52 pounds a year. When you lose weight slowly, your skin adjusts and you don't get that deflated-balloon look.

CALORIE CONTENT OF SNACK FOODS FOOD AMOUNT

Chocolate bar Chocolate creams Cookies Doughnut Banana Peach Apple Raisins Popcorn Potato chips Peanuts or pistachio nuts Walnuts, pecans, filberts or cashews Brazil nuts Butternuts Peanut butter Pickles Olives Ice cream Chocolate-nut sundae Ice cream soda Chocolate malted milk Eggnog (without liquor) Carbonated beverages Alcoholic Beverages Beer Wine Gin Rum Whiskey Brandy Cocktail 1 small bar 1 average size 1 medium size 1 plain 1 large 1 medium size 1 medium size 1/2 cup 1 cup popped 8-10 or 1/2 cup 1 4 whole or 1 tbsp. chopped 1 1 1 tbsp. 1 large sour 1 average sweet 1 1/2 cup 1 glass 1 glass 6 oz.  

OBESITY STARTS IN CHILDHOOD

The problem of overweight in adults may well have its roots in infancy and childhood. There has long been a tradition-certainly no longer valid in an age of modern medicine-that the plump child is better equipped to withstand disease. The practice of actually encouraging fatness in babies to help them withstand tuberculosis and other diseases is not only unnecessary; it is potentially dangerous. Recent scientific work provides some tentative new insights into how overfeeding of children in infancy and the preadolescent years may build up fat cells (adipose tissue) that may remain with them a lifetime. The studies suggest that once these cells are laid down, they never disappear.

When weight is lost, the cells shrink, but still remain.

 At times, they may send out signals demanding to be fed. This demand may help explain why many people find it difficult to keep their weight down after dieting. A constant craving for food may not be wholly psychological, as many have thought; it may be at least partly based on biological demand from deprived fat cells. A lean adult may have about 27 trillion fat cells in his body; an obese may have 77 trillion. Obesity, when it exists, can be and that involves childhood, even in early infancy.  But its prevention is far reasonable eating habits 

How eating binges, breakfast, beverages affect your weight loss, weight control, weight management

EATING BINGES

 Some dieters are able to go off their diets occasionally without ill effect. Their morale may even benefit from knowing they can do this every month, which is better than constant "cheating." But re- member that you probably have a great tendency to eat more than you need or you wouldn't be dieting in the first place, so be very careful.

TALKING ABOUT YOUR DIET

 If you do talk about it, some people may consider you a bore; some may try to get you to break your diet; some will help you to keep it. You have to know which kind you are with before you start discussing your diet. Sometimes, it may be just as well simply to say that your physician has asked you not to eat certain foods. As a general rule, the best social technique is to avoid calling attention to your problem. Simply eat very little of fattening foods placed before you.

BREAKFAST

 A reasonably healthy, high-protein meal in the morning keeps people from being hungry in the midmorning and from eating too much at noon.

BEVERAGES

As you can see from the listings in the table, alcoholic beverages are high in calories. They don’t expect perhaps when taken in excess. Three glasses of 76 / Building General Health as Preventive Therapy beer, at 120 calories per 8-ounce glass, will supply as many calories as a fairly substantial breakfast. An evening of cocktails can provide almost as many calories as a full day's reducing diet. Even more serious is the fact that the calories supplied by alcohol are empty ones, without necessary food values such as proteins or minerals.  

Many people have turned to weight-reducing clubs where join with others wishing to reduce. The clubs are helpful in pi t1viding motivation. But medical authorities have reservations about supervision provided.  This dubs vary considerably in their programs, but all emphasize diet. Coupled with lectures, literature, and experience-sharing, some prescribe particular exercises.

 Many require an initial medical certificate for membership, but few have continuing medical supervision. Physicians have reported that, because of the lack of medical supervision in some clubs, the condition of their heart and diabetic patients worsened as a result of diet advice given. If you are considering joining some diet club you may have read or heard about, the best policy is to check with your physician about that particular club and its standing and whether he advises that you join it. 

weight loss-fried foods-sweets-starches- diet control, natural diet

Avoid fried foods, especially those that are French fried. It is difficult to determine just how many calories these foods contain, since they absorb varying amounts of fat, but it is always a great deal. Boil or poach eggs; you won't mind unbuttered toast if you serve your egg on it. Try cooking eggs on a griddle or the type of pan that does not require greasing. If you cook stews ahead of time and let them cool, you can remove the hardened fat, at least from your portion-and stews often are even better when rewarmed. Trim fat from your meat, and omit rich gravy.

SWEETS

An artificial sweetener, in tablet, powdered, liquid, or crystal form, can be used in many ways in addition to sweetening beverages. It can be used with skim milk on cereal and on strawberries or other fruits, cooked or uncooked. (If you serve fruit stewed in sugar, give the syrup to someone who needs the calories.) Sponge and angel cake are not very high in calories if you separate out your portions before adding icing for others in the family or before adding jam or fruit syrup. Make your own gelatin desserts so you can use saccharin for your portion, sugar for the rest. Take very small portions of any dessert, and avoid soft drinks unless you use the low-calorie types.

STARCHES

Undoubtedly you are accustomed to getting bulk from starches. You can get it instead from leafy green vegetables. Don't munch on bread and butter. In restaurants, ask the waiter not to bring the bread until he serves the main course. In some areas, salads are served first-a good idea because salads take the edge off your hunger before you get to the higher-calorie foods. Use wine vinegar with herbs or lemon juice on your own salad while serving richer dressings to others. Good gravies can be made without flour; one way is to use powdered milk which is fat-free.

Vegetables, either dried ones or fresh ones cooked down, and herbs will thicken stews. Chinese restaurants serve bulky, low-calorie dishes-if you avoid the rice. Many Chinese vegetables can be purchased in stores. Avoid restaurants that have a strictly enforced "no substitutes" rule. Many restaurants will give you an extra vegetable or an extra serving of the one on your dinner, or a salad, in place of potatoes. When serving soups such as minestrone or chowder, take mainly the clear part for yourself, leaving most of the macaroni, potatoes, and so on, for the others. 

CALORIE CONTENT OF FOODS AND BEVERAGES - Weight Control - Weight Loss

FOODS AND BEVERAGES 1000S

 Soup Bouillon or consommé Cream soups Split-pea soup Vegetable-beef or chicken Tomato Chicken noodle Clam chowder Meat and fish Beef steak Roast beef Ground beef Roast leg of lamb Rib lamb chop Loin pork chop Ham, smoked or boiled Bacon frankfurter Tongue, kidney Chicken Turkey Salami Bologna Veal cutlet (un-breaded) Hamburger patty (regular ground beef) Beef liver, fried Bluefish, baked Fish sticks, breaded (including fat for frying) Tuna fish, canned, drained Salmon, drained Sardines, drained Shrimp, canned Trout Fish (cod, haddock, mackerel, halibut, whitefish, broiled or baked)

 Whole lobster Vegetables Asparagus Beans, green kidney lima Beets Broccoli Cabbage, raw cooked Carrots, sweet white potato chips Radishes Spinach Squash, summer winter Tomatoes, raw canned or cooked fruits Apple Applesauce, unsweetened sweetened Apricot, raw canned or dried Avocado Banana Cantaloupe Cherries, fresh canned, syrup Cranberry sauce Fruit cocktail, canned Grapefruit Olives Orange Peach, fresh canned, syrup Pear, fresh canned, syrup Pineapple, canned (with syrup) Plums, fresh canned, syrup Prunes, cooked with sugar Raisins, dried Tangerine cereal, bread, and crackers.  

      

 Building general Health as Preventive Therapy Weight Control

CALORIE CONTENT OF FOODS AND BEVERAGES 

Cereal, bread, and crackers Farina, cooked Oatmeal, cooked Rice, cooked Macaroni or spaghetti, cooked Egg noodles, cooked Flour Bread, white, rye, or whole wheat Ry-Krisp Saltine Ritz cracker Biscuit Hard roll Pancakes Waffles Bun-cinnamon with raisins Danish pastry Muffin Dairy products Whole milk Evaporated milk Skim milk Buttermilk (from skim milk) Light cream, sweet or sour 

Heavy cream Yoghurt Whipped cream Ice cream Cottage cheese Cheese Butter Egg, plain fried or scrambled Cake and other desserts Chocolate layer cake Angel cake Sponge cake Fruit pie Cream pie Lemon meringue pie Chocolate pudding  Fruit ice Doughnut, plain Brownie Cookie.

Appetite and exercise - IS MASSAGE A REDUCING AID? - CAN HOT BATHS OR SWEATING HELP?

As for appetite and exercise 

while it is true that a thin person in good condition may eat more after increased activity, his exercise will burn up the extra calories. But the overly fat person does not react the same way; only when he exercises to excess will he experience an appetite increase, since he has large stores of fat, and moderate exercise in his case is not likely to stimulate appetite. This difference between the response to exercise of fat and thin people is an important one.

There are many opportunities to be found throughout the day for using up calories through little extra bits of activity. You can, for ex- ample, use up 100 calories with 20 minutes of gardening, 30 minutes of ironing, or 30 minutes of playing with the children. Any time you get up from behind a desk, walk about the room, perhaps just bend and stretch for a few times, you will not be burning up great quantities of calories- but do this every hour or two, and at the end of the week you will have burned a significant number.

IS MASSAGE A REDUCING AID? No.

 Massage may tone up the skin and muscles and help the body adjust to its new, slimmer contours. Your doctor will know when to recommend massage if it would help. 

CAN HOT BATHS OR SWEATING HELP? 

Only temporarily, since they serve merely to eliminate water, which is almost immediately regained. Not only do these methods achieve no permanent results of value but they may put a strain on heart and circulation. Sauna baths, recently fashionable, expose the body to high temperatures to bring about violent sweating. This is a shock to the body, sometimes doubling the pulse rate, as much of a shock as sudden and violent exercise. 

To be sure, saunas have long been popular in Finland, but the Finns use saunas over a lifetime rather than starting suddenly in flabby middle age, and they dash water on heated stones, producing a more humid and more tolerable (and possibly safer for the lungs) type of heat than electrically heated American saunas. 

Exercises for weight control

THE EXERCISE FACTOR

 For years, the role of exercise in reducing has been misinterpreted. Today, regular exercise is known to be essential for maintaining good health and preventing many diseases as well as being a vital adjunct to dirt for weight control. As some put it, diet is half the battle for weight control; it helps you on your way. Exercise provides the vitality and the drive; it helps take you where you want to go. There are still two widely prevalent misconceptions about exercise and weight control.

 One is that it takes great amounts of time and effort to use up enough calories to affect weight significantly. The other is that exercise increases the appetite and the end result is increase, not decrease, in weight. The misconception about time and effort stems from the impression that any exercise has to be accomplished in a single uninterrupted session. To be sure, it takes an hour's jogging to use up 900 calories, but one does not have to do all the jogging in one stretch. 

One must walk 35 miles to lose a pound of fat, but walking an additional mile a day for 35 days will take off the pound.

One can lose 10 pounds in a year by walking an extra mile a day. In one dramatic demonstration of the value of exercise, the daily food intake of a group of university students was doubled, from 3,000 calories daily to 6,000. At the same time, exercise each day was stepped up. 

There was no gain in weight. 68 / Building General Health as Preventive Therapy Another fact about exercise that deserves consideration: Body weight affects the amount of energy expended whatever the activity may be -walking, jogging, tennis playing, or anything else. For example, a 100- pound individual walking 3 miles per hour will burn about 50 calories in 15 minutes; someone weighing 200 pounds would use up as many as 80 calories in the same period. 

Weight reduction

IS A DOCTOR NECESSARY? 

Weight reduction on a sound basis calls for the special knowledge of a physician. He will make certain that you do not lose your health while losing excess weight; that you do not reduce too rapidly and thereby put a strain on your heart and circulation; that you do not find yourself with a cosmetic problem because you have lost weight but have not regained skin tone and end up with flabby masses of pendulous skin. He will suggest proper exercise. 

He will also prescribe vitamins, minerals, and other substances, if necessary, to prevent weakening of bones and organs and to maintain resistance to disease. For example, if you use a "no-calorie" salad dressing made of mineral oil, your doctor may want you to take some vitamins, because mineral oil lends to prevent adequate absorption of some of the vitamins your diet would ordinarily provide. Moreover, it helps considerably if you can have your diet suitably adjusted to your eating habits.

You may be one of those who will be miserable if deprived of a bedtime snack. You may prefer a substantial dinner and be willing to cut down on lunch to have it. A physician can help you establish a sound diet and one best suited to your needs. He may, if necessary, prescribe sedatives for your use during the toughest phase of dieting; the psychological aspects of a relationship with a sympathetic, encouraging physician also can be of great importance during dieting and later on in maintaining low weight. A doctor's encouragement and praise of a patient's efforts in reducing, we have found, can be of major value.

PILLS AS PROPS

 Should you take drugs to reduce? Without a doctor's supervision, never. If, in an individual case, a physician feels that an anti-appetite drug as a temporary prop is justifiable, he will prescribe it-and it should be taken exactly as prescribed. Most physicians, however, prefer to have a patient Weight Control / 67 rely on willpower and determination rather than on drugs and to adjust the diet so this is feasible. In the past, medicines for weight reduction generally were based on amphetamine and so stimulated patients that physicians were reluctant to use them. Now, a number of appetite-reducing agents are available, free of the side effect of overstimulation.

These apparently safer agents are available only on prescription. Over-the-counter reducing preparations are big business. At worst, they can be risky business because of the possibility of side effects; at best, the money is foolishly spent because in and of them the medicines are not to be relied upon for effective permanent weight reduction. The problem with even safe reducing agents is that they are only supports that help temporarily. 

It makes much more sense-s-and has far greater chance of permanent success-to regulate your diet by a healthy change in eating habits which, once desired weight reduction is achieved, can be continued with some upward shift in calorie intake, to maintain you at proper weight. 

Weight Control - THE DANGERS OF UPS AND DOWNS

Weight Control  

 THE DANGERS OF UPS AND DOWNS 

The frequent weight gains and losses indulged in by. The many obese people who practice what one writer calls the "rhythm method of birth control" may actually be more harmful than maintenance of a steady excess weight. For example, it has been shown that serum cholesterol is elevated during periods of weight gain, thus increasing the risk that it will be deposited on artery walls? 

We have no evidence to show that once cholesterol is deposited it can be removed by weight reduction. And it is possible that a person whose weight has fluctuated up and down a number of times has been subjected to more Atherogenic (artery- hardening) stress than a person with stable though excessive weight- and such stress increases the danger of heart attack and stroke.

 Animal experiments have shown that animals of normal weight have a longer life expectancy than obese animals. They have also shown that if an animal has been obese and has been repeatedly reduced, it will have a shorter life expectancy than the obese animal that has never been reduced. Such evidence adds further question to the advisability of undertaking weight reduction that cannot be sustained.

 THE ONLY SCIENTIFIC WAY TO REDUCE

There is nothing complicated about the principles for safe, sound, and effective weight reduction and they are principles that rest on solid scientific study.

1.       There are no healthy substitutes for them, and any attempts to circumvent them are only invitations to frustration and failure.

2.       Without any equivocation but rather as forcibly as we can, we wish to emphasize that all else is bunk, junk, profitable only to the purveyors and never truly so to the believer-buyers-and this is the set of principles upon which you must, and can reliably, pin your hopes for safe and effective weight control: If the number of calories you eat averages more than the number your body uses, you gain.

3.      

        If calorie intake totals less than calorie use, you lose weight. If you are to lose one pound of fat, you will have to take in 3,500 calories less than you expend. And while a sound reducing diet should, of course, lead to weight loss, it must, in addition, have three basic characteristics:

It must produce loss of weight at a safe pace.

 It must offer variety so that it maintains health and provides some pleasure in eating as well as some satisfaction of hunger.

Building General Health as Preventive Therapy

It must teach new, and enjoyable, eating patterns so that you do not promptly slip back into old, weight-gaining eating habits. And, in most cases, coupled with a good reducing diet having such characteristics there must be a sound program of exercise or other physical activity that will increase the calorie expenditure level, ease the dieting regimen, and contribute to general health in the process. 

DOES THIS MEAN YOU? 

By definition, an obese person is anyone who weighs 30 percent or more over what he or she should weigh. Even if you are not that much over- weight, it can be important to lose the first 10 pounds or so of excess, because the chances are that if you are overweight at all, you will gain Weight Control / 6 more in the future, and it is easier to lose 10 pounds than 20, 30, 50, or 100. Usually, your mirror provides you with a fairly good clue about whether you are too heavy. You can consult the accompanying table to determine whether your eyes have deceived you.

DESIRABLE WEIGHTS FOR MEN AND WOMEN    

Weight in pounds, according to frame, as ordinarily dressed, including shoes

HEIGHT                                                                

(WITH SHOES ON)                                                           

FT. IN.   SMALL FRAME                   MEDIUM FRAME              LARGE FRAME

                                                Men                     

5              2              116-125                                124-133                131-142

5              3              119-128                                127-136                133-144

5              4              122-132                                130-140                137-149

5              5              126-136                                134-144                141-153

5              6              129-139                                137-147                145-157

5              7              133-143                                141-151                149-162

5              8              136-147                                145-160                153-166

5              9              140-151                                149-160                157-170

5              10           144-155                                153-164                161-175

5              11           148-164                                157-168                165-180

6              0              152-164                                161-173                169-185

6              1              157-169                                166-178                174-190

6              2              163-175                                171-184                179-196

6              3              168-180                                176-189                184-202

                                                Women                               

4              11           104-111                                110-118                117-127

5              0              105-113                                112-120                119-129

5              1              107-115                                114-122                121-131

5              2              110-118                                117-125                124-135

5              3              113-121                                120-128                127-138

5              4              116-125                                124-132                131-142

5              5              119-128                                127-135                133-145

5              6              123-132                                130-140                138-150

5              7              126-136                                134-144                142-154

5              8              129-139                                137-147                145-158

5              9              133-143                                141-151                149-162

5              10           136-147                                145-155                152-166

5              11           139-150                                148-158                155-169

You will note that this table, unlike some others, gives desirable rather than average weights. Average people tend to become fat with the passing of the years, and this is not desirable. Average weight tables reflect the fatties who make up the upper part of the average. Note that in each ural weight group there is an allowance or range of about 10 pounds. If you have lost or gained a few pounds outside the limits for your height and frame, discuss the matter with your physician at the next visit.

 If you vary 15 or more pounds from the limits, make an appointment for an immediate checkup. There are several simple tests, too, by which you can assess your actual fatness. One, the ruler test, is based on the fact that if there is no excess of fat, the abdominal surface between the flare of the ribs and front of the pelvis normally is flat. If you lie flat on your back and place a ruler on the abdomen, along the midline of the body, it should not point upward at the midsection. 

If it does, you need to slim down. The skinfold, or pinch, test simply calls for grasping a "pinch" of skin with thumb and forefinger-at your waist, stomach, upper arm, but- tocks, and calf. At least half of body fat is directly under the skin. Generally, the layer beneath the skin-which is what you measure with the pinch since only the fat, not muscle, pinches-should be between one-fourth and one-half inch. Since, with your pinch, you are getting a double thickness, it normally should be one-half to one inch.

A fold much greater than one inch indicates excess body fatness- one much thinner than half an inch indicates abnormal thinness.

GLANDULAR VERSUS ORDINARY OVERWEIGHT Some 50 years ago, when hormones were discovered, there was a common notion that obesity must be due to some hormone problem. When this turned out to be rarely the case, there was a shift to the idea that obesity is never due to hormonal disturbances but is always the result of overeating. Today, some physicians think that the reasonable view is that to become obese it is always necessary to eat more than you need for the energy you expend, and how often this may be due to some shift in hormone functioning, even within the so-called normal range of such functioning, is simply unknown.

What is known is that in those relatively few cases where a hormone problem can be detected and corrected, it is most commonly the thyroid gland that is at fault. Located at the side and in front of the windpipe, just below the" Adam's apple," the one-ounce thyroid gland acts some- what like a thermostat, regulating the rate at which body organs function and the speed with which the body uses food. With an overactive thyroid, body functions speed up noticeably. 

There may be a perceptibly faster heartbeat, nervousness, difficulty in sleeping at night, and weight loss. With an underactive thyroid producing inadequate amounts of thyroid hormone, there is a tendency to be lethargic and to gain weight. When thyroid dysfunction is suspected in an overweight person (or anyone else, there are tests-basal metabolism and others-that can determine whether, in fact, there is a problem. If under activity is established

VEGETARIAN DIETS AND NATURAL FOODS

VEGETARIAN DIETS 

There are three types. The strictest excludes all animal products as well  animal flesh and organs. The second allows use of such animal produce milk, cheese, and eggs. The mildest allows fish and shellfish in.

Some people adhere to them and may be lean, but there is no scientifically discernible special virtue in vegetarian diets. There are vegetarians who attribute their long life and healthy old age to their diet, but there are equally healthy old people who credit daily meat eating. One possible hazard in vegetarian diets, particularly the strictest, may be lack of sufficient protein. We learned recently of a 78-year-old physician-patient who developed a huge enlargement of the liver, estimated to weigh 15 pounds instead of the usual 3. Biopsy showed cirrhosis.

 He had never used alcohol but from the age of 10 had never eaten meat and had reduced other sources of the complete proteins (see page 49). Specialists in liver disease who were called in finally concluded that the many years of a diet inadequate in rich, complete proteins had caused damage to the liver. The prescription: beefsteaks, filet mignonette, roast beef. The patient is having the time of his life at meals.

NATURAL FOODS 

Many health food and natural food stores in the country offer a wide range of "unprocessed" or "organic" foods. The foods, for the most part, are good and nutritious. They often cost more than foods available at regular food stores and supermarkets. Claims made in their behalf are that they are grown in soil that has not been impoverished and they are not spoiled by processing. As arguing against the idea, that generally available foods are grown in poor soil. nutritionists’ note that commercial agriculture in this country treats soil as a precious commodity and keeps it rich through crop rotation and fertilization.

Even if soils were widely impoverished, they add, this would not necessarily mean that foods grown in them would be nutritionally inferior. Infertile soil may lead to reduced yield per acre but no inferiority in the makeup of the plant grown. Many nutritionists also observe that the nutritive value of a given crop, such as corn or wheat, is influenced more by the kind of seed planted than by the fertility of the soil. 

Thus, corn can be bred to contain more niacin or more starch, tomatoes to contain more vitamin A or vitamin C, through development of new strains and seeds. As for food processing, leading nutritionists argue that commercially canned and frozen foods-in terms of practical nutrition if not of taste -are not inferior to fresh. 

How often periodic medical checkups should be carried out?

How often periodic medical checkups should be carried out is best determined by the physician on the basis of what is most suitable for you as an individual rather than on the basis of a general rule. Age is one determinant. The elderly and the very young generally need more frequent examinations than those in between. But other factors must be considered-present state of health, past medical history, family medical history, occupational hazards if any, etc. Your physician will take these into account in deciding what is most appropriate for you -a checkup once a year, or twice a year, or perhaps once in two years.

BETWEEN CHECKUPS Manifestations of illness or impending illness take the form of signs or symptoms, or both. Signs are objective evidence: for example, a change in skin color or the swelling of a body part. Symptoms are subjective: for example, nausea or pain.

They can vary greatly, of course, from mild' and fleeting to severe and persistent. All deserve attention, though it is likely that if they are mild and transient the reason for them is inconsequential. Any persistentor recurring sign or symptom deserves action. Even if mild it should not be ignored. Passing it off as something not worth notice except by a hypochondriac is dangerous.

 You may become so habituated to its presence that you regard it as something "normal" for you-until the underlying problem reaches a stage where it is irreversible or leads to serious consequences. The following discussion is intended to help you interpret the significance of signs andsymptoms that may appear between checkups, as a guide to when to consult your physician without delay. 

How AUTOMATED MULTI-PHASE SCREENING helps to check diseases in health care

One of the relatively recent developments that is almost certain to bring striking changes in the practice of medicine, adding further to the emphasis on and practicality of preventive medicine, is automated multi- phase screening. The idea is to link electronic detection devices, large numbers of chemical tests, and computer science together to screen or check, at low cost, large numbers of apparently healthy people, looking for the most subtle signs of early disease and even of pre-disease states, doing far more routine testing than physicians have time for, providing them with the results of the tests, and giving them more opportunity to counsel patients and practice preventive medicine.

In a periodic checkup that may run two to three hours, a patient moves from one station to another for checks of hearing, visual acuity, respiration rate, lung capacity. An electrocardiogram is made; a measurement of pressure within the eye is quickly made for detection of glaucoma, a major cause of blindness. A chest x-ray is taken and, in the case of women, a three-dimensional breast photograph (mammography). Pulse and blood pressuremeasurements are included. The patient answers a self-administered questionnaire on health history. And blood and urine samples are taken and automatically checked for indications of infection, gout, diabetes, and other diseases and also for a variety of biochemical values that may give some indications of pre disease changes. A computer summarizes the findings and produces a printed record for the patient's personal physician to evaluate. Automated multiphase screening is moving rapidly out of the experimental phase. Much of the pioneering work in its development was done by physicians at the Kaiser Foundation Health Plan in northern California with some financial assistance from the U.S.Public Health Service

The Public Health Service has awarded funds to set up pilot programs in Milwaukee, New Orleans, Brooklyn, and Providence-some affiliated with health centers in poverty areas, others with universities, and still others with city health departments. Already, some large industries are planning automated multiphase screening facilities as part of their occupational health programs. And there are plans for forming medically directed private companies which would provide automated screening service for patients referred by physicians.

Automated screening facilities may not be available in your community yet. Ask your doctor about them. Tell him you are interested. If the facilities are not available, you will be doing a public service by encouraging your doctor to push for their establishment in the near future.

YOUR ROLE

You AS the patient in preventive medicine have a role to play that goes far beyond cooperating in regular checkups. You can build and maintain your health, taking advantage of the latest knowledge in such areas as nutrition, weight control, physical activity, rest and relaxation (to be covered in later sections of this posts). You can be alert, too, between checkups for any danger signals.

How Blood Pressure Determination helps to find and Prevent diseases?

 

Measuring blood pressure is an even more important part of the medical check today than it was in the past. For one thing, we know now how common elevated pressure is, affecting at least 17 million Americans. For another thing, we know now that high blood pressure, or hypertension, is an important factor in stroke, heart disease, and kidney disease. And best of all, hypertension today almost invariably can be controlled. Blood pressure is simply the push of blood against the walls of the arteries. It is highest when the heart contracts and pumps blood into the arteries and this peak pressure is called systolic. It is lowest when the heart relaxes between beats, and this lower pressure is the diastolic.

To measure pressure, a basically simple, though not simply named, device, the sphygmomanometer, is used. It's an inflatable cuff attached to mercury or other type of meter. When the cuff is wrapped around the arm above the elbow and inflated, the inflation does two things: it drives the mercury column up to near the top of the gauge and it compresses an artery in the arm so no blood flows through. With his stethoscope placed on the artery, the physician listens as he gradually lets air out of the cuff. At some point, as the air is released, the pressure of blood in the artery will begin to exceed the pressure of air in the cuff, and the blood will begin to flow again in the artery.

The beginning of flow produces a thudding sound the physician can hear through the stethoscope, and at this point the mercury gauge shows what the systolic pressure is. Then, as more air is released from the cuff there comes a point when the thudding sound no longer can be heard, and at this point the mercury gauge shows the diastolic pressure. It is normal for pressure to vary somewhat from day to day, even minute to minute. It goes up with excitement, which is why in an examination a physician may wish to take your pressure several times. In some people, however, the blood pressure is nearly always higher than it should be. 

STETHOSCOPE EXAMINATION FOR HEART PROBLEMS AND TO AVOID HEART ATTACK

STETHOSCOPE EXAMINATION

The stethoscope has a small cone which concentrates and slightly amplifies internal body sounds while excluding external noise. One of its major uses is in the detection of heart problems. The heart produces two distinct sounds-e-Iubb-dup, lubb-dup, lubb- dup-which are related to the closing of the valves inside the heart. The rate, rhythm, pitch, and intensity of these sounds, which can be studied with the stethoscope, provide indications of the health of the heart. The stethoscope can pick up any abnormal sounds-for example, a rubbing scratchy noise which may indicate pericardia, an inflammationof the outer coating of the heart.

With it, too, the physician can detect murmurs-audible vibrations produced by blood flow-and can distinguish among various types of them. There are murmurs associated with different kinds of congenital heart defects. Others are produced by over activity of the thyroid gland and disappear when the gland condition is corrected. A fever or anemia may produce a heart murmur which disappears when the anemia or fever is over- come. In addition-and worth special note here-there are innocent murmurs. Unfortunately, many people worry needlessly after being told at some point, perhaps during an insurance examination, that they have a murmur even though reassured it is "innocent." The fact is that innocent murmurs are unrelated to any physical problem and are quite common.

They can be found in as many as 15 percent of normal healthy adults and in an even higher percentage of normal healthy children. Such murmurs are more readily detectable in children because they have thinner chestwalls. And some authorities are convinced that if there were sensitive enough instruments, slight and innocent murmurs could be found in all people. Your physician has been trained to understand the significance of various types ofmurmurs, to distinguish carefully among them, and to heed those which tell him of existing or possibly brewing trouble.

Let him examine you and if he finds a murmur tell you exactly what it means. If he can report that it is innocent and no reason for worry that is exactly what he means. In addition to its value in studying the heart, the stethoscope often is useful in revealing characteristic sounds of asthma and of the lung disorder emphysema. Applied to the abdomen, it is often helpful in gastrointestinal problems; it may, for example, aid in diagnosis of intestinal obstruction. With the stethoscope, too, it is sometimes possible to detect blood vessel problems-the existence and location of an obstruction in an artery, for example.

Patient History and Physical Examination can be Physician’s tool to Prevent Diseases

Patient History and Physical Examination can be Physician’s tool to Prevent Diseases

One patient who experienced a slight change in urination-dribbling a little during the night- passed it off as a joke, kidding with his wife that somehow, though he was still a young and vigorous man, he had entered second childhood. He had actually developed an enlargement of the prostate gland. A year of delay made the operation he needed more difficult and led to a complication, kidney infection, caused by backing up of urine. In reporting symptoms to the doctor, don't grope for medical words; use simple English. Many diseases have strong psychological aspects, and symptoms may recede the moment you are in the doctor's office. Still, tell the doctor you have the symptoms even though it may seem silly to talk about them when they are not immediately present. You can be certain the doctor will understand the phenomenon.

THE PHYSICAL EXAMINATION 'Even as he shakes hands with you, an alert physician may pick up some clues. Are your hands warm and moist, with a fine tremor? These characteristics may suggest over activity of the thyroidgland. If the hands are cold and the skin is coarse and puffy, the thyroid could be under- active. Red fingertips may signal some abnormal flow of blood in the heart; flushing of the nail beds in time with the heartbeat may indicate another type of heart problem called aortic regurgitation. As he observes the body, the physician can learn a great deal. The color of lips and ears may indicate possible anemia.

The Promise and Nature of Preventive Medicine

 One leg is slightly shorter than the other-enough in some cases to account for a backache problem. He may note leg swellings traceable to a heart problem, and any enlarged glands, tumors, or abnormal pigmentation resulting from internal disease. In his examination, the physician will be looking to see if the body is symmetrical. Lack of symmetry is almost always a sign of some dis- ability or disease. If the left side of the neck looks different from the right, it may be because of a tumor which is pushing out on that side. If the thyroid is not symmetrical, it may be because of a benign tumor which has enlarged one lobe ofthe gland. In the retina at the back of the eyes, small blood vessels-arteries and veins-lie are almost naked, devoid of covering material.

And there, very quickly, with an instrument called the Ophthal-mo-scope, the physician by looking through the pupil of the eye can detect any blood vessel changes which may provide clues to diabetes or kidneydisease. Women need a breast examination for any tenderness, abnormal lump, or nipple discharge. During a vaginal examination, a smear of cells for the "Pap" test is usually taken; this is a test to detect early cancer in the area. Both men and women should have a rectal examination to detect any local disturbances. With an instrument, the Sigmoido-Scope, the physician can see and check the lower portion of the colon for any growths.

As a patient, you can help greatly by insisting that the physician do a thorough inspection, by reassuring him that you have no squeamishness. Some doctors feel that patients’ are resistant to rectal andgenital examination and omit these vitally important checks. 

How a Patient History Can be used in Preventive Health Care? follow 1000 posts

It is not essential that you have a detailed knowledge of modern examining and testing procedures. But some awareness of the basic, long-established methods and tests and the newest x-ray and laboratory tools, and what they can do, will be useful.

THE CASE HISTORY

The patient's history, always an invaluable guide in disease diagnosis, is equally valuable in prevention. We have mentioned earlier, in passing, some of the reasons. Occupational data-facts about the work you do and possibly the circumstances under which you do it-may reveal some hazards, physical or psychological, to which you are exposed. An account of family health-the illnesses of parents and grandparents, their longevity, the state of health of brothers and sisters-can provide clues to hereditary strengths and weaknesses.

Your own past illnesses are 'an. important part of the record. Some childhood episodes of illness, if severe, may have left a mark. Rheumatic fever, for example, may strike a child at 15 or earlier and may produce some heart damage. Yet, very often, the effects of the heart damage are not felt until age 35, 40, or even later. A record of the rheumatic fever incident may be of vital importance in accurate diagnosis of a heart condition. 

The case history-which includes what the patient reports about present problems-sometimes, provides the first indication of onset of a serious illness. For example, angina pectoris (chest pain) is associated with coronary heart disease. In coronary heart disease, the coronary arteries feeding the heart muscle become narrowed. There are sophisticated techniques now-including x-ray movies of the coronary arteries -to show up the narrowing. But in some early cases, angina may occur before there are sufficient changes to show up on the x-ray studies.

If in taking the history the physician determines that there have been angina episodes-perhaps after some sudden unusual exertion, perhaps upon leaving the house on a particularly cold morning-he can confirm the anginadiagnosis by giving the patient some nitroglycerin tablets to take when the next incident occurs; and if there is immediate relief of pain, the diagnosis is virtually 99.9 percent certain. During history taking, be accurate, don't make wild guesses, but do report things you may think are only minor, like a sense of just not feeling well. It's important to indicate any change because it may be an early warning of something potentially serious. 

CALCULATING RISKS and nature care on Our body care, diseases and conditions-1000 posts following

CALCULATING RISKS of Diseases and conditions

First, it became evident not only that people vary in susceptibility to disease but that increased risk depends upon many factors and that it is possible to calculate risks. Breast cancer, for example, occurs in 5 percent of white women over black in the United States-and so, on the average, there is a 1 in 20 But a woman with a positive family history of breast cancer-one mother or sister or aunt developed the disease-has triple the risk on her women. (Let us say, at once, that if this increased hazard be- of hereditary influences stood by itself it' would be only a more But it stands with increasingly sensitive and detecting her at earlier and earlier-and therefore more curable-stages, and scores the wisdom of special emphasis on breast cancer detection such a woman.
Other factors, racial and social, help to identify special proneness’s. Japanese have a high risk of stomach cancer but relatively low risk breast cancer; the Chinese and Malaysians have a high risk of nose throat cancer. In unskilled American workers and their wives, the incidence of cancer of the stomach and uterine cervix is three to four times higher than among people in the professional fields. On the other hand cancer of the breast and leukemia are substantially more common in the higher economic classes. there are occupational factors to be considered.

For example, urinary bladder cancer has an increased incidence among dye workers, in that industry programs have annual tests of urine. Medicine also has been establishing other characteristics associated with high risk of specific diseases as a means of permitting preventive medical care to be used. For coronary heart disease, which may lead to the heart attack, the characteristics include excessive levels of certain fats II the blood, high blood pressure, high pulse rate, cigarette smoking, physlcal inactivity, and premature cessation of ovarian activity in a woman. The incidence of the disease, in men aged 40 to 59 for example, (from 9 per 1,000 when one of these factors is present to 77 per 1,000 when any three of them are present.