7. Because of the negative impact of "sleep debt" (low level of alertness, reduced immunity, etc.), be sure to get enough sleep. Nearly half of all Americans suffer from sleep-related problems, most emanating from sleep deprivation. 8. Know the primary risk factors for heart disease: high cholesterol, elevated triglycerides, cigarette smoking, high blood pressure, physical inactivity, diabetes, family history of CAD, etc. If you have any of these risk factors, immediately begin to reduce them and to lead a "heart-healthy" lifestyle. 9. According to a number of nutrition experts, tea is beneficial to the heart and can help reduce the risk of heart disease. Regular black tea is a rich source of protective antioxidants. 10. Moderate consumption of alcohol (one drink a day) has been linked in some studies to a reduced risk of heart disease, apparently from an alcohol-induced rise in protective HDL cholesterol. 11. Prolonged exposure to noise above 90 decibels (lawn mowers, motorcycles) can cause temporary hearing loss, above 100 decibels (woodshop machinery) for more than 15 minutes can cause hearing damage, and above 110 decibels (chain saws, rock concerts) may cause permanent hearing loss. 12. A University of Wisconsin study found that cigarette smokers were more likely to have age-related hearing loss, because smoking may adversely affect the flow of blood to the inner ear. 13. Weight added to hips and thighs results in a "pear" shape, while extra weight on the torso or midsection causes an "apple" shape. Since research has shown that excess fat in the abdominal area is more closely linked to incidences of diabetes, heart disease and hypertension, "apples" especially, should avoid weight gain.

14. The new recommended dietary allowance (RDA) guidelines for all adults is 400 micrograms (mcg) of folic acid a day. Folic acid has been found to reduce the risk of having a child with a neural tube defect, such as spina bifida, and can reduce the risk of heart disease in both men and women. Leafy green vegetables, some fruits (including oranges) and legumes are among the best sources of folic acid.

15. Make sure to consume sufficient amounts of vitamin A (found in carrots and spinach) and vitamin E (found in whole-grain breads and cereals).

16. Certain prescribed medications may create problems if combined with herbs, vitamins or even aspirin. Talk to your doctor and pharmacist about every prescription, over-the-counter medication and herbal medicine before taking it.

17. Simple lifestyle changes such as wearing sunglasses, eating healthful foods and not smoking can help protect against vision loss. Wear sunglasses that block 99 to 100 percent of ultraviolet light, and eat a diet rich in fruits and vegetables, such as spinach and collard greens, which seem to protect the eyes against cataracts and macular degeneration.

18. Researchers at the University of Arizona found that some of the worst bacteria levels in the home were found in the kitchen. Reduce bacteria by 99 percent by using cleaning products containing bleach, and wash sponges with hot soapy water, rinse well, squeeze and let dry thoroughly. Also, discard sponges every few weeks.

19. Many doctors recommend that before starting medication for hypertension (high blood pressure), people should reduce body weight, reduce sodium intake to less than 2,000 milligrams a day, eat a diet rich in fruits and vegetables, and begin a regular exercise program.

20. Although brushing your teeth after a meal is the most effective way to prevent tooth decay and gum disease, rinsing with water will help to neutralize the acid created by eating, and help to reduce plaque-causing bacteria that may stick to your teeth.

21. Scientists report that eating an extra 200 milligrams of cholesterol per 1,000 calories a day can take approximately 3.4 years off the life span of a middle-aged man. Likewise, lowering the amount of cholesterol eaten to less than 200 milligrams per deciliter of blood can add about five years to the life of the average middle-aged man.

22. Since the Environmental Protection Agency mandated drastic reductions in the lead content of gasoline, it is estimated that approximately 5,000 fewer heart attacks and 1,000 fewer strokes occur each year. And, because pollution in the home can also be a public health hazard, be "pollution conscious" inside your homes: Investigate the quality of your drinking water, test for radon levels and minimize the use of pesticides.

23. Several "old-school" calisthenic-type exercises should be either avoided or performed in a slightly different manner to prevent injury. Instead of straight-leg sit-ups, perform bent-knee curls. Rather than deep knee bends, perform quarter or half squats and make sure that your knees never go beyond a 90-degree angle. Finally, instead of neck circles, perform slow head turns to the left and right.

24. The health benefits of drinking plenty of fluids daily are relatively well known. Plain water, milk and juice are good sources, as are fruits and vegetables.

25. Know the early warning signs of heart problems: pressure or pain in the chest behind the breastbone that often spreads to the arms, shoulders, back and even the jaw, feelings of weakness, shortness of breath, lightheadedness, nausea, dizziness or faintness.

26. The American Council for Headache Education says to call your doctor if you have any of the following problems: three or more headaches a week, a need to take something every day to relieve headache pain, a fever or a stiff neck accompanying the headache, unsteadiness on your feet, slurred speech and weak or numb arms or legs (possible stroke), or a characteristic change in a familiar headache.

27. To get the most out of a walking program, keep good posture with your head up and eyes forward, bend your arms at the elbows and swing your arms gently at your sides, take quick but comfortable steps, let the foot roll smoothly from heel to toe and push off strongly with the toes, wear comfortable walking shoes, and walk daily, even if for 10 or 15 minutes.

28. On average, people spend almost a quarter of the workday on their feet and, in a lifetime, each individual walks enough to have completely circled the globe four times. To minimize foot pain, wear proper-fitting shoes and avoid weight gain.

29. The American Academy of Ophthalmology states that individuals may strain or tire their eyes by working long hours at a computer, but they probably won't damage their eyesight. If you experience computer-related eye strain, take short, frequent breaks to rest your eyes and focus on distant objects for a few minutes. Also, remember to blink regularly when concentrating on the screen to avoid drying out the eyes.

30. Cold and flu viruses are usually spread by shaking hands with an infected person, or by touching something that the infected person has just handled. You can then infect yourself by touching your mouth, nose or eyes. Wash your hands frequently when around people with colds or flu, and maintain a safe distance from anyone who is coughing or sneezing, since these viruses can also be transmitted through the air.

31. Heartburn occurs when gastric juices, designed to digest food in the stomach, come up into the esophagus. Chronic heartburn can leave the esophagus with scar tissue and even change the type of cells that line it to cells that may be more likely to develop cancer.

32. A recent study found that taking Orlistat (a weight-loss medicine that is designed to prevent absorption of about 30 percent of dietary fat) for a year or more led to a 5- to 10-percent weight loss. However, since Orlistat interferes with fat absorption, it also has the potential for inhibiting the absorption of fat-soluble vitamins (A, D, E and K).

33. If you have moderately high levels of cholesterol, use soft-tub margarine and oil instead of harder processed fats such as stick margarine and butter. Butter and such have more trans fatty acids, which raise cholesterol and the risk of heart disease.

34. The Department of Agriculture suggests that people who eat about 2,000 Calories daily should limit themselves to about 10 teaspoons of added sugars per day. Unfortunately, the average American currently consumes about 20 teaspoons of added sugars per day.

35. According to the National Institute of Health, more than 50 percent of Americans are currently overweight, the highest number ever. Cut back on snacking, as many health experts and nutritionists believe that that it is partly to blame.

36. Herbal products are regulated by the FDA, but not in the stringent way that prescription and non-prescription drugs are. Consult with your doctor before using herbs.

37. Medical professionals recommend eating well to give your body the energy it needs to fight off a cold. If you have a cold, eat citrus fruits and leafy green vegetables for vitamin C and other antioxidants, nuts and lean meats (such as chicken and turkey) to provide extra energy, and liquids to keep hydrated.

38. Fiber helps reduce the risk of contracting cancer, heart disease and diabetes. Americans, however, eat only 12 to 14 grams of fiber per day, about half the recommended amount. Increase your total fiber intake with soluble fiber in oats, psyllium (Metamucil), beans and lentils, and insoluble fiber in wheat bran, seeds, whole grains and the skins of vegetables and fruits.

39. Research shows that cranberry juice can help prevent urinary tract infections. Certain compounds (called condensed tannins) exist in cranberries and blueberries that help prevent infection-causing bacteria from sticking to the bladder wall.

40. Researchers recently found that non-smokers who are exposed to secondhand smoke are 82 percent more likely to suffer a stroke. Previous studies have also shown that passive smoking increases the risk of heart disease, heart attack, lung and breast cancer, and breathing-related diseases.

41. Recent research has shown that adding peanuts, peanut butter or peanut oil to a diet low in saturated fat can lower total blood cholesterol levels and LDL (bad) cholesterol. The fat in peanuts is mostly monounsaturated, and peanuts are high in vitamin E, folic acid, thiamin, niacin, magnesium, zinc and protein.

42. Researchers have found that eating certain foods can leave individuals more satisfied and less likely to binge. A list of the top-10 most filling foods includes boiled potatoes, steamed fish, oatmeal, oranges, apples, whole-wheat pasta, grilled lean beef, baked beans, grapes and whole grain bread.

43. A recent study at Penn State's College of Medicine found that a diet high in caffeine is not a risk factor for a diminished level of bone density and osteoporosis in postmenopausal women. Researchers found that even women who drank several cups of coffee a day had bones that were just as strong as those in women with a lower caffeine intake.

44. Experts attribute falls among people over age 50 to two primary factors. Older people are more likely to have health problems, including physical impairments, and be taking multiple medications that can impair balance, reaction time, strength and vision. Also, relatively few older people do exercises to help reduce age-related declines in muscle strength and balance.

45. To use a computer mouse safely, position the mouse next to the keyboard so that you don't overextend your reach, grasp the mouse lightly and loosely, keeping your wrist straight, take your hand off the mouse while reading the screen, periodically relax your arms at your sides, and stand up and walk away from the computer to stretch and change posture as often as possible.

46. Communication "overload" can be very stressful. If you are surrounded by communications equipment such as multiple phone lines, computer screens, pagers, cellular phones and fax machines, create a couple of hours of quiet time per day away from these devices.

47. Research has shown that older adults can improve their higher brain functions by engaging in some form of physical activity. Any type of aerobic exercise appears to get blood pumping to the brain, makes people think more clearly, and improves functions associated with the "executive control processes" of the brain (making any new decisions, juggling tasks and learning new skills). Such brain functions are among those that show the greatest decrease in efficiency with age.

48. Stress causes the pulse to rise, the muscles to tense and the immune system to shut down. Learn to cope with and control the amount of stress at work. Avoid office gossip and people who are constantly negative, seek out someone who can provide encouragement when needed, set priorities and schedule tasks, remember that there is life outside of work, and take time off for a vacation or mental health day.

49. Generic drugs, in most instances, are just as good as their brand-name equivalents. Generics are required to contain the same active ingredients and release the drug in the body the same way that the brand-name version does, and are only different in the way the drug looks and in their inactive ingredients. Because you may be intolerant to an inactive ingredient in a generic, check with your physician or pharmacist before switching.

50. According to sleep researchers, most people need 60 to 90 minutes more sleep than they get daily (the average adult sleeps between seven and eight hours per day). If you need an alarm clock to wake up, find it difficult to get out of bed in the morning or are tired during the day, you probably need more sleep. To figure out how much sleep you actually need, go to bed 30 minutes earlier than usual for a week. If you're not more alert, add 15 more minutes a night each week until you start to feel well rested.

Make it happen

It's important to understand what behaviors will lead to a healthy lifestyle and why, and then make those behaviors an integral part of your daily life. Mixing adherence to sound health, fitness and nutrition practices with a personal commitment to common sense is an appropriate recipe for improving and sustaining a healthier and more enjoyable lifestyle. In other words, "living smart" is a fundamental requirement for "living well."

REFERENCES

Duyff, R.L. The American Dietetic Association's Complete Food and Nutrition Guide. Chronime Publishing: Minneapolis, Minn., 1998.

Feltman, J. (ed.). Prevention's Giant Book of Health Facts. Rodale Press: Emmaus, Pa., 1991.

Hoeger, W.K. The Complete Guide for the Development and Implementation of Health Promotion Programs. Morton Publishing Co.: Englewood, Colo., 1987.

Ringler, C.A. Nutrition for Dummies. IDG Books Worldwide: Foster City, Calif., 1997.


James Peterson, Ph.D., FACSM, is a sports medicine consultant, fellow of the American College of Sports Medicine, a former faculty member at the United States Military Academy and a former director of sports medicine for StairMaster Sports/Medical Products Inc.