by Mary Barlow

A panel of family doctors prescribes simple steps to improve your health.

Our daily habits are putting us at risk. That's what three family doctors said when we recently asked them, "What are the biggest mistakes we make when it comes to our health?" Considering today's health trends, they said, what we eat and drink, the amount of exercise we get, and the way we deal with stress just isn't good.

So while recommendations like, "exercise and eat right" echo the tone of our parents' mantras to "button your coat because it's cold outside," they remind us that we really need to pay attention to, well, the obvious.

"The concepts are so simple that they may seem trivial in a medical culture dominated by MRI, gee-whiz surgery, and genetically engineered drugs," says Harvey B. Simon, M.D.

Today about 66 percent of Americans are overweight, more than double the number in the mid-seventies. About 39 percent of us don't exercise at all, and 22 percent still smoke. These and other factors are resulting in significantly higher rates of chronic (ongoing) disease. About 125 million Americans are suffering with conditions such as diabetes, heart disease, asthma, arthritis, depression, and backaches.

Here are 11 things that our panel of doctors prescribes for a longer, healthier life.

Eat healthy and move more.
Too often, we put off losing weight, thinking that a few more months (or years) won't matter. But they do.

"While we may be able to lose weight at any time, we cannot reverse many health problems caused by obesity," says Lynn Ho, M.D. "Once you have really bad arthritis, losing weight will help, but you'll still have the condition."

• Dr. Simon suggests improving your diet by replacing one unhealthy meal or food item at a time with something healthy:
  
  
• Say you normally have sausages and toast for breakfast, a roast beef sandwich for lunch, and meat and potatoes for dinner. Start by changing only your breakfast. Instead of your usual meal, have something like high-fiber cereal, fresh blueberries, and low-fat milk.
• Once you're used to doing that, tackle lunch and so on. "It's not an all or nothing," says Dr. Simon. "If you slip up and have sausages for breakfast again, pick yourself up, dust yourself off, and start over again."
  
  
• To find out how much exercise you need, visit the Centers for Disease Control and Prevention. This site breaks down fitness by age and shows what you need to do for general health or to get six-pack abs.

Don't smoke.
A smoker's risk of heart attack is decreased within 24 hours after quitting.

Within a few months, circulation improves, walking gets easier, and lung function improves. Within a year, the risk of coronary artery disease is half the risk of a smoker. And in addition to the tremendous health benefits, quitting smoking saves money—a lot of money. "[Over 5 years], people who smoke a pack a day pay about the same amount as tuition for four years at a state college," says Jeffrey M. Borkan, M.D., Ph.D.

• Visit Smokefree.gov for free information and Web support.
• Call 1-800-QUIT-NOW for a free service with educational materials and coaches to work with you over the telephone.

Manage any chronic diseases.
If you have heart disease, diabetes, asthma, depression, or another chronic disease, you can improve how you feel and reduce your risk for complications by following your doctor's advice and paying attention to warning signals.

• Learn everything you can about your condition through books, reliable Web sites, and other literature.
• Join BCBSRI's health coaching program. As part of your plan at no extra charge, BCBSRI teams you up with a nurse or dietitian who can help you control your condition. To learn more, call (401) 459-2273 or 1-800-637-3718, ext. 2273.

Get your rest.
We often think it's no big deal to miss a bit of sleep every night. However, Dr. Ho says, "A lack of sleep decreases your level of concentration and focus, and makes it hard to receive and integrate information."

Night after night of lost sleep can lead to depression and anxiety, as well as poor balance and falls.

• Don't drink coffee after morning hours or alcohol before bedtime.
• Exercise regularly, but not within a few hours of bedtime.
• For more tips on getting a good night's rest, visit sleepfoundation.org.

Manage stress.
"Stress suppresses important parts of the immune system, and can leave you open to disease," says Dr. Ho. "If you have a disease, stress makes it worse."

• Dr. Simon notes that exercise promotes emotional well-being, and helps reduce stress, anxiety, and depression.
• To learn tips for managing stress, visit helpguide.org.

Protect your skin.
Just one sunburn can increase your risk of skin cancer.

• Use a sunscreen with a sun protection factor (SPF) of at least 15 every day on exposed areas of the body. Be sure to choose a "broad spectrum" sunscreen, which protects against both forms of ultraviolet radiation.
• Wear a wide-brimmed hat, long sleeves, and pants.

Maintain strong social connections.
"Having friends decreases your stress levels," says Dr. Ho. People who are married or have deep social ties tend to fare better in terms of health and happiness than people who do not have strong social connections.

• Stay in close contact with friends and family.
• Extend your social network by volunteering, taking a class, or pursuing other interests you enjoy.

Hold the salt.
The recommended daily amount of sodium is just one teaspoon a day (2,300 milligrams). For people with hypertension, and for middle-aged and older adults, the recommendation is 1,500 milligrams. Too much can lead to high blood pressure and other health problems.

"Seventy percent of salt in our diets comes from processed and prepared foods, and they cost more money," says Dr. Borkan. "I recommend that people eat more whole foods. Packaged foods are worse for your wallet and worse for your health."

• Eat more home-cooked meals made with fresh meats and vegetables, rather than prepackaged items.
• Use herbs and spices rather than salt to flavor food.

Eat together.
Sports, after-school activities, work schedules—these all challenge our ability to have family dinnertimes, but making an effort is worth it.

"There are nutritional benefits, it improves the well-being of children, and models family life and manners," says Dr. Borkan. "Eating dinners together decreases the risk of unhealthy weight. Kids eat more fruits and vegetables and do better in school."

According to the 2002 National Survey of American Attitudes on Substance Abuse VII: Teens, Parents and Siblings, "Teens who eat dinner with their family six to seven times a week are at almost half the risk of substance abuse as teens who eat dinner with family twice a week or less."

• To make the most out of your dinner ritual, turn off the television, dim the room, and light a candle.
• Sit at the table, and talk about everyone's day, but refrain from arguments.
• It's also important to define difficult terms for children so they can follow the conversation, which helps develop their vocabularies.

Get screened.
Getting all of your preventive screenings and vaccines for your age and health status can help you detect diseases early, and in some cases, avoid them altogether.

• Be sure to call your doctor to have any unusual symptoms checked out.
• To find out what preventive care you and your family should have, see our screening and immunization schedule.

Turn off the TV and read a book.
"We should be reducing television to one hour or less per day," says Dr. Borkan. "Television is reducing comprehension. It is passive learning, while reading stretches the mind."

• Set limits on television and Internet time.
• Keep soft music on in your home for background sound.
• Sit in a quiet room and read, and maybe, just maybe, your kids will come in and pick up a book, too.