Tools of Prevention

Lifestyle and disease are clearly linked. For example, eating an unhealthy diet Diet Atherosclerosis is a condition in which patchy deposits of fatty material (atheromas or atherosclerotic plaques) develop in the walls of medium-sized and large arteries, leading to reduced or... read more (high in calories, saturated fats, and trans fatty acids and deficient in certain other nutrients), not exercising regularly, and smoking increase the risk of developing heart disease Overview of Coronary Artery Disease (CAD) Coronary artery disease is a condition in which the blood supply to the heart muscle is partially or completely blocked. The heart muscle needs a constant supply of oxygen-rich blood. The coronary... read more , cancer Prevention of Cancer Although there are many different types of cancer, which have different causes and risk factors, doctors estimate that about 40% of cancers are preventable. Also, individual people have different... read more , and stroke Overview of Stroke A stroke occurs when an artery to the brain becomes blocked or ruptures, resulting in death of an area of brain tissue due to loss of its blood supply (cerebral infarction). Symptoms occur suddenly... read more —the three leading causes of death in the United States. Changing unhealthy lifestyle habits can help prevent particular disorders and/or improve fitness and quality of life. Talking with doctors and other health care professionals can help people make good decisions and establish healthy habits. However, establishing and maintaining a healthy lifestyle can be done only by the person. Consistently eating a healthy diet and getting enough exercise are difficult for many people, but people who do so reduce their risk of developing serious disorders and often feel better and have more energy.

Healthy eating habits Diet Coronary artery disease is a condition in which the blood supply to the heart muscle is partially or completely blocked. The heart muscle needs a constant supply of oxygen-rich blood. The coronary... read more can help people prevent or control disorders such as high blood pressure High Blood Pressure High blood pressure (hypertension) is persistently high pressure in the arteries. Often no cause for high blood pressure can be identified, but sometimes it occurs as a result of an underlying... read more , heart disease Overview of Coronary Artery Disease (CAD) Coronary artery disease is a condition in which the blood supply to the heart muscle is partially or completely blocked. The heart muscle needs a constant supply of oxygen-rich blood. The coronary... read more , diabetes Diabetes Mellitus (DM) Diabetes mellitus is a disorder in which the body does not produce enough or respond normally to insulin, causing blood sugar (glucose) levels to be abnormally high. Urination and thirst are... read more , osteoporosis Osteoporosis Osteoporosis is a condition in which a decrease in the density of bones weakens the bones, making breaks (fractures) likely. Aging, estrogen deficiency, low vitamin D or calcium intake, and... read more , and certain cancers. Recommendations include

Physical activity and exercise Benefits of Exercise Regular exercise makes the heart stronger and the lungs fitter, enabling the cardiovascular system to deliver more oxygen to the body with every heartbeat and the pulmonary system to increase... read more can help prevent obesity Obesity Obesity is excess body weight. Obesity is influenced by a combination of factors, which usually results in consuming more calories than the body needs. These factors may include physical inactivity... read more , high blood pressure High Blood Pressure High blood pressure (hypertension) is persistently high pressure in the arteries. Often no cause for high blood pressure can be identified, but sometimes it occurs as a result of an underlying... read more , heart disease Overview of Coronary Artery Disease (CAD) Coronary artery disease is a condition in which the blood supply to the heart muscle is partially or completely blocked. The heart muscle needs a constant supply of oxygen-rich blood. The coronary... read more , stroke Overview of Stroke A stroke occurs when an artery to the brain becomes blocked or ruptures, resulting in death of an area of brain tissue due to loss of its blood supply (cerebral infarction). Symptoms occur suddenly... read more , diabetes Diabetes Mellitus (DM) Diabetes mellitus is a disorder in which the body does not produce enough or respond normally to insulin, causing blood sugar (glucose) levels to be abnormally high. Urination and thirst are... read more , some types of cancer, constipation Constipation in Adults Constipation is difficult or infrequent bowel movements, hard stool, or a feeling that the rectum is not totally empty after a bowel movement (incomplete evacuation). (See also Constipation... read more , falls Falls in Older People , and other health problems. The best routine includes moderate physical activity for a total of 150 minutes per week, or vigorous aerobic activity for 75 minutes per week (or a combination of the two). Exercise periods should be at least 10 minutes long and ideally spread throughout the week. However, getting even a little bit of exercise is much better than none at all. For example, people who can devote only 10 minutes to physical activity a few times per week may still reap important benefits, particularly if the exercise is vigorous. Walking is one simple, effective exercise that many people enjoy. Certain types of exercise can also target specific problems. For example, stretching improves flexibility, which can help prevent falls Falls in Older People Most falls occur when older people with one or more physical conditions that impair mobility or balance encounter an environmental hazard. Although many people have no symptoms before a fall... read more . Aerobic exercise may decrease the risk of heart attack Acute Coronary Syndromes (Heart Attack; Myocardial Infarction; Unstable Angina) Acute coronary syndromes result from a sudden blockage in a coronary artery. This blockage causes unstable angina or a heart attack (myocardial infarction), depending on the location and amount... read more and angina Angina Angina is temporary chest pain or a sensation of pressure that occurs while the heart muscle is not receiving enough oxygen. A person with angina usually has discomfort or pressure beneath the... read more .

Quitting smoking Treatment While often very challenging, quitting smoking is one of the most important things smokers can do for their health. Quitting smoking brings immediate health benefits that increase over time... read more is important to a healthful lifestyle. A doctor can offer encouragement and advice on ways to successfully quit smoking, including information and recommendations on the use of nicotine replacement products, bupropion and varenicline (medications that help reduce cravings), and other tools.

Safe sex practices Overview of Contraception Contraception is prevention of ovulation (stopping the ovaries from releasing eggs) or prevention of fertilization of an egg by a sperm (conception) or prevention of attachment of a fertilized... read more remain important. Key safe sex practices are avoiding risky sex partners and remaining mutually monogamous. People who have more than one sex partner can greatly reduce their risk of contracting a sexually transmitted infection by correctly using a latex condom Prevention Sexually transmitted infection (STI) refers to an infection that is passed through blood, semen, vaginal fluids, or other body fluids during oral, anal, or genital sex with an infected partner... read more every time they have sex. People who are allergic to latex can use other kinds of condoms.

Limiting alcohol use Alcohol Use Alcohol (ethanol) is a depressant (it slows down brain and nervous system functioning). Consuming large amounts rapidly or regularly can cause health problems, including organ damage, coma,... read more is important. The Centers for Disease Control and Prevention (CDC) recommends that adults of legal drinking age either not drink any alcohol or limit the amount to 2 drinks or less in a day for men or 1 drink or less in a day for women on days when alcohol is consumed. (Each drink is about 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of more concentrated liquor, such as whiskey.) Whether drinking, even small amounts of alcohol, has any health benefits is unclear. Also, drinking even small amounts of alcohol may increase the risk of harmful effects.

Preventing injuries is crucial to maintaining a healthful lifestyle. People can lower their risk of injury by taking certain precautions, such as wearing appropriate protective equipment (including seat belts). For older people,the following can help reduce the risk of falling:

Adequate sleep Overview of Sleep Sleep is necessary for survival and good health, but why sleep is needed and exactly how it benefits people are not fully understood. One of sleep's benefits is its restorative effect on people's... read more is also an important part of a healthy lifestyle, particularly affecting mood and mental state. Insufficient sleep is a risk factor for injuries.

Vaccines Childhood Vaccinations Vaccination protects children against many infectious diseases. Vaccines contain either noninfectious components of bacteria or viruses or whole forms of these organisms that have been weakened... read more have been enormously successful. Dangerous and sometimes fatal infectious diseases such as diphtheria, pertussis, tetanus, mumps, measles, rubella, and polio have decreased by more than 99% from their peak number of cases, thanks to the availability of effective and safe vaccines and their widespread use. Furthermore, vaccinations save about $16 in health care costs for every $1 spent.

Many side effects have been attributed to vaccines (see Childhood Vaccination Concerns Childhood Vaccination Concerns Despite the strong vaccine safety systems in place in the United States, some parents remain concerned about the use and schedule of vaccines in children. These concerns can lead some parents... read more ). Actual side effects that occur depend on the vaccine, but common side effects are usually minor and include swelling, soreness, and allergic reactions at the injection site, and sometimes fever or chills. More serious side effects can occur. They include autoimmune reactions (for example, Guillain-Barré syndrome Guillain-Barré Syndrome (GBS) Guillain-Barré syndrome is a form of polyneuropathy causing muscle weakness, which usually worsens over a few days to weeks, then slowly improves or returns to normal on its own. With treatment... read more , which causes temporary weakness or paralysis). However, serious side effects are very rare if vaccines are used appropriately.

Systematic and extensive research has found no link between vaccines and other serious side effects such as autism. Reports that vaccines cause AIDS or sterility are urban legends and have no factual basis. Refusing vaccination to avoid side effects increases the risk of getting an infection, which is a much greater threat to health than are possible side effects of vaccination.

Children and adolescents, older adults, and people whose immune system is impaired are often the most vulnerable to infections that vaccines can prevent. If these people get such infections, they are also often the most likely to have serious symptoms. For example, whooping cough (pertussis) tends to cause severe symptoms in infants but can be as mild as a cold in older, otherwise healthy people. Although it is most important to vaccinate the most vulnerable people, vaccinating other people is also important. Doing so not only prevents illness in the vaccinated person but also reduces the number of people in the community who could develop and thus transmit infection to more vulnerable people. Thus, deaths and serious complications in the community are reduced by vaccinating as many people as possible. This effect is called herd immunity.

Screening is testing of people who are at risk of a disorder but do not have any symptoms (see also Medical Testing Decisions, Screening Tests Screening tests Because many different diseases can cause the same symptoms, it can be challenging for doctors and other primary care practitioners to identify the cause. Doctors first gather basic information... read more ). Screening can enable doctors to detect a disorder early and to start treatment early. Early treatment sometimes keeps disorders from turning deadly. For example, abnormalities of the cervix or colon can be diagnosed and cured before they become cancerous.

Screening programs have greatly reduced the number of deaths caused by some disorders. For example, deaths due to cervical cancer, once the most common cause of cancer death among American women, have decreased 75% since 1955. However, the decrease varies from area to area, depending on availability and affordability of screening and other factors. Screening can also detect disorders that cannot be cured but that can be treated before they cause too much damage (for example, high blood pressure High Blood Pressure High blood pressure (hypertension) is persistently high pressure in the arteries. Often no cause for high blood pressure can be identified, but sometimes it occurs as a result of an underlying... read more ).

Screening recommendations usually come from government or professional organizations and are based on the best available research. However, different organizations sometimes make different recommendations. There are several reasons for different recommendations. Even the best research results are not always conclusive. Also, screening recommendations must take into account how much risk and how much expense people are willing to accept, factors that cannot be known with certainty. Thus, decisions about screening are individualized. People should discuss screening with their doctor to determine what is best for them.

People may think that any test capable of detecting a serious disorder should be done. Screening can offer great benefits. However, it can also create problems. For example, screening test results are sometimes positive in people who do not have disease. As a result, some of these people then have additional follow-up tests and/or treatments that are unnecessary, often expensive, and sometimes painful or dangerous.

Also, sometimes screening detects abnormalities that cannot or need not be treated. For example, prostate cancer Prostate Cancer Prostate cancer begins in a small area of the prostate gland, an organ found only in males. The risk of prostate cancer increases as men age. Symptoms, such as difficulty urinating, a need to... read more often grows so slowly that in older men, the cancer is unlikely to affect their health before they die from another cause. In such cases, the treatment can be worse than the disease. Another example involves using whole-body computed tomography (CT) to screen everyone for cancer. This approach is not recommended because it does not have benefits (such as saving lives) that exceed the risks (such as developing disorders caused by the radiation exposure, including cancer). In addition, when people are told they might have a serious disorder, they can become anxious, and anxiety can affect health.

Because of these issues, screening is recommended only when

Some screening tests (such as tests for cervical and colon cancers) are recommended for all people of a certain age or sex. For people at increased risk because of other risk factors, tests may be recommended at an earlier age or at more frequent intervals than is recommended for people at average risk, or additional tests may be recommended. For example, a person with a family history of colorectal cancer or with a disease that increases the chances of developing colorectal cancer Colorectal Cancer Family history and some dietary factors (low fiber, high fat) increase a person’s risk of colorectal cancer. Typical symptoms include bleeding during a bowel movement, fatigue, and weakness... read more (such as ulcerative colitis Ulcerative Colitis Ulcerative colitis is a chronic inflammatory bowel disease in which the large intestine (colon) becomes inflamed and ulcerated (pitted or eroded), leading to flare-ups (bouts or attacks) of... read more ) would be advised to have a screening colonoscopy more often than is normal for people at average risk. If a woman has close relatives who have had breast cancer (family history Family history of breast cancer Breast cancer occurs when cells in the breast become abnormal and divide uncontrollably. Breast cancer usually starts in the glands that produce milk (lobules) or the tubes (ducts) that carry... read more ), screening for breast cancer with magnetic resonance imaging (MRI) in addition to mammography may be recommended.

Some screening measures are recommended for people with certain disorders. For example, people with diabetes should check their feet at least once a day for redness and ulcers, which, if ignored, may result in severe infection and ultimately amputation.

Preventive medication therapy (also known as chemoprevention) is the use of medications to prevent disease. For such therapy to be recommended, the person must be at risk of the disorder being prevented and be at low risk of side effects caused by the medication being considered.

Preventive medication therapy is clearly helpful in, for example, prevention of infection in people with certain disorders (such as AIDS), prevention of headache in people with migraines, and many other specific situations. Although preventive medication therapy is effective only in specific situations, some of those situations are common, so the therapy is useful for many people. For example, for adults at risk of coronary artery disease or stroke, aspirin is usually recommended. Newborns routinely receive eye drops to prevent gonococcal infection of the eyes. Women who are at high risk of breast cancer may benefit from preventive medication therapy (for example, with the medication tamoxifen).