Preventive Care Information

QUIT SMOKING (including cigars, pipes, chewing tobacco and smokeless tobacco)

  • Smoking increases the risk of heart disease, stroke, chronic obstructive lung disease (emphysema and chronic bronchitis), and a variety of cancers, including lung cancer, head and neck cancer, esophageal cancer and bladder cancer.

AVOID CONSUMPTION OF ALCOHOL

  • Historical note - for decades, the public health recommendation was alcohol in moderation - maximum of 1-2 drinks/day (1 drink = 12 ounces of beer, 5 ounces of wine, or 1 shot liquor). However, re-analysis in the early 2020’s of statistical population-based data led to the conclusion that better health in those consuming moderate amounts of alcohol was because healthier people were consuming moderate amounts of alcohol, not because alcohol is healthy, and thus the change in public health recommendations, to avoid consumption of alcohol.

  • Alcohol consumption increases the risk of cirrhosis of the liver, heart failure, and a variety of cancers, including breast cancer, colorectal cancer, esophageal cancer, head and neck cancer, and liver cancer.

EXERCISE REGULARLY

  • The ideal is at least 30 minutes of physical activity every day of the week; any physical activity is better than none.

  • The “Physical Activity Guidelines (PAG) for Americans,” published in the Journal of the American Medical Association (JAMA) in 2018, specifically call for 150 - 300 minutes of moderate-intensity aerobic physical activity per week or 75 - 150 minutes of vigorous physical activity per week… and state that any physical activity is better tan none, from a health perspective.

  • Aerobic exercise, defined as exercise which raises the heart rate and keeps the heart rate elevated steadily (i.e. walking, bicycling, cross country skiing, aerobics, swimming, roller blading), ideally 3-4 times per week. Interval training is ideal, meaning alternating between bursts of intense aerobic exercise for 30-60 seconds with intervals of less intense aerobic exercise.

  • Weight training (i.e. 8-12 reps for 2-3 sets) 2-3 times per week should be part of a comprehensive exercise program.

  • Balance and flexibility training should be part of a comprehensive exercise program.

  • For extensive information (with scientific citations) on the benefits of exercise, navigate to https://www.drlevyhealthinfo.com/exercise.

EAT HEALTHY

  • Eat a variety of fruits and vegetables (at least 5 portions per day), with diversity from one week to the next

  • Eat a variety of nuts and seeds (unroasted, unsalted, store in refrigerator)

  • Eat whole grains, NOT refined carbohydrates

  • Consume plentiful amounts of monounsaturated fat and omega 3 fats (fatty fish)

  • Limit milk and milk products (cheese, yogurt, ice cream)

  • Limit fatty, greasy, fried foods

  • Limit meat, especially red meat, and markedly limit intake of processed meat (fatty fish twice a week is good as a substitute)

  • Limit sweets

  • Limit sugar-sweetened beverages

  • AVOID trans fats (hydrogenated oils, shortening)

  • For extensive information (with scientific citations) on healthy eating (optimum nutrition), navigate to https://www.drlevyhealthinfo.com/nutrition

BRUSH your teeth twice a day AND FLOSS once a day (Consumer Reports. March 2023. 18-23; Consumer Reports. January/February 2025. 66-73). NOTE that the biologic rationale for flossing daily is strong, but the level of evidence for long term benefit from flossing is a lower level of evidence than the evidence for long term benefit of brushing

  • Toothbrush - use a toothbrush with soft or extra soft bristles (NOT medium or hard bristles), and brush for a total of two minutes each time

  • Toothpaste - the American Dental Association highly recommends using a toothpaste with fluoride. NOTE that charcoal toothpaste can be highly abrasive and might damage the enamel of the teeth, so not recommended

  • Technique - use a pea-sized amount of toothpaste, and use light pressure. Brush along the gums at a 45 degree angle, brush in small circles, brush the front, back and tops of all teeth. Ideally do NOT rinse mouth after brushing

  • Dental floss - beware that some dental flosses are covered with PFAS (“forever chemicals”) to make the floss slide better. In 2024, PFAS-free options include Nudge Clean Sustainable Pure Silk Floss, Radius Natural Biodegradable Silk Floss, and TreeBird Pure Silk Eco Floss

  • Mouthwash - biologic rationale is that the swishing of mouthwash in the mouth can coat parts of the surface that are harder to reach with toothbrushes and dental floss. Do NOT rinse mouth with water after using mouthwash

SEE A DENTIST once a year for a routine teeth cleaning, more often if plaque or tartar build-up

DENTAL X RAYS for screening every 2-3 years, unless you are prone to cavities

CONSIDER EYE EXAMS once a year over age 65, or if decreased vision

CONSIDER HEARING EVALUATION once a year over age 65, or if decreased hearing (www.hearing.loss.org)

WEAR A SEAT BELT when in a car; WEAR A HELMET when bicycling, roller blading, skate boarding, or riding a scooter

LIMIT SUN EXPOSURE or use a SPF 30 or greater sunscreen

SAFE SEXUAL PRACTICES - monogamous relationship is best; condoms for prevention

GUN SAFETY - if you own guns, consider keeping them locked and with the chamber empty

WHAT YOU SHOULD KNOW ABOUT HEART ATTACKS

  • Heart attacks are the number one killer of adults in the United States.

  • Most deaths from heart attacks occur in the first hour, and most occur suddenly from disturbances in heart rhythm.

  • Slow, deep breathing if you are experiencing a heart attack may decrease the risk of death, as heart rhythm disturbances may be less likely if one can stay relaxed.

  • Heart attacks are uncommon under age 50, but can occur at any age, especially in cigarette smokers, diabetics, and cocaine users.

  • Heart attack pain is typically experienced as a constant pressure or heaviness in the chest, often accompanied by shortness of breath or sweating.

  • If you think you might be having a heart attack, call 911. Prompt emergency treatment can save lives.

WHAT YOU SHOULD KNOW ABOUT STROKES

  • Symptoms of a stroke include any one of the following:

    • Sudden weakness or numbness of the face, arm, or leg, usually on only one side

    • Sudden loss of vision

    • Sudden difficulty speaking

    • Sudden difficulty walking due to imbalance

    • Sudden onset of a severe headache

  • Pain is usually not an indication of a stroke - the only exception is sudden onset of a severe headache.

  • If you think you might be having a stroke, call 911. Prompt emergency treatment can save lives.

REFERENCE BOOK:

American College of Physicians Complete Home Medical Guide. David R. Goldman (ed). 1999.

THE ANNUAL COMPLETE PHYSICAL EXAM

  • This is a time honored tradition, initially advocated by the American Medical Association in the 1920's (JAMA. 1923. 80. 1376-1381).

  • In 1979 the Canadian Task Force on the Periodic Health Examination first suggested that the few preventive health care interventions which were well supported by evidence could be done at visits for other purposes, rather than at a scheduled annual physical (Can Med Assoc J. 1979. 121. 1193-1254).

  • Since 1979, the American College of Physicians, American Medical Association, USPSTF, and U.S. Public Health Service have all agreed that comprehensive annual checkups of adults should be abandoned and replaced by a more selective approach (Ann Intern Med. 1981. 95. 729-732; JAMA. 1983. 249. 1626-1633; Ann Intern Med. 1991. 114. 758-783).

  • A periodic health evaluation with a focus on a healthy lifestyle and disease prevention is considered by most authorities to be the successor to the annual complete physical (Arch Intern Med. 1999. 159. 909-910).

DIETARY SUPPLEMENTS FOR PREVENTION FOR HEALTHY ADULTS (I consider the items at the top of the list to be highest priority)

  • Consider Vitamin D 1000 - 2000 IU daily, depending upon sun exposure and the amount of vitamin D in the multivitamin (NOTE some multivitamins contain 1000- 2000 IU vitamin D per serving)

  • Consider a multivitamin/multimineral daily

  • Consider NAC 500 - 600 mg daily (I added this supplement to my recommendations in 2017)

  • Consider magnesium (glycinate or citrate) 100 - 200 mg daily

  • Consider selenium 200 micrograms daily (or 2 Brazil nuts daily) - NOTE that some multivitamins contain as much as 200 micrograms of selenium per serving

  • Consider Vitamin E (a product containing mixed tocopherols and mixed tocotrienols) 400 IU twice a week (NOTE some multivitamins have mixed tocopherols or mixed tocotrienols in significant quantities)

  • Consider a whole food fruit and veggie supplement – examples include Swanson® Fruit and Veggies 4 Life (available by mail order), Juice Plus + ® (multi level marketed)

  • Females of child-bearing age, consider folate 0.4 mg daily (NOTE most multivitamins contain this quantity of folate)

  • Females, consider calcium citrate 300 - 500 mg daily

  • Over age 50, consider vitamin B12, 100 – 1000 mcg daily (NOTE some multivitamins contain this quantity of vitamin B12)

  • Over age 50, consider Coenzyme Q10, 50 - 100 mg daily - crystal free brands have the highest bioavailability

  • Over age 50, consider lithium orotate 5 mg daily ( (I added this supplement to my recommendations in 2024)

  • For detailed information on vitamins, minerals and dietary supplements for a healthy person, navigate to https://www.sanfordlevymd.com/vitamins-minerals-and-dietary-supplements-for-optimum-health

Page Updated December 27, 2024