Change your lifestyle, live longer

Sandra Cullen didn't think she was a candidate for diabetes or high cholesterol. But that changed in 2002 when the 39-year-old mother of twins sought a physicians help because she wasn't feeling quite right.

Routine tests showed borderline high cholesterol at levels of about 200 with the bad LDL cholesterol high. Her blood sugar and triglycerides were also on the rise. Her father had died at 58 years old from complications from diabetes, high blood pressure and asthma.

"I knew that I needed a lifestyle change in order to not end up the same way," she said. "I just felt like I didn't have time for it."

She made significant changes in her diet and picked up an old habit, exercise.

"Thankfully I had a great doctor," Cullen said. "She knew I was determined to change things and so she agreed to give me six months to improve my health through diet and exercise rather than immediately prescribing medication for me."

Within six months her fasting glucose level went down 60 points, HA1C (average glucose level of prior few months) went down below diabetic levels and cholesterol went from 200 to 132. The LDL and triglycerides also went from high levels to normal.

"I thought that exercising would make me more tired, but it actually gave me more energy," she said. "I also worried about the time spent away from my family to exercise, but they quickly realized that those extra few hours a week I spend exercising make me calmer and happier and so they are glad that I have an outlet to release my stress before I get home. As far as the changes in diet, I found that I had a lot less headaches and again a lot more energy from eating less sugar and too many carbs without protein."

A recent European Prospective Into Cancer study found that those who avoided nicotine, ate healthy, completed 30 minutes of exercise each day and were of average weight had a significantly reduced risk of developing cancer, Type 2 diabetes or having a heart attack or stroke.

But what does eating healthy and exercising mean exactly?

Dr. Sayed Hussain, general practitioner at Desert Springs Hospital, sees that this general prescription is a supersize combo between the portions and quality of food Americans eat in ratio to that of how much they exercise, which is usually very little.

"Most of us eat fast foods, on top of that we are not consistent with regular exercise," he said. "And diet plays a significant role in people's glucose tolerance leading to diabetes and heart problems later on."

The American Heart Association's guidelines are perfect, he said. Sedentary women age 31-50 should intake approximately 1800 calories, 1600 for women 51 and over. Men should consume 400 calories per day more than that. The AHA also recommends that foods be varied and consist of a balance of lean proteins, whole grain carbohydrates and vegetables. Try to get in 30 minutes of moderate physical activity a day by simply putting on your sneakers and getting outside for a brisk walk. Can't carve out a whole 30 minutes? The AHA recognizes that 10 minutes of exercise three times a day does a body just as good.

While diet and exercise are important, genes play a big role.

If a disease that can be controlled by diet and exercise runs in your family, make sure you are aware and doing something about it long before a doctor has to tell you to do so.

"Even if you are not obese, working out can keep your diabetes risk low if it runs in your family," he said. "We see that even bodybuilders have bad cholesterol because it can run in their genes. Familial risk is always a big risk."

There is one constant every doctor will prescribe for at-risk patients, with or without medication, said Fred Toffel, endocrinologist and Medical Director of the Diabetes Treatment Center at Desert Springs Hospital.

"Diet and exercise is always the background therapy," Toffel said. "Exercise is gong to build muscle cells, muscle burns glucose, burns fat, so ... we are developing more muscle cells and getting rid of fat and are able to metabolize sugar better. It solves a lot of problems."

By exercising you are burning calories even while sitting or sleeping, making the body run better 'round the clock.

"Exercise also strengthens the heart, increases your cardio output and allows you to get a restful sleep," Toffel said. "That puts less stress on the body and you'll feel better and eat less."

And it doesn't take a lot to benefit the body.

"I don't' expect everyone to run a marathon," he said. "I'd say 30 to 60 minutes of exercise is optimal 5 times a week. Just push yourself a little bit. The last thing you want to do is turn that treadmill up on high and hurt yourself and feel bad and then not want to work out at all."

Expect to three to six months to get in good enough shape to make a significant change in your health.

"It's going to take a while so start slowly," Toffel said, adding that talking to your doctor and/or a personal trainer to find your optimal workout is best. "Do something you think you are going to enjoy and do it with someone you like and don't start out too aggressively."

But pay attention to your diet.

"You can never exercise enough to offset a bad diet," he said. "And most [Americans] eat a few hundred calories in a minute."

Diet can be one of the hardest things to change, said Monica Serna, clinical nutrition manager for Desert Springs. However if you simply limit your portion size and lower your fat and salt intake, you can see marked results in weeks.

"Our portion sizes have increased over 20 years, therefore we are getting more fat and more salt where our body doesn't need, which leads to obesity," Serna said.

Marybeth Clark, registered dietician at Desert Springs, pointed out salt sneaks into the diet and is difficult to control unless you carefully monitor your intake.

A trendy addition to food is sea salt, which advertisers say reduces sodium. Not true, says Clark.

"Ounce for ounce it has same amount of sodium," she said.

The AHA suggests an intake at or below 2,400 mg, or one and one-quarter teaspoons per day. Clark recommends reaching for Ms. Dash or other salt-free seasoning before the Morton's.

The biggest salt culprit is one you may not suspect.

"A lot of the frozen dinners, Lean Cuisines, people think it's a better [diet] deal, they advertise that they are lower calories, lower fat, but the sodium content is so high," Serna said.

If you had to make only one change in your diet, Serna and Clark agree portion control is key to keeping fit, as well as what's on that portion-perfect plate.

"There's so many little things you can do to change your diet," Serna said. "But cutting down your portion sizes, that can really make a difference."

Clark suggests looking at your plate in fractions. If your plate contains one-quarter lean protein, such as skinless chicken breast or salmon, one-quarter whole grain starch, such as brown rice or whole wheat pasta and the other half other half non-starchy vegetables, such as broccoli or zucchini, you've got a perfectly balanced meal worthy of any diet.

Since most people know it's a good idea to get moving and eat well, and it feels good for the moment, why is it so hard to do?

"The biggest reason is people just don't think they have the time," said Bret FitzGerald, M. Ed., adjunct professor at UNLV's School of Public Health and vice president of corporate communications, "plus for most people it's not a pressing issue."

If someone has a toothache bad enough to interfere with sleep or work, they go to a dentist and get it repaired. When it comes to health and fitness, the issues that keep you healthy aren't pressing, interfering or making themselves known to motivate you.

FitzGerald, who has 30 years exper ience as a health educator, said the health club industry is making a change, focusing more on exercise as medicine for so many maladies.

No matter how much a person knows it's good for them, it takes a spoonful of powerful stuff to get them into the gym regularly, he said.

"It takes a person with motivation to start," he said.

His tips?

Write down your goals and check them regularly, whether they be numbers on the scale of numbers on your cholesterol screening. Or make an event a goal, either something big like a reunion or simply a planned pool party or night out.

"Visualize how good you'll feel so you have to maintain what you are doing so you look great for that event," he said.

And it's cost effective.

"If you work out, you lo wer your risk for diabetes, lower your cholesterol and then you don't spend money on meds," he said "A [monthly] membership to any club is going to cost a lot less than a month of medication."

More information on the Web at: