by Dr. Sam Benjamin Let's face it: it's up to you to stay well. If you can't meet the challenge, then smoking, obesity, drug use, or a poor diet will set you up for an early death. And the odds that you'll escape this destiny are small. All the surgeries, prescriptions, supplements, and high-quality medical care will be too little, too late, if you treat your body poorly. You can't defy your body's needs and think that the medical system will come along to fix you. It won't happen.

On the positive side, prevention of illness is the second key to good health. There are three aspects to prevention:

• Knowing what your risks are
  
  
• Taking prevention measures everywhere in your life
  
  
• Choosing your doctor wisely

It's no secret that men and women have different attitudes toward health and wellness.

Women are the heath-care advocates and generally pay a lot of attention to health issues. Still, only 13 percent of women know that heart disease is a huge threat to their health, according to The American Heart Association.

Men, on the other hand, often won't visit a doctor, even when they're sick. A survey sponsored by Men's Health magazine and CNN show that, ironically, men expect to live longer than their statistical life expectancy, most won't see a doctor for chest pain.

Both of these - a woman being ignorant of the heart disease threat - and a man refusing to see a doctor when he's sick - are just irresponsible! Heart disease, stroke, and other cardiovascular diseases kill nearly a million Americans a year and disable lots more.


Preventing what can kill you The obvious and best-known preventive measures to avoid heart disease, cancer, diabetes, and a host of other illnesses, include:

• Eat right - eat plenty of fruits, vegetables, whole grains, and low-fat foods; cut down on red and processed meats; maintain a healthy weight.
  
  
• Exercise at least 30 minutes most days.
  
  
• Keep your cholesterol, blood pressure, and blood sugar levels within normal ranges.
  
  
• Limit your alcohol intake.
  
  
• Limit your exposure to sun and use a sunscreen.
  
  
• Reduce your exposure to indoor pollution, which potentially causes cancer and other health issues, at home and in the workplace.
  
  
• Have regular preventive health screenings. The three leading medical causes of death are heart disease, cancer, and stroke - and health screenings are the best prevention against these killers. For example, 90 percent of testicular cancer is curable, if caught early.
  
  
• Don't smoke cigarettes or use tobacco products. Lung cancer is the biggest cancer killer, and 90 percent of lung cancer is caused by cigarettes.
  
  
• See your doctor regularly.
  
  
• Know your family medical history and your risk factors.
  
  
• Be sure you and your children have up-to-date vaccinations, which are simple preventive measures that can dramatically contribute to your health and well-being. While some vaccines have come under fire, such as the live polio vaccine of years ago, it is undeniable that many, if not all, vaccines are life-savers.
  
  
• Have good techniques for washing hands - which is essential to preventing the spread of illness in your household and workplace.
  
  
• Being sure to wash your kitchen counters after use and when preparing fresh meats, poultry, and fish. These efforts will go a long way towards cutting down intestinal infections at home.
  
  
• For restaurant food safety, check with local city and county Websites for restaurant health inspection reports. Only consume fresh cheese or milk if they are homogenized and pasteurized. Ask the server when in doubt - especially in ethnic or organic restaurants.

In the debate between using a primary care doctor or a specialist, a prominent public health specialist - Barbara Starfield, M.D, M.P.H., of Johns Hopkins School of Public Health - has made a convincing argument that our primary doctor must be our advocate, our first and safest line of defense. Starfield urges us to use specialists only when absolutely necessary.


These three aspects of preventing illness - knowing, preventing, and choosing - are the real issues in our health care system. They empower us to confront and resolve the health care problems.