American Medical Association Family Medical Guide
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"This completely updated fourth edition of our bestselling health reference is comprehensive, easy to understand, and even more user-friendly than the previous editions. We're excited to provide our patients with an invaluable resource to help them become more involved in their own health care. We think this is a book that belongs on the bookshelf in every home."
-AMA President John C. Nelson, MD, MPH
The American Medical Association is the nation's premier health authority-an organization that both patients and doctors look to for state-of-the-art medical information and guidance. Now, for the first time in 10 years, the AMA has updated its landmark medical reference-a book that belongs in every home.
This new edition of the American Medical Association Family Medical Guide has been thoroughly revised to bring it up to date and make it more accessible than ever before. Opening with a brand-new full-color section that walks you through key health issues, it follows with several new and expanded sections on everything from staying healthy and providing first aid and home care to diagnosing symptoms and treating hundreds of different diseases and disorders. This classic guide is the definitive home health reference for the twenty-first century-an indispensable book to keep you and your loved ones healthy.
* Authoritative guidance on hundreds of diseases and the latest tests, treatments, procedures, and drugs
* New or greatly expanded coverage of genetic testing, sexuality, learning disabilities, preventive health, infertility, pregnancy and childbirth, substance abuse, home caregiving, and first aid
* A host of new and updated features-including full-color spreads on important health topics, Q&A sections, first-person case histories, and newly designed symptoms flowcharts
* New chapters on diet and health, exercise and fitness, maintaining a healthy weight, reducing stress, genetics, complementary and alternative medicine, staying safe and preventing violence, cosmetic surgery, and preventive health care
* A new section on health issues at various life stages
* 64 pages in full color and almost 1,000 illustrations and photographs
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- Rating: 5 out of 5 stars5/5They really need to come out with a new edition of this book. One of my most used references. I haven't found any online resource that is quite as useful or accessable but we are looking at over twenty years out of date now. Are you listening AMA
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Book preview
American Medical Association Family Medical Guide - American Medical Association
Table of Contents
Other Books by the American Medical Association
Title Page
Copyright Page
Foreword
American Medical Association
How to Use This Book
Part One: What You Should Know: Information to Keep You Healthy
Part Two: Your Healthy Body
Part Three: First Aid and Home Caregiving
Part Four: What Are Your Symptoms?
Part Five: Health Issues Throughout Life
Part Six: Diseases, Disorders, and Other Problems
Glossaries
PART ONE - What You Should Know
Healthy Eating
Eat Five a Day for Better Health
Reading Food Labels
Vitamins and Minerals
Exercise
The Benefits of Exercise
Three Types of Exercise
Are You at a Healthy Weight?
Body Mass Index
Stress
The Body’s Response to Stress
Aging Well
Preventing Alzheimer’s Disease
Osteoarthritis
How Your Joints Work
How Osteoarthritis Affects Your Joints
Exercise and Osteoarthritis
Heart Disease
Risk Factors for Heart Disease
Preventing Heart Disease
Cancer
What Is Cancer?
Preventing Cancer
Cancer Treatments
Genetics
Genetics: The future of medicine
The Dangers of Smoking
The Benefits of Quitting Smoking
Terrorism
Biological Attacks
Chemical Attacks
Radiological Attacks
PART TWO - Your Healthy Body
Chapter 1 - Diet and Health
Eating for Good Health
The Basics of Nutrition
Chapter 2 - Exercise, Fitness, and Health
The Health Benefits of Physical Activity
Three Kinds of Exercise
Physical Activity and Children’s Health
Chapter 3 - A Healthy Weight
Are You Overweight?
The Risks of Being Overweight
Losing Weight Sensibly
If You Are Underweight
Chapter 4 - Reducing Stress
How Your Body Responds to Stress
How Stress Can Make You Sick
Stress and Sleep
How to Handle Stress
The Relaxation Response
Chapter 5 - Staying Safe
Keeping Your Children Safe
Keeping Your Home Safe
Motor Vehicle Safety
Water Safety
Chapter 6 - Preventing Violence
Family Violence
Media Violence
Gang Violence
Elder Abuse
Sexual Assault
Chapter 7 - Complementary and Alternative Medicine
Alternative Medical Systems
Herbal Remedies and Dietary Supplements
Manipulative Therapies
Mind-Body Therapies
Energy Therapies
Atlas of the body
Diagnostic imaging techniques
Visual aids to diagnosis
Chapter 8 - Preventive Health Care
Routine Health Care
Self-Examinations
Common Examinations and Tests
PART THREE - First Aid and Home Caregiving
Chapter 1 - First Aid
Index to First-Aid Procedures
Chapter 2 - Home Caregiving
Preparing for Home Care
Caregiving Skills
Modifying the Home Environment
Care for the Caregiver
PART FOUR - What Are Your Symptoms?
How to Use the Self-Diagnosis Symptoms Charts
How to Find the Chart You Need
Chart-Finder Index
GENERAL All ages
Feeling generally ill
Unexplained weight loss
Overweight
Difficulty sleeping
Fever
Excessive sweating
Swellings under the skin
Itching without a rash
Feeling faint and fainting
Dizziness
Headache
Numbness or tingling
Twitching and trembling
Pain in the face
Confusion
Impaired memory
Difficulty speaking
Disturbing thoughts or feelings
Unusual behavior
Depression
Anxiety
Hallucinations
Nightmares
Hair loss
General skin problems
Facial skin problems
Itchy spots and rashes
Rash with fever
Raised spots and lumps
Painful eye
Disturbed or impaired vision
Earache
Noises in the ear
Hearing loss
Runny nose
Sore throat
Hoarseness or loss of voice
Coughing
Coughing up blood
Wheezing
Difficulty breathing
Toothache
Difficulty swallowing
Sore mouth or tongue
Bad breath
Vomiting
Recurring vomiting
Abdominal pain
Recurring abdominal pain
Swollen abdomen
Gas and belching
Diarrhea
Constipation
Abnormal-looking stools
Palpitations
Chest pain
Abnormally frequent urination
Abnormal-looking urine
Painful urination
Lack of bladder control
Backache
Cramp
Painful or stiff neck
Painful arm or hand
Painful leg
Painful knee
Painful shoulder
Painful ankles
Swollen ankles
Foot problems
MEN
Painful or enlarged testicles
Painful intercourse in men
WOMEN
Pain or lumps in the breast
Breast problems in new mothers
Absent periods
Heavy periods
Painful periods
Pelvic pain in women
Irregular vaginal bleeding
Abnormal vaginal discharge
Vaginal irritation
Abnormal hair growth in women
Painful intercourse in women
COUPLES - Infertility
CHILDREN
Waking at night in children
Crying in infants
Vomiting in infants
Diarrhea in infants
Skin problems in young children
Slow weight gain in young children
Fever in young children
Fever in children
Abdominal pain in children
Itching in children
Coughing in children
Swellings in children
Limping in children
OLDER PEOPLE - Over 65 years
Lack of bladder control in older people
Confusion in older people
PART FIVE - Health Issues Throughout Life
Chapter 1 - Children’s Health
Routine Health Care
Developmental Milestones
Health Concerns of Newborns and Infants
Congenital Heart Defects
Neural Tube Defects
Other Congenital Disorders
Disorders of the Digestive System
Neurological Disorders
Common Ear Problems in Children
Disorders of the Respiratory System
Blood Disorders
Disorders of the Urinary Tract and Reproductive Organs
Disorders of the Muscles, Bones, or Joints
Childhood Infections
Chapter 2 - Adolescent Health
Physical and Sexual Development at Puberty
Health Concerns During Adolescence
Adolescent Sexuality
Psychological, Emotional, and Behavioral Development
Chapter 3 - Sexuality
The Sexual Response Cycle
Sexual Orientation
Contraception
Sexually Transmitted Diseases
Sexual Problems
Chapter 4 - Infertility
The Causes of Infertility
Diagnosing Infertility
Treating Infertility
Chapter 5 - Pregnancy and Childbirth
Pregnancy
Prenatal Care
Health Concerns During Pregnancy
Complications During Pregnancy
Childbirth
Adjusting After Pregnancy and Childbirth
Chapter 6 - Dying and Death
Terminal Illness
Organ Donation
Advance Directives
Palliative Care
The Process of Dying
Practicalities of Death
The Mourning Process
PART SIX - Diseases, Disorders, and Other Problems
Chapter 1 - Disorders of the Heart and Circulation
Heart Disorders
Heart Rate and Rhythm Disorders
Heart Valve Disorders
Heart Muscle and Pericardium Disorders
Disorders of the Circulation
Chapter 2 - Blood Disorders
Anemia
Bleeding and Bruising
Leukemias
Lymphomas
Disorders of the Bone Marrow
Chapter 3 - Disorders of the Respiratory System
The Nose
The Throat
The Lungs and Chest
Infections of the Respiratory Tract
Chapter 4 - Disorders of the Brain and Nervous System
Disorders of Blood Vessels in the Brain
Structural Disorders of the Brain and Spinal Cord
Disorders of Brain Function
Degenerative Diseases of the Brain
Infections of the Brain and Nervous System
Other Brain and Nervous System Disorders
Sleep Disorders
Chapter 5 - Behavioral, Emotional, and Mental Disorders
Mood Disorders
Anxiety Disorders
Personality Disorders
Eating Disorders
Psychotic Disorders
Developmental Disorders
Addictions and Abuses
Chapter 6 - Disorders of the Digestive System
Disorders of the Mouth and Tongue
Disorders of the Esophagus
Disorders of the Stomach and Duodenum
General Abdominal Disorders
Disorders of the Small Intestine
Disorders of the Large Intestine
Disorders of the Anus
Infections of the Digestive Tract
Disorders of the Liver, Gallbladder, and Pancreas
Chapter 7 - Disorders of the Urinary Tract
Infections, Inflammation, and Injury
Cysts, Tumors, and Stones
Kidney Failure
Chapter 8 - Disorders of the Male Reproductive System
Disorders of the Testicles and Scrotum
Disorders of the Prostate Gland
Disorders of the Bladder, Urethra, and Penis
Chapter 9 - Disorders of the Female Reproductive System
Menstruation
Breast Disorders
Disorders of the Ovaries, Uterus, and Cervix
Disorders of the Bladder and Urethra
Disorders of the Vagina and Vulva
Chapter 10 - Hormonal Disorders
Disorders of the Pituitary Gland
Disorders of the Pancreas
Disorders of the Adrenal Glands
Disorders of the Thyroid and Parathyroid Glands
Chapter 11 - Disorders of the Immune System
HIV Infection and AIDS
Allergies
Autoimmune Disorders
Chapter 12 - Infections and Infestations
Generalized Infections
Infestations and Diseases Spread by Insect and Animal Bites
Travelers’ Infections
Chapter 13 - Genetic Disorders
Genetic Counseling
Chromosome Abnormalities
Autosomal Recessive Disorders
Autosomal Dominant Disorders
X-Linked Disorders
Chapter 14 - Disorders of the Bones, Muscles, and Joints
Sports Injuries
Disorders of the Muscles, Tendons, and Ligaments
Bone Disorders
Joint Disorders
Back and Neck Problems
Chapter 15 - Disorders of the Ear
Disorders of the Inner Ear
Disorders of the Middle Ear
Disorders of the Outer Ear
Chapter 16 - Eye Disorders
Focusing Disorders
Disorders of the Eyelids
Disorders of the Outer Eye
Disorders of the Inner Eye
Other Eye Disorders
Chapter 17 - Disorders of the Skin, Hair, and Nails
Skin Disorders
Disorders of the Hair and Nails
Chapter 18 - Cosmetic Surgery
Facial Surgery
Skin Rejuvenation
Breast Surgery
Body Contouring
Hair Replacement Procedures
Chapter 19 - Teeth and Gums
Tooth Decay
Going to the Dentist
Root Canal
Tooth Abscess
Discolored Teeth
Poorly Aligned Teeth
Dental Treatments
Missing Teeth
Problems Caused by Wisdom Teeth
Denture Problems
Periodontal Disease
Glossary
Drug Glossary
Credits
Index
Other Books by the American Medical Association
American Medical Association
Complete Medical Encyclopedia
American Medical Association
Diabetes Cookbook
American Medical Association
Healthy Heart Cookbook
American Medical Association
Complete Guide to Men’s Health
American Medical Association
Guide to Talking to Your Doctor
American Medical Association
Guide to Home Caregiving
American Medical Association
Complete Guide to Your Children’s Health
American Medical Association
Complete Guide to Women’s Health
American Medical Association
Handbook of First Aid and Emergency Care
American Medical Association
Family Health Cookbook
American Medical Association
Essential Guide to Asthma
American Medical Association
Essential Guide to Depression
American Medical Association
Essential Guide to Hypertension
American Medical Association
Essential Guide to Menopause
001This book is printed on acid-free paper. 002
Copyright © 2004 by the American Medical Association. All rights reserved
Published by John Wiley & Sons, Inc., Hoboken, New Jersey
Published simultaneously in Canada
Design and production by Navta Associates Inc.
No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the Publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923, (978) 750-8400, fax (978) 646-8600, or on the web at www.copyright.com. Requests to the Publisher for permission should be addressed to the Permissions Department, John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, (201) 748-6011, fax (201) 748-6008.
The recommendations and information in this book are appropriate in most cases and current as of the date of publication; however, they are not a substitute for a medical diagnosis by a physician. For specific information about a health condition that you or a family member may have, the AMA recommends that you consult a physician. The names of organizations, products, and alternative therapies appearing in the book are given for informational purposes only. Their inclusion does not imply AMA endorsement—nor does the omission of any organization, product, or alternative therapy indicate AMA disapproval.
Limit of Liability/Disclaimer of Warranty: While the publisher and the author have used their best efforts in preparing this book, they make no representations or warranties with respect to the accuracy or completeness of the contents of this book and specifically disclaim any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives or written sales materials. The advice and strategies contained herein may not be suitable for your situation. You should consult with a professional where appropriate. Neither the publisher nor the author shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.
The information contained in this book is not intended to serve as a replacement for professional medical advice. Any use of the information in this book is at the reader’s discretion. The author and the publisher specifically disclaim any and all liability arising directly or indirectly from the use or application of any information contained in this book. A health care professional should be consulted regarding your specific condition.
For general information about our other products and services, please contact our Customer Care Department within the United States at (800) 762-2974, outside the United States at (317) 572-3993 or fax (317) 572-4002.
Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books. For more information about Wiley products, visit our web site at www.wiley.com.
Library of Congress Cataloging-in-Publication Data
American Medical Association family medical guide / American Medical
Association.
p. cm.
Includes bibliographical references and index.
ISBN 0-471-26911-5 (cloth)
1. Medicine, Popular. I. American Medical Association.
RC81.A543 2004
613—dc22
2004005764
Foreword
003Every day, Americans hear news of the latest medical study or another medical breakthrough. These scientific advances, along with the latest techniques for diagnosing and treating diseases, are helping us live longer and in better health than ever before. With this all-new, completely revised fourth edition of our best-selling American Medical Association Family Medical Guide, you have the tools you need to make sense of this abundance of information, enabling you to take charge of your health and health-care needs and make informed medical decisions.
Reviewed by nearly 50 practicing physicians from a cross section of medical specialties and written in clear, easy-to-understand language, this guide provides up-to-date explanations about how specific diseases are diagnosed and treated. The book also explains what you can do to prevent many of the most common chronic diseases and how and why some lifestyle factors (such as diet and exercise—or smoking) can improve your health—or harm it.
We at the AMA believe that good medicine begins with a good patient-doctor relationship. This revised and updated edition of the American Medical Association Family Medical Guide will help you and your doctor work closely together to achieve years of good health for you and your family.
Michael D. Maves, MD, MBA
Executive Vice President, CEO
American Medical Association
American Medical Association
How to Use This Book
A wealth of information on health and disease is at your fingertips in this totally revised and updated fourth edition of the American Medical Association Family Medical Guide. To get the most benefit from the book, take some time to familiarize yourself with it—in terms of general information and specific health questions you may have. First, scan the Table of Contents on pages ix through xii for a quick overview of how the book is organized.
When looking up a topic, start with the index. The index contains multiple cross-references to many entries to make it easier for you to find the information you need.
Part One: What You Should Know: Information to Keep You Healthy
Part One is an all-new, full-color section that highlights and illustrates the most important current health issues, including preventive health topics such as nutrition, exercise, weight, and stress reduction, and cutting-edge information about cancer and genetics.
Part Two: Your Healthy Body
Part Two is a completely revised and expanded section that presents up-to-date information on preventive medicine. Families need accurate, easy-to-understand recommendations on topics that are critical to their long-term health. You will learn how and why lifestyle factors—for example, eating a healthy diet, exercising regularly, maintaining a healthy weight, reducing stress, and getting sufficient sleep—have such a profound effect on your health.
Between chapters 7 and 8, you’ll find a 32-page full-color section. This section contains an Atlas of the Body, Diagnostic Imaging Techniques, and Visual Aids to Diagnosis. The Atlas is a handy reference for locating bones, muscles, and other parts of the body. Diagnostic Imaging Techniques explains the different types of diagnostic imaging procedures your doctor might recommend, such as ultrasound and magnetic resonance imaging (MRI). This section describes how each diagnostic test is done and which disorders the test might help diagnose. Visual Aids to Diagnosis presents photos of sores, rashes, and other recognizable signs and symptoms, along with brief descriptions of the disorders or conditions to which they might be linked.
Part Three: First Aid and Home Caregiving
Part Three focuses on two important topics—First Aid and Home Caregiving. The First Aid section provides step-by-step advice on how to handle injuries and emergencies including choking, bleeding, burns, and heatstroke. The Home Caregiving section gives practical information to help you take care of a person who is ill or disabled. For example, you will learn how to modify your home to make it easier for you to care for an older family member who has a disabling chronic illness such as Alzheimer’s disease.
Part Four: What Are Your Symptoms?
The popular and always-helpful symptoms charts have been completely revised and updated for this edition. Organized like flow charts, the symptoms charts direct you through a series of questions with yes or no answers from a specific symptom to reach a possible diagnosis or recommendation. The charts help you decide when it’s important to call your doctor about a problem, when to go to a hospital emergency department immediately, or when to take care of the problem yourself at home.
The symptoms charts contain many cross-references to articles in other parts of the book, especially to Part Five (Health Issues Throughout Life) and Part Six (Diseases, Disorders, and Other Problems). To make the best use of the symptoms charts and to obtain a full explanation of a specific disorder or condition, follow the cross-references to the articles.
Part Five: Health Issues Throughout Life
Part Five is an all-new section that discusses common health concerns that can occur at any time of life. This section has comprehensive chapters on children’s health, adolescent health, sexuality, infertility, pregnancy and childbirth, and dying and death. Part Five and Part Six (Diseases, Disorders, and Other Problems), which are both packed with helpful information, are the heart of the book.
Part Six: Diseases, Disorders, and Other Problems
You will probably use Part Six more than any other part of the book because this is where you will find information about hundreds of diseases and disorders. To make it easy for you to find the information you’re looking for, the chapters in this part of the book are arranged by body system. The articles in these chapters have an easy-to-follow, straightforward format that usually includes the following headings: Symptoms (describes the most common symptoms and signs of the disorder), Diagnosis (explains how the disorder is diagnosed), Treatment (explores the treatment options for the disorder), and Prevention (tells how the disorder can be prevented, when prevention is possible).
Within the articles on specific diseases, you will also find cross-references to other parts of the book. Use these cross-references, along with the index, to add to your knowledge of or improve your understanding about a particular health problem or concern.
Glossaries
This section contains a general Glossary and a Drug Glossary. The general Glossary defines some common medical terms you might hear or read. The Drug Glossary has two sections—a section on drug classes (the groups into which drugs are categorized) and a section on the top 200 prescription drugs.
PART ONE
What You Should Know
Information to Keep You Healthy
Healthy Eating
A wealth of information exists about the fundamental link between diet and health. Although many people think that healthy eating means flavorless, unsatisfying meals, this does not have to be the case. A healthy diet includes plenty of vegetables, fruits, whole grains, legumes, and other high-fiber, high-nutrient foods; supplies the right number of calories; and limits saturated fat and trans fats (such as those found in stick margarine), salt, sugar, and alcohol. The components of a healthy diet translate easily into delicious meals that can appeal to the whole family. For more about a nutritious diet, see pages 35 to 44.
Eat Five a Day for Better Health
We have all heard from experts that eating at least five fruits and vegetables each day is one of the most important things we can do for our health, but only one out of four of us is actually eating this amount. Fruits and vegetables provide a wide assortment of vitamins and minerals, including the antioxidant vitamins—vitamin C, the carotenoids (beta carotene, lycopene, and lutein), and vitamin E—which fight cell damage from free radicals, a major cause of aging and most chronic diseases. Fruits and vegetables also provide fiber, an essential nutrient that promotes healthy bowel function and helps lower the risk of heart disease and some types of cancer. Fruits and vegetables are so good-tasting and so good for you that you should try to consume as many as you can. Five servings a day is the minimum for keeping you healthy (10 a day is better). Here are some tips to help you get your daily dose of fruits and veggies:
• Have one or two servings of fruit at breakfast every day.
• Choose a fruit or vegetable for a snack.
• Have a salad at lunch.
• Stock up on dried, canned, and frozen fruits and vegetables.
• Serve more than one vegetable for dinner.
Eat your colors
Fruits and vegetables come in an array of colors, and the color of a food usually says something about its nutritional value. Each food color confers specific health benefits, so consuming a variety of fruits and vegetables provides the biggest health gains.
BLUES AND PURPLES
Blueberries, blackberries, purple grapes, plums, raisins, and eggplants give you:
• A reduced risk of some cancers
• A healthy urinary tract
• A sharp memory
• A long, healthy life
GREENS
Kiwi, honeydew melons, spinach, broccoli, romaine lettuce, kale, green peas, brussels sprouts, cabbage, and Swiss chard give you:
• Strong bones and teeth
• Good eyesight
• A reduced risk of some cancers
WHITES
Pears, apples, bananas, jicama, mushrooms, cauliflower, onions, and garlic give you:
• A healthy heart
• A good cholesterol profile
• A reduced risk of some cancers
REDS
Watermelon, strawberries, raspberries, cranberries, cherries, tomatoes, and radishes give you:
• A sharp memory
• A healthy heart
• A healthy urinary tract
• A reduced risk of some cancers
YELLOWS AND ORANGES
Oranges, grapefruit, peaches, cantaloupe, mangoes, pineapples, yellow and winter squash, carrots, and corn give you:
• A healthy heart
• A healthy immune system
• Good eyesight
• A reduced risk of some cancers
Reading Food Labels
Nutrition facts panel
The nutrition facts panel is the part of a food package label that lists serving size, the number of servings in the package, the number of calories in a serving, and the percent of daily values (which are the same as the recommended daily allowances) of many important nutrients—fats, carbohydrates, protein, cholesterol, fiber, sugar, sodium, vitamins A and C, and the minerals iron and calcium (no daily values have been set for protein and sugar).
What you can learn from food labels
1. To make it easy to compare different brands of the same food, all serving sizes are required to be the same.
2. This line shows the total calories in one serving and the number of calories from fat contained in the serving.
3. This section displays the amounts of different nutrients in one serving so you can easily compare the nutrient content of similar products and add up the total amounts of a given nutrient that you eat in a day.
4. The percent of daily values are indicated for each nutrient. Percent of daily values are based on a diet of 2,000 calories per day.
5. This area shows the percent of daily values for vitamins A and C and the minerals iron and calcium.
6. This section helps you calculate your daily allowance of various fats, sodium, carbohydrates, and fiber for both a 2,000- and a 2,500-calorie-per-day diet.
7. The number of calories in 1 gram of fat (9), carbohydrate (4), and protein (4) are listed here.
8. The federal government has approved the use of certain health claims on packaged foods. Examples include:
• A diet low in fat and rich in fruits and vegetables may reduce your risk of some cancers.
• A diet rich in fruits, vegetables, and grains may reduce the risk of heart disease.
• A low intake of calcium is one risk factor for osteoporosis.
9. Terms such as low,
high,
and free
on food labels must meet strict definitions. For example, a food described as very low sodium
must have no more than 35 milligrams of sodium for every 50 grams of food.
Shared family meals serve up benefits
Eating together as a family improves communication, promotes a strong family bond, and gives children a secure sense of belonging. Shared meals also save money.
005Vitamins and Minerals
This table describes the health benefits of the most important vitamins and minerals and some of the foods that contain these nutrients. Vitamins are divided into two categories—fat-soluble and water-soluble. Fat-soluble vitamins are found in fats and oils in foods and are stored in body fat. Water-soluble vitamins dissolve in water and mix easily in the blood. Your body stores only small amounts of water-soluble vitamins (the excess is eliminated in urine). Some vitamins are antioxidants, which protect against damage to cells by free radicals (molecules formed by normal cell processes). Antioxidants can help protect against disease and aging. The best way to get the vitamins and minerals your body needs is to eat a varied diet rich in low-fat, high-fiber vegetables, fruits, legumes, and whole grains; fish; and low-fat dairy products, poultry, and meats.
006007Exercise
Physical activity plays a crucial role in health. Regular exercise protects against the most common disorders—including heart disease, stroke, high blood pressure, obesity, type 2 diabetes, osteoporosis, colon cancer, and depression—and can help you live longer. Still, more than 60 percent of adults in the US fail to get the minimum recommended amount of exercise: half an hour to an hour of moderate activity such as brisk walking on most days of the week. You don’t have to do it all at one time: break up the time into 10- or 15-minute sessions scattered throughout the day. The activity you engage in doesn’t have to be strenuous to provide health benefits, especially if you have been inactive for some time. Of course, the more vigorous the activity, the more you will get out of it, but what is most important is becoming more active.
The Benefits of Exercise
If exercise were packaged in a pill, it would be the No. 1 prescribed medication in the US—and Americans would be much healthier. Even a small increase in your physical activity can substantially reduce your health risks, especially if you have been inactive. More activity—or activity that is more vigorous—will pay even bigger rewards. In addition, regular exercise provides the following health advantages:
• Lowers your risk of premature death.
• Reduces your risk of heart disease, high blood pressure, diabetes, and some cancers.
• Makes your heart pump more efficiently.
• Fights depression and anxiety.
• Improves strength, flexibility, and balance.
• Helps you maintain a healthy weight.
• Tones your muscles.
• Helps control your appetite.
• Keeps your mind sharp.
• Makes you look better.
• Boosts your self-confidence.
Fit Exercise Into Your Life
When you look at your busy life, a lot of things seem more important than exercise: your job, chauffeuring your kids to various activities, managing your household, or taking care of aging parents. And a lack of time may not be the only factor. Having too little money or social support—even bad weather—can all conspire against your best intentions to exercise. Here are some tips that might make it easier for you to begin an exercise program and stick with it:
• Choose an exercise you enjoy.
• Schedule time for exercise.
• Find a workout buddy or take an exercise class.
• Vary your activities to avoid boredom.
• Fight inertia by remembering how good exercise makes you feel.
If you don’t want to join a health club or can’t make the time for a long workout several times a week, try to incorporate exercise into your daily life in the following ways to accumulate 30 to 60 minutes of exercise every day:
• Climb up and down several flights of stairs at work once or twice a day.
• Take a brisk walk after dinner.
• Walk the dog.
• Pull your children around the neighborhood in a wagon or sled.
• Go to the local mall and walk.
• Park in a parking space farther from the store or office and walk to the building.
• Carry or push a golf bag instead of using a golf cart.
• Wash and wax the car.
• Do yard work.
• Clean the house.
• Jump rope.
• Mow the lawn with a hand mower.
• Lift hand weights, or do lunges, push-ups, and jumping jacks while you watch TV.
• On the weekends, organize a family bike ride, hike, or ball game. Go swimming, ice skating, or in-line skating together. Go dancing.
Making time for exercise
It’s easier to fit exercise into your busy schedule if you make it part of your daily routine. Try walking up and down several flights of stairs at work every day. It takes only a few minutes and it strengthens your heart, lungs, and bones.
008Three Types of Exercise
Three different types of exercise—aerobic, flexibility, and strengthening—help you achieve different kinds of physical fitness. Aerobic exercise (such as walking, jogging, and cycling) increases your heart rate to deliver more oxygen to your muscles. Strengthening exercises (such as lifting weights and doing push-ups) build muscle and bone to increase strength. Flexibility exercises (such as stretching or yoga) improve your ability to move your joints through their full range of motion. Including all three types of activity in your exercise regimen will help you reach a high overall level of fitness that can improve your health and reduce your risk of several of the most common chronic diseases, including heart disease and diabetes.
Choosing activities you enjoy will help you stay with your exercise program. Variety is the key, so don’t limit yourself to one activity. Jog one day and swim or bike the next. Work out with weights one day and use a stair-climbing machine the next day. Vary your stretching exercises as well. Not only will you maintain your enthusiasm for exercising, you will also be less likely to get injured.
Aerobic exercise
Aerobic exercise includes any activity that uses the large muscles, such as those in the legs, in repetitive motion that can be sustained over a long period. Examples of aerobic activity include walking, jogging, cycling, swimming, skating, cross-country skiing, and stair climbing. Aerobic exercise causes your heart and lungs to work more efficiently as they supply more and more oxygen-rich blood to your working muscles. Aerobic exercise builds endurance and provides a number of other important health benefits, including:
• Improved heart and lung function
• Reduced heart rate
• Lower blood pressure
• Higher blood levels of HDL (good) cholesterol
• Reduced body fat
• Improved weight control
• Increased bone strength
• Improved sleep
Aerobic exercise changes your body composition by lowering your body’s percentage of fat and increasing its percentage of muscle, giving you a toned, fitter body. Aerobic exercise also protects against several of the most common chronic health problems, including heart disease, high blood pressure, diabetes, osteoporosis, and some cancers.
If you have been inactive, start your aerobic exercise program with walking. Walking is an excellent aerobic activity that is low impact (and therefore safe for your joints), builds cardiovascular fitness and bone strength, and requires only a pair of sturdy, well-cushioned shoes. At first, try walking 10 to 15 minutes a day on most days of the week. After you build your endurance, add 5 minutes to your daily walking time each week until you can walk up to 30 to 60 minutes a day. You don’t have to do all of your walking in one session. Break up the activity into shorter sessions that add up to 30 to 60 total minutes. Walk with a friend or relative so you can encourage each other to stick with the program.
To determine whether you’re working out at the right level of intensity, make sure you are exercising at your target heart rate (see page 47), the pulse rate that is best for your age and overall physical condition. Try to do some aerobic exercise on most days of the week. Warm up and cool down before and after you exercise. And remember that the health benefits of aerobic exercise remain only as long as you continue exercising. That is why your goal should be to develop an exercise program that you can stay with for the rest of your life.
Make exercise a family habit
Exercising together as a family will not only increase your and your children’s endurance, build stronger bones, and improve your overall health, it will also help forge a strong family bond. Include physical activities such as hiking in your family vacations.
009Flexibility exercises
Flexibility is the ability to move your muscles and joints through their full range of motion. Some people are naturally more flexible than others, but you can always improve your flexibility with exercises that stretch specific muscles. Increased flexibility improves your ability to perform everyday activities, protects your muscles against pulls and tears, and helps relieve arthritis pain. It’s important to do stretches gently and slowly—don’t bounce. Do each stretch three times for maximum benefit.
Hip flexor/Quadriceps stretch
While standing, hold on to a sturdy chair back, a counter, or a railing with one hand. Bend one leg and, with the hand on that side, pull your foot up gently behind you, keeping your abdominal muscles pulled in and your knees close together. Maintain the position for at least 30 seconds. Repeat with the other leg.
010Calf stretch
Stand about 2 to 3 feet from a wall and place your palms on the wall. Step forward with one foot. Keeping both feet flat on the floor and your toes pointing straight ahead, bend the forward leg at the knee and lean forward, keeping your back leg straight (far left). Maintain the position for at least 30 seconds. Repeat with the other leg. Now do a set bending (rather than straightening) the back leg (left); maintain the position for at least 30 seconds.
011Back twist
Sit with your legs out in front of you on the floor. Cross one leg over the other with your knee bent and your foot flat on the floor. Keeping your back straight and your buttocks on the floor, take hold of the bent knee with the opposite hand and gently turn to the bent-knee side, rotating your hips and looking over your shoulder. Maintain the stretch for at least 30 seconds. Repeat on the other side.
012Hamstring stretch
Sit with one leg extended in front of you and the other leg bent. Reach forward with both hands along your extended leg as far as it feels comfortable. Bend from your hips, keeping your back straight. Maintain the position for at least 30 seconds. Repeat with the other leg.
013Side stretch
Sit cross-legged on the floor. Inhale and raise one arm to the ceiling and, exhaling, bend from the waist to the opposite side, sliding the other hand along the floor and keeping your buttocks on the floor. Maintain the stretch for at least 30 seconds. Inhale as you return to center, dropping your raised arm and lifting the other arm and repeating the bend to the other side.
014Lower back and buttocks stretch
Lie on your back on the floor with one leg stretched out straight and the other leg bent. Pressing your lower back gently to the floor, reach behind the thigh of the bent leg and pull it slowly toward your chest. Maintain the position for at least 30 seconds and release. Repeat with the other leg.
015Strengthening exercises
Strength-conditioning exercise is as beneficial for your heart as aerobic exercise, and is essential for keeping you fit and independent as you age. These exercises build muscle by forcing the muscles to work against the weight of your body or an object such as a weight. It’s a good idea to alternate strength-building exercises with aerobic exercise. Try to do the following exercises three times a week.
Triceps press
Sit on the floor with your knees bent at a 45-degree angle, your feet flat on the floor, hip-distance apart, and your hands on the floor behind you, fingertips pointing forward. Lift your hips off the floor (left). Bending at the elbows, lower your bottom until it almost touches the floor (right), hold for a count of five, and straighten the arms, returning to hips-up position. Do ten sets.
016Modified push-up
Get on your hands and knees on the floor and shift your weight forward, with your hands aligned under your shoulders and your feet raised off the floor (top). Bending your elbows, lower your body from the knees up until your chest almost touches the floor, keeping your hands in the same position on the floor and using your abdominal muscles to keep your back straight (bottom). Still keeping your back straight, push up until your arms are almost straight (but not locked) at the elbows. Repeat as many times as you can without straining. (For an extra challenge, try holding each position for a few seconds.)
017Abdominal curl
Lie on your back with your knees bent and your arms holding the backs of your thighs. Press the small of your back to the floor as you lift your head and upper body until most of your upper back is off the floor. Hold for a count of two. Lower your body to the floor, keeping the small of your back pressed to the floor to work your abdominal muscles and avoid straining your back. As your strength increases, increase the number of repetitions. A more difficult way to do sit-ups is with your arms over your chest and your hands on your shoulders, or with your hands placed lightly behind your neck.
018Biceps curl
Standing with your back straight, your knees bent slightly, and your feet slightly apart, hold two hand weights (begin with 1- or 2-pound weights) up to your shoulders, with your elbows bent up at your sides (left). Slowly bring the weights down to your thighs, palms turned out (right). Slowly raise the weights back up to your shoulders, keeping your elbows at your sides. When you can repeat the exercise 12 times, increase the weights by 1 pound.
019Pump-up
Standing with your back straight, knees bent slightly and feet slightly apart, hold two hand weights (with ends touching each other) at chest level, elbows bent out to the sides parallel to the floor and shoulders down (left). Lower the weights slowly to thigh level, keeping the ends of the weights together (right). Slowly raise the weights back up to your chest. When you can repeat the exercise 12 times, increase the weights by 1 pound.
020Are You at a Healthy Weight?
The percentage of overweight Americans has been steadily increasing over the past several decades. Nearly two out of three adults and about 15 percent of children in the US are overweight. Most alarming, overweight children and adolescents are developing common chronic illnesses—such as heart disease, high blood pressure, and type 2 diabetes—that used to affect only adults.
Body weight results from the complex interaction of inherited, physical, behavioral, socioeconomic, and cultural factors. The major factors contributing to overweight are basic—eating too much and exercising too little. And many Americans tend to eat the wrong kinds of foods: foods that are highly refined, high in salt, and often high in saturated and trans fats and calories and low in fiber.
Health Risks of Being Overweight
Being overweight increases your risk of a number of chronic health problems, including heart disease, high blood pressure, diabetes, and some cancers. The way in which fat is distributed on your body can also increase your health risks. You are at greater risk of health problems if you tend to accumulate fat around your abdomen than if you tend to accumulate fat around your hips and thighs. The risks increase further if your waist is 35 inches or larger (if you’re a woman) or 40 inches or larger (if you’re a man). To determine if you are overweight, check the BMI chart on the next page. To determine if your child is overweight, have him or her evaluated by the doctor. Your doctor can work with you to develop an effective weight-loss plan.
How to Achieve and Maintain a Healthy Weight
Losing weight and keeping it off is difficult, so it’s important to set realistic goals that you can achieve and maintain. If you are overweight, even a moderate reduction in body weight—as little as 10 percent—can significantly improve your health.
The only healthy way to lose weight is to use more calories than you take in. For most people, this means eating less and being more physically active. Losing weight gradually—no more than 1 or 2 pounds per week—improves your chances of keeping it off successfully. Changing your diet and exercise habits gradually will help you to make those changes a permanent part of your life.
Avoid fad diets that promise quick weight loss. Any diet that sounds too good to be true probably is. For more information about losing weight, see page 53.
Be Active
Regular exercise contributes to weight loss, especially when combined with a healthy diet. In addition to weight control, regular exercise helps reduce blood pressure, helps prevent heart disease, helps control cholesterol and blood sugar levels, slows bone loss associated with aging, lowers the risk of some types of cancer, and helps relieve anxiety and depression.
When beginning an exercise program, choose activities you enjoy and can easily fit into your day. Begin exercising slowly, and gradually increase the intensity of your workouts. For example, begin with a 10-minute walk three times a week and work your way up to 30 to 60 minutes of brisk walking five times a week.
If you find it difficult to set aside an entire hour for exercise each day, try scheduling shorter exercise sessions—for example, two or three 20-minute sessions a day. If you miss a day or two, don’t be discouraged. Return to your exercise routine as soon as you can. To learn more about what regular exercise can do for you and your family, read the chapter Exercise, Fitness, and Health starting on page 45. Get all members of your family into an active lifestyle:
• Make time for the entire family to participate in regular physical activities that everyone enjoys. Try walking, biking, playing tennis, or in-line skating.
• Plan active family vacations such as hiking, camping, or skiing trips.
• Assign active household chores to every family member, such as vacuuming, mowing the lawn, or washing the car.
• Encourage all family members to enroll in a structured physical activity such as tennis, martial arts, gymnastics, or dancing.
• Limit sedentary activities such as watching TV, playing video games, and surfing the Internet.
Body Mass Index
Body mass index (BMI) is a calculated score that indicates the healthiness of a person’s weight. Although the BMI does not directly evaluate body fat percentage, the formula is related to the amount of fat a person carries and is calculated using the person’s height and weight. BMI can help determine a person’s health risks and is a generally reliable health gauge for people between ages 19 and 70. The index is less reliable, however, for competitive athletes or body builders (who may have a high BMI but whose body is made up mostly of muscle) and for women who are pregnant or breastfeeding.
What’s your BMI?
To learn your body mass index (BMI), find your height in the left-hand column in the chart below and read across the row from your height until you reach your weight. Then look at the number at the bottom of your weight column—this is your BMI. In general, the higher your BMI, the higher your health risks.
A healthy BMI is between 18.5 and 24.9. You are considered underweight if your BMI is less than 18.5, overweight if your BMI is between 25 and 29.9, and obese if your BMI is 30 or higher. The risks are even higher in men whose waist is larger than 40 inches and in women whose waist is larger than 35 inches.
Body Mass Index
021Stress
Stress affects everybody, but some people react to it more strongly than others. When you experience stress, your body makes two hormones, cortisol and adrenaline, that help you deal with the tense situation. Over the long term, however, too much of these hormones produced for too long can cause anxiety and physical symptoms that can trigger or worsen illnesses such as high blood pressure, asthma, or heart disease. Persistent, prolonged stress can also adversely affect your immune system, making you more susceptible to infections and other illnesses.
A number of natural ways to reduce stress—such as deep breathing, yoga, meditation, biofeedback, exercise, and massage—have been proven to be effective. Try all of them until you find what works best for you. Cognitive-behavioral therapy (see page 710) provided by a mental health professional can also be helpful. If you feel overwhelmed by the stress in your life, talk with your doctor about effective stress-reduction methods (see page 58).
It’s Not All in Your Mind
Stress can affect your body in a number of ways. Chronic, long-term stress can be especially harmful. Learning how to manage your response to stress can help you avoid these damaging effects.
Hair
Some forms of baldness, such as alopecia areata, have been linked to stress.
Brain
Stress can trigger headaches and behavioral and emotional problems such as anxiety and depression. A persistent release of the stress hormone cortisol can kill brain cells directly, causing memory and learning problems.
Heart
Heaviness or pain in the chest (angina), rapid heartbeat, and abnormal heart rhythms can occur during or shortly after periods of stress.
Digestive tract
Stress can cause or worsen disorders or diseases of the digestive tract such as indigestion, peptic ulcers, and irritable bowel syndrome. Severe stress can slow digestion.
Abdominal fat
Prolonged or severe stress can cause fat to be deposited at the waist rather than on the hips and buttocks, increasing the risk of heart disease, cancer, type 2 diabetes, and other illnesses.
Bones
High levels of the stress hormone cortisol can cause bone loss.
Skin
Some people have outbreaks of skin problems such as eczema and psoriasis when they are under stress. Stress also can increase perspiration.
Mouth
Teeth grinding, mouth ulcers, and dry mouth seem to occur more often during times of stress.
Lungs
People with asthma often find that their condition worsens when they are under stress. Stress can also speed up breathing.
Bladder
Stress can trigger an urgent need to urinate.
Reproductive organs
Severe stress can suppress the reproductive system, causing absence of periods in women and erection problems and premature ejaculation in men.
Muscles
Minor muscular tics become more noticeable, especially on the face and hands, and muscles often become tense when a person is under stress.
Immune system
When a person is under stress, the immune system can become weakened, increasing the risk of infections and other illnesses.
022Don’t Cheat on Sleep
When it comes to stress, sleep is like medicine, but sometimes you can get caught in a vicious circle. You can’t sleep because you feel stressed, and the lack of sleep causes more stress, which affects your sleep. Lacking sufficient sleep for a long period can have harmful effects on your mind and body. Lack of sleep can increase your risk of type 2 diabetes, lower your resistance to illness, and raise your blood pressure—all important reasons to take sleep more seriously.
If you’re going through a high-stress period, one way to make sure you get a good night’s sleep is to shift your focus away from your daytime worries. When you go to bed at night, try to keep yourself from brooding over your daily problems and concerns. Things always seem worse in the middle of the night. Try to look at sleep as an escape from the stresses of the day, not a time for replaying them in your mind.
A midafternoon nap is another way to make up for insufficient sleep at night. Even a short, 20-minute nap will refresh you and improve your mental performance. Just make sure you finish your nap before 3 in the afternoon; napping later can make it harder to fall asleep at bedtime.
Try the tips on pages 57 and 58; they can help you improve your sleep. If you experience sleeplessness for longer than 6 weeks and these suggestions don’t seem to help, talk to your doctor. He or she may refer you to a sleep center for treatment.
023The Body’s Response to Stress
When you are under stress, your body reacts with a cascade of biological responses that begins in a small, grape-sized area of the brain called the hypothalamus. Often referred to as the master gland, the hypothalamus produces many different hormones that tell other glands to jump into action or to quiet down. The hypothalamus communicates to your nervous system to signal the adrenal glands to release adrenaline (epinephrine), a brain messenger that increases alertness and energy and enables you to respond quickly to stress. The hypothalamus also tells a neighboring gland called the pituitary to signal the adrenal glands to release stress hormones (such as cortisol) to enable your body to defend itself. However, over time, if you are under constant stress, these stress-related chemicals (designed to help protect you from harm) can actually turn on your body and be damaging.
Yoga as a Stress Reliever
Yoga is a form of physical activity that helps the body and mind work together to achieve a state of deep relaxation. The practice can lower stress, relieve muscle tension, and increase flexibility. Yoga positions, known as postures, were created thousands of years ago to give the body stability and balance. The deep, controlled breathing that accompanies these postures has a calming effect on the nervous system. The focused attention needed to reach and sustain such postures also helps the mind attain balance. In addition to its physical and mental benefits, yoga has a spiritual aspect that can also increase feelings of well-being.
Western science has shown that yoga produces measurable stress-reducing benefits that can help control conditions such as heart disease, high blood pressure, and asthma. If you are interested in taking a yoga class, contact your local park district, health club, or senior center.
024025Aging Well
Americans are living longer and healthier, and are more likely to live into their 80s or 90s than ever before. As you grow older, the lifestyle choices you make can either raise or lower your chances of staying healthy and independent well into old age. In fact, your lifestyle choices have twice as much influence as your genes on how well you age and how long you live. Habits that can increase your longevity and improve your quality of life include eating healthfully, exercising regularly, maintaining social relationships, keeping your weight down, not smoking, drinking alcohol only moderately, and keeping your mind active. No matter what your age, it’s never too late to adopt these health-promoting habits and reap their benefits.
Strategies for Successful Aging
The following measures are among the most important things you can do to stay healthy as you age:
• Eat a nutritious diet. Consume a varied diet rich in fiber (foods such as vegetables, fruits, whole grains, and legumes) and low in saturated and trans fats, sugar, and salt.
• Exercise regularly. Engage in a combination of aerobic, weight-bearing, and stretching exercises for up to an hour most days of the week.
• Stay connected socially. Reach out to family and friends, join clubs, volunteer in your community, or start a second career.
• Maintain a healthy weight. Keeping your weight down lowers your risk of a number of chronic diseases, including heart disease, diabetes, and some cancers.
• Don’t smoke. Smoking is the No. 1 cause of preventable premature death in the US.
• Keep your mind active. Read books, take a class, do crossword puzzles, help your grandchildren with their homework, learn to play a musical instrument, or go to museums.
Stay engaged
When it comes to getting older, the more active you are, the healthier you are likely to be, both mentally and physically. Staying active does not mean only physical exercise. It also means staying involved with people and favorite activities.
026Memory-Boosting Exercises
Memory loss is not a normal part of aging. It’s common to forget where you put your keys—at any age. You don’t need to worry about having a memory problem unless you forget what the keys are for. Practicing memory exercises such as the following can help you keep your memory sharp as you age:
• Memorize some poetry.
• Look at a photograph; then look away. Write down all the items in the photo that you remember—for example, how many people, animals, buildings, and other objects—and see how well you did.
• Pick up a paper clip, spool of thread, or other common object. Try to figure out a new use for the object.
• Draw a floor plan of your childhood home, complete with doors, windows, and furniture placement. Tell a story about an event that occurred there.
Preventing Alzheimer’s Disease
The following factors seem to have a protective effect against Alzheimer’s disease:
• Education People who attain a higher level of education tend to have a lower risk of Alzheimer’s disease than the general population.
• Mental activity Stimulating your mind may protect your brain from Alzheimer’s disease by giving you extra connections between cells.
• Physical exercise Exercise enlarges blood vessels, supplying more oxygen-rich blood to the brain.
• Vitamin E Eating foods rich in vitamin E—such as nuts, vegetable oils, whole grains, and green leafy vegetables—or taking vitamin E supplements may protect against Alzheimer’s by reducing the cell-damaging effects of molecules in the brain called free radicals.
• Folic acid Consuming adequate amounts of this B vitamin may help prevent Alzheimer’s disease by reducing the level in the brain of an amino acid called homocysteine. Elevated levels of homocysteine can damage cells in the area of the brain involved with learning and memory.
• Anti-inflammatory drugs Over-the-counter anti-inflammatory medications (such as aspirin and ibuprofen) help reduce inflammation in the brain. Inflammation can damage brain cells.
• Cholesterol-lowering medications People who take cholesterol-lowering medications called statins seem to be at significantly lower risk of Alzheimer’s disease than other people. The precise effect that elevated cholesterol has on the brain is unknown.
Staying fit as you age
Exercise is the best way to stop or reverse age-related loss of muscle, which can make even simple daily activities such as climbing stairs and getting up from a chair hard to do. Strength-building exercises using handheld weights, elastic exercise bands, or weight machines can help you maintain your independence and lower your risk of falls, even into your 90s. Go for frequent walks; walking regularly can significantly lower your risk of having a heart attack or stroke. At least four times a week, do the following exercises at home (for example, while you watch TV). If you’re over 50, talk to your doctor before starting an exercise program.
Head turn/Neck stretch
Sit with your back straight, feet flat on the floor, and head in an upright position. Turn your head gently and slowly to one side and hold for a count of 5. Turn your head slowly back to the center and then to the other side and hold for a count of 5. Repeat the sequence 5 to 10 times.
027Head roll/Neck stretch
Sit with your back straight, feet flat on the floor, and head in an upright position. Roll your head gently