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Modifying Risk Factors

Doctors use the term “modifiable risk factors” to describe those aspects of a person’s life that are potentially dangerous but which can be reversed, or modified. Conversely, some risk factors are less modifiable. If you have a family history of a certain cancer, you can’t order a new set of genes, but you can have regular check-ups and avoid substances known to trigger your particular cancer risk.

Of course, doctors must first decide that something is a risk factor to begin with. For example, up until the 1950s, cigarettes weren’t regarded as unhealthy and tobacco ads routinely showed doctors happily puffing away, with the phrase “More doctors smoke Camels than any other cigarette” plastered above his head, bold as brass. In fact, when I was in training, doctors routinely smoked during hospital rounds and interns bummed smokes from nurses and patients alike.

The debate about alcohol has also gone on for decades. Probably one of the numerically largest studies I’ve ever seen on any condition was published in the December 11, 2006, issue of Archives of Internal Medicine.

The authors looked over the data of (brace yourself) 1,105,835 people to come up with the following: women enjoy longer and healthier lives if they allow themselves 1 to 2 drinks a day, meaning 1 to 2 ounces of spirits or an equivalent amount of wine or beer. Bear in mind that 1.5 ounces of hard liquor has the same amount of alcohol as 4 ounces of wine–or one half cup.

Men can have up to 4 drinks a day. Both total alcohol abstinence or drinking more than these amounts are less healthful (unless you have an alcohol problem, in which case abstinence is quite good for you).

The same issue contained an article listing the most significant modifiable risk factors in middle aged women. You probably know this list in your sleep but since it’s a new year, let’s go over them again.

Your life will be shortened if you:

  • Smoke cigarettes.
  • Have high blood pressure and don’t do anything about it.
  • Are obese with your weight concentrated around your midsection (obese is definitely higher than overweight and the way the fat is distributed is important).
  • You’re a couch potato (or, if chained to your computer, a mouse potato).

The easiest to eliminate is high blood pressure, which usually requires just one pill daily–a very safe one with few side effects–to get under control. If you’re addicted to cigarettes and are serious about stopping, I’ve been seeing excellent results in my patients who are taking the new prescription medication Chantix, which blocks the receptor sites in your brain that are hooked on nicotine. Ask your doctor.

The tough duo is obesity and inactivity, but neither is insurmountable. If you can afford it, I recommend working professionals: a nutritional counselor and a personal fitness trainer. Three weeks of healthy eating and regular exercise later you’ll have geared your brain to “habit” mode and you’ll actually find it difficult to return to your old ways.

And, as a reward, your two glasses of wine aren’t particularly fattening.


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