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Copyright 2017 Davis Square Family Practice
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260 Elm Street #105
Somerville, MA 02144
(617) 666-9577
Fax (617) 666-3190
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Davis Square Family Practice
Office Hours
Monday - Thursday
8am to 6pm
Friday
8am - 5pm
Deborah Bershel, MD
Michelle Clark, NP
Carmen Phillips, NP
"Call our office to receive logon credentials."
Barbara Kaplan, LICSW
Christopher Mulvey, NP
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Preventive Health Tips
Top Preventive Medicine Suggestions

In general most people are well aware of what can be done to promote wellness but few of us are ever perfect. As with everything in medicine, sometimes todayís wisdom is proven to be wrong but Iím confident that most of the following recommendations will stand the test of time.

1.Donít smoke or quit smoking - Smoking shortens life expectancy by about 7 years. It doubles the risk of impotence before 40 years of age. It increases the risk of heart disease, is the main cause of emphysema and markedly increases the risk of lung cancer (90% of lung cancer is caused by cigs), throat cancer, mouth cancer, stomach and colon cancer,  and bladder cancer.

2.Stop substance abuse - Drinking more than 1-2 drinks/day (if female) and 2-3 (if male) is associated with poorer health outcomes. Street drugs and prescription drug abuse likewise leads to health problems. While I will not equate abuse of cocaine, amphetamine, PCP, opiods (such as heroin, Percocet, Oxycontin, etc.), benzodiapines (valium-like drugs) with marijuana, there is little doubt that daily use of Ďpotí is bad for your health. The devastation caused by substance abuse on the personís ability to function healthfully with family, friends and employer is often more immediate than the short-term physical effects on health.

3.Mental Health - If you are not content with your life - be it depression, anxiety, job dissatisfaction, relationship/family issues - then you are not leading a truly healthy life. Sometimes there are bumps in the road and they will smooth out with time but often years upon years go by and we end up far from happy. We are interested in helping you in coming up with an approach
(directing you to a therapist or providing medication or offering you with a empathetic ear) that you will be comfortable with.

4.Regular exercise - The more you do the better. In 2008 a large study showed that in every decade of life those who exercised the most died at half the rate of those at the bottom. I consider exercise as Ďsacredí as a medicine that you might take daily to lower your cholesterol or blood pressure.

5.Eat a healthy diet - Iím uncertain about precisely what this means except it has become quite clear that Americans eat too much. Eating lots of fresh fruits and vegetables will provide you with a wide array of cancer-preventive isoflavones that you just canít get from eating a hotdog on a bun. Research has confirmed that all mammals (though not yet proven in humans) live longer, essentially do not develop diabetes and have as much as a 50% reduction in cancer if they are deprived of calories. I will elaborate more on this subject under a separate obesity article that has yet to be completed.

6.Fish Oil - Fish oil has many positive effects on the body and unless you are a strict vegetarian or fish allergic (in which case you can get a similar 0mega-3 oil from flax seed) most everyone should be on 1000mg of it. It has an anti-inflammatory effect on the body and may be a part of a program to reduce levels of pain. In a 2009 study of British women there was a 50% reduction in the death from heart attacks in those on 1000mg fish oil or more. Sometimes we can successfully lower a personís triglycerides with it.

7.Vitamin D - We donít get enough of it in Boston (certainly not in the winter). Higher vitamin D levels are associated with a lower incidence of multiple sclerosis, heart disease and diabetes as well as many cancers (colon, breast, pancreatic, prostate). All adolescents and adults need to take at least 1000 i.u. (international units) daily and infants (who donít get it in formula) and children through 9 years old need 400 i.u.

8.Multivitamins - This may be controversial as many studies have yielded varying results. To my knowledge no study of multivits has shown a worse longterm from taking them. Around the year 2000, the Womenís Cooperative Health Study showed that multivits lowered the risk of colon cancer by about 75% if taken for 15 or more years. In non-smokers colon cancer is the second most common cancer, so this is big news in my opinion.

9.Resveratrol - A substance found in abundance in red wine, grape skin, pomegranate and blueberries. It appears to prevent the aging of our cells by slowing down the shorting of the telomeres of our chromosomes. (Regular exercise also slows down the shortening of telomeres). In addition it appears to prevent the development of diabetes. I recommend taking 150 mg of grape seed extract per day.

10.Coenzyme Q 10 - It appears to have an anti-inflammatory effect on the body and may lower levels of pain. It also appears to have a good effect on the heart. All patients on statin drugs (a type of cholesterol-lowering agent) should be on it as it those drugs block Coenzyme Q 10 in our cells (I apologize if I have failed to inform you of this previously). Iíd recommend 50-100 mg per day.

11.Aspirin - Taking a daily baby aspirin (for men over 40 and women over 50) is controversial, in my opinion. If you have low risk for heart disease (no family or personal history of heart disease or stroke, no hypertension, no cholesterol elevation, no cigarette use) then perhaps you will gain little from the aspirin and you may increase your risk of hemorrhage. Ask your clinician before you decide on your own to begin an aspirin regimen.

12. Alcohol in Moderation
- This is a tough one to recommend as alcohol has destroyed many lives and families. Nonetheless, the evidence is irrefutable, alcohol when taken in small amounts (1-2 drinks per day for women and 2-3 for
men) dramatically lowers the risk for heart disease. Red wine is best, then white, followed by beer and then hard liquor. In 2009 a longterm study showed that the risk  reduction was over 50% for lifetime drinkers and 33% for those who began
moderate drinking in midlife. Make no mistake, if you are at risk for alcohol abuse then donít even remotely contemplate drinking.
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