While each person is unique, we have some general guidelines that make sense for most of our adult patients. Please review and of course discuss any concerns you might have with your primary care provider. PAMF also provides additional information available in other forms: your primary care provider, printed handouts, classes and lectures from our Health Education Division and through staff in our Community Health Resource Center.

• Exercise
• Stress Management
• Sleep
• Nutrition: You Really Are What You Eat!
• Preventive Tests and Screening
• Immunizations
• Safety
• Sexual Health

Exercise

Your ideal goal is to get 30 minutes of exercise every day. Obviously, you do the best you can and you should not feel guilty if you can't live up to your ideal. Any exercise is certainly better than none and no one is too old to start. How much should you exercise? In general, exercise enough to raise your heart rate to a level based on your age using the following formula: (220 - your age) x 70%. So a 40 year-old would try to achieve a heart rate of (220-40) x 70% = 126 beats per minute, during 30 minutes of aerobic exercise. Weight bearing exercise is best: e.g. brisk walking, jogging, aerobics. Swimming and biking are not weight bearing, so they don't benefit your bones but are great for your heart and lungs and the muscle groups used. Stretch, especially after exercise. Enjoy!
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Stress Management

Everyone feels stressed at times. Learn to identify what makes you feel stressed, and try to build stress reduction and play time into every day. No one should work all the time. Seek professional help for dealing with stress and depression if you need it. Your primary care provider can help. We can also refer you to professional counselors, psychiatrists and support groups.
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Sleep

Most adults need 7 to 8 hours of a sleep a night. If you are "getting by" on less, consider whether you are doing so through stimulants like caffeine or aren't acknowledging your fatigue.
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Nutrition: You Really Are What You Eat!

Calcium builds strong bones. Pre menopausal women and teens need ~1200 mg a day, postmenopausal women need ~1500 mg a day, and men need ~1000 mg a day. You can find calcium in foods (especially dairy products) or calcium supplements.

Vitamin Supplements:

• Although not required, taking a daily multivitamin may be a good idea, especially if you don't regularly eat fresh fruits and vegetables. Good examples include Centrum® (or Centrum Silver ® for men and postmenopausal women) or generic brands with similar ingredients (check the bottle).
• Vitamin D: 400 IU a day is sufficient.
• Folic Acid (Folate): 400 micrograms a day, especially for women who might become pregnant.
• Vitamin C: no data confirm benefits of high doses here. Keep intake to less than 1000 mg a day.
• Iron supplements may be necessary for menstruating women whose food intake of iron isn't adequate.

Foods: Fresh, unprocessed foods are more nutritious. Follow the "food pyramid" chart which emphasizes grains, fresh fruits and vegetables and limits fat intake to less than 30% of total calories. Organic fruits and vegetables have no pesticides but need careful washing to remove dirt and bacteria.

Alcohol: Moderation is your guide. Drink generally no more than 7 drinks a week, and not all at once! Those with concerns about their alcohol intake can abstain entirely without compromising their health.

Caffeine: Limit your intake to no more than three 8-ounce cups of regular coffee per day or equivalent.

Smoking: Don't start. Don't inhale someone else's smoke and quit if you are a smoker yourself. Quitting really does improve your health no matter how old you are or how long you've been smoking. It's never too late! We have many ways to help you quit: medicines for the psychological craving and physical craving and classes to help with the social habits that you've established around smoking.
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Preventive Tests and Screening

We have detailed recommendations on the frequency of various preventive tests and studies for the average risk adult. These are available through pamphlets, wall charts, and our web site. We review and revise our screening guidelines each year based on published research about the benefits of screening tests to detect treatable conditions. How often and when to begin and end such tests depend on your own circumstances and family history. Routine tests include screening for chlamydia (a sexually transmitted infection), pap smears and mammograms (for women), blood pressure screening, lipid (cholesterol) testing, and colon cancer screening through stool cards and sigmoidoscopy. PSA screening for men should be discussed with your provider.
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Immunizations

Routine immunizations for healthy adults are limited:

• Tetanus-Diphtheria every 10 years
• Pneumovax ("pneumonia shot") once after age 65
• Influenza ("flu shot") every year after age 65

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Safety

Cars: Make sure everyone in your moving car uses seatbelts adjusted to the proper size. Use booster seats and car seats for your young passengers. No children under the age of 12 or older persons shorter than 4'9" (145 cm) should sit behind a seat with an airbag. Don't drive or allow others to drive while under the influence of alcohol or other mind-altering substances.

Sports: Use helmets with bike riding, skateboarding, snowboarding, etc. as appropriate. Even though the law doesn't require helmets for bikers over age 16 years, your older skull and brain are still vulnerable!

Guns: Lock them up unloaded away from children. Store ammo locked separately from firearms. Use safety locks. Make sure others you visit do the same.

Ultraviolet light protection: Protect yourself from skin cancer. Wear sunscreen products and/or cover your skin when in direct sunlight for more than 15 minutes, especially between 10 a.m. and 2 p.m. Let us check any suspicious skin changes, bleeding or painful areas of your skin.

Domestic Violence: No one deserves to be abused, physically or emotionally. If you have any concerns, please discuss them with your provider. We can help.
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Sexual Health

Contraception: Use a reliable method to prevent unwanted pregnancy.

Emergency contraception: The "morning after" pill is safe and effective in preventing pregnancy when taken within 72 hours after unprotected sexual intercourse. Women should talk to their provider about how to obtain this.

Practice "safer sex.": Unless you are sure you are in a mutually monogamous relationship, use condoms to reduce the chance of contracting sexually transmitted infections. See a health care provider if you have any concerns about exposure to such infections or if you have any symptoms.

Concerns about sexual desire or function: Please discuss them with your health care provider.
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