Staying Healthy Archive

Ask the doctor

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Q. To lose weight, should I focus more on my calorie count or the amount of time I spend exercising?

A. It is very, very hard to lose weight without both watching your calories and regularly exercising. But it's not that simple. For years, doctors (including me) told patients: "You've got to burn off more calories through exercise than the calories that you eat. If you do that, you'll maintain a healthy weight." We even implied that not being able to maintain a healthy weight, since it was so simple, reflected a weakness of character.

Treadmills are among the most effective types of exercise equipment — if you know how to use them.

Cardio exercise is essential for all-around health, but many older men have trouble hitting the recommended 150 minutes of moderate-intensity exercise per week. And some people may have limitations that prevent them from doing traditional cardio workouts like walking, running, or swimming.

But there may be another option: the standard gym treadmill.

Exercise shouldn't be something you do only when you want to drop those 10 extra pounds or prepare for the charity 10-kilometer run. To be successful, it should be something you do as routinely as eating, sleeping, and taking your morning shower. That can be difficult, as you may already know. The information below may help you stay on course when your motivation starts to flag. Remember, the result is worth the effort.

The value of maintaining an exercise program became evident when the results of the Harvard Alumni Health Study were published in the New England Journal of Medicine. The men who had been moderately active but later became sedentary had a 15% higher risk of death than their counterparts who had never been active. On the other hand, those who started and kept up an exercise program had a 23% lower risk of death, which approaches the 29% decrease in risk enjoyed by the men who'd always been active. But knowing the benefits of lifelong exercise or even creating a personal exercise plan will be of little use if you don't stick to your program. As you plan an exercise routine, you need to prepare for the challenges that await you, so you won't be thrown off track.

Vegetable-rich diets are associated with lower risk for chronic disease. To get the full range of nutrition from plant foods, choose from a variety of colors when you shop and eat, including blue/purple, green, orange/yellow, white/light green, and red.

Artificial tears, warm compresses, eye massage, or prescription medications may ease your discomfort.

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According to the American Optometric Association, most older adults experience some of the gritty, burning symptoms of dry eye syndrome. "The severity varies, from people who only get dry eyes in the winter to people who have dry eyes every day," says Dr. Matthew Gardiner, an ophthalmologist with Harvard-affiliated Massachusetts Eye and Ear Infirmary.

The eyes have it

Our eyes have a few sources of moisture. One is the lacrimal gland in the upper outer quadrant of the eye. It can produce large quantities of tears (if you cry or if something gets in your eye).

Don't accept regular fatigue as part of aging.

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Weariness, tiredness, lack of energy. There are many ways to describe those times when you are so fatigued you can't do anything. Often you bounce back after a quick rest or a good night's sleep, but if fatigue is occurring more often and lasting longer, it could be a sign of something more serious.

"Men may chalk up fatigue to aging, but there is no reason you should battle ongoing fatigue," says Dr. Suzanne Salamon, a geriatric physician with Harvard-affiliated Beth Israel Deaconess Medical Center. "Everyone gets tired sometimes, and your endurance may decline with age — you may not move as fast and sometimes tire quicker — but you should never be too fatigued to enjoy an active lifestyle."

The ear's self-cleaning system usually prevents wax from accumulating. But wax impaction requires medical attention.

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If you are like 90% of Americans, you assume that wax is something to be cleaned from your ears regularly, and you may have tried using cotton swabs, toothpicks, bobby pins, or any number of other small implements to do the job. However, according to the American Academy of Otolaryngology–Head and Neck Surgery Foundation, you are not only performing an unnecessary task, you are risking hurting your ears and jeopardizing your hearing. The academy's new guidelines on earwax repeated a familiar warning — "Don't stick anything smaller than your elbow in your ear."

Dr. Rachel Roditi, an otolaryngologist at Harvard-affiliated Brigham and Women's Hospital, agrees that there usually isn't much reason to clean one's ear canals: "I advise people that the ear has a lot of self-cleaning mechanisms already and so you usually don't need to do anything. Just let the ear do its job."

Like his father and grandfather before him, the typical American man of the 21st century works for his living. In most cases, though, he works with his mind, not his body.

It wasn't always that way. As recently as the 19th century, 30% of all the energy used in the American workplace was provided by human muscle power; today, the percentage is minuscule. In most ways, the transition from an agricultural economy to an industrial society to today's information age has been a great boon. But something has also been lost.