To gain control of your health risks, change your lifestyle—one step at a time.

If one or more of your close family members has had cancer, diabetes, or heart disease, this doesn’t mean you’re sure to have the same disease some day. Yes, you’re at higher risk—these chronic illnesses, like many others, do tend to run in families. But to a large degree you can take control over your future.

The secret to beating bad health genes is to begin with a realistic sense of your health risks, according to Richard J. Botelho, M.D., author of Motivate Healthy Habits: Stepping Stones to Lasting Change. Once you know your risks, you’re on the way to learning the best ways to lower them—and to choosing the one lifestyle change you know you’ll have the most success with.

“I like my patients to learn to master one risk factor, the one they’re willing to work on,” Botelho explains. Whether it’s shedding a few pounds, cutting back on fat or calories, lowering blood pressure, or walking a little more each day—any success you achieve with one risk factor becomes part of your learning process, and you can apply what you’ve learned to the next change you’re ready to make.

Unfortunately, many people feel so uneasy about their health risks, or so frustrated by being unable to change all their unhealthy habits, they give up trying. The people who succeed in gaining control over their health risks understand they must simply take it one step at a time.

Step by Step to Lower Risks
If you suspect you might be at risk for a chronic illness, don’t hide your head in the sand or live each day in fear of every ache, pain, or skipped heartbeat. Instead:

Do some detective work. Find out if any close relatives, such as your mother, father, brother, or sister, has a disease that may be genetically linked.

For example:

• A man whose father or brother had prostate cancer, or a woman whose mother or sister had breast cancer, runs an increased risk of having the same disease. Colorectal, pancreatic, and other cancers also can run in families. This is because some cancers are linked to mutated genes in the body’s cells that can be transmitted from one generation to the next.
• If a close relative has had a heart attack, especially before age 65, you too may be at increased risk for coronary heart disease.
• A family history of diabetes increases your risk for diabetes—in this case, most likely due to both shared genes and similar lifestyle habits.

Take a close look at your other risk factors. A family history of heart disease becomes a more serious concern if you smoke, don’t get much physical activity, or aren’t keeping your weight and cholesterol levels under control, for example. The more risk factors you have, the more likely you are to get the disease.

“You need to look at the spectrum of risk factors, and on the basis of that decide what you want to do about them,” Botelho notes.

Choose your favorite lifestyle change—then get started. “Many people need to take medications to help control their blood pressure or cholesterol levels. But lifestyle change is at least 50 percent of what you can do to reduce your risks,” says Botelho.

For example, if you have prediabetes— a condition that often precedes diabetes, in which blood sugar is somewhat elevated—you can cut your risk of developing type 2 diabetes in half, or at least delay its onset, by losing just 5 or 6 pounds and taking regular brisk walks, according to Botelho.

“It’s astounding how much you can do to reduce the risk that a disease might progress,” he says.

Here is Botelho’s advice for lifestyle changes that can help you lower your risk for cancer, heart disease, diabetes, and many other chronic diseases:

• Quit smoking. If you’re a smoker, the best lifestyle choice by far for your health is to quit smoking. Ask your doctor for advice on kicking the habit.
• Stay physically active. Are you prepared to make physical activity a high priority and schedule it into your daily routine? If so, you have a pretty good chance for success. You don’t have to get in all your exercise at once; you can aim for 10 minutes here and 10 minutes there.
• Lose a few pounds. If you’re going to modify just one habit in order to lose weight, begin by reducing your portion sizes by at least one-third while cutting out all snack foods and sugary sodas, Botelho suggests. This can bring relatively quick results—and from that success, you may gain some momentum for increasing your physical activity.
• Choose healthy foods. Besides helping you lose weight, a healthier diet, like exercise, can independently lower your blood pressure and your risk for certain cancers, Botelho notes. He recommends the DASH diet, an eating plan that is low in saturated fat, cholesterol, and total fat, and emphasizes fruits, vegetables, and low-fat dairy products. You’ll find it online in an Internet search.

The first step to making healthy changes, of course, is awareness of your personal health risks, such as a family history of heart disease.

“People respond to learning they’re at increased risk in different ways,” says Botelho. “Some people may say, ‘There’s nothing to worry about,’ while others will say, ‘I’m terrified.’ The idea is to become a master of your risks rather than becoming a victim of them.”

Get Creative with Lifestyle Choices

Need some inspiration for choosing which lifestyle change to launch into? Try an online risk calculator.

With any of these calculators, start by plugging in all the personal information the Web site asks for: your cholesterol level, weight, and so on. Once the calculator gives the results—for example, maybe it tells you that you run a 15 percent risk of having a heart attack in the next 10 years—that’s when you can get a little creative.

Try filling out the questionnaire again, and this time adjust your information slightly to see how it changes your results. For example, if you lowered your cholesterol from 240 to 190, what difference would that make, as opposed to quitting smoking or losing 10 pounds?

The results can help you choose your first and best lifestyle goal.

Try a risk calculator now at one of these Web sites:

• For heart disease: www.nhlbi.nih.gov, search for “heart disease calculator”
• For diabetes: www.diabetes.org, search for “risk test”
• For breast cancer: www.cancer.gov/bcrisktool
• For prostate cancer: www.organizedwisdom.com, search for “prostate cancer calculator”
• For colorectal cancer: www.cancer.gov/colorectalcancerrisk
• For a variety of chronic diseases: www.yourdiseaserisk.wustl.edu

Polly Turner spoke with Richard J. Botelho, M.D., professor of family medicine at the University of Rochester in New York, and author of Motivate Healthy Habits: Stepping Stones to Lasting Change. MH Publications, 2004, $14.95.

© StayWell Custom Communications. Information is the opinion of the sourced authors and organizations. Personal decisions regarding health, diet, and exercise should be made only after consultation with the reader's own medical advisers. This material may not be reproduced for redistribution without written permission from StayWell Custom Communications.