HEALTH - SIX MISTAKES TO AVOID

6 Stupid Health Mistakes
Even smart women make these. Here's how to wise up.
By Amanda Spake & Stacey Schultz, Prevention
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You know a lot about staying healthy, right? You're supposed to watch saturated fat and eat lots of vegetables—that's why you usually pick up a take-out salad for lunch and dinner (even when the kids get burgers). But you're not obsessed with the scale like some women you know. You brush your teeth and you last flossed, oh, maybe 2 weeks ago. You exercise but avoid lifting so you don't bulk up like those female gym rats lurking around the free weights. The tummy pains you got last week? Must have been gas, nothing more serious. And, hey, you'd like to get 8 hours of sleep, but the days are short, and it's hard to get everything done.

Sound familiar? Then you may be making some of the dumbest health mistakes a woman can make. Here, experts tell how never to be trapped by them again.

1. You Always Order a Salad

"The word 'salad' makes people think they are eating something healthy," says Brie Turner-McGrievy, RD, clinical research coordinator for the Physicians Committee for Responsible Medicine (PCRM) in Washington, DC. "But the truth is, a lot of take-out and restaurant salads are basically a burger in a bowl."

Last year, when Turner-McGrievy analyzed nutritional information for 34 salads available at the nation's largest fast-food and sandwich chains, only two the Au Bon Pain Garden Salad with fat-free raspberry vinaigrette and the Subway Veggie Delite with fat-free Italian dressing and no cheese got an "outstanding" rating for being high in fiber and low in saturated fat, cholesterol, sodium, and calories, according to federal nutritional guidelines.

Turner-McGrievy's "burger in a bowl" analogy is no exaggeration; the nutritional facts support it. McDonald's Crispy Chicken Bacon Ranch Salad with Newman's Own Ranch Dressing has more calories, fat, and saturated fat than a Big Mac 640 calories and 49 g of fat versus 600 calories and 33 g of fat. Other fast-food salads are almost as dismal. Get the skinny on all 34 salads tested in the PCRM salad analysis.

"Only about 10 percent of your diet should come from saturated fat. For a woman who is eating 1,500 to 2,000 calories a day, these salads contain all the saturated fat she should eat in a whole day," says the dietitian.

And many fast-food salads contain very little fiber (government guidelines say most women should have 25 to 35 g a day). "Most have no beans and very few vegetables," says Turner-McGrievy. "So if you have one of these salads for lunch, your other meals are going to have to be bran cereal to make up for the lack of fiber."

Taco Bell's Salad with Salsa was the clear winner in the fiber category, with 13 g. But with 42 g of fat and most of the sodium you should have in one day (1,670 mg the total recommended daily intake is 2,400 mg), it was rated unacceptable in the PCRM survey.

Here's how you can have your salad and eat it, too: If you order it without the taco shell, you lower your fat intake from 51 to 21 g, and the sodium drops to 1,400 mg.

The Fix

Don't scratch take-out salad off your menu; just apply a few commonsense rules before you order. For instance, avoid high-fat add-ons such as sour cream, extra cheese, croutons, bacon bits, and high-fat dressings, including Caesar and ranch. Opt for salads that aren't just a fiber-free mound of iceberg lettuce dotted with a few carrot and red cabbage shavings. Ask for low-calorie and fat-free dressing.

And plan ahead. Most fast-food chains supply online nutritional information for all their fare, so you can scout out the best salads before you leave for lunch.

2. You Avoid the Scale

For some women, the only thing in the house gathering more dust than the treadmill is the scale. "I have scale-phobia," admits one woman. "I have this thing about not weighing more than 132 pounds, but I haven't looked at my scale in months, so I don't really know how much I weigh."

She isn't the only queen of denial. "It always strikes me as funny how many women in my practice won't get on the scale," says Prevention advisor Mary Jane Minkin, MD, an obstetrician-gynecologist in New Haven, CT. "They just refuse. And I always say, 'Why don't you get on the scale, and I'll look and you don't.'"

Doctors call scale-phobia an avoidance behavior. The idea behind it: If I don't know for sure that I gained weight, maybe I didn't. You're most likely to duck the scale after a few days, weeks, or months of eating whatever you darn well please.

"It's typical for people not to want feedback on the part of their behavior that's not going well," says Kelly Brownell, PhD, director of the Yale Center for Eating and Weight Disorders. "For some people, getting back on the scale can be a help. The trick is knowing whether or not it will motivate you."

If you're trying to lose weight, you may need the kind of feedback the scale provides, Brownell says. If you weigh yourself regularly, you can notice a gain when it's easier to shed at 3 pounds, say, instead of 15. But it's important not to get so obsessed with the numbers that you're weighing yourself once or twice daily. Scales do lie. Your weight can vary from day to day, even hour to hour. You don't want to be discouraged when, despite all your best efforts, you put on 2 pounds between 6 a.m. and 6 p.m.

The Fix

Stay friendly with your scale while losing or maintaining your weight:

If you're trying to lose weight, get on the scale monthly. Do it first thing in the morning, naked, after you go to the bathroom. Schedule your weigh-ins at the same time in your menstrual cycle each month not when you're likely to have water-weight gain.

If you're maintaining, go with daily or weekly weigh-ins. The real "losers" in the National Weight Control Registry, the largest study of people who've been successful at long-term weight loss, maintain their weights by stepping on the scale at least once a week. Don't freak out over a 5-pound gain; that's a normal fluctuation. If you find yourself drifting higher than that, the alarm bells should sound. That's the time to rein yourself in: Cut out the snacks, and get back on the treadmill.

3. You Forget to Floss

Americans spend $600 million a year on procedures that bleach their teeth whiter than pearls, but many don't put in the less than 5 minutes a day it takes to floss. The result: At least 23 percent of women between 30 and 54, and 44 percent of women over 55, have severe gum (or periodontal) disease, reports the American Academy of Periodontology.

Gum disease is a serious bacterial infection that attacks the tissue surrounding one or more teeth and the bone supporting them. It's the number one cause of tooth loss in the United States, but it's far from just a cosmetic issue: When periodontal bacteria enter the bloodstream, they can travel to major organs and cause chronic inflammation. In recent years, researchers have come to suspect that such simmering infections in the body may be implicated in some cases of heart disease, stroke, cancer, and even premature birth.

"When you have gum disease, it's like having an infected, oozing hand. It's that big of an infection if it's generalized throughout the mouth," says Marjorie Jeffcoat, DMD, dean of the University of Pennsylvania School of Dental Medicine and lead researcher on a groundbreaking study that found that women with gum disease were three to eight times more likely to have a premature baby than were women with healthy gums. The culprit: a labor-inducing prostaglandin (similar to the drug Pitocin) produced by their immune systems to combat the infection.

Chronic inflammation may also explain why some people who have heart attacks have no known risk factors such as high blood pressure or high cholesterol. Infection triggers inflammation, which, under normal circumstances, is part of the healing process (it allows infection-fighting white blood cells to reach injured tissue). But when inflammation is chronic, it can damage artery walls and make them more prone to fatty buildup. Likewise, a chronic bacterial infection like gum disease "can predispose people to cancer," says Lisa Coussens, PhD, assistant professor at the University of California, San Francisco's Cancer Research Institute. Though a direct link hasn't been made between the two, she points out that people with other inflammatory diseases face increased cancer risk. For example, people with the inflammatory bowel condition known as Crohn's disease have a 60 percent increased risk of developing colon cancer.

Chronic infection can trigger cancer in several different ways. For example, inflammatory cells contain growth factors that stimulate cells to multiply in an attempt to help repair injured tissue. But by increasing the rate of cell division, this process might also put you at increased risk for mutations that lead to cancer development. When triggered by an infection, immune-system cells also alter the DNA of bacteria-laden cells, causing them to die. But there's the risk that this tinkering "can induce DNA damage and cause a mutation" that leads to cancer, says Coussens.

Women in particular need to pay close attention to gum health. "Flossing is so critical because the hormonal changes that occur in women during puberty, pregnancy, and menopause cause the oral bacteria that lead to gum disease to grow more readily," says David Schneider, DMD, a Bethesda, MD, periodontist. Drugs such as antidepressants, some blood pressure medications, and antihistamines can also raise your risk of gum disease because they reduce the saliva that helps wash bacteria away in the mouth.

The Fix

Floss at least once a day. Don't know how? Here are some simple instructions from the American Dental Association: Take about 18 inches of floss and wind it around the middle fingers. Hold a few inches of the floss tightly between thumbs and forefingers. Guide the floss between your teeth, using a gentle rubbing motion. When the floss reaches the gum line, curve it into a C shape against one tooth, and gently slide it into the space between the gum and the tooth. Hold the floss tightly against the tooth. Gently rub the side of the tooth, moving the floss away from the gum with an up-and-down motion. Repeat this for every tooth.
4. You're Afraid to Lift Weights

Some women avoid lifting weights because they think they'll end up looking like the female version of Arnold Schwarzenegger. They're wrong. "The vast majority of women do not have the genetic capability to develop large, bulky muscles," says Cedric Bryant, PhD, chief exercise physiologist for the American Council on Exercise, the organization that certifies personal trainers. To get that Arnold look, you need what Arnold has: testosterone plus many hours a day spent pumping iron. The average woman simply does not naturally produce enough testosterone to bulk up from weights, Bryant says, and most women are lucky to squeeze in half an hour a day doing any exercise.

So don't think of weight lifting as "lifting weights." Think of it as a great way to look more toned and trim without losing an ounce. In fact, once you start, you may even notice that you've put on a few pounds. Don't panic: You're gaining muscle, which weighs more than the fat you're losing. But since muscle is more dense than fat, it takes up less space, helping you fit into your clothes better. And if you lift regularly, you'll eventually start dropping pounds.

Here's another bonus: A recent study at the University of Alabama at Birmingham found that women on a strength-training program for 25 weeks lost significant amounts of belly fat—the dangerous kind that increases your risk of heart disease and diabetes.

The Fix

You don't have to spend a lot of time pumping iron to get the benefits. Two or three times a week on nonconsecutive days for about 30 minutes per session should do the trick. The American Council on Exercise says that light weights and multiple reps tend to help build endurance and muscle tone, while training with heavier weights generally produces stronger muscles.

5. You Ignore Aches and Pains

If you're knee-deep in caring for kids, managing a household, and holding down a job, you may be quick to brush off a nagging cough, back twinge, or bout of indigestion. You may think fatigue is your natural state. You shouldn't ignore any of those symptoms. Three years ago, Stephanie Goldner, a 37-year-old mother of four, went to work despite waking up with what felt like a bad case of indigestion. "I had to get to work," she says. "I had a deadline." But as soon as her colleagues at Baptist Hospital in Miami took one look at her, they sent her to the emergency room. There, she learned that her bad indigestion was actually a heart attack.

Why didn't she just stay in bed that morning? Her answer will probably sound familiar. "Even when you feel awful, you have things to do," Goldner says. "I really don't have time to coddle myself over a cold or heartburn."

And there's the irony: Although women tend to go to doctors more often than men, and though they're the caretakers for everyone from grandparents to the pet parakeet, they're least likely to take care of themselves, says Diana Dell, MD, assistant professor of obstetrics-gynecology and psychiatry at Duke University Medical Center. "Personal wellness and preventive care always take a backseat to caring for someone else."

Research suggests that some women will ignore even crushing fatigue and pain, symptoms that in a partner or child would send them scurrying for a doctor's appointment.

For example, a study of 1,725 US and Canadian women with ovarian cancer—one of the deadliest cancers because it's often not caught until it has advanced—found that nearly all had symptoms before they were diagnosed, but about half ignored them for more than 3 months before finally seeing a doctor. (Those symptoms included bloating, abdominal or pelvic pain, and bleeding.)

Likewise, many women who suffer heart attacks have symptoms such as unusual fatigue and shortness of breath as long as a month beforehand, says a new study that looked at 515 recently diagnosed women. And while some report their symptoms to a doctor, a significant number don't, says lead researcher Jean McSweeney, PhD, RN, of the University of Arkansas for Medical Sciences. "It's about fifty-fifty," she says. "Some of the women in our study who didn't go to their doctors attributed their symptoms to getting older. Others delayed seeking treatment because they were waiting for the symptoms to either get worse or go away."

In addition to ignoring warning signs, women can't seem to find time for routine maintenance. Breast cancer is the second leading cause of cancer death among women, yet 40 percent of women over 40 haven't had a mammogram in the past year, says Debbie Saslow, director of Breast and Gynecologic Cancer at the American Cancer Society. Women over 40 should have a routine screening annually. Similarly, up to 15 percent of vulnerable women have not had a Pap test to screen for cervical cancer in the past 3 years.

The Fix

Familiarize yourself with the symptoms of serious illness, know your risk factors, report anything unusual immediately, and don't let anything get in the way of regular screening tests, which can often detect problems when they're still small and treatable.

Goldner now says her heart attack was a wake-up call to take better care of her health. She quit smoking and lost 60 pounds. She advises other women to pay attention if they don't feel well. "Don't cruise along and hope that things will get better," she says. "At some point you have got to make yourself a priority."

6. You Don't Get 8 Hours of Sleep

Scrimping on sleep may seem like a smart way to squeeze a few more productive hours into the day, but busy women who do it can pay a heavy price with their health, says Suzanne Griffin, MD, a sleep specialist and psychiatrist at Georgetown University Hospital in Washington, DC. "This is a public health epidemic that is going unnoticed," she says. "Often what I hear, especially from mothers, is that they are intentionally staying up late at night because it is the only time they have to themselves" to do laundry, pay bills, and catch up on work.

Though there's no set amount of sleep people need, 8 hours is usually a minimum, says Clete Kushida, MD, PhD, director of the Stanford University Center for Human Sleep Research. Most women are getting only about 7 hours on weeknights, says a 2002 National Sleep Foundation survey of about 1,000 men and women. Twenty percent of those women reported daytime sleepiness, a sign that they weren't getting enough shut-eye.

The risks of sleep deprivation go way beyond waking up with that groggy feeling even coffee won't cure. Women who sleep less than 8 hours a night over a 10-year period are at slightly higher risk of heart disease, reported a study published in the past year in the Archives of Internal Medicine. Those 8 hours are also crucial to maintaining a healthy weight. Another study found that sleep deprivation can lead to an imbalance of various weight-related hormones that can encourage your cells to store excess fat and lower your body's fat-burning ability.

Still other research has linked sleep deprivation to depression and anxiety, as well as insulin resistance—a trigger for high blood pressure, heart disease, and type 2 diabetes. And accidents caused by sleepy drivers injure more than 40,000 people a year and kill at least 1,500, according to the National Highway Traffic Safety Administration

The Fix

Acknowledge the futility of trying to fit 26 hours' worth of activities into 24 hours. Cut back on your commitments, says Griffin. Divvy up family responsibilities with your partner and children. Establish a bedtime for yourself, and stick to it every night. Avoid caffeine in the afternoon and evening. And don't use alcohol as a sleep inducer; it can actually interfere with a full night's rest. Your sleep may improve if you adhere to the same relaxing bedtime rituals you've started for your kids, such as reading, listening to music, or taking a warm bath.