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Not sure where to start? Surprisingly, it doesn't really matter, since one positive change usually leads to another. Becoming more active physically, for example, inspires many people to eat a healthier diet. Make enough changes, and eventually you'll discover you've adopted a new way of life. It won't make you invincible or doctors unnecessary, and you can't wait forever. But you'll never know just how much damage you can undo if you don't try.
It's Never Too Late To...
Eat Right
For more than a decade, dietitians and nutritionists harangued us to lower the amount of fat in our diet. As it happens, their message was only partly correct. Although all fats are high in calories, certain fats, like the omega-3 fatty acids commonly found in fish, are actually good for you, provided you consume them in moderation. Not only do omega-3s reduce the risk of clot formation in blood vessels, they also lower the amount of triglycerides, another fatty substance in the blood. The bottom line is that folks who eat 6 to 8 oz. of fatty fish a week experience significantly fewer heart attacks and strokes. (A caveat: the Food and Drug Administration warns pregnant women not to ingest such species as swordfish and king mackerel to avoid birth defects due to possible mercury poisoning.)
Still on the consume-sparingly list are saturated fats, commonly found in red meats and whole-milk dairy products. Recent studies also suggest that another group of fats, called trans-fatty acids, found in abundance in crackers and cookies prepared with hydrogenated oils, may be an even more dangerous promoter of high cholesterol than saturated fats.
The most immediate benefit from adopting a healthy diet is that it can lower blood pressure. Even if you don't have hypertension, decreasing your blood pressure makes your blood vessels springier and can help stabilize potentially dangerous plaques in the arteries. Two major studies, one published last month, have shown that the DASH (for Dietary Approaches to Stopping Hypertension) diet--which emphasizes fruits and vegetables, promotes low-fat dairy and high-fiber grains, permits modest portions of lean meat and reduces sodium intake--can lower blood pressure as effectively as taking a prescription anti-hypertension drug. Just as important, the foods are filling, taste good and aren't that different from what most Americans are used to eating.
Lower blood pressure isn't the only reason to put a little DASH in your life. The extra calcium in the diet helps reduce the risk of osteoporosis. The fiber in the fruits, vegetables and other foods can decrease insulin resistance in many diabetics and even lower their need for medication. There's also the possibility, over the very long term, that it may help diminish the risk of some types of cancer. "It's not a diet for one disease," says Dr. Lawrence Appel, a DASH researcher at Johns Hopkins Hospital in Baltimore, Md. "It's a diet for all diseases." (For more on DASH, visit dash.bwh.harvard.edu.)
Quit Smoking
Long-term studies now indicate that it is harder to undo the damage to the lungs from smoking than most people and even many doctors realize. While quitting can eventually restore the lungs to their original bright pink form, that doesn't necessarily mean that all the cells deep within their folds are now healthy. "Quitters 30 years out still get lung cancer," notes Dr. Eva Szabo, chief of the lung-cancer research group at the National Cancer Institute. But their risk, she hastens to add, is substantially lower than it would be had they continued to smoke.
Fortunately, the circulatory system is more resilient. In the past few years doctors have learned that blood vessels and coronary tissue respond almost immediately to quitting smoking--even in smokers who are 60 or 70 years old. The risk of suddenly dying begins to drop within the first weeks and five years after quitting is nearly indistinguishable from that of someone who has never smoked. "I tell this all the time to my patients to help motivate them to quit smoking," says Dr. JoAnn Manson, chief of preventive medicine at Brigham and Women's Hospital in Boston. "They're always surprised to learn they're going to get benefits quickly."
Get Fit
Among the more surprising findings of the past decade is that weight training can reverse some effects of aging. In 1990 researchers from Tufts University showed that elderly nursing-home residents, ranging in age from 86 to 96, dramatically increased their strength and improved their balance in just eight weeks of supervised weight training. Further studies have since proved that working out with either free weights or machines helps restore lost bone density, diminish knee pain from arthritis, and moderate insulin insensitivity in Type 2 diabetics.
You don't have to wait until you're 90 to get started. Studies show that some of the greatest benefits occur in men and women who pick up weight training in their 30s and 40s. That doesn't mean you can ignore aerobic activity, however. Even a brisk walk three times a week for half an hour at a stretch does some good. But the best cardiovascular results appear once you start breaking a sweat at least five days a week. As you become more fit, you may need to increase the intensity or duration of physical activity.