Preventive Medicine Guidelines For Adults

Immunizations

  • Influenza – annually for everyone over 6 months of age.
  • Pneumonia – approved for those 50 and older, recommended for 65 and older along with younger adults with chronic medical conditions.
  • Shingles – for age 60 and over. (Not for those with severe allergic reactions to gelatin or neomycin or if immune compromised.)
  • Tetanus (Tdap) – booster every 10 years.  Once for adults over 65. Booster needed within 5 years for wound protection (severe cut, puncture, or burn).

 
Exams

  • Breast exam – annually, with self-exam monthly.
  • Dental – every 6 months.
  • Prostate – for men at and over 50, younger if there is family history of prostate cancer. Yearly exams no longer recommended by the U.S. Preventive Services Task Force.
  • Testicular – monthly self-exam for men ages 13 – 35.
  • Vision/glaucoma – consult your eye doctor. Yearly if diabetic or using contact lenses.

 
Tests

  • Bone density testing – usually starts at 65, earlier if reason.
  • Cholesterol – every 5 years after age 30; more often if abnormal.
  • Colon cancer screening — Stool blood check – yearly after age 50. Colonoscopy every 10 years or flexible sigmoidoscopy every 5 years at 50; earlier if strong family history of colon cancer.
  • Glucose – periodically; yearly after age 65.
  • Mammogram – every 1 – 2 years for women ages 40 – 80.
  • Pap smear – every 2 years starting at age 21; every 3 if over 30 and 10 years of normal paps; stop at 65 if 3 negative smears in the past 10 years or equivalent. Start over if new sexual partner.
  • PSA (prostate specific antigen) – for men at and over 50, younger if family history of prostate cancer. Yearly exam no longer recommended by USPSTF.

 
Vitamins and Supplements

  • Aspirin – 81 mg daily for men over 45 and women after menopause for prevention of heart attacks and strokes. Consider risks of ulcers, other GI bleeding.
  • Calcium 1,200 mg daily for women and 1,000 mg for men. Split the dose, as only 500 mg can be absorbed at once. Foods are the best source. Avoid oyster shell/coral calcium.
  • Multivitamins not recommended. Neither are routine Vit. E or B vitamins.
  • Vitamin D 1,000 IU daily and folic acid 400 mcg daily are good ideas.
  • Fish oil capsules. One or two before bed (avoids the fish burps) for cholesterol and heart health.

 
Exercise

  • 30-45 minutes daily 5 days a week of aerobic activity (walking, swimming, biking, etc.). Helps prevent osteoporosis, heart disease, obesity, diabetes, and has other benefits.
  • Maintain body mass index (BMI) less than 25.

 
Dietary Recommendations

  • Goal of daily calories coming from 40% protein, 40% carbohydrates, and 20% fats.
  • Mediterranean Diet handout available on our web site, our front desk, and http://tinyurl.com/7ycp7ld.
  • See also the DASH diet: http://tinyurl.com/8zud33a.
  • Focus on a variety of foods including fruits, vegetables, low-fat dairy, whole grains, legumes, fish, poultry, and lean meats (red meat twice weekly or less).
  • 5 – 7 servings of fruit and vegetables daily.
  • Limit animal fats and trans fats. Use monounsaturated fats such as olive, canola, and peanut oils, and do so in small amounts.
  • If your cholesterol is elevated, see our cholesterol improvement sheet on our web site or at the front desk.
  • Limit alcohol to a drink a day.
  • Avoid all nicotine products. Please talk to us if you are trying to quit. Many cancers are associated with tobacco products.
  • Cut way back on salt and sodium content.
  • Drink plenty of water daily.

 
Personal Health Goals

  • Blood pressure:  goal 120/80; but generally less than 139/89.
  • Lipids:
    • Cholesterol total less than 200.
    • LDL (bad lipid) less than 100.
    • HDL (good lipid) over 50.
    • Triglycerides less than 140.
    • Fasting glucose: goal less than 100.

 

Andre Van Mol, MD and Julie Winter, NP
3580 Santa Rosa Way, Redding, CA  96002
Phone: 530-222-3225 and Fax: 530-222-1219