Tricks for getting healthy without trying hard

Doing exactly the right thing can seem impossible. These quick methods come close.

Cardiovascular Activity

The ideal: Do 30 minutes most days of the week. The surgeon general advises this near-daily regimen will help lower LDL (bad) cholesterol, raise HDL (good) cholesterol, and improve cardio health, reducing the risk for diabetes and heart disease.

The next best thing: Take three 10-minute walks each day. Short bursts have real health benefits, says Cris Slentz, Ph.D., a senior research scientist at Duke University Medical Center, in Durham, North Carolina. Assuming the intensity is identical to that of a 30-minute workout, you’ll burn the same number of calories and get the heart-health benefits.

A few ideas:

- Devote 10 minutes of your lunch hour to a brisk walk.
- Climb a few flights of stairs several times a day instead of using the elevator.
- Offer to take a friend’s (energetic) dog for a walk.

Fresh Fruits and Vegetables

The ideal: Have five to nine servings of fresh fruits and vegetables daily. Eat such a bounty and you’ll get a full array of nutrients, as well as plenty of fiber, says Claudia Gonzalez, a registered dietitian in Miami.

The next best thing: They may not be farmers’ market–worthy, but sneak in servings this way:

- Try vitamin-rich dried fruits and single-serving packs of applesauce (applesauce has less fiber than fresh apples but still contains some vitamin C).
- Using frozen berries, whip up a fruit smoothie, which can hold up to three servings of fruit.
- Try canned. Vegetable and bean soups are good sources of fiber and can be as nutritionally rich as fresh produce, says Gonzalez. Go ahead and take a multivitamin if you’re still falling short. It may cover key nutrients. Find out how much of each nutrient you really need.


Fish

The ideal: Eat it twice a week. Fatty fish, like salmon, trout, and sardines, are packed with DHA and EPA omega-3 fatty acids, which have been found in many studies to reduce the risk of heart disease and boost the immune system.

The next best thing: Add flaxseed or fish oil to your diet. Here are two easy ways:

- Sprinkle one to two tablespoons of flaxseed on salads or oatmeal, says Tracy Gaudet, M.D., a women’s-health expert and the director of Duke Integrative Medicine, in Durham, North Carolina. For optimum absorption of nutrients, the seeds need to be broken, so if you have only whole flaxseed, run it through a coffee grinder for a few seconds.
- Talk to your doctor about fish-oil supplements. The American Heart Association suggests 1,000 milligrams of omega-3s a day for certain people at risk for heart disease.


Sleep

The ideal: Get at least seven hours each night. Skimping on sleep can have a major impact on your health. A 2007 study at the University of Warwick, in England, found that women who slept fewer than five hours a night were twice as likely to suffer from hypertension as women who got seven hours of sleep. Previous studies have linked lack of sleep to weight gain and a weakened immune system.

The next best thing: If you’ve been short on sleep, take a nap. A recent study found that people who took a short daily nap had a lower rate of dying from heart disease than did those who never snoozed during the day.

Two suggestions:

- Lie down for a 20-minute siesta in the afternoon to revive yourself.
- Take a quick catnap when you get home from work to counteract the effects of lost sleep.

Are diet pills safe?

Q: Is there a diet pill available that is safe to use and really works?

A: I wish we had a pill that could help people lose weight easily. None of the medicines on the market are worth using, if you ask me.

Drugs for weight loss that are sold over-the-counter, such as dietary supplements and appetite suppressants don't have a strong effect on weight loss. And using these drugs can cause side effects.

Prescription weight loss drugs have drawbacks, too. They include orlistat (sold as Xenical and Alli), sibutramine (sold as Meridia) and phentermine (sold as Adipex and Ionamin). In some European countries, you can buy rimonabant (sold as Acomplia). It is not sold in the United States.

In November 2007, the British Medical Journal (BMJ) looked at the benefits and of prescription drugs for weight loss. The article summarized the weight loss results and side effects for orlistat, sibutramine and rimonabant.

The findings in this study closely matched a report on rimonabant that came from the U.S. Food and Drug Administration (FDA) in August 2007. It also is similar to FDA testimony about sibutramine at a Senate hearing in 2004.

How do these weight loss drugs "size up?" They are not very impressive. According to the BMJ study, after using the drugs for 1 to 4 years, people lost:

6 pounds on average with orlistat

9 pounds on average with sibutramine

10 pounds on average with rimonabant

Previous studies have found an average weight loss of 2 to 13 pounds with phentermine.

Most patients would need to spend more than $1,000 a year on the drugs in order to see these results. Cost is one reason that a lot of users don't stick with these medicines. A Canadian study showed that fewer than 10% of people who use sibutramine or orlistat stay with it for at least a year. Fewer than 2% of people stay with it for two years.

Another problem with weight loss medicines is their side effects:

Orlistat causes oily stool, grease spots on underwear, and uncomfortable urges to have a bowel movement in up to one-third of people who take it. It also may decrease the absorption of vitamins from your diet.

Sibutramine raises blood pressure and pulse rate. In up to 1 out of 5 patients, it can cause insomnia, nausea, dry mouth or constipation.

Rimonabant was associated with symptoms such as depression and anxiety in up to 1 out of 4 users. At usual doses:

9% of patients developed depression
5% needed to start medicine for depression
9% had to start an anxiety medicine or sleeping pill

The suicide rate doubled

Phentermine can cause a rapid heartbeat, high blood pressure, restlessness, anxiety, or diarrhea
Phentermine formerly was used along with the drug fenfluramine. This combination was known as Fen-Phen. In some people, it led to heart valve damage or abnormal artery pressures in the lungs. Fenfluramine is off the market. But similar problems might occur if phentermine interacts with drugs that are like fenfluramine. This includes antidepressants such as Prozac. These drugs can't be safely combined with phentermine.

Surely, there must be a better way to lose weight.

As old fashioned as it sounds, modest daily calorie intake and regular exercise are still the cornerstones of weight control. Weight loss drugs certainly can be a part of treatment for a person who is severely overweight. However, they are not good enough to substitute for other strategies. I don't recommend them for most people who need to lose weight.