If you knew that smoking that cigarette would make you drop dead instantly, you wouldn't smoke it, would you? Future threats of ill health are often not immediate enough to make you sit up and take notice.

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But you can prevent many serious diseases or conditions, or even early death, by making healthy choices now. The 28th of May is “International day of action for women’s health” and we focus on preventative measures that women can take.

Lifestyle and diet choices impact heavily on your health by the time you reach your forties. That cigarette, that doughnut, that decision not to go walking – these are all things, that when added together, could have serious long-term effects on your health.

So are you a sitting duck where your health is concerned? If heart disease, osteoporosis or diabetes runs in your family, is there anything you can do to prevent these? Or is it just a matter of time before it strikes? Which diseases cause the deaths of most women in South Africa?

The diseases or conditions that are the leading causes of death among women over the age of 20 in South Africa are HIV/Aids (32,3%) stroke (9,2%), ischaemic heart disease (7,4%), hypertensive heart disease (4,8%), tuberculosis (4,6%), Diabetes mellitus (type 2 diabetes) (4,1%) and lower respiratory infections (3,6%). The most common types of cancer are cervical cancer (1,7%), breast cancer (1,5%) and lung cancer (1,1%). (Statistics provided by the Medical Research Council's report on Initial Burden of Disease Estimates for South Africa, 2000)

Early detection and treatment of many of the above diseases can increase your chances of survival dramatically.

Everyone knows the basics of keeping healthy, such as exercising and healthy eating. Doing it is another story, though. Take a look at some startling facts below that might just galvanise you into action.

Do these eight things and stay healthy

Not smoking. Quitting smoking is the single most effective action you can take to reduce your risk of disease and death. Smoking triples your risk of dying from heart disease if you are middle-aged. The other most dramatic long-term risks associated with smoking are cancer, emphysema and stroke. In fact, lung cancer is 12th on the list of leading causes of death among women in South Africa.

When you smoke a cigarette, the nicotine changes how your body and brain function. It causes a rapid release of adrenaline, which causes rapid heartbeat, increased blood pressure, rapid, shallow breathing and increased glucose levels in your blood.

And it will definitely be worth your while. After 10 years the risk of lung cancer drops by 50 % and after 15 years the risk of coronary disease is similar to those of people who have never smoked.

Regular checkups. Things can go wrong with your body, even if you do everything according to do the book. You just need to detect it as soon as possible. Many conditions, such as high blood pressure or small breast lumps, have no obvious symptoms and can often only be detected by means of regular screening tests.

It is vital to know your family history (and therefore your genetically-inherited health risks). Being alert may lead to early detection of diseases, followed by lifesaving actions. An example is the early detection of colorectal cancer, often found in families. The checklist below is merely a recommendation. If you have any specific problems, such as high blood pressure, it will have to be checked more regularly.

Take note of the following screening tests and check-up list:

• Pap smear (every one to two years for women between the ages of 20 and 40; every two to three years for women between the ages of 40 and 70)
• Blood pressure test (at least every two years)
• Pelvic examination (every year)
• Cholesterol test (every five years from the age of 20)
• Clinical breast examination (every three years from the age of 20)
• Mammography (every one to two years from the age of 40)
• Colon cancer screening (every two to three years from the age of 40 if you have no family history, but every one to two years from the age of 20 if you have a history of colon cancer.)

Take heed of these warning signs of cancer. Cancer claims the lives of many South African women every year. But many of these cancers have a good prognosis, if detected early. The cancers affecting all South African women, in order of prevalence, are:

• Breast cancer
• Cervical cancer
• Colo-rectal cancer
• Lung cancer
• Oesophageal cancer

Some have no screening tests for early detection and quite a few have no warning signs. There are others, though, that have very specific warning signs.

Growths or tumours are often early warning signs and should be checked out immediately, as time is of the essence. Internal tumours can cause a wide variety of symptoms, including exhaustion and localised pain. An unexplained change in how your body functions, for example sudden bowel problems or slow wound healing, could also be a warning sign. Sudden headaches, unexplained blood in your stools or localised discomfort in a particular spot over a number of days, are all symptoms that need medical attention.

Healthy eating. The rule of 'rubbish in, rubbish out' applies here. Eat badly, and your body will show the results before long. Apart from helping with weight control, healthy eating can also help prevent many diseases, most notably diseases associated with the western lifestyle, such as heart disease, hypertension, type 2 diabetes, obesity and a suppressed immune system.

The health benefits of eating healthily are clear: a European study has shown that those who consumed 35 grams of fibre daily had a 40 percent lower risk of cancer than those who ate 15 grams daily.

Your checklist for healthy eating:

• Maintain a healthy weight
• If you are overweight, lose weight. Limit your total energy intake to 6000 to 8000 kilojoules per day, depending on your level of activity. Non-active women need fewer kilojoules to sustain their weight.
• Eat at least 5 portions of fruit and vegetables daily (a portion size is fist size)
• Complex carbohydrates (wholewheat grains) should form the basis of every meal. These include porridge, wholewheat bread, brown rice, pasta and jacket potatoes and should not be more than 180 g (5-8 fist size servings of carbohydrates) per day for active women.
• Eat two portions (90 g or the size of your palm) plant and animal protein foods (fish, meat, eggs, poultry) to get the greatest benefit, but avoid excessive saturated fat intake. Restrict your red meat intake to four portions per week. Rather eat fish like mackerel, pilchards, tuna or salmon, and skinless chicken.
• Limit your fat intake to less than six teaspoons per day, including the hidden fats in meat, biscuits, grave, cream, stews and pastries. For many people this means halving their usual fat intake.

Exercise. Daily exercise has numerous health benefits, not least of which that it decreases your chances of getting fatal diseases. Exercise also burns calories and helps with weight management, blood pressure control, blood sugar control, reduction of stress levels and depression and it also helps to prevent osteoporosis. There is also much evidence that exercise can provide protection against breast and colon cancer. It will also help with weight control.

American research has shown that almost a third of cancer deaths each year are related to obesity and lack of activity.

Your checklist for exercising:

• See your doctor before embarking on an exercise programme.
• Stretch properly before and after your exercise session.
• Exercise at least three times a week to a point of rapid breathing, but you should be able to carry on a conversation as you exercise.
• Exercise for at least 30 minutes at a time in order to get your heart rate up. This can also be done in shorter stretches, but not less than ten minutes at a time, as this will deprive you of the respiratory and cardiovascular benefits of regular exercise.
• Get a partner to exercise with you as it can help to motivate you.
• Walking, swimming and cycling are good ways of exercising.

Be sun sensible. South Africa has the second highest rate of skin cancer, exceeded only by Australia. It can be prevented by sticking to the following rules:

Your checklist for being sun wise:

• Stay indoors or in the shade between 10 a.m. and 3 p.m.
• Play tennis or golf early in the morning or late in the afternoon.
• Wear at least a 25-factor sun block every day, rain or shine.
• Wear long sleeves and a hat when you have to go out into the sun.

Moderate drinking. Excessive drinking can lead to cirrhosis of the liver, but that's not all – it can also damage your bones, make you more susceptible to osteoporosis and increase your risk of coronary heart disease. Even low levels of alcohol affect motor coordination, memory and lower social inhibitions. Cirrhosis of the liver, caused by prolonged heavy drinking, is the 14th leading cause of death among women in South Africa.

The study also found that overall death rates were seven times greater among women who drank two or more times a day than among those who drank less than three drinks a week. But the news is not all bad for those who like an odd glass of wine Interestingly, women who did not drink at all had an 80 percent greater risk of heart disease, compared to women who had a couple of drinks a week. So the secret seems to lie in moderation.

Safety and security. South African crime rates are high and women are often the targets of hijackings, robberies and assaults. Crime-related injuries can have as adverse an effect on your health as accidents can, so everything possible should be done to prevent being injured in this manner. HIV/Aids and car accidents also claim thousands of lives in this country.

Your checklist for being safe:

• Avoid dark or deserted places such as parking garages – especially late at night.
• Always be aware of other people's movements and possible motives when you are outside your home.
• Don't enter your home when there are strangers in the street.
• Have armed response and panic buttons installed in your home.
• Be aware that you are most at risk when getting into or out of your car.
• Remember that domestic violence kills – more women are viciously assaulted by their partners than by strangers. Leave abusive spouses.
• Do a self-defence course so that you know how to protect yourself.
• Never investigate on your own when you suspect a crime is being committed or when you hear a noise in the house.
• Never go anywhere in your car without fastening your seatbelt and never drive drunk or get into a car with a drunk driver.
• Never have unsafe sex – condom use should not be negotiable.

(Susan Erasmus, Health24)

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