Healthy Lifestyle Habits – Females ♀
Education / Counseling
To have a healthy life, please follow these suggestions:
Behavioural
Folic acid
 If you are planning to become pregnant, you need to take folic acid supplement.
 This decreases the chance of neural tube defects (NTD), a kind of birth defect in your baby
 You should take folic acid supplementation of 0.4 to 0.8mg daily (one month before and three
months after conception)
 For women with previous NTD pregnancies: supplementation with 4mg folic acid daily 3 months
before and after conception reduces recurrence
Good nutritional habits
 prevents coronary artery disease, colon cancer
 advice: decrease intake of fat, saturated fat, and cholesterol; increase intake of fiber
 For more information on healthy eating, please visit www.Ontario.ca/EatRight. You can also call a
Registered Dietitian for free at 1-877-510-510-2.
Adequate calcium intake (1000 to 1500mg/day)
 prevents osteoporosis
 if not adequate from diet alone (usually 3 or more servings of dairy products), calcium
supplementation recommended
Adequate vitamin D (200 IU/day in people age 50-64, 400-800 IU/day in people age ≥65)
 prevents osteoporosis
 take vitamin D3 supplements to reach recommended daily intake
Regular, moderate physical activity
 prevents cardiovascular disease, hypertension, obesity, type II diabetes mellitus and osteoporosis
 recommend: moderate-level physical activity performed consistently to accumulate 30 minutes or
more over the course of most days of the week; includes: normal walking, golfing on foot, slow
biking, raking leaves etc.
 For more information on healthy active living, you may order Canada’s Physical Activity Guides at
www.phac-aspc.gc.ca/paguide-guideap/order-commandez-eng.php. You may also call the toll-free
telephone service at 1-888-334-9769.
Avoid sun exposure, use protective clothing
 prevents skin cancer
 recommend: use sunscreen protection
 avoid indoor tanning (tanning beds, sun lamps)
Safe sex practices / Sexually Transmitted Disease Prevention
 decreases the chance of transmission of STDs (eg- gonorrhea, syphilis, Chlamydia, HIV, herpes,…)
 condoms can cut risk but not to 0%.
 abstinence is most effective
 stay with one sexual partner you know and trust
Smoking:
 causes cancer, heart disease, lung disease and many other serious diseases
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should try best to quit, ask your doctor for help in quitting. Medications can double or triple your
quitting success rate.
dietary advice: eat an average of seven portions of green leafy vegetables or fruit per week to lower
risk of lung cancer
Alcohol:
 harmful effects if drink more than 1-2 drinks per day
 if you drink more than that and have trouble cutting down or quitting, ask your doctor for help
Elderly
 ask your doctor for full assessment if you are getting forgetful
 ask your doctor for full assessment if you are falling repeatedly
Oral Hygiene: prevents periodontal disease, and oral cancer
 brushing / flossing teeth after each meal: flossing teeth prevents gingivitis in adults; brushing teeth
is essential in the application of fluoride dentifrice to prevent dental caries and gingivitis
 fluoride (in toothpaste / in water / in supplement): daily use gives significant reductions in tooth
decay
 tooth scaling and prophylaxis: intensive professional oral hygiene and prophylaxis prevents chronic
gingivitis and periodontitis
 stopping smoking: reduces the risk of oral cancer
Personal safety
 wear seat belts: prevents injury from motor vehicle collisions
 wear helmets when biking, playing sports with risk of head injury
 noise control / hearing protection / no loud music to prevent hearing loss
Parents with children < 15 years of age
 poison control prevention: lock away all harmful/ poisonous substances. Know poison control
centre phone number 416 813 5900
 child proof home
 have working smoke detectors, non-flammable sleepwear and hot water thermostat setting of <54C
Immunizations
Tetanus vaccine
 need routine booster doses every 10 years if had primary series
 adults without a primary series need three doses
 primary adult series are given at time 0, 1-2 months, and 6-12 months.
Influenza vaccine
 need annual immunization
 High risk group: ≥65 years of age, chronic cardiac or pulmonary disorders, chronic diseases,
traveling to places where the virus is likely present, health care workers, personnel in contact with
people in high-risk groups, household contacts of a high risk person
Varicella vaccine, varicella immunity (Chickenpox)
 Tell your doctor if you have had chickenpox. If not, ask for blood test to see if you need 2 varicella
(chickenpox) vaccinations
 Vaccine administered to women of childbearing age, health care workers, household contacts of
immunocompromised people, people exposed at work, new immigrants from tropical climates
 need 2 doses at least 4 weeks apart, if ≥13 years
Pneumococcal vaccine
 Needed in high risk groups: sickle cell disease, asplenia, splenic dysfunction, chronic
cardiorespiratory disease (except asthma), cirrhosis, alcoholism, chronic renal disease, nephritic
syndrome, diabetes mellitus, chronic CSF leak, HIV infection, smokers
 all persons ≥65 years
Acellular pertussis vaccine(Adacel)
 single dose of acellular pertussis vaccine to all adults who have not received a dose in the past (not
covered by government, about $45)
Human papilloma virus vaccine
 decreases chance of getting genital warts and cervical cancer
 for females between 9 and 13 years
 benefit females between 14 and 26 years of age even if already sexually active
 give 3 doses at 0, 1, and 6 months
 $150/dose, $450/3 doses
 grade 8 girls get it free in school
Investigations / Labs
Mammography with Clinical Breast Exam
 age 50-70, screen every 1-2 years for breast cancer (may consider for women aged 40-49)
 earlier if family history of breast cancer
Colorectal cancer screening of patients ≥ 50 years
 Hemoccult multiphase (stool occult blood test) every 1-2 years
 OR flexible sigmoidoscopy
 OR colonoscopy
Cervical cytology (Pap test)
 to screen for invasive cervical carcinoma
 annual screening following initiation of sexually activity or age 18 to age 70
 after 2 normal smears, screen every 3 years
Screening for sexually transmitted infections
 high risk populations: age <30 with at least 2 sexual partners, age 16 at first intercourse, prostitutes
etc
 Syphilis (serology testing)
 Gonorrhea (screen with Gram stain and culture of cervical or urethral specimen)
 Chlamydia (screen with culture or polymerase chain reaction)
 HIV (screen with blood test)
 Hepatitis B virus (screen with hepatitis B surface antigen (HBsAg) in blood
Audioscope (hearing test )
 65 years and older; inquire / whispered voice test
Fasting lipid profile (total cholesterol, HDL-C, triglyceride and LDL-C)
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screen women who are postmenopausal or >50
screen adults with risk factors (diabetes mellitus, smoker, hypertension, abdominal obesity, family
history of premature coronary artery disease, hyperlipidemia, exertional chest discomfort, dyspnea,
erectile dysfunction, chronic kidney disease, atherosclerosis, major CAD risk factors)
screening frequency every one to three years or sooner.
Target:
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High risk: LDL <2.0mmol/L; total cholesterol to HDL-C ratio <4.0
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Moderate risk: LDL <3.5mmol/L; total cholesterol to HDL-C ratio <5.0
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Low risk: LDL <5.0mmol/L; total cholesterol to HDL-C ratio <6.0
Fasting blood glucose
 screen for type II diabetes mellitus, done every 3 years in adults ≥40 years of age; screen more
frequent with risk factors (first degree relative with DM, presence of complications associated with
DM, hypertension, dyslipidemia, overweight, abdominal obesity, member of high risk population
(Aboriginal, Hispanic, Asian, South Asian or African descent), history of impaired glucose
tolerance or impaired fasting glucose, vascular disease, history of gestational DM or macrosomic
infant, schizophrenia, polycystic ovarian syndrome)
 FBS ≥7.0 mmol/L is diagnostic of diabetes mellitus
 screen to prevent cardiovascular events and death
Bone mineral density
 screen for osteoporosis, to prevent fragility fractures
 screen all postmenopausal women age >65
 OR screen if have one of: vertebral compression fracture, fragility fracture after age 40, family
history of osteoporotic fracture, systemic glucocorticoid therapy of >3 months duration,
malabsorption syndrome, primary hyperparathyroidism, propensity to fall, osteopenia apparent on
x-ray film, hypogonadism, early menopause (<45 years)
 OR screen if have 2 of: rheumatoid arthritis, past history of clinical hyperthyroidism, chronic
anticonvulsant therapy, low dietary calcium intake, smoker, excessive alcohol intake, excessive
caffeine intake, weight <57 kg, weight loss >10% of weight at age 25, chronic heparin therapy
Depression Screening
1) Over the past 2 weeks, have you felt little pleasure in doing things?
2) Over the past 2 weeks, have you felt down, depressed or hopeless?
Positive screen is a yes answer to one or both questions. Please inform your doctor if positive.
If you have any questions on any of the above, please ask. Please keep track of the tests and treatments you
should have and inform us if you need any of them. Remember your health is your responsibility.
Dr Tat-Kwan Wong,
Dr T K Wong Medicine Prof. Corp.
#402, 2830 Keele St.
Toronto, ON M3M 3E5
Tel & Fax: 416 633 7337
Updated June 4, 2010