Health Care Systems of Malaysia

Malaysia is fortunate to have a very comprehensive range of the health services. The Malaysian government is very much committed to its principles of a universal access to high-quality health care in which the local Ministry of Health offers thru wide varieties of nationwide networks of clinics and hospitals. However, in spite of the dedication of the local government of Malaysia to provide the best possible health care, there are still some problems that are unsolved, and one of those is the unavailability of quality health care centers in remove areas. When patients are transferred from a specific health center to a more probable hospital, doing so not only incurs some inconveniences on the part of the patient and the family, but also adds costs to the health care systems. In order to deal with the issue, a tool has been designed called the tele primary care. This method helps the doctors on remote areas to discuss problem cases by tele-consultations with specialists and doctors on hospitals.

The Malaysian government is continually striving to make the healthcare system better but there is still a dearth of medical expertise in the country and their high concentration in the urban areas. The current efforts in the past few years have certainly made developments for the health care system in Malaysia.
The Evolution of Healthcare in Malaysia

The health care in Malaysia has notably undergone some radical transformations. The earliest pre-colonial medical cares were confined mostly on those traditional remedies that are evident today on local Chinese, Malays, and some other ethnic group populations. However, with the birth of colonialism, more modern and westernized medical practices are then slowly introduced to this country. Since its independence way back August of 1957, the different systems of medical care were then transferred from British colonial rules to meet the growing needs of proper health care in Malaysia.



At present, Malaysia is divided into two sectors—the public sectors and the private sectors. Doctor are generally required to render three years of serving in public hospitals throughout the whole nation, making it a point to provide adequate coverage of the medical needs of the general population. Foreign doctors are also encouraged to share their expertise in Malaysia.



Over the years, Malaysia has been continuously vigilant about their health care system. For emigrants who are planning to stay in Malaysia, the health care system of this Asian Dragon is one thing to be worried about. The presence of so many medical schools in this nation is enough to attest that Malaysia is really serious with their aim in providing quality health care not only to its residents but to its tourists, emigrants, and visitors as well.

One of the flagship projects of the Malaysian government in the past decade has been medical tourism. This provides for affordable costs for procedures and accommodations for this particular market segment.



Some Medical Issues in Malaysia

Very common among Asian countries are over-prescription of some doctors who think of nothing but how to gain much money from their patients. This particular is actually very rampant not only in Malaysia, but also in some neighboring Asian countries. Although there are some reductions of over-prescription cases, the problem still remains up to this day. Emigrants are warned about these issues as there are possibilities that they might come across with this. Additionally, problems about selling fake drugs have been recorded, according to major pharmaceutical firms in Malaysia but these problems have long been solved. Again, everybody should be cautious about it because safety and health are very important things.



The medical society of Malaysia also recommends all travelers, tourists, emigrants, and the likes to visit their personal physicians or travel health clinics at least four to eight weeks prior to departure. Vaccinations on the following possible medical problems should be properly done:

Hepatitis- recommended for all the travelers

Typhoid- recommended for the travelers who may drink or eat outside major hotels and restaurants

Yellow Fever- required for every traveler that is more than a year old of age upon arrival. Not recommended otherwise

Japanese Encephalitis- for long term traveler on rural areas, or those who may possibly be engaged in unprotected and extensive outdoor activities on rural areas

Hepatitis B- for travelers who have direct contacts with local residents. This is very important especially if the visit is more than six months.

SEXUAL CHILD ABUSE

What is sexual child abuse?

 -  Sexual abuse is the third most frequently reported form of child mistreatment (10% of all cases). 

 -  Sexual abuse is that of a child involved in sexual activity for which consent cannot be given, is outside of the victim's developmental age, is unable to comprehend, and/or "violates the law or social taboos of society." Examples include fondling and any form of genital, anal, or oral-genital contact with a child that are unwarranted.

  - These acts may occur whether the child is clothed or unclothed. Non-touching child sexual abuse would include exhibitionism, voyeurism, and the involvement of a child in prostitution or pornography.

What causes child abuse deaths?

   -  Caused by accidents due to lack of supervision or abandonment or from the failure to seek medical attention for an injury, illness, or condition.

   -  Fatal injuries from mistreatment can and do result from many different acts. Children may die from severe head trauma (injury), shaken baby syndrome, trauma to the abdomen or chest, scalding, burns, drowning, suffocation, poisoning, starvation, etc

How is child abuse treated?

• The safety of the abused child and any other potential victim of abuse in the household is paramount. Removal of the victim and placement in protective custody in a group home or foster care is often necessary.
  
  
• Effective counseling for the child, family, and the abuser is essential to deal with the associated emotional and psychological stress and trauma.
  
  
• In the event of neglect, establishing realistic expectations of the child's needs and capabilities is required.
  
  
• Parental high-risk behaviors such as substance/alcohol abuse must be addressed.
  
  
• Law-enforcement evaluation is performed, followed by the filing of charges, court appearance, and (if found guilty) sentencing as indicated.
  
  
• Pedophiles (people who have sexually abused children) often require intense psychological and pharmacological therapy prior to release into the community because of the high rate of repeat offenders.

How can child abuse be prevented?

• A support-group structure is needed to reinforce parenting skills and closely monitor the child's well-being.
  
  
• Visiting home nurse or social-worker visits are also required to observe and evaluate the progress of the child and his/her caretaking situation.
  
  
• The support-group structure and visiting home nurse or social-worker visits are not mutually exclusive. Many studies have demonstrated that the two measures must be coupled together for the best possible outcome.
  
  
• Children's school programs regarding "good touch...bad touch" can provide children with a forum in which to role-play and learn to avoid potentially harmful scenarios.
  
  
• Parents should make sure that their child's daycare center is licensed and has an open-door policy regarding parental visitation.
  
  
• Public-awareness programs regarding child abuse and neglect can be informative.
  
  
• Developing free and anonymous support systems (for example, "hot lines") encourages the reporting of potential instances of child abuse.

What more can be done to prevent child neglect?

• proper use of car seats and seat belts;
  
  
• consistent use of helmets for bicycling, skateboarding, and skiing/snowboarding;
  
  
• pool and water safety;
  
  
• firearm safety;
  
  
• preventing community violence; and
  
  
• poisoning prevention.

HEALTH AND AGING PROCESS

The aging process is for the greater part no mystery anymore. It consists for a great part of daily damages done on the macroscopic, tissue, cellular and genetic levels. These add up as the years are passing. These damages have specific causes like oxidating agents, sun beams, mechanical wear and tear, psychological stress, lack of some nutritional components and too much of others, like fat.



Another component of aging is the reduction of the telomere chains at the chromosome ends, as each cell division occurs. However, the body has means to repair these ends again, with an enzyme called telomerase. The rapidity of the aging process depends on lack of efficiency in this repair process. The above mention aging causes also slow down this repair process.


The factors causing aging, also causes other diseases like cancer and coronary heart disease. Both aging and these diseases can in great extend be prevented with the knowledge possessed today, and the damages can in great extend be reversed. The components to achieve this are:

-Adequate dayly food containing whole cereals, peas, beans, vegetables, fruit, fish, mushroms, fouls and seafood, and with just a moderate amount of red meat.


-Just a moderate amount of fat and most of the fat supply comming from sources like olive, fish, nuts, sun-flower, etc. Then you will get a good balance between mono-unsaturated fat (olive), poly-unsaturated fat of the omaga-3-type (fish) and poly-unsaturated fat of the omega-6-type.



-Just a very moderate amount of butter, soya oil, corn oil and palm oil. A high consumption of these fat sources gives you too much saturated fat and poly-unsaturated omega-6-fat.


-Just a very moderate amount of sugar, refined flour or refined cereals.


-Supplements of specific nutritional components like vitamins, minerals, lecitin and some essential fatty acids.


-Adequate training, that both gives both a muscular load, work up your condition and stretches out your body. To stretch out, yoga-exercizes are ideal.


-Adequate rest and stress-reduction. Daily meditation is a method of achieving this. Natural relaxing agents or spesific tools for meditation or relaxation may also be useful.


-Supplements of specific anti-aging agents like anti-oxidants or human growth hormone.


-Use of spesific anti-aging agents to apply upon the skin surface.


-To protect the skin against excessive sun exposure.


The amount one needs of nutritional supplements, like vitamins and minerals, differs very much according to a person`s health condition, work load and exposure to environmental stress. A person having a poor digestion, doing high performance sport or being exposed to a high amount of environmental stressors, may need more than an person in an average situation.

TUBERCULOSIS ( TB )

What is tuberculosis?

     - Tuberculosis (TB) is an infectious disease caused by bacteria whose scientific name is    Mycobacterium tuberculosis

     -  TB most commonly affects the lungs but also can involve almost any organ of the body. 

     -   Many years ago, this disease was referred to as "consumption" because without effective treatment, these patients often would waste away. 

     -    Today, of course, tuberculosis usually can be treated successfully with antibiotics.

How does a person get TB?

      -  Person can become infected with tuberculosis bacteria when he or she inhales minute particles of infected sputum from the air. 

       -  The bacteria get into the air when someone who has a tuberculosis lung infection coughs, sneezes, shouts, or spits (which is common in some cultures).

       -  Tuberculosis is spread (transmitted) primarily from person to person by breathing infected air during close contact.

What happens to the body when a person gets TB?

        -  When the inhaled tuberculosis bacteria enter the lungs, they can multiply and cause a local lung infection (pneumonia).
        -   The local lymph nodes associated with the lungs may also become involved with the infection and usually become enlarged.
         -   The hilar lymph nodes (the lymph nodes adjacent to the heart in the central part of the chest) are often involved.

How common is TB, and who gets it?

Anyone can get TB, but certain people are at higher risk, including

• people who live with individuals who have an active TB infection,
  
  
• poor or homeless people,
  
  
• foreign-born people from countries that have a high prevalence of TB,
  
  
• nursing-home residents and prison inmates,
  
  
• alcoholics and intravenous drug users,
  
  
• people with diabetes, certain cancers, and HIV infection (the AIDS virus),
  
  
• health-care workers. 

Symptoms of tuberculosis?

      - The usual symptoms that occur with an active TB infection are a generalized tiredness or weakness, weight loss, fever, and night sweats.
      -  If the infection in the lung worsens, then further symptoms can include coughing, chest pain, coughing up of sputum (material from the lungs) and/or blood, and shortness of breath.
      -  If the infection spreads beyond the lungs, the symptoms will depend upon the organs involved.

How does a doctor diagnose tuberculosis?

       -  TB can be diagnosed in several different ways, including chest X-rays, analysis of sputum, and skin tests
       -  Several types of skin tests are used to screen for TB infection.
       -  These so-called tuberculin skin tests include the Tine test and the Mantoux test, also known as the PPD (purified protein derivative) test.

 

Obesity now a major health concern in Malaysia

BENTONG - Malaysians' penchant for skipping breakfast and eating late, especially at night, coupled with a sedentary lifestyle is ruining their figure and health.

Health Minister Datuk Seri Liow Tiong Lai said obesity is becoming the major health issue with the number of obese people almost tripling in the past 15 years from four per cent in 1996 to 14 per cent in 2010.


And since obesity is the gateway to other chronic diseases such as high blood pressure, heart and kidney problems, he said the risk of more Malaysians developing these diseases will become greater in future.

Liow said the ministry would soon mount a health campaign aimed at educating the public on how to prevent these chronic diseases.


He said the ministry would seek help from non-governmental organisations to reach out to the people especially in villages and rural areas.



"The problem with us is that Malaysians just love to eat especially late night suppers and we don't exercise.


"Unlike our forefathers who woke up early and had an early and heavy breakfast and light dinner, we wake up late and often miss breakfast and even lunch. But we make it up by having a heavy late dinner.


"Our forefathers did physical work and sweated it out, but we work in an office and rarely exercise. That is why obesity is becoming a problem, even among children," he said after distributing Mandarin oranges and angpows to patients during a visit to Bentong Hospital here yesterday.


Liow, who is also Bentong MP, said the ministry was worried over the rise in the number of patients with chronic diseases, especially in rural areas.



"When the haemodialysis machines at the hospital here were increased from four to 14, the number of patients also grew from six to 55 now.

"Considering that Bentong is a small town with only a population of 140,000, the number of kidney patients is high compared to the national average of 70:100,000 population."

Earlier, Liow witnessed the handing over of three new haemodialysis machines from Radicare (M) Sdn Bh chief operating officer Halwah Abdul Manap to hospital director Datuk Dr Chandra Sekanan Raman.
Liow also announced that the ministry would consider sending more medical specialists especially trauma specialists to the hospital since it handled a lot of trauma and accident cases due to its proximty to Karak Highway.



He also visited the hospital's new four-storey building which is due for completion in 2012 which will house the patients' wards, emergency clinic and mortuary.

Suicide in Youth

According to the Surgeon General, a youth commits suicide every two hours in our country. In 1997, more adolescents died from suicide than AIDS, cancer, heart disease, birth defects and lung disease. Suicide claims more adolescents than any disease or natural cause. Adolescents now commit suicide at a higher rate than the national average of all ages. The rate of adolescent suicide in adolescent males has tripled between 1960 and 1980. Suicide rates for adolescent females have increased between two to three fold. There have been striking increases in suicidal behaviors among African American males, Native American males and children under 14. Much of the increase can be accounted for by deaths due to guns. 

Suicidal behavior is the end result of a complex interaction of psychiatric, social and familial factors. There are far more suicidal attempts and gestures than actual completed suicides. One epidemiological study estimated that there were 23 suicidal gestures and attempts for every completed suicide. However, it is important to pay close attention to those who make attempts. 10% of those who attempted suicide went on to a later completed suicide. A suicide has a powerful effect on the individual’s family, school and community. We must deal with it as a public health crisis in our schools, clinics and doctors’ offices. 

Social changes that might be related to the rise in adolescent suicide include an increased incidence of childhood depression, decreased family stability, and increased access to firearms. 

Suicidal behaviors are often associated with depression. However, depression by itself is seldom sufficient. Other co-existing disorders, such as attention deficit hyperactivity disorder, substance abuse or anxiety can increase the risk of suicide. Recent stressful events, can trigger suicidal behavior, particularly in an impulsive youth. Girls may be more likely to make suicidal attempts, but boys are more likely to make a truly lethal suicide attempt. 

Risk factors for suicide include:

 

• Previous suicide attempts
• Close family member who has committed suicide.
• Past psychiatric hospitalization
• Recent losses: This may include the death of a relative, a family divorce, or a breakup with a girlfriend.
• Social isolation: The individual does not have social alternatives or skills to find alternatives to suicide
• Drug or alcohol abuse: Drugs decrease impulse control making impulsive suicide more likely. Additionally, some individuals try to self-medicate their depression with drugs or alcohol.
• Exposure to violence in the home or the social environment: The individual sees violent behavior as a viable solution to life problems.
• Handguns in the home, especially if loaded.

Some research suggests that there are two general types of suicidal youth. The first group is chronically or severely depressed or has Anorexia Nervosa.  Their suicidal behavior is often planned and thought out. The second type is the individual who shows impulsive suicidal behavior. He or she often has behavior consistent with conduct disorder and may or may not be severely depressed. This second type of individual often also engages in impulsive aggression directed toward others. 

Adolescents often will try to support a suicidal friend by themselves. They may feel bound to secrecy, or feel that adults are not to be trusted. This may delay needed treatment. If the student does commit suicide, the friends will feel a tremendous burden of guilt and failure. It is important to make students understand that one must report suicidal statements to a responsible adult. Ideally, a teenage friend should listen to the suicidal youth in an empathic way, but then insist on getting the youth immediate adult help. 

Warning Signs:

• Suicidal talk
• Preoccupation with death and dying.
• Signs of depression
• Behavioral changes
• Giving away special possessions and making arrangements to take care of unfinished business.
• Difficulty with appetite and sleep
• Taking excessive risks
• Increased drug use 
• Loss of interest in usual activities

UNDERSTAND THE RISK FACTORS FOR TEEN SUICIDE

1. Previous suicide attempts/current suicidal thoughts
2. Drug or alcohol abuse
3. Access to firearms
4. Situational stress

KNOW THE WARNING SIGNS

Signs of depression in teens

1. Sad, anxious or “empty” mood
2. Declining school performance
3. Loss of pleasure/interest in social and sports activities
4. Sleeping too much or too little
5. Changes in weight or appetite

Signs of Bipolar Disorder in Teens

1. Difficulty sleeping
2. Excessive talkativeness, rapid speech, racing thoughts
3. Frequent mood changes (both up and down) and/or irritability
4. Risky behavior
5. Exaggerated ideas of ability and importance

TAKE ACTION

Three steps parents can take

1. Get your child help (medical or mental health professional)
2. Support your child (listen, avoid undue criticism, remain connected)
3. Become informed (library, local support group, Internet)

Three steps teens can take

1. Take your friend’s actions seriously
2. Encourage your friend to seek professional help, accompany if necessary
3. Talk to an adult you trust. Don’t be alone in helping your friend.

Intervention: 

 

Intervention can take many forms and should throughout the different stages in the process. Prevention includes education efforts to alert students and the community to the problem of teen suicidal behavior. Intervention with a suicidal student is aimed at protecting and helping the student who is currently in distress. Postvention occurs after there has been a suicide in the school community. It attempts to help those affected by the recent suicide. In all cases it is a good idea to have a clear plan in place in advance. It should involve staff members and administration. There should be clear protocols and clear lines of communication. Careful planning can make interventions more organized, and effective. 

Prevention often involves education. This may be done in a health class, by the school nurse, school psychologist, guidance counselor or outside speakers. Education should address the factors that make individuals more vulnerable to suicidal thoughts. These would include depression, family stress, loss, and drug abuse. Other interventions may also be helpful. Anything that decreases drug and alcohol abuse would be useful. A study by Rich et al found that 67% of completed youth suicides involved mixed substance abuse.  PTA meetings family spaghetti dinners can draw in parents so that they can be educated about depression and suicidal behavior. “Turn off the TV Week” campaigns can increase family communication if the family continues with the reduced TV viewing. Parents should be educated about the risk of unsecured firearms in the home. Peer mediation and peer counseling programs can make help more accessible. However, it is critical that students go to an adult if serious behaviors or suicidal issues emerge. Outside mental health professionals can discuss their programs so that students can see that these individuals are approachable.

Intervention with a suicidal student:  

Many schools have a written protocol for dealing with a student who shows signs of suicidal or other dangerous behavior. Some schools have automatic expulsion policies for students who engage in illegal or violent behavior. It is important to remember that teens who are violent or abuse drugs may be at increased risk for suicide. If someone is expelled, the school should attempt to help the parents arrange immediate, and possibly intensive psychiatric and behavioral intervention. 

1. Calm the immediate crisis situation. Do not leave the suicidal student alone even for a minute. Ask whether he or she is in possession of any potentially dangerous objects or medications. If the student has dangerous items on his person, be calm and try to verbally persuade the student to give them to you. Do not engage in a physical struggle to get the items. Call administration or the designated crisis team. Escort the student away from other students to a safe place where the crisis team members can talk to him. Be sure that there is access to a telephone.
2. The crisis individuals then interview the student and determine the potential risk for suicide.
   1. If the student is holding on to dangerous items, it is the highest risk situation. Staff should call an ambulance and police and the student’s parents. Staff should try to calm the student and ask for the dangerous items.
   2. If the student has no dangerous objects, but appears to be an immediate suicide risk, it would be considered a high-risk situation. If the student is upset because of physical or sexual abuse, staff should notify the appropriate school personnel and contact Child Protective Services. If there is o evidence of abuse or neglect, staff should contact parents and ask them to come in to pick up their child. Staff should inform them fully about the situation and strongly encourage them to take their child to a mental health professional for an evaluation. The team should give the parents a list of telephone numbers of crisis clinics. If the school is unable to contact parents, and if Protective Services or the police cannot intervene, designated staff should take the student to a nearby emergency room.
   3. If the student has had suicidal thoughts but does not seem likely to hurt himself in the near future, the risk is more moderate. If abuse or neglect is involved, staff should proceed as in the high-risk process. If there is no evidence of abuse, the parents should still be called to come in. They should be encouraged to take their child for an immediate evaluation.
   4. Follow-Up: It is important to document all actions taken. The crisis team may meet after the incident to go over the situation.  Friends of the student should be given some limited information about what has transpired. Designated staff should follow up with the student and parents to determine whether the student is receiving appropriate mental health services. Show the student that there is ongoing care and concern in the school.

Postvention: 

An attempted or completed suicide can have a powerful effect on the staff and on the other students. There are conflicting reports on the incidence of a contagion effect creating more suicides. However, there is no doubt that individuals close to the dead student may have years of distress. One study found an increased incidence of major depression and posttraumatic stress disorder 1.5 to 3 years after the suicide. There have been clusters of suicides in adolescents. Some feel that media sensationalization or idealized obituaries of the deceased may contribute to this phenomenon. 

The school should have plans in place to deal with a suicide or other major crisis in the school community. The administration or the designated individual should try to get as much information as soon as possible. He or she should meet with teachers and staff to inform them of the suicide. The teachers or other staff should inform each class of students. It is important that all of the students hear the same thing. After they have been informed, they should have the opportunity to talk about it. Those who wish should be excused to talk to crisis counselors. The school should have extra counselors available for students and staff who need to talk. Students who appear to be the most severely affected may need parental notification and outside mental health referrals. Rumor control is important. There should be a designated person to deal with the media. Refusing to talk to the media takes away the chance to influence what information will be in the news. One should remind the media reporters that sensational reporting has the potential for increasing a contagion effect. They should ask the media to be careful in how they report the incident. Media should avoid repeated or sensationalistic coverage. They should not provide enough details of the suicide method to create a “how to” description. They should try not to glorify the individual or present the suicidal behavior as a legitimate strategy for coping with difficult situations. 

What can you say to support a student with suicidal thoughts and a low self-esteem?

• Listen actively. Teach problem-solving skills
• Encourage positive thinking. Instead of saying that he cannot do something, he should say that he will try.
• Help the student write a list of his or her good qualities.
• Give the student opportunities for success. Give as much praise as possible
• Help the student set up a step-by-step plan to achieve his goals.
• Talk to the family so that they can understand how the student is feeling.
• He or she might benefit from assertiveness training
• Helping others may raise one’s self-esteem.
• Get the student involved in positive activities in school or in the community.
• If appropriate, involve the student’s religious community.
• Make up a contract with rewards for positive and new behaviors.

5 ways-free strategies to help prevent heart disease

• You can prevent heart disease by following a heart-healthy lifestyle.
• Heart disease may be the leading cause of death for both men and women, but that doesn't mean you have to accept it as your fate. 
• Although you lack the power to change some risk factors — such as family history or age — there are some key heart disease prevention steps you can take.
• Take steps to avoid heart disease — don't smoke, get regular exercise and eat healthy foods. 
• Avoid heart problems in the future by adopting a healthy lifestyle today. 

Here are five heart disease prevention tips to get you started.


1. Don't smoke or use tobacco products

     - Smoking or using other tobacco products is one of the most significant risk factors for developing heart disease. When it comes to heart disease prevention, no amount of smoking is safe. Smokeless tobacco and low-tar and low-nicotine cigarettes also are risky, as is exposure to secondhand smoke.

    - Tobacco smoke contains more than 4,800 chemicals. Many of these can damage your heart and blood vessels, making them more vulnerable to narrowing of the arteries (atherosclerosis). Atherosclerosis can ultimately lead to a heart attack.

    - In addition, the nicotine in cigarette smoke makes your heart work harder by narrowing your blood vessels and increasing your heart rate and blood pressure. Carbon monoxide in cigarette smoke replaces some of the oxygen in your blood. This increases your blood pressure by forcing your heart to work harder to supply enough oxygen. Even so-called "social smoking" — only smoking while at a bar or restaurant with friends — is dangerous and increases the risk of heart disease.

    - Women who smoke and take birth control pills are at greater risk of having a heart attack or stroke than are those who don't do either. Worse, this risk increases with age, especially over 35.

     - The good news, though, is that when you quit smoking, your risk of heart disease drops dramatically within just one year. And no matter how long or how much you smoked, you'll start reaping rewards as soon as you quit
.

2. Get active

-   Regularly participating in moderately vigorous physical activity can reduce your risk of fatal heart disease.  And when you combine physical activity with other lifestyle measures, such as maintaining a healthy weight, the payoff is even greater.

-   Physical activity helps you control your weight and can reduce your chances of developing other conditions that may put a strain on your heart, such as high blood pressure, high cholesterol and diabetes. It also reduces stress, which may also be a factor in heart disease.

-   Guidelines recommend that you get at least 30 to 60 minutes of moderately intense physical activity most days of the week. However, even shorter amounts of exercise offer heart benefits, so if you can't meet those guidelines, don't give up. You can even break up your workout time into 10-minute sessions and still get the same benefits

-   And remember that things like gardening, housekeeping, taking the stairs and walking the dog all count toward your total. You don't have to exercise strenuously to achieve benefits, but you can see bigger benefits by increasing the intensity, duration and frequency of your workouts.

3.Eat a heart-healthy diet

-   Eating a special diet called the Dietary Approaches to Stop Hypertension (DASH) eating plan also can help protect your heart. Following the DASH diet means eating foods that are low in fat, cholesterol and salt

-  The diet is rich in fruits, vegetables, whole grains and low-fat dairy products that can help protect your heart. Legumes, low-fat sources of protein and certain types of fish also can reduce your risk of heart disease


-   Limiting certain fats you eat also is important. Of the types of fat — saturated, polyunsaturated, monounsaturated and trans fat — saturated fat and trans fat increase the risk of coronary artery disease by raising blood cholesterol levels.

-   Major sources of saturated fat include beef, butter, cheese, milk, and coconut and palm oils. There's growing evidence that trans fat may be worse than saturated fat because unlike saturated fat, it both raises your low-density lipoprotein (LDL), or "bad," cholesterol, and lowers your high-density lipoprotein (HDL), or "good," cholesterol.

-   Sources of trans fat include some deep-fried fast foods, bakery products, packaged snack foods, margarines and crackers. Look at the label for the term "partially hydrogenated" to avoid trans fat.

4. Maintain a healthy weight

-   As you put on weight in adulthood, your weight gain is mostly fat rather than muscle. This excess weight can lead to conditions that increase your chances of heart disease — high blood pressure, high cholesterol and diabetes.

-  One way to see if your weight is healthy is to calculate your body mass index (BMI), which considers your height and weight in determining whether you have a healthy or unhealthy percentage of body fat.

-  Even small reductions in weight can be beneficial. Reducing your weight by just 10 percent can decrease your blood pressure, lower your blood cholesterol level and reduce your risk of diabetes

5. Get regular health screenings

-   High blood pressure and high cholesterol can damage your heart and blood vessels. But without testing for them, you probably won't know whether you have these conditions. Regular screening can tell you what your numbers are and whether you need to take action.

• Blood pressure. Regular blood pressure screenings start in childhood. Adults should have their blood pressure checked at least every two years. You may need more frequent checks if your numbers aren't optimal or if you have other risk factors for heart disease. Optimal blood pressure is less than 120/80 millimeters of mercury 
• Cholesterol levels. Adults should have their cholesterol measured at least once every five years. You may need more frequent testing if your numbers aren't optimal or if you have other risk factors for heart disease. Some children may need their blood cholesterol tested if they have a strong family history of heart disease. 
 

Prevention pays :

       Heart disease is often avoidable. Following a heart-healthy lifestyle doesn't have to be complicated. Find ways to include heart-healthy habits into your lifestyle — and you may well enjoy a healthier life for years to come.