Clinical tips: family health

happy family with three generations

Ben Basger takes a look at issues around preventive health for all the family

Did you know that the Royal Australian College of General Practitioners (RACGP) Red book (or ‘Guidelines for preventive activities in general practice’) is freely available on the internet? (

Preventive healthcare includes the prevention of illness, the early detection of specific disease and the promotion and maintenance of health – admirable objectives indeed. The Red book provides recommendations for all age groups.

The Red book states that the leading risk factors contributing to the burden of disease are (beginning with the most common) tobacco use, high blood pressure, overweight/obesity, physical inactivity, high blood cholesterol, alcohol use and low consumption of fruit and vegetables.

It further states that a healthy lifestyle is vital for preventing disease, including cancer.

Recommendations for adults to reduce their risk of cancer and stay healthy are; do not smoke; maintain a healthy weight; be active; eat a balanced and nutritious diet; limit alcohol consumption; be sun smart; and protect against infection. This appears to be typical of the advice your mother may have given you.

Isn’t it interesting that people are looking for magic medicines (often from manufacturers such as ‘Natural Phenomenon laboratories’ or suchlike) to keep them healthy, when their efforts would more appropriately be directed into other areas like fruit and vegetables.

Is it acceptable for people to substitute fruit and vegetables for magic medicines? Perhaps fruit and vegetables are difficult to recognise.

For children aged six to thirteen years old, the Red book recommends the following activities; measure growth and BMI routinely; promote oral health through regular dental reviews; promote healthy eating and drinking; promote healthy physical exercise and reduction of sedentary behaviour; enquire about progress at school as an index of wellbeing; when behaviour is a concern, explore possible contributing factors within the family and the wider social environment; preventive counselling and advice for injury prevention and harm minimisation; promote social and emotional wellbeing; promote sun protection.

When we look at recommendations for older people, what do we find? Here are three you may find interesting are:

  • A single dose of zoster vaccine is recommended for adults aged >60 years (apart from influenza and pneumococcal vaccination for over 65 years)
  • “Vigorous” (i.e. more than moderate) physical activity is recommended for those who are capable
  • Approximately 30% of people aged ≥65 years report one or more falls in the past 12 months. Apart from many other falls reduction strategies listed, there is the recommendation to regularly review medication. “Reduce dose to address side effects and dose sensitivity and stop medications that are no longer needed”. Medications that can promote falls include psychotropic medications, and medications with anticholinergic activity, sedation effects and hypotensive effects or orthostatic hypotensive side effects

Dr Ben Basger PhD MSc BPharm DipHPharm FPS AACPA is a clinical pharmacist and educator at Wolper Jewish Hospital and The University of Sydney, NSW.

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