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Still, we have our work cut out for us. Nearly 50 million Americans continue to smoke. More than 60% are obese or overweight--20 years ago, it was 47%. One in four Americans gets no regular exercise at all. Perhaps 25% of the populace consumes the recommended minimum of five servings a day of fruits and vegetables. The incidence of adult-onset (or Type 2) diabetes, having jumped 33% from 1990 to 1998, climbed an additional 6% in 1999, according to a report released last week by the CDC. Health experts worry that if present trends continue, the incidence of cancer could increase and the death rate from heart disease--which had been leveling off--could reverse itself.

Wouldn't it be great if there were a vitamin or a drug or a fad diet that would protect you? Unfortunately, undoing the damage from a lifetime of bad habits means learning--and sticking with--a whole new set of behaviors. After all, anybody can lose 10 or 20 lbs., and many of us have--over and over again. It's only by maintaining that weight loss, however, that you derive real, lasting benefits.

That's the bad news. The good news is that even small changes can lead to big improvements. For example, doctors for years thought that lowering cholesterol levels reduces the risk of heart attack by shrinking artery-choking plaques. As it turns out, lowering cholesterol levels doesn't change the size of the plaques very much. But it makes them less reactive, thereby lowering the chances that they will rupture. Similarly, even a modest reduction in blood pressure decreases the likelihood that a plaque will burst, reducing the risk of both heart attack and stroke. The payoff can be huge. "It isn't just a matter of living an extra day," explains Dr. James Cleeman, coordinator of the National Cholesterol Education Program at the National Institutes of Health. "Avoiding strokes and heart attacks adds quality to your life."

Not sure where to start? Surprisingly, it doesn't really matter, since one positive change usually leads to another. Becoming more active physically, for example, inspires many people to eat a healthier diet. Make enough changes, and eventually you'll discover you've adopted a new way of life. It won't make you invincible or doctors unnecessary, and you can't wait forever. But you'll never know just how much damage you can undo if you don't try.


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