Prevention and Screening

Healthy Lifestyle

Aspect	Recommendations
Diet	Less than 30% of calories from fat
	Less than 10% of calories from saturated or trans fat
	Less than 300 mg of cholesterol/day
	25 - 35 g of fibre/day
Physical Activity	30-60 mins of cardiovascular exercise at least 3 times /week
Weight	BMI less than 25
	Males: waist less than 100 cm
	Females: waist less than 90 cm
Vitamin Supplements	Folic acid 1 mg/day in women of chid-bearing age
	Calcium 1000 mg & vitamin D 400 IU/day in persons 50 to 65
	Calcium 1500 mg & vitamin D 800 IU/day in persons 65 & over
Alcohol	No more than 2 drinks/day
	If pregnant: no alcohol
Smoking	No smoking

Minimum Screening in Adults

Age group	Males	Females	Frequency
All	Complete exam	Complete exam	Every year
From start of sexual activity to 70 years old	N/A	Pap smear	Every year
40 years old or over	Fasting blood sugar	Fasting blood sugar	Every 3 years
	Lipid profile	Lipid profile	Every 5 years
50 years old or over	Fecal occult blood	Fecal occult blood	Every 2 years
	Rectal exam	N/A	Every year
50 to 70 years old	N/A	Screening mammography	Every 2 years

65 years old or over	Bone mineral density measurement	Bone mineral density measurement	Every 2 years

Perinatal Care

Weeks Gestation	Visit / Test	Comments
Pre-conception	Folic acid supplementation, rubella status, varicella status	Folic acid helps prevent neural tube defects; rubella & varicella vaccines are given before pregnancy if not immune
1st Prenatal Visit	Urine and blood tests, pelvic exam, Pap smear, and cultures for bacteria	E.g. to check for anemia, certain infections including HIV, and your blood type
Up till 30 weeks	Routine visit every 4 weeks	At each routine visit the following are done: weight, BP, urine dipstick, fetal position, symphysis-fundal height, fetal heart rate
30 to 36 weeks	Routine visit every 2 weeks
Beyond 36 weeks	Routine visit every week

16 weeks	Triple screen	To assess the risk for neural tube defects & Down Syndrome
18 weeks	Ultrasound	To confirm due date, check on baby's health, & assess position of the placenta in the uterus
24 to 28 weeks	50 g oral glucose tolerance test	To screen for diabetes
36 weeks	GBS swab	To test for bacteria that could infect the baby during delivery
6 weeks post-partum	Routine visit	Assessment of bleeding, bladder function, bowel function, birth control, breast feeding, blues

Well-Child Visits

Age Preventive Measure Anticipatory Guidance

A few days Sleep on back only
Car seat
Crib bars less than 6 cm apart
Second-hand smoke
Water temp less than 50 C Developmental stimulation
Emergency if fever > 38 C

2 months Falls
Choking Solid foods
Teething

6 months Dental check-ups
No bottle in bed
Burns
Electrical outlets
Sun exposure Night wakening
Separation anxiety
Poison control number

9 months Brushing teeth

12 months Discipline

18 months Temper tantrums

2 years Toilet training

4 years Helmut

5 years Learn address & phone number

Childhood Immunizations

American Academy of Pediatrics, Committee on Infectious Diseases "Recommended Childhood Immunization Schedule--United States, January-December, 1998." Pediatrics 101:155-156, 1998.

Canadian Task Force on Preventive Health Care (CTFPHC)

U.S. Preventive Services Task Force (USPSTF)

Age	Preventive Measure	Anticipatory Guidance
A few days	Sleep on back only Car seat Crib bars less than 6 cm apart Second-hand smoke Water temp less than 50 C	Developmental stimulation Emergency if fever > 38 C
2 months	Falls Choking	Solid foods Teething
6 months	Dental check-ups No bottle in bed Burns Electrical outlets Sun exposure	Night wakening Separation anxiety Poison control number
9 months	Brushing teeth
12 months		Discipline
18 months		Temper tantrums
2 years		Toilet training
4 years	Helmut
5 years	Learn address & phone number