The food pyramid almost crushed Elaine Monarch. She'd always enjoyed whole wheat bread and the other healthy carbohydrates that form the pyramid's foundation, but her resolve to eat plenty of grains grew even stronger after she went to her doctor complaining of bloating and diarrhea. "He told me I needed more fiber in my diet," she says. "That advice practically killed me."
Monarch, it turns out, has celiac disease: Her immune system attacks the gluten from grains, damaging her small intestine in the process. The founder of the Celiac Disease Foundation, she is still diligent about consuming enough fiber—but these days she gets it from fruit, nuts, and supplements instead of grains.
Americans are constantly bombarded with expert health advice, and many of the messages are unquestionably right for everyone. No one will ever get sick from avoiding cigarettes or trans fats. But some of the most commonly repeated pieces of advice actually aren't meant for everyone. After all, the USDA couldn't equip its pyramid with a section just for people with celiac disease. Health recommendations are sometimes based on studies that didn't include a good cross section of the general public. And even when broadly representative studies trumpet a 94 percent success rate, that still leaves 6 people out of 100 looking for answers.
"What's good for the population as a whole is not necessarily good for a given individual," says Dan Roden, MD, assistant vice chancellor for personalized medicine at Vanderbilt University.
So we took a look at some pieces of conventional wisdom that are truly wise—for most people. Then we asked the experts what you ought to do, just in case you're not completely average in every way. Feeling kind of special? This is for you.
Your Fitness Routine
Smart advice: Vigorous workouts do more for you than moderate ones.
Tailor it if you're sedentary and your main goal is weight loss. If you work too hard—and tire too quickly—you may not burn enough calories to make a real dent in your weight. A 2003 study of 184 women found that walking at a moderate pace for at least 150 minutes each week for a year was just as slimming as working out more intensely for shorter periods of time. In fact, women assigned to long sessions of moderate exercise lost about the same amount as women who worked harder for shorter bursts—15 to 18 pounds, on average. To drop weight, exercise most days of the week at a pace that you can sustain for 30 to 40 minutes. You should be able to talk without gasping for air.
Smart advice: Walking is the simplest way to get exercise—all you need are sneakers and a sidewalk.
Tailor it if you have heart disease and it's a smoggy day. Studies show that the tiny particles in the air during a high-smog day can increase the risk of heart attack. Move your workout indoors on smoggy days (check airnow.gov for local air quality), and flick on the air conditioner—it can cut indoor pollutant levels by up to 50 percent.
Smart advice: Every little bit of exercise gets you fitter even housework or gardening.
Tailor it if you're trying to prevent or treat heart disease. True, any activity is better than none but sweeping or pulling weeds probably won't work your heart hard or long enough to significantly reduce the odds of clogged arteries, heart attack, or stroke. Instead, do 30 minutes of moderately vigorous exercise four or five times a week to dramatically lower your heart risk. A study of nearly 40,000 women found that briskly walking at least two hours each week halved the risk of heart disease.
Smart advice: Swimming is an ideal low-impact aerobic exercise.
Tailor it if you have asthma. The chlorine in a pool—even if it's outdoors—can trigger an attack. In children, it may even raise the odds of developing the disorder in the first place. To be on the safe side, find a different form of exercise if you have asthma that flares up poolside, experts say; if you have a child under age 7 with allergies, don't take him to a pool with a strong smell of chlorine. (And if you're trying to slim down, here's another argument for a land-based workout: Most swimmers don't burn enough calories to shed many pounds.)