Hike or bike trails to explore the great outdoors. Photo courtesy Shutterstock.

Exploring the great outdoors can be a springboard to better health, says Dr. Mary Reimer, director of the Reimer Wellness Center in Palo Alto, California.

For starters, drink plenty of water and stretch before being active. Then, slather on the sunscreen. Finally, jump-start your healthiest year ever with Dr. Reimer’s tips for day trips that leave you energized—not exhausted!

1. Explore new places. Scope out choice destinations via bike and hike paths. Resist the urge to see as many things as possible from the car.

2. Enjoy new activities. Pack up the kids and play beach volleyball or tackle an outdoor adventure course. Alternatively, sign up for a yoga retreat, or plant the garden or flower bed you’ve always wanted.

3. Eat new foods. While you are out and about, discover tasty seasonal snacks (and save calories) at farmers markets and produce stands—not at the gas station. When eating out, watch portion sizes and savor a variety of local flavors by sharing entrees with family members or ordering smaller appetizers.

For more about outdoor fun, see Get Out, Get Fit.

Ready, Set, Get Moving! The Saturday Evening Post

To prevent skin cancer, sunburn, and early skin aging, dermatologists recommend a water resistant, broad spectrum (blocks UVA and UVB rays) SPF between 30 and 50. Why do we see products with much higher numbers? Marketing, basically. Higher numbers make us think we’re getting better protection, but proof is lacking according to the FDA, which has proposed capping SPFs at 50 to limit unrealistic claims.

So skip the overblown numbers and save your skin with five simple tips from the American Academy of  Dermatology:

• Apply sunscreen 15 minutes before going out in the sun. Exception: Products with titanium dioxide or zinc oxide are effective immediately.

• Spread lotion in thin layer on dry skin (or use enough spray for a glossy sheen as it goes on).

• Reapply product every two hours.

• Seek shade whenever you are taller than your shadow.

• Wear protective clothing, hats, and sunglasses.

Burning Questions The Saturday Evening Post

So go ahead and step out in your favorite flip-flops for summertime strolls and parties. (P.S. Be sure to protect your feet with sunscreen.) Then, step into well-cushioned shoes when walking on concrete or pavement and exercising to dodge painful problems, say Mount Sinai School of Medicine Orthopaedic doctors who treat an influx of flip flop injuries each summer. Here’s why!

Flip-flops offer limited support.

1. People grip and hold flip-flops in place with their toes. Result: This motion changes the way you walk and can stress the toes, ankles, legs, hips, and back.
2. Flat and flimsy shoe beds provide inadequate foot support for all-day wear. Result: Arch pain, plantar fasciitis, and nerve issues.
3. Lack of shock absorption. Result: Pain in feet, legs, hips, and back.

Flip-flops offer limited coverage.

1. Few people understand or think of the foot as a place where skin cancer can arise. Result: Foot melanoma can be deadly. Mount Sinai Podiatrist Dr. Bryan Markinson reports a sharp rise in foot melanoma among his patients. Alert to sandal wearers: Remember to apply sunscreen to your feet!
2. Flip-flops leave toes and nails uncovered and unprotected. Result: Broken toes and toenails.
3. Feet can roll off the shoe. Result: Cuts and infections.

Mount Sinai’s Leni and Peter W. May Department of Orthopaedics specializes in surgery of the foot and ankle, knee, hip, hand, elbow, shoulder, and spine; total joint replacement for knee, hip, foot, ankle, and shoulder; microvascular surgery; cancer surgery; and minimally invasive surgery.

Flip-Flops For Summer Fun The Saturday Evening Post

“Exercising outdoors frees the mind,” says Tyler Cooper, M.D., M.P.H., CEO of Cooper Aerobics Enterprises, Inc., and co-author of Start Strong, Finish Strong with his father, Dr. Kenneth Cooper. “Just get outside and start moving. Being active most days of the week in some form or fashion will really pay dividends in the long run.”

3 Steps to Shoes That Fit

Bad shoes can sideline the best walking program, warns health fitness specialist Kristen Davis.

“Impact forces from the ground travel up your legs,” she explains. “Proper shoes protect your feet and keep your knees and hips from hurting, too.”

Here is Davis’ game plan to find shoes that make you want to walk—and that’s the point, right?

Insist on Comfort

Try on different brands and styles and walk around in both shoes. Trained staff at 
a running store can test your gait and get you in 
the best shoe.

Return It

Check out the store’s return 
policy in case shoes no longer feel comfortable after walking two or three miles.

Set a Budget

Expect to spend $50 to $100 for walking shoes and to get a new pair every six months. “New Balance and Brooks have great walking shoes,” advises Davis.

Pick the Right Program

Outdoor fun should match your personality and fitness level. Consider these categories, then choose your favorites (after consulting your doctor, of course).

The Nature Lover: Plant a garden or flower bed. Spend extra time raking and weeding on especially nice days or offer to do yard work for others. Bike or hike on local nature trails, or plan a trip to state or federal parks.

The People Person: Set up a badminton net and arrange neighborhood games. Take a morning jog, lunchtime stroll, or evening walk with friends. Join a water exercise class or swim club at the local pool.

The Competitor: Train for a sprint triathlon (half-mile swim, 12-mile bike ride, and a 3.1-mile run); join a bocce or softball league; or devise a workout of lunges, push-ups, and squats utilizing outdoor railings and steps.

Start Small, Finish Stronger

Setting realistic goals and finding a fitness partner can help you stay motivated.

“The ideal goal is 30 minutes of exercise five times a week, but even three times a week adds years to a person’s life,” says Dr. Cooper. “Success breeds success, and any amount of exercise is better than none at all.”

Get Out, Get Fit The Saturday Evening Post

But with so many choices, which treatments actually improve and protect the skin’s appearance, and which ones simply add a new wrinkle to the budget? The best way to answer that question is to look first at what it is you’re saving your skin from:

When outdoors, wear a wide-brimmed hat and tightly woven clothing that covers your body.

Block the Sun

Protecting your skin from ultraviolet (UVA/UVB) radiation exposure (including indoor tanning), extremes of heat and cold, and air pollution can significantly reduce your risk of wrinkles and skin cancer.

“Baby boomers didn’t know better and received a great deal of harmful sun exposure before sunscreens were available,” says Dr. C. William Hanke, an eminent dermatologist and past president of the American Academy of Dermatology. “Ultraviolet light causes malignant melanoma, as well as basal cell and squamous cell carcinomas, which are much more common skin cancers.”

Thankfully, broad-spectrum sunscreens protect against both UVA and UVB rays and are widely available today. They’re crucial for skin protection, and not just in the summer. While the sun’s UVB rays are strongest in the northern hemisphere May through September, UVA rays are present year round, penetrating windshields, light clothing, and office windows.

However, comparing the ingredients of one sunscreen to another can leave one bleary-eyed and confused.

“Check the product label,” advises Dr. Hanke. “Good broad-spectrum sunscreens have an SPF of 30 or greater and contain protective ingredients that include: avobenzone, ecamsule, oxybenzone, titanium dioxide, and zinc oxide.”

Choose a sunscreen that works best for you. People with oily skin may prefer an alcohol-based gel. Individuals with dry skin want a cream for moisture.

When applying sunscreen, don’t forget less obvious, but vulnerable areas, such as the ears, neck, and face—anywhere that is exposed.

“We see golfers in my clinical practice all the time,” says Dr. Hanke, who reports an increasing number of cancers on the lips, ears, and eyelids of outdoor enthusiasts who fail to adequately protect sensitive areas. “They golf for five or six hours at a time and need to wear sunscreens. The same advice applies to winter skiers as well.”

Clothing also adds an extra layer of protection. “Wear a hat,” stresses Dr. Hanke. “Men with hereditary hair loss who don’t wear hats are at higher risk for premalignant lesions and skin cancers—mostly squamous cell carcinomas—on their scalps. It can be a huge problem.”

When choosing sun-protective clothing, opt for dense, tightly woven fabrics.

“If you hold the hat or shirt up to the light and can see through it, so can the sun,” Dr. Hanke adds. “The hat should have a tight weave to protect the scalp.”

Today, most sporting goods companies, apparel stores, and online outlets sell sun-protective clothing.

Snuff Out Smoke

Aside from the serious health consequences, smoking and secondhand exposure is also bad for your skin—next in line to the sun in causing wrinkles. Nicotine impairs blood flow to the skin, accelerating the normal aging of epidermal tissue.

Keep It Clean

Science of Skin
Older skin is thinner and more fragile, and the deep layers 
contain less elastic tissue. Blood vessels are also less elastic, so that even minor injuries can cause bruising. The skin may be mottled with small, flat brown areas called lentigines (from the Latin word for lentils).

Young Skin: A thick outer layer and a large number of elastic fibers in the deeper layers help maintain the smoothness of young skin.

Older Skin: A thinner outer layer and fewer elastic fibers in the deeper layers result in skin that appears loose, with deeper creases and wrinkles.

Images reprinted from The Human Body, ©1995 Dorling Kindersley Ltd.

Facial hygiene is also critical. One of the first steps is choosing the right cleanser.

“If you have oily skin, you can use any soap you want, and it will probably not be irritating,” Dr. Hanke says. “The soap that I recommend for most people and use myself is plain white Dove. People with dry or oily skin can use it.”

For people with rough and scaly skin, occasionally using an exfoliant makes skin appear smoother and feel softer.

“As you age, dead cells build up on the skin surface,” Dr. Hanke explains. “Exfoliation removes the dead surface layer, and moisturizing helps keep skin soft.”

Cleanse your face twice a day—once in the morning and again at bedtime, then apply a moisturizer based on your skin type. For dry skin, opt for an occlusive moisturizer that covers the skin with a waterproof film through which water cannot evaporate or escape. For sensitive skin, some experts recommend applying a moisturizer containing soothing ingredients, such as bisabolol, a chamomile extract.

“As we get older, our skin is not the barrier that it once was,” says Dr. Hanke. “It dries out more easily. As a result, people need to moisturize their skin more frequently.”

Do high-end products equate with higher quality?

“Some inexpensive moisturizers such as Neutrogena and Oil of Olay are very good, as are some very expensive ones, such as La Prairie and LaMer,” notes the dermatologist. “Find one that works for you and does not irritate your skin.”

A word of caution: Don’t introduce too many products at the same time.

“Stick with one product line,” advises Dr. Hanke. “Different products can inactivate each other through chemical reactions and potentially irritate the skin surface.”

Rejuvenating Aging Skin

Innovations in anti-aging skin care are on the fast track to meet the growing demand of baby boomers (and their parents). From nonprescription “cosmeceuticals” to laser treatments, therapies are available that improve the skin’s surface texture, reduce irregular pigmentation, and help reverse the effects of sun damage.

Topicals: Typically used to address milder signs of aging. For example, retinol, a vitamin A compound, is the first antioxidant topical widely used in nonprescription creams and is the less potent cousin of tretinoin (Retin-A, Avage, Renova), a prescription-strength treatment for acne and fine wrinkles.The fastest growing segment of topical skin care, cosmeceuticals combine aspects of the cosmetic and pharmaceutical industries. Cosmeceuticals influence the function of the skin with biologically active compounds (vitamins, oils, herbs, and botanical extracts). Botanicals, for example, contain antioxidants that protect the skin’s surface. William Beeson, M.D., clinical professor in dermatology at Indiana University School of Medicine and noted facial plastic surgeon, has researched a cornucopia of compounds that rejuvenate skin tissues. His research led to the discovery of unique properties in rosemary, an herb that contains a potent antioxidant called carnosic acid. After demonstrating clinical efficacy, Dr. Beeson and colleagues developed a formulation called Effulgere (effulgere.com) that penetrates the skin surface more deeply and helps “protect the skin from further damage by enhancing the skin’s lipid barrier, brightening the skin, and improving its texture and tone.”

Chemical Peels: A chemical solution—such as phenol, tricholoacetic acid (TCA), or alpha hydroxy acids (AHAs)—that removes damaged outer layers of the skin, revealing the healthier layers below. Wrinkles from sun damage, aging, and heredity can be significantly reduced by undergoing a series of peels that also improve irregular skin pigmentation and remove early skin cancers (actinic keratoses).

Lasers: Many laser treatments are now used to minimize wrinkles, scars, skin discolorations (freckles or “age spots”), and blemishes on the face, neck, chest, and back of hands by removing the outer layer of skin (epidermis). The treatment simultaneously heats underlying tissues (dermis), stimulating the growth of new collagen fibers that form smoother, firmer skin. One of the more popular areas in minimally invasive cosmetic surgery, fractionated carbon dioxide (CO2) laser treatment is performed under topical anesthesia on select areas of damaged skin. The outpatient procedure creates microscopic holes in the skin, which then heal with new collagen that tightens skin and evens tone. Newer technologies offer surgeons a greater level of control in laser surfacing, permitting extreme precision, particularly in delicate areas.

Fillers: These reduce the appearance of facial lines and wrinkles by “plumping” furrows and hollows in the face, giving the skin a more youthful-looking appearance. Fillers (Juvaderm, Restylane, Gore-Tex) are very effective at contouring specific areas on the face, such as around the lips, including long, vertical “marionette” lines that start at the corners of the mouth and extend down the chin. Botulinum toxin type A (Botox, Dysport) injections also diminish lines and wrinkles associated with facial expression, including vertical lines between the eyebrows and on the bridge of the nose, forehead lines and furrows, and crow’s feet.

Saving Face: Skin Care Tips The Saturday Evening Post

Protection is the key to saving your skin. Fortunately, consumers have a wide array of choices of sunscreens, sunglasses, sunless tanning products, and clothing that offers coverage from the No. 1 cause of all skin cancers and the primary cause of aging—the sun.

To learn more about current measures to preserve the skin and reduce the appearance of sun-damaged, the Post interviewed dermatologist Zoe. D. Draelos, M.D., F.A.A.D., vice president of the American Academy of Dermatology. A consulting professor of dermatology at Duke University School of Medicine, Dr. Draelos is also editor-in-chief of the Journal of Cosmetic Dermatology and has written eight dermatology textbooks, 32 book chapters, and more than 300 scientific articles. She has served as president of the North Carolina Dermatology Association and as a member of the board of directors of the American Society for Dermatology Surgery.

PP: Why do so many products use botanicals in their ingredients?

ZD: Botanicals are usually used as antioxidants, which are designed to prevent the damage that occurred from UV radiation striking the skin. But botanicals can be used for many purposes in anti-aging products—for their anti-aging properties, to color or scent the product, and many other purposes.

PP: What do you see as the major anti-aging breakthroughs in skin treatment today?

ZD: One of the big breakthroughs is understanding aquaporins, which are responsible for regulating the transport of water and other small solutes across plasma membranes, ultimately acting as pores within the walls of skin cells to keep skin moisturized and hydrated.

Old-fashioned ingredients, such as glycerin, actually affect the amount of water the skin holds. Many moisturizers now contain very high glycerin levels. Anti-aging moisturizers attempt to reduce the appearance of fine lines and wrinkles by enhancing the skin’s water-holding capacity. Glycerin is a well-known emollient and lubricant that is great for dry skin. Glycerin—a basic ingredient for Corn Husker’s Lotion—has been rediscovered for its water-holding ability. When you increase the water-holding capacity in the skin, you can get rid of the fine lines of dehydration.

Many sophisticated fillers (see below) that doctors use to rid wrinkles contain a substance known as hyaluronic acid (HLA), which soaks up water. Holding water in the skin is a very powerful cosmetic tool to improve skin appearance. This water balance is like the spigot on the hose. When you turn the spigot down, not as much water comes out, so the skin is better hydrated. If you open it up and let a lot of water out, the skin becomes dehydrated. It may be that the aquaporin channels are defective and the reason why the skin dries out is because too much water is leaving the body. Understanding how aquaporins work would allow you to develop therapeutic moisturizers to increase the water-holding capacity of the skin and alleviate dry, itchy skin that is especially found in elderly people.

Rejuvenating Aging Skin

Innovations in anti-aging skin care are on the fast track to meet the growing demand of baby boomers (and their parents). Therapies are available that improve the skin’s surface texture, reduce irregular pigmentation, and help reverse the effects of sun damage.

Fillers: These reduce the appearance of facial lines and wrinkles by “plumping” furrows and hollows in the face, giving the skin a more youthful-looking appearance. Fillers (Juvaderm, Restylane, Gore-Tex) are very effective at contouring specific areas on the face, such as around the lips, including long, vertical “marionette” lines that start at the corners of the mouth and extend down the chin. Botulinum toxin type A (Botox, Dysport) injections also diminish lines and wrinkles associated with facial expression, including vertical lines between the eyebrows and on the bridge of the nose, forehead lines and furrows, and crow’s feet.

Saving Face: Exclusive Web Update The Saturday Evening Post

Top 5 Tips from the American College of Emergency Physicians:

Safe Meals: Use a meat thermometer. Cook fresh poultry to 165 F, hamburgers to 160 F, and beef to at least 145 F. Refrigerate all perishable food within 2 hours, 1 hour if the temperature outside is above 90 degrees F. Keep uncooked meats away from other foods.

Safe Grilling: Thoroughly clean a grill of any grease or dust. On gas grills, check tubes leading into the burner for any blockages from insects or food grease and replace connectors if needed. Do not use a grill in a garage, breezeway, carport, porch, or near any surface that can catch fire. Always follow the manufacturer’s instructions that accompany the grill.

Safe in the Water: Don’t drink alcohol when swimming or boating. Wear a lifejacket whenever you are on a boat. Make sure young children are supervised at all times when near the beach, on a boat, or by a pool or hot tub. Don’t swim alone or in bad weather. Learn to swim and teach your children to swim. We also recommend that you learn CPR in case of an emergency.

Safe in the Sun: Protect against sunburn and heat stroke. Wear sunscreen with an SPF of 15 or higher and apply it generously throughout the day. Wear a hat outdoors and UV-blocking sunglasses to protect your eyes. Drink plenty of water, especially when in the sun or sweating heavily. If you feel faint or nauseous, get into a cool place immediately.

Safe on the Road: Don’t drink alcohol and drive or travel with anyone who has been drinking. Wear your seatbelt at all times. Make sure your vehicle has been properly serviced and is in good working shape before a long road trip. Familiarize yourself with your surroundings and know the location of the nearest emergency room in case of an emergency.

“Many of the factors that will determine your safety over Memorial Day weekend—and any time this summer—come down to good decision-making and common sense,” said Dr. Gardner. “As someone who sees the consequences up close, my best advice is: know your limits, be mindful of certain risks and stay smart.”

Plan Now for Safety The Saturday Evening Post