Health: Dr Ann Robinson

Luck versus lifestyle

Q I'm looking for an honest answer. Is it really worth giving up cigarettes, losing weight, taking exercise and getting neurotic about what I eat? My children are forever assuring me that it is, but I have several friends who led impeccable lifestyles yet succumbed to awful illnesses. Is there any real evidence that lifestyle matters, or is it all down to genes and luck?

A The best evidence that lifestyle matters relates to women but surely applies to men too. In 1976, 122,000 female American nurses aged 30-55 were selected and followed up using biannual questionnaires. In the past 14 years, there have been 1,128 heart attacks and 705 strokes. Women with the healthiest lifestyles had 80% less chance of having a heart attack or stroke. It's easy to get defeatist about health and reckon that if you smoke, there's little point in exercising because you're going to die anyway and so on. But it's not true; every little helps on the path to the perfect lifestyle, so listen to your kids, wise up and go for one goal at a time - preferably by ditching cigarettes first, as that's the single biggest danger to you. There's a useful evidence-based healthy- living page at

Domestic pressure

Q I've recently been told that I have slightly raised blood pressure which needs to be monitored. I work long hours and find it hard to get to the surgery. Could I buy a blood pressure machine and record my own?

A Yes. It's an excellent idea and is likely to become standard practice in future. You need a reliable machine which can be recommended by your local pharmacist. You'll want to consult your GP to plan how often to take readings, the level you're aiming for, ways you can achieve it - such as losing weight and cutting down on salt and alcohol - and when to return to the GP.

Boyish breasts

Q I'm a 14-year-old boy and I'm growing breasts. I'm so embarrassed. What should I do?

A At least 65% of boys your age have some breast enlargement. It's a normal part of puberty. Hormones from your brain are making the male hormone in your bloodstream rise. Unfortunately, this also causes a temporary increase in "female" hormones called oestrogens, and that's why your breasts have grown. Your breasts will start shrinking soon as your "male" hormone, testosterone, kicks in. By the time you're 17, you are unlikely to have enlarged breasts. You may also find it reassuring to know that temporary breast enlargement seems to be linked to more advanced development of the penis and testicles. Any boy who laughs at you and doesn't have enlarged breasts almost certainly has a smaller penis and testicles than you.

• These answers are as accurate and full as possible, but should never be used as a substitute for seeking medical help. If you have a question, email or write c/o Health Editor, The Guardian, 119 Farringdon Road, London EC1R 3ER. Dr Robinson regrets that she cannot enter into personal correspondence.

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