Exercise is just as important as diet. Regular, moderate-intensity exercise helps the body use dietary carbohydrates better, reducing the risk of progression to diabetes. Your exercise goal should be to eventually reach 20-30 minutes a day of moderate exercise. Some people are already way above that, while others may take weeks to safely get to that level of intensity. Neither exercise nor a proper diet are guarantees against developing diabetes, but the two together are powerful.

DEAR DR. ROACH: This is a general question about vaccine reactions. My husband and I both recently had influenza vaccines and shingles second vaccine. Neither of us had a reaction other than a red spot where the injections were done. Does this mean that they weren't effective? We're both over 75 and wonder how strong our immune systems are. Should there have been some reaction? J.D.

ANSWER: Both the flu vaccine and the shingles vaccine are effective at reducing risk of developing their respective diseases, although neither of them is perfect. Last year, the flu vaccine was about 45% effective overall, while Shingrix (the new two-shot vaccine) has greater than 90% effectiveness in protecting against shingles, even in people in their 70s.

A vaccine reaction within the first 24 hours often relates to the body's response to the preservatives and stabilizers in the vaccine. A lack of reaction to the vaccine does not mean that your body isn't responding to the key portion of the vaccine, the part that gives immunity to the virus. You should still be protected.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.

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To Your Good Health: Prediabetes can first be addressed with diet, exercise advice - Corvallis Gazette Times