Q. I'm sitting with family and close friends, talking about New Year's resolutions. Most of us are overweight, take medicines for high cholesterol and high blood pressure, and three of us have borderline diabetes. We know we need to moderate our alcohol use, watch what we eat and exercise regularly but, Doc, where should we start?

A. Happy New Year, and congratulations! You have already finished Step 1: Contemplate change, set your intention to act and establish a support system.

The next step is to make a plan, one that brings you joy and inspiration. The plan must be doable for you, practical and not overly ambitious. Remember, as the Mafia saying goes: "10 percent of something is better than 100 percent of nothing."

Try these three strategies:

Limit your alcohol intake. Unfortunately, we live in a binge culture. Too often, when I ask patients how much alcohol they drink, I hear answers like "two or three times per week." A "time" usually means anywhere from four drinks to 12. Keep alcohol to two drinks per day and, if you abstain during the week, don't make up for lost time on the weekend. Excess alcohol is hard on the liver, increases body weight and blood pressure, and weakens our resolve to stay on track with our New Year's resolutions.

Consider the foods you eat. Remember, salt affects blood pressure. Most of the salt we eat is not what we sprinkle on but in prepared foods. Fructose, sugar and "white foods" (rice, potatoes and bread) affect diabetes. A shift to yams or sweet potatoes and to whole grains, especially brown rice, is huge. Fatty foods raise cholesterol. Curb the french fries and katsu, for starters.

Fast food and most items that come out of a can or bottle are often loaded with sugar, salt and fat. The more you are able to prepare your own meals, the more you can ensure that they are healthy. Always try to buy food that is grown locally and get organic when possible.

Get more exercise. We are so blessed to live in Hawai'i, where there are so many options for physical activity. The key is to create a routine that fits into your schedule and that you find inspiring. In general, low impact is better than high, and symmetrical activities are better than ones that always use one arm or one leg or have you twisting in the same direction every time. Yoga, anyone?

Remember, we all slip up once in a while. When that happens, be kind to yourself and renew your resolve. Above all, make it fun!