To look around at all the health articles, tips, tricks, listicles and books, you’d think health was an extraordinarily complicated matter—and must arise from some elusive combination of interval training, crossword puzzles, and avocados. But it’s not actually that complicated. In fact, what science knows to contribute to health is just a simple handful of things: We should exercise, eat well, sleep enough, avoid toxins, and take care of our mental health. All the other bits of advice generally fall within these five categories. Of course, there are some things that are outside of our control, like genetic predisposition and autoimmune disease. But of the part that we do have control over, the behaviors that define health aren’t all that complex.
And it’s why public health experts are so frustrated with all the extraneous and needlessly complicated information floating around these days. “There are so many false narratives today (fake health news) that people genuinely are confused,” says David L. Katz, founding director of the Prevention Research Center at Yale University and the True Health Initiative. Some people may not know what to do, and others, even if they know what to do, may not have the means to do it. “There are people living with such constant daily challenges,” adds Katz, “that they never even think about health until it becomes the most urgent crisis du jour.”
Here’s a rundown of the five main habits that contribute to health, and why they actually do this. How to help people implement them is again the harder question.
Move your body
Most people are generally aware that exercise is good for them, but may not be clear on exactly why this is. It’s not just a method of staying thin or getting fit—where exercise is really powerful is in its effects on the risk of chronic disease. Exercise has been shown to contribute to heart health in a number of ways, from helping reduce blood pressure to affecting the vasculature in our bodies to helping maintain our cholesterol balance (the “good”-to-“bad” ratio), and increasing insulin sensitivity. Regular exercise also benefits the immune system, reducing inflammatory markers like CRP, IL-6 and TNF, which are known to be associated with chronic disease. Exercise is also well known to reduce cancer risk, for multiple types of cancer. And it’s excellent for the brain: It helps treat mental health disorders like depression, boosts the production new neurons in the hippocampus and regulates the endocrine system, including stress response and the cascade of hormones that underlie it. Importantly, exercise is also linked to a reduced risk of brain diseases like Alzheimer’s disease and vascular dementia.
On the flip side, being sedentary is linked to a host of ill effects, from Alzheimer’s disease to heart disease to cancer to premature death. Both observational studies—in people who get regular exercise and in people who don’t—and lab studies that illuminate the cellular and molecular mechanisms show that exercise is one of the central things we can do for our health.
Eat a plant-based diet
This one has been illustrated again and again in various ways. Large-scale epidemiological studies have shown that people who eat a largely plant-based diet are less prone to disease and live longer than people who eat other types—you don’t have to be vegetarian or vegan, but a diet that’s based largely on plants does seem necessary. A study a couple of years ago even showed that switching diets (from a typical meaty American diet to a plant-based rural South African diet and vice-versa) altered the microbiome and the inflammatory markers involved in colon cancer risk in a relatively short amount of time. Other research has shown that a plant-based diet reduces the risk of heart disease, dementia, cancer, metabolic disease, overweight and obesity, and diabetes.
The star of diets in recent years has been the Mediterranean diet, or a derivative of it, like the MIND diet. These diets include copious amounts of vegetables and fresh fruits (although the MIND diet excludes fruits, because of their relatively high sugar content), whole grains, nuts, legumes, fish and healthy fats like olive oil. It limits dairy, meat, processed foods, alcohol (though a little red wine is okay) and, importantly, sugar. The research in the last decade has highlighted the fact that sugar actually presents a much larger health risk than fats; in fact, there’s no formal upper limit on fats anymore, assuming that they’re healthy fats. Cutting out processed foods including sugar, and eating as many foods in their natural form, or close to it, as we can, is probably one of single best changes we can make for long-term health.
The purpose of this mysterious nightly behavior eluded researchers for many years, but it’s starting to become clearer. Sleep serves a number of purposes, particularly for the brain, which can’t survive without it. While we’re sleeping, the brain actively doing things: strengthening connections we need, and pruning the ones we don’t. And perhaps even more crucial than this, it clears out the “gunk” that contributes to Alzheimer’s disease—by the same token, sleep deprivation is linked to a heightened risk of Alzheimer’s. Sleep loss, and the stress and hormone dysregulation that comes of it, is linked to a host of other problems, including weight gain, metabolic syndrome, diabetes, inflammation, depression, stroke and heart disease.
Aiming for between seven and nine hours per night for adults is generally a good rule of thumb. (If you’re getting or need much less or much more than this, it might be a sign of a health problem, so this should be checked out.)
Make your mental health a real priority
This is one of the most fascinating ones, since it underlines how big an influence our mental health has on our physical health. It actually contains a couple of points, which are separate but related. The first part is taking care of your own internal mental health, and treating mental health disorders when they arise. Depression, anxiety, addiction and chronic stress all raise the risk of other diseases and the risk of early mortality.
Also under the umbrella of mental health is staying socially connected. An almost 80-year-long Harvard study has found that a key indicator of a person’s health and longevity was whether he or she had rich social connections. This may work for a couple of reasons: We’re social creatures by nature, and being around other people is a huge stress relief and mood booster. Additionally, having a social network, including a partner, may also make it more likely that you’ll take better care of yourself along the way and seek medical care when problems arise.
There are other, more specific elements that fall under this category—for instance, having a life purpose outside yourself is also linked to a significantly longer life and to improved inflammatory gene expression. And staying cognitively active by engaging in hobbies, crossword puzzles and brain games may help, but the research is a little more mixed there.
Avoid taking in harmful chemicals, and critters, as much as possible
This one includes the big carcinogen, which still kills way too many people around the globe—tobacco. It also covers drinking, which, if you’re going to do it, should probably fall into the “light” category. The tobacco literature speaks for itself, but the research on alcohol is only just becoming clearer. Some researchers believe that moderate drinking is okay and even beneficial for reducing disease risk. But recent studies have suggested that even light drinking confers some level of cancer risk. Therefore, very light drinking is probably the best advice, and most experts say not to start drinking for the health benefits if you don’t currently.
This category also includes exposure to other toxins, carcinogens and endocrine disruptors, from smog to beauty products to plastics. There are lots of “bad chemicals” out there and it’s impossible to avoid everything; but cutting down where we can is probably smart. The use of OTC meds like acetaminophen and ibuprofen should also probably be sparing, since they’ve been shown to have some long term risks.
Finally, also in this category is trying to reduce our exposure to bacteria and viruses—within reason. This includes everything from practicing safe sex to washing your hands regularly to getting vaccinated. The antibacterial craze has largely backfired, so you don’t have to go crazy with antibacterial soap and wipes. Let your kids play in the dirt and with the pets. A little exposure to germs (again, within reason) can actually be a good thing.
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Again, a healthy lifestyle is not really all that complicated. It boils down to just a handful of behaviors. But this is also what makes it so difficult—that these things are, in the end, all behaviors, which means it’s up to us to be aware of them and to see them through.
And, of course, the relevant organizations need to agree on the list of healthy behaviors, and not get swayed by Big Food, lobbyists and advertising. The trick then is how to make these basic habits common knowledge. Says Katz, “If we actually could rally our culture to clarity about where ‘there’ is, we might devote more resources to getting there from here. And we might be less complacent about such hypocrisies as lamenting the prevalence of type 2 diabetes in children, while introducing the attached new products as part of every kid’s ‘complete breakfast.’ There should be collective outrage—but there isn’t.”