Daytime television talk shows, popular podcasts and diet books on the New York Times best-seller list would have you believe that being healthy is complicated. You need to eat the latest superfood, buy the perfect supplements or join the hippest fitness cult. These theories are particularly popular right now, as people commit to New Year’s resolutions.
But after practicing family medicine for 16 years, with a focus on nutrition and obesity, I’ve learned that the keys to good health are quite simple to describe. In fact, I believe the best health advice can be boiled down to 48 words.
So what are these 48 words? In no particular order:
Don’t smoke (2).
Get vaccinated (4).
Avoid trans fats (7).
Replace saturated fats with unsaturated if you can (15).
Cook from whole ingredients — and minimize restaurant meals (23).
Minimize ultraprocessed foods (26).
Cultivate relationships (28).
Nurture sleep (30).
Drink alcohol at most moderately (35).
Exercise as often as you can enjoy (42).
Drink only the calories you love (48).
There’s not much that needs to be said here. Smoking remains the leading worldwide cause of preventable death, including 480,000 deaths per year in the United States alone. If you’re not a smoker, don’t start. If you are a smoker, 1-800-QUIT-NOW will direct you to local resources to help with quitting.
The world is facing outbreaks of vaccine-preventable diseases that had been well on their way to eradication. Take measles, which in 2018 killed 140,000 people worldwide, with most of the fatalities occurring in children under the age of 5. Or influenza, which is responsible for between 290,000 and 650,000 global deaths per year. Ensure your children receive their full vaccination schedules, including the HPV vaccine, and everyone an annual flu shot. And check with your physician that your vaccinations are up to date and that you don’t require any boosting or adult vaccines, such as those that prevent shingles and pneumonia.
Nonnaturally occurring trans fats increase your risk of heart disease. Though products often claim to be free from trans fats, labeling laws allow them to make that claim if they contain less than 0.5 grams of trans fat per serving. To be certain, have a peek at the ingredient list, and if you see “partially hydrogenated” on it, put it back on the shelf.
Though you need not get hung up on the total fat content of your diet, whenever possible, you should substitute unsaturated fats (e.g., olive oil, avocados, nuts, seeds and fish) for saturated fats (e.g., meat and dairy). This is a point of consensus between the staunch low-carbohydrate diet advocate David Ludwig and the whole-grain proponent Walter Willett.
Though you wouldn’t know it from reading magazines, nutritional epidemiology isn’t capable of providing us with specific “best” diets. Home cooking however, associates with broadly healthier dietary patterns, including the consumption of fruits and vegetables, as well as with less risky body weights. Additionally, restaurant meals regularly contain staggeringly large amounts of calories and sodium. You’ll get bonus marks if you eat the meals you cook at a table, free from distractions, with friends or family. And cooking might also save you a small annual fortune, which in turn might benefit your health. Remember, too, cooking is a life skill. Consider making sure your children learn it before they leave home.
Ultraprocessed foods may well play a large role in our global struggles with obesity, as recently demonstrated by a National Institutes of Health study led by Kevin Hall. The study found that people were eating roughly a meal’s worth of calories more per day when the food they ate was ultraprocessed. The smallest amount that you need to enjoy your life is your goal.
Whether it’s with your friends or your family, socializing appears crucial to good health. A 2010 metanalysis involving more than 300,000 people found that the mortality risks associated with loneliness were comparable to those associated with smoking and exceeded those seen with a lack of physical activity or with obesity. There’s no right way to do this, but options may include connecting with long-lost friends, getting active in an online community or with an in-person club, volunteering for a cause you feel strongly about or joining a recreational sports team.
In a systematic review of over five million people, short sleep durations were associated with mortality, diabetes, high blood pressure, heart disease and obesity. Dark, cool and quiet rooms, regular bedtimes, decreased caffeine and more can help to improve your sleep. You might also want to take a quick online STOPBANG quiz, and if you score 3 or higher, get an overnight sleep study to rule out the greatly underdiagnosed and easily treatable condition called obstructive sleep apnea.
Alcohol is thought to lead directly to nearly 90,000 deaths a year in the United States, by way of increasing the risk of injuries, violence, heart disease, liver disease and cancer. As with any indulgence, the goal should be the smallest amount you need to like your life. If that’s more than a drink per day for women and two for men, and you’re concerned that you may have a dependence on alcohol, consider seeking help from your physician or primary care pro
Though commonly only considered in the name of weight (where it’s often less helpful than feels fair), the overall health benefits of exercise are difficult to overstate. Exercise increases life span and treats or prevents many, if not most, chronic noncommunicable diseases. My exercise mantra is simple: Some is good, more is better, everything counts. It’s also most likely better to do a small amount of exercise consistently than a large amount of exercise temporarily.
Liquid calories don’t fill you up, meaning no matter the calories in your meals’ associated beverages, you’ll likely eat the same amount of food. There are no beverages with sufficiently proven health benefits to warrant going out of your way to drink them, and beverage calories in large part come from sugar and alcohol. So make sure if you do drink calories, you love the ones you’re drinking, and then, again, only in the smallest quantity you need to be happily satisfied.
Though far from sexy, spending your energy and willpower on the actions described by these 48 words is likely to have a far greater impact on your health than jumping on the latest zealot’s restrictive bandwagon. If you’re great at them, they could be the only 48 words of health advice that you’ll ever need.
Yoni Freedhoff is an associate professor of family medicine at the University of Ottawa, the founder and medical director of Ottawa’s Bariatric Medical Institute, blogger at Weighty Matters and the author of “The Diet Fix: Why Diets Fail and How to Make Yours Work.”
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