Guidelines

Nutrition

Avoid Alcohol

Alcohol delays and reduces REM sleep, even at low doses of about two standard drinks.¹ 1 GARDINER et al., Sleep Medicine Reviews, 2025. DOI In two small experiments with college students (15 and 13 people), alcohol before bed impaired memory for a newly learned skill, though not for facts.² 2 SMITH and SMITH, Sleep, 2003. DOI Alcohol is also associated with brain changes beyond sleep. In a UK cohort followed for 30 years, drinking 14 to 21 units a week went with about three times the odds of right-sided hippocampal atrophy compared with abstaining, and light drinking (under 7 units a week) showed no protective effect. That study found faster decline in lexical fluency but, after correction for multiple testing, no association with semantic fluency or word recall,³ 3 TOPIWALA et al., BMJ, 2017. DOI so the shrinkage is better documented than any loss of memory. In 36,678 UK Biobank adults, higher intake was already associated with lower brain volume among people averaging one to two units a day (a cross-sectional comparison).⁴ 4 DAVIET et al., Nature Communications, 2022. DOI

Alcohol is metabolized to acetaldehyde, which damages DNA, and about 4% of cancers worldwide are attributed to it.⁵ 5 RUMGAY et al., Nutrients, 2021. DOI Even light drinking, up to about one drink a day, is linked to more esophageal (squamous cell) and breast cancer, the breast increase being small,^{6, 7} 6 BAGNARDI et al., Annals of Oncology, 2013. DOI 7 JUN et al., Epidemiology and Health, 2023. DOI and one meta-analysis of cohort studies concluded that no level of drinking is safe for cancer risk, although its pooled all-cancer estimate for light drinking was not significant.⁷ 7 JUN et al., Epidemiology and Health, 2023. DOI Alcohol also impairs driving: in a case-control study in two US cities, crash risk started to rise at a blood alcohol concentration of about 0.04 to 0.05%.⁸ 8 BLOMBERG et al., Journal of Safety Research, 2009. DOI

For the heart, the answer depends on the dose. Observational studies show light drinkers doing better than abstainers, but light drinkers also live healthier lives, and genetic studies, which are much less open to that problem, do not confirm the protection.^{9, 10} 9 BIDDINGER et al., JAMA Network Open, 2022. DOI 10 MILLWOOD et al., The Lancet, 2019. DOI In 371,463 UK Biobank participants, adjusting for lifestyle attenuated the apparent benefit of modest intake; each standard deviation of genetically predicted intake went with 1.3-fold higher odds of hypertension and 1.4-fold higher odds of coronary artery disease, with light intake adding little and heavier intake adding exponentially more.⁹ 9 BIDDINGER et al., JAMA Network Open, 2022. DOI In Chinese men, genotype-predicted intake raised blood pressure and stroke risk but was not significantly associated with heart attack.¹⁰ 10 MILLWOOD et al., The Lancet, 2019. DOI In an open-label randomized trial of 140 people with atrial fibrillation who drank 10 or more drinks a week, recurrence within six months was 53% with abstinence versus 73% with usual drinking.¹¹ 11 VOSKOBOINIK et al., New England Journal of Medicine, 2020. DOI A meta-analysis of 36 trials, mostly in men, found that cutting back significantly lowered blood pressure only in people drinking more than two drinks a day.¹² 12 ROERECKE et al., The Lancet Public Health, 2017. DOI

Inflammation is the weakest of these claims. Heavy drinking is linked to it: a meta-analysis of 17 observational comparisons found higher circulating cytokines in people with alcohol use disorder than in controls.¹³ 13 ADAMS et al., Brain, Behavior, and Immunity, 2020. DOI At moderate intake, a 1987-88 cross-sectional German survey found the opposite association in men (borderline significant, P = 0.048): non-drinkers and heavy drinkers had higher C-reactive protein than moderate drinkers; the association was not significant in women.¹⁴ 14 IMHOF et al., The Lancet, 2001. DOI That is an association, and the lifestyle confounding seen for heart disease may apply here too.

The downsides of alcohol surpass its positive effects: in a global modeling estimate for people aged 15 and older, the level of drinking that minimizes overall health loss is zero.¹⁵ 15 GRISWOLD et al., The Lancet, 2018. DOI Two analyses of the same 107 cohort studies by overlapping authors find no statistically significant mortality benefit from low-volume drinking once former drinkers are separated from lifetime abstainers and study quality is accounted for (studies that did not meet the quality criteria showed a benefit; the authors disclose past funding from government alcohol monopolies, personal fees from a state alcohol retailer, and travel support from an organization that advocates against alcohol use),^{16, 17} 16 STOCKWELL et al., Journal of Studies on Alcohol and Drugs, 2024. DOI 17 ZHAO et al., JAMA Network Open, 2023. DOI and risk of death rises at higher intakes, starting at lower levels for women than for men.¹⁷ 17 ZHAO et al., JAMA Network Open, 2023. DOI

Compounds credited to wine are available elsewhere. Resveratrol is found in grapes, apples, berries, and peanuts,¹⁸ 18 WEISKIRCHEN and WEISKIRCHEN, Advances in Nutrition, 2016. DOI and the amount in wine at moderate drinking levels may be too low to matter.¹⁹ 19 PASTOR et al., Critical Reviews in Food Science and Nutrition, 2019. DOI

Time Caffeine Consumption

Adenosine is a sleep-regulating molecule that is thought to build up with prolonged wakefulness, and caffeine blocks its receptors, so you feel less sleepy.²⁰ 20 REICHERT et al., Journal of Sleep Research, 2022. DOI It also costs sleep. A meta-analysis of 24 studies estimated that a coffee-sized dose (about 107 mg) should be consumed at least 8.8 hours before bed to avoid losing sleep time.²¹ 21 GARDINER et al., Sleep Medicine Reviews, 2023. DOI A 400 mg dose disrupted sleep even when taken 6 hours before bed,²² 22 DRAKE et al., Journal of Clinical Sleep Medicine, 2013. DOI while a 100 mg dose had no significant effect 4 hours before bed in a small crossover trial of 23 men.²³ 23 GARDINER et al., SLEEP, 2025. DOI That suggests a four-hour cutoff is adequate only for small doses. A safer rule: no caffeine in the 9 hours before bed for a coffee-sized dose, and 12 hours or more for large doses.

You will often read that you should wait 90 minutes to two hours after waking, because caffeine inhibits cortisol production or causes a mid-morning crash. The cortisol premise does not hold up. Caffeine raises cortisol rather than blocking it, though daily use blunts the response. In a crossover trial of 96 adults, 250 mg doses at 9 AM, 1 PM, and 6 PM raised cortisol across the day after five days on 0 mg of caffeine a day, while after five days on 300 or 600 mg a day the cortisol response to the 9 AM dose disappeared, though it returned after the 1 PM dose.²⁴ 24 LOVALLO et al., Psychosomatic Medicine, 2005. DOI Whether waking itself triggers a cortisol surge is also in doubt: sampling tissue cortisol continuously in 201 volunteers showed no evidence of a change in the rate of increase in the hour after waking compared with the hour before.²⁵ 25 KLAAS et al., Proceedings of the Royal Society B: Biological Sciences, 2025. DOI In 22 sleep-restricted young men, an engineered bedtime caffeine capsule gave higher cortisol an hour after waking in a post hoc comparison, with no significant overall effect on the response.²⁶ 26 DORNBIERER et al., Scientific Reports, 2021. DOI If you like to delay your first cup, that is a preference, not something this evidence requires.

In one trial of 28 volunteers kept awake for 88 hours, sustained low-dose caffeine eliminated the vigilance impairment seen right after waking from naps.²⁷ 27 VAN DONGEN et al., Sleep, 2001. DOI In a double-blind trial of 369 habitual consumers, going without caffeine overnight went with greater sleepiness and poorer performance later in the afternoon, while tolerance means frequent consumption fails to enhance mental alertness.²⁸ 28 ROGERS et al., Psychopharmacology, 2013. DOI

Stopping abruptly after regular use causes withdrawal: in experimental studies about half of people got a headache, and symptoms typically began 12 to 24 hours after the last dose.²⁹ 29 JULIANO and GRIFFITHS, Psychopharmacology, 2004. DOI

Reduce Sweets and Saturated Fats

Start with sugar-sweetened drinks: in low-quality observational evidence, each additional 250 mL a day is associated with 17% higher risk of coronary heart disease, and an umbrella review recommends keeping free sugars under 25 g a day.³⁰ 30 HUANG et al., BMJ, 2023. DOI Diets built on foods that raise blood sugar fast (high glycemic index) are associated with higher risk of type 2 diabetes (relative risk 1.27, highest versus lowest intake) in a meta-analysis of large cohorts.³¹ 31 JENKINS et al., The Lancet Diabetes & Endocrinology, 2024. DOI Most packaged foods contain added sugar: 66% of products at one major Canadian retailer in 2015, and 75% of US packaged foods bought in 2005 to 2009 contained sweeteners.^{32, 33} 32 ACTON et al., CMAJ Open, 2017. DOI 33 NG et al., Journal of the Academy of Nutrition and Dietetics, 2012. DOI

Sugar does act as a preservative, but only when it is concentrated: in lab tests on three food-poisoning bacteria, concentrated sugar solutions inhibited growth, while very low concentrations stimulated it.³⁴ 34 MIZZI et al., Letters in Applied Microbiology, 2020. DOI Your gut also teaches your brain what to want. In animal studies, carbohydrate, fat, and protein infused into the gut conditioned a preference for the flavors paired with them.³⁵ 35 SCLAFANI and ACKROFF, American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 2012. DOI In a small human experiment, after four days of eating yogurt in which one flavor was paired with about 102 kcal of added maltodextrin (a glucose polymer) and the other with almost none (1.8 kcal), the share of intake going to the maltodextrin-paired flavor rose, mainly in the 28 of 52 volunteers who preferred it less at the start, though they did not rate it as more pleasant.³⁶ 36 RIBEIRO et al., PLOS Biology, 2024. DOI A human PET and fMRI study found a delayed, post-ingestive dopamine release after palatable food, and release in some brain regions tracked the desire to eat.³⁷ 37 THANARAJAH et al., Cell Metabolism, 2019. DOI So this gut-driven wanting is documented, but in these studies it is a learned preference for calories, not specific to sugar, and it is not the same as addiction: a narrative review in a sponsored journal supplement found little evidence for sugar addiction in humans, and addiction-like bingeing in animals arises with intermittent access to sweet food.³⁸ 38 WESTWATER et al., European Journal of Nutrition, 2016. DOI

Cutting saturated fat lowers LDL cholesterol a little in randomized trials,³⁹ 39 HOOPER et al., Cochrane Database of Systematic Reviews, 2020. DOI and a consensus statement concludes that LDL cholesterol causes atherosclerotic cardiovascular disease (many of its authors disclose ties to makers of LDL-lowering drugs).⁴⁰ 40 FERENCE et al., European Heart Journal, 2017. DOI In those long trials, cutting saturated fat reduced combined cardiovascular events by about 17% but did not clearly change mortality.³⁹ 39 HOOPER et al., Cochrane Database of Systematic Reviews, 2020. DOI The benefit is little or none for people at low risk and may be important for people at high risk (low to moderate certainty), and in a subgroup analysis the effect on nonfatal heart attacks was larger when polyunsaturated fat replaced the saturated fat (interaction P = 0.05).⁴¹ 41 STEEN et al., Annals of Internal Medicine, 2026. DOI

For foods where sugar and fat come together, see Favor Minimally Processed Food.

Practice Fasting

Time-restricted eating (eating within a daily window of roughly 8 to 12 hours) helps people with overweight or obesity lose a little weight (low-certainty evidence), and subgroup analyses in a meta-analysis of 19 mostly short trials suggest that is mostly because they eat less.⁴² 42 CHANG et al., iScience, 2024. DOI In a 12-month trial of 139 people with obesity, adding an 8-hour eating window to calorie restriction did not significantly improve weight loss beyond calorie restriction alone (net difference -1.8 kg, 95% CI -4.0 to 0.4),⁴³ 43 LIU et al., New England Journal of Medicine, 2022. DOI and in a second 12-month trial an 8-hour window without calorie counting was not significantly different from calorie restriction.⁴⁴ 44 LIN et al., Annals of Internal Medicine, 2023. DOI A network meta-analysis of 99 mostly short trials (median 12 weeks) found intermittent fasting about as good as continuous calorie restriction for weight and cardiometabolic markers.⁴⁵ 45 SEMNANI-AZAD et al., BMJ, 2025. DOI

The fasting-mimicking diet (five low-calorie days a month) reduced body weight, blood pressure, and IGF-1 in a 100-person, 3-month randomized trial of generally healthy adults (the diet came from L-Nutra, a company in which two of the authors hold equity),⁴⁶ 46 WEI et al., Science Translational Medicine, 2017. DOI and lowered HbA1c, IGF-1, and blood pressure across 11 small, varied randomized trials.⁴⁷ 47 MOHAMMADZADEH et al., Diabetology & Metabolic Syndrome, 2025. DOI In a 30-person pilot trial sponsored by the diet's maker, it changed autophagic flux (cellular recycling, measured in blood cells) by the end of 6 days, though not at every time point.⁴⁸ 48 ESPINOZA et al., GeroScience, 2025. DOI

Does fasting trigger cellular defenses? In animals, yes: a narrative review of rodent and human work describes fasting activating adaptive stress-response pathways that improve mitochondrial health, DNA repair, and autophagy, and it calls for randomized trials to show that this improves health in humans.⁴⁹ 49 MATTSON et al., Ageing Research Reviews, 2017. DOI The human data are small and inconsistent. In 11 overweight adults who ate matched food for four days, an 8 am to 2 pm eating window lowered 24-hour glucose by 4 mg/dl compared with an 8 am to 8 pm window and, in the morning before breakfast, raised the blood-cell expression of the autophagy gene LC3A and the stress-response gene SIRT1 (exploratory outcomes), which is gene expression, not measured autophagy.⁵⁰ 50 JAMSHED et al., Nutrients, 2019. DOI In a 6-month trial of 121 adults with obesity that measured autophagic flux, the intermittent fasting group differed from standard care at 6 months (P = 0.04, post hoc), possibly partly because autophagy tended to fall in the control group, and flux did not rise significantly from baseline in the fasting group itself.⁵¹ 51 BENSALEM et al., The Journal of Physiology, 2025. DOI In 50 women on an 8-week intermittent fasting protocol (two fasting arms, no non-fasting control), muscle autophagy markers were not activated, and several mRNA markers fell in the group eating 70% of its energy needs, although one marker rose after a 24-hour fast.⁵² 52 CHAUDHARY et al., Nutrition, 2022. DOI So the cellular mechanism is established in animals, and short human trials show small metabolic changes, but the 12-month weight-loss trials above found no advantage over calorie restriction.

Adopt a Plant-Based Diet

Plant-based diets shrink your food footprint: the impacts of the lowest-impact animal products typically exceed those of vegetable substitutes,⁵³ 53 POORE and NEMECEK, Science, 2018. DOI and modeling suggests flexitarian to vegan diets could cut food-related greenhouse gas emissions by 54 to 87%.⁵⁴ 54 SPRINGMANN et al., The Lancet Planetary Health, 2018. DOI

In cohort studies, vegetarians had lower risk of ischemic heart disease (incidence and/or mortality, relative risk 0.75) and lower total cancer incidence (0.92), but not lower cancer or all-cause mortality; vegans had lower cancer incidence (0.85, from few studies).⁵⁵ 55 DINU et al., Critical Reviews in Food Science and Nutrition, 2017. DOI Mostly small randomized trials show improvements in weight, blood pressure, HbA1c, and LDL cholesterol, and unhealthy vegetarian diets, poor in nutrients like B12, iron, zinc, and calcium or rich in refined foods, are linked to higher risk.⁵⁶ 56 WANG et al., European Heart Journal, 2023. DOI Plant-based diets tend to be lower in saturated fat and higher in fiber.⁵⁷ 57 MELINA et al., Journal of the Academy of Nutrition and Dietetics, 2016. DOI

The evidence on animal protein is mixed. One observational cohort study, based on a single diet recall and with an author holding equity in the medical-food company L-Nutra, tied high protein intake at ages 50 to 65 to a 75% higher mortality and a four-fold increase in cancer death, with the link weakened or abolished for plant protein and reversed after 65.⁵⁸ 58 LEVINE et al., Cell Metabolism, 2014. DOI A meta-analysis of 31 cohorts found higher total protein associated with lower all-cause mortality and plant protein with lower all-cause and cardiovascular mortality, and animal protein not significantly associated with cancer mortality.⁵⁹ 59 NAGHSHI et al., BMJ, 2020. DOI The clearest signal is for red and processed meat, not for animal protein as a whole. A meta-analysis of prospective studies found that the highest versus lowest intake of processed meat went with an 18% higher risk of colorectal cancer and red meat with 10%, and red meat also with higher risk of breast, endometrial, and lung cancer.⁶⁰ 60 FARVID et al., European Journal of Epidemiology, 2021. DOI A separate review rated the certainty of this evidence low to very low and the absolute effects very small: three fewer servings of processed meat a week went with very small decreases in cancer mortality and in esophageal, colorectal, and breast cancer.⁶¹ 61 HAN et al., Annals of Internal Medicine, 2019. DOI Heme iron, which meat contains, is one proposed mechanism: a meta-analysis found 18% higher colon cancer risk at the highest heme iron intake,⁶² 62 BASTIDE et al., Cancer Prevention Research, 2011. DOI but pooled analyses of three cohorts (211,851 participants, up to 36 years of follow-up) found heme iron largely unassociated with colorectal cancer (hazard ratio 1.03, 95% CI 0.91 to 1.17).⁶³ 63 SHI et al., Cancer Causes & Control, 2026. DOI

IGF-1, a growth signal, is the other suspect. In 14,709 US nurses and health professionals, those in the top fifth of animal protein intake had 4.8% higher IGF-1 (seen only in participants with at least one unhealthy lifestyle risk factor, such as overweight, inactivity, smoking, or heavy drinking), and IGF-1 and its binding proteins statistically accounted for about 5 to 20% of the link between animal protein and type 2 diabetes, but plant protein was also positively associated with IGF-1.⁶⁴ 64 LEE et al., Clinical Nutrition, 2022. DOI In a 6-week trial of 37 people with type 2 diabetes, diets with 30% of energy from animal or plant protein raised IGF-1 from baseline, with no detectable difference between the two sources.⁶⁵ 65 SCHÜLER et al., European Journal of Nutrition, 2021. DOI So IGF-1 levels do not clearly separate animal protein from plant protein. On inflammation, a meta-analysis of 18 randomized trials found a small rise in C-reactive protein with total red meat intake, but not in the subgroup of unprocessed red meat alone, and limited trials showed no change in IL-6 or TNF-alpha.⁶⁶ 66 WANG et al., Critical Reviews in Food Science and Nutrition, 2026. DOI Plant-based diets tend to contain less saturated fat;⁵⁷ 57 MELINA et al., Journal of the Academy of Nutrition and Dietetics, 2016. DOI for what that means, see Reduce Sweets and Saturated Fats.

It's OK to take supplements...

...but don't overdo it. On a varied diet only a few have reliable evidence of benefit, and some help only specific groups. Vitamin D is covered under Sunlight.

Creatine. Creatine pays off with resistance training. A meta-analysis of 35 randomized trials (1,192 participants) found 1.10 kg more lean mass with resistance training (95% CI 0.56 to 1.65) and no statistically significant effect without it (0.03 kg, 95% CI −0.65 to 0.70),⁶⁷ 67 DELPINO et al., Nutrition, 2022. DOI and a preregistered meta-analysis of 12 studies in adults under 50 found 1.14 kg more lean mass (0.69 to 1.59; 11 studies) and 0.73 kg less fat mass (−1.34 to −0.11; 7 studies) than resistance training alone, mostly in small trials of men; the two analyses share some of the same trials.⁶⁸ 68 DESAI et al., Journal of Strength & Conditioning Research, 2024. DOI In older adults doing resistance training, 22 randomized trials (721 participants) found 1.37 kg more lean tissue (0.97 to 1.76),⁶⁹ 69 CHILIBECK et al., Open Access Journal of Sports Medicine, 2017. DOI while a GRADE-rated analysis of 11 trials in adults 60 and older found a small strength gain of moderate certainty (g = 0.31, 95% CI 0.18 to 0.45) but only a positive, statistically non-significant and imprecise effect on muscle mass (6 studies, g = 0.35, 95% CI −0.09 to 0.78; low certainty).⁷⁰ 70 YAO et al., Frontiers in Nutrition, 2026. DOI Vegetarians start with lower muscle creatine (117 versus 130 mmol/kg in an 8-week trial of 42 people) and gained more lean tissue from supplementation.⁷¹ 71 BURKE et al., Medicine & Science in Sports & Exercise, 2003. DOI In a meta-analysis of mostly small studies (12 for serum creatinine, 5 for glomerular filtration rate), creatine raised serum creatinine slightly without a significant change in filtration rate,⁷² 72 NAEINI et al., BMC Nephrology, 2025. DOI and a 12-week trial in 26 young resistance-trained men (46 randomized), one of the studies in that review, measured filtration rate directly and found no change and no significant rise in serum creatinine.⁷³ 73 LUGARESI et al., Journal of the International Society of Sports Nutrition, 2013. DOI In a preregistered crossover trial of 123 adults taking 5 g a day for 6 weeks, 17% reported a side effect on creatine versus 4% on placebo, most often digestive problems (6% vs 2%) and weight gain (3% vs 0%).⁷⁴ 74 SANDKÜHLER et al., BMC Medicine, 2023. DOI

Vitamin B12. Low B12 status is uncommon in US adults, most of whom eat animal foods: in NHANES 1999 to 2004 (12,335 adults), 2.7% had low or transitional status on a proposed combined indicator of serum B12, methylmalonic acid, and homocysteine (a proposed cutoff that the authors say may need revision).⁷⁵ 75 MINEVA et al., The American Journal of Clinical Nutrition, 2021. DOI The Institute of Medicine advises people over 50 to get B12 mainly from fortified food or a supplement, because an estimated 10 to 30 percent of older people may be unable to absorb the B12 in food.⁷⁶ 76 INSTITUTE OF MEDICINE, National Academies Press, 1998. DOI In a randomized trial of 390 insulin-treated people with type 2 diabetes, metformin lowered serum B12 by 19% over 4.3 years and raised the absolute risk of deficiency by 7.2 percentage points.⁷⁷ 77 DE JAGER et al., BMJ, 2010. DOI In a Kaiser Permanente case-control study of 25,956 people with a B12 deficiency diagnosis and 184,199 controls, being dispensed two or more years of proton pump inhibitors went with higher odds of a deficiency diagnosis (OR 1.65, 95% CI 1.58 to 1.73).⁷⁸ 78 LAM et al., JAMA, 2013. DOI Older adults with atrophic gastritis, or taking higher doses of proton pump inhibitors, are more likely to have low B12,⁷⁹ 79 PORTER et al., The American Journal of Clinical Nutrition, 2021. DOI and metformin, proton pump inhibitors, and H2 blockers can reduce B12 absorption, though whether this causes clinical deficiency is unproven (a review whose record lists a vitamin maker as funder).⁸⁰ 80 MILLER, Advances in Nutrition, 2018. DOI Vegetarians are at risk of deficiency and should consider B12 supplements,⁸¹ 81 PAWLAK et al., Nutrition Reviews, 2013. DOI and vegans need a reliable source such as fortified foods or supplements.⁵⁷ 57 MELINA et al., Journal of the Academy of Nutrition and Dietetics, 2016. DOI A systematic review of mostly observational studies, by authors employed by Unilever (a company that sells fortified foods and supplements), found that meat-eaters have higher B12 intake and status than people on plant-based diets.⁸² 82 NEUFINGERL and EILANDER, Nutrients, 2022. DOI

Pregnancy. Anyone who could become pregnant should take 400 to 800 µg of folic acid a day to prevent neural tube defects.⁸³ 83 US PREVENTIVE SERVICES TASK FORCE et al., JAMA, 2023. DOI The American Thyroid Association recommends that women take a multivitamin containing 150 µg of iodine daily, as potassium iodide, before conception, during pregnancy, and while breastfeeding, and advises against iodine or kelp supplements above 500 µg a day.⁸⁴ 84 LEUNG et al., Thyroid, 2015. DOI In pregnancy, omega-3 lowered preterm birth before 37 weeks in a Cochrane review (RR 0.89, 95% CI 0.81 to 0.97; 26 trials, 10,304 women; two authors disclose ties to dairy and infant-nutrition companies).⁸⁵ 85 MIDDLETON et al., Cochrane Database of Systematic Reviews, 2018. DOI

A well-planned plant-based diet can cover most needs, but vegans need a reliable B12 source.⁵⁷ 57 MELINA et al., Journal of the Academy of Nutrition and Dietetics, 2016. DOI A systematic review of 141 studies, by authors employed by Unilever, found that iodine intake was lower on plant-based diets, and iron and zinc status tended to be lower even though iron intake was higher, while meat-eaters were at risk of inadequate intake of fiber, folate, and magnesium.⁸² 82 NEUFINGERL and EILANDER, Nutrients, 2022. DOI Get tested for a specific nutrient when you have symptoms or a risk factor, not as a routine bundle. Other conditions or medications might interfere with nutrient absorption. Talk to your health professional.

Favor Minimally Processed Food

Eat mostly whole, minimally processed food and limit ultra-processed products such as packaged snacks and ready meals. In a hospital trial, 20 adults ate about 500 kcal a day more over two weeks on an ultra-processed diet than on an unprocessed one with matched nutrients, gaining 0.9 kg on one and losing 0.9 kg on the other.⁸⁶ 86 HALL et al., Cell Metabolism, 2019. DOI An umbrella review of observational studies links higher intake to cardiovascular death and type 2 diabetes with statistically "convincing" associations, though the certainty of the underlying evidence is mostly low (very low for cardiovascular death, moderate for diabetes).⁸⁷ 87 LANE et al., BMJ, 2024. DOI

Organic Is Optional

Organic crops do differ. A meta-analysis of 343 crop-composition studies, partly funded by a trust that supports organic farming research, found more polyphenols in organic crops (about 19% more phenolic acids and 51% more anthocyanins), less cadmium, and pesticide residues four times less often.⁸⁸ 88 BARAŃSKI et al., British Journal of Nutrition, 2014. DOI Vitamins and minerals are a different story. A systematic review of satisfactory-quality studies found no evidence of a difference in 8 of 11 crop nutrient categories, with more nitrogen in conventional crops and more phosphorus in organic ones.⁸⁹ 89 DANGOUR et al., The American Journal of Clinical Nutrition, 2009. DOI An analysis restricted to studies that accounted for cultivar, harvest, and soil found total micronutrient content 5.7% higher on average in organic plant foods, with organic higher in more comparisons (462 versus 364),⁹⁰ 90 HUNTER et al., Critical Reviews in Food Science and Nutrition, 2011. DOI and a vote-count review of 147 articles found no difference in 42% of comparisons, a difference in 29%, and conflicting results in 29%, concluding that organic food is not generally more nutritious.⁹¹ 91 THAISE DE OLIVEIRA FAORO et al., Heliyon, 2024. DOI So organic produce is richer in polyphenols, but not much richer in vitamins and minerals. Few human studies measured health outcomes.⁹² 92 SMITH-SPANGLER et al., Annals of Internal Medicine, 2012. DOI So buy organic if you want fewer residues, but don't count on a health benefit. Organic farming used more land per unit of output and had similar climate impact per kilogram in a pooled analysis of 100 life cycle assessments.⁹³ 93 HASHEMI et al., Communications Earth & Environment, 2024. DOI

Consult a Dietician

If you want to lose weight or manage diabetes, see a registered dietitian instead of going alone. A systematic review and meta-analysis of 62 randomized trials, produced by the Academy of Nutrition and Dietetics' Evidence Analysis Center, found that, in adults with overweight or obesity, dietitian-led weight programs led to about 4 percentage points more body weight lost than usual care or no intervention.⁹⁴ 94 MORGAN-BATHKE et al., Journal of the Academy of Nutrition and Dietetics, 2023. DOI In primary care, dietitian visits improved blood sugar control in all four trials that targeted it, but the evidence for cholesterol and blood pressure is weaker.⁹⁵ 95 MITCHELL et al., Journal of the Academy of Nutrition and Dietetics, 2017. DOI

Sunlight

Light Sets Your Body Clock

Light reaches the body clock through the eyes. Retinal ganglion cells that contain melanopsin, most sensitive to blue-green light near 480 nm, combine their own signal with input from rods and cones to set the clock and suppress melatonin.^{96, 97} 96 BROWN, Journal of Pineal Research, 2020. DOI 97 BROWN et al., PLOS Biology, 2022. DOI Outdoor light is far brighter than indoor light: in a study of 55 adults, wrist-device readings of ambient light were about 142 lux under indoor artificial light and about 176,000 lux outdoors in summer.⁹⁸ 98 OSTRIN, Optometry and Vision Science, 2017. DOI An expert consensus whose authors include several with lighting-industry ties recommends at least 250 melanopic lux at the eye by day, at most 10 in the 3 hours before bed, and at most 1 for sleep (melanopic lux measures how strongly light drives these cells).⁹⁷ 97 BROWN et al., PLOS Biology, 2022. DOI

Get Outside in the Morning

Get outside or sit by a bright window in the morning. A systematic review of 45 studies of healthy adults found broad trends: brighter morning light went with an earlier sleep period and better self-reported sleep, and light above 1,000 lux went with better objectively measured sleep than dim or moderate light.⁹⁹ 99 DAUTOVICH et al., Sleep Health, 2019. DOI In an observational study of 109 office workers, more morning light went with falling asleep faster (self-reported).¹⁰⁰ 100 FIGUEIRO et al., Sleep Health, 2017. DOI In 8 adults, a week of camping with only natural light moved markers of internal circadian time about 2 hours earlier than a week of normal electrically lit life.¹⁰¹ 101 WRIGHT et al., Current Biology, 2013. DOI A lamp did not clearly help: in a randomized trial of 191 older adults, 12 weeks of self-directed use of a lamp rated above 8,000 melanopic lux at 20 cm (about half reported daily use) produced no significant overall difference in rest-activity and sleep outcomes.¹⁰² 102 CONSTANTINO et al., Journal of Pineal Research, 2026. DOI

Dim the Evening, Darken the Night

In a study of 59 homes, nearly half were predicted, from wearable light recordings and laboratory dose-response curves, to suppress melatonin by at least 50% on average, with predicted individual responses in the average home ranging from 0 to 87%.¹⁰³ 103 CAIN et al., Scientific Reports, 2020. DOI In 72 healthy men, evening display light with lower melanopic content, matched for luminance and color, shortened the time to fall asleep and reduced melatonin suppression, though the sleep-latency difference was significant only in the brightest of four luminance groups.¹⁰⁴ 104 SCHÖLLHORN et al., Communications Biology, 2023. DOI In 88,905 UK adults who wore a light sensor for a week, the brightest 10% of night light went with higher all-cause mortality over 8 years (adjusted hazard ratios 1.21 to 1.34) and the brightest 10% of daytime light with lower mortality (0.66 to 0.83); this is observational, so illness and lifestyle may shape both light exposure and mortality, and two of the authors have lighting-industry funding and another co-founded the maker of the sensor.¹⁰⁵ 105 WINDRED et al., Proceedings of the National Academy of Sciences, 2024. DOI Dim the lights in the 3 hours before bed and keep the bedroom dark.⁹⁷ 97 BROWN et al., PLOS Biology, 2022. DOI

Children Need Time Outdoors

Extra outdoor time lowers a child's risk of developing myopia. In a cluster randomized trial of 1,903 first-graders in Guangzhou, an extra 40-minute outdoor class each school day plus parental encouragement of outdoor time lowered 3-year myopia incidence among initially non-myopic children to 30.4% from 39.5% (difference −9.1 percentage points, 95% CI −14.1 to −4.1).¹⁰⁶ 106 HE et al., JAMA, 2015. DOI A Shanghai trial of 6,295 students aged 6 to 9 found an adjusted incidence risk ratio of 0.84 (95% CI 0.72 to 0.99) over 2 years in schools allocated 40 extra outdoor minutes a day; measured outdoor time was only about 20 minutes a day higher than in controls, and 80 added minutes did no better.¹⁰⁷ 107 HE et al., Ophthalmology, 2022. DOI A meta-analysis of 7 randomized trials (9,437 children, including both trials above) found a pooled risk ratio of 0.84 (95% CI 0.78 to 0.91) for myopia onset, based on 5 trials,¹⁰⁸ 108 MEI et al., Frontiers in Public Health, 2024. DOI though a 2025 analysis rated certainty low for how many hours outdoors are needed (moderate for refraction, high for axial length).¹⁰⁹ 109 MARTINEZ-PEREZ et al., Acta Ophthalmologica, 2025. DOI Outdoor time lowered the risk of new myopia, but a dose-response analysis of six studies in children who already had myopia showed outdoor time unrelated to progression.¹¹⁰ 110 XIONG et al., Acta Ophthalmologica, 2017. DOI

Sun on the Skin

Sunlight acts on the skin in ways that go beyond vitamin D. UVA releases nitric oxide stored in the skin: in a small group of healthy volunteers, 20 J/cm² of whole-body UVA lowered systolic and diastolic blood pressure by 11% at 30 minutes, for up to 60 minutes.¹¹¹ 111 OPLÄNDER et al., Circulation Research, 2009. DOI In 24 healthy volunteers, UVA at two standard erythemal doses lowered blood pressure, and UVA on the forearm raised blood flow independently of nitric oxide synthase activity, which suggests preformed skin stores.¹¹² 112 LIU et al., Journal of Investigative Dermatology, 2014. DOI A lasting effect is not established. In a randomized, sham-controlled crossover trial of 13 adults with high-normal or stage 1 hypertension (80 were planned), 5 J/cm² of whole-body UVA daily for 14 days did not change 24-hour ambulatory blood pressure, although clinic blood pressure within 90 minutes of the last exposure fell by 8.0/3.8 mm Hg with UVA and did not change with sham (+1.1/+0.9); this trial and the 24-volunteer study share two authors.^{113, 112} 113 WELLER et al., Journal of Human Hypertension, 2022. DOI 112 LIU et al., Journal of Investigative Dermatology, 2014. DOI In a separate randomized trial of 119 adults with low vitamin D, 24 whole-body UVB or UVA sessions over 12 weeks left ambulatory blood pressure unchanged in both arms (UVB minus UVA difference −2.2 mm Hg systolic, 95% CI −7.8 to 3.3), even though 25(OH)D rose from 43.7 to 92.6 nmol/L with UVB and from 45.4 to 64.9 nmol/L with UVA.¹¹⁴ 114 SCRAGG et al., Journal of Hypertension, 2011. DOI

Cohort studies point both ways. In a Swedish cohort of 29,518 women followed for 20 years, women who avoided sun had about twice the all-cause mortality rate of women with the highest sun exposure (rate ratio 2.0, 95% CI 1.6 to 2.5), but avoiders differed in age and income, and a published critique of a follow-up analysis of the same cohort argued that sun avoidance may mark chronic disease rather than cause death.^{115, 116} 115 LINDQVIST et al., Journal of Internal Medicine, 2014. DOI 116 HOFFMANN and SOBOTZKI, Journal of Internal Medicine, 2017. DOI In the Adventist Health Study-2 (83,205 adults), 2 hours a day outdoors in daylight in warmer months, compared with 30 minutes, went with lower all-cause mortality (HR 0.90, 95% CI 0.86 to 0.93) and cardiovascular mortality (0.89, 0.83 to 0.95), with no clear difference in cancer mortality at 2 hours and higher cancer mortality at 5 hours a day (HR 1.15, 95% CI 1.02 to 1.29).¹¹⁷ 117 NAZEEH et al., Environmental Epidemiology, 2025. DOI In the NIH-AARP cohort (346,615 white, non-Hispanic adults aged 50 to 71), living in the highest quartile of ambient UV radiation went with higher all-cause mortality than the lowest (HR 1.06, 95% CI 1.03 to 1.09).¹¹⁸ 118 LIN et al., American Journal of Epidemiology, 2013. DOI Observational data like these cannot separate sunlight from the health and income that let people spend time outdoors.

Vitamin D: Sun, Season, Supplements

In adults, low vitamin D status looks more like a marker of ill health than a cause of it. A systematic review of 290 prospective cohorts and 172 trials concluded that the gap between moderate to strong observational associations and trials that did not show an effect on disease occurrence suggests low 25(OH)D is a marker of ill health, although low-dose supplementation in elderly people seemed to slightly reduce all-cause mortality.¹¹⁹ 119 AUTIER et al., The Lancet Diabetes & Endocrinology, 2014. DOI In the D-Health trial (21,315 Australians aged 60 or older, 60,000 IU monthly for 5 years), vitamin D did not change all-cause mortality (HR 1.04, 95% CI 0.93 to 1.18).¹²⁰ 120 NEALE et al., The Lancet Diabetes & Endocrinology, 2022. DOI A stratified Mendelian randomization of 386,406 middle-aged people of European ancestry showed genetically predicted 25(OH)D unrelated to coronary heart disease, stroke, or all-cause mortality at any observed level, although small effects cannot be excluded (a revised analysis; the journal retracted the earlier version and republished it).^{121, 122} 121 SOFIANOPOULOU et al., The Lancet Diabetes & Endocrinology, 2024. DOI 122 THE EDITORS OF THE LANCET DIABETES & ENDOCRINOLOGY, The Lancet Diabetes & Endocrinology, 2024. DOI In VITAL, a trial of 25,871 US men aged 50 and older and women aged 55 and older, 2,000 IU of vitamin D a day did not reduce cancer or cardiovascular events in participants not selected for vitamin D deficiency,^{123, 124} 123 MANSON et al., New England Journal of Medicine, 2019. DOI 124 LEBOFF et al., New England Journal of Medicine, 2022. DOI or fractures in participants not selected for low bone mass.¹²⁴ 124 LEBOFF et al., New England Journal of Medicine, 2022. DOI The 2024 Endocrine Society guideline suggests vitamin D supplementation for children and adolescents, adults over 75, pregnant women, and people with high-risk prediabetes, and suggests against going above the recommended intake in healthy adults under 75 or testing 25(OH)D routinely.¹²⁵ 125 DEMAY et al., The Journal of Clinical Endocrinology & Metabolism, 2024. DOI So supplementing above the recommended intake is not supported in healthy adults under 75.

The sun is not a year-round vitamin D plan. In a laboratory model, winter sunlight in Boston from November through February produced no previtamin D3 in sunlit skin samples, and in Edmonton the ineffective period ran from October through March.¹²⁶ 126 WEBB et al., The Journal of Clinical Endocrinology & Metabolism, 1988. DOI In the UK, modeling based on all-weather UV data suggests that about 9 minutes of lunchtime sun a day from March to September (with forearms and lower legs exposed in summer) keeps white adults at or above 25 nmol/L through winter, which is the paper's threshold for deficiency.¹²⁷ 127 WEBB et al., Nutrients, 2018. DOI For people at intermediate skin cancer risk, an Australian expert consensus statement says sun exposure, at Australian UV levels, can maintain adequate vitamin D.¹²⁸ 128 NEALE et al., Australian and New Zealand Journal of Public Health, 2024. DOI

Avoid Sunburn

Sun causes skin cancer, so one narrative review, which calls the evidence on vitamin D and skin cancer controversial, recommends that people at risk keep sun protection and preferably source vitamin D through diet.¹²⁹ 129 MARTIN-GORGOJO et al., Nutrients, 2021. DOI Burning is the clearest line. A 2025 meta-analysis of studies in Fitzpatrick skin types I to IV pooled an adjusted odds ratio of 1.23 (95% CI 1.04 to 1.46) for melanoma with a history of sunburn,¹³⁰ 130 KWA et al., Journal of the European Academy of Dermatology and Venereology, 2025. DOI and a 2008 meta-analysis pooled 51 study populations for ever versus never sunburned and, in the 26 with dose-response data, found melanoma risk rising with the number of sunburns in childhood, adolescence, and adulthood.¹³¹ 131 DENNIS et al., Annals of Epidemiology, 2008. DOI A meta-analysis of 57 studies found intermittent sun exposure and sunburn to be risk factors for melanoma, while high continuous occupational exposure appeared inversely associated.¹³² 132 GANDINI et al., European Journal of Cancer, 2005. DOI The US Preventive Services Task Force recommends counseling people aged 6 months to 24 years with fair skin about minimizing UV exposure (grade B), and selective counseling for fair-skinned adults over 24 (grade C), because the net benefit there is small.¹³³ 133 US PREVENTIVE SERVICES TASK FORCE et al., JAMA, 2018. DOI For spots that change, see Dermatologist for Spots That Change.

Red and Infrared Light

Evidence that red or near-infrared light improves human vision comes mainly from one London laboratory, in small studies. In a study of adults aged 28 to 72, 670 nm light improved blue-axis color contrast sensitivity in those around 40 and older; the red-axis improvement was not significant.¹³⁴ 134 SHINHMAR et al., The Journals of Gerontology: Series A, 2020. DOI In a single-blind trial of 55 office workers, a week with an added warm-white LED desk lamp raised color-test error scores by 33% (15 people), while the same lamp with added 850 nm infrared lowered them by 23% (20 people); 20 controls under ordinary office lighting did not change.¹³⁵ 135 ROBINSON et al., PLOS One, 2026. DOI In an uncontrolled pilot, daily 670 nm light for 12 months did not improve function in the 23 people with intermediate macular degeneration who completed it.¹³⁶ 136 GREWAL et al., Journal of Clinical Medicine, 2020. DOI These results are preliminary.

Sleep

Get Light in the Morning

See Get Outside in the Morning under Sunlight.

Have a Consistent Schedule

Go to bed and wake up at about the same time every day. In an observational cohort of 60,977 UK adults, the more regular sleepers had 20 to 48% lower all-cause mortality over about six years than the least regular fifth, and regularity was a stronger predictor of mortality than sleep duration in model comparisons.¹³⁷ 137 WINDRED et al., SLEEP, 2024. DOI A systematic review of 59 mostly observational studies links irregular sleep timing to depressive symptoms, hypertension, and cardiovascular events, and its authors call for randomized trials of schedule stabilization.¹³⁸ 138 KALKANIS et al., Sleep Medicine Reviews, 2025. DOI

Set a Go-to-Bed Alarm

Set an alarm for when you want to start winding down, not only for when you wake up. A fixed, planned bedtime may help: in a meta-analysis of 42 highly heterogeneous sleep-extension studies, programs that specified a sleep schedule had larger effects on sleep duration than indirect approaches such as coaching or education,¹³⁹ 139 BARON et al., Sleep Medicine Reviews, 2021. DOI and in an observational study of 119 university students, nights with a bedtime plan started about 12 minutes earlier.¹⁴⁰ 140 PU et al., Sleep Medicine, 2025. DOI

Sleep 7-Hour+ Every Night

Sleep at least 7 hours a night. The American Academy of Sleep Medicine and the Sleep Research Society recommend 7 or more hours for adults,¹⁴¹ 141 WATSON et al., Journal of Clinical Sleep Medicine, 2015. DOI and an overview of 11 systematic reviews, mostly of cohort studies, found 7 to 8 hours was the range most favorably linked to health.¹⁴² 142 CHAPUT et al., Applied Physiology, Nutrition, and Metabolism, 2020. DOI Very long sleep is also associated with worse outcomes, but whether it causes them is unresolved.¹⁴³ 143 JIKE et al., Sleep Medicine Reviews, 2018. DOI

Recharge with NSDR Protocols

Try a 10-minute guided relaxation recording (NSDR or yoga nidra) when you feel drained. In a randomized trial of 102 physically active young adults, one 10-minute session lowered self-rated fatigue, sleepiness, and stress compared with 10 minutes of sitting quietly, with differences still present 40 minutes later, though the effects were small and physical performance did not change.¹⁴⁴ 144 BOUKHRIS et al., Applied Psychology: Health and Well-Being, 2026. DOI A two-month online yoga nidra trial, mostly against a waitlist control, found very small effects on self-reported well-being (d 0.08 to 0.16).¹⁴⁵ 145 MOSZEIK et al., Stress and Health, 2025. DOI Don't treat it as a fix for insomnia: in a network meta-analysis of 241 trials, adding relaxation procedures (not NSDR specifically) to cognitive behavioral therapy for insomnia did not significantly improve remission (incremental odds ratio 0.81, 95% CI 0.64 to 1.02).¹⁴⁶ 146 FURUKAWA et al., JAMA Psychiatry, 2024. DOI

Visit a Sleep Clinic

See a sleep clinic if you snore loudly, feel sleepy through the day, or have struggled to sleep for months. A modeling study funded by ResMed, a maker of sleep apnea devices, estimated that 425 million adults aged 30 to 69 have moderate-to-severe sleep apnea by sleep-test criteria,¹⁴⁷ 147 BENJAFIELD et al., The Lancet Respiratory Medicine, 2019. DOI and cognitive behavioral therapy for insomnia (CBT-I) still improved insomnia 12 months after treatment in a meta-analysis of randomized trials, though the effect shrank (insomnia severity g 0.64 at 3 months, 0.25 at 12 months).¹⁴⁸ 148 VAN DER ZWEERDE et al., Sleep Medicine Reviews, 2019. DOI For adults without recognized symptoms, the US Preventive Services Task Force found the evidence on sleep apnea screening insufficient.¹⁴⁹ 149 US PREVENTIVE SERVICES TASK FORCE et al., JAMA, 2022. DOI

Fitness

Exercise Weekly

Do at least 150 to 300 minutes of moderate activity per week, or at least 75 to 150 minutes of vigorous activity.¹⁵⁰ 150 BULL et al., British Journal of Sports Medicine, 2020. DOI In a pooled analysis of six cohorts totaling 661,137 adults, 150 to 300 minutes of moderate activity per week went with 31% lower mortality than no leisure-time activity.¹⁵¹ 151 AREM et al., JAMA Internal Medicine, 2015. DOI

Strengthen

Do muscle-strengthening exercise that works all major muscle groups on at least 2 days a week.¹⁵⁰ 150 BULL et al., British Journal of Sports Medicine, 2020. DOI In a meta-analysis of 16 prospective cohort studies (very low certainty by the authors' GRADE rating), about 30 to 60 minutes a week went with 10 to 20% lower risk of death, cardiovascular disease, and cancer, and the benefit of doing more was unclear.¹⁵² 152 MOMMA et al., British Journal of Sports Medicine, 2022. DOI

Stand Up and Move

Sit less, and break up long stretches of sitting with short walks. In eight accelerometer cohorts, the most sedentary quarter of middle-aged and older adults had 2.6 times the risk of death of the least sedentary quarter.¹⁵³ 153 EKELUND et al., BMJ, 2019. DOI In seven one-day trials in mostly overweight adults, with results that varied widely between trials, light walking breaks lowered blood sugar after meals, and insulin too in the four trials that measured it; standing breaks lowered blood sugar by less.¹⁵⁴ 154 BUFFEY et al., Sports Medicine, 2022. DOI

Stretch

Stretch to keep your range of motion, not to prevent injuries. Stretch training increased range of motion in healthy people in a meta-analysis of 77 studies,¹⁵⁵ 155 KONRAD et al., Journal of Sport and Health Science, 2024. DOI but pooled trials found no reduction in sports injuries from stretching (relative risk 0.96), while strength training cut them to about a third (0.32), in separate subgroups of heterogeneous trials.¹⁵⁶ 156 LAUERSEN et al., British Journal of Sports Medicine, 2014. DOI

Keep Some Impact in Your Week

In pooled observational studies, recreational runners did not have more hip or knee osteoarthritis than non-runners (odds ratio 0.86, 95% CI 0.69 to 1.07),¹⁵⁷ 157 ALENTORN-GELI et al., Journal of Orthopaedic & Sports Physical Therapy, 2017. DOI and jump training raised femoral neck bone density by about 1.5% in a meta-analysis of 18 small trials in adults.¹⁵⁸ 158 FLORENCE et al., Journal of Sports Sciences, 2023. DOI Competitive runners (professional, elite, or international level) had higher odds of hip or knee osteoarthritis than non-running controls, but the estimate is imprecise (odds ratio 1.34, 95% CI 0.97 to 1.86), and the review could not tell whether the link is causal.¹⁵⁷ 157 ALENTORN-GELI et al., Journal of Orthopaedic & Sports Physical Therapy, 2017. DOI If you already have a joint injury, osteoarthritis, or low bone density, ask a professional.

Consult a Specialist

See a doctor before you start if you get warning symptoms during activity or have a known heart, metabolic, or kidney condition. Since a 2014 expert roundtable, the American College of Sports Medicine bases pre-exercise screening on three factors: how active you already are, whether you have symptoms or known heart, metabolic, or kidney disease, and how hard you plan to exercise.¹⁵⁹ 159 RIEBE et al., Medicine & Science in Sports & Exercise, 2015. DOI It dropped risk-factor profiling, a change meant to reduce unnecessary barriers to exercise.¹⁵⁹ 159 RIEBE et al., Medicine & Science in Sports & Exercise, 2015. DOI If new muscle or joint pain starts, see a physiotherapist early: in 10 trials (certainty very low to moderate), seeing a physiotherapist first meant fewer scans (relative risk 0.55) and possibly less medication (0.29), with little to no difference in disability and very uncertain effects on pain.¹⁶⁰ 160 ABUHL et al., Physical Therapy, 2025. DOI

Health

Dentist

Go to the dentist at the interval your dentist sets for your risk, not automatically every six months. In a four-year trial of 2,372 UK adults, risk-based and 6-month check-ups gave no detectable difference in gum bleeding or quality of life, and adults a dentist judged suitable for a 24-month interval (a smaller group, about 140 per arm) showed no evidence of a difference either.¹⁶¹ 161 CLARKSON et al., Health Technology Assessment, 2020. DOI A Cochrane review, whose adult evidence is this same trial and whose authors include investigators of that trial (who did not extract its data or rate its bias), found little to no difference in cavities between the risk-based and 6-month intervals.¹⁶² 162 FEE et al., Cochrane Database of Systematic Reviews, 2020. DOI Everyone in these trials was a regular attender.^{162, 161} 162 FEE et al., Cochrane Database of Systematic Reviews, 2020. DOI 161 CLARKSON et al., Health Technology Assessment, 2020. DOI

Dermatologist for Spots That Change

See a dermatologist about any mole or spot that changes, bleeds, or looks different from the rest. Melanoma found at a later stage carries a higher risk of death,¹⁶³ 163 HENRIKSON et al., JAMA, 2023. DOI but routine full-body checks in adults with no symptoms have not been shown to lower melanoma deaths,¹⁶³ 163 HENRIKSON et al., JAMA, 2023. DOI and the US Preventive Services Task Force rates the evidence as insufficient.¹⁶⁴ 164 US PREVENTIVE SERVICES TASK FORCE et al., JAMA, 2023. DOI

Blood Tests When There Is a Reason

Get blood tests when your age, risk, or symptoms give a reason, not as a routine bundle. In a Cochrane review of randomized trials in unselected adults (15 with outcome data), general health checks had little or no effect on total mortality (risk ratio 1.00, 95% CI 0.97 to 1.03; 11 trials, high-certainty evidence).¹⁶⁵ 165 KROGSBØLL et al., Cochrane Database of Systematic Reviews, 2019. DOI One clear indication: the US Preventive Services Task Force recommends screening for prediabetes and type 2 diabetes in adults aged 35 to 70 who are overweight or obese.¹⁶⁶ 166 US PREVENTIVE SERVICES TASK FORCE et al., JAMA, 2021. DOI

Genetic Tests Only With a Reason

If you are a woman with a personal or family history of breast, ovarian, tubal, or peritoneal cancer, or an ancestry linked to BRCA mutations, ask a clinician about genetic counseling and testing. For women without such a history, the US Preventive Services Task Force recommends against routine testing.¹⁶⁷ 167 US PREVENTIVE SERVICES TASK FORCE et al., JAMA, 2019. DOI Polygenic risk scores are not ready for routine use: a systematic review concluded that translational research is still needed before they enter mainstream clinical practice.¹⁶⁸ 168 KUMUTHINI et al., Human Genetics, 2022. DOI

Sustainability

Buy Less

Buy fewer new things. In a global input-output model using 2007 data, household consumption accounted for more than 60% of global greenhouse gas emissions, and a household's footprint rises with how much it spends.¹⁶⁹ 169 IVANOVA et al., Journal of Industrial Ecology, 2016. DOI In a systematic review, most studies found an association between consuming less and higher wellbeing or no significant difference, and the authors conclude that reduced consumption does not typically have a negative association with wellbeing in wealthy nations.¹⁷⁰ 170 VOLLEBREGT et al., Sustainable Production and Consumption, 2024. DOI

Don't Waste

Buy and cook only what you will eat, and avoid packaging and single-use items you would throw away. For household food waste, prevention beat recycling: in a proof-of-concept model of Trondheim, Norway, cutting food waste by 15 to 30% avoided more emissions than the recycling strategies it was compared with.¹⁷¹ 171 DE SADELEER et al., Resources, Conservation and Recycling, 2020. DOI A life cycle model of municipal waste found that preventing waste (food, unsolicited mail, beverage packaging) cut the global warming impact of the waste system.¹⁷² 172 GENTIL et al., Waste Management, 2011. DOI

Prefer Public Transport

Take the bus or train instead of driving when you can. In a US modeling analysis, cars and public transit have similar average emissions per passenger-kilometer for urban travel, but marginal emissions are 50% lower for transit, and marginal car emissions are about 90% of the car average.¹⁷³ 173 BIGAZZI, Applied Energy, 2019. DOI Getting to and from stops also adds walking.¹⁷⁴ 174 RISSEL et al., International Journal of Environmental Research and Public Health, 2012. DOI

Slow Tourism

Take the train or coach instead of the plane when you can, and take fewer long-distance trips. A trip by train produced three to five times less emissions than a comparable trip by aircraft in a five-scenario European life cycle assessment,¹⁷⁵ 175 ROOSIEN et al., Aerospace, 2024. DOI and avoiding one transatlantic round trip saves about 1.6 tonnes of CO2-equivalent.¹⁷⁶ 176 WYNES and NICHOLAS, Environmental Research Letters, 2017. DOI

Downsize

Live in the smallest home that fits your life. In England, building size alone accounted for 24% of the variability in household energy use, against 11% for household size.¹⁷⁷ 177 HUEBNER and SHIPWORTH, Applied Energy, 2017. DOI In the US, residents of high-income ZIP codes emit about 25% more greenhouse gas per person from home energy than residents of low-income ZIP codes, mostly because their homes are larger.¹⁷⁸ 178 GOLDSTEIN et al., Proceedings of the National Academy of Sciences, 2020. DOI

Become an Urban Dweller

Choose a dense, walkable neighborhood where you can. Across the 125 largest US urbanized areas, doubling population-weighted density was associated with 48% lower CO2 from household travel and 35% lower CO2 from home energy.¹⁷⁹ 179 LEE and LEE, Energy Policy, 2014. DOI A city address alone does not shrink your footprint, though: on average in Europe, carbon footprints are 7% lower in cities than in rural areas at equal income and household characteristics, but city incomes are about 6% higher, which compensates, and the pattern differs by country.¹⁸⁰ 180 OTTELIN et al., Environmental Research Letters, 2019. DOI

One-Time Actions

Get a Comfortable Mattress

Choose a medium-firm mattress and replace it when it stops feeling supportive. A review of 39 mostly small studies, without formal quality assessment, concluded that medium-firm mattresses promote comfort, sleep quality, and spinal alignment,¹⁸¹ 181 CAGGIARI et al., Journal of Orthopaedics and Traumatology, 2021. DOI and in a randomized trial of 313 adults with chronic low back pain, a medium-firm mattress beat a firm one for pain in bed and for disability at 90 days.¹⁸² 182 KOVACS et al., The Lancet, 2003. DOI That trial included only people with back pain.

Use a Standing Desk and a Good Office Chair

Use a sit-stand desk and alternate sitting and standing through the day. Sit-stand desks cut sitting time by up to about 75 minutes a day,¹⁸³ 183 ROUYARD et al., The Lancet Public Health, 2025. DOI but in a one-year trial, adding them to a workplace program did not significantly change a combined cardiometabolic risk score (a secondary outcome; the trial's power calculation covered only sitting time and light activity).¹⁸⁴ 184 PEREIRA et al., International Journal of Behavioral Nutrition and Physical Activity, 2020. DOI Pick a chair you find comfortable and can adjust: the evidence that any chair type reduces back pain is weak and conflicting.¹⁸⁵ 185 CHANNAK et al., International Journal of Occupational Safety and Ergonomics, 2022. DOI

Install Blackout Curtains in the Bedroom

Keep your bedroom dark; blackout curtains are one way. In a laboratory study of 20 healthy adults, one night of moderate room light (100 lux) raised heart rate during sleep and increased insulin resistance the next morning,¹⁸⁶ 186 MASON et al., Proceedings of the National Academy of Sciences, 2022. DOI and a meta-analysis of seven cross-sectional studies linked light at night to more sleep problems (odds ratio 1.22), with a larger association for indoor light (1.74).¹⁸⁷ 187 XU et al., Science of The Total Environment, 2023. DOI A small crossover trial in 20 healthy men found that two nights of dim light (under 5 lux) did not change glucose, insulin, or c-peptide.¹⁸⁸ 188 CHAMORRO et al., Sleep Medicine, 2021. DOI

Relationships

These are principles, not research findings.

Always respect your partner

That also applies to friends and acquaintances. Communication, albeit important, will always break down at some point.

Sometimes, be a little deaf

When a thoughtless or unkind word is spoken, best tune out.

Be together for the right reasons

Don't be pressured into it, don't do it for image, don't think love will solve everything, and don't do it to fix yourself.

True love is a choice

Happily Ever After does not exist.

References

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