Long-lasting healthy changes: Doable and worthwhile

I've been a physician for 20 years now, and a strong proponent of lifestyle medicine for much of it. I know that it's hard to make lasting, healthy lifestyle changes, even when people know what to do and have the means to do it. Yet many studies and my own clinical experience as a Lifestyle Medicine-certified physician have shown me a few approaches that can help make long-lasting healthy lifestyle changes happen.

What is lifestyle medicine?

In the US, lifestyle medicine is built around six pillars: eating healthy foods; exercising regularly; easing stress; getting restful sleep; quitting addictive substances like tobacco and limiting alcohol; and nurturing social connections.

How will this help you? Here's one example. A study published this summer in the Journal Neurology followed over 70,000 health professionals for more than two decades. Those who reported eating a diet high in colorful fruits and vegetables had a significantly lower risk of subjective memory loss — which is a sign of dementia — compared with those who did not.

A multitude of studies over many years have mined health data on this same cohort. Harvard T.H. Chan School of Public Health nutrition expert Dr. Walter Willett observed that, based on these studies, four combined healthy lifestyle factors — a healthy diet, not smoking, engaging in moderate activity, and avoiding excess weight — could prevent about 70% to 80% of coronary heart disease and 90% of type 2 diabetes. The catch, he noted, is that only about 4% of people participating in these studies attained all four.

Abundant research shows healthy lifestyle factors protect us against serious, often disabling health problems: diabetes, high blood pressure, dementia, heart disease, strokes, cancer, and more. Clearly, taking steps toward a healthier lifestyle can make a big difference in our lives, but it can be hard to change our habits. Below are a few tips to help you start on that path.

Find motivation

What motivates you? Where will you find good reasons to change? Yes, studies show that being at a healthy weight and shape is associated with a longer life and lower risk of many chronic diseases. However, in my experience, only emphasizing weight or waist size isn't helpful for long-term healthy lifestyle change. Indeed, studies have shown that focusing too much on those numbers is associated with quitting a health kick, whereas small goals related to positive actions were associated with successful long-term lifestyle change.

Examples of this include aiming for at least 21 minutes of activity per day and/or five servings of fruits and vegetables per day. (These activity and nutrition goals are actually recommendations of the American Heart Association, FYI!) If we strive to live healthy so that we can live a long, healthy life, we have a greater chance of long-term success — which typically will result in weight and waist loss.

Put healthy habits on automatic

Healthy choices can become more automatic if you remove the "choice" part. For example, take the thinking out of every eating or activity decision by planning ahead for the week to come:

• Choose a basic menu for meals and build in convenience. Focus on simple, healthy recipes. Frozen produce is healthful, easy to keep on hand, and sometimes less expensive than fresh. Shopping the salad bar costs more, but could help on busy nights.
• Jot down your activity schedule. Choose some physical activity most days — the more vigorous and the longer the better, but anything counts! Even as little as 10 minutes of light to moderate activity per week has been associated with a longer life span.
• Track food and activity choices each day. Using an app or notebook for this can help you become more aware and accountable. Try noting barriers, too, and brainstorm workarounds for overly busy days and other issues that push you off track.

Understand how emotions affect you

If feeling stressed, angry, or sad is a trigger for overeating or another unhealthy activity, it's important to recognize this. Writing down triggers over the course of a week can enhance your awareness. Building better stress management habits can help you stick to a healthy lifestyle plan. Getting sufficient restful sleep and scheduling personal time, regular activity, and possibly meditation, therapy, or even just chats with good friends are all steps in the right direction.

A healthy lifestyle is key to a long, healthy life, and is attainable. Success may require some thoughtful trial and error, but don't give up! I have seen all kinds of patients at all ages make amazing changes, and you can, too.