Health and longevity / Chapter 2
This section covers just two types of long-term health risks: those with a major impact on overall mortality and those backed by solid evidence. The items are listed in order of cost-effectiveness. A few entries are marked “randomized trials,” meaning participants were randomly assigned to different groups for comparison — this is the most reliable type of evidence. All other figures come from observational studies that only track people over time without any grouping. These studies produce risk ratios such as HR and RR, but they also contain two kinds of confounding factors: participants naturally differ from one another, and some already had health problems before the study began. Therefore these numbers only indicate general trends and approximate magnitudes; they do not guarantee that following these steps will bring about exactly those reductions.
The items in this section are grouped by topic, with item numbers shown in parentheses.
Smoking, alcohol, and betel nut: The earlier you quit smoking, the better (Item 1); avoid smoking at home or in the car (Item 2); get medication to help you quit (Item 3); pick a specific quit date (Item 4); visit a smoking cessation clinic or call 12320 (Item 5); if quitting proves difficult, consider e‑cigarettes as a last resort (Item 6); never chew betel nut (Item 8); limit or completely avoid alcohol (Item 19); if stopping abruptly causes tremors, do not force yourself to quit cold turkey (Item 20); keep track of how much you drink each week (Item 21).
Foods to cut back on: Skip sugary drinks altogether (Item 7); reduce consumption of processed meats (Item 18); limit ultra‑processed foods as much as possible (Item 28); avoid drinking tea or soup that is piping hot (Item 30).
Healthier swaps and additions: Switch to low‑sodium salt (Item 9); enjoy a small handful of nuts every day (Item 22); replace red meat with fish and poultry (Item 23); choose whole grains instead of refined rice and flour (Item 24); sip tea at least three times a week (Item 25); drink three to four cups of coffee daily (Item 26); eat five servings of fruits and vegetables each day (Item 27); include chili peppers in your diet more than four times a week (Item 33); have a serving of dairy each day (Item 34); there is no need to avoid eggs (Item 35).
Exercise and weight: Aim for 7,000–8,000 steps each day (Item 11); play racket sports regularly (Item 14); fit in short bursts of physical effort whenever possible (Item 15); add strength training to your weekly routine (Item 16); avoid sitting for long stretches without a break (Item 17); keep your BMI between 20 and 25 (Item 32); count your daily dog walks toward your step total (Item 44).
Sleep and night shifts: Get roughly seven hours of sleep each night (Item 13); limit naps to half an hour or less (Item 37); catch up on sleep the day after a late night (Item 38); if you work night shifts, try to switch to a day schedule as soon as you can (Item 39).
Cooking oils and smoke: Refrain from burning coal or firewood for cooking or heating (Item 29); do not buy bulk, homemade peanut oil (Item 40); use plant oils instead of lard or butter (Item 41); always run a range hood while stir‑frying (Item 42).
Dental care, medication, and other habits: Brush and floss your teeth thoroughly each day (Item 10); take prescribed medications exactly as directed (Item 12); spend some time outdoors in daylight (Item 31); take a bath whenever you have the chance (Item 36); if hot flashes and night sweats around menopause disrupt your life, ask a gynecologist to assess hormone therapy (Item 43).
On average, smokers live more than 10 years less than non-smokers. Quitting before age 40 eliminates roughly 90% of the extra death risk caused by continued smoking. The earlier you quit, the more years you gain. …
Around 600,000 people worldwide die each year from secondhand smoke exposure; nearly 30% of those are children. …
Relying on sheer willpower alone rarely works for most smokers. People taking varenicline are more than twice as likely to succeed compared to those taking a placebo. …
Many people try to cut back a little each day until they reach zero. Yet after six months, only 15. …
Medications and regular follow-up support from professionals are two distinct components that work best together. …
Switching to nicotine‑containing e‑cigarettes helps roughly 60% more people quit smoking than nicotine patches — this finding is quite reliable. However, e‑cigarettes are not harmless; long‑term safety data remain limited. …
People who drink more than two sugary drinks per day have about a 20% higher chance of dying during the same period compared to those who rarely drink them. …
People who chew betel nut have roughly a 20% higher chance of dying during the same period compared to non-chewers. Their risk of developing diabetes and metabolic syndrome is nearly 50% higher. …
For people who have had a stroke or are over 60 with hypertension, switching to low‑sodium salt can lower their chance of dying within five years by about 12% and the risk of another stroke by roughly 14%.
People who floss daily have roughly a 10% lower chance of dying over the same period. For elderly individuals with no natural teeth, the risk of death is about 90% higher. …
People who walk roughly 7,800 steps daily have a mortality risk roughly 45% lower than those walking only 3,500 steps. …
For every 10 mmHg drop in blood pressure, mortality decreases by roughly 13%, while stroke risk drops by about 27%. Each 1.0 mmol/L reduction in LDL cholesterol achieved by statins lowers mortality by roughly 10%. …
People who regularly get less than 7 hours of sleep have roughly a 10% higher chance of dying over time. The more irregular their schedule, the greater the risk. …
People who regularly play tennis, badminton, or table tennis have about half the risk of dying during the same period compared to non-players. Their risk of dying from cardiovascular causes is roughly 56% lower. …
For individuals who do not exercise regularly, performing just three 1–2 minute bouts of strenuous activity each day can reduce their overall risk of death by roughly 40% compared to those who do none at all. …
People who engage in 30–60 minutes of strength training each week have a 10–20% lower risk of dying during that period compared to those who don’t train at all. Training beyond this amount won’t bring any extra benefit. …
People who sit the longest have a 2.6 times higher chance of dying during the same period compared to those who sit the least. Sitting continuously for long stretches adds extra risk on top of that. …
People who eat the most ham, bacon, sausages, and similar processed meats have a roughly 20% higher chance of dying during the same period compared to those who eat the least. …
After consuming 100 g of pure alcohol per week, the more one drinks, the earlier they tend to die. 100 g of pure alcohol is roughly equivalent to 2.5 L of beer. …
Individuals who consume large amounts of alcohol every day can suffer from withdrawal symptoms when they suddenly stop. …
A doctor can spend a few minutes reviewing your weekly alcohol intake, explaining the associated risks, and helping you set a realistic goal. …
People who regularly eat nuts have roughly 20% lower mortality rates than those who don’t. Even eating nuts just once a week yields a 10% reduction in risk. The greatest benefit is seen when intake reaches a daily handful.
Eating two extra servings of processed or red meat each week raises the risk of death by roughly 3% compared to normal intake. Switching to the same amount of fish or poultry eliminates this increase. …
People who eat an extra 90 g of whole grains daily have a roughly 17% lower risk of dying during the same period. That amount equals about three servings. The risk continues to drop when intake rises to around 200 g per day.
People who regularly drink tea have a roughly 15% lower chance of dying during the same period. Starting at age 50, they can expect to live 1.26 years longer on average, and 1. …
People who drink three to four cups of coffee a day have about a 17% lower chance of dying over the same period than people who do not drink it. …
Consuming an extra 200 g of fruits and vegetables each day lowers the risk of death by roughly 10% during the same period. …
People who consume the most ultra-processed foods have a roughly 20% higher risk of dying during the study period compared to those who eat the least, and a 50% higher risk of dying from cardiovascular disease. …
People who cook with coal or wood face roughly a 10% higher chance of dying over the same period compared to those using electricity or gas. For those who heat their homes with coal or wood, the risk is about 14% higher. …
Drinking tea that is extremely hot raises your risk of esophageal cancer by 8 times compared to drinking lukewarm tea. Even “hot” tea doubles that risk. …
Women who deliberately avoid sunlight can expect to live 0.6 to 2.1 years less than those who get the most sun exposure. Even non-smokers who avoid the sun tend to have lifespans similar to smokers who get plenty of sun.
Mortality is lowest when BMI falls within 20–25. At BMI 27.5–30, risk rises by roughly 20%; at 30–35, it increases by about 45%; at 35–40, it nearly doubles. …
People who eat chili peppers four or more times each week have a roughly 23% lower chance of dying during the same period compared to those who rarely consume them; their risk of cardiovascular-related death is also about one-third lower.
People who consume two or more servings of milk or yogurt each day have a roughly 17% lower chance of dying during the same period compared to those who do not drink any.
Eating an extra half whole egg each day raises the overall mortality risk by roughly 7%. Swapping that half egg for egg whites, fish, poultry, or nuts actually lowers the risk of death across all categories. …
People who bathe almost daily have roughly 28% lower risk of cardiovascular events and about 46% lower risk of brain hemorrhage compared to those who bathe fewer than twice a week.
People who nap for less than an hour show no increase in mortality or chronic disease risk, and their mental clarity actually improves. …
People who get less sleep than they need and fail to make it up the following night have roughly a 15% higher risk of mortality compared to those with regular sleep patterns. …
People who work night shifts develop cardiovascular disease about 13% more often than those who don’t, and cardiovascular deaths rise by roughly 27%. …
When peanuts get damp and moldy, they produce aflatoxin, a confirmed human carcinogen that primarily harms the liver. …
Cutting back on saturated fats like lard and butter and switching to vegetable oils lowers the risk of heart disease and stroke by roughly 17%. However, overall mortality shows no change. …
Non-smoking Chinese women who rarely or never use a range hood while cooking face roughly twice the risk of developing lung cancer compared to those who use one regularly. …
Around menopause, hormone therapy cuts hot flashes by about 75% compared with placebo. The price is slightly more breast cancer, blood clots and stroke: roughly 8 extra cases of each per 10,000 women per year. …
Dog owners are on average about a quarter less likely to die over the same period, and those who keep a dog after a heart attack or stroke do even better. …
This part comes from the parveen0029/The-Evidence-Based-Life edition.
For individuals with elevated blood glucose who have not yet reached the diagnostic threshold for diabetes, eating less, moving more, and losing a modest amount of weight reduces the risk of progressing to full diabetes by 30% to 60%. …
This part comes from the parveen0029/The-Evidence-Based-Life edition.
Moldy peanuts and corn can produce aflatoxins, potent chemical carcinogens that cause liver cancer. In a long-term Shanghai prospective cohort, individuals with detectable urinary aflatoxin biomarkers had roughly 3. …
This part comes from the parveen0029/The-Evidence-Based-Life edition.
Consuming raw or undercooked freshwater fish and shrimp can transmit Clonorchis sinensis (the Chinese liver fluke). …
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