Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

A pivotal paper published in Europe more than a decade ago, entitled “Healthy Living Is the Best Revenge,” found that adhering to just four simple healthy lifestyle factors compared to none could potentially have a strong impact on the prevention of chronic diseases. We’re talking nearly 80 percent less chronic disease risk––slashing diabetes risk by 93 percent, dropping heart attack risk by 81 percent, cutting stroke risk in half, and cancer by 36 percent. Think about what that means. The potential for preventing disease and death is enormous. In the U.S. alone every year, there are a half million heart attacks, a half million strokes, a million new cases of diabetes, and a million new cancer diagnoses. The message is clear: adopting a few healthy behaviors can have a major impact. What are those four fabled factors? Never smoking, not being obese, averaging about a half hour of exercise a day, and adhering to healthy dietary principles, like lots of fruits, vegetables, and whole grains, and less meat. Follow those four simple rules and boom! Enjoy nearly 80 percent reduced risk of major chronic diseases.

What does that mean for mortality risk? A similar batch of four health behaviors combined predicted a four-fold difference in total mortality, with an estimated impact equivalent to 14 years in chronological age, meaning the individuals were dying at such a reduced rate that it was as if they were 14 years younger. “Finally, a Regimen to Extend Human Life Expectancy.” This commentary was in reference to this study, where a similar analysis of the impact of healthy lifestyle behaviors on life expectancies was made, but this time it looked directly at the U.S. population, which is particularly important, since Americans have a shorter life expectancy compared with residents of nearly all other high-income countries. The researchers concluded that adopting a healthy lifestyle could substantially reduce premature mortality and prolong life expectancy in U.S. adults. Okay, but by how much? They estimated that adherence to a low-risk lifestyle could prolong life expectancy at age 50 years by 14.0 years in women and 12.2 years in men. So, if you’re 50 right now, instead of only living to 79 if you’re a woman, and 75½ if you’re a man, taking even just basic care of yourself could propel you to an average life expectancy of 93 if you’re a woman and 87½ if you’re a man.

The bottom line is it’s never too late to turn back the clock. A midlife switch just to the basics, like at least five daily servings fruits and vegetables, walking even like 20 minutes a day, maintaining a healthy weight, and not smoking results in a substantial reduction in mortality even in the following few years. We’re talking a 40 percent lower risk of dying in the subsequent four years. So, making the necessary changes to adhere to a healthy lifestyle could be considered extremely worthwhile, and middle age is certainly not too late to act.

As an aside, realizing the 12 to 14 years of added life study was based on data from health professionals, that got me excited about all the potential knock-on effects. If health professionals start getting healthier, they can become role models for more healthful living and potentially save more lives than just their own. But that may have just been wishful thinking. Practicing what you preach can sometimes backfire. Evidently, “displays of excellence can paradoxically turn off the very people they are trying to inspire.”

You’d assume that not being a hypocrite and trying to walk the walk would just lead to positive consequences, inspiring confidence in others. Don’t you want a dance instructor who can dance, a music teacher who can play, and a health professional who’s healthy? But this simple intuition fails to take into account concerns about making other people feel inadequate. Like you know how vegetarians are the targets of a surprising amount of hostility and ridicule. That’s because they may come off as morally superior and make people feel like they’re being looked down upon.

There was an elegant demonstration of this phenomenon in this study where “Principled deviants who take the high road threaten others’ moral self-worth.” This is what they did. Research subjects were asked to complete a racist task by an experimenter, and those moral rebels who refused to obey were cheered by observers but were disparaged by participants who had themselves gone through with it, and for whom the rebel’s stance thus an implied indictment of their spinelessness. Isn’t that interesting?

So, when doctors portray themselves as “the picture of health,” patients might think they’re being holier-than-thou and unintentionally alienate people, potentially turning off the very patients who most need their help. You can see how someone with a weight issue might feel threatened and judged by a physician triathlete. But what are we supposed to do? We want healthy practitioners. Physicians who smoke are less likely to tell their patients to quit smoking, physicians who are overweight are less likely to counsel their patients about weight, and physicians who don’t work out are less likely to talk about exercise. What we can do to make patients more comfortable is emphasize that our role is to help people meet their own personal health goals, whatever they may be. Studies show that when doctors do this, taking this approach, it increases the appeal of fitness-focused physicians to overweight patients. So, we can then display exemplary behavior, while at the same time not inadvertently alienate the very people who would benefit most from our guidance.

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