Lifestyle choices can be fraught. When it comes to healthy or unhealthy living, our choices can fall anywhere on what seems to be a pretty massive scale. When you have elite athletes on one end and morbidly obese shut-ins on the other, it can be hard to assess what is “healthy enough.”
I’m going to propose a somewhat radical perspective on the question. One that does not let me off the hook for making poor choices. I propose that healthy enough is way healthier than you ever thought you could be.
When I was diagnosed with cancer in 2020, I knew I had some unhealthy habits. But I had no idea how far my lifestyle was from the healthiest one for me.
In order to make the best decisions for your healthiest lifestyle, you have to understand the latest research on food, exercise, and sleep, and how all of these factors influence aging and disease.
I read A Metabolic Approach to Cancer in 2020, and I was shocked by how much I had done wrong in the first five decades of my life. I was eating sugar, high glycemic index carbs, and barely adequate protein. I had been a heavy drinker for a decade or more, and alcohol is highly correlated with my specific form of breast cancer. I was eating tons of restaurant foods cooked in inflammatory oils.
Apart from the drinking, most people would have looked at my lifestyle and thought it was pretty healthy. I didn’t drink soda or eat fast food. I didn’t buy bags of chips, and I only rarely took a fun-size candy bar from the stash at work. I chose meals with veggies involved, bought pasture-raised meat and eggs, and took supplements daily.
Getting cancer and looking at the latest research on how lifestyle impacts outcomes made me see that I was far from the “healthy enough” lifestyle I thought I had. I had to cut out gluten, for one thing. My body pretty clearly responded poorly to wheat-based foods, and after I removed that staple of my diet, my chronic acid reflux stopped and my inflammation markers moved in a healthy direction.
I went ketogenic for about eight months after I realized that carbs and sugar feed tumors. I was shocked by the bowls of candy at reception when I went for radiation treatments. Oncologists know better than to feed their patients sugar, but they have been taught that diet and lifestyle are outside their purview. So why not cheer up people going through something rough?
Why not? Because you are training people to believe that eating small amounts of sugar is “healthy enough.” Yes, it is true that a tiny amount of sugar can be tolerated by most people, it should be vigilantly avoided by anyone with active cancer. Which should make you look askance at Ensure—a staple of the advanced cancer patient’s diet. Our medical system is not healthy enough. It may be trying to make you less healthy.
Who teaches kids how to eat?
When I was a kid, we had a very cursory introduction to the infamous food pyramid as part of our health education. 8-11 servings of grains? Almost no fat? Science has long since debunked this psychotic approach to eating, but it would seem many Americans never got the memo. Now there’s a cartoon plate divided roughly into veggies, protein, grains, and fruit…with a little disc of dairy off to the side. It seems to be saying: eat all the things in roughly equal proportions.
At home, kids learn by seeing how their parents eat which could be pretty unhealthy. They typically covet those delicious and forbidden foods packed with sugar and unhealthy oils, and their parents may or may not care.
They might eat school lunches, which are made with cheap, processed, and preserved ingredients (and extra sugar). They see their peers gorging on cookies and French fries and assume there must be nothing wrong with these foods. If their friends can eat Ding Dongs and donuts, why should they be deprived?
If their parents aren’t aware of the dangers of trans fats and refined sugar, will kids learn about this at school? I would argue that even if they do, that lesson is lost in the other messages they receive in their school lunches, vending machine offerings, and fast food venues. The message is clear: It is healthy enough to feast on junk food. Don’t bother learning how to eat or think differently.
If you grew up in the age of industrialized foods (which you did, unless you’re 150 years old), you learned this lesson, too. I was lucky that my mom worked in a health food store in the 1970s and passed along her knowledge. Although much of the wisdom about what’s healthy has shifted since the 70s, I learned early to question and avoid corporate food. I worry that most kids never have the opportunity to become skeptical.
It is not healthy enough to eat like other Americans. It is not healthy enough to be vegan. It is not healthy enough to eat takeout, even if you choose the healthier options. Even if you are doing everything right, your diet may still contain hidden toxins or compounds that your body doesn’t like.
How much do you really need to move?
I used to treat my body like an annoying chore. I had to drag it out of storage at least once a week and exercise it. Then I would put it away and go about my business as a disembodied intellect. I am a knowledge worker. My value is found in my mind, and my body is superfluous.
It took me almost fifty years to start treating my body like it’s actually mine. My brain is just part of the package, and what I do for my body is critical for keeping my brain functioning well.
Humans weren’t really design for knowledge work, and the many hours spent in chairs staring at screens. As we’ve all heard, “sitting is the new smoking.” So we’ve got standing desks and reminders to stand up and move throughout the day.
But what is healthy enough? The latest studies have given us a number: 150 minutes of exercise per week. Is that really enough? It seems to be the minimum required dosage to prevent the serious impacts of s sedentary lifestyle, but it is still not enough to be a healthy, vibrant, active person.
Given that only 8% of Americans gets enough physical activity in their lives, starting with that 150 minute recommendation for the other 92% may be just barely healthy enough.
You don’t have to run marathons or become a power lifter to be healthy enough. But you do have to lean into movement and away from sitting. Movement may be working out, or it may be cleaning your bathroom, or a leisurely stroll, or a dance break while you’re working. It is better to be doing some form of movement during every waking hour. Small but consistent is better than intense but infrequent.
How healthy can an old person be?
I’m getting on the longevity bandwagon. It’s not that I want or need an especially long lifespan, but I’d like to get as much life as I can while I’m here. But who really wants to live extra decades while immobile or sick? Not me.
It turns out there are ways to turn back the clock on aging. If you follow Dave Asprey, Peter Attia, or Mark Hyman, you can find all the science on the topic. We don’t have to get old in the same way our grandparents did, but to avoid “old age” there is some work to do.
Not surprisingly, exercise and sleep are big ones. You start losing muscle mass in your 40s, and if you don’t ramp up strength training in middle age, you may find yourself frail and weak in your 70s. I do not enjoy strength training at all, but I do it for future me.
Good sleep wards off dementia and improves health outcomes across the board. It can be daunting to approach this if you are not a good sleeper, but it is worth tweaking bedtime, light exposure, alcohol intake, and all the other things that can impact sleep quality. Small changes can really make a difference. I now consider sleep my most important daily project and make sure I am in bed for at least eight hours.
Food matters for your “healthspan” as well. Insulin resistance, inflammation, toxic exposure, etc. all stem from food end environmental exposure, and also feed into disease.
Understanding your own unique nutritional needs is a process, but far too many people opt to just go with default cultural norms of cheap, fast, delicious food. Even if it is making them sick. Aging well requires a rejection of what “big food” is shoving down your throat. And probably some supplements, as our food is not as nutritious as it once was.
It’s not easy to be a rebel when it comes to aging. But is it worth it? I would argue that it is worth it, and not only for some potential future self. The truth is, everything you do to protect yourself from unhealthy aging will also make you feel better today.
The loneliness epidemic
It started before Covid shut us all in our homes for two years or more. We were already living in bubbles of isolation, especially older people…but increasingly young people, too. The internet connected us in a new, more isolating way. It’s weird how being connected to nearly everyone on earth can make you feel more isolated than ever. Then social media made it worse, with its toxic troll culture. Children are learning to hate themselves and each other.
The U.S. Surgeon General recently identified loneliness as a public health crisis, and social media as a public health risk. As with the ever-changing dietary recommendations, I wonder if anyone will listen. By and large, the government saying you should eat more vegetables has not led to big shifts in health outcomes.
Still, this pronouncement from on high should be a wake up call for most of us. I, for one, grew up in a socially disconnected culture. Nuclear family units meant we did not have the same community around us that had existed just a generation or two prior. Geographic dispersion broke up even those small family units, as it became the norm for kids to go somewhere far away for college and never come back.
Religion has often provided a de facto community for most people, but now most people choose to live a secular life. I was raised outside of religion, and I’m glad for that. But that means I have to figure out some other way to find/ build community. To be very honest, I am 51 years old, and I still haven’t figured this one out. But at least I know I need to.
You could probably be healthier
Okay, so there are some people who are arguably too healthy. They spend most of their time exercising and don’t put any junk into their bodies, and probably live in a mansion in the Hollywood hills, because that’s the level of privilege required to really put that much effort into health.
Most of the rest of us have to work all day, at jobs that don’t necessarily allow for two hour workout breaks and home-cooked meals. I’m lucky now, in that I am doing remote work and have the flexibility to schedule some extra exercise, and even an occasional nap. But that has not always been the case for me, and is not the case for many people.
But the fact that you can’t go all in should not deter you from becoming healthier than you are right now. We all have room for tweaks. More efficient workouts. A bit more emphasis on strength and mobility as we age. A longer window for sleep. More local produce.
So, no, I am not healthy enough—despite being much healthier than I was, and most likely neither are you. But unlike many life circumstances, this is something you can choose to change. You do have agency in this one realm. You get to decide how you treat your own body.