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It’s the season for resolutions. Many people are looking to make positive changes in their lifestyles. Which are the ones that will make the biggest difference for their health?
According to CNN wellness medical expert Dr. Leana Wen, the five most crucial steps a person can take are increasing exercise, stopping smoking, reducing alcohol, cutting ultraprocessed foods and improving social connection.
I spoke with her to find out why those lifestyle choices stand out and how people can get started on making the changes. Wen is an emergency physician and professor of health policy and management at George Washington University’s Milken Institute School of Public Health. She previously was Baltimore’s health commissioner.
CNN: Let’s start with exercise. We all know about the health benefits of exercise, but how much exercise do people need to see a benefit in their well-being?
Dr. Leana Wen: The US Centers for Disease Control and Prevention recommends 150 minutes a week of moderate- to high-intensity exercise. According to research published last year that reviewed data from 196 studies, this amount of exercise has remarkable health benefits. Compared with inactive adults, people who participated in this level of physical activity had a 31% lower risk of death from any cause, a 29% lower risk of dying from cardiovascular disease and a 15% lower risk of death from cancer.
What I found to be the most remarkable part of the study is that it showed people who engaged in just half the recommended amount also experienced substantial health benefits. Participating in 75 minutes a week of moderate-intensity activity was associated with a 23% reduced risk of early death. It also decreased the incidence of cardiovascular disease by 17% and cancer by 7%.
My first takeaway here is that the amount of exercise matters. People should strive for the 150 minutes a week, as recommended. However, some people may be intimidated by the idea of going from no exercise to this amount. That’s why the second takeaway is so key: Just 11 minutes a day can make a big difference. This could be accomplished by walking briskly around the block, taking stairs instead of the elevator and even doing vigorous housework.
Another way to think about the importance of exercise is as follows. If there were a pill that could reduce your risk of death by up to 31%, I imagine many people would be interested in that. That’s the benefit of exercise — and it also has many other health impacts, including lowering the risk of dementia and improving mental well-being.
CNN: Stopping smoking is also one of your top tips. What does the research show as to why?
Wen: According to the CDC, cigarette smoking is the leading cause of preventable death in the US. Compared with nonsmokers, smokers have two to four times the risk of developing strokes and heart disease and more than 25 times the risk of developing lung cancer. Smokers are also more than 12 to 13 times more likely to die from chronic obstructive pulmonary disease compared with nonsmokers.
The total amount of damage to the body depends on how long and how much someone has smoked. Crucially, quitting smoking can reverse many of these adverse effects. The positive health impacts of breaking the habit include reducing cardiovascular disease, lung disease and cancer risk. The sooner people quit the better, though people who already have heart and lung disease will still benefit from not smoking.
There are a variety of tools that can help people to quit smoking, including nicotine replacement, medications, apps and support groups. I urge current smokers to discuss these options with their physicians.
CNN: You also have alcohol on this list. How much alcohol is too much? When should people consider reducing their alcohol intake?
Wen: There are two considerations here. One is the amount that people are drinking compared with guidelines. According to the Dietary Guidelines for Americans, adults of legal drinking age should limit their intake to two drinks or less in a day for men and one drink or less in a day for women when alcohol is being consumed.
Further, the CDC considers “heavy drinking” to be consuming 15 drinks or more per week for men and eight drinks or more per week for women. “Binge drinking” is generally defined as five or more drinks on a single occasion for men and four or more drinks for women.
People who exceed the dietary guidelines or meet the definition of heavy drinking or binge drinking should consider reducing their alcohol intake. It’s also important to consider whether drinking is interfering with your work, family or social life. These are signs of potentially problematic relationships with alcohol.
Dry January is an option for people who are questioning their relationship with alcohol and want to see whether they can stop for a month. People who drink heavily every day should not quit cold turkey. They should contact their physician, who can help with a treatment plan.
CNN: Your next item is about food, specifically cutting ultraprocessed food. Why did you choose this one?
Wen: The second-leading cause of preventable death, after cancer, in the US is obesity. More than 40% of American adults have obesity, which is linked to many adverse health outcomes.
Addressing obesity is complex. There are promising new drugs that may help many individuals. The food that we consume also has a major impact on our metabolic health.
Specifically, ultraprocessed foods increase the risk of obesity as well as chronic conditions such as heart disease, diabetes and cancer. These are foods containing ingredients that “never or rarely (are) used in kitchens, or classes of additives whose function is to make the final product palatable or more appealing,” according to the Food and Agriculture Organization of the United Nations. Such additives include preservatives, emulsifiers, artificial coloring and dyes, added sugars, and salts and fats.
These ingredients are intended to help make the food more appealing, but they have no health or nutritious benefit. In fact, some of these additives may be harmful, and ultraprocessed food appears to promote less satiety, meaning that people will consume more of it compared with less processed, whole foods. Studies have shown that people who eat processed foods end up consuming more calories and gaining more weight compared with those who consume a whole food diet with minimally processed food.
It may be difficult to avoid ultraprocessed food altogether, but we can be more mindful and aim to consume more whole foods, like vegetables, fruits, nuts, whole grains, milk, fish and meat. Try to reduce sodas, chips and traditional “junk foods,” as well as instant foods and other products that have long ingredient lists containing additives.
CNN: Finally, social connection. There certainly appears to be a loneliness epidemic happening globally.
Wen: Yes. A 2023 survey, taken across 142 countries, found that nearly 1 in 4 people 15 years of age and older reported feeling very lonely or fairly lonely. Loneliness and social isolation have been associated with many adverse health effects, including early mortality.
The new year is a good time to work on strengthening social connections. There are simple steps we can all take such as making time to reconnect with friends and being intentional in giving our loved ones our full attention when we are with them — rather than being distracted by phones and other devices. These small steps can improve our emotional health and can also enhance our long-term physical well-being.
Editor’s note: Not sure how to establish a habit? Try out behavioral scientist Katy Milkman’s five strategies for nailing your New Year’s resolutions.