healthy living and diets

see also:

• diets and healthy foods
• salt / sodium in food products

• do not smoke
• do not abuse substances
  • these will generally take you down a dark path you may not get back from - there are no easy ways of managing the hardships of life - substances will only make them worse
• do not gamble
  • gambling is addictive for many and can destroy their lives and careers as well as their relationships with family and loved ones
• get the recommended vaccinations
  • benefits clearly outweigh risks
  • they reduce morbidity and mortality from infections including long term sequelae
  • they reduce the risk of passing on life threatening infections to immunocompromised people including your loved ones such as infants and grandparents, or those on chemotherapy
  • human papilloma virus (HPV) vaccination clearly markedly reduces cancer rates such as cervical cancer
  • shingles vaccination for older adults reduces dementia rates and possibly has other neurologic benefits in addition to markedly reducing long term neuropathic shingles pain
• take steps to prevent development of type 2 diabetes mellitus
  • diabetes is a major risk factor for cardiovascular disease and all cause mortality ¹⁾
  • see below, regular exercise, healthy eating and avoidance of obesity are all critical components
• regular exercise
  • at least 7500 steps a day
• reduce adverse environmental exposures
  • air pollution and health risks
  • foods that may be toxic or bad for you
  • excessive UV light exposure will not only age your skin rapidly but increase risk of skin cancers
• get back to nature for your mental health
  • One in five Australians experience mental illness, such as anxiety, depression and substance use disorders. This is a particular concern among young Australians, with 29% experiencing high psychological distress, almost a quarter being lonely most of the time and 60% experiencing some social exclusion, with those living in regional and remote areas amongst the groups more likely to experience social isolation. Getting back to nature regularly with “Nature Scripts” had a significant cost effective positive impact.²⁾
• control your BMI and maintain it to around 25
  • lower BMI or higher BMI is associated with higher all cause mortality ³⁾
• control your BP and maintain systolic level to around 120mmHg
  • lower systolic BP or higher systolic BP is associated with higher all cause mortality, this is especially if aged under 60yrs ⁴⁾
• do not excessively lower non-HDL cholesterol below 110mg/dL (2.8mmol/L)
  • lower non-HDL cholesterol is associated with higher all cause mortality ⁵⁾
  • higher non-HDL cholesterol is associated with higher hazard ratio for cardiovascular disease but does not significantly increase all cause mortality suggesting it may have a protective effect on non-cardiovascular lethal conditions ⁶⁾
• do not drink alcohol, or at least have minimal intake - it is a toxin and can impair judgement increasing trauma risks
• to live is to take risks but to live well and longer means taking steps to manage those risks - don't be foolish!
  • trauma can be disabling - don't needlessly expose yourself to trauma - even a fractured ankle can limit your activities for a long time
• take time out to examine your life
  • this is the harder part - you need to understand only you are responsible for your life, your decisions, your habits which will determine your health and that the world owes you nothing and most people don't even think about you - so don't excessively worry about what other people think - be kind to and respectful of others, especially those who cannot offer you anything, and they hopefully will be that way to you and you may have had a positive impact in their lives - after all, like you, everyone else is struggling with their own internal demons, worries, fears, and anxieties.
  • take time to chill out without being distracted by social media, music, other people and develop a better understanding of what makes you tick and what you may really want from life that gives it meaning for you
  • how you allow your brain to think repeatedly becomes hard wired and then will determine your habitual behaviours - these may not always be in your best interest, so take care with how you think
  • remember that how you perceive the world and others is likely to be more dependent on your past experiences with similar cues rather than the reality of who they really are - be kind and avoid being judgmental and you will be rewarded for taking this extra step to avoid transferring your past onto others
  • hopefully, by actively attending to this you will develop a confident inner peace and calmness which will not only improve your mental and physical health by reducing stress levels but allow you a greater capacity to manage challenges

source: NEJM 2023: Global Effect of Modifiable Risk Factors on Cardiovascular Disease and Mortality

• water
• protein
  • the only main protein stores are muscle so if you don't have appropriate proteins with an adequate mix of amino acids then your body will need to break down muscle - and noone wants that!
• caloric intake to match energy needs
• vitamins
• minimal daily requirement of minerals
• dietary fibre
• nutrients to maintain a healthy GIT flora or microbiota

• alcohol
  • like it or not, alcohol is a toxin and carcinogen and probably has no real beneficial effects other than for pleasure, but it does have cumulative toxic effects
  • current advice suggests no more than 2 glasses alcohol per day long term, and no more than 4 glasses alcohol on any one occasion.
  • women are at particular risk due to the increased risk of breast cancer as intake increases
  • middle aged men who drink more than 3 standard drinks a day have faster cognitive decline with age, speeding up memory loss by up to 6 years ⁸⁾
  • more than 6 glasses a day significantly increases the risk of dependence, liver cirrhosis, peptic ulceration, cancer and a range of other medical problems
• very hot drinks
  • frequent drinking of very hot teas is associated with significantly increased risk of oesophageal cancer - an issue common in the Middle East
• sodium
  • for most people, salt intake should be limited to 2-4g/day (1-2g/day sodium) - see salt / sodium in food products
  • sodium is often hidden in foods such as cheese, soups, and most processed foods - so make a point of NOT ADDING extra salt at the dinner table!
• foods containing potentially carcinogenic substances:
  • processed meats
    • these contain nitrates and nitrites which are converted to nitrosamines
    • WHO states eating only 50g/day of processed meat such as 6 slices of bacon or one hot dog would increase lifetime risk of colorectal cancer (bowel cancer) from 5% to 6%
    • ideally these should be eliminated from your diet
  • BBQ meats especially over flames:
    • cooking meats at high temperatures such as on open flame BBQ grills also increases carcinogenic chemicals such as heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs)
  • red meats
    • it is prudent that these should be limited as there is evidence to suggest they may increase cancer risk and possibly other health risks
    • American Institute for Cancer Research recommends limiting red meat to three portions, or 12-18 ounces, or 340-500g a week and consuming little to no processed meats
• poor nutrient quality foods, especially those high in sodium or saturated fats
  • these include most of the processed foods in the supermarket - read the labels carefully
  • for every 10% increase in ultra-processed food in a person’s diet, there was an increased incidence of 2% for cancer overall, and a 19% increase for ovarian cancer
  • each 10% increase in ultra-processed food consumption was also associated with increased mortality for cancer overall by 6%, alongside a 16% increase for breast cancer and a 30% increase for ovarian cancer ⁹⁾
• high simple sugar content foods
  • American Heart Association (AHA) recommends no more than 9 teaspoons, or 3 tablespoons, or 40g of sugar per day for men and no more than 6 teaspoons, or 2 tablespoons, of sugar per day for women.
  • 375mL can of Coca Cola contains 40g of sugar that's your daily maximum in one drink! Pepsi Cola, Fanta, Vanilla Coke, Schweppes Traditional Raspberry have even more!
  • most drinking chocolate powders contain 75-80% sugar and you need a tablespoon per mug of hot chocolate plus sugars in milk! - use cocoa instead - although some cocoa powders may have heavy metal contamination
  • most cakes, jams, marmalades, confectionary, chocolates, soft drinks and ice cream are BAD for you - sorry!
• artificial sweeteners
  • these may actually cause increased weight gain and there is a suggestion that some may be carcinogenic
• honey
  • in moderation, honey is safe for most people but although it has a small anti-oxidant effects and some vitamins and minerals, it actually has more calories than white sugar so will still add to your energy intake significantly and its glycaemic index is only marginally lower than white sugar.
  • in amounts typically consumed (1 tablespoon), honey is not considered a “good source” of any of these vitamins and minerals as it has less than 1% of your recommended daily allowance per serving, thus supposed benefits are probably not real.
• most pizzas, especially those with ham or bacon
  • these tend to not only have a base of a large amount of processed meats, but are generally high in sodium content
• foods that increase uric acid levels, risk gout, and which may be associated with the metabolic syndrome
  • fructose - intake should be a bare minimum
    • hence avoid:
      • high fructose corn syrup containing products
      • most fruit juices (but fruit is OK)
      • most soft drinks
      • other high fructose foods or drinks
  • high purine containing foods
    • consume in small amounts only or avoid
    • meats, especially liver, kidney, brain, anchovies, sardines, etc
    • high-purine plants and algae include some legumes (lentils and black eye peas) and spirulina
    • other high-purine sources include yeast as in yeast extract (eg. Vegemite) and beer
    • do not over-indulge in other foods with moderate amounts of purines such as:
      • other meats and seafood, asparagus, caulifower, spinach, mushrooms, green peas, lentils, beans, oatmeal, wheat bran, and wheat germ
• certain fish or parts of fish which have dangerous levels of toxins
  • liver and kidneys of large fish
  • fish at the top of the food change with high levels of heavy metals such as mercury as well as industrial toxins as well as ciguatera toxin reef fish food poisoning
  • whale blubber
  • spoilt fish - can cause scombroid histamine food poisoning due to spoiled fish
• certain dietary fibres
  • inulin
    • found in foods like garlic, leeks and sunchoke and in dietary fibre supplements
    • stimulates microbes in the gut to release bile acids that increase the production of molecules such as IL-33 that promote intestinal inflammation and activation of group 2 innate lymphoid cells (ILC2s) which may cause inflammatory bowel disease (IBD) ¹⁰⁾

• end stage renal failure patients
  • require a renal diet to minimise potassium intake in particular
• those on warfarin
  • should avoid having fluctuating vitamin K intakes (eg. varying amounts of leafy vegetables) as this will effect their INR and warfarin control
• those who form kidney stones
  • consider minimising foods high in oxalates
    • almonds, peanuts, kiwifruit, rhubarb, carrots, potatoes, spinach, kale, beets, chocolate, wheat bran, tea
  • fortunately, you can flush out oxalates by drinking plenty of water - and this is the main advice - if urine is yellow, you are not drinking enough water!
  • lemon juice seems to increase the renal excretion of oxalates so may be beneficial
  • high potassium foods may also reduce stones - but obviously cannot be eaten if one has end stage renal disease!
• pregnancy
  • pregnant women should avoid foods that may expose risks to the baby such as Listeria
• Coeliac disease
  • gluten must be entirely eliminated from the diet
• those with irritable bowel syndrome
  • may need to limit FODMAP foods
• severe food allergies
  • foods which cause anaphylactic reactions in a person must be totally avoided
  • some food “allergies” are just intolerances such as lactose intolerance and these may be able to be consumed in small quantities
• those with gastro-oesophageal reflux
  • individuals may be more sensitive to certain foods than others and will need to closely examine what their triggers are (in addition to stress), for example sun-dried tomatoes may be a potent trigger for some but normal tomatoes are not.
• infants under 12 months age
  • are at risk of botulism
    • should not be given raw honey
  • are at risk of Listeria
    • should not be given unpasteurised dairy products

• a good amount of still water EVERY day:
  • your gut and kidneys will thank you and you may just avoid being constipated or having extremely painful renal colic!
  • by replacing soft drinks, fruit juices, sparkling drinks with still water, you body will thank you and so will your teeth and gums
  • having a consistent good urine output also seems to reduce risk of bladder cancer presumably by flushing out carcinogens more rapidly
• a healthy protein and vitamin B12 source
  • most fish will provide this (just don't eat the batter if battered, and don't add too much salt - but perhaps avoid purine-rich fish such as anchovies, sardines)
  • fresh milk or low sugar yoghurts in moderation if not lactose intolerant
    • milk seems to have a protective effect for gout and may have beneficial GIT flora effects
  • eggs in moderation
  • adults need a minimum of 2.4mcg B12 per day which can be obtained from 5 large cooked eggs (don't eat this many!) or 2 cups of 2% milkfat milk, or 85g canned tuna or cooked salmon or minced lean beef
• good nutrient quality, high fibre foods
  • most fruits and vegetables in moderation
    • increase fruit and vegetables in diet seems to improve eGFR in patients with HT ¹¹⁾
  • avocado may be one of the most beneficial of foods
  • leafy vegetables also provide folate
  • moderate your intake of high purine veges as outlined above
  • citrus fruits are an important source of vitamin C - just ensure they do not stay on your teeth long as they are acidic
• complex carbohydrates in moderation
  • potatoes, sweet potatoes, rice, cereals, etc
    • a large study published in 2025 showed that potato consumption did not appear to cause increased risk of heart disease or hypertension although more than one serving of fried potatoes per week had a 10% higher risk of hypertension compared to those consuming none ¹²⁾
  • starches are classified based on their digestion rates into three major categories: rapidly digestible starch (RDS), slowly digestible starch (SDS) and resistant starch (RS)
  • resistant starch intake has been associated with several health benefits, such as improved stool quality, reduced glycemic response, and a favorable impact on gut microbiota. RS mostly escapes digestion in the small intestine and is fermented in the colon by microorganisms, producing short-chain fatty acids (SCFA). Recommended daily levels of RS are 15–20 g/day. ¹³⁾
  • examples of RS: cooked and cooled potatoes, bread, corn flakes, starch foods with repeated moist heat treatment, whole or partly milled grains, seeds or legumes, modified starches, high amylose foods.
  • wholemeal vs white bread:
    • probably not a lot of difference for your health as long as either are consumed in moderation and the white bread is fortified to add back nutrients and does not have excessive additives such as emulsifiers which may adversely effect the gut microbiome¹⁴⁾
    • all wheat products contain gluten as well as FODMAP issues such as fructans (esp. wholemeal) and raffinose which can worsen irritable bowel syndrome (IBS)
• healthy fats and oils
  • the Mediterranean diet appears to be a very healthy one and olive oil is a key component
• adequate iron intake
  • this is particularly important in menstruating women who have higher iron needs of ~18mg/day compared with men and post-menopausal women of 8mg/day while pregnant women need 27mg/day
  • iron absorption from the gut is improved if taken with foods containing vitamin C such as tomatoes but is reduced if taken with caffeine, red wine, milk products or calcium supplments
  • red meats have the highest levels of iron but these should be eaten in moderation and some may prefer to avoid them and rely upon other sources such as poultry, eggs, salmon, tuna
  • those who elect to be vegan can source non-haem iron from iron-fortified cereals, nuts, seeds, dried fruit, wholemeal pasta/bread, or legumes but will need almost twice as much iron per day given the absorption is not as efficient as with haem iron.
• adequate calcium intake to reduce risk of osteoporosis
  • dairy products are a good source, if in doubt one can take calcium supplements as per your GP (+/- vitamin D)
• unsalted nuts in moderation
  • take care not to break your teeth on them though!
• caffeine drinks
  • seem to be beneficial on a range of measures as long as excessive amounts are not consumed (perhaps max. 2 cups coffee per day)
• probably beneficial:
  • broccoli
    • contains a particularly beneficial isothiocyanate compound called sulforaphane however for high levels, one needs to chop the broccoli 30-90min prior which allows hydrolysis of glucosinolates, and then to lightly cooking in a stir fry for under 3 minutes rather than microwave or steam as it needs the plants myrosinase enzyme to produce it prior to eating it and both myosinase and sulforaphane are heat sensitive. ¹⁵⁾
  • polyphenols
    • these include:
      • flavonoids
      • cinnamic acids and derivatives
    • may reduce GIT inflammation and improve GIT microbiome
    • main sources are tea, coffee, wine, grapes, apples, blueberries, oranges, and strawberries, wheat, beans
    • prenol lipids and phenylpropanoic acids were linked to reduced GI permeability, primarily from olive products ¹⁶⁾