Eliminate Most of Your Chronic Disease Risk in Four Steps

Turning the Clock Back 14 Years

In 1903, Thomas Edison predicted that the doctor of the future will give no medicine, but instead “instruct his patient in the care of the human frame in diet and in the cause and prevention of disease.” A hundred and one years later, the American College of Lifestyle Medicine was born. Lifestyle docs like myself still prescribe meds when necessary, but, based on the understanding that the leading causes of disability and death in the United States are caused mostly by lifestyle, our emphasis is particularly on what we put in our mouths: food and cigarettes. An “impressive number of studies have shown that lifestyle is the root cause of what ails us.” The good news is that by changing our lifestyle we can dramatically improve our health.

You have the power.

We’ve known for a long time that for most of the leading causes of death our genes account for at most 10 to 20% of risk, given that rates of killers like heart disease and major cancers differ up to a 100-fold among various populations, and that when people migrate from low- to high-risk countries, their disease rates almost always change to those of the new environment. For example, at least 70% of strokes and colon cancer are avoidable, as are over 80% of coronary heart disease and over 90% of type 2 diabetes. So maybe it’s “time we stop blaming our genes and focus on the 70% that is under our control.” That may be the real solution to the health care crisis.

It doesn’t take much. Adhering to just four simple healthy lifestyle factors can have a strong impact on the prevention of chronic diseases: not smoking, not being obese, exercising half an hour a day, and eating healthier (more fruits, veggies, whole grains, less processed foods and meat). Four simple things cut our risk of developing a chronic disease by 78%. 95% of diabetes risk out the window, 80% of heart attack risk, gone. Half of stroke risk, a third of cancer risk, simply gone. Think of what that means in terms of the numbers. As it stands now, each year a million Americans experience their first heart attack or stroke, a million get diabetes, a million get cancer.

Do we actually get to live longer, too? The CDC followed about 8,000 Americans 20 years or older for about six years. They found that three cardinal lifestyle behaviors exerted an enormous impact on mortality. People who do not smoke, consume a healthy diet, and engage in sufficient physical activity can substantially reduce their risk for early death. By “not smoking” they just meant not currently smoking; by “healthy diet” they just meant in the top 40% in terms of complying with the rather wimpy federal dietary guidelines; and by being “physically active” they just meant averaging about 21 minutes a day or more of at least moderate exercise. Those that managed at least one of the three had a 40% lower risk of dying. Those that hit two out of three cut their chances of dying by more than half. Those that scored all three threw 82% of their chances of dying in those six years out the window.

What does that mean in terms of how much longer we get to live? A similar study on health behaviors and survival, highlighted in my video, Turning the Clock Back 14 Years, didn’t just take people’s word for how healthfully they were eating, they measured the level of vitamin C in people’s blood, a biomarker for how many plants they were eating, and the drop in mortality risk in those nailing all healthy behaviors was equivalent to being 14 years younger.

I discuss the role diet may play in preventing the 15 leading causes of death in my 2012 annual review video Uprooting the Leading Causes of Death.

How does your diet compare? Calculate Your Healthy Eating Score.

I go into depth into the exercise component in my video Longer Life Within Walking Distance.

For more on slowing the aging process, see my videos:

And more on my chosen clinical specialty, lifestyle medicine, in:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my videos for free by clicking here and watch my full 2012 – 2015 presentations Uprooting the Leading Causes of Death, More than an Apple a Day, From Table to Able, and Food as Medicine.

Image Credit: Marlon E / Flickr

  • Leonid Kalichkin

    Unrelated. I drink green/white tea with every meal. Should I be concerned about iron absorption if I have normal level of hemoglobin?

    • mjs_28s

      Your answer might be in your question.

      If your blood tests show normal iron range for you then you have your answer.

  • lilyroza

    If we’ve known for a long time that genes comprise at most only 10 to 20% of risk, shouldn’t it read that we should focus on the 80 to 90% of risk that is within our control? Or is there another risk factor not being mentioned?

  • Panchito

    There are several steps for gene expression. It is not just the DNA stored as some people may believe. Diet alone plays its role (ie. signal transduction, transcription factors, etc.). It could be said that there is a best diet for best gene expression (healthiest).

  • salbers

    Dr. Greger should consider adding one more item to his list, an item he has spoken at length about in his lecture “40 year old vegan dies of heart attack” – Fatty acid metabolism. The National Academy of Science has now linked over 60 chronic diseases to Omega 3 fatty acid deficiency. Getting your fatty acid profile right takes more work, but still has a huge payback in optimized health.

    • rob

      can Omega 3 be checked in a blood test?

      • Douglas

        It can but it’s expensive.

      • salbers

        There are at least four stateside labs that offer personal serum fatty acid profiling (gas chromatography) by mail for about $100. Women spend that on a new hairdo.

        This mature technology is deadly accurate and very enlightening. Don’t do it unless you have a tolerance for bad news because most vegans are greatly deficient, both as to level and ratio – even those who supplement according to Dr. Greger’s recommendation.


        I’ll send you a referral if you agree to publish your results so everyone can learn by your experience.

      • AZ DONALD

        my dr contracts with cleveland clinic heart labs for their patented bloodwork and I had half a page of omega 3 and 6 info on it.

  • Tanya Meeth

    Also unrelated: I am a huge fan of carbonated water (filtered). Although I’ve tried to research to determine if it’s unhealthy, I’ve not come up with anything at all. I guess two concerns would be: the water is slightly acidic (carbonic acid); plus the source of the CO2 itself seems problematic (which I have to expect is full of impurities, since, as one source indicates: is distilled from “industrial by-products as their crude materials”. I’m vegan, whole-foods, plant-based – and this truely is my biggest vice (if it is one!). Anyone know?

    • Joseph Gonzales R.D.

      I think it’s fine, but it may damage tooth enamel if you constantly expose teeth to the carbonation. I can look into more research, but please give me some time. A nice glass straw (a big hit these days) may avoid/limit exposure.

  • Slavica Mazak Beslic

    Is the best way : to use only raw plants ( fruits , vegerables and nuts plus seeds ?

    • Joseph Gonzales R.D.

      Cooked foods also have their benefits, so a diet of both cooked and raw is preferred.

  • Carly

    Does this include the smoking of e-cigarettes? I’m still wondering if this is a “safer” option since the vapor contains almost none of the chemicals found in regular tobacco cigarettes.

  • Questioner

    Wood smoke kills 50,000 people every year. I wish you would do a video on that. Wood smoke causes asthma, emphysema, lung cancer. It affects old people and young people the most. If the smoke is in town–the particles are small. So they go through the walls of the neighbor’s house and make them have disease too. The neighbors cannot escape wood smoke by going into their house. Lung cancer that is caused by wood smoke is very deadly. It may be up to 40 times more cancer causing than tobacco smoke. So just a small amount does a lot of lung damage. The smoke covers the inside surfaces of the house and percolates off of it year around, called tertiary exposure. So there is year around exposure.

  • Melissa Coles

    My question isn’t about chronic disease, but I switched to a whole food, low fat vegan diet in January 2015. I’ve had fantastic results including 90 lb weight loss, cholesterol down to 150…the list is endless. BUT my hair is falling out! It isn’t noticeable in the mirror, but on my brush and in the tub etc. Every day I am losing TONS of hair. I was so concerned I went to see my doctor and I’m waiting on my labs to come back. I supplement B12 and wanted to know if you have seen this before or if you can recommend anything to help?

  • Lee Campbell

    I would love to eat less meat and more beans/grains but I can’t. Grains and beans (among other things) make my antinuclear antibodies go through the roof resulting in terrible joint paint, fatigue, brain fog, etc. What does it mean that the only diet that I can function on is autoimmune paleo?

    • Lee Campbell