Our annual review of simple stuff to win better health.

The coronavirus pandemic sent an overpowering message to people around the planet: Pay attention to your health — or else. But with the hideous toll it has taken on our country, is it a bit much to add to Americans’ burdens by talking at this moment about diet, exercise, and improving personal health?

Maybe, maybe not.

At some point, we’re going to be in a more normal state, returning to our workplaces and activities with people we miss. And we will want to look and feel our best.

There’s no better time than now for a new year overview of simple things we can do to shore up our own personal health.

So, let’s bid farewell to a horrible 2020 just past and set a fresh, more healthful course in the new year — with steady, sustainable attention to crucial concerns like diet and exercise.

Many Americans may have felt as if the coronavirus painted a target on their backs, as public health officials warned that certain aspects of their health heightened their risk with this disease.

These underlying conditions were not exotic. Too many were familiar challenges to too many people’s well-being. They included excess weight, high blood pressure, smoking, diabetes, and heart diseases — all conditions that medical scientists long have advised can be improved if patients take better care of themselves, notably through diet and exercise.

Consider what the federal Centers of Disease Control and Prevention reported, well before the pandemic occurred, about the risks of carrying too many pounds:

“People who have obesity, compared to those with a normal or healthy weight, are at increased risk for many serious diseases and health conditions, including the following: All causes of death (mortality); high blood pressure (hypertension);  high LDL cholesterol, low HDL cholesterol, or high levels of triglycerides (dyslipidemia); Type 2 diabetes; coronary heart disease; stroke; gallbladder disease; osteoarthritis (a breakdown of cartilage and bone within a joint); sleep apnea and breathing problems; many types of cancer; low quality of life; mental illness such as clinical depression, anxiety, and other mental disorders; [and] body pain and difficulty with physical function.”

The World Health Organization for years has urged people globally to get up and move more, noting the value of exercise to health and the harms caused by couch-potato living:

“Sedentary lifestyles increase all causes of mortality, double the risk of cardiovascular diseases, diabetes, and obesity, and increase the risks of colon cancer, high blood pressure, osteoporosis, lipid disorders, depression and anxiety. According to WHO, 60% to 85% of people in the world — from both developed and developing countries — lead sedentary lifestyles, making it one of the more serious yet insufficiently addressed public health problems of our time. It is estimated that nearly two-thirds of children are also insufficiently active, with serious implications for their future health.

“Physical inactivity, along increasing tobacco use and poor diet and nutrition, are increasingly becoming part of today’s lifestyle leading to the rapid rise of diseases such as cardiovascular diseases, diabetes, or obesity. Chronic diseases caused by these risk factors are now the leading causes of death in every part of world except sub-Saharan Africa, where infectious diseases such as AIDS are still the leading problem. These chronic diseases are, for the most part, entirely preventable.”

The basic prescriptions for better health and longer, more satisfying lives have not changed much for years, the pandemic notwithstanding. Many of us can recall the expert guidelines, almost like a mantra: Eat healthfully and not too much. Cut out the excess sugar and salt. Don’t smoke (or vape). Move as much as possible, with vigorous exercise a great idea — but not too much. Get a good night’s sleep. Moderate or reduce the use of intoxicants, whether booze or marijuana. Build and maintain good relationships and minimize the stress. Find a purpose in life, recognizing that this may mean spiritual or religious beliefs are a part of what you do.

Still, if we know these truths, why are they so hard to follow?

During the intense stresses of the pandemic, we’ve all been locked down to some degree. We understandably may have decided against beating ourselves up as we’ve tried to cope.

Translation: Too many of us packed on the “quarantine 15” — excess weight that now may add to our struggles. In the dark winter chill, it may seem like an Everest-sized resolution to improve our diet, exercise, and well-being.

But that is the sort of challenged thinking that, in more normal times, led to the fast-fading January fitness club crunch. It didn’t work. Neither did folks leaping on fad diets that lasted for just weeks. It’s unclear whether “Dry January” plans, with tipplers forgoing drink after the holidays, had much success. If people make their 2021 health resolutions in the same way, these too may have weak outcomes.

Instead, it is important to know that changing routines — creating new habits — takes focus, practice, time, and a commitment. Seasoned journalist Charles Duhigg reported in his book the key steps to remodeling behavior, focusing on four areas or a loop that underlies habits. He says people need to: Identify your routine. Experiment with rewards. Isolate the cue. Have a plan. In brief, as he explains, people fall into unconscious patterns or routines that they can’t disrupt until they identify them. They need to understand, too, why their habits work for them (rewards), and what behaviors or circumstances (cues) trigger these. By understanding these steps, people can determine how to alter them over time.

Resist the excuses

Many people may fault the season, for example, for their becoming all but inert. Sure, it can seem daunting to exercise in cold, windy, rainy, or snowy conditions. But, hey, huge parts of the northern hemisphere experience weather far uglier than the DMV (the District of Columbia, Maryland, and Virginia). Hearty souls have learned to gear up appropriately and to find fun pastimes.

Consult with your own doctor before launching into new diet or fitness regimens. Don’t tarry, though, about making beneficial changes.

Be wary of winter falls on slippery surfaces. But consider amping up your activity, slowly and with intention. Set aside time as your schedule accommodates and make it a regular thing, say, to take a brisk walk of whatever duration you can manage. Do it early to set the tone for the day or do it later to help deal with stresses that may build up. Make it a break and a reward, focusing on staying in the moment and taking in small and shifting details — birds, insects, wildlife, and plants — especially as the weather improves.

The DMV has terrific parks and paths and hikes (like the Potomac Heritage Scenic Trail) to accommodate all capacities. People flock from all around the planet for the privilege of strolling the National Mall or around other historic sites. If museums and gardens reopen, these can provide options, as can “retail exercise” — sojourns through shopping malls or other retail centers (stash the credit cards and wallet at home, of course). Enthusiasts also shout out the cardio-building value of outdoor stair exercise. If the area gets enough snow, maybe add snow shoeing or cross-country skiing in facilities available nearby.

Plenty of activity options

If walking or running do not suit, try biking. Squeeze in rides amid inclement weather. Again, the DMV is blessed with lots of options for cyclists. Do mind the rules of the road, be considerate of others, and be safe while riding. Consider clearing space in the house or garage for devices that allow users to mount their bikes and use them like exercise cycles in the gym.

By the way, pick with care, but a little online searching will produce a sizable array of choices for free exercise videos or streams of all sorts. These allow viewers to try out everything from Zumba to Qi Gong. If you and the significant other have grown weary of each other 24/7, maybe a little spark will be reignited by trying online lessons in various styles of dancing together? Maybe you want to boost your flexibility with online yoga training and ballet barre classes?

Experts say that those seeking to optimize their workouts in the least time may want to try so-called high-intensity interval training — regimens that include multiple, short bouts of vigorous activities that work major areas of the body in heart-rate raising fashion. These sessions may call for jogging, broken up with periods of sprints, jumping jacks, rapid bench– or stair-stepping, or burpees (squats and thrusts).

Strength and resistance training are always key components of solid exercise regimens, especially for older people. These do not require heavy-duty equipment, as online research can demonstrate. Many exercises rely on the resistance of an individual’s own body weight (think pushups) or the use of convenient elastic bands or cords. Some people find e-devices helpful in monitoring their exercise, and it may surprise them to see how fast calorie counts can soar with a morning or afternoon of vigorous house cleaning, including hoisting a vacuum cleaner or bucket and mop, up and down stairs.

Many enthusiasts also know that showy blossoms and luscious fruits and vegetables will prosper in the spring and summer, depending on gardeners’ toil in the winter. Check out DMV and university extension services for ideas and tips for seasonal yard prep that will pay off — not only in greening your thumb but also in getting you active and mentally and physically fitter, right?

Finding what pleases you

Pick activities that appeal and, as circumstances allow, reinforce their value to you in multiple ways, as Duhigg suggests. Involve others in them, as is safe and appropriate. Bring the spouse, kids, and the dog along, if possible, on walks, hikes, and rides. It may not be wise to participate in group activities, unless public health officials advise it is so. If vaccination, health restrictions, the weather, and other circumstances allow, it may be beneficial to boost your activity in group sports, swimming, and in-person pastimes. It may be that you can boost your commitment to improving your well-being just by talking about your plans and accomplishments with others. It’s harder to back out if you’ve promised your partner or family. If you’re the wagering type, putting a little cash down may give you a concrete goal to help ensure you get busy with your ambitions.

You should not expect instant, positive results. Losing weight, even with optimal, intense support, is difficult.

Getting fit takes time. But imagine how much more you will enjoy an active spring or summer, especially if the coronavirus is much corralled by then (or a little later), and that could be a giant motivator, including for another key area that will require attention: your diet.

For a fast-food nation, the coronavirus pandemic put a renewed spotlight on shortcomings in the way Americans eat.

The restaurant business cratered. Groceries, at least early on, struggled to keep shelves stocked. The public got an eyeful, almost akin to the exposés of legendary muckraker Upton Sinclair, about the persistent health problems associated with exploitative food growing and processing in industrial facilities like meat and chicken packing plants.

For many of us, food all but returned to its primal callings. Forced to stay at home, we not only cooked and baked, but many people also found deep comfort in preparing and eating meals. Take-away and meal-delivery eating never disappeared. It even flourished. But while many households struggled with having everyone home, 24/7, in close confines and under one roof, long commutes vanished for many. That meant people could plan and eat breakfast, lunch, and dinner with loved ones.

Alas, whether due to round-the-clock anxious snacking and hasty eating between relentless online meetings, the quarantine bulge also became common. It has not helped that lockdown imbibing became  a trend, along with home baking of carbohydrate- and calorie-laden creations.

Easing up on anxious eating

It is easy to see why. But is it time to ease off the comfort chowing down, bite by bite, into the new year? Can we adhere to the healthful approach suggested by experts and summarized by journalist Michael Pollan: “Eat food. Not too much. Mostly plants.” He also has observed in his dietary “rules”: “If it’s a plant, eat it. If it was made in a plant, don’t.” Or: “It’s not food if it arrived through the window of your car.” And: “Buy smaller glasses and plates” — your portions will seem larger. Also: “Do all your eating at a table” and “Try not to eat alone,” because this will help you slow down and enjoy your meals more.

Sure, we all want to support our favorite local eateries by buying their takeout food or dining outdoors in restaurants, if allowed. With some employers failing to respect the boundaries and pushing (wrongly) their staff to do more work at home than they were tackling in the office, we all may find ourselves grabbling fast-food, notably burgers and pizzas.

But, hey, try reducing the consumption of processed foods. Add more fish and nuts to your diet. Federal advisors, quietly, have kept meeting during the pandemic and they wanted new government nutrition guidelines to urge the public to slash even more the intake of refined foods, as well as sugar. The Trump Administration, in its dwindling days, declined this advice. Still, the good-nutrition folks and doctors long have chased us to cut the high number of calories most of us gobble down.

The coronavirus health restrictions, however, may provide a little cause for optimism about Americans’ diet. That’s because so many of us have greater control of what we eat and how it gets prepared while we’re staying at home. We can recommit in the new year to steady, incremental changes that can add up in positive way.

We can, slowly, cut back on processed snacks, replacing them with fresh fruit and vegetables (think apple and carrot slices versus chips and dips). We can ease up our consumption of red meat and carbohydrates (potatoes and rice), putting more salad and vegetables on the lunch and dinner plate. Instead of setting aside time for daily cocktails or comfort baking, maybe divert yourself and your loved ones into increasing exercise and activity?

Cutting calories? It’s not complicated

It takes little imagination and less calculation to see that many of us, with small and steady changes, could go hundreds of calories to the healthful side of the ledger each week and thousands per month (see example in newsletter’s  By the Numbers section). We could do so by increasing our activity, eliminating excess alcohol, snacks, and baked and processed goods, while opting for smaller portion meals with fewer carbs and less red meat. As experts have underscored, what we eat may be a bigger factor in weight gain and loss than how much we exercise. That’s because it is hard to run, swim, or play — without injury — with the intensity and duration to burn off excess consumption.

Tempting though it may be, please don’t get tangled up in the thicket of fad diets and nutrition trends. When it comes to these areas, hokum abounds along with sketchy information. U.S. News, as it does with doctors, hospitals, and universities, consults with experts and ranks diets annually, though the list leaders change relatively little. A recent rage suggested that “intermittent fasting,” including forgoing eating after a specified time at night, could be a dieting boon. Not necessarily so, subsequent studies found.

New research suggests why ordinary folk should take expert “studies” on diet and nutrition topics with a grain of salt: That’s because researchers found that even peer-reviewed publications in nutrition come with extensive conflicts of interest that undercut published journals’ credibility:

“It’s common for studies in leading nutrition journals to have ties with the food industry, and such studies are more likely to have findings that support industry interests, researchers report. They reviewed all peer-reviewed studies published in 2018 in the 10 most-cited nutrition and diet-related academic journals. The researchers found that 13.4% of the more than 1,400 studies reported that they had connections with the food industry, such as funding from food makers or authors linked with food companies. Compared to a random sample of 196 studies without food industry involvement, those with industry ties were more than five times more likely to report results that favored food industry interests (55.6% vs. 9.7%), according to the study published Dec. 16 in the journal PLOS ONE.”

As Gary Sacks, an author of this study and an associate professor at Deakin University, in Melbourne, Australia, summarized the significance of the research findings, saying: “Where the food industry is involved, research findings are nearly six times more likely to be favorable to their interests than when there is no food industry involvement.”

Rigorous, reliable research on diet and nutrition is difficult to find, so it’s worth paying close attention to the results of an $8-million, year-long study conducted at Stanford University with more than 600 test subjects. Its recommendations are filled — in a good way — with common sense and moderation.

The New York Times reported that findings of the study, funded by the National Institutes of Health, the Nutrition Group and others, help debunk some long-held notions about dieting — and some diet fads. Here’s the core of the work’s key findings, according to the newspaper:

“[P]eople who cut back on added sugar, refined grains, and highly processed foods while concentrating on eating plenty of vegetables and whole foods — without worrying about counting calories or limiting portion sizes — lost significant amounts of weight over the course of a year. The strategy worked for people whether they followed diets that were mostly low in fat or mostly low in carbohydrates. And their success did not appear to be influenced by their genetics or their insulin-response to carbohydrates, a finding that casts doubt on the increasingly popular idea that different diets should be recommended to people based on  their DNA makeup or on their tolerance for carbs or fat.”

Getting healthier, in other words, need not be an ordeal as much as an exercise in common sense.

The United States long has outspent other western industrial nations for its health care, while racking up overall poorer outcomes. America’s health care outflow devours trillions of dollars annually, edging toward spending 1 out of every 5 dollars of gross domestic product.

The pandemic has left our health care system wobbling, and it even may collapse in some areas as coronavirus cases overwhelm doctors, nurses, and other front-line health workers and hospitals and clinics. Standing at the precipice of a further health care calamity, it may be past time for each of us to step up, for our own sakes as well as for our nation, to make ’21 a banner year for improving our well-being, individually and collectively.

This effort may be motivated by the simple desire just to fit in one’s former work duds, or to be robust enough to take full advantage of an impending time of active socializing, travel, dining out, attending cultural performances — and so much more.

Savaged by serious ills

Still, there is another unhappy reality in which improvements in diet, exercise, stress reduction, sound sleep, moderation in the use of alcohol (and marijuana) and abstaining from smoking (and vaping) can be hugely beneficial: dealing with chronic health conditions.

The CDC reports that 6 in 10 American adults struggle with at least one chronic illness, while 4 in 10 must deal with two or more. These persistent, debilitating, and costly conditions include: cancer, heart disease, lung illness, stroke, diabetes, kidney ailments, and Alzheimer’s disease. Better diet could boost patients’ efforts to improve their control of high blood pressure and cholesterol (and heart ailments), as well as diabetes and kidney issues, experts say. Keeping a healthful lifestyle, recent research found, can result in a measurable association with longer lives, freer of harmful conditions. As the researchers reported of their scrutiny of 15 years of data on 116,000 European subjects:

“The main finding of this study was that a high overall healthy lifestyle score and various lifestyle profiles characterized by four optimal lifestyle factors were associated with significant gains in years lived without major noncommunicable diseases between ages 40 and 75 years in both sexes. Comparing the best with the worst lifestyle score was associated with approximately 9 additional years without chronic diseases. A 1-point advantage in healthy lifestyle score was associated with an almost 1-year increase in years spent without type 2 diabetes, coronary heart disease, stroke, cancer, asthma, and COPD.

“Of the 16 different lifestyle profiles studied, all 4 that were associated with the longest disease-free life span included a BMI less than 25 and at least 2 of the following health behaviors: never smoking, physical activity, and moderate alcohol consumption. The results were essentially the same when heart failure and dementia—2 further common conditions of older age—were considered in addition to the other 6 diseases.”

After all the anxiety, anguish, and sacrifice that so many Americans have experienced in the pandemic year, it would be a doggone shame to just shrug and say, phew, the nation survived it. Instead, we all can determine if the vaccines work for us and get the shots if they do (see sidebar). We can practice great hygiene (especially robust hand washing), cover our faces, maintain distances, and avoid closed spaces with questionable ventilation. We can stay at home as much as we can, not mixing with others outside our immediate households. We can act with mutual altruism, protecting ourselves and our loved ones as well as others, and hoping they do the same for us.

We’ll emerge in due time, maybe not just OK but better — healthier and knowing we are in a better place than before. As always, my colleagues in the firm and I wish that you and yours enjoy all the best health in 2021 and beyond!