Reviving our fading New Year’s resolutions

New Year’s is receding fast in the rearview mirror. And for many of us, our sincere resolutions about losing weight and getting fitter are also fading fast.

But there’s good news for helping us renew our commitment to more healthful living.

Modern medicine already has in hand significant research about preventing debilitating and deadly illnesses like heart disease, cancers, Alzheimer’s and dementia. Studies are showing that many of us start but don’t keep up the powerful prescription to slash risk factors for these and other chronic illnesses.

Yes, all the things that your doctor and medical scientists want you to resolve to take up in 2025 and beyond have potent potential — at lower cost and often with only modest change — to keep you from a lifetime of health struggles.

So let’s dive into what the research shows.

The annual advice for making 2025 and beyond more healthful for all will be familiar and straightforward. It’s worth repeating:

DIET: Eat less (use smaller plates and don’t keep going back for seconds and more). Eat more plant-based foods (whole grains, fruits, and vegetables of many colors), sustainable fish, beans, and nuts. Cut your consumption of red meat, pork, and cured or preserved meat products (hot dogs, sausages, and the like). Slash the salt (look at the product labels and don’t be surprised by foods high in sodium like breads and canned soups) and do the same for the sugar (wean the kids off sweet drinks, including excess downing of fruit juices, phony juices, and sodas). Avoid foods with labels listing many unfamiliar ingredients, aka chemical additives. Be wary of foods that have undergone extensive processing. Skip fast foods and meals on the run in favor of sit-down, home-cooked, and intentional dining, especially with loved ones and friends.

While research and experience are increasing the support for new, hormone-regulating, appetite-decreasing weight-loss medications, many of us may not need to drop so many pounds as to seek this medical option. Diets persist not only in their popularity and wild changes (at least as recommended by online “influencers”) but also in their adoption by regular folks. (It’s no wonder, with the CDC estimating that 41% of Americans older than 20 carry excess weight or are obese.) Stop listening to celebrities or heeding unreliable internet postings. No one diet fits and works for all. Dieting for weight loss requires discipline and a sustained commitment. It is tough to rigorously study a complex question to find “best” diets. Medical and nutritional experts have found extensive evidence about the benefits of select diets and their approaches. To find what might suit you best, talk to your doctor and dig into the online information from mainstream sources such as Harvard, the Mayo Clinic, Consumer Reports, and U.S. News and World Report.

EXERCISE: It’s great if you have the vim and vigor to participate in high-demand cardio exercises like brisk running or speedy swimming. If you can, make regular time for these. But even if you have gotten to pokey phases of life, get up and move. Walk more — it can be around the block, up the office stairs, or around the house to take care of chores. Avoid sitting for prolonged periods. Set an alarm on digital devices to force yourself to take breaks — to walk down the hall to talk to a colleague (rather than sending a message on the company system). Grab the kids and spouse, a good buddy, or the pooch, maybe even the tabby, and saunter around the neighborhood after work or after meals. If it is stormy or too hot or cold outside, leave the credit cards and most of the cash behind and consider walking around the local mall. Or jump in the indoor pool. Go dancing. Vary your workout routines. Be sure to include plenty of stretching and work with weight-resistance training.

In case you haven’t determined this from years of trying: Exercise offers its own benefits, and it should not be looked at as a panacea for weight loss.

SUBSTANCES: Moderation matters with intoxicants and tobacco. The new year offers a great time to reconsider and slash or eliminate smoking, and vaping, as well as drinking alcohol and taking in marijuana and other substances. Studies are leading doctors and others to walk back from theories about beneficial, moderate drinking. The U.S. Surgeon General, in his waning days in office, urged Congress to consider the extensive research he has amassed and to require cancer-warning labels on alcoholic beverages.

Widespread marijuana use also has increased concerns about the harms of grass use, especially to excess. It should be clear that smoking tobacco — cigarettes (flavored or not), cigars, pipes, hookahs, and more — harms users’ health, significantly. Vaping, as a potential option to reduce one bad habit (smoking), creates its own negatives, notably for the young. If you don’t drink, smoke, or vape (tobacco or marijuana) or abuse other substances, don’t start. Don’t mix booze or other intoxicants with prescription medications and please don’t drive under the influence. Those taking multiple prescription or over-the-counter drugs should get their doctor and pharmacist to review the list often to eliminate meds no longer needed.

SLEEP: Human beings need regular sleep to stay mentally and physically healthy. Studies emphasize that a good night’s rest is crucial for young people’s growth and development. However, digital devices often interfere with sleep by causing late-night stress from work or the excitement of video games and TV shows. For better sleep, especially for kids but also for adults, try these tips: Start winding down an hour before bedtime. Turn off all electronic screens and consider removing laptops, tablets, and smartphones from the bedroom. Have a comforting drink, like warm milk, and avoid heavy meals before sleep. Maintain a consistent sleep schedule. Keep the bedroom at a comfortable temperature and mostly dark. Teens may have different sleep patterns due to their natural development, often staying up late and sleeping in. They need more sleep than they might realize, and parents may need to encourage good sleep habits.

If that rundown of ways to advance toward a more healthful lifestyle seems daunting, medical researchers now offer powerful incentives: These lifestyle changes can play a significant role in preventing a disease that many dread: cancer.

In 2024, the American Association for Cancer Research — an internationally recognized and respected group — issued its annual report and emphasized the importance of reducing the risk of a disease that federal officials say has been one of the two leading causes of deaths in this country for 75 years. The group and others say that cancer treatment, as costly as it can be, likely cannot keep pace with the number of cancer cases, and so prevention is a must.

This is not as formidable a goal as it might seem, studies show:

“In the United States, 40% of all cancers are associated with modifiable risk factors, which necessitates a robust emphasis on and support for public health-focused research. The significant decline in cancer mortality over the past three decades is, in part, attributable to reductions in smoking following the implementation of public health campaigns and policy initiatives. Nearly 20% of U.S. cancer diagnoses are related to excess body weight, unhealthy dietary patterns, alcohol intake, and physical inactivity.”

The group also noted that known hazards, which can be reduced, also can help avert cancer cases:

“Air pollution, water contamination, carcinogenic chemicals in consumable goods (e.g., cars and furniture), endocrine-disrupting chemicals, and naturally occurring radon gas increase a person’s risk for certain types of cancer, including common cancers such as lung cancer.”

Among the risk modifications that most regular folks can undertake, some stand out, cancer researchers have found. As mentioned above, smoking causes huge harm (a prime offender in 20% of cancer cases). Decades of sustained campaigning against tobacco abuse has led to big health gains in this country.

Medical experts continue to target poor diet and sedentary living as two other areas of significant cancer-causing concern. These two not only roll up to increase cancer risks, but they also prove to be big factors in obesity — itself a problem tied to increased cancers — and the complication of yet another harmful and chronic condition: diabetes.

A study published by the American Cancer Society in mid-2024 found that “excess body weight, or obesity, came in second [behind smoking in] accounting for 7.6% of cancer cases in men and women combined … Physical inactivity was the fifth most significant changeable risk factor and could be blamed for over 3% of cancers.” A 2023 study published in JAMA Oncology, a medical journal, also noted that: “Not exercising accounts for about 3% of cancer cases … Conversely, incorporating physical activity into your daily routine can reduce cancer risks by as much as 30% …”

Medicine has made major strides in combating cancer, improving and sustaining lives of the patients with a disease that once was considered a death sentence. Research and innovation are targeting therapies better, reducing harsh, invasive, painful, and draining treatments such as those involving radiation, chemicals, and big-scale surgery.

The advances have come at a steep cost, with cancer treatment forecast by 2030 to cost patients, their loved ones, and the country hundreds of billions of dollars annually. Prescription cancer drugs and other care in this field have become so crushing that cancer specialists have recognized that “financial toxicity” is a major challenge.

The news about heart disease prevention is even more dramatic than for cancer. Research is showing how healthful lifestyles could slash the incidence of heart disease by as much as 80%, depending on the exact cardiac condition.

The American Heart Association says that researchers and clinicians have such high confidence in the positive effects of preventive measures that they have distilled extensive studies into what the heart organization has dubbed “Life’s Essential Eight.” They could be a template for healthier New Year’s resolutions, as described above in this newsletter. The steps are:

§ Eat better.
§ Be more active.
§ Quit tobacco.
§ Get healthy sleep.
§ Manage weight.
§ Control cholesterol.
§ Manage blood sugar.
§ Manage blood pressure.

Americans must adopt these measures with urgency and a resolve that lasts far beyond 2025, the heart organization says:

“Most heart disease and stroke deaths are preventable. However, cardiovascular disease remains the No. 1 killer and the most expensive disease, costing nearly $1 billion a day. While cardiovascular disease is largely preventable, it tops the disease burden list and this situation is expected to worsen according to recent projections showing that by 2035, 45% of the U.S. adult population will live with cardiovascular disease at an annual cost of more than $1 trillion.”

Stat, an online science and medical news site, recently posted a series on heart specialists’ increasing frustrations with the stagnation and even retreat in progress against cardiac conditions:

“[H]eart disease is far higher than it should be given the tools we have. This is compounded by a disconnect that has formed in the public’s mind between threat and perception. This year, an American Heart Association survey revealed that just over half of Americans are unaware that heart disease remains the leading cause of death, outstripping cancer. Nor are most people aware of the vulnerability of particular groups …  ‘People don’t know that cardiovascular disease is actually the leading cause of mortality in pregnant or postpartum women,’ said Janet Wei, assistant medical director of the Biomedical Imaging Research Institute at Cedars-Sinai Medical Center in Los Angeles. If current trends continue, the heart association estimates, by 2050 at least 6 in 10 U.S. adults will live and die with cardiovascular disease of some type, reflecting an older population burdened by high blood pressure and obesity, despite what we know about those conditions predicting disease.”

As one of the experts quoted in the series says: “The best medicine is prevention, a path paved by better access to health care and starting with primary care providers. ‘All of this is still a downstream consequence of the fundamental issue: How do we prevent heart disease?” Clyde Yancy, chief of cardiology at Northwestern University Feinberg School of Medicine, said about deaths from heart disease, which total about 1,905 deaths each day in the U.S. ‘We’re talking now about moving upstream and really addressing how we can change lifestyles at an earlier age.’”

Joseph Wu, past president of the American Heart Association and director of the Stanford Cardiovascular Institute, is quoted in the news article with a view that will be familiar to those resolving to take steps to be healthier in the new year:

“[I]nstilling healthy habits is hard for both doctors and patients. ‘You could do all the basic research you want, but if you can’t implement it, it doesn’t translate to improved outcomes,’ he said. ‘Patients themselves know that obesity is bad. Patients themselves know that high blood pressure, high cholesterol is bad, but they just don’t take on active participation until they’re sick.’”

The U.S. 65-and-older population is booming by the day, and with it, anxiety about Alzheimer’s and other types of dementia.

Pollsters say these thinking disorders are highly feared and stigmatized by too many Americans.

Researchers at RAND, a Santa Monica, Calif., think tank, have found that the actual prevalence of these troubling conditions has shown an unexpected dip from earlier forecasts:

“In 2021, about 6.2 million U.S. adults aged 65 or older lived with dementia. Because age is the strongest risk factor for dementia, it has been predicted that increasing life expectancies will substantially increase the prevalence of Alzheimer’s disease and related dementias from about 50 million to 150 million worldwide by 2050. However, there is growing evidence that age-adjusted dementia prevalence has been declining in developed countries …”

The RAND experts and others say that changes toward healthier lifestyles — and other factors — may be key in averting a crisis in caring for a significant population of older patients with cognitive decline.

The RAND experts explain the conditions:

“Dementia causes serious loss of cognitive ability, including memory, communication and language, reason and judgment, and visual perception. Alzheimer’s disease is the most common form, but all dementias go beyond the normal signs of aging to interfere with daily life, affecting millions of people each year.”

No cure exists for these conditions, and treatments — notably costly and difficult prescription medications — are only slowly emerging. That has led researchers to zero in on positive preventative measures, including those reported in the Lancet. As a science news article described the expert findings in the journal: “45% of dementia risk can be reduced.” The team of more than two dozen experts said:

“[A]n ambitious program for preventing dementia … could be implemented at the individual, community, and policy levels and across the life span from early life through mid and late life. The key points include: In early life, improving general education. In midlife, addressing hearing loss, high LDL cholesterol, depression, traumatic brain injury, physical inactivity, diabetes, smoking, hypertension, obesity, and excessive alcohol. In later life, reducing social isolation, air pollution, and vision loss. Together, these add up to the Lancet Commission on Dementia’s estimate that 45% of dementia risk can be reduced. And an abundance of new research shows that when risk factors are addressed, such as exposure to air pollution, they are linked with improved cognition and likely reduction of dementia risk. New evidence supports the notion that in high-income countries, reducing dementia risk can translate to more healthy years, years free of dementia, and a shorter duration of ill health for people who develop dementia.”

RAND researchers, in an observational study of common factors associated with dementia and Alzheimer’s incidence, found that people increased their risk of these conditions if they: did not exercise, had diabetes or a high body mass index, had never worked, lacked private health insurance, never drank or excessively drank alcohol, [and] had few hobbies. Their study reported that low levels of education mattered and:

“Low cognitive ability, functional limitations, and poor physical health are strong predictors of dementia as many as 20 years before its onset … Early detection of cognitive impairment helps people take mitigating actions to prepare for future loss of their financial and physical independence.”

The American Heart Association in the fall of 2024 issued a scientific statement, based on extensive study, linking cardiovascular, brain, and neurologic health, CNN reported. Dr. Fernando Testai, a professor of neurology and rehabilitation at the University of Illinois College of Medicine in Chicago, in a statement quoted in the news article, said this about this vital connection:

“Dementia is commonly seen as an incurable and relentless disease that cannot be prevented. Evidence shows, however, that adopting a healthy lifestyle and identifying and treating vascular risk factors early may help preserve normal brain function and reduce the burden of Alzheimer’s disease and other related dementias.”

In case anyone skipped the heart organization’s “essential eight” in the section above, the group underscored how steps like those also can be crucial to keeping the brain and nerves healthy and functioning well, avoiding conditions that lead to harsh cognitive decline.

As CNN also reported, quoting Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver:

“If there is only lifestyle change you can make, focus on exercise, Freeman said. Adults should do 150 minutes of moderate-intensity activity or 75 minutes of vigorous activity each week, along with strength training, according to the CDC. You know you’re doing moderate exercise when you are breathing hard and unable to sing a song, but can still talk. Vigorous activities such as jogging, swimming laps, or playing basketball will make it hard to speak at all. The increase in activity benefits the whole body, including the brain, studies have shown. A September 2022 study found people who walked at a very brisk pace of 112 steps per minute for 30 minutes a day lowered their risk of dementia by 62% …

“‘Physical activity is just absolutely magnificent,’ Freeman told CNN. ‘And when if you blend that with eating a more plant-based diet, de-stressing, sleeping enough and connecting with others — that’s your magic recipe.’”