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The Harvard Guide


to Healthy Living
10 steps to a
longer healthier life

Harvard Medical School


Trusted advice for a healthier life
2 THE HARVARD GUIDE TO HEALTHY LIVING | 10 steps to a longer healthier life w w w.heal th.ha r va rd.edu
Harvard Medical School

SPECIAL REPORT
10 STEPS TO A LONGER HEALTHIER LIFE

Risk reduction has a lot in common with one-stop shopping: it’s possible to reduce your risk
of the many major degenerative diseases by following the advice below.

Stay away from


1 cigarette smoke
Iff you smoke, quit. There are Separate yourself from smokers. Regular moderate exercise can
few things you can do that will Inhaling another’s smoke is also help to protect you against the
have such immediate and lasting emerging as a weaker, but still following problems:
benefits as giving up cigarettes. noteworthy, risk factor. If you’re a Heart disease and
In 20 minutes, your heart rate nonsmoker, become a nag. Let the stroke. Regular exercise helps
will fall. By tomorrow you’ll have smokers in your circle of friends to strike a healthier balance
cleared the excess carbon mon- and family know that you would of blood lipids (HDL, LDL, and
oxide from your blood. Within like them to quit, and encourage triglycerides) and helps arter-
months, you’ll be breathing more them in their efforts. Be patient. ies retain resilience despite the
easily and coughing much less. Only 4% to 7% of smokers are effects of aging. It reduces blood
Over the years, your risk for lung able to quit on any attempt pressure, which in turn lowers
cancer, stroke, and heart disease without aids like nicotine replace- the risk not just of heart disease,
will have dropped by at least half. ment products or medical help, but also of stroke and kidney
In 15 years, you’ll have erased and only one-quarter to one-third failure. Exercising regularly may
your excess risk for heart disease. who use any quit-smoking medi- also promote the growth of
cine stay smoke-free for more collateral arteries, small blood
than six months. It usually vessels feeding the heart. Even if
takes many attempts before you already have heart disease,
a person is successful at quit- exercise lowers your chances of
ting. dying from it.
Cancer. Exercise reduces
Keep moving
2 Lack of physical activity
is an independent risk
the risk of cancers of the co-
lon, breast, endometrium, and
prostate. By helping you attain a
factor for nearly all of the
healthy weight, exercise also less-
diseases that are most likely
ens your risk for other cancers in
to kill or disable you. In the
which obesity is a factor.
long-running Framingham
Diabetes. Exercise pares
Heart Study, moderate activ-
excess weight, modestly lowers
ity tacked on 1.3 years of life
blood sugar levels, and boosts
for men and 1.5 years of life
sensitivity to insulin so that
for women versus low activ-
your body needs less of it. If you
ity. Raising the bar to high ac-
already have diabetes, exercise
tivity added 3.7 years for men
helps control blood sugar.
and 3.5 years for women.
Osteoporosis. When com-
bined with calcium, vitamin D,
and bone-saving medications if

THE HARVARD GUIDE TO HEALTHY LIVING | 10 steps to a longer healthier life w w w.heal th.har va rd.edu 3
necessary, weight-bearing exercise to the health benefits of specific may help satisfy appetite. The
like walking, running, and strength foods or nutrients, rarely have monounsaturated fats in olive
training helps ward off bone loss. entire eating regimens undergone oil, nuts, and fish can have anti-
Arthritis. Exercise helps pro- close scientific examination. A inflammatory effects, which may
tect joints by easing swelling, pain, notable exception is the Medi- help stave off heart disease and
and fatigue and by keeping carti- terranean diet, a term coined to many other conditions. Perhaps
lage healthy. Strong muscles sup- describe the traditional eating most important to its success is
port joints and lighten the load pattern of people living in the that Mediterranean-style eating
upon them. Exercise may limit and region bordering the Mediterra- excludes many foods known to
even reverse knee problems by nean Sea. The Mediterranean diet cause health problems: saturated
helping to control weight. consists mostly of plant foods fat from animal sources, trans fat,
Accidents. Activities like (fruits, vegetables, grains, beans, and refined carbohydrates.
stretching, yoga, and tai chi extend nuts, and seeds); animal protein Studies have found that the diet
range of motion and enhance consumed chiefly in the forms of helps to lower the risk of the fol-
balance, which helps prevent falls fish and poultry; olive oil as the lowing conditions:
and other accidents. principal fat; and wine taken with Obesity. A two-year random-
Depression and anxiety. meals (see Figure 1). ized trial comparing low-fat, low-
Exercise lifts spirits by releasing Although the diet was a product carbohydrate, and Mediterranean
mood-elevating hormones, of the foods easily cultivated or diets in middle-aged, mildly obese
relieving stress, and promoting gathered in that region centuries men and women found that those
a sense of well-being. In some ago, modern research confirms who followed the low-carb and
studies, exercising regularly has its unintentional wisdom. Multiple Mediterranean diets lost an aver-
helped ease mild to moderate compounds in plant foods appear age of 10 pounds, compared with
depression as effectively as to act as antioxidants, slowing the an average of 6 pounds among
medications; combining exercise aging process and hindering the those on the low-fat diet. The
with medications, therapy, and development of cancer and heart Mediterranean diet also lowered
social engagement is even better. disease. By slowing digestion, the LDL (bad) cholesterol most and
fiber in whole grains, legumes, controlled blood sugar most
Eat like an Aegean
3 Although countless observa-
tional studies have pointed
and fruit can help keep blood
sugar under control; fiber also
creates a feeling of fullness, which
effectively.
Heart disease. In the Nurs-
es’ Health Study, which involved
nearly 75,000 women, those
HOW MUCH EXERCISE IS ENOUGH? whose diets most closely approxi-
mated the Mediterranean pattern
In the fall of 2008, the U.S. Department of Health and Human Services is- were 28% less likely to die of
sued a detailed exercise prescription for the nation. Every adult was urged heart disease or stroke during an
to get at least 150 minutes of moderate aerobic activity—the equivalent
of walking at a rate of 3 to 5 miles per hour—or at least 75 minutes of 18-year period than women who
higher-intensity activity—a rate of 5 mph or more—a week. The sessions ate a typical American diet.
should be at least 10 minutes long and may combine both moderate and Diabetes. In a 13,380-person
vigorous activities. In addition, adults were advised to engage in at least Spanish study, participants who
two sessions of strengthening exercises a week.
strongly adhered to a traditional
Go beyond the basics if you can, say the guidelines. Once you’re rou-
tinely logging the recommended levels of aerobic activity, start to add a Mediterranean diet were 83%
few minutes a day. (Ramping up slowly reduces the likelihood of injury.) less likely to develop diabetes
The HHS committee found that you can get even greater health benefits than those following the diet least
and more effective weight control when you reach twice the recom- closely.
mended weekly amount—that is, 300 minutes of moderate activity, 150
minutes of vigorous activity, or a combination of the two. And more than Alzheimer’s disease. A
that may be even better still. study of cognitive function in
The HHS exercise guidelines emphasize that people with chronic medi- 2,258 older Americans over a
cal conditions and disabilities should get just as much exercise as other four-year period found a 40% re-
adults, if they can, and advise them to speak with their health care provid- duced risk for Alzheimer’s disease
ers about appropriate kinds and levels of exercise. The American College
of Sports Medicine Web site also has detailed advice for people with cer- among those who most closely
tain chronic health conditions at www.exerciseismedicine.org/public.htm. followed the Mediterranean diet.
All-cause mortality. The

4 THE HARVARD GUIDE TO HEALTHY LIVING | 10 steps to a longer healthier life w w w.heal th.ha r va rd.edu
NIH–AARP Diet and Health gallbladder, pancreas, or kidney. In you use. One way to start is to
Study, involving nearly 400,000 men, excess weight also increased follow the exercise and dietary
women and men ages 50 through the risk of dying from stomach or guidelines outlined above. In
71, found that people who most prostate cancer. In women, deaths fact, information from the Na-
closely followed this diet were from cancer of the breast, uterus, tional Weight Control Registry,
about 20% less likely to have died cervix, or ovary were elevated in a database of more than 6,000
of heart disease, cancer, or any women with higher BMIs. people who have lost at least 30
cause over a five-year follow-up Fat distribution also plays a role pounds and kept them off for at
period. in health risk (see Figure 2). least a year, reinforces that notion.
Other conditions. Research While fat accumulated in the The registrants report exercis-
has also found Mediterranean- lower body settles directly under ing approximately one hour a day
style eating to be associated with the skin, fat in the abdominal area (primarily through brisk walking);
improvements in rheumatoid is largely visceral, serving as pad- eating an average of 1,400 calories
arthritis, reduced risk for COPD, ding between the organs. Visceral a day, with about 25% provided
and reduced risk for recurrence fat produces substances that spur by fat; making breakfast a regular
of colon cancer. inflammation and decrease the habit; and maintaining a consistent
body’s response to insulin, which eating pattern across weekdays
Mind your BMI
4 Excess body weight increases
your risk for more than 50
sets the stage for diabetes. That’s
why a big belly—a waist mea-
surement of 35 inches or more
and weekends. They also keep
close tabs on their weight, hitting
the scales frequently.
different health problems. These
in women or 40 inches or more
conditions include some of the Lift a glass, but only
leading causes of death—heart
disease, stroke, and diabetes—as
in men—confers a higher risk of
heart disease and diabetes.
The best way to lose excess
5 one (or two for men)
We toast to good health for
well as less serious ailments such good reason. Moderate drink-
weight, wherever it is located, is
as arthritic knees and gallstones. ing—defined as one drink per
to consume fewer calories than
A Harvard study that combined
data from more than 50,000 men
and more than 120,000 women Figure 1 Mediterranean diet pyramid
found that obesity increased the
risk of diabetes 20 times and
substantially boosted the risk
Meats and sweets
of developing high blood pres- Less often
sure, heart disease, stroke, and Poultry and eggs
gallstones. Among people who Wine Moderate portions,
In moderation every two days or weekly
were overweight or obese, there
Cheese and yogurt
was a direct relationship between Moderate portions,
daily to weekly
body mass index (BMI) and risk:
the higher the BMI, the higher the Fish and seafood
likelihood of disease (see Table1). Often, at least two
times per week
Drink
Studies are also linking obesity to water
cancer deaths. An American Can- Fruits, vegetab bles,
cer Society investigation followed grains (mostly whole),
olive oil, beeans, nuts,
more than 900,000 people for 16 legumes and a seeds,
years. The findings suggested that herbs an nd spices
Base everyy meal
among people ages 50 and older, on thesee foods
overweight and obesity accounts
for 14% of all cancer deaths in
men and 20% of all cancer deaths Be
e physically
in women. Higher BMIs were acttive; enjoy
associated with a higher risk of meeals with
othhers
dying from cancer of the esopha-
Illustration by George Middleton ©2009 Oldways Preservation and Exchange Trust
gus, colon and rectum, liver, www.oldwayspt.org

THE HARVARD GUIDE TO HEALTHY LIVING | 10 steps to a longer healthier life w w w.heal th.har va rd.edu 5
day for women and two for But the dangers of heavy drink- stomach, and several types of
men—has been linked to a lower ing far outweigh these potential cancer. Some studies hint that for
risk for heart disease and death benefits. For men, heavy drinking women, even moderate drinking
from all causes. Alcohol of any means more than four drinks on may raise the risk of breast cancer,
kind increases HDL cholesterol, any day or more than 14 drinks especially for women with a family
improves the body’s response to per week. For women, it’s defined history of the disease or who are
insulin, and reduces inflammation. as more than three drinks on any on hormone therapy.
Wine in particular contains small day or more than seven drinks
Don’t Run Up
amounts of plant substances called
flavonoids that have demonstrated
anti-inflammatory and anticancer
per week. Heavy drinkers face a
higher risk of liver disease, heart
disease, sleep disorders, depres-
6 a Sleep Debt
Medical evidence suggests
that for optimum health and func-
activity in laboratory experiments. sion, stroke, bleeding from the
tion, the average adult should get
seven to nine hours of sleep daily.
Table 1 Weighing in But more than 60% of women
regularly fall short of that goal.
The body mass index (BMI) is an index of weight by height. The definitions of normal,
And as your sleep debt mounts,
overweight, and obese were established after researchers examined the BMIs of
millions of people and correlated them with rates of illness and death. These studies the health consequences increase,
identified the normal BMI range as that associated with the lowest rates of illness putting you at growing risk for
and death. Obesity has been further subdivided into three classes (I, II, and III). weight gain, diabetes, heart dis-
ease, stroke, and memory loss.
HEIGHT BODY WEIGHT IN POUNDS In some cases, sleep debt results
4’10” 91–115 119–138 143–162 167–186 191+ from insomnia or other underly-
ing conditions that may require
4’11” 94–119 124–143 148–168 173–193 198+ medical attention. But most sleep
5’0” 97–123 128–148 153–174 179–199 204+ debt comes from burning the
candle at both ends—consistently
5’1” 100–127 132–153 158–180 185–206 211+ failing to get to bed on time and
5’2” 104–131 136–158 164–186 191–213 218+ to stay there until you’ve slept
enough.
5’3” 107–135 141–163 169–191 197–220 225+
Fortunately, sleep doesn’t charge
5’4” 110–140 145–169 174–197 204–227 232+ interest on the unpaid balance,
or even demand a one-for-one
5’5” 114–144 150–174 180–204 210–234 240+
repayment. It may take some
5’6” 118–148 155–179 186–210 216–241 247+ work, but you can repay even a
5’7” 121–153 159–185 191–217 223–249 255+ chronic, longstanding sleep debt
(see “Sound advice for sleeping
5’8” 125–158 164–190 197–223 230–256 262+ soundly,” page 8).
5’9” 128–162 169–196 203–230 236–263 270+ Be your own
5’10”
5’11”
132–167
136–172
174–202
179–208
209–236
215–243
243–271
250–279
278+
286+
7 best advocate
To help ensure you’re
taking the best possible care of
6’0” 140–177 184–213 221–250 258–287 294+ your own health, perseverance
will serve you well, along with
6’1” 144–182 189–219 227–257 265–295 302+
these tips:
6’2” 148–186 194–225 233–264 272–303 311+ Form a partnership. At
6’3” 152–192 200–232 240–272 279–311 319+ midlife and beyond, good health
is increasingly dependent on good
6’4” 156–197 205–238 246–279 287–320 328+ collaborations with your clinicians.
BMI 19–24 25–29 30–34 35–39 40+ Since you are likely to be making
more medical visits, find a primary
OVER- CLASS I CLASS II CLASS III care clinician with whom you feel
NORMAL
WEIGHT OBESITY OBESITY OBESITY
comfortable. Work with your

6 THE HARVARD GUIDE TO HEALTHY LIVING | 10 steps to a longer healthier life w w w.heal th.ha r va rd.edu
from bridge clubs to group travel
Figure 2 Types of body fat to part-time jobs.
Although the benefits of social
T excess pounds that tend to
The networks are largely unchal-
crreep on at midlife often settle
arround the belly and hips. Fat that lenged, investigators from the
acccumulates in the lower body is Framingham Study have substanti-
foound between the skin and the ated the importance of holding
ab bdominal wall—so-called subcuta-
neous fat. Fat in the abdominal area
firm to your principles even when
iss largely visceral fat. Located around they may be counter to those of
thhe abdominal organs as well as your group of friends. Their data
behind the abdominal cavity, visceral indicate that adopting health hab-
Visceeral fat
faat appears to increase the risk of
innsulin resistance, which can set the its of your group can have nega-
sttage for type 2 diabetes. tive as well as positive effects on
your health. Data collected over
more than 30 years indicated
that a person had a 36% chance
of giving up cigarettes when a
Subcutaneous fat
friend stopped smoking, but a
57% chance of becoming obese if
a friend’s BMI mushroomed.
clinician to devise a schedule for Keep connected
screening tests and clinical exams
(see Table 2). If you are prescribed
8 Don’t go bowling alone. Nu-
merous studies have charted 9 Say NO to stress
You know what stress is.
medications, take them as direct- the positive influence of social Whether the source is a
ed; don’t stray from the designat- networks on health later in life. death in the family, the pain of ar-
ed dose without talking to your The Baltimore Longitudinal Study thritis, or an unfulfilled obligation,
doctor. Find out what you should on Aging and the Georgia Cen- stress affects the body the same
expect from every new medica- tenarian Study have both found way—triggering a cascade of
tion and procedure, and let your that older adults who remained hormones that produce a familiar
clinician know what you expect it socially active lived longer and physical response— pounding
to accomplish in return. healthier lives than their solitary heart, rapid breathing, and clammy
Lower your expecta- counterparts. The type of pursuit palms. Intermittent episodes of
tions. Few medical treatments, didn’t matter. Activities ranged stress are not harmful; in fact, we
from knee replacements to
face lifts, will restore you to
your 20-year-old self. Accept a What’s a standard drink?
few minor aches and pains as a
consequence of overexertion. If • 1½ ounces (a jigger) of 80-proof liquor (bourbon, gin, rum, scotch, tequila,
vodka, or whiskey)
you have a chronic condition like
fibromyalgia or irritable bowel • 2–3 ounces of fruit, coffee, chocolate, or other flavored liqueurs (cordials)
syndrome, be prepared to try a • 3 ounces of fortified wine (sherry, port, marsala, or Madeira)
number of therapies before find- • 4–5 ounces of table wine
ing the one, or the combination, • 12 ounces of regular or light beer
that works best for you.
Pay attention to your
body. Keep an eye on new spots
and bumps, and any changes in
your regular patterns, be they in
appetite, sleep, energy, bowel hab-
its, or mood. It’s easy to write off Spirits Brandy Cordial Fortified Table Beer
many changes as consequences 1.5 oz 1.5 oz 2–3 oz wine wine 12 oz
of aging when they could signal 3– 4 oz 5 oz
underlying disease.

THE HARVARD GUIDE TO HEALTHY LIVING | 10 steps to a longer healthier life w w w.heal th.har va rd.edu 7
experience many of these symp- Whenever you notice your stress inhalation and exhalation.
toms during excitement and plea- symptoms, take a moment—or If you have two minutes.
sure. However, chronic stress is two, or three—to relax. Here Count down slowly from 10 to
a major contributor to a host of are some suggestions from Dr. zero. With each number, take
serious physical and psychological Herbert Benson, president of the one complete breath, inhaling and
conditions. Benson-Henry Institute for Mind exhaling. For example, breathe
Whatever it is that sets your Body Medicine at Massachusetts in deeply saying “10” to yourself.
stress cycle in motion, having a General Hospital: Breathe out slowly. On your
personal escape plan can help When you’ve got one next breath, say “nine,” and so
you manage stressful situations minute. Place your hand just on. If you feel lightheaded, count
and even nip stress in the bud. beneath your navel so you can down more slowly to space your
To create a plan, make a list of feel the gentle rise and fall of your breaths further apart. When you
the specific mental, emotional, belly as you breathe. Breathe in reach zero, you should feel more
and physical sensations that you slowly. Pause for a count of three. relaxed. If not, go through the
feel when stressed. For example, Breathe out. Pause for a count exercise again.
do you get a stomachache, grind of three. Continue to breathe When you’ve got three
your teeth, raid the fridge, and deeply for one minute, pausing minutes. While sitting down,
have trouble thinking clearly? for a count of three after each take a break from whatever
you’re doing and check your body
for tension. Relax your facial
SOUND ADVICE FOR SLEEPING SOUNDLY muscles and allow your jaw to fall
open slightly. Let your shoulders
drop. Let your arms fall to your
• Create a sleep sanctuary. Reserve it for sleep, intimacy, and other
restful activities, like pleasure reading and meditation. Keep it on the sides. Allow your hands to loosen
cool side. Banish the television, computer, cell phone or digital so that there are spaces between
organizer, and other diversions from that space. your fingers. Uncross your legs
• Nap only if necessary. Night owls and shift workers are at the greatest or ankles. Feel your thighs sink
risk for sleep debt. Napping an hour or two at the peak of sleepiness into your chair, letting your legs
in the afternoon can help to supplement hours missed at night. But fall comfortably apart. Feel your
naps can also interfere with your ability to sleep at night and throw shins and calves become heavier
your sleep schedule into disarray. and your feet grow roots into the
• Avoid caffeine after noon, and go light on alcohol. Caffeine can stay in floor. Now breathe in slowly and
your body for up to 12 hours. Alcohol can act as a sedative, but it also breathe out slowly.
disturbs sleep.
Dr. Benson offers two other
• Get regular exercise, but not within three hours of bedtime. Exercise tools for stress reduction—the
acts as a short-term stimulant. worry box and the gratitude jour-
• Address a long-term debt. If you’ve shorted yourself on sleep for nal. The first is a repository for
decades, you won’t be required to put in a Rip Van Winkle–like effort concerns that are beyond your
to repay the hours of missed slumber. Nonetheless, it could take a few
weeks to recoup your losses. Plan a vacation with a light schedule and
power to influence—the safety
few obligations—not a whirlwind tour of the museums of Europe or of your children or grandchildren,
a daughter’s wedding. Then, turn off the alarm clock and just sleep the direction of the stock market,
everynight until you awake naturally. At the beginning, you may be the heating of the planet. Write
sleeping 12 hours or more a night; by the end, you’ll be getting about each worry on a slip of paper, put
the amount you regularly need to awake refreshed. it in the box, and forget about it
• Avoid backsliding into a new debt cycle. Once you’ve determined how for at least a week. The second is
much sleep you really need, factor it into your daily schedule. Try to a ritual—reflecting on the posi-
go to bed and get up at the same time every day—at the very least, on
weekdays. If need be, use weekends to make up for lost sleep.
tive experiences and encounters
of the day. If you jot them down
• If you’re able to get enough sleep but don’t feel refreshed in the in a journal, even in the darkest
morning, discuss the problem with your clinician. Many common
medical conditions, from depression to sleep apnea (brief cessations of nights, you’ll eventually have an
in breathing during sleep), could be responsible. encyclopedia of appreciation for
your circumstances.

8 THE HARVARD GUIDE TO HEALTHY LIVING | 10 steps to a longer healthier life w w w.heal th.ha r va rd.edu
Table 2 Screening tests and immunization schedule
TESTS/IMMUNIZATIONS AGES 50–64 AGES 65 AND OLDER
General exam; weight and height Discuss with clinician
Thyroid (TSH) test Every 5 years

HIV test Get this test at least once to find out your HIV status; ask your clinician if repeat
testing is necessary

Blood pressure measurement At least every 2 years


Cholesterol test Discuss with clinician; many groups recommend screening every 5 years.
Blood glucose or A1c test Every 3 years
Sexually transmitted infection (STI) tests Both partners should be tested for STIs and HIV before initiating intercourse
Mental health screening Discuss with clinician
Colorectal health: Use one of the following three methods:
1) Fecal occult blood test Yearly Discuss with clinician
2) Flexible sigmoidoscopy Every 5 years Discuss with clinician
3) Colonoscopy Every 10 years Discuss with clinician
Complete eye exam Every 2–4 years or as advised by clinician Every 1–2 years
Hearing test Every 3 years Every 3 years
Mole exam Yearly clinical exam or physical; self-exam monthly
Dental exam Routinely; discuss with dentist
Influenza vaccine Yearly
Pneumococcal vaccine One time only
Tetanus-diphtheria booster Every 10 years
Herpes zoster vaccine for shingles Once only at 60 or later; discuss with clinician
For women:
Bone density screen Discuss with clinician At least one; talk to clinician about repeating
Mammogram Every 2 years; discuss with clinician
Clinical breast exam Discuss with clinician
Pap smear Every 1–3 years Discuss with clinician
Pelvic exam Every 1–3 years
Chlamydia test Get if you have new or multiple partners
For men:
Digital rectal exam Discuss with your doctor or nurse
Prostate-specific antigen (PSA) test Discuss with your doctor or nurse
Testicular exam Discuss with your doctor or nurse

Source: U.S. Department of Health and Human Services.

THE HARVARD GUIDE TO HEALTHY LIVING | 10 steps to a longer healthier life w w w.heal th.har va rd.edu 9
Use supplements
10 selectively
It was once believed In 2008, a Cochrane Collabora-
that it was possible to compen- tion review found that low-risk
sate for dietary deficiencies by people in trials for a host of
popping a multivitamin every day. diseases who were given supple-
But research suggests that mul- ments of vitamin A, vitamin E, and
tivitamins may not be all they’re beta carotene had a slightly higher
cracked up to be. Moreover, many death rate. And there’s some
multivitamins contain some mi- evidence that excess folic acid
cronutrients in amounts greater (the synthetic version of folate, a
than those recommended in the vitamin found abundantly in veg-
government’s Dietary Guidelines etables, fruits, and grains) may be
for Americans. This effect may be contributing to an uptick in colon
amplified if you take more than polyps. Both observations war-
one pill to get the minimum re- rant further study.
quirement of a specific micronu- Experts agree that the best way
trient—for instance, taking extra to get the nutrients we need is
pills to get enough vitamin D may through food. It is likely that what
mean you’re getting too much counts is the synergistic interac-
vitamin A. In some cases, high tions of these nutrients—which
levels may be harmful. might also help explain why trials
Meanwhile, the benefits of mul- of single nutrients often don’t
tivitamins remain uncertain. pan out.
The Women’s Health Initiative However, it may be too soon to
concluded that postmenopausal draw the line on all supplements.
women who took multivitamins Adequate calcium and vitamin D
did not have a lower death rate are essential in preserving bone
than others and were just as density. Although you can get the
likely to develop cardiovascular recommended 1,200 mg of cal-
disease or cancers of the lung, cium from your diet, studies sug-
colon and rectum, breast, and gest that most people (especially
endometrium. These results are women) do not. It is possible to
consistent with findings from get the government-endorsed
other studies. And in 2006, the vitamin D intakes (400 IU for ages
NIH said there wasn’t enough 51 to 70; 600 IU over age 71)
evidence for a recommendation through diet or sun exposure. But
about taking multivitamins. many health experts now recom-
There’s also been little or no mend 1,000 IU, which is more
evidence of protection against difficult without taking supple-
cardiovascular disease or can- ments—especially during winter
cers from a number of individual months if you live in the northern
vitamin supplements, including vi- United States, if you always wear
tamin E, vitamin C, beta carotene, sun block, or if you are unable
and the B vitamin trio—B6, B12, to spend time outdoors. Consult
and folic acid. Recent research your doctor about the appropri-
suggests that potential harm has ate supplementation for you.
been added to the mix.

10 THE HARVARD GUIDE TO HEALTHY LIVING | 10 steps to a longer healthier life w w w.heal th.ha r va rd.edu
THE HARVARD GUIDE TO HEALTHY LIVING | 10 steps to a longer healthier life w w w.heal th.har va rd.edu 11
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