21 action cards

Prefer white meat — poultry and fish — over red and processed meat.

The source's first solid input. Its cited JAMA Internal Medicine study found that adding at least half a daily serving of red meat (≈14 g processed or 40 g unprocessed) was followed by +10% all-cause mortality over the next eight years, and two weekly servings of red or processed meat (not poultry or fish) by +3%; poultry and fish showed no such association.

Center the diet on vegetables and fruit.

The source's evidence states that 200 g/day of fresh fruit lowers mortality by 17%, and flavonoid-rich food is associated with −20% mortality — a cup of tea, an apple or orange, or 100 g of blueberries or broccoli provides over 500 mg of flavonoids.

Regular chili consumption is associated with −23% all-cause mortality.

A US cohort (16,179 people, 19-year follow-up) found eating chili more than 4 times a week associated with −23% total mortality and −34% cardiovascular mortality; an Italian adult cohort reported the same inverse association.

Several servings of nuts per week are associated with markedly lower mortality.

An NEJM study found people eating 7+ servings of nuts a week had −20% mortality; another pooled analysis (7,216 people) showed −39% at 3+ servings. A walnut study: ≥5 servings/week (28 g each) was associated with +1.3 years of healthy life expectancy, −14% all-cause and −25% cardiovascular mortality.

Keep carbohydrate intake moderate (~50% of energy); favor plant protein.

The source merges "moderate carbs, more plant protein" into one action item (−10% ACM). Its evidence section flags carbs as highly disputed: a Lancet Public Health cohort found lifespan longest at ~50% energy from carbohydrate, with both lower and higher intakes shortening it; §4 notes the literature on carb ratio is significantly contradictory.

Ultra-processed foods — chips, burgers, chocolate — are associated with higher mortality.

The source gives a −62% to −18% benefit range for eating less. Two prospective BMJ cohorts (SUN and NutriNet-Santé) both link ultra-processed food intake to higher all-cause mortality and cardiovascular disease risk.

Moderate coffee intake is associated with lower all-cause, cardiovascular, and cancer mortality.

A meta-analysis of 40 studies and 3,852,651 subjects found a non-linear association: lowest all-cause mortality at ~3.5 cups/day (RR 0.85), lowest cardiovascular mortality at ~2.5 cups (RR 0.83), lowest cancer mortality at ~2 cups (RR 0.96); more intake adds no further benefit.

Two daily servings of dairy are associated with −17% all-cause mortality.

The PURE study (21 countries, ~130,000 people): versus no dairy, two daily servings (one ≈244 g milk/yogurt, 15 g cheese or 5 g butter) were associated with −17% all-cause mortality, −23% cardiovascular mortality and −33% stroke.

Drinking tea ≥3 times a week is associated with −15% ACM and +1.26 years of life expectancy.

The China-PAR project (~100,000 Chinese adults, 7-year follow-up) produced these figures; another study of 438,443 people over 11.1 years found HR 0.89 for non-daily and 0.92 for daily drinkers versus never-drinkers, with the protective association mainly seen in men.

Both sugar-sweetened and sugar-free sweetened drinks are associated with higher mortality — limit or avoid them.

One daily cup of sugar-sweetened drink is associated with +7% ACM, two cups +21% (34-year follow-up: +31% cardiovascular, +16% cancer mortality); a 10-country European study found ≥1 soft drink/day associated with +18% mortality — +27% for sugar-free and +11% for sugared. The source also notes "+dopamine": the pleasure is real but is not a health benefit.

The source advises quitting alcohol; the risk increase for not quitting has "no upper bound".

The source states "otherwise +~50% ACM, with no upper bound" — mortality risk grows with intake and has no ceiling. Its evidence section has no dedicated alcohol entry; the figure is the action item's own wording.

Even low-intensity smoking raises mortality; quitters fare better than continuing smokers.

Compared with never-smokers, <10 cigarettes/day carries HR 1.17 and ≥10/day HR 1.54, similar across age and sex; smokers lose 11–12 years of life on average. People who had already quit at enrollment had lower mortality than continuing smokers — it is never too late to quit.

Moderate sun exposure is associated with longer lifespan (26-year Danish study).

A 26-year Danish study found more sun exposure significantly extends life — even patients whose skin cancer was induced by overexposure lived 6 years longer on average. The source's action item says "−~40% ACM" but its evidence section gives no source for that figure; it is kept here verbatim and marked as such.

A classic prescription drug; the source says diabetics on it gain +3 years versus healthy people.

The evidence section credits it with potential protection across tumors, cardiovascular disease, diabetes, obesity, liver and kidney disease, and aging; adverse effects are well documented — vitamin B12 deficiency (7%–17.4%), gastrointestinal reactions (up to 53%), fatigue (9%), headache (6%), rare but serious lactic acidosis and liver injury, and one study suggesting paternal use may cause offspring defects. Prescription-only — follow medical advice.

Daily multivitamins are associated with −8% cancer risk; other effects are not significant.

The source's only evidence entry states that taking multivitamins lowers cancer risk by 8% with no other significant effects — the supported benefit is a modest reduction in cancer risk alone.

Dietary spermidine intake is significantly inversely associated with all-cause mortality.

In a 20-year follow-up of 829 participants aged 45–84, the high-intake group (>79.8 µmol/day) had a crude mortality of 15.1% versus 40.5% in the low-intake group (<62.2 µmol/day); the association stayed significant after adjusting for age, sex and calories. Rich food sources: natto and other soy products, shiitake, durian, wheat germ, green peppers, broccoli, cheese.

Regular glucosamine/chondroitin use is associated with lower mortality.

US NHANES data (16,686 adults, median 107-month follow-up): participants taking 500–1000 mg glucosamine/chondroitin daily for over a year had −65% cardiovascular and −39% overall mortality — the source calls the effect "comparable to regular exercise".

The most cost-effective exercise in the source's evidence.

Three 45–60 minute racquet-sport sessions a week are associated with ~−47% ACM. Badminton, table tennis and tennis all count; the source notes that the westernized research background "probably means tennis", implying whole-body exercise is what matters.

Regular toothbrushing is associated with −25% premature mortality.

A 500,000-person Chinese study found infrequent brushers had +9% cancer, +12% COPD, +25% liver-cirrhosis risk and +25% premature mortality. The source turns this around into its "brush your teeth" action item at −25% ACM.

Seven hours of sleep has the lowest ACM; the bedtime-timing finding is contested.

In data from over 300,000 Asians, sleeping ≥10 h versus 7 h was associated with +34% ACM in men and +48% in women. The source also claims falling asleep between 22:00 and 24:00 is best and itself marks this as contested — "earlier bedtime +43% ACM, later +15%"; that study relied on self-reported bedtimes and shows correlation only.

Moving from obese to overweight is associated with −54% ACM — and earlier is better.

A JAMA sub-journal study found adults who moved from obese to overweight had −54% all-cause mortality versus the stably obese (HR 0.46); those who went from overweight in early adulthood to normal weight by mid-life saw no risk reduction (HR 1.12). The source's evidence advises losing weight early.