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was associated more with the prevention of negative health consequences; today it is related to the promotion of positive health consequences. Adhering to a healthy lifestyle means practicing a way of living that builds, maintains, and promotes health and well‐being through a cluster of positive health behaviors.

       Key Point

      Adhering to a healthy lifestyle means practicing a way of living that builds, maintains, and promotes health and well-being.

The main characteristics of a healthy lifestyle include following a healthy diet; being physically active; maintaining a healthy weight; avoiding tobacco use, excess alcohol use, and the use of other harmful substances; controlling stress; and resting adequately (Figure 4.1).

      A healthy diet throughout our lifecycle starts from infancy through breastfeeding. Optimal nutrition through childhood and adolescence helps to foster healthy growth; adequate nutrition throughout the adult life preserves health and maintains a good quality of life. In general, a healthy diet may vary greatly, depending on the personal characteristics, age, gender, physical activity habits, dietary preferences, and cultural habits, but also on food availability and accessibility. Chapter 6 presents the various dietary patterns that are considered healthy, based on extensive research conducted over the past 50 years.

      Regular physical activity reduces the risk of CVD, certain types of cancer, hypertension, and depression and contributes to weight control and prevention of overweight and obesity. To ensure good health, physical activity should be an essential component of everyday living. Physical activity may include sports or planned exercise; walking, biking, or running as transportation; leisure time physical activity (such as dancing); occupational (i.e., work) or household chores; play; games; and activities in the context of daily family and community life. Combining aerobic, muscle‐strengthening, and bone‐strengthening types of exercise provides optimal health benefits. Chapter 9 summarizes the various forms of physical activity and the benefits accrued from them.

       Key Point

      Regular physical activity reduces the risk of cardiovascular disease, certain types of cancer, hypertension, and depression and contributes to weight control and prevention of overweight and obesity.

      Moderate alcohol intake may have some beneficial effects on CVD risk by lowering the risk of ischemic heart disease and ischemic stroke and associated mortality in some populations. When examining average alcohol consumption in comparison to lifetime abstainers, the relationship with ischemic heart disease risk follows a J‐curve. The curve turns into a negative relationship at much lower average alcohol intake levels in women compared with men. However, average alcohol consumption alone is not sufficient to describe the relationship between alcohol and ischemic heart disease.

      Drinking patterns play an important role in health; both episodic and chronic heavy drinking may counteract the beneficial association with ischemic heart disease risk and elevate other health risks substantially. There is some evidence to suggest that drinkers who have one to two drinks per day without episodic heavy drinking have a lower ischemic heart disease risk compared to lifetime abstainers. However, different drinking patterns are associated with very different health outcomes in diverse population groups with the same level of consumption.

Furthermore, large epidemiological studies suggest that any alcohol consumption may increase the risk for various types of cancers (Figure 4.2). Thus, recommendations for clinicians remain challenging because average low alcohol consumption may have both beneficial and detrimental health effects. According to the WHO, there is no specific limit for alcohol consumption; drinking less is better.

FIGURE 4.1 Basic principles of a healthy lifestyle.

       Key Point

      According to the WHO, there is no specific limit for alcohol consumption; drinking less is better.

      Refraining from smoking and all forms of tobacco use is a health‐maintaining behavior. Quitting smoking at any age can greatly reduce the risk of developing smoking‐related diseases. Although the health benefits are greater for people who quit smoking at earlier ages, benefits ensue at any age. Smoking cessation is associated with lower risk for lung cancer and many other types of cancer, heart disease, stroke, peripheral vascular disease, respiratory symptoms, and lung diseases.

       Key Point

      Although the health benefits are greater for people who quit smoking at earlier ages, benefits ensue at any age.

      Sleep is a basic element of everyday life, as people spend approximately one third of their lives sleeping; this topic has gained the interest of philosophers, physicians, and scientists since ancient and prehistoric times. The functions of sleep, the mechanisms that regulate sleep physiology, and its role in physical and mental health have been the subjects of debate since the fourth century BCE. Sleep is not just a simple absence of wakefulness. It is considered a physiologically active state in which specific processes and metabolic pathways occur that are essential for the regulation of daytime functioning and overall well‐being.

       Key Point

      Sleep is not just a simple absence of wakefulness.

      The amount and quality of sleep may significantly affect the health of the person. For example, inadequate sleep is detrimental to the process of learning and memory stabilization. Both insufficient and prolonged sleep are associated with increased risk for developing metabolic syndrome. The basic physiological determinants and the health effects of sleep will be presented in detail in Chapter 10.

FIGURE 4.2 Association of alcohol with cancer.

      Source: Reprinted with permission from the Cancer Research UK, 2018.

Finally, the role of stress on human health has been studied extensively during the last three decades. Stress is caused by various life events; these events don't have to be negative to cause stress. For example, making wedding preparations is a good thing but nevertheless a source of stress. Routine daily activities can also induce stress. However, people's responses to stressors vary greatly and depend mainly on the perception of the specific event; i.e., an event that may cause stress to one person may have no effect on another person. It has been shown that even minor stressful events constitute a substantial source of stress, resulting in deterioration of both mental and physical health. When the adverse effects of daily difficulties and inconveniences congregate, they can aggravate susceptibility to several diseases and undermine overall well‐being. Chapter 11 presents the effects of social life and stress on the prevention and treatment of major diseases.

      Take‐Home Messages

       Healthy lifestyle is a way of living that builds, maintains, and promotes health and well‐being through a cluster of positive

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