What evidence‑based lifestyle and preventive measures should be recommended for healthy individuals at each stage of life, from infancy through older adulthood?

Evidence-Based Health Recommendations Across the Lifespan

All individuals, regardless of age, should prioritize daily physical activity, maintain a healthy weight, consume a plant-based diet rich in vegetables and whole grains, avoid tobacco completely, limit alcohol, and ensure adequate sleep—these behaviors reduce cardiovascular disease, cancer, and all-cause mortality at every life stage. 1

Universal Recommendations for All Ages

Physical Activity

• Engage in physical activity daily, as any amount provides immediate health benefits and "moving more and sitting less" is the fundamental principle 1
• Physical activity maintains physical fitness, reduces cardiovascular disease risk, prevents multiple cancers, improves cognition, and decreases dementia risk across all age groups 1
• The benefits extend beyond cardiovascular health to include improved bone health, reduced fall risk, better mental health, and enhanced quality of life 1

Nutrition

• Follow a Mediterranean-style or plant-based dietary pattern high in vegetables, fruits, whole grains, beans/legumes, and healthy fats 1, 2
• Limit red meat, processed meats, highly processed foods high in fats and sugars, and sugar-sweetened beverages 1
• Ensure adequate calcium and vitamin D intake for bone health 1
• Obtain nutrients from food sources rather than relying on dietary supplements 1

Weight Management

• Achieve and maintain a healthy body weight throughout life to reduce cardiovascular disease, diabetes, and cancer risk 1
• Even modest weight loss (5-10% of body weight) improves insulin resistance and metabolic abnormalities 1

Tobacco and Alcohol

• Discontinue all tobacco products including cigarettes, e-cigarettes, and hookah, and avoid secondhand smoke exposure 1
• Drink alcohol sparingly if at all, with balanced use and avoidance of misuse 1

Sun Safety

• Use sunscreen with SPF ≥30 that protects against UVA and UVB rays, reapply every 2 hours 1
• Wear protective clothing and avoid tanning beds 1

Sleep

• Strive for sufficient sleep on a regular basis: adults need 7-9 hours, adolescents 8-10 hours, and older adults 7-8 hours 1

Preventive Care

• Follow up with primary care regularly and adhere to age-appropriate health screening and cancer screening recommendations 1

Age-Specific Recommendations

Children (Ages 3-5)

• Encourage active play throughout the day for at least 3 hours to enhance growth and development 1
• Focus on conveying the pleasures of healthy nutrition and joys of physical activity rather than disease prevention 1

Youth (Ages 6-17)

• Obtain at least 60 minutes of moderate-to-vigorous physical activity daily, including aerobic activities plus muscle and bone strengthening exercises 1
• Actively encourage non-smoking behavior starting around age 11-12 years 1
• Children can follow heart-healthy dietary patterns while maintaining appropriate growth and lowering future cardiovascular disease risk 1

Adults (All Ages)

• Complete at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic activity per week, plus at least 2 days of muscle-strengthening activity 1
• The 2018 Physical Activity Guidelines removed the prior 10-minute bout requirement—any amount of activity counts 1
• Maintain a diet consistent with the DASH (Dietary Approaches to Stop Hypertension) pattern, which lowers blood pressure and cardiovascular risk 1
• Aim for fasting glucose <100 mg/dL through weight management and physical activity 1

Older Adults (≥65 Years)

• Continue the same physical activity and dietary recommendations as younger adults, as older individuals can make and sustain lifestyle changes effectively 1
• Even small improvements in risk factors (modest reductions in blood pressure and LDL cholesterol) provide substantial benefit due to high absolute cardiovascular disease risk 1
• Select nutrient-dense food choices within each food group, as energy needs decrease while vitamin and mineral requirements remain constant or increase 1
• Combine adequate protein intake with exercise programs including aerobic, weight-bearing, and resistance training to prevent sarcopenia and frailty 1
• For those with diabetes, avoid overtreatment and consider deintensification of treatment goals to reduce hypoglycemia risk 1
• Regular physical activity reduces sedentary time, prevents mobility disability, and reduces frailty 1

Pregnancy and Postpartum

• Physical activity reduces risk of gestational diabetes and postpartum depression 1
• Maintain healthy dietary patterns throughout pregnancy, as exposure to risk factors before birth influences lifetime cardiovascular disease risk 1

Critical Implementation Points

Lifelong Prevention Approach

Prevention must start before birth and continue throughout life, as cardiovascular disease prevention is a lifetime effort with benefits at every age 1

• Atherosclerosis begins in youth, and risk factors "track" from childhood into adulthood 1
• Preventive measures (blood pressure lowering, smoking cessation) remain beneficial up to advanced age 1

Multidisciplinary Support

Utilize clinicians, physical therapists, dieticians, social workers, patient navigators, certified exercise professionals, health coaches, and tobacco treatment specialists to assess barriers and support patients in overcoming challenges 1

Accident Prevention

Promote accident prevention programs to avoid musculoskeletal injuries, and implement health promotion at workplaces and during sports activities to prevent abnormal overuse 1

Common Pitfalls to Avoid

• Do not wait until middle age to begin prevention efforts—start in childhood 1
• Do not assume older adults cannot benefit from lifestyle changes—they can sustain changes as well as or better than younger adults 1
• Do not focus solely on weight loss in frail older adults—prioritize functional status and muscle preservation 1
• Do not rely on dietary supplements instead of obtaining nutrients from whole foods 1
• Concern about weight gain should never be a reason to continue tobacco use 1

Immediate and Long-Term Benefits

Physical activity provides immediate health benefits including improved cognition, reduced anxiety, and better sleep, while consistent adherence over time provides the greatest long-term benefits 1

Managing Chronic Conditions

Many chronic conditions including osteoarthritis, hypertension, type 2 diabetes, anxiety, depression, dementia, ADHD, and Parkinson's disease can be managed more effectively with physical activity, resulting in reduced all-cause mortality and improved quality of life 1