The Five Foundations of Preventive Health

Nutrition: eat for the life you want

A healthy eating pattern matters more than any single perfect meal. In practice that means building most meals around plants, an adequate source of protein, and foods that still look close to their original form.

Build colour and variety

The World Health Organization (WHO) recommends at least 400 g of fruit and vegetables a day for everyone over the age of ten. That is roughly five portions spread across your meals. It is a population reference rather than a personal prescription; the right quantity for you depends on your health, training and treatment goals.

Prioritise fibre

WHO guidance also recommends at least 25 g of naturally occurring dietary fibre a day for adults. Beans, lentils, chickpeas, whole grains, vegetables, nuts and seeds are the most reliable sources. Most people get there by changing a staple rather than adding a supplement: lentils in a stew, oats at breakfast, or wholegrain bread instead of white.

Include protein at each main meal

A useful protein source at each main meal supports muscle maintenance, recovery and satiety. This becomes more important with age, when muscle is harder to build and easier to lose. How much you need varies with body size, activity level and kidney function, so this is a good number to set with your doctor or dietitian.

Improve the default

Swap sugary drinks for water and replace ultra-processed snacks with minimally processed options. WHO advises keeping free sugars below 10% of daily energy intake (around 50 g for most adults) and salt below 5 g a day.

The principle: think pattern, not punishment. A diet you can sustain for years does more than a strict one you abandon in a month.

Movement: train the heart, keep the muscle

The body adapts to what you ask of it. Regular movement supports heart health, blood glucose control, bone strength, independence in later life and mental wellbeing, so its benefits reach well beyond fitness.

Train the heart

The WHO guidelines on physical activity recommend 150 to 300 minutes of moderate-intensity aerobic activity a week for adults, or 75 to 150 minutes of vigorous activity. Brisk walking, cycling, swimming or anything else that noticeably raises your breathing rate counts.

Keep muscle

Muscle-strengthening activity that works all major muscle groups on at least two days a week is recommended alongside aerobic exercise. Weights, resistance bands and bodyweight exercises all work, provided the load progresses gradually over time.

Move between workouts

A daily workout does not cancel out a day spent sitting. Short walks, taking the stairs and standing breaks reduce the total time you spend inactive, which the same guidelines identify as a separate risk.

Before you start: training should reflect your health, ability and goals. Seek clinical advice before starting or significantly changing a programme if you have a medical condition, concerning symptoms such as chest pain or breathlessness, an injury, or after a long period of inactivity.

Sleep and mental health: protect recovery

Recovery is part of the health plan. Sleep and mental health affect concentration, appetite, blood pressure, glucose regulation and the choices you make the next day. Most adults need seven or more hours a night, but quality and regularity matter as much as the total.

Protect the pattern

Go to bed and wake at similar times every day, including weekends where practical. A consistent wake time is often the single most useful anchor.

Design the room

Keep the bedroom cool, dark and quiet, and reserve the bed for sleep and recovery rather than work or scrolling.

Time caffeine earlier

Caffeine lasts longer than most people expect. In a controlled study published in the Journal of Clinical Sleep Medicine, a large dose of caffeine taken six hours before bed still reduced measured sleep by more than an hour, and participants did not notice the difference. As a working rule, avoid caffeine after about 2 p.m., or at least six hours before bed, particularly if you are sensitive to it.

Create a screen buffer

Put screens away at least 30 minutes before bed, and longer if you can. If that is not possible, dim the screen and the room lighting.

Treat mental health early

A calm wind-down routine helps, but it is not a substitute for care. Persistent low mood, anxiety or poor sleep deserves professional support. So do loud snoring, pauses in breathing at night and daytime sleepiness, which can point to a treatable sleep disorder.

Tobacco and alcohol: less exposure, less risk

Tobacco and alcohol are not simply lifestyle details. Both raise long-term disease risk, even when no symptoms are present.

Tobacco: there is no safe level

According to the WHO, tobacco kills more than 7 million people every year, including over 1.6 million non-smokers exposed to second-hand smoke. All forms of tobacco are harmful. The most effective goal is to stop completely, and combining behavioural support with approved stop-smoking medication improves the chance of success compared with willpower alone. If you have tried before, that is useful information rather than a failure; most people who quit successfully needed several attempts.

Alcohol: less is better

The International Agency for Research on Cancer classifies alcohol as a Group 1 carcinogen, and the WHO notes that it causes at least seven types of cancer, including bowel and female breast cancer. For cancer risk, no amount of alcohol is completely safe, and risk generally rises as intake rises. Practical steps that help:

• Make alcohol-free days the default rather than the exception.
• Reduce the total number of drinks across the week.
• Avoid using alcohol to manage stress or to fall asleep. It shortens and fragments sleep later in the night.

The practical rule: do not smoke. When it comes to alcohol, less is better.

Know your numbers: measure early, interpret in context

Numbers do not define your health, but the right ones can reveal risk years before symptoms appear. A trend over time is usually more informative than any single result, which is why we track measurements across months rather than reacting to one reading.

Blood pressure: measure it properly

The 2025 American Heart Association and American College of Cardiology guideline classifies blood pressure below 120/80 mm Hg as normal for adults. A single reading can mislead, so an average of correctly taken readings is far more useful. At home: sit quietly for five minutes with your back supported, feet flat and arm resting at heart height, then take two readings a minute apart. Repeat in the morning and evening for several days and record the average.

Waist-to-height ratio: a simple self-check

Measure your waist midway between your lowest rib and the top of your hip bone, then divide it by your height in the same units. A 170 cm adult should aim for a waist under 85 cm. UK NICE guidance classifies 0.4 to 0.49 as healthy, 0.5 to 0.59 as increased risk and 0.6 or more as high risk for adults with a BMI under 35. Because it reflects fat stored around the organs, it adds useful context that weight and BMI alone miss.

Fasting insulin: useful, but never on its own

Fasting insulin can help assess insulin resistance, but it is not a standalone diagnostic test and has no universal cut-off. It should be interpreted alongside fasting glucose, HbA1c and your clinical picture.

Cholesterol: look beyond the total

Total cholesterol is a blunt measure. LDL cholesterol, non-HDL cholesterol, apolipoprotein B (ApoB) and lipoprotein(a), or Lp(a), give a much more precise picture of cardiovascular risk. Lp(a) is largely inherited, and European cardiology guidance recommends measuring it at least once in adulthood.

Targets must be personalised. The references above are general. Your own targets depend on your age, history, family risk and any treatment you are receiving.

A week that builds health

Choose a minimum version of each habit that you can keep up even during a demanding week. Add complexity only once the basics are reliable.

• Nutrition: add plants to two meals each day and plan one high-fibre staple.
• Movement: sit less, break up long periods of sitting, move a little more than you do now, and make water your default drink.
• Sleep and mind: protect a regular wake time and a 30 to 60 minute wind-down.
• Tobacco and alcohol: keep smoke exposure at zero and plan your alcohol-free days first.
• Your numbers: take a proper blood pressure average and record one weekly waist or weight measurement.

The five foundations are simple. Their effect is cumulative, and consistency is what turns them into results.