How to prioritize your preventive strategy in your 30s and 40s.
Ever wondered what increases your risk of having a major adverse health event? In medicine we call that mortality, also morbidity.
After reading this article by Dr. Cifu I thought about digging into the research. As with all research, there’s no clear answer, but this list is quite an accurate, though likely not precise list.
For an average, generally healthy 30- to 40-year-old who does not smoke or use illicit drugs, here’s the most defensible descending order.
Welcome to the Physician-Led Health Coaching weekly newsletter. I’m Dr. Ashori, a board-certified physician & health coach. I help people fix brain fog, fatigue, and stubborn weight before they turn into real disease.
Top 10 Ways to Reduce Your Risk of Dying Early
The top 4 on this list is what I promised and are the most effective strategies. But what matters more is knowing what you are at risk for. Then set out to mitigate your individual risk.
For example, I’m a rock climber. My biggest risk isn’t #1 or 2, it’s #3.
1. Build or Maintain Physical Fitness
Regular aerobic exercise, resistance training, and daily movement have the broadest reach across cardiovascular disease, cancer, diabetes, mental health, and functional aging.
Meeting both aerobic and strength-training guidelines has been associated with roughly 40% lower all-cause mortality compared with doing neither. (British Journal of Sports Medicine)
If you can’t do any of that above, just walk every day. It’ll get you 90% there.
2. Know and Control Your Blood Pressure
High blood pressure progressively increases the risk of heart disease, stroke, kidney disease, and premature death. Even “high-normal” blood pressure in early and middle adulthood predicts greater long-term cardiovascular risk. (New England Journal of Medicine)
Every 10 mmHg increase in systolic blood pressure was associated with an unadjusted 17% higher relative risk of death from cardiovascular disease, according to that study above.
“Among the six populations we studied, the relative increase in long-term mortality due to CHD for a given increase in blood pressure is similar, whereas the absolute risk at the same level of blood pressure varies substantially.”
3. Take Injury Prevention Seriously
Wear a seatbelt, use an appropriate helmet (especially when rock climbing), avoid distracted or impaired driving, and practice safe firearm storage.
Unintentional injuries remain the leading cause of death through age 44, although drug poisoning accounts for a significant portion of that category. (CDC)
For you, it might be getting on your ladder to work on your roof or swimming in the ocean. Know your biggest risk and mitigate it.
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4. Avoid Heavy and Binge Drinking
The important distinction is not simply “drink or do not drink.” It is avoiding intoxication, binge drinking, impaired driving, and cumulative heavy use.
Excessive alcohol contributes to injuries, violence, cancer, liver disease, cardiovascular disease, and approximately 178,000 US deaths annually. (CDC)
5. Know and Control Your LDL-C, ApoB, or Non-HDL-C
Someone can exercise and feel healthy while carrying substantial long-term cardiovascular risk from high atherogenic particles or inherited lipid disorders.
Lipoprotein measured in young adulthood predicts cardiovascular disease decades later. (New England Journal of Medicine)
“Our study focused on five modifiable risk factors for which strict control could potentially prevent 57.2% of all cases of cardiovascular disease in women and 52.6% of all cases in men globally.”
6. Prevent Visceral-fat Gain and Metabolic Dysfunction
Waist gain, insulin resistance, fatty liver, hypertension, and rising glucose often develop together.
Maintain a favorable waist size, body composition, glucose regulation, and metabolic profile while preserving muscle and fitness. (British Journal of Sports Medicine)
“Our analyses found that those classified as fit, regardless of BMI status, showed no statistically significant increase in CVD or all-cause mortality risk compared with normal weight-fit individuals.”
7. Eat a Consistently High-Quality Diet
Prioritize minimally processed foods, vegetables, legumes, fruit, whole grains, nuts, seeds, and appropriate protein.
Limit excess sodium, refined carbohydrates, processed meats, and heavily processed calorie-dense foods.
Diet works partly by improving blood pressure, lipids, glucose, weight, and cancer risk, rather than through one supposedly perfect food. (World Health Organization)
“A healthy diet comprises a combination of different foods… Eating a variety of foods and consuming less salt, sugars and saturated and industrially-produced trans-fats, are essential for healthy diet.”
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8. Protect Your Mental Health and Respond Early
Suicide is already one of the leading causes of death in this age group. Persistent depression, escalating alcohol use, hopelessness, severe anxiety, and suicidal thinking deserve the same urgency as significant physical symptoms. (JAMA Psychiatry)
“Although the pooled effect size for suicidal ideation was small, the 30% lower risk of suicide attempts associated with both direct and indirect treatments can be considered clinically relevant, given the severity of such events.”
9. Get Adequate Sleep & Evaluate Possible Sleep Apnea
Chronic short sleep is associated with higher all-cause and cardiovascular mortality.
Snoring, witnessed breathing pauses, morning headaches, unexplained hypertension, and excessive daytime sleepiness should not be dismissed simply because someone is young or productive. (PubMed)
“Short sleep duration (< 7 h per night) was associated with a 14% increase in mortality risk compared to the reference of 7-8 h.”
10. Use Preventive Medicine Appropriately
Stay current on recommended vaccines, complete age- and risk-appropriate cancer screening and prevention, protect your skin from excessive UV exposure, and discuss earlier screening when family history warrants it. (uspreventiveservicestaskforce.org)
“The USPSTF recommends offering or referring adults with cardiovascular disease risk factors to behavioral counseling interventions to promote a healthy diet and physical activity.”
Disclaimer:
Dr. Mohammad Ashori is a U.S.-trained family medicine physician. The content shared here is for education and general guidance. It is not personal medical advice, diagnosis, or treatment, and it does not create a doctor-patient relationship. Humans are complicated and your personal details matter. Your healthcare team is your best resource before making medical decisions, changing medications, or managing symptoms. This information is to help you add more depth to those conversations.
