I got it right

I'm on the right track, anyway...

“Rocktopia” coined by my daughter Sara, 2015, South Lake Tahoe - Photo Credit, Lyle McKeany

My last full post was about how I got it wrong as a young dietitian. Take home message: listen to your hunger instead of eating by the clock.

Yes, we are still figuring things out, and I know how frustrating this is. Are eggs in or out? (in). Is fat good or bad? (it depends). What about eating after 7 pm? (see intro paragraph).

Keep in mind that the ability to learn, shift viewpoints, and admit past mistakes is a strength, not a weakness. I choose humility over hubris every time.

---

Today, I bring you a two-part story.

Part one is an admission, once again, of how I got it (a little bit) wrong.

As a brand new dietitian, I was ready to save the world with food and nutrition, complete with realistic — and embarrassingly expensive — food portion size models.

Did I address exercise? Only in passing.

Did I know anything about sleep? Of course not.

Fruits and vegetables were the answer.

While I continue to be a produce advocate, I hope I now have a more realistic and effective approach for addressing my patients’ needs. Sure, veggies are important, but are they the most important? Are they accessible? Is my patient open to discussing it?

Meeting patients where they are is a practice philosophy that I’ve been aware of my entire career, but have truly come to understand and embody in the last several years. It isn’t about me at all, after all — I am simply available to guide and support.

Part two of my story is unfolding as I write this.

After decades of carefully planning studies to evaluate the role of individual lifestyle factors on health and longevity, the field is transitioning to a “multifactorial” approach. That is, acknowledging the several factors that contribute to lifespan and healthspan and the new appreciation that these factors may actually work together, instead of independently.

While Insight into Health was created to put my clinical process into a digestible system, it is a process that continues to grow and evolve as I learn more.

This means that every patient takes a unique journey, which sometimes begins with nutrition and other times starts with other lifestyle factors.

You’ll understand my excitement, then, when I came across a study published earlier this year¹ that looked to evaluate the effectiveness of this type of approach on longevity and healthspan.

This study emphasises that combined SPAN behaviours act synergistically, whereby the collective behaviours were more strongly associated with all-cause mortality risk than the individual behaviours. We show that the optimal SPAN combination included high MVPA (42–103 min/day), moderate sleep (7.2–8.0 h/day), and high DQS (57.5–72.5), which corresponded to a 64% lower risk for all-cause mortality compared to the lowest combined tertile category for all three exposures. Our study also underscores the significance of incremental combined positive lifestyle behaviours. Compared to those with poor SPAN behaviours, very modest collective variations, such as a 15 min/day increase in sleep, less than 2 min/day higher MVPA, and higher diet quality equivalent to increasing daily intake of cooked vegetables by 1/3 cup or fruit by 1.5 servings, were associated with a 10% lower risk of all-cause mortality.

And while reading the excerpt from this study may sound as foreign to you as reading legalese is to me, I’ll attempt to distill the exciting bits:

• Sleep, physical activity, and nutrition, or SPAN (researchers love acronyms), are typically studied individually

• This study looked at the combination of these three lifestyle factors on lifespan

• Over 59,000 individuals with an average age of 64 were followed for 8 years, and a clear interaction between sleep, physical activity, and nutrition was found:

  • Those who participated in regular physical activity, consumed a nutrient-dense diet, and slept moderately well showed the biggest lifespan benefits (by 64%!)

• But the most exciting part is that even small changes (adding just 15 minutes of sleep, increasing daily physical activity minutes, and sneaking in 1/3 cup more veggies per day (yes - veggies!)) were associated with longer lifespan

What is the take-home here? Adequate sleep, regular exercise, and healthy eating all work together to promote health, AND it doesn’t take a drastic change to start benefiting.

So, instead of striving for perfect or taking the “all or nothing approach,” I encourage you to start with one small change. And then another. And another. Incrementally stacking the changes on top of each other — not unlike the stones in Rocktopia — and building a lifestyle that leads towards a longer, healthier life.

Thank you for being here,

~Allison

What did you think of this narrative + research review style post? I would love to hear your thoughts, and, as always, I appreciate your likes and shares.

1. Stamatakis, E., Koemel, N.A., Biswas, R.K. et al. Minimum and optimal combined variations in sleep, physical activity, and nutrition in relation to all-cause mortality risk. BMC Med 23, 111 (2025). https://doi.org/10.1186/s12916-024-03833-x