Most people, certainly most reading this, want to have good lifestyle habits so that they will enjoy life with optimal health. These blogs offer my analyses about eating and exercise to achieve this goal. But knowledge is not enough. It’s easy to skip exercise and tempting to indulge in unhealthy food and drink.

As I reflect on my own behavior and observe others it’s clear that poor choices multiply as the day moves into evening. For me, a major cause is fatigue: I find it easy to exercise and eat only healthy foods when I’m not tired and my observations and reading confirm this is true for many others as well.

This is not an easy issue since social time is often evenings when we can be with family and friends who may not have our lifestyle knowledge and goals. My strategies-

Exercise early in the day.

Eat a substantial breakfast and lunch which consist entirely of whole plant foods and whole grains.

Eat dinner at home as much as possible since you have control of the food supply. The corollary is don’t have unhealthy food in your refrigerator or cupboards.

Take a late afternoon nap if very tired.

I would love to hear from others about their experiences and strategies for coping with “good habit fatigue.”

Andy Polansky, a friend and former radiology colleague, suggested the book False Positive by Theodore Dalrymple. This book consists of the author’s comments on a year of the New England Journal of Medicine, one of the most respected medical journals. Dalrymple is British and, I suspect, classically educated since his writing is elegant and filled with classical and Shakespearean references.

One of his comments is on an article discussing rates of certain common cancers in the United States. He notes that, compared to African-Americans, Americans of European heritage have 50% more diagnoses of breast, prostate, colon and melanotic skin cancers, but the death rates from each of these cancers is approximately the same between blacks and whites.

What can this possibly mean? Dalrymple’s conclusion is the same as mine: many cancers are not clinically important, but screening, much more common in affluent people, leads to diagnosis and often treatment of cancers that will never kill you. The anxiety, complications and cost of these unnecessary treatments is enormous.

Screening in medicine is a huge, profitable business, advocated by almost all medical organizations and taught to medical students as gospel. Certain screenings are of well proven value: blood pressure in western countries or any population with a western lifestyle (societies with a mainly whole plant food diet have a very low rate of hypertension.) Screening for cancer (this does not mean looking for cancer in those who have signs or symptoms or a reason they have a high chance of a specific cancer) is problematic at the least. My personal choice was to have one colonoscopy in my late 50’s and to see a dermatologist since I am fair skinned, had a lot of sun exposure, and have had multiple skin cancers.

Over the past months I’ve started to write about a subject for this site several times. Each time before starting I reviewed what I had written in past years and discovered that I had covered this or a very similar topic in past years: there isn’t that much to healthy eating and lifestyle- eat mainly whole plant foods (as Michael Pollan told us so well); get at least a moderate amount of exercise most days; avoid tobacco, illegal drugs and excess alcohol. Add in a good night’s sleep, cultivate relationships and community, make use of meditation or other relaxation techniques. Most who do these simple, common-sense things will be happy, healthy and have the much better likelihood of avoiding premature death and chronic illness.

Our local grocery store on Kauai makes tasty vegetarian and fish sushi on site daily. This is a staple for many neighbors and we enjoyed it too until we read the ingredients listed in very fine print on the label. They find it necessary to include lots of things which we never suspected including “wheat protein” (gluten). Since I have celiac disease I can’t eat this. Presumably, one of the commercial sauces they use for binding includes gluten and several other unusual ingredients. Fortunately a local food truck makes similar, even better, vegan sushi without all the chemicals.

The food industry loves complexity including a wide variety of chemicals for preservation and flavor enhancement. Review of the contents of most popular, commercial, “healthy” whole grain breads typically shows 25-30 ingredients, many of them chemicals of some sort. I don’t know health effects of each of these chemicals but I’d be amazed if at least some of them aren’t bad for you. Healthy eating habits require a magnifying glass while grocery shopping outside the produce aisle.