Many chronic diseases are caused by key risk behaviors. By making healthy choices, you can reduce your likelihood of getting a chronic disease and improve your quality of life.

Quit Smoking

Stopping smoking (or never starting) lowers the risk of serious health problems, such as heart disease, cancer, type 2 diabetes, and lung disease, as well as premature death—even for longtime smokers. Take the first step and call 1-800-QUIT-NOW for FREE support.

Eat Healthy

Eating healthy helps prevent, delay, and manage heart disease, type 2 diabetes, and other chronic diseases. A balanced, healthy dietary pattern includes a variety of fruits, vegetables, whole grains, lean protein, and low-fat dairy products and limits added sugars, saturated fats, and sodium.

Get Regular Physical Activity

Regular physical activity can help you prevent, delay, or manage chronic diseases. Aim for moderate intensity physical activity (like brisk walking or gardening) for at least 150 minutes a week, with muscle-strengthening activities 2 days a week.

Avoid Drinking Too Much Alcohol

ver time, excessive drinking can lead to high blood pressure, various cancers, heart disease, stroke, and liver disease. By not drinking too much, you can reduce these health risks.

Get Screened

To prevent chronic diseases or catch them early, visit your doctor regularly for preventive services.

Take Care of Your Teeth

Oral diseases—which range from cavities and gum disease to oral cancer—cause pain and disability for millions of Americans. To help prevent these problems, drink fluoridated water, brush with fluoride toothpaste twice a day, and floss daily. Visit your dentist at least once a year, even if you have no natural teeth or have dentures.

Get Enough Sleep

Insufficient sleep has been linked to the development and poor management of diabetes, heart disease, obesity, and depression. Adults should get at least 7 hours of sleep daily.

Know Your Family History

If you have a family history of a chronic disease, like cancer, heart disease, diabetes, or osteoporosis, you may be more likely to develop that disease yourself. Share your family health history with your doctor, who can help you take steps to prevent these conditions or catch them early.

Make Healthy Choices in School, at Work, and in the Community

By making healthy behaviors part of your daily life, you can prevent conditions such as high blood pressure or obesity, which raise your risk of developing the most common and serious chronic diseases. Learn more about healthy actions you or your loved ones can take.

Sleep difficulties are very common, can cause problems with daytime functioning and may contribute to many other medical conditions. There is help available for the two most common sleep issues - insomnia and obstructive sleep apnea.

What's Important to Know?

Maintaining Healthy Sleep

Getting high quality sleep is key for good health. Sleeping well is just as important as exercise and eating wisely. If you are already getting quality sleep, here are some tips to help you continue sleeping well:

• Allow yourself enough time to sleep at night.
• Keep a regular sleep schedule every day.
• Allow time to unwind before bed.
• Avoid alcohol and caffeine before bedtime.
• Exercise regularly.
• Avoid napping.
• Keep the bedroom quiet, dark, and comfortable.
• Avoid using electronic devices in the bedroom (TV, cell phones, tablets, computers). White noise from fans or sound machines is fine.
• Use the bed only for sleep and intimacy.
• Identify stressors & continue to manage stress.

Poor Sleep Is Related To:

• Obesity
• Heart disease and stroke
• Diabetes
• Pain
• Depression, anxiety, and irritability
• Concentration and memory problems
• Accidents and impaired work performance

Want to Know More?

One in three people have problems sleeping at some point in their lives. There’s a big difference between one night of poor sleep and trouble that persists. If your sleep trouble goes on for months, you may have a sleep disorder.

The two most common sleep disorders are:
Insomnia Disorder and Obstructive Sleep Apnea Disorder.

Insomnia symptoms include difficulty with:

• Falling asleep
• Staying asleep
• Waking too early

Obstructive Sleep Apnea is a sleep disorder caused by blocking of the airway during sleep. Symptoms can include:

• Loud snoring
• Excessive daytime sleepiness
• Observed episodes of stopped breathing during sleep
• Waking up gasping or choking
• Difficulty concentrating during the day

Effective treatments are available for both Insomnia and Sleep Apnea.

Talk to your health care team to learn about alternatives to sleep medications, including virtual insomnia treatment options.

Pay attention to stress. Tools are available to help you manage and reduce your stress.

What's Important to Know?

If you are having difficulty coping with the demands of your life, you are experiencing stress. Everyone has stress. While some challenge in life is healthy, too much stress can create problems.

If you are overly stressed for too long, that stress can put your health at risk. If you have too much stress, your body will let you know in different ways, and you may:

• Have difficulty concentrating
• Feel worried and fearful
• Feel “wound up”— with sweaty palms, pounding heart, and tense muscles
• Feel irritable toward others
• Feel tired

Strive for a healthy weight. Managing your weight helps you stay healthy now and in the future.

What's Important to Know?

Maintaining a healthy weight can help you feel better and have more energy. It can also help prevent and control many chronic diseases and conditions. Having overweight or obesity increases your risk for diabetes, high blood pressure, cholesterol problems, heart disease, gallbladder disease, female health disorders, arthritis, some types of cancer, and sleep apnea. If you currently have overweight or obesity, losing as little as 5-10% of your current body weight can lower your risks for these diseases.

A simple way to know if you are currently at a healthy weight is to know your body mass index (BMI). You can use a BMI Calculator to determine your current weight status. Maintaining a healthy weight means balancing the number of calories you eat with the calories your body uses or burns:

• If you maintain your weight, you are “in balance.” You are eating close to the same number of calories that your body is using. Your weight will remain stable.
• If you are losing weight, you are eating fewer calories than you are using. Your body is burning its fat storage cells for energy, so you will lose weight.
• If you are gaining weight, you are eating more calories than your body is using. These extra calories will be stored as fat, and you will gain weight.

When Striving to Maintain a Healthy Weight, Remember to:

1. Adopt healthy lifestyle habits. Develop and nurture connections with others and look for purpose and meaning in your life. Fulfilling your social, emotional, and spiritual needs restores food to its rightful place as a source of nourishment and pleasure.
   • Find joy in moving your body and becoming more physically active in your everyday life. Strive to include at least 2½ hours each week of moderate-intensity activity.
   • Eat when you are hungry, pay attention to when you are full, and seek satisfying foods, such as sources of fiber and protein that you enjoy.
   • Tailor your tastes so that you enjoy more nutritious foods. Use more herbs and spices to gradually reduce excess salt, sugar, and dietary fat. Know that there is still room for less nutritious choices in the context of an overall healthy diet and lifestyle.
2. Trust yourself. We all have internal systems designed to keep us healthy and at a healthy weight. Support your body in finding its appropriate weight by paying attention to signals of hunger, fullness, and appetite.
3. Make a commitment. The decision to change to a healthier lifestyle and lose weight is a big step. Start by making a commitment to yourself. Writing down the reasons you want to lose weight. Focus on the many benefits you could experience with weight loss including improved sleep, better mood, decreased pain, improved blood pressure or blood sugar control.

Being physically active can improve your health. Any amount of physical activity is better than none. A single bout of activity provides immediate health benefits such as lowering anxiety and blood pressure and improving quality of sleep.  There are even more long-term health benefits.

What's Important to Know?

All adults should avoid inactivity by moving more and sitting less. Regular physical activity lowers the risk of depression, type 2 diabetes, heart disease, high blood pressure, obesity, stroke, and 8 types of cancer. It may also reduce the risk of weight gain, dementia and falls, improve bone health, endurance and help you feel more energetic. Be active for any and all reasons that are meaningful to you!

Physical activity is anything that gets the body moving. It can be moderate intensity, meaning that you can talk while being active, or it can be vigorous intensity, meaning that you cannot say more than a few words without taking a breath. Choose activities that you enjoy and start at a comfortable level. Once the activity begins to seem easy, be active for a longer amount of time, or be active more often, or a combination of both.

Physical activity is safe for almost everyone, and its health benefits far outweigh the risks. Even if you think you are out of shape, or have not been active in a long time, you can still be active safely. Unless you have a chronic condition, such as diabetes, heart disease or arthritis, or you have active symptoms, such as chest pain or pressure, dizziness, or joint pain, you do not need to talk to your health care team before starting activity. If you have a concern about a health condition, talk with your health care team about the types and amounts of activity that are best for you.

For important health benefits, do at least 2½ hours of moderate-intensity or 1¼ hours of vigorous-intensity aerobic activity each week, or an equal combination of both. Any amount of activity is better than none and your episodes of activity can last any amount of time. You should be active as often as possible during the day and week.

Do muscle strengthening activities at least twice each week and try to use muscles from all parts of your body—the legs, hips, back, chest, abdomen, shoulders and arms. Stretching regularly can improve flexibility, joint motion, circulation, and can also help relieve stress.

The benefits of eating wisely add up over time, bite by bite.

What's Important to Know?

Eating wisely is one of the best tools you have to prevent chronic diseases like obesity, heart disease, high blood pressure, and Type 2 diabetes. The keys to improving health through nutrition are to:

1. Follow a healthy dietary pattern that is right for you.
2. Choose nutrient-dense food and drink choices that you enjoy, reflect your culture, and fit your budget.
3. Focus on nutrient-dense foods and drinks to meet food group needs and stay within appropriate calorie limits. A healthy eating pattern includes:
   • Vegetables of all types - dark green, red, and orange in color as well as legumes (beans, peas, and lentils).
   • Fruits - especially whole fresh fruits - but they may be canned or frozen too.
   • Grains - at least half of which are high fiber whole-grains.
   • Dairy - fat-free or low-fat milk, yogurt, and cheese, and/or lactose-free versions and fortified soy alternatives.
   • An assortment of protein foods - lean meats, poultry, and eggs; seafood; legumes (beans, peas, lentils); and nuts, seeds, and soy products.
   • Oils - vegetable oils and oils in food, such as seafood and nuts
4. Limit foods and beverages higher in added sugars, saturated fat, and sodium, and limit alcoholic beverages. For example:
   • Added sugars - Consume less than 10% of your daily calories from added sugars. These are sugars and syrups that are added to foods or beverages when they are processed or prepared.
   • Saturated fat - Consume less than 10% of your daily calories from saturated fats and avoid trans-fats.
   • Sodium - Limit to no more than 2,300 mg of sodium per day. Choose foods with little added salt and make meals without salt when possible. Adults with high blood pressure may benefit from limiting to 1,500 mg of sodium per day.
   • Alcoholic beverages - Adults of legal drinking age can choose not to drink, or to drink in moderation by limiting to 2 drinks or less in a day for men and 1 drink or less in a day for women and people over age 64. Drinking less is better for health than drinking more. Children, pregnant women, and those with certain medical conditions who should not drink any alcohol.

Maintain or strive for a healthy weight by balancing the energy (calories) from foods and drinks with the energy burned through physical activity. To lose weight, most people need to reduce the number of calories consumed and increase their physical activity.

If you choose to drink alcohol, drink in moderation (for women, no more than 1 drink a day; for men, no more than 2 drinks a day). Avoid "binge drinking."

What's Important to Know?

If you choose to drink alcohol, drink in moderation. Women and everyone over age 64 should drink no more than 1 drink per day (and not more than 7 drinks per week). Men aged 64 and under should drink no more than 2 drinks per day (and not more than 14 drinks per week). One drink is equivalent to:

• 12 oz. regular beer, usually about 5% alcohol or
• 8-9 oz. malt liquor, or
• 5 oz. table wine (12%), or
• 1.5 oz. 80-proof hard liquor

Drinking too much alcohol, or “binge drinking,” can lead to a higher risk of health problems such as liver damage, pancreatitis, or other issues. Binge drinking is defined as:

• More than 3 drinks on one occasion for women and adults over age 64
• More than 4 drinks on one occasion for men

For many adults, drinking small amounts of alcohol does not cause serious health problems. Women who drink no more than 1 drink a day (and not more than 7 drinks per week) and men who drink no more than 2 drinks a day (and not more than 14 drinks per week) are at low risk for developing problems with alcohol use.

However, as we age, our bodies do not process alcohol as easily, and the limits for all people over age 64 are no more than 1 drink a day and 7 drinks per week. In addition, there are people such as children, pregnant women, and those with certain medical conditions who should not drink any alcohol.

Be tobacco free! Don't use tobacco in any form. If you are using tobacco, the VA can help you quit. Avoid secondhand smoke. If you are pregnant, both you and your baby will benefit when you quit using tobacco.

What's Important to Know?

Quitting tobacco use is the single most important thing you can do to improve your health and protect your family’s health. If you quit smoking or other forms of tobacco, you and your family will experience short and long-term health benefits. It’s never too late to quit—your health will improve at any age after quitting tobacco!

All forms of tobacco use— including cigarettes, cigars, pipes, snuff, snus, chewing tobacco and more—are harmful. Tobacco use harms nearly every organ of the body and causes:

• Cancers
• Heart disease and stroke
• Chronic obstructive pulmonary disease (COPD) and other lung/breathing problems
• Complications in those who are pregnant

Secondhand smoke is the smoke released from a burning cigarette, cigar or pipe, as well as the smoke exhaled by the smoker. There is no safe level of secondhand smoke. It can cause harmful effects on non-smokers’ health and can increase their risk of heart disease, lung cancer, and other health problems by 20-30%.

Tobacco use is the largest cause of preventable illness and death in the United States. Tobacco and secondhand smoke kill approximately 480,000 people in the U.S. each year.

Many good things happen as soon as you quit. You’ll breathe easier, save money, smell better, and have more energy. If you’re pregnant, your baby will be healthier. You’ll also be protecting your health and protecting your family and friends from secondhand smoke.

Be involved in your health care. There are many ways to take an active role. Work with your health care team to meet your health goals and accomplish what matters most to you.

What's Important to Know?

Playing an active role in your health care is key to meeting your health goals. To get the most out of your visit, plan the questions you want to ask and the things you want to discuss. When you leave your visit, know what actions to take to best manage your health. Here are some specific ways to be more involved:

Before your visit:

• Write down your health goals, needs, questions, and concerns.
• Make a list of all the medicines you take, including vitamins and supplements.

During your visit:

• Tell your team about your health goals, needs, and treatment preferences.
• Share any health questions and concerns with your team at the beginning of your visit.
• Tell your team about your past illnesses, hospital stays, surgeries, and any other health issues you may be experiencing.
• Share your list of medicines and why you take them. Ask for written instructions to take home with you for any current or new medicines.
• Work together with your team to create a treatment plan that meets your health goals, needs, and preferences, and that addresses what matters most to you.

• Take notes about what you and your health care team discuss and decide. Bring a family member or friend to help.
• Ask about next steps in your health care plan, such as additional appointments and treatments or how you will access test results.
• Share steps that you plan to take reach your health goals. If you are unsure, ask your team for help in identifying specific actions you might take to follow through with your plan.
• Ask your team any other questions you have at the end of your visit. Speak up if you have concerns or think something is wrong.

After your visit:

• Tell your team if you have more questions or concerns, or if there is a change in your health.

Recommendations for preventive services depend on your age, sex, health status, and family history. Find out which screening tests and immunizations are recommended for you.

What's Important to Know?

It’s important to keep up with your screening tests and immunizations to prevent certain kinds of illness. Recommendations for preventive services depend on your age, sex, health status, and family history. Every person is different.

All preventive services have possible benefits (pros) and harms (cons). Depending on your values and preferences about these benefits and harms, you may wish to receive additional, fewer, or different services than those that are recommended. Talk with your health care team about their recommendations for screening tests and immunizations that are right for you.

“Screening” means looking for a condition before there are any signs or symptoms of that condition. If you already have a symptom of the condition, you should talk with your provider about it, even if you were recently screened and no problem was found.

Regardless of age, gender, health status and family history, you should be screened for alcohol abuse, depression, high blood pressure, human immunodeficiency virus (HIV), military sexual trauma, obesity, posttraumatic stress disorder (PTSD), and tobacco use.

You should also follow the appropriate cancer screening guidelines. Keeping up with immunizations is also important to stay healthy. You should receive a flu shot every year and a tetanus shot at least every 10 years but some Veterans may need it sooner (indicated for wound management if greater than 5 years has passed since your last shot and those Veterans that are pregnant should receive Tdap vaccine during every pregnancy from 27-36 weeks of gestation).

If you have not received a COVID-19 vaccine already, you can best protect yourself by doing so now. COVID-19 vaccines are highly effective in preventing serious illness from COVID-19. They will also protect you from newer virus variants that may spread more easily and affect you more severely. COVID-19 vaccines may be given at the same time as other vaccines, including influenza vaccines. Vaccination is the best way to protect yourself, your family, and your community.

These are actions you can take to protect yourself and those you love from harm and injury. Common safety issues are sexually transmitted infections, falls, violence and self-harm.

Intimate partner violence (IPV), also called domestic violence, affects millions of Americans. IPV is the most common cause of injury to women in the U.S. IPV is defined as actual or threatened emotional, physical, or sexual abuse or stalking behaviors by an intimate partner.

These are actions you can take to protect yourself and those you love from harm and injury. Common safety issues are sexually transmitted infections, falls, motor vehicle crashes, violence and self-harm.

What's Important to Know?

Falls cause the most fractures and are the leading cause of injury deaths among older adults. About half of all falls happen at home, and there are practical things you can do to reduce your risk of falling there. Engaging in regular physical activity, monitoring or avoiding certain medications, and getting your eyes checked may reduce your risk of falling. Other things you can do to prevent falls are:

• Remove small throw rugs to prevent tripping and falling. If you choose to use them, anchor them with double-sided tape or anti-slip mats underneath.
• Improve the lighting in your home. As you get older, you need brighter lights to help you see well. Hang light-weight curtains or shades to reduce glare.
• Wear shoes inside and outside the house. Avoid going barefoot or wearing slippers.
• Remove things (papers, books, clothes, shoes) from stairs and places where you walk, so you will be less likely to trip. Install handrails and lights in all staircases.

• Keep items you use often in cabinets that you can reach easily without using a step stool.
• Install grab bars next to your toilet and in your tub or shower. Make sure you use non-slip mats in the bathtub and on shower floors.
• Use a walker or a cane for extra support.
• Physical activity, especially balance training exercises, may reduce your risk of falling by increasing strength and balance. Lack of physical activity leads to weakness and increases your chances of falling.

It is important to recognize signs that you or someone you know may be in crisis.

What's Important to Know?

People can experience an emotional or mental health crisis in response to a wide range of situations. A crisis may be triggered by troubles such as problems in personal relationships or loss of a job. A crisis can lead people to consider hurting or even killing themselves (suicide). In general, Veterans are at a higher risk of suicide than civilians.

These warning signs may indicate that someone is in crisis and/or possibly suicidal:

• Hopelessness, feeling like there's no way out
• Anxiety, agitation, sleeplessness, or mood swings
• Feeling like there is no reason to live
• Rage or anger
• Engaging in risky activities without thinking about possible harm
• Increasing or excessive tobacco, alcohol, or drug abuse
• Withdrawing from family and friends
• Expressing feelings of being trapped with no way out
• Expressing overwhelming guilt or shame

These signs require immediate attention:

• Thinking about killing yourself
• Looking for ways to kill yourself
• Talking about death, dying, or suicide
• Self-destructive behavior such as drug abuse, reckless behaviors, weapon use, etc.

If you or someone else is in a serious crisis and feeling suicidal:

• Seek immediate help from your health care team or the nearest hospital emergency room
• Call 911
• During times of crisis or hopelessness, consider removing firearms from the home or using a gun lock or gun safe to make them less accessible

Sexually Transmitted Infections (STIs) are infections you can get or give someone by having sex while you or your partner are infected.

What's Important to Know?

Sexually Transmitted Infections (STIs), often referred to as Sexually Transmitted Diseases (STDs), are infections you can get or give someone by having sex while you or your partner has an infection. STIs are the same thing as sexually transmitted diseases (STDs). Many STIs do not have symptoms. You and/or your partner can have an STI and pass it on without knowing it. Some STIs can cause organ damage and infertility. Having one STI may raise your risk for getting other STIs. Some examples of STIs are chlamydia, gonorrhea, syphilis, human immunodeficiency virus (HIV), and human papillomavirus (HPV). Recently, monkeypox has been identified as a STI, though it can also spread through the air in droplets and infect others who breathe in the droplets. If you or your partner have skin sores or blisters, this could be a sign of monkeypox or another infection.

You can get STIs from any sexual activity, whether it involves the mouth, anus, vagina, penis, or sex toys. Some STIs can pass from a pregnant woman to their baby before or during the baby’s birth. Most STIs can be treated and cured. Some cannot be cured but can be managed by taking medicines. If you are treated for an STI, your sex partner(s) may also need to be treated to prevent you from being re-infected.

The spread of some STIs can be reduced by using new, lubricated latex condoms every time you have sex for the entire sex act and by reducing your number of sex partners. For those allergic to latex, polyurethane and polyisoprene condoms offer protection from STIs but may break more easily. Lambskin condoms and birth control pills can help prevent pregnancy, but they will not protect you from STIs.

A vaccine is available for HPV, the virus that can cause cervical and anal cancer. A vaccine is also available to protect yourself against hepatitis A and B, which are sexually transmitted viruses that infect your liver and can lead to severe illness including liver cancer. A vaccine is also available for monkeypox.

Multiple medications are available to protect yourself against HIV infection. HIV pre-exposure prophylaxis (PrEP) is a medication (oral medication or injection) that is highly effective at preventing HIV infection for people at risk. HIV post-exposure prophylaxis (PEP) is medication taken to prevent HIV in emergency situations after a possible exposure. It must be taken within 72 hours of exposure.

Getting tested and knowing your status is also an important part of reducing the spread of STIs. If you are at risk for one STI, you are at risk for all STIs!