Excerpt from “Eat Move Sleep: How Small Choices Lead to Big Changes” by Tom Rath (© 2013 by Tom Rath)

Choices count. You can make decisions today that will give you more energy tomorrow. The right choices over time greatly improve your odds of a long and healthy life.

A hundred years ago, many people died from infectious diseases because they had no cure. But today, a majority of people die from preventable conditions. The next time you are with two friends, consider that two of the three of you are likely to die from heart disease or cancer. The problem is, you do not see the threats that your small daily decisions pose in the moment. You have little urgency to change your diet until all those years of fried food, sugar, and processed meat cause a heart attack at age 60. At that point, reversing disease is possible but more difficult.

No matter how healthy you are today, you can take specific actions to have more energy and live longer. Regardless of your age, you can make better choices in the moment. Small decisions — about how you eat, move, and sleep each day — count more than you think. As I have learned from personal

experience, these choices shape your life.

A Personal Perspective

At age 16, I was playing basketball with friends when I noticed something wrong with my vision. There was a black circle in the middle of my visual field. I assumed it would go away. Instead, it got progressively worse. I finally told my mom, who immediately took me to an eye doctor.

That black spot turned out to be a large tumor on the back of my left eye. The doctor said it might lead to blindness. As if that was not enough, I needed to get a blood test to rule out other medical problems. A few weeks later, my mom and I went back to the doctor’s office for the results.

The doctor told us I had a rare genetic disorder called Von Hippel-Lindau (VHL). While VHL typically runs in families, my condition was a new mutation that affects just one in every 4,400,000 people. This mutation essentially shuts off a powerful tumor suppressor gene and leads to rampant cancerous growth throughout the body.

I still vividly recall sitting on one side of a large wooden desk as my doctor tried to explain what it would

be like to battle cancer for the rest of my life. It was one of those moments when your stomach sinks and your mind races for an alternate explanation. My doctor then described how I was also likely to develop cancer in my kidneys, adrenal glands, pancreas, brain, and spine.

While the thought of losing my eyesight was tough, these longer-term issues were even more daunting. That conversation with the doctor forced me to wrestle with much larger questions about my life. Would people treat me differently if they knew about my illness? Was there any chance I would get married and have kids? Perhaps most importantly, I wondered if there was any way I could

live a long and healthy life.

Doctors tried everything to save my eyesight, from freezing the tumors to cooking them with a laser. But the sight in my eye never returned. Once I got over this loss, I turned my attention to learning everything I could about the other manifestations of this rare disease.

I quickly realized that the more I learned, the more I could do to increase my odds of living longer. As new information emerged, I discovered I could stay ahead of my condition with annual MRIs, CTs, and eye exams. If doctors caught tumors early when they were small, the tumors were less likely to spread and kill me. Learning that was a huge relief. Even if it required some difficult surgeries, there was something I could do to live longer.

I have had annual exams and scans for 20 years now and currently have small tumors in my kidneys, adrenal glands, pancreas, spine, and brain. Every year, I “watch and wait” to find out if any of these tumors are large enough to require surgery. In most cases, they are not.

Waiting around for active tumors to grow may sound nerve-wracking. It could be, if I dwelled on the genetic condition that is beyond my control. Instead, I use these annual exams to stay focused on what I can do to decrease the odds of my cancers growing and spreading.

As each year goes by, I learn more about how I can eat, move, and sleep to improve my chances of living a long and healthy life. Then I apply what I learn to make better choices. I act as if my life depends on each decision. Because it does.

Small Choices Change Everything

Making better choices takes work. There is a daily give and take, but it is worth the effort. The vast knowledge we have to prevent cancer, heart disease, and other chronic illnesses is staggering. Every day, I read about new ideas that could help someone I care about live a longer and healthier life.

Over the last decade, I have dedicated a great deal of time to organizing this virtual sea of information in a way that can benefit others. What I look for are simple and proven ideas. I read a wide range of academic studies and research-based articles — from medical and psychological journals to in-depth books — and try to extract knowledge that can help people make better decisions and live healthier lives.

Let me be clear. I am not a doctor. Nor am I an expert on nutrition, exercise physiology, or sleep disorders. I am just a patient. I also happen to be a researcher and voracious reader who loves to extract valuable findings and share them with friends. In this book, you will find the most credible and practical ideas I have found so far.

What I learned from all this research influences my countless daily decisions. Every bite of food either

increases or decreases my odds of spending a few more years with my wife and two young children. Half an hour of exercise in the morning makes for better interactions all day. Then a sound night of sleep gives me energy to tackle the next day. I am a more active parent, a better spouse, and more engaged in my work when I eat, move, and sleep well.

What seem like small or inconsequential moments accumulate rapidly. When your good daily decisions outweigh your poor ones, you boost your chances of growing old in better health. Life itself is a big game of beating the odds. Take, for example, these four largely preventable diseases: cancer, diabetes, heart disease, and lung disease.

Combined, they kill nearly 9 in 10 people.

Researchers have estimated that 90 percent of us could live to age 90 with some simple lifestyle choices.

What’s more, we could live free of common diseases that make our final years miserable. Even if you have a family history of heart disease or cancer, most of your fate is in your control.

A recent study suggests you do not “inherit” longevity as much as previously believed. Instead, the sum of your habits determines your life span. How long you live is more about how you live your life and less about how long your parents lived.

I am a living testament to the fact that lousy predispositions can be encoded in your genes. Yet even in this extreme case, my decisions affect the odds of new tumors growing and my existing cancers spreading. The reality is, the majority of your risk in life lies in the choices you make, not in your family tree.

No single act can prevent cancer or guarantee you will live a long life. Anyone who promises you something that absolute is a fraud. What I will share in this book are some of the most practical ideas to improve your odds of a longer, healthier, and more fulfilling life.


Tom Rath is considered one of the most influential authors of the last decade, whose books and studies have focused on the role of human behavior in health, business, and economics. Rath has written several international bestsellers, including the #1 New York Times bestseller How Full Is Your Bucket? In 2012, his book StrengthsFinder 2.0 was the top-selling nonfiction book worldwide. Rath’s most recent New York Times bestsellers are Strengths Based Leadership and Wellbeing: The Five Essential Elements. In total, his books have sold more than 5 million copies and have made more than 250 appearances on the Wall Street Journal bestseller list.

Rath serves as a senior scientist and advisor to Gallup, where he previously spent 13 years leading the organization's work on employee engagement, strengths, and well-being. Rath also served as vice chairman of the VHL cancer research organization. He earned degrees from the University of Michigan and the University of Pennsylvania, where he is now a guest lecturer. He and his wife, Ashley, and their two children live in Arlington, Virginia.

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