{"doi":"10.1002/lim2.70008","title":"Lifestyle Medicine Essentials: “Walk More, Eat Less, Sleep More”—White's Early Inspiration","abstract":"One of the American Heart Association (AHA) founders, Paul Dudley White (June 6, 1886–October 31, 1973), a renowned cardiologist in the 20th century, emphasized the importance of a balanced lifestyle to maintain heart health. In keeping with his beliefs, he was a vigorous walker and bicycle rider. He was appointed as President Dwight D. Eisenhower's cardiologist following his heart attack in 1955 and played an important role in his recovery and his subsequent running for a second presidential term of office [1]. Dr. White's key recommendations were to “walk more, eat less, and sleep more”; coincidently, he is the father of prevention cardiology. White advocated for exercise, diet, and weight control in preventing heart disease, prescribing cycling for the president. Furthermore, Dr. White played a key role in establishing the National Institutes of Health and the Framingham Heart Study, which identified major risk factors for heart disease [1, 2]. Over the last 100 years, advancements in technology, research, and development have led to numerous groundbreaking discoveries in cardiology, revolutionizing the diagnosis and treatment of cardiac diseases. These include electrocardiography (ECG), cardiac catheterization and coronary angiography, open-heart surgery, cardiopulmonary resuscitation, percutaneous coronary intervention, the use of defibrillators, thrombolytic therapy, genetic insights into heart disease, high-resolution imaging (such as echocardiography, cardiac CT, and MRI), and an enhanced understanding of leukocyte biology [3, 4]. Today, the application of artificial intelligence is accelerating ECG and imaging analysis, enabling personalized risk assessments, diagnostics, and long-term treatment plans. Despite these revolutionary and timely advances, the “Life's Essential 8” with primary diet, sleep, and exercise—remain foundational elements of lifestyle medicine. These three lifestyle components regulate body weight, blood pressure, lipids, and glucose, playing a decisive role in the prevention and management of cardiovascular diseases. White recognized the crucial role of physical activity in preventing heart disease. White prescribed exercise to President Eisenhower after his heart attack, replacing bed rest as the standard of care [1]. White's research showed that physically active bus conductors had a 30% lower incidence of coronary heart disease compared with sedentary bus drivers. He advocated for incorporating more walking into daily activities to improve cardiovascular health. White emphasized the need for a balanced diet, low in saturated fats and high in fruits and vegetables to reduce the risk of heart disease. He encouraged his patients to discipline their diet and avoid excess sweets, starches, and rich foods. White believed that a sensible diet, combined with regular exercise, was essential for maintaining cardiovascular health. To recognize the commitment, the Paul Dudley White Bike Path in Boston, named after the pioneering cardiologist, promotes outdoor exercise and heart health along the scenic Charles River. White recognized the importance of adequate sleep for overall health and well-being. He recommended that his patients aim for 7–8 h of sleep per night to allow their bodies to rest, restore, and recover. A diet low in saturated fats and high in fiber and plant foods can substantially reduce the risk of developing heart disease. Insufficient sleep (quality, timing, or regularity due to circadian disorders) is associated with an increased risk of heart disease, as it can contribute to inflammation, atherosclerosis, and metabolic disturbances. Initially, AHA developed Life's Essential 7 and then added a sleep metric given the importance of sleep to cardiac health. In conclusion, Paul Dudley White's “walk more, eat less, and sleep more” philosophy emphasizes the importance of a balanced lifestyle for maintaining cardiovascular health and mitigating noncommunicable diseases. 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