by DR. MICHAEL HUNTER

To optimize health, say the experts, you need to choose a healthy diet, maintain the proper weight, be part of a community and not drink to excess or smoke. But let's not forget two other essential components of health: sleep and physical activity/exercise.

Researchers from The University of Sydney in Australia analyzed data from more than 380,000 middle-aged men and women over an 11-year-period and discovered that poor sleep was associated with a higher risk of early mortality. The risk increased when combined with low physical activity.

The researchers also observed that getting no physical activity led to worse health outcomes regardless of sleep amount. In addition, those with lower sleep scores had a higher chance of dying from cardiovascular disease or a stroke.

The scientists concluded that any level of physical activity at or above the lower threshold recommended by the World Health Organization (WHO) seemed to eliminate most of the negative impacts of poor sleep on mortality.

Compared with those with high physical activity and healthy sleep scores, those at the other end of the scale (no moderate to vigorous physical activity, plus poor sleep) had the highest risk of premature mortality.

On occasion, it’s probably not unreasonable to sacrifice sleep to exercise if you are not too tired. However, if you chronically get insufficient sleep, you will be more fatigued and set yourself up for more severe health problems down the road, including cardiovascular disease and cancer. In addition, you need adequate sleep to recover from exercise.

The goal is to find the right balance. For age-specific recommendations on activity, go to the WHO website at who.int/news-room/fact-sheets/detail/physical-activity. For sleep advice, see “Getting your Zzz’s”.

The message is clear: To have the best health outcomes, sleep well and move.