Lifestyle Medicine

Lifestyle has a great deal of influence over health. Through daily habits and activities health can be strengthened or weakened. There are many aspects of this that can be considered, but one useful way of approaching it is by considering the six pillars of lifestyle medicine: nutrition, physical activity, sleep, stress management, social connection and avoidance of risky substances.

Nutrition - There are numerous styles of eating that can support health and different individuals will have different nutritional needs. Aspects to consider include total calorie intake as well as intake of macronutrients (protein, carbohydrate, fat), fiber, and micronutrients (such as vitamins and minerals). Diet plays a major role in maintaining a healthy body composition, cardiovascular health, insulin sensitivity and the microbiome. Increasingly, diet is also thought to have an impact on our mental health. Among the most studied and recommended diets are the Mediterranean Diet and the DASH (Dietary Approaches to Stop Hypertension) diet which have demonstrated cardiovascular benefit. However, other approaches such as ketogenic diets have also proven valuable under certain conditions.

Physical Activity - There are numerous benefits to exercise, from increased cardiovascular health to improved mental health. Again, this will be specific to the individual as personal ability and interest varies. For those who can, regular walking outdoors, perhaps a mile or two per day, can be a beneficial habit. Strength training is also important both because muscular strength helps prevent falls and injury but also because increased muscle mass improves metabolic health.

Restorative sleep - Sleep is necessary for health. Sleep allows for growth and repair and is a need shared by essentially all animals on Earth. Lack of sleep increases the risk of obesity, insulin resistance and mood disturbances. A scheduled sleep window of at least eight hours is a great first step towards this pillar of health. Other steps to consider include avoiding caffeine and other stimulants later in the day, avoiding screens in the evening, and avoiding alcohol which degrades sleep quality.

Stress management - Stress includes both physiologic stress and psychologic stress. As with many of the other lifestyle factors there are clear links between stress and cardiovascular disease, insulin resistance and mental health. There has even been some observed correlation between stress and immune system dysfunction. Stress management includes reducing physiologic and psychological stressors where possible and developing skills and practices to cope with these stressors when they cannot be eliminated. In addition to the aforementioned factors of nutrition, exercise, and sleep, other approaches that can improve our ability to deal with stress include practices such as meditation, prayer, gratitude, social activities or even hobbies.

Positive Social Connections - Humans are social creatures. Loneliness and social isolation reduce life expectancy. Relationships with family, friends, and colleagues, can all support our health. Through conscious cultivation, these relationships can be strengthened and the deleterious effects of isolation and loneliness avoided. Community groups, volunteer organizations, sports teams, exercise classes and religious groups are all possible options for those interested in increasing social connection.

Avoidance of Risky Substances - Tobacco use, drug abuse and excessive alcohol have many known deleterious effects such as heart disease and cancer. Avoidance is best but treatment for those who suffer from addiction is also important to minimize the risk of subsequent harm.

The six pillars of lifestyle medicine constitute a useful framework for looking at ways we can enhance health through behavioral changes. As can be seen, there is much connection and overlap between these six categories. Improving one area tends to improve others and the benefits of improving in multiple categories are often synergistic.

Our bodies are capable of self-healing and, in fact, are carrying out the healing process all the time as a necessary condition of life. Through attention to lifestyle factors, including but not limited to those discussed above, we can support this vital process.

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