Focus on the Six Pillars to Improve Wellness
As we spend more time indoors, especially during a holiday season, we will likely catch one of the dreaded respiratory viruses going around. The past few years have been a whirlwind of COVID-19, influenza, and RSV, but we still have plenty of adenovirus, rhinovirus, and norovirus to share. And now that we are mostly unmasked and back to business as usual, some of these viruses are hitting harder than they were when we were masking and self-isolating.
As a family physician also certified in Lifestyle Medicine, I frequently counsel people on how to improve their health by focusing on the “six pillars”: better sleep, avoiding risky substances, managing stress, staying connected to those we love, eating well by focusing on nutrition and incorporating more physical activity into our daily lives. All six of these mindful strategies have been shown to improve wellness and even reverse chronic illness when practiced regularly.
Let’s talk about how to use these six pillars to stay well during the upcoming several weeks, a time of gathering for parties and family drama.
Sleep: Most of us don’t get enough of it. Did you know that adequate sleep for adults is 7-9 hours a night? Children need much more: babies sleep most of the day (12-16 hours); toddlers 11-14; pre-K 10-13 hours; school-aged kids 9-12; and teens need 8-10. Sleep is a critical time of rest and repair. Many of the body’s essential hormonal functions are working while you’re sleeping. The consequences of poor sleep are worse than just being cranky: all that stress leads to inflammation, insulin resistance, excess body fat, decreased performance, decreased attention, and overall worse health, including diminished immune response. You get sick more easily and more often. How can you improve your sleep? Stop eating at least 2 hours before bedtime. Put away the devices. Blue light from your phone, iPad, and TV are all well-known sleep disrupters. And cut back on the alcohol. Although you feel sleepy at first, alcohol induces a dysfunctional sleep pattern that will wake you up 2-3 hours later (often with a headache), and you may have trouble getting back to sleep.
Avoiding Risky Substances:The holiday season is when we enjoy cocktails with friends and celebrate! However, moderation is key. Generally, moderate drinking is described as one drink per day for women and two drinks per day for men. The National Institutes of Health characterizes low-risk drinking for men as no more than four drinks on any given day and no more than 14 drinks in 7 days, and for women, no more than three drinks on any given day and no more than seven drinks in 7 days. “Binge” drinking is defined as five drinks in 2 hours for men and four drinks in 2 hours for women. While alcohol is the most overused risky substance, tobacco and other drugs (street drugs or prescribed but misused) can be harmful. If you feel a need to cut down, consider setting a SMART goal: specific, measurable, attainable, realistic, and time-based. Talk with your healthcare provider about helping with cutting back on any substance use that may be keeping you from living your best life.
Managing stress, especially in a holiday season, is one of the most important parts of wellness. Many other lifestyle medicine principles (sleep, nutrition, physical activity, social connectedness) will naturally reduce stress when practiced together. Take time for yourself—for fun, hobbies, spiritual wellness, and the things you enjoy doing that matter to you. Writing even one sentence daily in a gratitude journal before bed may help you center your thoughts. Learning meditation techniques such as deep breathing or incorporating mindfulness and prayer into your daily walk will reduce stress. Find something to laugh at—this is a huge stress reliever!
Social Connection: We know that blood pressure and heart rate go down when we spend time together with those we love—and that doesn’t have to be a human! Pet therapy is important for many of us. Loneliness was a tremendous problem during the COVID-19 epidemic. We saw unprecedented numbers of seniors and school-aged children isolated at home for months at a time.. Social networks can alleviate some of this loneliness, but for many of us it’s not a substitute for real in-person connection. If you miss spending time with others, find something to do that will get you out there. Take a class. Go to a concert. But get a flu shot first, preferably two weeks ahead.
Eat Well. Nutrition is the cornerstone of wellness. Lifestyle medicine advocates a whole food, mostly plant-based diet, encouraging a variety of minimally processed vegetables, fruits, whole grains, legumes, nuts, and seeds. Avoid sugary drinks, processed meats, and packaged snacks. Large population data shows that eating plant-based can reverse diabetes and heart disease and prevent most cancers. Even eating one plant-based meal daily is a great way to incorporate healthier foods into your lifestyle. Your body and mind will thank you.
And finally, move more! Physical activity is critical to our overall well-being. Exercise that engages large muscles, moves joints through their range of motion, and gets your heart rate up fast enough so you can talk but not sing is necessary to maintain cardiovascular fitness and optimal respiratory function. The CDC (Centers for Disease Control) recommends at least 150 minutes (about two and a half hours) of moderate-intensity physical exercise a week for adults 18-64 years old or 75-150 minutes of vigorous activity per week. All adults should add in strength training two days/week to maintain muscle strength and flexibility. Get any exercise you can—even a 10-minute walk after dinner has decreased average blood sugar and blood pressure. Adults over 65 should continue exercising as much as their bodies allow, but also add in balance training—tai chi and yoga are excellent.
