November 01, 2023 | Planning Matters | 7 min read
Investing in Your Health Through the Six Pillars of Lifestyle Medicine
Living a long life is only fun if you have a quality of life in which you can move around, think clearly, look after yourself, and pursue your interests. A long life span is best accompanied by a long health span.
It’s remarkable that 150 years ago, the average lifespan was only about 45 years as people died of trauma and infection. Today with the advent of sanitation, clean water, plentiful food, warm, dry housing, workplace safety, and antibiotics these are no longer the main causes of death. Disability, trauma and infection have also been replaced by chronic diseases such as cancer, dementia, diabetes, hypertension, obesity, and cardiovascular disease – and these are largely the result of lifestyle, the choices you make every day. But by making small, consistently healthy choices, you can prevent these chronic diseases altogether or at the very least delay them to the very last years of your life.
Health and wellness is a multi-trillion-dollar industry crowded with celebrity opinions and snake oil salesmen. So where to start? The Six Pillars of Lifestyle Medicine, a science-based non-pharmacologic (non-drug therapy) approach, provides the basic tools to create health, prevent illness, and treat disease. Even in terminal illness, healthy life choices can improve quality of life and potentially slow the progression of disease.
The Six Pillars are:
- Sleep
- Nutrition
- Movement
- Relationships
- Productivity
- Mental Health
Easy to tick off on 6 fingers: sleep, eat, move, connect, work, and breathe! The pillars are each important in their own right, but are also inter-connected. Here’s a rundown.
Sleep
Sleep is the first and most important pillar as – believe it or not – you will die more quickly from lack of sleep than from lack of food. If you do not have a problem with sleep, that’s a gift! If you struggle with sleep and have resorted to sleeping pills, though, be aware the evidence shows that behavioural changes are a better long-term solution for insomnia than prescription drugs. What can you do?
A cognitive behavioral sleep program for insomnia can be effective, which suggests doing three things:
- Limit your time in bed – This allows for the build-up of adenosine in the brain (a byproduct of cognitive activity while awake) that creates the drive to sleep.
- Get outside in bright daylight, daily – This resets your internal sleep clock, commonly known as your circadian rhythm.
- Create a strict association between the bedroom and sleep – This includes having a quiet, dark room, avoiding blue-light devices like computers and phones, and keeping the dog off the bed (sorry Fido!).
As this can be tough to tackle on your own, I recommend getting a hand from a professional.
Nutrition
The big “US Burden of Disease” studies always list poor diet as one of the top risk factors for chronic disease, cardiovascular disease, cancer, dementia, diabetes, obesity, and hypertension. But while diet has become the new religion, much of this religion is based on dogma and not on evidence – partly due to the difficulty of structuring effective, “blind” studies of nutrition. Study participants tend to know what they’re eating.
With all that said, what we eat matters! The scientific evidence clearly recommends eating a high-quality diet with lots of unprocessed fruits and vegetables at every meal and minimal processed food. These choices will accrue health benefits over time as they provide for lots of fibre, and low levels of refined carbohydrates, saturated fat, and sodium. Processed food is ubiquitous in our environment so do the best you can, and don’t eat between dinner and breakfast to give your digestive tract a chance to rest, relax, and restore.
Movement
Everybody – and every body – benefits from movement regardless of how young or old you are, how well or sick you are, and in even terminal illness. Movement keeps you high functioning and helps prevent chronic disease.
The first thing I tell my patients is that a gym membership is not required. It’s easy to remember “10,000 steps” but in truth that’s not a magic number as any number of steps is beneficial and in fact, many of the benefits are gained at 4,500 to 7,500 steps. (The benefits keep accumulating as your step count goes up, though, of course.)
Even something as simple as standing up regularly can be beneficial, especially if you have a sedentary job or otherwise spend a lot of sitting. Get up and move as often as possible. Watch the clock and get up and move at least every 30 minutes. You will think more clearly as a result.
Relationships
From birth to death, healthy relationships play an essential role in building confidence, resiliency, and a general sense of well-being. This starts in infancy, when the establishment of a secure attachment between child and caregiver is crucial. If you have a child or grandchild in your life, spend as much focused time with them as possible. You are irreplaceable. The benefit is also mutual, as evidence shows that people with healthy relationships live longer and experience less mental illness.
Productivity
Throughout your life, you go through several stages with respect to productivity and the closely related feeling of Purpose. For children, having fun and learning about the world is a full-time job and very intrinsically rewarding. Young adulthood is about getting higher education, navigating personal relationships, and finding satisfying work. And during the middle years of child-raising and career growth, life can be overwhelmingly full of purpose and productivity.
If you are feeling a lack of productivity, make a commitment to help another who is overwhelmed with work that needs to be done and/or challenges that need to be met.
Mental Health
Your mental health is an extremely important facet of your overall health and happiness, and the good news is you can accomplish a lot through the simplest of practices: breathing. Mindful breathing exercises can restore the balance between your sympathetic (Fight! Flight! Freeze!) and parasympathetic (rest… digest… relax… recover… restore… repair…) nervous systems.
By boosting your parasympathetic nervous system, you can reduce anxiety and depression and actually increase your baseline level of contentment and happiness, something that tends to stay the same unless you actively take steps to improve it. Remarkably, studies have shown that people who have won the lottery and people who became paraplegic in an accident reverted to their own baseline level of happiness after one year. But you can increase your baseline level of happiness by making small regular changes. Take your mental health seriously. Start by learning a simple breathing exercise.
To wrap up, here are a few simple pearls to help you begin to implement the Six Pillars of Lifestyle Medicine:
- Sleep: To avoid ruining a good sleep or complement an insomnia program, generally retire and rise at approximately the same time every day, avoid alcohol and caffeine in the evening, and sleep in a cool, dark, quiet room with no screens.
- Nutrition: Make your own salad dressing and keep it in the fridge: a spoonful of Dijon mustard, a pinch of salt, pepper, and garlic powder, a tablespoon of vinegar, and 1/4 cup of olive oil. For snacking, make your own popcorn in a hot air popper and toss with oil and salt. Try avocado, canola or olive oil. The new Canadian guidelines recommend two drinks per week for lowest-risk alcohol consumption.
- Exercise: Get really comfortable shoes and walk more in your ordinary life regardless of your exercise regime. Take the stairs every chance you get if that works for your body. When sitting at your desk, watching TV or on the computer, watch the clock and get up and move.
- Relationships: Take out your cell phone and text a friend you have not connected with in awhile, something as simple as “Thinking of you and I wanted to say hello.” Meet for coffee or a walk.
- Productivity: If you are feeling unhappy for any reason, do a small thing exclusively for someone else with no obvious benefit to you. You will feel happier. This works like magic.
- Mental Health: Take a walk in nature. It is the physical activity we lack the most in the modern world. Expose yourself to music, arts, and culture. Laugh out loud. Breathe. Recognize mild depression and mild anxiety and deal with it early by sleeping well, upping your physical activity, connecting with a friend and helping others. This can prevent mild problems from escalating.
There is ample scientific evidence that these six pillars can create health, prevent disease and help treat cardiovascular disease, some cancers, dementia, diabetes, hypertension anxiety depression and most of the other chronic diseases. This might be the best investment you ever make!
About the Contributor
Dr. Ann Crabtree is a Clinical Associate Professor in the Cumming School of Medicine at the University of Calgary, and past elected member of the Governing Council of the College of Physicians & Surgeons of Alberta. As a consulting physician, she specializes in prescription drug de-prescribing and evidence-based non-pharmacologic healthcare. Dr. Crabtree is available for talks and articles and can be reached at acrabtree@shaw.ca
