By Dr Rasarie Wimalana

As the rising tide of chronic Non-Communicable Diseases (NCDs) like diabetes, heart disease, and obesity sweeps across the globe, a transformative approach in healthcare is redefining how we address our health: Lifestyle Medicine.

Lifestyle medicine employs evidence-based lifestyle changes to prevent, treat, and often reverse chronic diseases. It centres on six key pillars: nutrition, physical activity, sleep, stress management, avoidance of risky substances, and positive social connections. Lifestyle interventions serve as the primary and first-line treatment method through lifestyle prescriptions, with medication and other modalities used as necessary. The American College of Lifestyle Medicine reports that this approach can address up to 80% of chronic diseases, empowering individuals to take control of their health.

In our previous discussion, we introduced this paradigm-shifting field. This month, we explore the six pillars that create the foundation for a vibrant, healthy life.

A Whole Food Plant-Predominant Eating Pattern

Good nutrition forms the foundation of our health, directly influencing our well-being. Our diverse food choices are influenced by a tapestry of factors—personal preferences, location, finances, upbringing, and cultural background. This multifaceted nature likely underlies our deep connection to what we eat.

The 2017 Global Burden of Disease Report revealed a startling fact: poor dietary habits now outrank tobacco use and high blood pressure as the leading causes of non-communicable diseases worldwide, claiming one in five lives. Lifestyle medicine champions an eating pattern rich in whole, plant-predominant foods. This vibrant mix of whole grains, legumes, vegetables, fruits, nuts, and seeds—packed with nutrients, antioxidants, and fibre—isn’t just food; it’s potent medicine for our bodies.

Robust research shows that a whole food, plant-predominant diet effectively reduces chronic disease risk and aids in their management. It’s proven to support weight loss, lower LDL cholesterol, blood pressure, and blood sugar, and prevent heart disease—benefits now endorsed by leading medical organisations worldwide.

This doesn’t mean other foods are prohibited; food choices are personal and influenced by various factors. The focus is on embracing nutrient-dense foods that nourish the entire body. These powerful choices don’t just feed us; they transform us. They optimise our gut health, improve insulin sensitivity, support blood vessels, boost mental clarity, and pave the way for a longer, more vibrant life. By making these informed food choices, we become the architects of our health destiny.

Physical Activity and Regular Exercise

Exercise is more than just a tool for weight management or aesthetic improvement. It’s a powerful ally for mental well-being, graceful aging, and even treating cardiometabolic diseases. The benefits are remarkable: from enhancing muscular and cardiovascular fitness to strengthening bones, reducing fall risks, and lowering cancer risks. Exercise is often likened to a magical pill that could transform lives—if it came in a bottle, it would fly off the shelves.
Here’s a striking fact: physical inactivity is the fourth leading risk factor for global mortality, accounting for about 1 in 10 premature deaths. This isn’t meant to alarm, but to inspire. Research shows that those who exercise the most tend to lose the fewest years of life, regardless of their weight. Even small changes matter – for instance, taking a quick 2-minute break from sitting every 20 minutes has been shown to help improve blood sugar levels.
Lifestyle medicine promotes holistic physical fitness, encompassing cardiovascular endurance, strength, balance, flexibility, and body composition. For optimal benefits, adults should aim for at least 150 minutes of moderate-intensity exercise and two days of muscle-strengthening activity weekly. However, those with heart, kidney, or metabolic conditions should seek medical clearance before starting a new exercise routine, especially if unaccustomed to regular workouts or experiencing symptoms—prioritising safety is essential.

Restorative Sleep

Sleep is a crucial yet often overlooked pillar of health, particularly for corporate professionals and shift workers. It’s an essential component of our well-being, silently orchestrating vital functions to restore and rejuvenate our bodies and minds. The overwhelming urge to sleep, which can strike even in the most inconvenient moments like while driving, serves as a powerful reminder of sleep’s non-negotiable role in our lives.

Restorative sleep consists of three key elements: duration, quality, and regularity. Neglecting our sleep doesn’t just leave us tired; it opens the door to serious health risks. Poor sleep is linked to obesity, diabetes, heart disease, and weakened immunity. Recent studies reveal more alarming connections, associating poor sleep with certain cancers and increased overall mortality.

Our emotional and mental well-being are equally at risk. Sleep deprivation affects our mood, learning ability, emotional regulation, and even moral judgment. It can lead to unhealthy food cravings and, in the workplace, result in presenteeism and reduced productivity.

Most adults need 7-9 hours of sleep daily, though requirements vary individually. We can gauge our sleep quality by observing several factors: our dependence on the snooze button, how refreshed we feel upon waking, our ability to manage tasks without frequent caffeine boosts, the need for lengthy afternoon naps, and any significant differences between our weekday and weekend sleep patterns.

Achieving restful sleep involves a delicate interplay between our circadian rhythm, sleep hormones, and behaviour. Lifestyle Medicine promotes restorative sleep through robust sleep hygiene practices—practical steps we can all take. These include optimising diet, physical activity, sleep environment, and managing light and sound exposure. For some, cognitive behavioural therapy or sleep restriction may be necessary when these measures aren’t enough.

A crucial first step is recognising sleep’s vital importance and actively prioritising it in our daily lives.

Strategies for Managing Stress

Stress-related complaints frequently prompt primary care visits, highlighting stress’s widespread impact. While stress is an inevitable—and often instructive—part of life, unmanaged stress can foster unhealthy habits and lead to maladaptive coping mechanisms.
Imagine stress as a symphony conductor, orchestrating a complex interplay of hormones and neurotransmitters that affect our cardiovascular and metabolic functions. While initially protective, prolonged stress can become harmful. It may suppress our immune system, trigger inflammation, and potentially damage organs and tissues, leading to physical ailments. For instance, depression often accompanies chronic diseases like diabetes and can negatively impact heart health in those with coronary artery disease.

This intricate connection underscores the importance of our response to everyday stressors. Rather than fearing stress, we can view it as an evolutionary gift—a built-in alarm system. However, when this alarm is constantly triggered, our body’s protective mechanisms may inadvertently cause harm, even if the perceived threat isn’t significant or real.

While completely eliminating stress is unrealistic, we can cultivate skills to transform knee-jerk reactions into thoughtful responses, gradually building stress resilience. Research reveals several effective paths: our mental health is closely tied to our lifestyle—a solid foundation of proper nutrition, regular exercise, and quality sleep is essential. Deep breathing and grounding techniques serve as anchors during turbulent times. Mindfulness meditation and yoga provide sanctuaries for your mind and body, while time in nature offers rejuvenation. Cognitive behavioural therapy, positive psychology, and empathetic relationships with healthcare providers are potent allies in your journey toward stress resilience.

Avoidance of Risky Substances

Every breath is precious, and tobacco use threatens our lung health profoundly. The World Health Organisation (WHO) identifies it as the leading preventable cause of death worldwide. Smoking’s impact extends far beyond cancer and lung disease—it has no safe threshold and affects our entire well-being. Its reach includes coronary artery diseases, diabetes, compromised immunity, impaired wound healing, and reproductive issues, including risks to maternal and fetal health.

Alcohol walks a fine line between social lubricant and health hazard. Its effects ripple through our bodies in ways we might not immediately notice, from high blood pressure and stroke to unintentional injuries and various cancers. While some guidelines have suggested moderate consumption in the past, the WHO’s 2023 stance is that there’s no safe amount of alcohol—no proven threshold at which alcohol consumption is risk-free. This sobering reality empowers us to make informed choices about our health.

Lifestyle medicine can help in this journey, with a focus on empowerment rather than deprivation. Through personalised strategies like counselling, behaviour change therapies, and supportive peer groups, individuals worldwide have transformed their health stories —this approach may include medication support when necessary.

Fostering Positive Social Connections

This fascinating pillar reveals that our relationships are powerful allies in our journey to health and happiness. Decades of research, including Harvard’s 80-year study, support this concept, concluding that healthy social connections are the single most important predictor of happiness and longevity.

It’s not just about living longer—it’s about living better. Those with positive connections and an optimistic outlook are more resilient to stress, less prone to chronic diseases, and more likely to thrive. It’s as if good relationships create a protective shield, deflecting stressors, and amplifying well-being. Lifestyle medicine harnesses this power, using even micro-moments of connection to trigger beneficial physiological responses, like activating the calming parasympathetic nervous system.

Positive psychology interventions help us become architects of our own happiness, guiding us to recognise our strengths, engage fully with life, find meaning, practice gratitude and empathy, and more. Research now tells us that happiness is contagious —and these practices can create ripples of positivity that touch everyone around us.

Lifestyle medicine empowers us through six pillars: nourishing food, exercise, sleep, stress resilience, avoiding risky substances, and positive connections. They’re the blueprint for a vibrant and fulfilling life. By embracing these principles, you’re not just nurturing your own health—you’re planting seeds of wellness that will blossom in your family and ripple out to touch your entire community.

Together, we can cultivate a healthier, more vibrant nation, one mindful choice at a time.
For more information please visit the Sri Lankan Society of Lifestyle Medicine at www.slslm.org.lk.

***

Dr Rasarie Wimalana is a certified practitioner in Lifestyle Medicine from the International Board of Lifestyle Medicine, and the Founder and Chairperson of Sajeevan Lifestyle Medicine. Additionally, she serves as a Vice President of the Sri Lankan Society of Lifestyle Medicine.