Wellness is ease, illness is dis-ease

This blog post is written by Aditi Nerurkar, MD

Assistant Medical Director, Cheng and Tsui Center for Integrative Care, Beth Israel Deaconess Medical Center

I heard this phrase early in my medical training and it had a profound impact on me.  I’ve often thought of my role as an integrative medicine doctor as one of bringing people back to a state of ease.  For some patients, this bringing into balance has meant medications, but for nearly all patients, my wellness prescription has included these five fundamentals: eat, sleep, move, bond, and chill.

Eat

Food isn’t just fuel, its information. Our cellular processing changes depending on what we eat.  My guiding principle when it comes to food is to eat as close to the ground as possible- minimize boxed food and aim to consume food resembling its natural state. We can do this by shopping around the periphery of a grocery store. Visit each wall (that’s where the produce, grain, dairy and protein is kept) and avoid the middle aisles (the territory of processed, boxed food).

While what we eat is critically important to preventing dis-ease, how much we eat is just as vital.  As Americans, our perception of portions isn’t very accurate.  To recalibrate our built-in satiety center, I recommend practicing the ancient Japanese custom ofHaru Hachi Bu. It literally means “stop eating when you’re 80% full.”  I remember this expression as I take my first bite.  It’s a good gauge to stop yourself from eating when you’re no longer hungry, rather than when you’re stuffed (there’s a difference!)

Sleep

Sleep is restorative for nearly every organ in the body. It's therapeutic in the truest sense (our immune system is most active at night while we sleep). Most adults need 7-9 hours of sleep per night.  While there’s a lot of great information out there on sleep hygiene, the most helpful tip I’ve learned from my sleep doctor colleagues is to focus on what we do 2 hours before bedtime and limit this activity. (For many of us, it is spent in front of a TV, computer or smartphone.)  Limiting our screen time could be the difference between a 10pm bedtime versus a midnight bedtime.  This simple fix could considerably help our chronic state of sleep deprivation.

Move

If we could bottle up the benefits of exercise, it would be one of the most potent drugs on the market.  Exercise has benefits for heart disease, brain health, immunity, insomnia, depression, and has even been linked to longevity.  So why doesn’t everyone do it?  Motivation (or lack thereof) is a big reason.  Even star athletes don’t always want to exercise. As one record-holding, marathoning patient once told me, “Exercise is like brushing your teeth.  Do you ask yourself if you feel like brushing your teeth?  No, you just do it.” I loved his matter-of-fact, non-negotiable approach to exercise.  And he’s right.  As Edward Stanley famously said in the 1800s, “Those who think they have no time for bodily exercise now, will sooner or later have to find time for illness.”  While an exercise prescription of 150 minutes per week is ideal, any amount of exercise is better than 0 minutes.

Bond

Social connectedness isn’t something that’s often discussed in the context of health, but increasingly, we’re learning that your sense of belonging can have an impact on your well-being.  In his book, The Blue Zones, Dan Beuttner travelled to the world’s areas with the greatest concentration of centenarians (people over the age of 100).  In all these societies, the common denominator predicting longevity was social connectedness.  The power of social networks on our health has also been extensively studied by Harvard/Yale researcher Nick Christakis.  But when it comes to social connectedness, face-to-face interactions are where the benefits lie (sorry, Facebook!).  One marker of social connectedness is to think about how many people you can call at 4am if case of emergency.  If 5 or more people make the list, you’ve got a solid network of social support.  If your list has 3 people or less, it might be wise to invest in some good old-fashioned quality time with others.

Chill

While spending time with others can be a boon for your health, so can time spent in quiet reflection.  Mind-body activities like meditation, yoga, and tai chi reduce stress, which has been linked to everything from heart disease to the common cold.  Studies also show that by engaging in a mind-body practice regularly, we improve our emotional regulation, and our sense of resiliency and optimism.  And recent research has found that meditation, in particular, can alter our brain structure, and even our genes!

So there you have it. To live a life of ease, not dis-ease, focus your efforts on these five fundamentals of wellness.  And share your experiences each step of the way, with those committed to your health- your doctor, family, friends, neighbors…  Because as one ancient proverb wisely points out, “When the ‘I’ is replaced by ‘we,’ even illness becomes wellness.”

Follow Dr. Nerurkar on Twitter @AditiNerurkar