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The Four Pillars of Health - Optimising Sleep, Movement, Relaxation, Nutrition for Wellness

Updated: May 27

Four Greek columns representing the four pillars of health and wellbeing

Embracing a Holistic Approach: The Vital Link Between Physical and Mental Health.

I am a huge fan of Dr Rangan Chatterjee, who is a British GP with a holistic approach to caring for his patients.

In recent years he has established a significant presence on television and radio.

He has also written several books and has a very popular podcast, which reflects the growing popularity of people investing more in their self-care and wellbeing.

He views health as being part of a cycle in which all components of the human biological system are involved, along with the environment in which that system is operating.

This cyclical view is quite different from the more traditional medical approaches, which tend to be quite compartmentalised and focus solely on symptoms and isolated body parts.

Someone holding a brain in one hand and a skeleton in the other hand, to represent the compartmentalisation of mental and physical health

For many years mental health has been seen as a completely different thing to physical health, but their interconnectedness is being increasingly being understood.

This means that as well as looking at things that you might think of as being more traditionally medical, ie the nuts and bolts of our biology, he also takes into consideration lifestyle and environmental factors that can be leveraged to move someone towards health from a position of ill-health.

Gone are the days when mental health and physical health were considered to be separate things and "never the twain shall meet"; the brain is an organ in the body as much as any other, and the mind is a function of that it makes sense that the biological health of the brain impacts on our mental health.

Much as Dr Chatterjee likes to look at the whole picture and include lifestyle and environmental factors when considering the physical health issues of his patients, I think it is just as important to include physical health (along with lifestyle and environmental factors) when developing an understanding of an individual's mental health challenges.

As he says "...every part of our body affects, to a greater or lesser degree, pretty much every other part..." so it is important to look at the whole picture!

The Four Pillars of Health: Sleep, Movement, Nutrition and Relaxation

A view from below, looking upwards, of two columns, to represent the pillars supporting good health and wellbeing

In his first book, Dr Chatterjee developed the idea that the foundations for health are supported by four pillars - sleep, movement, nutrition, and relaxation.

I'm going to dedicate some posts over the coming weeks to looking at each of these areas and thinking about how even small changes can start to make a big difference to our mental health and wellbeing.

We can learn lots of different tools and coping strategies through doing therapy, but at the end of the day if those tools are not being built upon a solid foundation then they're not going to be as effective at helping us as they might be.

The Essential Role of Sleep: Boosting Mental and Physical Wellbeing

A woman in bed asleep wearing an eye mask, to illustrate good sleeping practice

When we sleep we’re not just recharging our batteries to enable us to face the following day, it is a time when many critical processes within the body occur.

While we are sleeping, our energy expenditure goes down which allows resources to be redirected towards restorative processes - tissues, muscle, and cells that have been damaged or stressed by daily wear and tear are repaired, enabling us to heal from injuries, and in the case of the young, to grow.

Our sleep is a key part of our memory consolidation process, which also facilitates learning; information acquired during the day is processed and the important stuff is stored away, which helps us to solidify memories.

As we have developed a greater understanding of the functioning of the brain we have learned that during sleep it goes through a process of flushing – toxins and metabolic waste products that can accumulate during wakefulness are cleared away through the glymphatic system which helps maintain brain health and functioning.

Our hormonal balance is subtle and nuanced, and sleep is involved in its regulation and therefore impacts many different bodily functions, such as growth, metabolism, stress, and immunity.

Chronic sleep disruption can have a knock-on effect on our hormone balance which will then eventually impact our overall health.

 lying on a couch trying to sleep, a cushion behind her saying 'insomnia', to illustrate difficulties in sleeping

It will also have an impact on the ability of our immune system to respond to infection and inflammation, making us more susceptible to viruses and bacteria.

As anyone who has experienced insomnia knows, sleep plays a big part in regulating our mood and emotional wellbeing; poor sleep can lead to irritability, and mood swings, and if experienced over an extended period it is linked to increased risk of depression and anxiety.

For more on sleep, I have written about the impact of caffeine here, and the impact of menopause here.

Movement Matters: Unlocking Physical and Mental Health Benefits through Exercise

For a long time, the focus of messaging about exercise through the media has been that it will benefit us in losing weight, but this one-dimensional view is wrapped up in marketing strategies by food companies trying to deflect from the impact of their products on the obesity crisis.

However, that is not to say that movement and exercise aren’t extremely important.

A mother and toddler doing yoga together to illustrate the importance of flexibility exercises

A report from the Academy of Medical Royal Colleges advises that 30 minutes of moderate exercise taken five times a week is more powerful in managing and preventing chronic disease than many of the drugs that are currently prescribed!

Regular physical activity reduces the risk of developing cardiovascular disease, type 2 diabetes, dementia, and some cancers by at least 30% but it does not promote weight loss in the way that the Food Industry’s PR machine would have us believe.

It is also extremely important for helping us to reduce stress and is an excellent tool for combating anxiety and depression.

If you think about it, before modern times, when our flight and fight response kicked in we would invariably follow through with some form of movement – all the adrenaline and cortisol coursing through our veins would be worked off by fleeing from the situation or facing the threat head-on.

These days, the things we’re perceiving as threats, more often than not, aren’t things that are a physical danger to us so there isn’t an automatic, and natural, outlet for the fight or flight response.

A toddler jumping off a sofa

Next time you’re feeling anxious, do a little experiment and try doing something physical…a few star jumps or some such…you might find that it helps you to feel a bit better because you will burn up some of the stress hormones that have built up.

Personally, I like to use the word ‘movement’ rather than ‘exercise’ as I find when talking to clients that the word ‘exercise’ brings up the idea of going to the gym or going running, which isn’t everyone’s cup of tea.

But any kind of activity is helpful and movement takes many forms.

It’s useful for us to have a mixture of activities incorporating aerobic movements, strength building, and flexibility.

An important aspect is to find ways of doing this that are fun because that will help you to keep going on the occasions when you’re not really feeling like it.

Even the simplest of interventions can help – next time you go to the supermarket, park as far away from the front door as you can so that you have a short walk to get in there or take the steps rather than the escalator; these seemingly small changes can soon add up!

For more on movement, I have written about strategies for incorporating it into your life here.

Nourish Your Body and Mind: Harnessing the Power of Nutrition for Optimal Mental and Physical Health

‘You are what you eat’ is a longstanding phrase that actually has a lot of wisdom in it.

But there is a lot of confusion about what is the right way to eat, with many different camps all vying for the position of healthiest or optimum diet.

One unifying perspective though for all the experts, whether they identify as being vegan or carnivore (or all the different shades of eating in between), is that one particular kind of food is really bad news for both our physical and mental health!

A large bag of highly processed fast food

Consequently, there has been a lot of noise in the press recently about the impact of ultra-processed foods on our wellbeing because they have now been linked with more than 30 different health problems, such as heart disease, cancer, and anxiety.

It is very sobering, and perhaps shocking, to know that in the last decade, poor diet (ie ultra-processed) has overtaken tobacco as the leading cause of early death globally.

Although here in the UK we have good access to, and a greater variety of, foodstuffs than we ever have had before, the general population is not eating sufficient nutrients that are essential for good brain health due to overconsumption of ultra-processed foods which are depleted of vitamins and minerals, and full of emulsifiers and other additives.

There is a whole new area of psychiatry developing called ‘Nutritional Psychiatry’ or ‘Metabolic Psychiatry’ which focuses on the use of food and supplements in the treatment of mental health problems – something which I find very exciting indeed!

I have attended several conferences where leading practitioners in the field of Nutritional Psychiatry have given talks and I will write about what I learned in future posts.

Outstretched hands holding an apple on the left and a half eaten donut on the right, to illustrate the choice between healthy and ultra-processed foods

But, in the meantime, if you want to find out more about the issue of Ultra-processed foods this is an excellent talk by Dr Chris van Tulleken and I can really recommend watching it.

And here I have written more about the impact of what we eat on our wellbeing, in the context of the microbiome.

Stress Less, Live More: The Importance of Relaxation and Stress Management for Wellbeing

Robert M. Sapolsky is a Professor of Biological Sciences, Neurology, and Neurological Sciences at Stanford University who has written a book called "Why Zebras Don't Get Ulcers".

In this book, he explores the impact of stress on our physiological systems such as the nervous, endocrine, and immune systems.

A woman sitting at her desk with her head in her hands, surrounded by open books and a laptop, to illustrate stress

He teaches that chronic stress disrupts the body’s natural balance and this can lead to physical health problems such as cardiovascular disease, gastrointestinal disorders, and immune suppression.

But it’s not just our physical health that is susceptible to chronic stress, our mental health is too.

In the book, “The Stress-Proof Brain”, Dr. Melanie Greenberg explains how chronic stress can impact the brain, actually changing its structure and function, particularly in the areas that have been identified as being associated with emotional regulation, decision-making, and memory.

She explores the concept of neuroplasticity, which is basically the brain’s ability to adapt and change in response to our experiences – I have written about this myself in this post.

The good news is that there is plenty that we can do to help ourselves once we have a good understanding of how stress is impacting us.

Here I have written an in-depth explanation of our natural stress response system with some ideas of tools we can use to manage it.

Achieving Optimal Well-being: Integrating Mind and Body Approaches

As I am sure you can appreciate, this is a huge topic and I could have just kept writing and writing!

So you will be seeing more posts doing deeper dives into these different aspects of mental health in the future.

If you are interested in finding out more about Dr Chatterjee then he has a big presence on social media, which you can access via his website:

I can really recommend his podcast, which now has hundreds of interviews with a broad range of people on all aspects of physical and mental health.

Usually, the principles that he discusses are not complex and are within the realms of plausibility for us to start to integrate them into our daily lives.

There is no one-size-fits-all; rather imagine that each of the tools is like a square for a patchwork quilt.

There is an infinite combination of squares that could be put together to make a functioning quilt and everyone will have differing preferences on the pattern, but in combining our own set of squares we can come up with something that works for us.

How do you incorporate sleep, movement, relaxation, and nutrition into your daily routine?

Please do share your insights, tips, and questions in the comments below - I would love to hear from you!

Let’s inspire and support each other on our journey to holistic health and wellbeing.

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