February 2023 | Lifestyle Medicine

Social Isolation and Loneliness Affect Cardiovascular Health

February 22, 2023/in Social Engagement /by Maya Shetty

“Human beings are wired to connect.” Neuroscience suggests that minor neurons in our brains are stimulated when we interact with others. Social isolation during COVID-19 pandemic has emphasized the importance of psychosocial determinants of cardiovascular diseases. Is social isolation and loneliness a health pandemic?

A wave of new research on the health impact of social connection has tried to address this question. In 2023, researchers from UK published a study showing the association of social isolation and loneliness with incident heart failure on over 400,000 adults between 40 and 69 years. Social isolation was defined as “being objectively alone or having infrequent social connections, and loneliness was defined as “a painful feeling caused by a discrepancy between one’s desire for connections and the actual degree of connections”. They found that even when other known risk factors are controlled for (such as age, sex, and other socioeconomic factors), social isolation and loneliness increased the risk of developing heart failure by 15-20% in a dose-dependent manner. Living alone contributed to the greatest risk of heart failure. The associations between social isolation and loneliness and incident of heart failure were independent of individual’s genetic risk of heart failure.

Social isolation and loneliness may precipitate unhealthy lifestyles (physical inactivity, alcohol addiction) and hinder older adults from getting social support or seeking health care resources. Social isolation and loneliness are associated with increased activity of hypothalamic-pituitary-adrenal axis and sympathetic nervous system, enhanced inflammatory and oxidative stress which all in turn may accelerate atherosclerosis leading to cardiac remodeling preceding heart failure.

The study is a call to action. To address heart failure and the health pandemic that social disconnectedness has created, there is an urgent need for community-level strategies aimed at reducing social isolation and loneliness.

The power of social connection pillar of lifestyle medicine, your HEART depends on it! It is easier than you think. Let’s start from ourselves, find what works for you: increase contact with family and friends, join groups or clubs (sports club, gym, group activity) and use social media in a positive way to connect with others (join local support group, learn what’s happening in your community).

By: Rusly Harsono, MD

No Content Available

Journal References:

Reference: Liang YY, Chen Y, Feng H, Liu X, Ai QH, Xue H, Shu X, Weng F, He Z, Ma J, Ma H, Ai S, Geng Q, Zhang J. Association of Social Isolation and Loneliness With Incident Heart Failure in a Population-Based Cohort Study. JACC Heart Fail. 2023 Jan 20:S2213-1779(23)00026-4. doi: 10.1016/j.jchf.2022.11.028. Epub ahead of print. PMID: 36737310; PMCID: PMC9891238.

Unveiling the Impact of Lifestyle Factors on Mental Health

February 13, 2023/in Cognitive Enhancement /by Maya Shetty

Recent research has elucidated the role of these lifestyle factors – diet, sleep, and exercise, on our minds. Upon finding a link between various mental disorders to these factors, Firth et al., conducted a review and analysis of the top-tier evidence to examine how physical activity, sleep, dietary patterns and tobacco smoking can impact the development and treatment of a variety of different mental disorders.

Broadly, they found evidence that physical activity is helpful for both the prevention and treatment of a variety of mental health disorders and is one of the most extensively researched “lifestyle factors”. They also found that tobacco smoking was a significant risk factor that contributed to people developing mental illness. Poor sleep was also a modifiable risk factor in both the development and worsening of mental health disorders and symptoms, and in the research, a complex two-way relationship between sleep and mental health symptoms is highlighted. More evidence is needed to establish the role of dietary patterns in mental health.

With these findings, the researchers have made recommendations for the integration and delivery of lifestyle interventions in healthcare settings at a broad scale to help people improve their mental health. A few important steps to optimizing mental health and cognitive performance include taking adequate time for exercise, creating an environment conducive to quality sleep, not smoking tobacco, and fueling your mind and body with healthy, whole foods.

By: Douglas Noordsy, MD and Vanika Chawla, MD

No Content Available

Journal References:

Reference: Firth J, Solmi M, Wootton RE, et al. A meta-review of “lifestyle psychiatry”: the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders. World Psychiatry. 2020;19(3):360-380. doi:10.1002/wps.20773

An Interview with Barbara Waxman: The Leading Authority on Middlescence

February 7, 2023/in Pillar /by Maya Shetty

Barbara Waxman is the leading authority on Middlescence and a passionate advocate for aging, wisdom, and thriving in midlife. Her mission is to shift cultural norms around aging by establishing Middlescence as a unique life stage. Barbara is the founder of Odyssey Group Coaching, which aims to help middlescents thrive personally and professionally. She is one of the only Gerontologist-coaches in the United States. Here are her thoughts on the field of Lifestyle Medicine:

What made you interested in Lifestyle Medicine?

The truth is that my interest in Lifestyle Medicine stems from a painful experience back in 1999. My daughter, Jill, was 8 years old and was diagnosed with an autoimmune disease. We spent about a year having her see specialists (in traditional western medicine) while also trying a number of other drug therapies. None were successful. At the point surgery was recommended we decided to suspend our disbelief and research ‘alternative’ options. This was over twenty years ago, before Lifestyle Medicine was on the map.

I learned the importance of integrating ancient wisdom with newfound approaches. I fully immersed myself into into learning everything I could about integrative medicine and the important role it can play in health maintenance. I’m happy to report that it worked! A combination of modalities resolved Jill’s disease and she is now 31 and in full health.

Just a few years later I was diagnosed with Hashimoto’s (an autoimmune disorder of the thyroid). It motivated me to develop tools for myself and my clients to better understand the cornerstone principles of energy and health. I learned that lifestyle is medicine. My involvement with the American College of Lifestyle Medicine; Stanford Lifestyle Medicine and more, was born out of these experiences.

What is your main career focus?

As a gerontologist and professional leadership coach I focus on working with adults, midlife and better. Think of me as a leadership and life stage expert supporting people to have more clarity, joy and impact in their lives. I deliver on that mission through coaching, speaking, advising and workshops.

What are the key findings from Lifestyle Medicine coaching?

Every client I work with takes an initial assessment of their overall wellbeing; this is based on the principles of lifestyle medicine. One of the key findings that I share is an understanding of how energy needs to be understood to maximize one’s feelings of empowerment, clarity and the ability to have impact. Our prevailing culture emphasizes quick fixes to problems that can be resolved in sustainable ways with shifts in daily habits and rituals. For example, understanding the sleep one needs is foundational to having sustainable clarity and resourcefulness throughout the day. I regularly share the idea that one’s most valuable currency is not money or time—it’s the energy one brings to the time available. Lifestyle medicine is not about avoiding death but about living your best life.

What are your top three recommendations for improving lifestyle?

Invest in the relationships that fuel you and divest yourself of those that deplete you (to the extent possible).

In the words of Michael Pollan: “Eat food. Not too much. Mostly plants.”

Do one kind thing for someone or something in service to others daily.

What’s your favorite Lifestyle Medicine practice in your own life?

Breathing in nature, even if it’s sometimes only stepping outside my front door, is cleansing and clarifying. Taking moments of reflection and emptying my mind every single day is one of my top picks.

A Strong Sense of Life Purpose is Associated With Better Quality of Life

February 1, 2023/in Gratitude & Reflection /by Maya Shetty

Purposeful living is a self-organizing life aim to stimulate goals, promote healthy behaviors and give meaning to life. Many of us are most likely agree that having a sense of purpose in life is associated with overall both physical and mental health quality of life. Needs a scientific proof to this? This article showed a very interesting association of life purpose with all-cause mortality in older adults. The study analyzed a total of 6,985 individuals between 50-60 year. Hazard ratio, 2.43; 95% CI, 1.57-3.75, comparing those in the lowest life purpose category with those in the highest life purpose category. There were also significant association between life purpose and specific cause mortality attributed to heart, circulatory and blood conditions. There are several possible mechanisms through which life purpose might potentially be associated with mortality such decreased expression of proinflammatory genes in purposeful living (studied by Fredrickson et al), lower cortisol and proinflammatory cytokines in purposeful living (studied by Ryff et all), elevated inflammatory markers such as CRP and inflammatory cytokines such as IL-6 in those without low to no purposeful living (studied by Harris et, Reuben et al and De Martinis et al).

By: Rusly Harsono, MD, & Maya Shetty, BS

No Content Available

Journal Reference:

Alimujiang A, Wiensch A, Boss J, Fleischer NL, Mondul AM, McLean K, Mukherjee B, Pearce CL. Association Between Life Purpose and Mortality Among US Adults Older Than 50 Years. JAMA Netw Open. 2019 May 3;2(5):e194270. doi: 10.1001/jamanetworkopen.2019.4270. PMID: 31125099; PMCID: PMC6632139.